Search results for: mental health symptoms
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10215

Search results for: mental health symptoms

5085 Intimate Partner Violence and the Risk of Children’s Growth and Development

Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

Abstract:

Background: The negative consequences of intimate partner violence (IPV) on children have not been studied extensively. This study aimed to determine the prevalence of different types of IPV and its association with children’s growth and developmental problems. Methods: In a descriptive-analytical study, 596 mothers of one-year-old children referred to the primary health centers in Gonbad-e- Kavoos city were recruited (2018). The data were collected using the World Health Organization Domestic Violence, Ages and Stages Questionnaire-12 and the socio-economic, obstetrics, demographic and anthropometric characteristics related questionnaire. BMI Z-Score was categorized into three grades; thin (Z<-2), normal (-2≤Z<1), and overweight-obese (Z≥1). The data were analyzed using descriptive analysis, chi-square test, and regression. Results: The prevalence of physical, psychological, and sexual IPV was 7.4%, 29.5%, and 2.4%, respectively. Most of the children were of normal weight at one-year-old (91.7%). Similarly, the prevalence of overweight and obese was 13.3% and 8%, respectively. 2% of children had developmental problems at age one. There was a significant relationship between the father’s education and occupation and IPV and children’s delay in growth, respectively. There was no significant difference between BMI Z-Score and developmental disabilities in the children in women exposed and not exposed to all types of IPV. Conclusions: The prevalence of psychological IPV was common. IPV and children’s growth problems were influenced by the father’s socio-economic status. Preventing psychological IPV as a forerunner of other types of IPV and improving the economic situation may help in the reduction of these difficulties.

Keywords: children, development, growth, intimate partner violence

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5084 An Analysis of The Philippines' Legal Transition from Open Dumpsites to Solid Waste Management Facilities

Authors: Mary Elenor Adagio, John Roben Ambas, Ramilyn Bertolano, Julie Ann Garcia

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Ecological Solid Waste Management has been a long-time concern in both national and international spheres. The exponential growth of waste generation is not properly matched with a waste management system that is cost-effective. As a result, governments and their communities within inevitably resort to the old ways of opening dumpsites to serve as a giant garbage bin. However, due to the environmental and public health problems these unmanaged dumpsites caused, countries like the Philippines mandated the closure of these dumpsites and converted them into or opened new sanitary landfills. This study aims to determine how the transition from open dumpsites to Solid Waste Management Facilities improve the implementation of the Solid Waste Management Framework of the government pursuant to Republic Act 9003. To test the hypothesis that the mandatory closure of dumpsites is better in the management of wastes in local government units, a review of related literature on analysis reports, news, and case studies was conducted. The results suggest that advocating for the transition of dumpsites to sanitary landfills would not only prevent environmental risks caused by pollution but also reduce problems regarding public health. Although this transition can be effective, data also show that with a lack of funding and resources, many local government units still find it difficult to provide their solid waste management plans and to adapt to the transition to sanitary landfills.

Keywords: solid waste management, environmental law, solid waste management facilities, open dumpsites

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5083 Occupational Safety and Health in the Wake of Drones

Authors: Hoda Rahmani, Gary Weckman

Abstract:

The body of research examining the integration of drones into various industries is expanding rapidly. Despite progress made in addressing the cybersecurity concerns for commercial drones, knowledge deficits remain in determining potential occupational hazards and risks of drone use to employees’ well-being and health in the workplace. This creates difficulty in identifying key approaches to risk mitigation strategies and thus reflects the need for raising awareness among employers, safety professionals, and policymakers about workplace drone-related accidents. The purpose of this study is to investigate the prevalence of and possible risk factors for drone-related mishaps by comparing the application of drones in construction with manufacturing industries. The chief reason for considering these specific sectors is to ascertain whether there exists any significant difference between indoor and outdoor flights since most construction sites use drones outside and vice versa. Therefore, the current research seeks to examine the causes and patterns of workplace drone-related mishaps and suggest possible ergonomic interventions through data collection. Potential ergonomic practices to mitigate hazards associated with flying drones could include providing operators with professional pieces of training, conducting a risk analysis, and promoting the use of personal protective equipment. For the purpose of data analysis, two data mining techniques, the random forest and association rule mining algorithms, will be performed to find meaningful associations and trends in data as well as influential features that have an impact on the occurrence of drone-related accidents in construction and manufacturing sectors. In addition, Spearman’s correlation and chi-square tests will be used to measure the possible correlation between different variables. Indeed, by recognizing risks and hazards, occupational safety stakeholders will be able to pursue data-driven and evidence-based policy change with the aim of reducing drone mishaps, increasing productivity, creating a safer work environment, and extending human performance in safe and fulfilling ways. This research study was supported by the National Institute for Occupational Safety and Health through the Pilot Research Project Training Program of the University of Cincinnati Education and Research Center Grant #T42OH008432.

Keywords: commercial drones, ergonomic interventions, occupational safety, pattern recognition

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5082 Numerical Modelling and Experiment of a Composite Single-Lap Joint Reinforced by Multifunctional Thermoplastic Composite Fastener

Authors: Wenhao Li, Shijun Guo

Abstract:

Carbon fibre reinforced composites are progressively replacing metal structures in modern civil aircraft. This is because composite materials have large potential of weight saving compared with metal. However, the achievement to date of weight saving in composite structure is far less than the theoretical potential due to many uncertainties in structural integrity and safety concern. Unlike the conventional metallic structure, composite components are bonded together along the joints where structural integrity is a major concern. To ensure the safety, metal fasteners are used to reinforce the composite bonded joints. One of the solutions for a significant weight saving of composite structure is to develop an effective technology of on-board Structural Health Monitoring (SHM) System. By monitoring the real-life stress status of composite structures during service, the safety margin set in the structure design can be reduced with confidence. It provides a means of safeguard to minimize the need for programmed inspections and allow for maintenance to be need-driven, rather than usage-driven. The aim of this paper is to develop smart composite joint. The key technology is a multifunctional thermoplastic composite fastener (MTCF). The MTCF will replace some of the existing metallic fasteners in the most concerned locations distributed over the aircraft composite structures to reinforce the joints and form an on-board SHM network system. Each of the MTCFs will work as a unit of the AU and AE technology. The proposed MTCF technology has been patented and developed by Prof. Guo in Cranfield University, UK in the past a few years. The manufactured MTCF has been successfully employed in the composite SLJ (Single-Lap Joint). In terms of the structure integrity, the hybrid SLJ reinforced by MTCF achieves 19.1% improvement in the ultimate failure strength in comparison to the bonded SLJ. By increasing the diameter or rearranging the lay-up sequence of MTCF, the hybrid SLJ reinforced by MTCF is able to achieve the equivalent ultimate strength as that reinforced by titanium fastener. The predicted ultimate strength in simulation is in good agreement with the test results. In terms of the structural health monitoring, a signal from the MTCF was measured well before the load of mechanical failure. This signal provides a warning of initial crack in the joint which could not be detected by the strain gauge until the final failure.

