Search results for: primary health care

Authors: Amanda Aliende da Matta

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This communication presents an aspect of phenomenon selection in an applied hermeneutic phenomenology study on care and vulnerability: the need to consider it as a situated universal. For that, we will first present the study and its methodology. Secondly, we will expose the need to understand phenomena as situation-defined, incorporating feminist thought. In an informatics class for 14 year olds, we explained the exercise: students have to make a 5 slide presentation about a topic of their choice. A does it on streetwear, B on Cristiano Ronaldo, C on Marvel, but J did it on Down Syndrome. Introducing it to the class, J explains the physical and cognitive differences caused by trisomy; when asked to explain it further, he says: "they are angels, teacher," and shows us a poster on his cellphone that says: if you laugh at a different child he will laugh with you because his innocence outweighs your ignorance. The anecdote shows, better than any theoretical explanation, something that some vulnerable people have; something beautiful and special but difficult to define. Let's call this something caring. The research has the main objective of accounting for the experience of caregiving in vulnerability, and it will be carried out with Applied Hermeneutic Phenomenology (AHP). The method's objective is to investigate the lived human experience in its pre-reflexive dimension to know its meaning structures. Contrary to other research methods, AHP does not produce theory about a specific context but seeks the meaning of the lived experience, in its characteristic of human experience. However, it is necessary that we understand care as defined in a concrete situation. We cannot start the research with an a priori definitive concept of care, or we would fall into the mistake of closing ourselves to only what we already know, as explained by Levinas. We incorporate, then, the notion of situated universals. Loyal to phenomenology, the definition of the phenomenon should start with an investigation of the word's etymology: the word cura, in its etymological root, means care. And care comes from the Latin word cogitātus/cōgĭto, which means "to pursue something in mind" and "to consider thoroughly." The verb cōgĭto, meanwhile, is composed of co- (altogether) and agitare (to deal with or think committedly about something, to concern oneself with) / ăgĭto (to set in motion, to move). Care, therefore, has in its origin a meditation on something, a concern about something, a verb that has a sense of action and movement. To care is to act out of concern for something/someone. This etymology, though, is not the final definition of the phenomenon, but only its skeleton. It needs to be embodied in the concrete situation to become a possible lived experience. And that means that the lived experience descriptions (LEDs) should be selected by taking into consideration how and if care was engendered in that concrete experience. Defining the phenomenon has to take into consideration situated knowledge.

Keywords: applied hermeneutic phenomenology, care ethics, hermeneutics, phenomenology, situated universalism

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Authors: Florence Awde

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In 2023, it was expected 350 parents in Arizona would have a child receive a cancer diagnosis (Welcome Arizona Cancer Foundation For Children, n.d.). The news of a child’s diagnosis with cancer can be overwhelming and confusing, especially for those lucky enough to lack a personal tie to the disease that takes approximately 1800 children’s lives each year in the United States (Deegan et al., n.d.). A parent’s beliefs, attitudes, and understandings surrounding cancer are vital for medical staff to provide adequate and culturally competent care for each patient, especially across cultural and ethnic lines in regions housing multicultural populations. Arizona's cultural/linguistic mosaic houses many White and Latino populations and English and Spanish speakers. Variations in insurance coverage, from those insured through public insurance programs (e.g., Medicaid) or private insurance plans (e.g., employee-sponsored insurance) versus those uninsured, also factor into health-seeking attitudes and behaviors. To further understand parental attitudes, understandings, and beliefs towards childhood cancer, 22 parents (11 of Latino ethnicity, 11 of White ethnicity) were interviewed on these facets of childhood cancer, despite 21 of the 22 never having a child receive a cancer diagnosis. The exploration of these perceptions across ethnic lines revealed a higher report of fear-orientated beliefs amongst Latino parents--hypothesized to be rooted in the starkly contrasting lack of belief in the possibility of recovering for children with cancer, compared to their white counterparts who displayed more optimism in the recovery process. Further, this study’s results lay the foundation for future scholarship to explore avenues of information dispersal to Latino parents that correct misconceptions of health outcomes and enable earlier intervention to be possible, ultimately correlating to better health and treatment outcomes by increasing parental health literacy rates for childhood cancer in the Phoenix Metropolitan.

