Search results for: poor health

Authors: Jessica Hemberg, Anna K. Forsman, Johanna Nordmyr

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With a considerable increase in the aging population in the Nordic countries there is a call for a deeper understanding of healthy aging and its underlying mechanisms. The aim of this study is to uncover health and well-being for older adults according to their own views and understand what role the existential dimension play? The study uses a hermeneutical approach. Material was collected through focus group interviews with 18 older adults. The texts were interpreted through hermeneutical reading. The underlying mechanisms of health among older adults are described, illustrating the key prerequisites for health as being in the present. This implies ‘living on the continuums of life and death’ and in this field of forces also ‘living on the continuum of the past and the future’. Important aspects for being in the present was balancing ambivalent emotions, considering existential issues, and being in connectedness. Health for older adults may be understood in the light of the metaphor of taking it one day at a time. Being in the present was emphasized as a health potential for older adults highlighting the existential health dimension. From a societal point of view, this implies that health promotion should focus on highlighting the importance of the existential dimension of health since it holds health-promoting potentials for older adults. Optimal health for older adults requires awareness of one’s attitude to life through being in the present as a basis for a positive and healthy outlook on life.

Keywords: focus group interviews, hermeneutics, life experiences, older adults

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Authors: Saadelnour Abdueljabbar Adam

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Wastes from slaughterhouses in most towns in Sudan are often poorly managed and sometimes discharged into adjoining streams due to poor implementation of standards, thus causing environmental and public health hazards and also there is a large amount of manure from dairy farms. This paper presents a solution of organic waste from cow dairy farms and slaughterhouse. We present the findings of experimental investigation of biogas production using cow manure, blood and rumen content were mixed at three proportions :72.3%, 61%, 39% manure, 6%, 8.5%, 22% blood; and 21.7%, 30.5%, 39% rumen content in volume for bio-digester 1,2,3 respectively. This paper analyses the quantitative and qualitative composition of biogas: gas content, and the concentration of methane. The highest biogas output 0.116L/g dry matter from bio-digester1 together with a high-quality biogas of 85% methane Was from the mixture of cow manure with blood and rumen content were mixed at 72.3%manure, 6%blood and 21.7%rumen content which is useful for combustion and energy production. While bio-digester 2 and 3 gave 0.012L/g dry matter and 0.013L/g dry matter respectively with the weak concentration of methane (50%).

Keywords: anaerobic digestion, bio-digester, blood, cow manure, rumen content

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Authors: Namhun Lee, Seong Jin Kim

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The construction industry represents one of the largest industries in the United States, yet it continues to face several occupational health and safety challenges. Many workers on construction sites are suffering from extended exposure to stressful situations such as poor and hazardous work environments and task complexity. Stress can be commonly defined as a feeling of emotional or physical tension, which can easily impact construction safety and result in a higher rate of job-related injuries in the construction industry. Physiological signals transmitted from wearable biosensors can be used to detect excessive stress. Therefore, workers’ stress should be detected and mitigated to prevent any type of serious incident or accident proactively. By doing this, construction productivity, as well as job satisfaction, would also be improved in the construction industry. To establish a foundation in this field of research, a conceptual framework for using wearable technology for construction safety has been developed for continuous and automatic monitoring of worker’s stress. The conceptual framework will serve as a foothold in future studies on the application of wearable technology for construction safety.

Keywords: construction safety, occupational stress, stress monitoring, wearable biosensors

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Authors: Dolly Gadhiya, Jayvadan Patel, Mihir Raval

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Lercanidipine hydrochloride is a calcium channel blockers used for treating angina pectoris and hypertension. Lercanidipine is a BCS Class II drug having poor aqueous solubility. Absolute bioavailability of Lercanidipine is very low and the main reason ascribed for this is poor aqueous solubility of the drug. Design and formulatation of nanocrystals by media milling method was main focus of this study. In this present study preliminary optimization was carried out with one factor at a time (OFAT) approach. For this different parameters like size of milling beads, amount of zirconium beads, types of stabilizer, concentrations of stabilizer, concentrations of drug, stirring speeds and milling time were optimized on the basis of particle size, polydispersity index and zeta potential. From the OFAT model different levels for above parameters selected for Plackett - Burman Design (PBD). Plackett-Burman design having 13 runs involving 6 independent variables was carried out at higher and lower level. Based on statistical analysis of PBD it was found that concentration of stabilizer, concentration of drug and stirring speed have significant impact on particle size, PDI, zeta potential value and saturation solubility. These experimental designs for preparation of nanocrystals were applied successfully which shows increase in aqueous solubility and dissolution rate of Lercanidipine hydrochloride.