Keywords: composite single-lap joint, crack propagation, multifunctional composite fastener, structural health monitoring

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5081 Evaluation of Nematicidal Action of Some Botanicals on Plant-Parasitic Nematode

Authors: Lakshmi, Yakshita Awasthi, Deepika, Lovleen Jha, Archna Kumar

Abstract:

From the back of centuries, plant-parasitic nematodes (PPN) have been recognized as a major threat to agriculturalists globally. It causes 21.3% global food loss annually. The utilization of harmful chemical pesticides to minimize the nematode population may cause acute and delayed health hazards and harmful impacts on human health. In recent years, a variety of plants have been evaluated for their nematicidal properties and efficacy in the management of plant-parasitic nematodes. Several Phyto-nematicides are available, but most of them are incapable of sustainable management of PPN, especially Meloidogyne spp. Thus, there is a great need for a new eco-friendly, highly efficient, sustainable control measure for this nematode species. Keeping all these facts and after reviewing the literature, aqueous extract of Cymbopogon citratus, Tagetes erecta, and Azadirachta indica were prepared by adding distilled water (1 g sample mixed with 10ml of water). In vitro studies were conducted to evaluate the efficacious nature of targeted botanicals against PPN Meloidogyne spp. The mortality status of PPN was recorded by counting the live and dead individuals after applying 100μl of selected extract. The impact was observed at different time durations, i.e., 24h and 48h. The result showed that the highest 100% mortality was at 48h in all three extracts. Thus, these extracts, with the addition of a suitable shelf-life enhancer, may be exploited in different nematode control programs as an economical, sustainable measure.

Keywords: Meloidogyne, Cymbopogon citratus, Tagetes erecta, Azadirachta indica, nematicidal

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5080 Three Year Pedometer Based Physical Activity Intervention of the Adult Population in Qatar

Authors: Mercia I. Van Der Walt, Suzan Sayegh, Izzeldin E. L. J. Ibrahim, Mohamed G. Al-Kuwari, Manaf Kamil

Abstract:

Background: Increased physical activity is associated with improvements in health conditions. Walking is recognized as an easy form of physical activity and a strategy used in health promotion. Step into Health (SIH), a national community program, was established in Qatar to support physical activity promotion through the monitoring of step counts. This study aims to assess the physical activity levels of the adult population in Qatar through a pedometer-based community program over a three-year-period. Methodology: This cross-sectional longitudinal study was conducted between from January 2013 and December 2015 based on daily step counts. A total of 15,947 adults (8,551 males and 7,396 females), from different nationalities enrolled in the program and aged 18 to 64, are included. The program involves free distribution of pedometers to members who voluntarily choose to register. It is also supported by a self-monitoring online account and linked to a web-database. All members are informed about the 10,000 steps/day target and automated emails as well as text messages are sent as reminders to upload data. Daily step counts were measured through the Omron HJ-324U pedometer (Omron Healthcare Co., Ltd., Japan). Analyses are done on the data extracted from the web-database. Results: Daily average step count for the overall community increased from 4,830 steps/day (2013) to 6,124 steps /day (2015). This increase was also observed within the three age categories (18–30), (31-45) and (>45) years. Average steps per day were found to be more among males compared with females in each of the aforementioned age groups. Moreover, males and females in the age group (>45 years) show the highest average step count with 7,010 steps/day and 5,564 steps/day respectively. The 21% increase in overall step count throughout the study period is associated with well-resourced program and ongoing impact in smaller communities such as workplaces and universities, a step in the right direction. However, the average step count of 6,124 steps/day in the third year is still classified as the low active category. Although the program showed an increase step count we found, 33% of the study population are low active, 35 % are sedentary with only 32% being active. Conclusion: This study indicates that the pedometer-based intervention was effective in increasing the daily physical activity of participants. However, alternative approaches need to be incorporated within the program to educate and encourage the community to meet the physical activity recommendations in relation to step count.

Keywords: pedometer, physical activity, Qatar, step count

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5079 Pedagogy to Involve Research Process in an Undergraduate Physical Fitness Course: A Case Study

Authors: Indhumathi Gopal

Abstract:

Undergraduate research is well documented in Science, Technology, Engineering, and Mathematics (STEM), neurosciences, and microbiology disciplines, though it is hardly part of a physical fitness & wellness discipline. However, students need experiential learning opportunities, like internships and research assistantships, to get ahead with graduate schools and be gainfully employed. The first step towards this goal is to have students do a simple research project in a semester-long course. The value of research experiences and how to integrate research activity in a physical fitness & wellness course are discussed. The investigator looks into a mini research project, “Awareness of Obesity among College Students” and explains how to guide students through the research process, including journal search, data collection, and basic statistics. Besides, students will be introduced to the statistical package program SPSS 22.0 to assist with data evaluation. The lab component of the combined lecture-physical activity course could include the measurement of student’s weight with respect to their height to obtain body mass index (BMI). Students could categorize themselves in accordance with the World Health Organization’s guidelines. Results obtained after completing the data analysis help students be aware of their own potential health risks associated with overweight and obesity. Overweight and obesity are risk factors for hypertension, hypercholesterolemia, heart disease, stroke, diabetes, and certain types of cancer. It is hoped that this experience will get students interested in scientific studies, gain confidence, think critically, and develop problem-solving and good communication skills.