Keywords: Childhood Cancer, Parental Beliefs, Parental Attitudes, Parental Understandings, Phoenix Metropolitan, Culturally Competent Care, Health Disparities, Health Inequities

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Authors: Wanwisa Deenin, Abdulhadee Yakoh, Chahya Kreangkaiwal, Orawon Chailapakul, Kanitha Patarakul, Sudkate Chaiyo

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LipL32 is an outer membrane protein present only on pathogenic Leptospira species, which are the causative agent of leptospirosis. Leptospirosis symptoms are often misdiagnosed with other febrile illnesses as the clinical manifestations are non-specific. Therefore, an accurate diagnostic tool for leptospirosis is indeed critical for proper and prompt treatment. Typical diagnosis via serological assays is generally performed to assess the antibodies produced against Leptospira. However, their delayed antibody response and complicated procedure are undoubtedly limited the practical utilization especially in primary care setting. Here, we demonstrate for the first time an early-stage detection of LipL32 by an integrated lateral-flow immunoassay with electrochemical readout (eLFIA). A ferrocene trace tag was monitored via differential pulse voltammetry operated on a smartphone-based device, thus allowing for on-field testing. Superior performance in terms of the lowest detectable limit of detection (LOD) of 8.53 pg/mL and broad linear dynamic range (5 orders of magnitude) among other sensors available thus far was established. Additionally, the developed test strip provided a straightforward yet sensitive approach for diagnosis of leptospirosis using the collected human sera from patients, in which the results were comparable to the real-time polymerase chain reaction technique.

Keywords: leptospirosis, electrochemical detection, lateral flow immunosensor, point-of-care testing, early-stage detection

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Authors: Billy Zou

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Statement of the Problem: The burden of mental illness and problem behaviors in adolescence has risen worldwide. While less than 50% of teens have access to traditional mental health care, more than 73% have smartphones. Internet-based interventions offer advantages such as cost-effectiveness, availability, and flexibility. Methodology & Theoretical Orientation: A literature review was done using a PubMed search with the words mental health app yielding 2113 results. 103 articles that met inclusion criteria were reviewed, and findings were then described and synthesized. Findings: 1. Computer-based CBT was found to be effective for OCD, depression, social phobia, and panic disorder. 2. Web-based psychoeducation reduced problem behavior and improved parental well-being. 3. There is limited evidence for mobile-phone-based apps, but preliminary results suggest computer-based interventions are transferrable to mobile apps. 4. Adherence to app-based treatment was correlated with impressions about the user interface Conclusion & Significance: There is evidence for the effectiveness of computer-based programs in filling the significant gaps that currently exist in mental health delivery in the United States and internationally. There is also potential and theoretical validity for mobile-based apps to do the same, though more data is needed.

Keywords: children's mental health, mental health app, child and adolecent psychiatry, digital therapy

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Authors: Sangeeta Girdhar, Amanat Grewal, Nahush Bansal

