Search results for: university students' health

Authors: Pedro Augusto Da Silva E Souza Miranda, Niloofar Jalali, Shweta Mistry

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BACKGROUND: Software developers utilize automated solutions to scrape users’ reviews to extract meaningful knowledge to identify problems (e.g., bugs, compatibility issues) and possible enhancements (e.g., users’ requests) to their solutions. However, most of these solutions do not consider the health risk aspects to users. Recent works have shed light on the importance of including health risk considerations in the development cycle of mHealth apps to prevent harm to its users. PROBLEM: The COVID-19 Pandemic in Canada (and World) is currently forcing physical distancing upon the general population. This new lifestyle made the usage of mHealth applications more essential than ever, with a projected market forecast of 332 billion dollars by 2025. However, this new insurgency in mHealth usage comes with possible risks to users’ health due to mHealth apps problems (e.g., wrong insulin dosage indication due to a UI error). OBJECTIVE: These works aim to raise awareness amongst mHealth developers of the importance of considering risks to users’ health within their development lifecycle. Moreover, this work also aims to help mHealth developers with a Proof-of-Concept (POC) solution to understand, process, and identify possible health risks to users of mHealth apps based on users’ reviews. METHODS: We conducted a mixed-method study design. We developed a crawler to mine the negative reviews from two samples of mHealth apps (my fitness, medisafe) from the Google Play store users. For each mHealth app, we performed the following steps: • The reviews are divided into two groups, before starting the COVID-19 (reviews’ submission date before 15 Feb 2019) and during the COVID-19 (reviews’ submission date starts from 16 Feb 2019 till Dec 2020). For each period, the Latent Dirichlet Allocation (LDA) topic model was used to identify the different clusters of reviews based on similar topics of review The topics before and during COVID-19 are compared, and the significant difference in frequency and severity of similar topics are identified. RESULTS: We successfully scraped, filtered, processed, and identified health-related topics in both qualitative and quantitative approaches. The results demonstrated the similarity between topics before and during the COVID-19.

Keywords: natural language processing (NLP), topic modeling, mHealth, COVID-19, software engineering, telemedicine, health risks

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Authors: S. J. Sirima, C. Thirawan, R.Puntharikorn, K. Ungsumalin, J. Kaemwich

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Acinetobacter spp. is a gram negative bacterium causing the high incidence of multi-drug resistance in patients admitted to an intensive care unit. A hundred isolates of Imipenem-resistant Acinetobacter spp. isolated from patients admitted at tertiary health care center, Northeastern region, Ubon Ratchathani, Thailand, were subjected to modified Hodge test and combined disc test in order to evaluate the production of carbapenemases. The results revealed that about 35% of isolates were found to be carbapenemases producers. In addition, multiplex polymerase chain reactions were performed to detect blaOXA-like genes. It showed that 92% of isolates possess blaOXA-51-like and blaOXA-23-like genes. However, blaOXA-58-like gene was detected in only 8 isolates. No detection of blaOXA-24-like gene was observed in all isolates. In conclusion, an ability to produce carbepenemases would be an important mechanism of multi-drug resistance among clinical isolates of Acinetobacter spp. at tertiary health care center, Northeastern region, Ubon Ratchathani, Thailand. Furthermore, it was likely that the class D carbapenemases genes, blaOXA-51-like and blaOXA-23-like, might contribute to imipenem-resistance exhibiting among isolates.

Keywords: Acinetobacter spp., blaOXA-like genes, carbapenemases, tertiary health care center

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Authors: Khaleel Alyahya, Faizah Alotaibi

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The coronavirus disease 19 (COVID-19) pandemic has caused an increase in general fear and anxiety around the globe. With the public health measures, including lockdown and travel restrictions, the COVID-19 period further resulted in a sudden increase in the vulnerability of people too ill mental health. This becomes greater among individuals who have a history of mental illness or are undergoing treatment and do not have easy access to medication and medical consultations. The study aims to measure the impact of COVID-19 and the degree of distress with the DASS scale on the mental health of residents living in Saudi Arabia. The study is a quantitative, observational, and cross-sectional conducted in Saudi Arabia to measure the impact of COVID-19 on the mental health of both citizens and residents of Saudi Arabia during pandemics. The study ran from February 2021 to June 2021, and a validated questionnaire was used. The targeted population of the study was Saudi citizens and non-Saudi residents. A sample size of 800 participants was calculated with a single proportion formula at 95% level of significance and 5% allowable error. The result revealed that participants who were always doing exercise experienced the lowest level of depression, anxiety, and stress. The highest prevalence of severe and extremely severe depression was among participants who sometimes do exercise at 53.2% for each. Similar results were obtained for anxiety and stress, where the extremely severe form was reported by those who sometimes did exercise at 54.8% and 72.2%, respectively. There was an inverse association between physical activity levels and levels of depression, anxiety, and stress during the COVID-19. Similarly, the levels of depression, anxiety, and stress differed significantly according to the exercise frequency during COVID-19.