Keywords: physical fitness, undergraduate research experience, obesity, BMI

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5078 Healthcare Utilization and Costs of Specific Obesity Related Health Conditions in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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5077 Brain-Derived Neurotrophic Factor and It's Precursor ProBDNF Serum Levels in Adolescents with Mood Disorders: 2-Year Follow-Up Study

Authors: M. Skibinska, A. Rajewska-Rager, M. Dmitrzak-Weglarz, N. Lepczynska, P. Sibilski, P. Kapelski, J. Pawlak, J. Twarowska-Hauser

Abstract:

Introduction: Neurotrophic factors have been implicated in neuropsychiatric disorders. Brain-Derived Neurotrophic Factor (BDNF) influences neuron differentiation in development as well as synaptic plasticity and neuron survival in adulthood. BDNF is widely studied in mood disorders and has been proposed as a biomarker for depression. BDNF is synthesized as precursor protein – proBDNF. Both forms are biologically active and exert opposite effects on neurons. Aim: The aim of the study was to examine the serum levels of BDNF and proBDNF in unipolar and bipolar young patients below 24 years old during hypo/manic, depressive episodes and in remission compared to healthy control group. Methods: In a prospective 2 years follow-up study, we investigated alterations in levels of BDNF and proBDNF in 79 patients (23 males, mean age 19.08, SD 3.3 and 56 females, mean age 18.39, SD 3.28) diagnosed with mood disorders: unipolar and bipolar disorder compared with 35 healthy control subjects (7 males, mean age 20.43, SD 4.23 and 28 females, mean age 21.25, SD 2.11). Clinical characteristics including mood, comorbidity, family history, and treatment, were evaluated during control visits and clinical symptoms were rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale. Serum BDNF and proBDNF concentrations were determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Serum BDNF and proBDNF levels were analysed with covariates: sex, age, age > 18 and < 18 years old, family history of affective disorders, drug-free vs. medicated status. Normality of the data was tested using Shapiro-Wilk test. Levene’s test was used to calculate homogeneity of variance. Non-parametric Tests: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient were applied in analyses The statistical significance level was set at p < 0.05. Results: BDNF and proBDNF serum levels did not differ between patients at baseline and controls as well as comparing patients in acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6). Comparing BDNF and proBDNF levels between patients in euthymia and control group no differences have been found. Increased BDNF level in women compared to men at baseline (p=0.01) have been observed. BDNF level at baseline was negatively correlated with depression and mania occurence at 24 month (p=0.04). BDNF level at 12 month was negatively correlated with depression and mania occurence at 12 month (p=0.01). Correlation of BDNF level with sex have been detected (p=0.01). proBDNF levels at month 3, 6 and 12 negatively correlated with disease status (p=0.02, p=0.008, p=0.009, respectively). No other correlations of BDNF and proBDNF levels with clinical and demographical variables have been detected. Discussion: Our results did not show any differences in BDNF and proBDNF levels between depression, mania, euthymia, and controls. Imbalance in BDNF/proBDNF signalling may be involved in pathogenesis of mood disorders. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: bipolar disorder, Brain-Derived Neurotrophic Factor (BDNF), proBDNF, unipolar depression

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5076 Re-Presenting the Egyptian Informal Urbanism in Films between 1994 and 2014

Authors: R. Mofeed, N. Elgendy

Abstract:

Cinema constructs mind-spaces that reflect inherent human thoughts and emotions. As a representational art, Cinema would introduce comprehensive images of life phenomena in different ways. The term “represent” suggests verity of meanings; bring into presence, replace or typify. In that sense, Cinema may present a phenomenon through direct embodiment, or introduce a substitute image that replaces the original phenomena, or typify it by relating the produced image to a more general category through a process of abstraction. This research is interested in questioning the type of images that Egyptian Cinema introduces to informal urbanism and how these images were conditioned and reshaped in the last twenty years. The informalities/slums phenomenon first appeared in Egypt and, particularly, Cairo in the early sixties, however, this phenomenon was completely ignored by the state and society until the eighties, and furthermore, its evident representation in Cinema was by the mid-nineties. The Informal City represents the illegal housing developments, and it is a fast growing form of urbanization in Cairo. Yet, this expanding phenomenon is still depicted as the minority, exceptional and marginal through the Cinematic lenses. This paper aims at tracing the forms of representations of the urban informalities in the Egyptian Cinema between 1994 and 2014, and how did that affect the popular mind and its perception of these areas. The paper runs two main lines of inquiry; the first traces the phenomena through a chronological and geographical mapping of the informal urbanism has been portrayed in films. This analysis is based on an academic research work at Cairo University in Fall 2014. The visual tracing through maps and timelines allowed a reading of the phases of ignorance, presence, typifying and repetition in the representation of this huge sector of the city through more than 50 films that has been investigated. The analysis clearly revealed the “portrayed image” of informality by the Cinema through the examined period. However, the second part of the paper explores the “perceived image”. A designed questionnaire is applied to highlight the main features of that image that is perceived by both inhabitants of informalities and other Cairenes based on watching selected films. The questionnaire covers the different images of informalities proposed in the Cinema whether in a comic or a melodramatic background and highlight the descriptive terms used, to see which of them resonate with the mass perceptions and affected their mental images. The two images; “portrayed” and “perceived” are then to be encountered to reflect on issues of repetitions, stereotyping and reality. The formulated stereotype of informal urbanism is finally outlined and justified in relation to both production consumption mechanisms of films and the State official vision of informalities.

Keywords: cinema, informal urbanism, popular mind, representation

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5075 The Geographic Distribution of Complementary, Alternative, and Traditional Medicine in the United States in 2018

Authors: Janis E. Campbell

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Most of what is known about complementary, alternative or traditional medicine (CATM) in the United States today is known from either the National Health Interview Survey a cross-sectional survey with a few questions or from small cross-sectional or cohort studies with specific populations. The broad geographical distribution in CATM use or providers is not known. For this project, we used geospatial cluster analysis to determine if there were clusters of CATM provider by county in the US. In this analysis, we used the National Provider Index to determine the geographic distribution of providers in the US. Of the 215,769 CAMT providers 211,603 resided in the contiguous US: Acupuncturist (26,563); Art, Poetry, Music and Dance Therapist (2,752); Chiropractor (89,514); Doula/Midwife (3,535); Exercise (507); Homeopath (380); Massage Therapist (36,540); Mechanotherapist (1,888); Naprapath (146); Naturopath (4,782); Nutrition (42,036); Reflexologist (522); Religious (2,438). ESRI® spatial autocorrelation was used to determine if the geographic location of CATM providers were random or clustered. For global analysis, we used Getis-Ord General G and for Local Indicators of Spatial Associations with an Optimized Hot Spot Analysis using an alpha of 0.05. Overall, CATM providers were clustered with both low and high. With Chiropractors, focusing in the Midwest, religious providers having very small clusters in the central US, and other types of CAMT focused in the northwest and west coast, Colorado and New Mexico, the great lakes areas and Florida. We will discuss some of the implications of this study, including associations with health, economic, social, and political systems.