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Introduction: There is an increasing burden of hypertension in India. The morbidity and mortality arising from complications are mainly due to non-adherence to medication, unhealthy dietary habits, and lack of physical activity. Non-adherence is a well-recognised factor contributing to inadequate control of high blood pressure. Adherence to pharmacotherapy for hypertension varies from 43% to 88%. Non-adherence is influenced by various socio-demographic factors. Understanding these factors is useful in managing non-adherence. Therefore, the study was planned to determine adherence among hypertensives and factors associated with non-adherence to treatment. Methodology: A cross-sectional study was conducted at Urban Health Training Centre of Dayanand Medical College and Hospital Ludhiana. Patients attending the OPD over a period of 3 months were included in the study. Prior ethical approval was obtained, and informed consent was taken from subjects. A predesigned semi-structured questionnaire was applied, which included socio-demographic profile, treatment-seeking behaviour, adherence to the antihypertensive medication, lifestyle factors (intake of alcohol, smoking, consumption of junk food, high salt intake) contributing to the development of the disease. Reasons for non-adherence to the therapy were also explored. Data was entered into excel, and SPSS 26 version was used for analysis. Results: A total of 186 individuals were interviewed. Out of these, 113 females (60.8%) and 73 males (39.2%) participated in the study. Mean age of participants was 60.9 ± 10.7 years. Adherence to anti-hypertensive treatment was found in 68.3% of the participants. It was observed that adherence was more in literate individuals as compared to illiterate (p value- 0.78). Adherence was lower among smokers (33.3%) and alcohol consumers (53.8%) as compared to non-users (69.4% and 70.6%, respectively). The predominant reasons for skipping medications were discontinuing medication when feeling well, forgetfulness and unawareness. Conclusion: There is a need to generate awareness regarding the importance of adherence to therapy among patients. Intensive health education and counselling of the patients is the need of the hour.

Keywords: hypertension, anti-hypertensive, adherence, counselling

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Authors: Grace Onubedo

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The primary objective of this research study is to contribute to and deepen the understanding of the realities and conditions for which children recruited by violent extremist organisations in Nigeria live, as well as ascertain the state of their mental health following their reunification with either family or protection workers. The research is intended to contribute to a more focused child protection programming agenda for children associated with armed forces and groups in Nigeria and the wider conflict setting. The extent to which violence has affected the psychological well-being and mental health of children abducted and exposed to activities of Violent Extremist groups remains a largely empirical question. This research attempts to answer the following research questions with the aim of providing further evidences for informed programming: I. What are the demographic characteristics of children associated with armed groups? II. What is the state of their mental health? III. What is the relationship between their background and their mental health?

Keywords: counterterrorism, psychosocial support, psychological distress, children, armed groups

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Authors: Caroline Seo, Jennifer Stephens, Kirstin H. Heinrich

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Background: Clostridiodes (formerly Clostridium) difficile infection (CDI) is an anaerobic, spore-forming bacterium with manifestations including diarrhea, pseudomembranous colitis and toxic megacolon. Despite general understanding that CDI may be associated with marked burden on patients’ health, there has been limited information available on the humanistic burden of CDI. The objective of this literature review was to summarize the published data on the humanistic burden of CDI globally, in order to better inform future research efforts and increase awareness of the patient perspective in this disease. Methods: A comprehensive literature review of the past 15 years (2002-2017) was conducted using MEDLINE, Embase and Cumulative Index of Nursing and Allied Health Literature. Additional searches were conducted from conference proceedings (2015-2017). Articles selected were studies specifically designed to examine the humanistic burden of illness associated with adult patients with CDI. Results: Of 3,325 articles or abstracts identified, 33 remained after screening and full text review. Sixty percent (60%) were published in 2016 or 2017. Data from the United States or Western Europe were most common. Data from Brazil, Canada, China and Spain also exist. Thirteen (13) studies used validated patient-reported outcomes instruments, mostly EQ-5D utility and SF-36 generic instruments. Three (3) studies used CDI-specific instruments (CDiff32, CDI-DaySyms). The burden of CDI impacts patients in multiple health-related quality of life (HRQOL) domains. SF-36 domains with the largest decrements compared to other GI diarrheal diseases (IBS-D and Crohn’s) were role physical, physical functioning, vitality, social functioning, and role emotional. Reported EQ-5D utilities for CDI ranged from 0.35-0.42 compared to 0.65 in Crohn’s and 0.72 in IBS-D. The majority of papers addressed physical functioning and mental health domains (67% for both). Across various studies patients reported weakness, lack of appetite, sleep disturbance, functional dependence, and decreased activities of daily lives due to the continuous diarrhea. Due to lack of control over this infection, CDI also impacts the psychological and emotional quality of life of the patients. Patients reported feelings of fear, anxiety, frustration, depression, and embarrassment. Additionally, the type of disease (primary vs. recurrent) may impact mental health. One study indicated that there is a decrement in SF-36 mental scores in patients with recurrent CDI, in comparison to patients with primary CDI. Other domains highlighted by these studies include pain (27%), social isolation (27%), vitality and fatigue (24%), self-care (9%), and caregiver burden (0%). Two studies addressed work productivity, with 1 of these studies reporting that CDI patients had the highest work productivity and activity impairment scores among the gastrointestinal diseases. No study specifically included caregiver self-report. However, 3 studies did provide mention of patients’ worry on how their diagnosis of CDI would impact family, caregivers, and/or friends. Conclusions: Despite being a serious public health issue there has been a paucity of research on the HRQOL among those with CDI. While progress is being made, gaps exist in understanding the burden on patients, caregivers, and families. Future research is warranted to aid understanding of the CDI patient perspective.