Keywords: mental, COVID-19, pandemic, lockdown, depression, anxiety, stress

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Authors: Maha Rashid Al-Azib, Almuzn Qasem Alqathradi, Amal Munir Alshahrani, Bilqis Mohammed Assiri, Ali Almuflih

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The Occupational Safety and Health Management System in one of the largest Saudi companies has been experiencing in the last 10 years extensive direct and indirect expenses due to lack of proactive leading indicators and safety leadership effective procedures. And since there are no studies that are associated with this department of safety in the company, this research has been conducted. In this study we used a mixed method approach containing a literature review and experts input, then a qualitative questionnaire provided by Institute for Work and Health related to determining the company’s occupational safety and health management system level out from three levels (Compliance - Improvement - Continuous Learning) and the output regarding the company’s level was in Continuous Learning. After that Deming cycle was employed to create a set of proactive leading indicators and analyzed using the SMART method to make sure of its effectiveness and suitability to the company. The objective of this research is to provide a set of proactive indicators to contribute in making an efficient occupational safety and health management system that has less accidents which results in less expenses. Therefore, we provided the company with a prototype of an APP, designed and empowered with our final results to contribute in supporting decisions making processes.

Keywords: proactive leading indicators, OSH MS, safety leadership, accidents reduction

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Authors: Hela Ghali, Oumayma Ben Amor, Salwa Khefacha, Mohamed Ben Rejeb, Sirine Frigui, Meriam Tourki Dhidah, Lamine Dhidah, Houyem Said Laatiri

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Background: Blood exposure accidents are the most common problem in hospitals that threaten healthcare professionals with a high risk of infectious complications which weighs heavily on health systems worldwide. Paramedics are the highest risk group due to the nature of their daily activities. We aimed to determine knowledge and attitudes about the management of blood-exposure accidents among nurses and technicians in two pediatric departments. Materials/Methods: This is a cross-sectional descriptive study conducted on March 2017, carried out with the care staff of the pediatric ward of the Farhat Hached Teaching Hospital of Sousse and pediatric surgery of the Fattouma Bourguiba University Hospital in Monastir, using a pre- tested and self-administered questionnaire. Data entry and analysis were performed using Excel software. Results: The response rate was 85.1%. A female predominance (82.5%) was reported among respondents with a sex ratio of 0.21. 80% of the participants were under 35 years old. Seniority of less than 10 years was found in 77.5% of respondents. Only 22.5% knew the definition of a blood- exposure accident. 100% and 95% of participants reported the relative risk, respectively, to hepatitis and AIDS viruses. However, only 15% recognized the severity factors of a blood-exposure accident. Hygiene compliance was the most important dimension for almost the entire population for the prevention. On the other hand, only 12.5% knew the meaning of 'standard precautions' and ¼ considered them necessary for at-risk patients only. 40% reported being exposed at least once, among them, 87.5% used betadine, and 77.5% said that anti-infectious chemoprophylaxis is necessary regardless of the patient's serological status. However, 52.5% did not know the official reporting circuit of management of blood-exposure accident in their institutions. Conclusion: For better management of risks in hospitals and an improvement of the safety of the care, a reinforcement of the sensibilization of the caregivers with regard to the risks of blood exposure accident is necessary, while developing their knowledge to act in security.

Keywords: attitudes, blood-exposure accident, knowledge, pediatric department

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Authors: A. C. Obosi, H. O. Osinowo, L. I. Okeke

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Benign prostatic hyperplasia (BPH) is one among other prostate diseases with an increasing public health concern. The prevalence and increased psychological distress of BPH among men negatively impact on their health-related quality of life (HRQoL). Although several biomedical factors have been implicated in poor HRQoL among people with BPH, there is a dearth of research on the psychosocial factors predicting HRQoL among them especially in developing climes. This study, therefore, examined the psychosocial (knowledge, perceived stigma, depression, anxiety, perceived social support and illness acceptance) predictors of health-related quality of life among persons living with BPH in Ibadan, Nigeria. Biopsychosocial model and Health-related Quality of life guided this study which utilized ex-post facto design. Eighty-seven males living with BPH were purposively selected and actively participated in the study. Participants’ mean age was 61.77 ± 15.80 years. A standardized questionnaire comprising Socio-demographics and measures of health-related quality of life (α = 0.47); knowledge (α = 0.72); psychological distress (α = 0.95); perceived social support (α = 0.96) and Illness acceptance (α = 0.89) scales was utilized in the study. Data were content analysed, while bivariate correlation, hierarchical multiple regression and t-test for independent samples were computed at p < 0.05. Results revealed that 42.5% of the respondents reported poor HRQoL. Furthermore, age, length of illness, perceived stigma, depression, anxiety, knowledge, perceived social support and illness acceptance jointly predicted HRQoL significantly (R2=0.33, F(9,75)=4.05) and accounted for 33% variance in the total observed variance on HRQoL, while Illness acceptance (β=0.43), anxiety (β=-0.54), and perceived social support (β=0.16) had significant independent contributions to the observed variance on HRQoL. Illness acceptance, knowledge, perceived social support and psychological distress such as anxiety, depression and perceived stigma are important predictors of HRQoL. Therefore, it was recommended that urgent psychological intervention targeted at improving the quality of life of these persons be undertaken.