Keywords: Lercanidipine hydrochloride, nanocrystals, OFAT, Plackett Burman

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Authors: Sujith Gunawardhana

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The circular economy is a system in which resources and energy are derived from renewable sources, utilized efficiently, recycled, and reused to reduce waste, reduce nonrenewable resource consumption, and mitigate negative environmental impacts. However, it poses moral questions about sustainability, the environment, and societal issues. Many societies face challenges when implementing the circular economy, as the concept is still young. The equitable distribution of the advantages and costs of circularity should be ensured during implementation, as some communities, particularly disadvantaged or marginalized ones, may suffer unfairly disproportionately from the harmful effects of production and recycling facilities. Prioritizing the health and safety of workers, communities, and the environment is essential, and strict rules must be implemented to guard against harm. However, most underdeveloped countries need a legal safeguard for this situation. The ultimate objective of the circular economy is to improve social, environmental, and economic performance, but its implementation also requires consideration of the ethics of care and non-epistemic values. Those are often hindered in underdeveloped countries, as the availability of infrastructure and technology, affordability, and legislative framework are poor. To achieve long-term success in the circular economy, evaluating implementation steps and considering health, safety, environmental, and social risks is crucial. To implement the circular economy, respect ethics of care and non-epistemic values. Adopt Kantian Ethics and control technology design to ensure equal benefits for all involved. Ethical gaps may lead underdeveloped countries to generate social pressure against the circular economy.

Keywords: circular economy, ethics, values, sustainability

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Authors: Marilou P. Angeles

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Seniors are a growing number of population all over the world, and they are getting sick with illnesses like diabetes, high blood, and high cholesterol. It is necessary to see the relationship of their physical illness and its effect on their quality of life. Having chronic illnesses also can affect the mood of the elderly; becoming cranky, lonely, not eating, etc. Therefore, there is a need to study the relationship of the quality of life of the elderly and the level of depression. Depression for elderly is known as late onset depression or vascular depression since it is tied to the vascular illnesses they are experiencing, although this is not homogeneous. There is heterogeneity in seniors. The purpose of the study is to determine how keep the satisfaction in life i.e., quality of life of seniors, as long as possible. This study was made in 4 barangays in Longos, Potrero, Tonsuya and Catmon, in Malabon, Metro Manila, Philippines. These Filipino seniors are availing of free medicines for their diabetes, high blood, and high cholesterol ailments in the barangay health centers, given freely by the Department of Health. Two instruments were used; quality of life (CASP-19) and patient health questionnaire(PHQ-19). The quality of life questionnaire was based on the theory of Abraham Maslow, human: beings are motivated to action by needs, starting from the lowest, physiological to the highest self-transcendence. Severity of depression is determined by PHQ-9, and according to the unified model of depression by Aaron Beck and Kurt B. Bredemeier, depression happens when a person cannot cope with life has not able to satisfy his needs as a person. The Pearson R correlation was used to determine the significance of the relationship between quality of life and depression. Finding is there is negative relationship between quality of life and depression. It means that a high value of quality of life lowers or minimizes depression. CASP-19 found that the Filipino elderly were in control, independent, enjoying their lives even if they are poor, and this is shown by the significant results. Self-transcendence, a need to give back to others, is important for Filipino elderly. Although the seniors have difficulty with money and they were affected by their illnesses, they are full of optimism, they are ignoring their physical pain because they are focusing on helping their loved ones (i.e., self-transcendence), their children and grandchildrenothers, and if problems come, they are resilient accepting of the challenges, because they have strong faith in God. They are also having pleasures interacting with their friends and neighbors who, like them, have the same health problems. And these two coping strategies for the elderlies allow them to live a meaningful life, a life high in quality. Thus, where there is high quality of life, there is none or minimal depression. Recommendation for future study is finding the relationship of spirituality to quality of life of seniors.

Keywords: CASP-19, depression, quality of life, PHQ-9, senior citizen

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Authors: S. Hosseini, M. Ahmadi Najafabadi, M. Akhlaghi

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The health of the journal bearings is very important in preventing unforeseen breakdowns in rotary machines, and poor lubrication is one of the most important factors for producing the bearing failures. Hydrodynamic lubrication (HL), mixed lubrication (ML), and boundary lubrication (BL) are three regimes of a journal bearing lubrication. This paper uses acoustic emission (AE) measurement technique to correlate features of the AE signals to the three lubrication regimes. The transitions from HL to ML based on operating factors such as rotating speed, load, inlet oil pressure by time domain and time-frequency domain signal analysis techniques are detected, and then metal-to-metal contacts between sliding surfaces of the journal and bearing are identified. It is found that there is a significant difference between theoretical and experimental operating values that are obtained for defining the lubrication regions.

Keywords: acoustic emission technique, pressure fed journal bearing, time and frequency signal analysis, metal-to-metal contact

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Authors: A. Abubakar, A. Parsa, S. Walker

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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.

Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach

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Authors: Anisha Mandal, Swambabu Varanasi

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Lead is one of the most prevalent toxic heavy metal ions, and its pollution poses a significant threat to the environment and human health. On the other hand, Ethylenediaminetetraacetic acid is a widely used metal chelating agent that, due to its poor biodegradability, is an incessant pollutant to the environment. For the first time, a green, simple, and cost-effective approach is used to hydrothermally synthesise photoluminescent carbon dots using Moringa Oleifera Gum in a single step. Then, using Moringa Oleifera Gum-derived carbon dots, a photoluminescent "ON-OFF-ON" mechanism for dual mode detection of trace Pb2+ and EDTA was proposed. MOG-CDs detect Pb2+ selectively and sensitively using a photoluminescence quenching mechanism, with a detection limit (LOD) of 0.000472 ppm. (1.24 nM). The quenched photoluminescence can be restored by adding EDTA to the MOG-CD+Pb2+ system; this strategy is used to quantify EDTA at a level of detection of 0.0026 ppm. (8.9 nM). The quantification of Pb2+ and EDTA in actual samples encapsulated the applicability and dependability of the proposed photoluminescent probe.

Keywords: carbon dots, photoluminescence, sensor, moringa oleifera gum

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Authors: Francesco Colcerasa, Fabio Pisani

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We contribute to the subjective well-being literature testing the relationship between life satisfaction and inequality of opportunity in health, measured through the Human Opportunity Index calculated at the national level using individual socio-economic data from the cross-country European Social Survey sample. We compute several indexes of opportunity inequality in health, each obtained according to a different combination of circumstances (gender, immigrant status, parents’ education). We find a robust and significant relationship where life satisfaction is higher in correspondence with low levels of health opportunity inequality. The result is twofold. On the one hand, the importance of the well-being of other types of inequality than income inequality emerges. On the other hand, the socioeconomic roots of inequality in health are investigated, suggesting that circumstances at birth have a role in future well-being. Several rationales for the nexus between life satisfaction and inequality of opportunity in health are possible, which we investigate by splitting the sample. Among others, we find a prominent role of pro-social preferences – formalized as interest towards own offspring (which can be interpreted as intergenerational justice) – as a mediating factor of the relationship.

Keywords: Inequality of opportunity, subjective wellbeing, health, health inequality, inequality of opportunity in health

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Authors: Anis Belhaj Mohamed, Moncef Saidi, Mohamed Soussi, Ibrahim Bouazizi, Monia Ben Jrad

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This paper summarizes the results of Rock-Eval pyrolysis and biomarker data of shale samples collected from the Ordovician age (Llanvirnian-Llandeilian) (Azzel Formation) in the Chotts basin southern part of Tunisia. The results are supported by analysis of cutting samples from wells. The Azzel shales has poor to moderate, occasionally good, potential for sourcing oil and gas with Total Organic Carbon (TOC) content varying from 0.80 to 4.49 % and petroleum potential (PP) values varying between 0.68 to 9.20 Kg of HC/t rock in Baguel and Alaguia wells. However, the Azzel Formation show poor to fair TOC and PP in Elfranig and HajBrahim wells not exceeding 1.10% and 1.05 kg HC/t of rock respectively. The Hydrogen Index (HI) and the Oxygen Index (OI) values of 95–165 mg S2/g TOC and of 33–108 mg CO2/g rock relatively show that the Ordovician shales exhibit type II Kerogen that reached the main oil window stage and that the organic matter was bad preserved, Tmax values of 435 – 448°C indicate the organic matter is mature. The biomarker features of the extract samples are characterized by high proportion of tricyclic terpanes that are dominated by C23 and C21 tricyclic terpanes. The hopanes fraction is dominated by C29 and C30 hopanes. The Ordovician shales show a predominance of C27 over C29 steranes (C27/C29>1) and relatively high proportions of diasteranes supporting the shaly character of the source rock.

Keywords: biomarkers, organic geochemistry, ordovician source rock, diasteranes

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Authors: Muhammad Zafarullah Khan, Sumeera Abbasi

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The Farmers Field School (FFS) aims at benefiting poor farmers by improving their knowledge of existing agricultural technologies and integrated crop management to become independent and confident in their decision. The study on effect of farmer’s field school on vegetables production before and after FFS implementation in district Peshawar in four selected villages on each crop in 2011 was conducted from 80 farmers. The results were compared by using paired t-test. It was observed that 80% of the respondents were satisfied with FFS approach as there was a significant increase in vegetable production. The seed rate of tomato and cucumber decreased from 0.185kg/kanal to 0.1 kg/ kanal and 0.120kg/kanal to 0.01kg/kanal while production of tomato and cucumber were increased from 8158.75kgs/kanal to 1030.25kgs/kanal and 3230kgs/kanal to 5340kgs/kanal, respectively after the activities of FFS. FFS brought a positive effect on vegetable production and technology adoption improving their income, skills and knowledge ultimately lead farmers towards empowerment. The input cost including seed, crop management, FYM, and weedicides for tomato were reduced by Rs.28, Rs. 3170 and Rs.658 and cucumber reduced by Rs.35, Rs.570 and Rs.430. Only fertilizers cost was increased by Rs. 2200 in case of tomato and 465 in case of cucumber. FFS facilitator and coordinator should be more skilled and practical oriented to facilitate poor farmers. In light of the above study, more FFS should be planned so that the more farmers should be benefited.