Keywords: burden, Clostridiodes, difficile, humanistic, infection

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Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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Authors: F.Sadoughi, A. Sarsarshahi, L, Eerfannia, S.M.A. Khatami

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Hospital information systems with lots of ability would lead to health care quality improvement. Evaluation of this system has done according different method and criteria. The main goal of present study is to prioritize the most important factors which are influence these systems evaluation. At the first step, according relevant literature, three main factor and 29 subfactors extracted. Then, study framework was designed. Based on analytical hierarchical process (AHP), 28 paired comparisons with Saaty range, in a questionnaire format obtained. Questionnaires were filled by 10 experts in health information management and medical informatics field. Human factors with weight of 0.55 were ranked as the most important. Organization (0.25) and technology (0.14) were in next place. It seems MADM methods such as AHP have enough potential to use in health research and provide positive opportunities for health domain decision makers.

Keywords: Analytical hierarchy process, Multiple criteria decision-making (MCDM), Hospital information system, Evaluation factors

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Authors: Wenru Wang

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Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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Authors: Nelson Igaba, C. Onaga, S. Hlongwane

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Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.

Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement

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Authors: Bonnie R. Brammall, Rhonda M. Garad, Helena J. Teede, Cheryce L. Harrison

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Introduction: Reproductive aged women are at high-risk for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life phase. Healthy lifestyle interventions during the preconception and antenatal period improve maternal and infant health outcomes. Yet, interventions from preconception through to postpartum and translation and implementation into real-world healthcare settings remain limited. OptimalMe is a randomised, hybrid implementation effectiveness study of evidence-based healthy lifestyle intervention. Here, we report engagement, acceptability of the intervention during preconception, and self-reported behaviour change outcomes as a result of the preconception phase of the intervention. Methods: Reproductive aged women who upgraded their private health insurance to include pregnancy and birth cover, signalling a pregnancy intention, were invited to participate. Women received access to an online portal with preconception health and lifestyle modules, goal-setting and behaviour change tools, monthly SMS messages, and two coaching sessions (randomised to video or phone) prior to pregnancy. Results: Overall n=527 expressed interest in participating. Of these, n=33 did not meet inclusion criteria, n=8 were not contactable for eligibility screening, and n=177 failed to engage after the screening, leaving n=309 who were enrolled in OptimalMe and randomised to intervention delivery method. Engagement with coaching sessions dropped by 25% for session two, with no difference between intervention groups. Women had a mean (SD) age of 31.7 (4.3) years and, at baseline, a self-reported mean BMI of 25.7 (6.1) kg/m², with 55.8% (n=172) of a healthy BMI. Behaviour was sub-optimal with infrequent self-weighing (38.1%), alcohol consumption prevalent (57.1%), sub-optimal pre-pregnancy supplementation (61.5%), and incomplete medical screening. Post-intervention 73.2% of women reported engagement with a GP for preconception care and improved lifestyle behaviour (85.5%), since starting OptimalMe. Direct pre-and-post comparison of individual participant data showed that of 322 points of potential change (up-to-date cervical screening, elimination of high-risk behaviours [alcohol, drugs, smoking], uptake of preconception supplements and improved weighing habits) 158 (49.1%) points of change were achieved. Health coaching sessions were found to improve accountability and confidence, yet further personalisation and support were desired. Engagement with video and phone sessions was comparable, having similar impacts on behaviour change, and both methods were well accepted and increased women's accountability. Conclusion: A low-intensity digital health and lifestyle program with embedded health coaching can improve the uptake of preconception care and lead to self-reported behaviour change. This is the first program of its kind to reach an otherwise healthy population of women planning a pregnancy. Women who were otherwise healthy showed divergence from preconception health and lifestyle objectives and benefited from the intervention. OptimalMe shows promising results for population-based behaviour change interventions that can improve preconception lifestyle habits and increase engagement with clinical health care for pregnancy preparation.