Keywords: benign prostatic hyperplasia, Health-related quality of life, prostate disorders, psychosocial factors

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Authors: Anthoni Jeorge

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Throughout the history of the world, servant leadership has been researched, and favourable results such as individual, team, and organizational have been linked to the construct. This research paper designates St. Camillus de Lellis, a practitioner of servant leadership and founder of the Ministers of the Sick as a servant leader in his approach to care for the sick. Service is the visible face of his servant leadership. First of all, despite many challenges, St. Camillus de Lellis practiced leadership by the example of compassionate service to the sick. Second, he made service to the sick the highest priority of his life. Third, Camillus displayed servant leadership such that his manner of leadership gave birth to a New School of Service to the Sick. The paper identifies the distinctive dimensions and essential elements which characterized his service-centered leadership. Furthermore, discuss the six major characteristics of a servant leader as set forth by St. Camillus’s life example. The research illustrates the transformational power of servant leadership infield healthcare in general and, in doing so, provides servant leadership seekers ways servant leadership can transform elder care in one’s own field (St. Camillus Health Systems). Thus, it ascertains that servant leadership is best-fit for humanized elder care. Supported by the review of literature, the paper ascertains that Camillus, by identifying himself with the sick, gained deeper insights concerning the pain and suffering of the population. Uniquely drawn from his true grit, Camillus’ service-centered leadership is value-based, people-oriented, and compassion-filled. His way of service to the sick is the prolongation of gestures of mercy and compassion. It is hoped that the results of this study will help health care workers and servant leadership practitioners to humanize elder care and cultivate servant leadership attitude in their health care services to the sick. By incorporating such service-oriented elements into their leadership orientation, health care workers will be true servant leaders of the sick.

Keywords: leadership, service, healthcare, compassion

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Authors: Oskar Sekowski

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Current global warming causes changes in the traditional zones of viticulture worldwide. During 20th century, the average global air temperature increased by 0.89˚C. The models of climate change indicate that viticulture, currently concentrating in narrow geographic niches, may move towards the poles, to higher geographic latitudes. Global warming may cause changes in traditional viticulture regions. Therefore, there is a need to estimate the climatic conditions and climate change in areas that are not traditionally associated with viticulture, e.g., Poland. The primary objective of this paper is to prepare methodology to evaluate the climatic and meteorological potential for viticulture in Poland based on a case study. Moreover, the additional aim is to evaluate the climatic potential of a mesoregion where a university vineyard is located. The daily data of temperature, precipitation, insolation, and wind speed (1988-2018) from the meteorological station located in Łazy, southern Poland, was used to evaluate 15 climatological parameters and indices connected with viticulture. The next steps of the methodology are based on Geographic Information System methods. The topographical factors such as a slope gradient and slope exposure were created using Digital Elevation Models. The spatial distribution of climatological elements was interpolated by ordinary kriging. The values of each factor and indices were also ranked and classified. The viticultural potential was determined by integrating two suitability maps, i.e., the topographical and climatic ones, and by calculating the average for each pixel. Data analysis shows significant changes in heat accumulation indices that are driven by increases in maximum temperature, mostly increasing number of days with Tmax > 30˚C. The climatic conditions of this mesoregion are sufficient for vitis vinifera viticulture. The values of indicators and insolation are similar to those in the known wine regions located on similar geographical latitudes in Europe. The smallest threat to viticulture in study area is the occurrence of hail and the highest occurrence of frost in the winter. This research provides the basis for evaluating general suitability and climatologic potential for viticulture in Poland. To characterize the climatic potential for viticulture, it is necessary to assess the suitability of all climatological and topographical factors that can influence viticulture. The methodology used in this case study shows places where there is a possibility to create vineyards. It may also be helpful for wine-makers to select grape varieties.

Keywords: climatologic potential, climatic classification, Poland, viticulture

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Authors: Piotr Romaniuk, Krzysztof Kaczmarek, Adam Szromek

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Background: A number of approaches to assess the performance of health system have been proposed so far. Nonetheless, they lack a consensus regarding the key components of assessment procedure and criteria of evaluation. The WHO and OECD have developed methods of assessing health system to counteract the underlying issues, but they are not free of controversies and did not manage to produce a commonly accepted consensus. The aim of the study: On the basis of WHO and OECD approaches we decided to develop own methodology to assess the performance of health systems in Central and Eastern European countries. We have applied the method to compare the effects of health systems reforms in 20 countries of the region, in order to evaluate the dynamic of changes in terms of health system outcomes.Methods: Data was collected from a 25-year time period after the fall of communism, subsetted into different post-reform stages. Datasets collected from individual countries underwent one-, two- or multi-dimensional statistical analyses, and the Synthetic Measure of health system Outcomes (SMO) was calculated, on the basis of the method of zeroed unitarization. A map of dynamics of changes over time across the region was constructed. Results: When making a comparative analysis of the tested group in terms of the average SMO value throughout the analyzed period, we noticed some differences, although the gaps between individual countries were small. The countries with the highest SMO were the Czech Republic, Estonia, Poland, Hungary and Slovenia, while the lowest was in Ukraine, Russia, Moldova, Georgia, Albania, and Armenia. Countries differ in terms of the range of SMO value changes throughout the analyzed period. The dynamics of change is high in the case of Estonia and Latvia, moderate in the case of Poland, Hungary, Czech Republic, Croatia, Russia and Moldova, and small when it comes to Belarus, Ukraine, Macedonia, Lithuania, and Georgia. This information reveals fluctuation dynamics of the measured value in time, yet it does not necessarily mean that in such a dynamic range an improvement appears in a given country. In reality, some of the countries moved from on the scale with different effects. Albania decreased the level of health system outcomes while Armenia and Georgia made progress, but lost distance to leaders in the region. On the other hand, Latvia and Estonia showed the most dynamic progress in improving the outcomes. Conclusions: Countries that have decided to implement comprehensive health reform have achieved a positive result in terms of further improvements in health system efficiency levels. Besides, a higher level of efficiency during the initial transition period generally positively determined the subsequent value of the efficiency index value, but not the dynamics of change. The paths of health system outcomes improvement are highly diverse between different countries. The instrument we propose constitutes a useful tool to evaluate the effectiveness of reform processes in post-communist countries, but more studies are needed to identify factors that may determine results obtained by individual countries, as well as to eliminate the limitations of methodology we applied.