Keywords: complementary medicine, alternative medicine, geospatial, United States

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5074 Advancing the Analysis of Physical Activity Behaviour in Diverse, Rapidly Evolving Populations: Using Unsupervised Machine Learning to Segment and Cluster Accelerometer Data

Authors: Christopher Thornton, Niina Kolehmainen, Kianoush Nazarpour

Abstract:

Background: Accelerometers are widely used to measure physical activity behavior, including in children. The traditional method for processing acceleration data uses cut points, relying on calibration studies that relate the quantity of acceleration to energy expenditure. As these relationships do not generalise across diverse populations, they must be parametrised for each subpopulation, including different age groups, which is costly and makes studies across diverse populations difficult. A data-driven approach that allows physical activity intensity states to emerge from the data under study without relying on parameters derived from external populations offers a new perspective on this problem and potentially improved results. We evaluated the data-driven approach in a diverse population with a range of rapidly evolving physical and mental capabilities, namely very young children (9-38 months old), where this new approach may be particularly appropriate. Methods: We applied an unsupervised machine learning approach (a hidden semi-Markov model - HSMM) to segment and cluster the accelerometer data recorded from 275 children with a diverse range of physical and cognitive abilities. The HSMM was configured to identify a maximum of six physical activity intensity states and the output of the model was the time spent by each child in each of the states. For comparison, we also processed the accelerometer data using published cut points with available thresholds for the population. This provided us with time estimates for each child’s sedentary (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Data on the children’s physical and cognitive abilities were collected using the Paediatric Evaluation of Disability Inventory (PEDI-CAT). Results: The HSMM identified two inactive states (INS, comparable to SED), two lightly active long duration states (LAS, comparable to LPA), and two short-duration high-intensity states (HIS, comparable to MVPA). Overall, the children spent on average 237/392 minutes per day in INS/SED, 211/129 minutes per day in LAS/LPA, and 178/168 minutes in HIS/MVPA. We found that INS overlapped with 53% of SED, LAS overlapped with 37% of LPA and HIS overlapped with 60% of MVPA. We also looked at the correlation between the time spent by a child in either HIS or MVPA and their physical and cognitive abilities. We found that HIS was more strongly correlated with physical mobility (R²HIS =0.5, R²MVPA= 0.28), cognitive ability (R²HIS =0.31, R²MVPA= 0.15), and age (R²HIS =0.15, R²MVPA= 0.09), indicating increased sensitivity to key attributes associated with a child’s mobility. Conclusion: An unsupervised machine learning technique can segment and cluster accelerometer data according to the intensity of movement at a given time. It provides a potentially more sensitive, appropriate, and cost-effective approach to analysing physical activity behavior in diverse populations, compared to the current cut points approach. This, in turn, supports research that is more inclusive across diverse populations.

Keywords: physical activity, machine learning, under 5s, disability, accelerometer

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5073 Preventing the Septic Shock in an Oncological Patient with Febrile Neutropenia Submitted to Chemotherapy: The Nurse's Responsibility

Authors: Hugo Reis, Isabel Rabiais

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The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

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5072 A Close Study on the Nitrate Fertilizer Use and Environmental Pollution for Human Health in Iran

Authors: Saeed Rezaeian, M. Rezaee Boroon

Abstract:

Nitrogen accumulates in soils during the process of fertilizer addition to promote the plant growth. When the organic matter decomposes, the form of available nitrogen produced is in the form of nitrate, which is highly mobile. The most significant health effect of nitrate ingestion is methemoglobinemia in infants under six months of age (blue baby syndrome). The mobile nutrients, like nitrate nitrogen, are not stored in the soil as the available forms for the long periods and in large amounts. It depends on the needs for the crops such as vegetables. On the other hand, the vegetables will compete actively for nitrate nitrogen as a mobile nutrient and water. The mobile nutrients must be shared. The fewer the plants, the larger this share is for each plant. Also, this nitrate nitrogen is poisonous for the people who use these vegetables. Nitrate is converted to nitrite by the existing bacteria in the stomach and the Gastro-Intestinal (GI) tract. When nitrite is entered into the blood cells, it converts the hemoglobin to methemoglobin, which causes the anoxemia and cyanosis. The increasing use of pesticides and chemical fertilizers, especially the fertilizers with nitrates compounds, which have been common for the increased production of agricultural crops, has caused the nitrate pollution in the (soil, water, and environment). They have caused a lot of damage to humans and animals. In this research, the nitrate accumulation in different kind of vegetables such as; green pepper, tomatoes, egg plants, watermelon, cucumber, and red pepper were observed in the suburbs of Mashhad, Neisabour, and Sabzevar cities. In some of these cities, the information forms of agronomical practices collected were such as; different vegetable crops fertilizer recommendations, varieties, pesticides, irrigation schedules, etc., which were filled out by some of our colleagues in the research areas mentioned above. Analysis of the samples was sent to the soil and water laboratory in our department in Mashhad. The final results from the chemical analysis of samples showed that the mean levels of nitrates from the samples of the fruit crops in the mentioned cities above were all lower than the critical levels. These fruit crop samples were in the order of: 35.91, 8.47, 24.81, 6.03, 46.43, 2.06 mg/kg dry matter, for the following crops such as; tomato, cucumber, eggplant, watermelon, green pepper, and red pepper. Even though, this study was conducted with limited samples and by considering the mean levels, the use of these crops from the nutritional point of view will not cause the poisoning of humans.

Keywords: environmental pollution, human health, nitrate accumulations, nitrate fertilizers

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5071 Human Immunodeficiency Virus Infection/AIDS Abandoned Children in Kenya

Authors: Ruth Muturi Wanjiku

Abstract:

HIV/AIDS in Kenya for unborn and young kids. HIV/AIDS is a significant health concern in Kenya, with an estimated 1.5 million people living with the disease. Unfortunately, many of these individuals are unaware of their HIV status, and the disease continues to spread among the population or unborn kids. HIV/AIDS can be transmitted from an infected mother during pregnancy, childbirth, or breastfeeding. However, with early testing and treatment, the risk of mother-to-child transmission can be significantly reduced. Therefore, it is crucial for pregnant women to get tested and receive appropriate medical care. For young kids, HIV/AIDS education is critical to preventing the spread of the disease. It is essential to teach children about the importance of safe sex practices, avoiding risky behaviors such as sharing needles and getting tested regularly. Additionally, children should be taught about the stigma surrounding HIV/AIDS and encouraged to treat individuals living with the disease with compassion and respect. In conclusion, HIV/AIDS is a significant health concern in Kenya that affects individuals of all ages. For unborn kids, early testing and treatment are critical to reducing the risk of mother-to-child transmission. For young kids, education about HIV/AIDS and safe sex practices is essential to preventing the spread of the disease and reducing stigma. It is essential to promote awareness and encourage individuals to get tested and seek medical care if they believe they may be infected with HIV/AIDS.