Keywords: effect, farmer field school, vegetables production, integrated crop management

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Authors: Bing-Fang Lee, Srinivasan Periasamy, Ming-Yie Liu

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Shift work sleep disorder is a common problem in industrialized world. It is a type of circadian rhythmic sleep disorders characterized by insomnia and sleep deprivation. Lack of sleep in workers may lead to poor health conditions such as hepatic dysfunction. Melatonin is a hormone secreted by the pineal gland to alleviate insomnia. Moreover, it is a powerful antioxidant and may prevent acute liver injury. Therefore, workers take in melatonin to deal with sleep-related health is an important issue. The aim of this study was to investigate the effect of melatonin on an acute hepatic injury model sinusoidal obstruction syndrome (SOS) in mice. Male C57BL/6 mice were injected with a single dose (500 mg/kg) of monocrotaline (MCT) to induce SOS. Melatonin (1, 3, 10 and 30 mg/kg) was injected 1 h before MCT treatment. After 24 h of MCT treatment, mice were sacrificed. The blood and liver were collected. Organ damage was evaluated by serum biochemistry, hematology analyzer, and histological examination. Low doses of melatonin (1 and 3 mg/kg) had no protective effect on SOS. However, high doses (10 and 30 mg/kg) exacerbated SOS. In addition, it not only increased serum glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT) and extended liver damage indicated by histological examination but also decreased platelet levels, lymphocyte ratio, and glutathione level; it had no effect on malondialdehyde and nitric oxide level in SOS mice. To conclude, melatonin may exacerbate MCT-induced SOS in mice. Furthermore, melatonin might have a synergistic action with SOS. Usage of melatonin for insomnia by people working in long shift must be cautioned; it might cause acute hepatic injury.

Keywords: acute liver injury, melatonin, shift work, sleep deprivation

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Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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Authors: Taner Ersoz, Filiz Ersoz

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This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.

Keywords: multiple correspondence analysis, multivariate categorical data, health care services, health satisfaction survey

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Authors: Alongkorn Pekalee, Rossarin Gray

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Various determinants associated with older health include socio-demographic factors and health-promoting behaviors but lack in scholars recommended what factors associated with health status in specific sub-groups of older adults. The current study aims to explore the health-promoting behaviors and to examine and compare the associations of these factors with self-rated health status among three older age cohorts in Thai traditional context. Methods: This study is based on the Survey of Older Persons in Thailand (SOPT), in 2017, conducted by the National Statistical Office (NSO) of Thailand. Participants were classified into three groups by using the Thai contextual recommendation: youngest-old cohort (60-69), old-old cohort (70-79) and oldest old cohort (80 or older). Health promoting behaviors are the behaviors which associated with the health status of older adults include alcohol consumption, smoking, diet, and physical activity. Health status was defined as a subjective measurement by using self-rated health, a simple measure of general health. The socio-demographic factors, health-promoting behaviors, and health status were explained and summarized by descriptive statistics. The binary logistic regression was performed to analyze the data and evaluate the associations between independent and dependent variables. Results: Increase of age contributes to a higher proportion of health-promoting behaviors. All variables were associated with self-reported health status as good health among three older age cohorts statistically significant (p-value = 0.000). However, the influence of income sufficiency on health status is more notable, especially in older adults who aged 60-69 and 70-79. The influence of dietary and physical activity on health status became greater as age increased. Conclusion: the results suggest that income sufficiency should be noted in a plan to promote healthy aging, and co-residence should be more concerned especially in the oldest old cohort. Moreover, the interventions or policies to promote older health behaviors like diet and physical activity should be emphasized in the oldest old cohort more than others.

Keywords: health-promoting behaviors, older adults, self- rated health, Thailand

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Authors: Hirseland Andreas, Kerschbaumer Lukas