Keywords: health system outcomes, health reforms, health system assessment, health system evaluation

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Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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Authors: Eva Šmelová, Alena Berčíková

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The issue of school maturity and readiness of a child for a successful start of compulsory education is one of the long-term monitored areas, especially in the context of education and psychology. In the context of the curricular reform in the Czech Republic, the issue has recently gained importance. Analyses of research in this area suggest a lack of a broader overview of indicators informing about the current level of children’s school maturity and school readiness. Instead, various studies address partial issues. Between 2009 and 2013 a research study was performed at the Faculty of Education, Palacký University Olomouc (Czech Republic) focusing on children’s maturity and readiness for compulsory education. In this study, social skills were of marginal interest; the main focus was on the mental area. This previous research is smoothly linked with the present study, the objective of which is to identify the level of school maturity and school readiness in selected characteristics of social skills as part of the adaptation process after enrolment in compulsory education. In this context, the following research question has been formulated: During the process of adaptation to the school environment, which social skills are weakened? The method applied was observation, for the purposes of which the authors developed a research tool – record sheet with 11 items – social skills that a child should have by the end of preschool education. The items were assessed by first-grade teachers at the beginning of the school year. The degree of achievement and intensity of the skills were assessed for each child using an assessment scale. In the research, the authors monitored a total of three independent variables (gender, postponement of school attendance, participation in inclusive education). The effect of these independent variables was monitored using 11 dependent variables. These variables are represented by the results achieved in selected social skills. Statistical data processing was assisted by the Computer Centre of Palacký University Olomouc. Statistical calculations were performed using SPSS v. 12.0 for Windows and STATISTICA: StatSoft STATISTICA CR, Cz (software system for data analysis). The research sample comprised 115 children. In their paper, the authors present the results of the research and at the same time point to possible areas of further investigation. They also highlight possible risks associated with weakened social skills.

Keywords: compulsory education, curricular reform, educational diagnostics, pupil, school curriculum, school maturity, school readiness, social skills

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Authors: Hong Wu, Naiji Lu

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Improvement of health behavior among people with chronic diseases is vital for increasing longevity and enhancing quality of life. This paper researched the causal effects of informal care on the compliance with doctor’s health advices – smoking control, dietetic regulation, weight control and keep exercising – among older people with chronic diseases in China, which is facing the challenge of aging. We addressed the selection bias by using propensity score matching in the estimation process. We used the 2011-2012 national baseline data of the China Health and Retirement Longitudinal Study. Our results showed informal care can help improve health behavior of older people. First, informal care improved the compliance of smoking controls: whether smoke, frequency of smoking, and the time lag between wake up and the first cigarette was all lower for these older people with informal care; Second, for dietetic regulation, older people with informal care had more meals every day than older people without informal care; Third, three variables: BMI, whether gain weight and whether lose weight were used to measure the outcome of weight control. There were no significant difference between group with informal care and that without for BMI and the possibility of losing weight. Older people with informal care had lower possibility of gain weight than that without; Last, for the advice of keeping exercising, informal care increased the probability of walking exercise, however, the difference between groups for moderate and vigorous exercise were not significant. Our results indicate policy makers who aim to decrease accidents should take informal care to elders into account and provide an appropriate policy to meet the demand of informal care. Our birth policy and postponed retirement policy may decrease the informal caregiving hours, so adjustments of these policies are important and urgent to meet the current situation of aged tendency of population. In addition, government could give more support to develop organizations to provide formal care, such as nursing home. We infer that formal care is also useful for health behavior improvements.

Keywords: chronic diseases, compliance, CHARLS, health advice, informal care, older people, propensity score matching

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Authors: Ghada M. AlSwayied, Anas N. AlHumaid

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Smoking has been linked to thousands of deaths worldwide. Around three million adults continue to use tobacco each day in Saudi Arabia; a sign that smoking is prevalent among Saudi population and obviously considered as a public health threat. Although the awareness against smoking is continuously running, it can be observed that smoking behavior increases noticeably as common practice especially among young adults across the world. Therefore, it was an essential step to guess what does motivate smokers to think about quit smoking. Can a graphic and emotional ad that is focusing on health consequences do really make a difference? A case study has been conducted on the Annual Anti-Smoking National Campaign, which was provided by Saudi Ministry of Health in the period of May 2017. To assess campaign’s effects on the number of calls, the number of visits and online access to health messages during and after the campaign period from May to August compared with the previous campaign in 2016. The educational video was selected as a primary tool to deliver the smoking health message. The Minister of Health who is acting as a role model for young adults was used to deliver a direct message to smokers with an avoidance of smoking cues usage. Due to serious consequences of smoking, the Minister of Health delivered the news of canceling the media campaign and directing the budget to smoking cessation clinics. It was shown that the positive responses and interactions on the campaign were obviously remarkable; achieving a high rate of recall and recognition. During the campaign, the number of calls to book for a visit reached 45880 phone calls, and the total online views ran to 1,253,879. Whereas, clinic visit raised up to 213 cumulative percent. Interestingly, a total number of 15,192 patients visited the clinics along three months compared with the last year campaign’s period, which was merely 4850 patients. Furthermore, around half of patients who visited the clinics were in the age from 26 to 40-year-old. There was a great progress in enhancing public awareness on: 'where to go' to assist smokers in making a quit attempt. With regard to the stages of change theory, it was predicted that by following direct-message technique; the proportion of patients in the contemplation and preparation stages would be increased. There was no process evaluation obtained to assess implementation of the campaigns’ activities.