Keywords: AIDS, HIV, children, pregnant

Procedia PDF Downloads 52
5070 Barriers and Opportunities for Implementing Electronic Prescription Software in Public Libyan Hospitals

Authors: Abdelbaset M. Elghriani, Abdelsalam M. Maatuk, Isam Denna, Amira Abdulla Werfalli

Abstract:

Electronic prescription software (e-prescribing) benefits patients and physicians by preventing handwriting errors and giving accurate prescriptions. E-prescribing allows prescriptions to be written and sent to pharmacies electronically instead of using handwritten notes. Significant factors that may affect the adoption of e-prescription systems include lacking technical support, financial resources to operate the systems, and change resistance from some clinicians, which have been identified as barriers to the implementation of e-prescription systems. This study aims to explore the trends and opinions of physicians and pharmacists about e-prescriptions and to identify the obstacles and benefits of the application of e-prescriptions in the health care system. A cross-sectional descriptive study was conducted at three Libyan public hospitals. Data were collected through a self-constructed questionnaire to assess the opinions regarding potential constraining factors and benefits of implementing an e-prescribing system in hospitals. Data presented as mean, frequency distribution table, cross-tabulation, and bar charts. Data analysis was performed, and the results show that technical, financial, and organizational obstacles are the most important obstacles that prevent the application of e-prescribing systems in Libyan hospitals. In addition, there was awareness of the benefits of e-prescribing, especially reducing medication dispensing errors, and a desire of physicians and pharmacists to use electronic prescriptions.

Keywords: physicians, e-prescribing, health care system, pharmacists

Procedia PDF Downloads 111
5069 The Model Development of Caregiver Skills for the End of Life’s Cancer Patients

Authors: Chaliya Wamaloon, Malee Chaisaena, Nusara Prasertsri

Abstract:

Informal caregivers providing home-based palliative and end-of-life (EOL) care to people with advanced cancer is needed, however, there has not been develop caregiver skills for the EOL in cancer patients. The aim of this research was to study the model development of caregiver skills for the EOL in cancer patients. Mixed methods research was conducted in 3 phases. All subjects were in Ubon Rathchathani Cancer Hospital including 30 EOL cancer patient caregivers, 30 EOL cancer patients, and 111 health care professionals who provided care for the EOL cancer patients and 30 EOL target participants who had been trained to be cancer patient caregivers. The research tools were questionnaires, semi structured interviews, and caregiver skills questionnaires. Data were analyzed by using percentage, mean, standard deviation, pair t-test, and content analysis. The result from this study showed the model development of caregiver skills for cancer patients consisted of 9 domains skills: 1. monitoring, 2. interpreting, 3. making decisions, 4. taking action, 5. making adjustments, 6. providing hands-on care, 7. accessing resources, 8. working together with the ill patients, and 9. navigating the healthcare system. The model composed of skills development curriculum for cancer patient caregivers, Manual of palliative care for caregivers, diary of health care records for cancer patients, and the evaluation model of development of caregiver skills for EOL cancer patients. The results of the evaluation in the development model of caregiver skills for EOL cancer patients showed that the caregivers were satisfied with the model of development for caregiver skills at a high level. The comparison of the caregiver skills before and after obtaining the development of caregivers skills revealed that it improved at a statistically significant level (p < 0.05).

Keywords: caregiver, caregiver skills, cancer patients, end of life

Procedia PDF Downloads 155
5068 Organizational Climate of Silence and Job Performance: Examining the Mediatory and Moderating Role of Work Engagement and Supervisor Support among Frontline Nurses

Authors: Sabina Ampon-Wireko

Abstract:

Purpose: The study explores the influence of the organizational climate of silence on job performance through the mediating effects of work engagement (WE). Further, the degree to which supervisor support (SS) and work engagement moderate job performance are examined. Method: Using a questionnaire, the study collected 565 valid responses from frontline nurses in Ghana. The hierarchical regression technique was employed in estimating the relationship between the variables. Findings: The results showed a significant negative influence of top managers' and supervisors' attitudes to silence on both contextual and task performance. Communication opportunities, however, revealed positive and significant effects on contextual and task performance. Work engagement had no role in mediating top managers' and supervisors’ attitudes toward silence, communication opportunities, and task performance. Supervisor support acted as a moderating factor in the relationship between job engagement and task performance. In contrast, despite the direct positive relationship between supervisor support and contextual performance, it failed to moderate the relationship between work engagement and contextual performance. Practical implications: The study's findings demonstrate the need for health managers and supervisors to become more conscious of silence. The findings offer diverse recommendations for encouraging the sharing of relevant ideas, facts, and opinions within the health sector.

Keywords: organizational climate of silence, job performance, work engagement, supervisor support, frontline nurses

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5067 Delay in the Diagnosis of Tuberculosis and Initiation of TB Treatment in the Private and Public Health Sectors, Udaipur District, Rajasthan, India, Nov 2013

Authors: Yogita Tulsian, R. S. Gupta, K. F. Laserson

Abstract:

Background: Delays in the diagnosis and treatment of TB facilitates disease transmission in the community, so we conducted a study to evaluate the burden of and risk factors for delay in TB diagnosis and initiation of TB treatment among patients in the private and public sectors in Udaipur district, Rajasthan, India. Methods: A retrospective cohort study was conducted among 100 new sputum-positive TB. Patients were interviewed in the intensive phase of treatment September 2013-November 2013 Long total diagnosis delay (TDD) was defined as a time interval between first symptom to confirmed diagnosis > 30 days. Long health treatment delay (HTD) was defined as a time interval between confirmed diagnosis to treatment initiation > 7 days. Results: We observed a median TDD of 55 days (range: 7-136 days) in the public sector and of 92 days (11-380 days) in the private sector. Long TDD in the private sector was significantly associated with middle-higher socio-economic status (Risk Ratio (RR): 2;95% CI: 1.3-3). The reasons reported from the private sector for long TDD were suspect TB patients not advised for sputum examination (RR: 42; 95% CI:2.6-660), practise of self-medication (RR: 17.4; 95% CI: 1.1-267), or lack of awareness (RR: 9.7;95% CI: 0.6-145). The median HTD in the public sector was 3 days (range: 0-14 days), and in the private sector, 2 days (range: 0-11 days) (non-significant difference). Conclusions: Long TDD in private sector may be improved through sputum referral for all suspect TB cases and better education to all regarding TB.