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In the case of Germany, there are about one million long-term unemployed – a figure that did not vary much during the past years. These long-term unemployed did not benefit from the prospering labor market while most short-term unemployed did. Instead, they are continuously dependent on welfare and sometimes precarious short-term employment, experiencing work poverty. Long-term unemployment thus turns into a main obstacle to become employed again, especially if it is accompanied by other impediments such as low-level education (school/vocational), poor health (especially chronical illness), advanced age (older than fifty), immigrant status, motherhood or engagement in care for other relatives. As can be shown by this current research project, in these cases the chance to regain employment decreases to near nil. Almost two-thirds of all welfare recipients have multiple impediments which hinder a successful transition from welfare back to sustainable and sufficient employment. Prospective employers are unlikely to hire long-term unemployed with additional impediments because they evaluate potential employees on their negative signaling (e.g. low-level education) and the implicit assumption of unproductiveness (e.g. poor health, age). Some findings of the panel survey “Labor market and social security” (PASS) carried out by the Institute of Employment Research (the research institute of the German Federal Labor Agency) spread a ray of hope, showing that unlikely does not necessarily mean impossible. The presentation reports on current research on these very scarce “success stories” of unlikely transitions from long-term unemployment to work and how these cases were able to perform this switch against all odds. The study is based on a mixed-method design. Within the panel survey (~15,000 respondents in ~10,000 households), only 66 cases of such unlikely transitions were observed. These cases have been explored by qualitative inquiry – in depth-interviews and qualitative network techniques. There is strong evidence that sustainable transitions are influenced by certain biographical resources like habits of network use, a set of informal skills and particularly a resilient way of dealing with obstacles, combined with contextual factors rather than by job-placement procedures promoted by Job-Centers according to activation rules or by following formal paths of application. On the employer’s side small and medium-sized enterprises are often found to give job opportunities to a wider variety of applicants, often based on a slow but steadily increasing relationship leading to employment. According to these results it is possible to show and discuss some limitations of (German) activation policies targeting the labor market and their impact on welfare dependency and long-term unemployment. Based on these findings, indications for more supportive small-scale measures in the field of labor-market policies are suggested to help long-term unemployed with multiple impediments to overcome their situation (e.g. organizing small-scale-structures and low-threshold services to encounter possible employers on a more informal basis like “meet and greet”).

Keywords: against-all-odds, mixed-methods, Welfare State, long-term unemployment

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Authors: Maulana Ayoub Ali

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“Both Socialist as well as the capitalist in the economic systems have proven their failure to ensure economic justice that serves to benefit all in the society, both the rich and the poor. In particular, capitalism is currently causing a terrifying scenario by making the rich richer and the poor poorer” . In this paper, the author looks at the level of exploitation which is taking place to small and middle entrepreneurs (SME’s), government and private employees as well as large investors in East African countries who depends on interest-based loans which undermines their lives every day due to heavy monthly returns. Numbers of families have been evicted from their family premises and SME’s properties have been attached in the courts due to failure to return their loans timely. In fact, there are a lot of issues which have taken place on the ground which badly affected number of families socially and most importantly economically due to engagement in interest-based loans offered by commercial banks in East Africa. This paper looks on the alternative ways of eliminating interest-based loans to better lives of devastated Africans who are almost “dying” of heavy debts generated through higher interest loans. Reaching to that particular root the author has visited various literatures in a bid to deeply investigate and find out the best alternative mode of enabling African SME’s, businessmen and employees to benefit from the interest-free loans. The question is whether interest-free loans can be a long term solution towards poverty alleviation in East Africa generally and Tanzania in particular.

Keywords: interest-free loans, SME’s, financial institutions, poverty, east Africa

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Hulya Ilyasoglu Buyukkestelli, Sedef Nehir El

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Lutein is a member of xanthophyll group of carotenoids found in fruits and vegetables. Lutein accumulates in the macula region of the retina and known as macular pigment which absorbs damaging light in the blue wavelengths. The presence of lutein in retina has been related to decreased risk of two common eye diseases, age-related macular degeneration, and cataract. Being a strong antioxidant, it may also have effects on prevention some types of cancer, cardiovascular disease, cognitive dysfunction. Humans are not capable of synthesizing lutein de novo; therefore it must be provided naturally by the diet, fortified foods, and beverages or nutritional supplement. However, poor bioavailability and physicochemical stability limit its usage in the food industry. Poor solubility in digestive fluids and sensitivity to heat, light, and oxygen are both affect the stability and bioavailability of lutein. In this context, new technologies, delivery systems and formulations have been applied to improve stability and solubility of lutein. Nanotechnology, including nanoemulsion, nanocrystal, nanoencapsulation technology and microencapsulation by complex coacervation, spray drying are promising ways of increasing solubilization of lutein and stability of it in different conditions. Bioavailability of lutein is also dependent on formulations used, starch formulations and milk proteins, especially sodium caseinate are found effective in improving the bioavailability of lutein. Designing foods with highly bioavailable and stabile lutein needs knowledge about current technologies, formulations, and further needs. This review provides an overview of the new technologies and formulations used to improve bioavailability of lutein and also gives a future outlook to food researches.

Keywords: bioavailability, formulation, lutein, nanotechnology

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Authors: Dan Richard D. Fernandez

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This study determined the perspectives of community health workers’ perspectives in the sustainability of primary health care. Eight community health workers, two community officials and a rural health midwife in a rural community in the in the Philippines were enjoined to share their perspectives in the sustainability of primary health care. The study utilized the critical research method. The critical research assumes that there are ‘dominated’ or ‘marginalized’ groups whose interests are not best served by existing societal structures. Their experiences highlighted that the challenges of their role include unkind and uncooperative patients, the lack of institutional support mechanisms and conflict of their roles with their family responsibilities. Their most revealing insight is the belief that primary health care is within their grasp. Finally, they believe that the burden to sustain primary health care rests on their shoulders alone. This study establishes that Multi-stakeholder participation is and Gender-sensitivity is integral to the sustainability of Primary Health Care. It also observed that the ingrained Expert-Novice or Top-down Management Culture and the marginalisation of BHWs within the system is a threat to PHC sustainability. This study also recommends to expand the study and to involve the local government units and academe in lobbying the integration of gender-sensitivity and multi-stake participatory approaches to health workforce policies. Finally, this study recognised that the CHWs’ role is indispensable to the sustainability of primary health care.