Keywords: smoking, health promotion, role model, educational material, intervention, community health

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Authors: Mikiyas Yonas Fufa

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- Maternal and child health service was a critical service which may have many risks and many maternal and newborn mortality is there if not managed properly. In middle and low countries like Ethiopia accessibility and quality of MCH service is low. During this COVID-19 Pandemics even the pervious access of MCH will be decreased. So many pregnant mothers are not attending their ANC, Delivery and other services in the hospital because they think they are more vulnerable to COVID-19. This condition may make an increase of maternal and neonatal morbidity and mortality. The innovation is an idea (which is development of a mobile app prepared by Maternity Foundation organization that focuses on midwifery care. The app has detailed videos on danger signs in pregnancy and procedures during labor and delivery). By telling this to clients it is planned to explore the perception, attitude towards this innovation and barriers to accepting it. What is planned to study is to explore the perceptions and barriers towards using of new idea which is innovation of mHealth on the MCH services. It is planned to interview the pregnant mothers who come for ANC at health facility and mothers who are absent from their appointment of services. In this way it is planned to explore how the mothers accept this idea and what barriers make them from accepting this idea. This is a phenomenological qualitative study and application of diffusion of innovation theory on the MCH services. The participant will be selected by using quota sampling methods for the mother who are interviewed at hospitals and snowball/quota sampling methods for the mother who are absent from their appointment/visits. Sample size of the participant depends on the saturation of data/idea. Each participant will be interviewed based the open-ended questionnaires, and the interview will be recorded then transcribed then finally analyzed by the open code 4.03. Beneficiaries: The federal ministry of health prepares them to develop the apk of mhealth. Health professionals in the MCH will have a low overload and accessibility and the quality of care will be increased during COVID-19 Different collaborations will be participated and promote the mother to enjoy the new idea.

Keywords: COVID-19, m health, MCH, diffusion of innovation

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Authors: Erfan Abdeldaim Mohamed Ahmed Abdalla

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The era of the knowledge explosion in which we live requires us to develop educational curricula quantitatively and qualitatively to adapt to the twenty-first-century skills of critical thinking, problem-solving, communication, cooperation, creativity, and innovation. The process of developing the curriculum is as significant as building it; in fact, the development of curricula may be more difficult than building them. And curriculum development includes analyzing needs, setting goals, designing the content and educational materials, creating language programs, developing teachers, applying for programmes in schools, monitoring and feedback, and then evaluating the language programme resulting from these processes. When we look back at the history of language teaching during the twentieth century, we find that developing the delivery method is the most crucial aspect of change in language teaching doctrines. The concept of delivery method in teaching is a systematic set of teaching practices based on a specific theory of language acquisition. This is a key consideration, as the process of development must include all the curriculum elements in its comprehensive sense: linguistically and non-linguistically. The various Arabic curricula provide the student with a set of units, each unit consisting of a set of linguistic elements. These elements are often not logically arranged, and more importantly, they neglect essential points and highlight other less important ones. Moreover, the educational curricula entail a great deal of monotony in the presentation of content, which makes it hard for the teacher to select adequate content; so that the teacher often navigates among diverse references to prepare a lesson and hardly finds the suitable one. Similarly, the student often gets bored when learning the Arabic language and fails to fulfill considerable progress in it. Therefore, the problem is not related to the lack of curricula, but the problem is the development of the curriculum with all its linguistic and non-linguistic elements in accordance with contemporary challenges and standards for teaching foreign languages. The Arabic library suffers from a lack of references for curriculum development. In this paper, the researcher investigates the elements of development, such as the teacher, content, methods, objectives, evaluation, and activities. Hence, a set of general guidelines in the field of educational development were reached. The paper highlights the need to identify weaknesses in educational curricula, decide the twenty-first-century skills that must be employed in Arabic education curricula, and the employment of foreign language teaching standards in current Arabic Curricula. The researcher assumes that the series of teaching Arabic to speakers of other languages in regular schools do not address the skills of the twenty-first century, which is what the researcher tries to apply in the proposed unit. The experimental method is the method of this study. It is based on two groups: experimental and control. The development of an educational unit will help build suitable educational series for students of the Arabic language in regular schools, in which twenty-first-century skills and standards for teaching foreign languages will be addressed and be more useful and attractive to students.

Keywords: curriculum, development, Arabic language, non-native, skills

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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Authors: Naira Poghosyan