Keywords: preconception, pregnancy, preventative health, weight gain prevention, self-management, behaviour change, digital health, telehealth, intervention, women's health

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Authors: Uvais Qidwai, Amor Moursi, Mohamed Tahar, Malek Hamad, Hamad Alansi

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This paper focuses on the development and implementation of an advanced plant health monitoring system with an AI backbone and IoT sensory network. Our approach involves addressing the critical environmental factors essential for preserving a plant’s well-being, including air temperature, soil moisture, soil temperature, soil conductivity, pH, water levels, and humidity, as well as the presence of essential nutrients like nitrogen, phosphorus, and potassium. Central to our methodology is the utilization of computer vision technology, particularly a night vision camera. The captured data is then compared against a reference database containing different health statuses. This comparative analysis is implemented using an AI deep learning model, which enables us to generate accurate assessments of plant health status. By combining the AI-based decision-making approach, our system aims to provide precise and timely insights into the overall health and well-being of plants, offering a valuable tool for effective plant care and management.

Keywords: deep learning image model, IoT sensing, cloud-based analysis, remote monitoring app, computer vision, fuzzy control

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Authors: O. Yu Shchelkova, E. B. Usmanova

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Introduction: Last decades scientific research of quality of life (QoL) is developing fast worldwide. QoL concept pays attention to emotional experience of disease in patients, particularly to personal sense of possibility to satisfy actual needs and possibility of full social functioning in spite of disease limitations. QoL in oncological patients is studied intensively. Nevertheless, the issue of QoL in patients with bone tumors focused on psychological factors of QoL and relation to disease impact on QoL is not discussed. The aim of the study was to reveal the basic aspects and personality factors of QoL in patients with bone tumor. Results: Study participants were 139 patients with bone tumors. The diagnoses were osteosarcoma (n=42), giant cell tumor (n=32), chondrosarcoma (n=32), Ewing sarcoma (n=10) and bone metastases (n=23). The study revealed that patients with bone metastases assess their health significantly worse than other patients. Besides patients with osteosarcoma evaluate their general health higher than patients with giant cell tumors. Social functioning in patients with chondrosarcoma is higher than in patients with bone metastases and patients with giant cell tumor. Patients with chondrosarcoma have higher physical functioning and less restricted in daily activities than patients with bone metastases. Patients with bone metastases characterize their pain as more widespread than patients with primary bone tumors and have more functional restrictions due to bone incision. Moreover, the study revealed personality significant influence on QoL related to bone tumors. Such characteristics in structure of personality as high degree of self-consciousness, personal resources, cooperation and disposition to positive reappraisal in difficult situation correspond to higher QoL. Otherwise low personal resources and slight problem solving behaviour, low degree of self-consciousness and high social dependence correspond to decrease of QoL in patients with bone tumors. Conclusion: Patients with bone metastasis have lower QoL compared to patients with primary bone tumors. Patients with giant cell tumor have the worth quality of life among patients with primary bone tumors. Furthermore, the results revealed differences in QoL parameters associated with personality characteristics in patients with bone tumors. Such psychological factors as future goals, interest in life and emotional saturation, besides high degree of personal resources and cooperation influence on increasing QoL in patients with bone tumors.