Keywords: community health workers, multi-stakeholder participation, sustainability, gender-sensitivity

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Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

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Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29)，the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

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Authors: Joe Voshall, Leigha Shoup

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In 2022, the Ohio Peace Officer Training Council and the Attorney General required officers to complete a minimum of 24 hours of continued professional training for the year. Much of the training was based on Mental Health or similarly related topics. This includes Officer Wellness and Officer Mental Health. It is becoming clearer that the stigma of Officer / First Responder Mental Health is a topic that is becoming more prevalently faced. To assist officers and first responders in facing mental health issues, we are developing new training. This training will aid in recognizing mental health-related issues in officers/first responders and citizens, as well as further using the same information to better respond and interact with one another and the public. In general, society has many varying views of mental health, much of which is largely over-sensationalized by television, movies, and other forms of entertainment. There has also been a stigma in law enforcement / first responders related to mental health and being weak as a result of on-the-job-related trauma-induced struggles. It is our hope this new training will assist officers and first responders in not only positively facing and addressing their mental health but using their own experience and education to recognize signs and symptoms of mental health within individuals in the community. Further, we hope that through this recognition, officers and first responders can use their experiences and more in-depth understanding to better interact within the field and with the public. Through recognition and better understanding of mental health issues and more positive interaction with the public, additional achievements are likely to result. This includes in the removal of bias and stigma for everyone.

Keywords: law enforcement, mental health, officer related mental health, trauma

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Authors: Abdelsalam Omran Gebril

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Pollution and solid waste are the most important environmental problems plaguing the city of Benghazi as well as other cities and towns in Libya. These problems are caused by the lack of environmental planning and sound environmental management. Environmental planning is very important at present for the development of projects that preserve the environment, therefore, the planning process should be prioritized over the management process. Pollution caused by poor planning and environmental management exists not only in Benghazi but also in all other Libyan cities. This study was conducted through various field visits to several neighborhoods and areas within Benghazi as well as its neighboring regions. Follow-ups in these areas were conducted from March 2013 to October 2013 and documented by photographs. The existing methods of waste collection and means of transportation were investigated. Interviews were conducted with relevant authorities, including the Environment Public Authority in Benghazi and the Public Service Company of Benghazi. The objective of this study is to determine the causes of solid waste pollution in Benghazi City and its surrounding areas. Results show that solid waste pollution in Benghazi and its surrounding areas is the result of poor planning and environmental management, population growth, and the lack of hardware and equipment for the collection and transport of waste from the city to the landfill site. One of the most important recommendations in this study is the development of a complete and comprehensive plan that includes environmental planning and environmental management to reduce solid waste pollution.

Keywords: solid waste, pollution, environmental planning, management, Benghazi, Libya

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Authors: Chu Wan-Loy, Kok Yih-Yih, Choong Siew-Ling

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The human health risks due to poor air quality caused by a wide array of microorganisms have attracted much interest. Airborne algae have been reported as early as 19th century and they can be found in the air of tropic and warm atmospheres. Airborne algae normally originate from water surfaces, soil, trees, buildings and rock surfaces. It is estimated that at least 2880 algal cells are inhaled per day by human. However, there are relatively little data published on airborne algae and its related adverse health effects except sporadic reports of algae associated clinical allergenicity. A collection of airborne algae cultures has been established following a recent survey on the occurrence of airborne algae in indoor and outdoor environments in Kuala Lumpur. The aim of this study was to investigate the allergenic potential of the isolated airborne green and blue-green algae, namely Scenedesmus sp., Cylindrospermum sp. and Hapalosiphon sp.. The suspensions of freeze-dried airborne algae were adminstered into balb-c mice model through intra-nasal route to determine their allergenic potential. Results showed that Scenedesmus sp. (1 mg/mL) increased the systemic Ig E levels in mice by 3-8 fold compared to pre-treatment. On the other hand, Cylindrospermum sp. and Hapalosiphon sp. at similar concentration caused the Ig E to increase by 2-4 fold. The potential of airborne algae causing Ig E mediated type 1 hypersensitivity was elucidated using other immunological markers such as cytokine interleukin (IL)- 4, 5, 6 and interferon-ɣ. When we compared the amount of interleukins in mouse serum between day 0 and day 53 (day of sacrifice), Hapalosiphon sp. (1mg/mL) increased the expression of IL4 and 6 by 8 fold while the Cylindrospermum sp. (1mg/mL) increased the expression of IL4 and IFɣ by 8 and 2 fold respectively. In conclusion, repeated exposure to the three selected airborne algae may stimulate the immune response and generate Ig E in a mouse model.