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In knowledge society the content of the studies, the methods used and the requirements for an educator’s professionalism regularly undergo certain changes. It follows that in knowledge society the aim of education is not only to educate professionals for a certain field but also to help students to be aware of cultural values, form human mutual relationship, collaborate, be open, adapt to the new situation, creatively express their ideas, accept responsibility and challenge. In this viewpoint, the development of communicative language competence requires a through coordinated approach to ensure proper comprehension and memorization of subject-specific words starting from high school level. On the other hand, ESP (English for Specific Purposes) teachers and practitioners are increasingly faced with the task of developing and exploiting new ways of assessing their learners’ literacy while learning and teaching ESP. The presentation will highlight the latest achievements in this field. The author will present some practical methodological issues and principles associated with learning, teaching and assessing ESP skills of the learners, using the two software programs of EXE 2.0 and Hot Potatoes 6. On the one hand the author will display the advantages of the two programs as self-learning and self-assessment interactive tools in the course of academic study and professional development of the CLIL learners, on the other hand, she will comprehensively shed light upon some methodological aspects of working out appropriate ways of selection, introduction, consolidation of subject specific materials via EXE 2.0 and Hot Potatoes 6. Then the author will go further to distinguish ESP courses by the general nature of the learners’ specialty identifying three large categories of EST (English for Science and Technology), EBE (English for Business and Economics) and ESS (English for the Social Sciences). The cornerstone of the presentation will be the introduction of the subject titled “The methodology of teaching ESP in non-linguistic institutions”, where a unique case of teaching ESP on Architecture and Construction via EXE 2.0 and Hot Potatoes 6 will be introduced, exemplifying how the introduction, consolidation and assessment can be used as a basis for feedback to the ESP learners in a particular professional field.

Keywords: ESP competences, ESP skill assessment/ self-assessment tool, eXe 2.0 / HotPotatoes software program, ESP teaching strategies and techniques

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Authors: Tara Gurung, Suprina Prajapati

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Health and well being of people is a crucial for accomplishing sustainable development goals of any country. The present study focuses on quality of life of patients undergoing hemodialysis. Hemodialysis is a life sustaining treatment for patients with end stage renal disease (ESRD). Hemodialysis can bring about significant impairment in health related quality of life (HRQOL). The purpose of this study was to assess the quality of life of hemodialysis patients undergoing hemodialysis. A descriptive cross-sectional research design was utilized in total 100 samples using random sampling technique. The findings revealed that the total quality of life of the patients was 30.41±3.99 out of 100. The total physical component score was statistically significant with education status of the patients where p value for t test was 0.03 (p=0.03) and occupation of the patients where p value for the ANOVA test was 0.007 (p=0.007). The study recommended that it would be better if awareness programs regarding chronic kidney disease and life style modification in hemodialysis patients is given to the patients so that it would help patients to maintain the HRQOL.

Keywords: health and well bing, hemodialysis, patients quality of life

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Authors: Gabriel I. Oke, Faremi O. Ayodeji

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Background: Access to youth Friendly Health Corners is vital for ensuring sexual reproductive health and total well being of young Adults since human sexuality has been widely misunderstood. Meanwhile, behavior of young people towards it remains at variance with the alarm. This study attempt to access the impact of youth corners also called Adolescent Friendly Health Corners on manifestation of human sexual behavior among Nigerian adolescent and young adults. Description: Hundred young adults and adolescents of both sex between the Age range of 12-25years were randomly selected from 5 secondary schools and 3 prominent universities in Southwestern Nigeria and focal group discussions (FGD) were conducted among them. Fifty secondary and primary health facilities were visited between February and June 2017 to conduct interviews for health workers and to ascertain the presence or absence of youth corners. Results: 95% of the health facilities visited lack Youth Corners section neither are they willing to make provision for it due to lack of workmanship and sponsorship. However, 5% with Youth corners does not have well-trained Counselors or a Health Educator but health professionals from nursing profession. 90% of the respondents of which 16-17 years of Age is the mean age had their first sexual exposure with no use of protection even before been introduced to what Sexuality is all about. Virtually, none of the respondents had ever visited a Youth Corner before or heard the term before. 86% have heard about the term STI before of which 60% are using protection, 10% care less about any information attached to the term STI, 4% have not heard of the term STI before even when translated to their local dialect. 20% are abstaining as at the time the study was conducted and they attribute their sexual decision to religion and parental influence. Of the age group 20-25, 45% claimed they have had symptoms of one STI or the other and 40% claimed they have been tested positive for an STI before of which 12% have positive HIV status. Promiscuous behaviors were found among them before they reach the age 16years with pornography ranking the highest, followed by masturbation. Respondents blame this on peer pressure, the lack of Youth Friendly Centers in their locality and lack of proper Sexual Orientation on time. About half of the respondents make use of contraceptives while others have varying views. We found out that inability to access Youth Friendly Centers amongst the respondents might be one of the singular reasons of their early experimentation of their sex life and lack of healthy sexual lifestyle. (95% CI, P=0.922) Conclusion: The study reveals that a connection between youth Friendly Centers and Prevention of Sexually Transmitted Diseases, therefore more sustainable Friendly Youth Corners with well-trained educators are needed in various Health facilities to checkmate the numerous risks of Young People along the path of adulthood.

Keywords: adolescents, sexually transmitted infections, reproductive health, youth corners

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Authors: Aaron Akinloye

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This research examined the influence of jungle justice as it affects the emotional health challenges among residents in Lagos metropolitan city. Descriptive survey research design was used along with the questionnaire as research instrument. Population for the study comprised residents in Yaba and Shomolu Communities of Lagos State, Nigeria. Accidental sampling technique was used to sample 300 Residents. Self-developed questionnaire was used to obtain data on the variables under investigation. Research instrument was validated following the face, content, and construct validation of the instrument. Thereafter, the reliability coefficient yielded 0.84. It is therefore concluded and recommended that; there is a significant influence of jungle justice on trauma among residents- df (298) t= 2.33, p< 0.05; there is a significant influence of jungle justice on pressure among residents- df (298) t= 2.16, p< 0.05: there is a significant influence of jungle justice on fear among residents- df (298) t= 2.20, p< 0.05; there is a significant influence of jungle justice on depression among residents- df (298) t= 2.14, p< 0.05. Recommendations were made that; there should be deliberate effort to implement comprehensive awareness campaigns to educate the residents on the detrimental effects of jungle justice on individuals and the community members as a whole; there should be an improvement in the effectiveness and efficiency of the existing law enforcement agencies in Lagos metropolitan city; development and implementation of support systems for victims of jungle justice, which include trauma, counselling, mental health services, and rehabilitation programmes; there should be proper review and revision of the legal framework to address the issue of jungle justice effectively.