Keywords: quality of life, psychological factors, bone tumor, personality

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Authors: Sakineh Nouri Saeidlou, Fatemeh Rezaiegoyjeloo, Parvin Ayremlou, Fariba Babaie

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Introduction: Childhood overweight and obesity is a major public health problem in both developed and developing countries. Overweight and obesity in children may have severe consequences later in adolescence and adulthood. The aim of current study was to determine the prevalence trend of overweight and obesity in school-aged children from 2009 to 2011. Methods: The present study was a population-based study and conducted in three consecutive years, from 2009 to 2011. The study population included all of primary, secondary and high school children in rural and urban regions of West Azarbijan province in West-North of Iran. Body mass index (BMI), the ratio of weight to height squared [weight (kg)]/ [height (m)]2, was calculated to the nearest decimal place. Overweight and obesity were classified using CDC recommendations for age and sex: a BMI 85th–95th percentile was classified as overweight and a BMI>95th percentile was classified as obese. All statistical analyses were performed using the Excel Software. Descriptive statistics were used to characterize the sample in different time periods. The prevalence was calculated as the ratio of number present cases to a given population number in a given subgroup at a given time. Results: Overall, 165740, 145146 and 146203 school children were assessed at 2009, 2010 and 2011, respectively. Prevalence of overweight in primary school children among girls were 52.83, 86.93 and 116.36 and for boys were 57.07, 53.4 and 93.55 per 1000 person in 2009, 2010 and 2011 years ,respectively. The prevalence of obesity in secondary school children for girls were 22.26, 27.75 and 28.43 and 26.52, 25.72 and 35.85 for boys per 1000 person in 2009, 2010 and 2011, respectively, The highest prevalence of overweight was 77.58, 142.4 and 126.46 per 1000 person among primary, secondary and high school children, respectively, in 2011. The lowest prevalence of obesity was 12.52, 24.1 and 21.61 per 1000 person among primary, secondary and high school children, respectively, in 2009. Conclusion: However, the rapid increase in both obesity and overweight should have a special attention. Research on prevalence trend of overweight and obesity in children is poorly reported in Iran. So that, future studies need to follow-up on the associations between overweight and obesity with health outcomes when children develop and reach adolescence and adulthood.

Keywords: overweight, obesity, school children, prevalence trend, Iran

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Authors: D. Osborn, L. Easthope

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The increasing threat of ‘marauding terror,' utilising improvised explosive devices and firearms, has focused the attention of policy makers and emergency responders once again on the treatment of the critically injured patient in a highly volatile scenario. Whilst there have been significant improvements made in the response and lessons learned from recent disasters in the international disaster community there still remain areas of uncertainty and a lack of clarity in the care of the critically injured. This innovative, longitudinal study has at its heart the aim of using ethnographic methods to ‘slow down’ the journey such patients will take and make visible the ethical complexities that 2017 technologies, expectations and over a decade of improved combat medicine techniques have brought. The primary researcher, previously employed in the hospital emergency management environment, has closely followed responders as they managed casualties with life-threatening injuries. Ethnographic observation of Exercise Unified Response in March 2016, exposed the ethical and legal 'vacuums' within a mass casualty and fatality setting, specifically the extrication, treatment and care of critically injured patients from crushed and overturned train carriages. This article highlights a gap in the debate, evaluation, planning and response to an incident of this nature specifically the incapacitated, unidentified patients and the ethics of submitting them to the invasive ‘Disaster Victim Identification’ process. Using a qualitative ethnographic analysis, triangulating observation, interviews and documentation, this analysis explores the gaps and highlights the next stages in the researcher’s pathway as she continues to explore with emergency practitioners some of this century’s most difficult questions in relation to the medico-legal and ethical challenges faced by emergency services in the wake of new and emerging threats and medical treatment expectations.