Keywords: diagnosis delay, treatment delay, privatesector, public sector

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5066 Cognitive Behaviour Hypnotherapy as an Effective Intervention for Nonsuicidal Self Injury Disorder

Authors: Halima Sadia Qureshi, Urooj Sadiq, Noshi Eram Zaman

Abstract:

The goal of this study was to see how cognitive behavior hypnotherapy affected nonsuicidal self-injury. DSM 5 invites the researchers to explore the newly added condition under the chapter of conditions under further study named Nonsuicidal self-injury disorder. To date, no empirical sound intervention has been proven effective for NSSI as given in DSM 5. Nonsuicidal self-injury is defined by DSM 5 as harming one's self physically, without suicidal intention. Around 7.6% of teenagers are expected to fulfill the NSSI disorder criteria. 3 Adolescents, particularly university students, account for around 87 percent of self-harm studies. Furthermore, one of the risks associated with NSSI is an increased chance of suicide attempts, and in most cases, the cycle repeats again. 6 The emotional and psychological components of the illness might lead to suicide, either intentionally or unintentionally. 7 According to a research done at a Pakistani military hospital, over 80% of participants had no intention of committing suicide. Furthermore, it has been determined that improvements in NSSI prevention and intervention are necessary as a stand-alone strategy. The quasi-experimental study took place in Islamabad and Rawalpindi, Pakistan, from May 2019 to April 2020 and included students aged 18 to 25 years old from several institutions and colleges in the twin cities. According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, the individuals were assessed for >2 episodes without suicidal intent using the intentional self-harm questionnaire. The Clinician Administered Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess the individual for NSSI condition. Symptom checklist-90 (SCL-90) was used to screen the participants for differential diagnosis. Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was used to rule out the BPD cases. The selected participants, n=106 from the screening sample of 600, were selected. They were further screened to meet the inclusion and exclusion criteria, and the total of n=71 were split into two groups: intervention and control. The intervention group received cognitive behavior hypnotherapy for the next three months, whereas the control group received no treatment. After the period of three months, both the groups went through the post assessment, and after the three months’ period, follow-up assessment was conducted. The groups were evaluated, and SPSS 25 was used to analyse the data. The results showed that each of the two groups had 30 (50 percent) of the 60 participants. There were 41 males (68 percent) and 19 girls (32 percent) in all. The bulk of the participants were between the ages of 21 and 23. (48 percent). Self-harm events were reported by 48 (80 percent) of the pupils, and suicide ideation was found in 6 (ten percent). In terms of pre- and post-intervention values (d=4.90), post-intervention and follow-up assessment values (d=0.32), and pre-intervention and follow-up values (d=5.42), the study's effect size was good. The comparison of treatment and no-treatment groups revealed that treatment was more successful than no-treatment, F (1, 58) = 53.16, p.001. The results reveal that the treatment manual of CBH is effective for Nonsuicidal self-injury disorder.

Keywords: NSSI, nonsuicidal self injury disorder, self-harm, self-injury, Cognitive behaviour hypnotherapy, CBH

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5065 Medical Waste Management in Nigeria: A Case Study

Authors: Y. Y. Babanyara, D. B. Ibrahim, T. Garba

Abstract:

Proper management of medical waste is a crucial issue for maintaining human health and the environment. The waste generated in the hospitals has the potential for spreading infections and causing diseases. The study is aimed at assessing the medical waste management practices in Nigeria. Three instruments, questionnaire administration, in-depth interview and observation method for data collection were adopted in the study. The results revealed that the hospital does not quantify medical waste. Segregation of medical wastes is not conducted according to definite rules and standards. Wheeled trolleys are used for on-site transportation of waste from the points of production to the temporary storage area. Offsite transportation of the hospital waste is undertaken by a private waste management company. Small pickups are mainly used to transport waste daily to an off-site area for treatment and disposal. The main treatment method used in the final disposal of infectious waste is incineration. Non-infectious waste is disposed off using land disposal method. The study showed that the hospital does not have a policy and plan in place for managing medical waste. The study revealed number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collections and disposal of waste, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting the bags to only one colour for all waste, the absence of a dedicated waste manager, and no committee responsible for monitoring the management of medical waste. Recommendations are given with the aim of improving medical waste management in the hospital.

Keywords: medical waste, treatment, disposal, public health

Procedia PDF Downloads 298
5064 The Efficacy of Government Strategies to Control COVID 19: Evidence from 22 High Covid Fatality Rated Countries

Authors: Imalka Wasana Rathnayaka, Rasheda Khanam, Mohammad Mafizur Rahman

Abstract:

TheCOVID-19 pandemic has created unprecedented challenges to both the health and economic states in countries around the world. This study aims to evaluate the effectiveness of governments' decisions to mitigate the risks of COVID-19 through proposing policy directions to reduce its magnitude. The study is motivated by the ongoing coronavirus outbreaks and comprehensive policy responses taken by countries to mitigate the spread of COVID-19 and reduce death rates. This study contributes to filling the knowledge by exploiting the long-term efficacy of extensive plans of governments. This study employs a Panel autoregressive distributed lag (ARDL) framework. The panels incorporate both a significant number of variables and fortnightly observations from22 countries. The dependent variables adopted in this study are the fortnightly death rates and the rates of the spread of COVID-19. Mortality rate and the rate of infection data were computed based on the number of deaths and the number of new cases per 10000 people.The explanatory variables are fortnightly values of indexes taken to investigate the efficacy of government interventions to control COVID-19. Overall government response index, Stringency index, Containment and health index, and Economic support index were selected as explanatory variables. The study relies on the Oxford COVID-19 Government Measure Tracker (OxCGRT). According to the procedures of ARDL, the study employs (i) the unit root test to check stationarity, (ii) panel cointegration, and (iii) PMG and ARDL estimation techniques. The study shows that the COVID-19 pandemic forced immediate responses from policymakers across the world to mitigate the risks of COVID-19. Of the four types of government policy interventions: (i) Stringency and (ii) Economic Support have been most effective and reveal that facilitating Stringency and financial measures has resulted in a reduction in infection and fatality rates, while (iii) Government responses are positively associated with deaths but negatively with infected cases. Even though this positive relationship is unexpected to some extent in the long run, social distancing norms of the governments have been broken by the public in some countries, and population age demographics would be a possible reason for that result. (iv) Containment and healthcare improvements reduce death rates but increase the infection rates, although the effect has been lower (in absolute value). The model implies that implementation of containment health practices without association with tracing and individual-level quarantine does not work well. The policy implication based on containment health measures must be applied together with targeted, aggressive, and rapid containment to extensively reduce the number of people infected with COVID 19. Furthermore, the results demonstrate that economic support for income and debt relief has been the key to suppressing the rate of COVID-19 infections and fatality rates.