Keywords: jungle justice, emotional health, depression, fear

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Authors: Rattanathip Rattanachai, Kunyanuth Kularbphettong

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This paper describes the development of a Vegetation Searching System based on Web Application in case of Suan Sunandha Rajabhat University. The model was developed by PHP, JavaScript, and MySQL database system and it was designed to support searching endemic and rare species of tree on web site. We describe the design methods and functional components of this prototype. To evaluate the system performance, questionnaires for system usability and Black Box Testing were used to measure expert and user satisfaction. The results were satisfactory as followed: Means for experts and users were 4.3 and 4.5, and standard deviation for experts and users were 0.61 and 0.73 respectively. Further analysis showed that the quality of plant searching web site was also at a good level as well.

Keywords: endemic species, vegetation, web-based system, black box testing, Thailand

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Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

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Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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Authors: S. Somerset, D. J. Hoare, P. Leighton

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Limited participation in physical activity and sport has been linked to poorer mental and physical health in children. Studies have shown that children who participate in sports benefit from improved social skills, self-confidence, communication skills and a better quality of life. Children who participate in sport are also more likely to continue their participation into their adult life. Deaf or hard of hearing children should have the same opportunities to participate in sport and receive the benefits as their hearing peers. Anecdotal evidence suggests this isn’t always the case. This is concerning given there are 45,000 children in the UK with permanent hearing loss. The aim of this study was to understand what encourages or discourages deaf or hard of hearing children to take part in sports. Ethical approval for the study was obtained from the University of Nottingham School of Medicine ethics committee. We conducted eight focus groups with deaf or hard of hearing children aged 10 to 15 years. A total of 45 children (19 male, 26 female) recruited from local schools and sports clubs took part. Information was gathered on the children’s thoughts and feelings about participation in sport. This included whether they played sports and who with, whether they did or did not like sport, and why they got involved in sport. Focus groups were audio recorded and transcribed. Transcripts were analysed using thematic analysis. Several key themes were identified as being associated with levels of sports participation. These included friendships, family and communication. Deaf or hard of hearing children with active siblings had participated in more sports. Communication was a common theme throughout regardless of the type of hearing-assistive technology a child used. Children found communication easier during sport if they were allowed to use their technology and had particular difficulty during sports such as swimming. Children expressed a desire not to have to identify themselves at a club as having a hearing loss. This affected their confidence when participating in sport. Not surprisingly, children who are deaf or hard of hearing are more likely to participate in sport if they have a good support network of parents, coaches and friends. The key barriers to participation for these children are communication, lack of visual information, lack of opportunity and a lack of awareness. By addressing these issues more deaf and hard of hearing children will take part in sport and will continue their participation.

Keywords: barrier, children, deaf, participation, hard of hearing, sport

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Authors: Patricia Wahl, Dirk Bruland, Albert Lenz

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Children of mentally ill parents are a large high risk group for mental disorders which is hardly reached by preventive programs. The children inherit a heightened risk to develop a mental disorder themselves during their lifetime, but they and their parents are often rejecting to seek help. To elicit the factors determining this prevention dilemma, an explorative qualitative interview study is conducted in 25 families with mentally ill parents and yet unaffected children. Inclusion criteria are the children’s age (7 to 14 years old) and that these children live together with the affected parent. With regard to the concept of Mental Health Literacy the following research questions are leading the Qualitative Content Analysis: What are the needs of families with mentally ill parents? How can their help-seeking behaviour be described? What are their subjective illness theories? And which influences do gender, ethnicity and socio-economic status have on needs, help-seeking and illness theories? Mental Health Literacy relates to the knowledge and attitudes towards mental disorders influencing the recognition, management or prevention of these disorders. The concept seems to be an interesting starting point for our analysis with the aim to understand antecedences and processes in the families more deeply. Results of an extensive literature review serve as deductive framework for our analysis, first findings from the interviews will be available up to the time of the conference and can be presented. They hopefully will give inside in the families’ living environment and help to adapt/develop interventions and in the long term reduce health inequalities. The project at hand is part of the Health Literacy in Childhood and Adolescence (HLCA) Research Consortium financed by the German Federal Ministry of Education and Research (BMBF).

Keywords: children of mentally ill parents, help-seeking behaviour, mental health literacy, prevention dilemma

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Authors: Kanyarat Bussaban, Kunyanuth Kularbphettong

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This research aims to create a model for analysis of student behavior using Library resources based on data mining technique in case of Suan Sunandha Rajabhat University. The model was created under association rules, apriori algorithm. The results were found 14 rules and the rules were tested with testing data set and it showed that the ability of classify data was 79.24 percent and the MSE was 22.91. The results showed that the user’s behavior model by using association rule technique can use to manage the library resources.