Keywords: airborne algae, respiratory, allergenic, immune response, Malaysia

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Authors: Rida Wanbha Nongbri, Sabuj Kumar Mandal

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The Sustainable Development Goals (SDGs) for 2016-2030 were adopted in response to Millennium Development Goals (MDGs) which focused on access to sustainable water and sanitations. For over a decade, water has been a significant subject that is explored in various facets of life. Our day-to-day life is significantly impacted by water poverty at the socio-economic level. Reducing water poverty is an important policy challenge, particularly in emerging economies like India, owing to its population growth, huge variation in topology and climatic factors. To design appropriate water policies and its effectiveness, a proper measurement of water poverty is essential. In this backdrop, this study uses the Alkire Foster (AF) methodology to estimate a multidimensional water poverty index for India at the household level. The methodology captures several attributes to understand the complex issues related to households’ water deprivation. The study employs two rounds of Indian Human Development Survey data (IHDS 2005 and 2012) which focuses on 4 dimensions of water poverty including water access, water quantity, water quality, and water capacity, and seven indicators capturing these four dimensions. In order to quantify water deprivation at the household level, an AF dual cut-off counting method is applied and Multidimensional Water Poverty Index (MWPI) is calculated as the product of Headcount Ratio (Incidence) and average share of weighted dimension (Intensity). The results identify deprivation across all dimensions at the country level and show that a large proportion of household in India is deprived of quality water and suffers from water access in both 2005 and 2012 survey rounds. The comparison between the rural and urban households shows that higher ratio of the rural households are multidimensionally water poor as compared to their urban counterparts. Among the four dimensions of water poverty, water quality is found to be the most significant one for both rural and urban households. In 2005 round, almost 99.3% of households are water poor for at least one of the four dimensions, and among the water poor households, the intensity of water poverty is 54.7%. These values do not change significantly in 2012 round, but we could observe significance differences across the dimensions. States like Bihar, Tamil Nadu, and Andhra Pradesh are ranked the most in terms of MWPI, whereas Sikkim, Arunachal Pradesh and Chandigarh are ranked the lowest in 2005 round. Similarly, in 2012 round, Bihar, Uttar Pradesh and Orissa rank the highest in terms of MWPI, whereas Goa, Nagaland and Arunachal Pradesh rank the lowest. The policy implications of this study can be multifaceted. It can urge the policy makers to focus either on the impoverished households with lower intensity levels of water poverty to minimize total number of water poor households or can focus on those household with high intensity of water poverty to achieve an overall reduction in MWPI.

Keywords: .alkire-foster (AF) methodology, deprivation, dual cut-off, multidimensional water poverty index (MWPI)

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Authors: Shedy Maharani Nariswari, Prima Agustia Nova, I. Made Kariasa

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Background. Heart Failure (HF) is a chronic and progressive condition associated with significant morbidity, mortality, health care expenditures, and a high readmission rate over the years. Self‐care is essential to manage chronic heart failure in the long term, and it is related to better outcomes and can enhance the quality of life. Objective. The aims of this study were to describe the relationship between self-care behavior and quality of life among heart failure patients in East Jakarta, Indonesia. Methods. This study used a correlational-descriptive design with a cross-sectional study, the sampling method used purposive sampling method. Self-care was measured using Self-care Heart Failure Index version 6.2, and quality of life was measured using The Minnesota Living with Heart Failure. Pearson correlation and Spearman-rho correlations are used to analyze the data. Results. We recruited 103 patients with HF in both outpatient and inpatient ward: mean age 59.26 ± 11.643 years, 63.1% male. Patients with higher levels of education were associated with higher self-care maintenance (p= 0.007). The patient's average quality of life is quite high, with a score of 72,07 ± 16,89. There were a significant relationship among self-care maintenance (r=0,305, p=0,001), self-care management (r=0,330, p=0,001), and self-care confidence (r=0,335, p=0,001) towards the quality of life. Most participants have inadequate self-care maintenance, self-care management, and self-care confidence (score < 70), while the score of quality of life is categorized as poor. Conclusion. The self-care behaviors were limited among patients living with HF in Indonesia yet was associated with better quality of life. It is necessary to promote health related to knowledge and adherence to self-care behavior so that it can improve the quality of life of heart failure patients. This study can be used as a reference to promote self-care among patients with heart failure, it can help to enhance their quality of life.