Keywords: COVID-19, infection rate, deaths rate, government response, panel data

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5063 Patient Support Program in Pharmacovigilance: Foster Patient Confidence and Compliance

Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

Abstract:

The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance

Procedia PDF Downloads 296
5062 Psychosocial Risks and Occupational Health in a Mexican Small and Medium-Sized Enterprises

Authors: Magdalena Escamilla Quintal, Thelma Cetina Canto, Cecilia Aguilar Ortega

Abstract:

Due to the importance that people represent for companies, the setting of a clear control of the risks that threaten the health and the material and financial resources of workers is essential. It is irrelevant if the company is a small and medium-sized enterprise (SME) or a large multinational, or if it is in the construction or service sector. The risk prevention importance is related to a constitutional and human right that all people have; working in a risk-free environment to prevent accidents or illnesses that may influence their quality of life and the tranquility of their family. Therefore, the objective of this study was to determine the level of psychosocial risks (physical and emotional) of the employees of an SME. The participants of this study were 186 employees of a productive sector SME; 151 men and 35 women, all with an average age of 31.77 years. Their seniority inside the SME was between one month and 19.91 years. Ninety-six workers were from the production area, 28 from the management area, as well as 25 from the sales area and 40 from the supplies area. Ninety-three workers were found in Uman, 78 in Playa del Carmen, 11 in Cancun and seven in Cd. del Carmen. We found a statistically significant relationship between the burnout variable and the engagement and psychosomatic complaints as well as between the variables of sex, burnout and psychosomatic complaints. We can conclude that, for benefit of the SME, that there are low levels of burnout and psychosomatic complaints, the women experience major levels of burnout and the men show major levels of psychosomatic complaints. The findings, contributions, limitations and future proposals will be analyzed.

Keywords: psychosocial risks, SME, burnout, engagement, psychosomatic complaints

Procedia PDF Downloads 353
5061 Utilization of Cervical Cancer Screening Among HIV Infected Women in Nairobi, Kenya

Authors: E. Njuguna, S. Ilovi, P. Muiruri, K. Mutai, J. Kinuthia, P. Njoroge

Abstract:

Introduction: Cervical cancer is the commonest cause of cancer-related morbidity and mortality among women in developing countries in Sub Saharan Africa. Screening for cervical cancer in all women regardless of HIV status is crucial for the early detection of cancer of the cervix when treatment is most effective in curing the disease. It is particularly more important to screen HIV infected women as they are more at risk of developing the disease and progressing faster once infected with HPV (Human Papilloma Virus). We aimed to determine the factors affecting the utilization of cervical cancer screenings among HIV infected women above 18 years of age at Kenyatta National Hospital (KNH) Comprehensive Care Center (CCC). Materials and Methods: A cross-sectional mixed quantitative and qualitative study involving randomly and purposefully selected HIV positive female respectively was conducted. Qualitative data collection involved 4 focus group discussions of eligible female participants while quantitative data were acquired by one to one interviewer administered structured questionnaires. The outcome variable was the utilization of cervical cancer screening. Data were entered into Access data base and analyzed using Stata version 11.1. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising. Results: We enrolled a total of 387 patients, mean age (IQ range) 40 years (36-44). Cervical cancer screening utilization was 46% despite a health care provider recommendation of 85%. The screening results were reported as normal in 72 of 81 (88.9%) and abnormal 7 of 81(8.6%) of the cases. Those who did not know their result were 2 of 81(2.5%). Patients were less likely to utilize the service with increasing number of years attending the clinic (OR 0.9, 95% CI 0.86-0.99, p-value 0.02), but more likely to utilize the service if recommendation by a staff was made (OR 10, 95% CI 4.2-23.9, p<0.001), and if cervical screening had been done before joining KNH CCC (OR 2.9, 95% CI 1.7-4.9, p < 0.001). Similarly, they were more likely to rate the services on cervical cancer screening as good (OR 5.0, 95% CI 1.7-3.4, p <0.001) and very good (OR 8.1, 95% CI 2.5-6.1, p<0.001) if they had utilized the service. The main barrier themes emerging from qualitative data included fear of screening due to excessive pain or bleeding, lack of proper communication on screening procedures and increased waiting time. Conclusions: Utilization of cervical cancer screening services was low despite health care recommendation. Patient socio-demographic characteristics did not influence whether or not they utilized the services, indicating the important role of the health care provider in the referral and provision of the service.

Keywords: cervical, cancer, HIV, women, comprehensive care center

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5060 Woodcast Is Ecologically Sound and Tolerated by Majority of Patients

Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

Abstract:

Background: NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studiesare shortcoming on individual patient experience. The aim of this study was to assess the patient’ssatisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. Methods: For all patients managed with woodcast in our unit, we undertook a structured questionnairethat included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score, and the pain numerical score at the time of injury and six weeks after. Results: 30 patients were initially managed with woodcast.80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. Conclusion: For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Pariscasting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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5059 An Emergentist Defense of Incompatibility between Morally Significant Freedom and Causal Determinism

Authors: Lubos Rojka

Abstract:

The common perception of morally responsible behavior is that it presupposes freedom of choice, and that free decisions and actions are not determined by natural events, but by a person. In other words, the moral agent has the ability and the possibility of doing otherwise when making morally responsible decisions, and natural causal determinism cannot fully account for morally significant freedom. The incompatibility between a person’s morally significant freedom and causal determinism appears to be a natural position. Nevertheless, some of the most influential philosophical theories on moral responsibility are compatibilist or semi-compatibilist, and they exclude the requirement of alternative possibilities, which contradicts the claims of classical incompatibilism. The compatibilists often employ Frankfurt-style thought experiments to prove their theory. The goal of this paper is to examine the role of imaginary Frankfurt-style examples in compatibilist accounts. More specifically, the compatibilist accounts defended by John Martin Fischer and Michael McKenna will be inserted into the broader understanding of a person elaborated by Harry Frankfurt, Robert Kane and Walter Glannon. Deeper analysis reveals that the exclusion of alternative possibilities based on Frankfurt-style examples is problematic and misleading. A more comprehensive account of moral responsibility and morally significant (source) freedom requires higher order complex theories of human will and consciousness, in which rational and self-creative abilities and a real possibility to choose otherwise, at least on some occasions during a lifetime, are necessary. Theoretical moral reasons and their logical relations seem to require a sort of higher-order agent-causal incompatibilism. The ability of theoretical or abstract moral reasoning requires complex (strongly emergent) mental and conscious properties, among which an effective free will, together with first and second-order desires. Such a hierarchical theoretical model unifies reasons-responsiveness, mesh theory and emergentism. It is incompatible with physical causal determinism, because such determinism only allows non-systematic processes that may be hard to predict, but not complex (strongly) emergent systems. An agent’s effective will and conscious reflectivity is the starting point of a morally responsible action, which explains why a decision is 'up to the subject'. A free decision does not always have a complete causal history. This kind of an emergentist source hyper-incompatibilism seems to be the best direction of the search for an adequate explanation of moral responsibility in the traditional (merit-based) sense. Physical causal determinism as a universal theory would exclude morally significant freedom and responsibility in the traditional sense because it would exclude the emergence of and supervenience by the essential complex properties of human consciousness.

Keywords: consciousness, free will, determinism, emergence, moral responsibility

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5058 Effects of Dust Storm Events on Tuberculosis Incidence Rate in Northwest of China

Authors: Yun Wang, Ruoyu Wang, Tuo Chen, Guangxiu Liu, Guodong Chen, Wei Zhang

Abstract:

Tuberculosis (TB) is a major public health problem in China. China has the world's second largest tuberculosis epidemic (after India). Xinjiang almost has the highest annual attendance rate of TB in China, and the province is also famous because of its severe dust storms. The epidemic timing starts in February and ends in July, and the dust storm mainly distribute throughout the spring and early summer, which strongly indicate a close linkage between causative agent of TB and dust storm events. However, mechanisms responsible for the observed patterns are still not clearly indentified. By comparing the information on cases of TB from Centers for Disease Control of China annual reports with dust storm atmosphere datasets, we constructed the relationship between the large scale annual occurrence of TB in Xinjiang, a Northwest province of China, and dust storm occurrence. Regional atmospheric indexes of dust storm based on surface wind speed show a clear link between population dynamics of the disease and the climate disaster: the onset of epidemics and the dust storm defined by the atmospheric index share the same mean year. This study is the first that provides a clear demonstration of connections that exist between TB epidemics and dust storm events in China. The development of this study will undoubtedly help early warning for tuberculosis epidemic onset in China and help nationwide and international public health institutions and policy makers to better control TB disease in Norwest China.

Keywords: dust storm, tuberculosis, Xinjiang province, epidemic

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5057 Public Policy for Quality School Lunch Development in Thailand

Authors: W. Kongnoo, J. Loysongkroa, S. Chotivichien, N. Viriyautsahakul, N. Saiwongse

Abstract:

Obesity, stunting and wasting problems among Thai school-aged children are increasing due to inappropriate food consumption behavior and poor environments for desirable nutritional behavior. Because of a low school lunch budget of only 0.40 USD per person per day, food quality is not up to nutritional standards. Therefore, the Health Department with the Education Ministry and the Thai Health Promotion Foundation have developed a quality school lunch project during 2009–2013. The program objectives were development and management of public policy to increase school lunch budget. The methods used a healthy public policy motivation process and movement in 241 local administrative organizations and 538 schools. The problem and solution research was organized to study school food and nutrition management, create a best practice policy mobilization model and hold a public hearing to motivate an increase of school meal funding. The results showed that local public policy has been motivated during 2009-2011 to increase school meal budget using local budgets. School children with best food consumption behavior and exercise increased from 13.2% in 2009 to 51.6% in 2013 and stunting decreased from 6.0% in 2009 to 4.7% in 2013. As the result of national policy motivation (2012-2013), the cabinet meeting on October 22, 2013 has approved an increase of school lunch budget from 0.40 USD to 0.62 USD per person per day. Thus, 5,800,469 school children nationwide have benefited from the budget increase.

Keywords: public policy, quality school lunch, Thailand, obesity

Procedia PDF Downloads 335
5056 Infertility Awareness: Knowledge and Attitude of Medical & Non-Medical Moroccan Young People

Authors: Sana El Adlani, Yassir Ait Ben Kaddour, Abdelhafid Benksim, Abderraouf Soummani, Mohamed Cherkaoui

Abstract:

Background: Infertility in all countries of the word is on an increase, it’s why the World Health Organization included an investigation into young people's fertility. In this sense, it’s important to increase efforts to improve the knowledge about fertility for the young population. The aim of this study is to describe the difference between knowledge and attitude of medical and non-medical Moroccan young people. Materials and Methods: 100 medical Moroccan students (group 1) participated in the study, between 18 and 30 years, by a simple random sampling method, during 2020 and using a previously validated questionnaire. The answers were confronted to the result of our same study among 355 non-medical Moroccan young people (group 2) in 2019. Statistical analyses were performed using Statistical Package for the Social Sciences (version 10). Result: Medical students had a significantly higher level of knowledge about infertility than non-medical young people. However, both groups were aware of the impact of lifestyle on infertility. The knowledge state of the first group about infertility management was higher than the second group. Moreover, all non-medical Moroccan young people believed that it is easier to conceive if the couples had already their first baby, whereas, among medical students, only 53% had confirmed this belief. The results showed that 65% of medical students had proposed to try fertility treatments more than one time if treatment fails. Besides, the first advice of the second group was polygamy and adoption. Conclusion: Following the result of our study, the investigation of young people is the measure to optimize reproductive health. So, it’s crucial that the government increase efforts to improve the knowledge about infertility not only for medical universities but for all scholar programs.

Keywords: attitude, infertility, knowledge, medical, non-medical, young people

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