Keywords: behavior, data mining technique, a priori algorithm, knowledge discovery

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Authors: Makkhan Lal Meena, R. C. Bairwa, G. S. Dangayach, Rahul Jain

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The current study looked at the frequency of chronic illness conditions, accidents, health complaints, and ergonomic issues among 100 conventional and 100 greenhouse farmers. Data related to the health symptoms and ergonomic problems were collected through questionnaires by conducting direct interviews of farmers. According to the findings, symptoms of heat exposure (skin rashes, headache, dizziness, and lack of appetite) were substantially higher among conventional farmers than greenhouse farmers. The greenhouse farmers reported much more pain, numbness, or weakness in wrists/hands, fingers, upper back, hips, and ankles/feet than conventional farmers. The findings of the study suggest that suitable ergonomic knowledge and awareness campaign programs concentrating on safety at work, particularly low back pain, should be implemented in workplaces to allow for earlier detection of symptoms among the greenhouse farmers.

Keywords: accident, conventional farmer, ergonomics, health symptoms, greenhouse farmers, pesticide

Procedia PDF Downloads 264

Authors: Xuzhen Yang, Yan Shan, Yabo Ding, Keke DIao, Yanjun Zhang, Yijia Huang

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Purpose: Our aim is to understand the unique experiences of patients with peritoneal dialysis and how they deal with issues brought on by disease and dialysis. Patients and Methods: Semi-structured interview was designed to collect information, and inpatients with peritoneal dialysis in a university-based tertiary hospital in the central province of China were purposively chosen as interviewees. The content analysis method was used to analyze the data. Results: Nine patients participated in the study, and three themes and eight subthemes were generated. Conclusion: Patients using peritoneal dialysis encounter numerous challenges and problems in the process of disease and dialysis, and they took attempt to cope with them well to adapt to living with peritoneal dialysis.

Keywords: peritoneal dialysis, experience, patient, coping strategy

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Authors: Erfan Abdeldaim Mohamed Ahmed Abdalla

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The complexity of Arabic grammar poses challenges for learners, particularly in relation to its arrangement, classification, abundance, and bifurcation. The challenge at hand is a result of the contextual factors that gave rise to the grammatical rules in question, as well as the pedagogical approach employed at the time, which was tailored to the needs of learners during that particular historical period. Consequently, modern-day students encounter this same obstacle. This requires a thorough examination of the arrangement and categorization of Arabic grammatical rules based on particular criteria, as well as an assessment of their objectives. Additionally, it is necessary to identify the prevalent and renowned grammatical rules, as well as those that are infrequently encountered, obscure and disregarded. This paper presents a compilation of grammatical rules that require arrangement and categorization in accordance with the standards outlined in the Common European Framework of Reference for Languages (CEFR). In addition to facilitating comprehension of the curriculum, accommodating learners' requirements, and establishing the fundamental competencies for achieving proficiency in Arabic, it is imperative to ascertain the conventions that language learners necessitate in alignment with explicitly delineated benchmarks such as the CEFR criteria. The aim of this study is to reduce the quantity of grammatical rules that are typically presented to non-native Arabic speakers in Arabic textbooks. This reduction is expected to enhance the motivation of learners to continue their Arabic language acquisition and to approach the level of proficiency of native speakers. The primary obstacle faced by learners is the intricate nature of Arabic grammar, which poses a significant challenge in the realm of study. The proliferation and complexity of regulations evident in Arabic language textbooks designed for individuals who are not native speakers is noteworthy. The inadequate organisation and delivery of the material create the impression that the grammar is being imparted to a student with the intention of memorising "Alfiyyat-Ibn-Malik." Consequently, the sequence of grammatical rules instruction was altered, with rules originally intended for later instruction being presented first and those intended for earlier instruction being presented subsequently. Students often focus on learning grammatical rules that are not necessarily required while neglecting the rules that are commonly used in everyday speech and writing. Non-Arab students are taught Arabic grammar chapters that are infrequently utilised in Arabic literature and may be a topic of debate among grammarians. The aforementioned findings are derived from the statistical analysis and investigations conducted by the researcher, which will be disclosed in due course of the research. To instruct non-Arabic speakers on grammatical rules, it is imperative to discern the most prevalent grammatical frameworks in grammar manuals and linguistic literature (study sample). The present proposal suggests the allocation of grammatical structures across linguistic levels, taking into account the guidelines of the CEFR, as well as the grammatical structures that are necessary for non-Arabic-speaking learners to generate a modern, cohesive, and comprehensible language.

Keywords: grammar, Arabic, functional, framework, problems, standards, statistical, popularity, analysis

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Authors: Muneshia Maheshwar, Kanwal Gul, Shakira Fareed, Ume-Amama Areeb Gul

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Organic food is commonly known for its healthier content without the use of pesticides, herbicides, inorganic fertilizers, antibiotics and growth hormones. The aim of this research is to examine the effect of health consciousness, environmental concern and organic food knowledge on both the intention to buy organic foods and the attitude towards organic foods and the effect of attitude towards organic foods on the intention to buy organic foods in Pakistan. Primary data was used which was collected through adopted questionnaire from previous research. Non- probability convenience sampling was used to select sample size of 200 consumers based on Karachi. The data was analyzed through Descriptive statistics and Multi regression method. The findings of the study showed that the attitude and the intention to buy organic food were affected by health consciousness, environmental concern, and organic food knowledge. The results also revealed that attitude also affects the intention to buy organic food.

Keywords: health consciousness, attitude, intention to purchase, environmental concern, organic food knowledge

Procedia PDF Downloads 243