Keywords: heart failure, self-care maintenance, self-care management, self-care confidence, quality of life

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Authors: Shahjada Selim

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Background: Erectile dysfunction (ED) is an important impediment to quality of life of men. ED is approximate, three times more common in diabetic than non-diabetic men, and diabetic men develop ED earlier than age-matched non-diabetic subjects. Glycemic control and other factors may contribute in developing and or deteriorating ED. Aim: The aim of the study was to determine the prevalence of ED and its risk factors in type 2 diabetic (T2DM) men in Bangladesh. Methods: During 2013-2014, 3980 diabetic men aged 30-69 years were interviewed at the out-patient departments of seven diabetic centers in Dhaka by using the validated Bengali version of the questionnaire of the International index of erectile function (IIEF) for evaluation of baseline erectile function (EF). The indexes indicate a very high correlation between the items and the questionnaire is consistently reliable. Data were analyzed with Chi-squared (χ²) test using SPSS software. P ≤ 0.05 was considered significant. Results: Out of 3790, ED was found in 2046 (53.98%) of T2DM men. The prevalence of ED was increased with age from 10.5% in men aged 30-39 years to 33.6% in those aged over 60 years (P < 0.001). In comparison with patients with reported diabetes lasting ≤ 5 years (26.4%), the prevalence of ED was less than in those with diabetes of 6-11 years (35.3%) and of 12-30 years (42.5%, P <0.001). ED increased significantly in those who had poor glycemic control. The prevalence of ED in patients with good, fair and poor glycemic control was 22.8%, 42.5% and 47.9% respectively (P = 0.004). Treatment modalities (medical nutrition therapy, oral agents, insulin, and insulin plus oral agents) had significant association with ED and its severity (P < 0.001). Conclusion: Prevalence of ED is very high among T2DM men in Bangladesh and can be reduced the burden by improving glycemic status. Glycemic control, duration of diabetes, treatment modalities, increasing age are associated with ED.

Keywords: erectile dysfunction, diabetes, men, Bangladesh

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Authors: Marcel Duh, Jadranka Stricevic, David Halozan, Dusan Celan

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Back pain is not only the result of structural or biomechanical abnormalities of the spine but is also associated with cognitive and behavioral aspects of pain and thus represents biopsychosocial problem. Stressors are not only interpersonal conflicts, negative life events, and dangerous situations but also noise. Effects of noise on human beings are psychological (excitement, stress), sensory, and physiological. The harmful effects of noise can be seen in the 40-65 dB range and are manifested as fatigue, irritability, poor sleep and psychological discomfort of the worker. Within 65-90 dB range, body metabolism increases, oxygen consumption is higher, tachycardia and hypertension appear, and the tone of skeletal muscles increases. The purpose of the study was to determine whether the stress caused by noise at the work place increases the incidence of back pain. Measurements of noise levels were carried out in three different wards of social care institution. The measurement on each ward was repeated 3 times (total of 9 measurements) for 8 hours during the morning shift. The device was set up in the room where clients spent most of the day. The staff on the ward replied to the questionnaire consisting of closed type questions about basic demographic information and information about back pain. We find that noise levels as measured in our study had no statistically significant effect on the incidence of back pain (p = 0.90). We also find that health care workers who perceive their work as stressful, have more back pain than those who perceive their job as unstressful, but correlation is statistically insignificant (p = 0.682). With our study, we have proven findings of other authors, that noise level below 65 dB does not have a significant influence on the incidence of back pain.

Keywords: health care workers, musculoskeletal disorder, noise, sick leave

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Authors: Gunjan Razdan, Priyanka Sreenath, Jagannath Behera, S. K. Mishra, Sunil Mehra

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Uttar Pradesh is one of the poor performing states with high Malnutrition and Anaemia among adolescent girls resulting in high MMR, IMR and low birth weight rate. The rate of anaemia among adolescent girls has doubled in the past decade. Adolescents gain around 15-20% of their optimum height, 25-50% of the ideal adult weight and 45% of the skeletal mass by the age of 19. Poor intake of energy, protein and other nutrients is one of the factors for malnutrition and anaemia. METHODS: The cross-sectional survey using a mixed method (quantitative and qualitative) was adopted in this study. The respondents (adolescents, parents and frontline health workers) were selected randomly from 30 villages and surveyed through a semi-structured questionnaire for qualitative information and FGDs and IDIs for qualitative information. A 24 hours dietary recall method was adopted to estimate their dietary practices. A total of 1069 adolescent girls, 1067 boys, 1774 parents and 69 frontline functionaries were covered under the study. Percentages and mean were calculated for quantitative variable, and content analysis was carried out for qualitative data. RESULTS: Over 80 % of parents provided assertions that they understood the term balanced diet and strongly felt that their children were having balanced diet. However, only negligible 1.5 % of parents could correctly recount essential eight food groups and 22% could tell about four groups which was the minimum response expected to say respondents had fair knowledge on a balanced diet. Only 10 percent of parents could tell that balanced diet helps in physical and mental growth and only 2% said it has a protective role. Besides, qualitative data shows that the perception regarding balanced diet is having costly food items like nuts and fruits. The dietary intake of adolescents is very low despite the increased iron needs associated with physical growth and puberty.The consumption of green leafy vegetables (less than 35 %) and citrus fruits (less than 50%) was found to be low. CONCLUSIONS: The assertions on an understanding of term balanced diet are contradictory to the actual knowledge and practices. Knowledge on essential food groups and nutrients is crucial to inculcate healthy eating practices among adolescents. This calls for comprehensive communication efforts to improve the knowledge and dietary practices among adolescents.

Keywords: anemia, knowledge, malnutrition, perceptions

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