Keywords: ethics, disaster, Disaster Victim Identification (DVI), legality, unidentified

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Authors: Robert John Godby

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To be responsive now and in the future, workplaces must address the demands of multicultural teams as they become more common elements of the global labor force. This is especially the case for aged care due to the aging population, industry growth and migrant recruitment. This research identifies influences on and improvements for learning in these environments. Its unique contribution is to illuminate how culturally diverse workplaces can work and learn together more effectively. A mixed-methods approach was used to gather data about this topic in two phases. Firstly, the research methods included a survey of 102 aged care workers around Australia from two multi-site aged care organisations. The questionnaire elicited both quantitative and qualitative data about worker characteristics and perspectives on working and learning in aged care. Secondly, a case study of one aged care worksite was formulated drawing on worksite information and interviews with workers. A review of the literature suggests that learning in multicultural work environments is influenced by three main factors: 1) the individual workers themselves, 2) their interaction with each other and 3) the environment in which they work. There are various accounts of these three factors, how they are manifested and how they lead to a change in workers’ disposition, knowledge, or expertise when confronted with new circumstances. The study has found that a key individual factor influencing learning is cultural background. Their unique view of the world was shown to affect their approach to both their work and co-working. Interactional factors suggest that the high requirement for collaboration in aged care positively supports learning in this context; however, it can be hindered by cultural bias and spoken accent. The study also found that environmental factors, such as disruptions caused by the pandemic, were another key influence. For example, the need to wear face masks hindered the communication needed for workplace learning. This was especially challenging due to the diverse language backgrounds and abilities within the teams. Potential improvements for learning in multicultural aged care work environments were identified. These include more frequent and structured inter-peer learning (e.g. buddying), communication training (e.g. English language usage for both native and non-native speaking workers) and support for cross-cultural habitude (e.g. recognizing and adapting to cultural differences). Workplace learning in cross-cultural aged care environments is an area that is not extensively dealt with in the literature. This study addresses this gap and holds the potential to contribute practical insights to aged care and other diverse industries.

Keywords: cross-cultural learning, learning in aged care, migrant learning, workplace learning

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Authors: Faith O. Olanrewaju

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Internal displacement and the vulnerability of women are two critical aspects of forced migration that have dominated both global and local discourses. Statistics show that in November 2021, there were over 2.1 million internally displaced persons (IDPs) in Nigeria. Literature also states that displaced women and girls are more vulnerable than displaced men. They are susceptible to adversative experiences, including various forms of sexual violence and rape. As a result, the displaced women and girls are faced with psychological and physical traumas, including HIV/AIDS as well as unexpected or poorly spaced pregnancies. In addition, the poor condition of living of internally displaced women in IDP camps affects their reproductive health, pregnancy outcomes, and maternal mortality levels. Incontrovertibly, internally displaced women constitute an imperative contributor to the ills of Nigeria's maternal health status, which is the second worse globally and the worst in Africa. World Health Organisation statistics showed that approximately 536,000 girls and women die from pregnancy-related causes globally, and Nigeria accounts for 14% of the global maternal deaths. Undeniably, this supports the claims that maternal mortality remains a challenge in Nigeria and can be exacerbated by internal displacement crises. Therefore, maternal mortality remains a critical impediment to the actualisation of the 3.1 SDG target. Owing to this, concerns arise about the quality of the policy in Nigeria’s health sector. More specifically, this study is concerned with the maternal health care services displaced women receive in IDP camps in the three states affected by internal displacement in north-central Nigeria, an understudied area. The novelty of the study also lies in its comparative investigation of maternal healthcare service delivery in three different camp structures (faith-based, government, and informal IDP camps), a pattern that is absent in literature. Therefore, this study will investigate how the camp structures affect access to maternal health services in the study areas; analyse the successes and challenges in the delivery of maternal health care services to displaced women in the various camps; and recommendation and strategies for reducing maternal healthcare disparities/gaps across IDP camps in Nigeria (should they exist). It will adopt a mixed-method approach and multi-stage sampling technique. A total of 1,152 copies of the study questionnaire will be distributed to displaced pregnant and nursing mothers (PNM); nine focus group discussions will also be held with the displaced PNM; in-depth interviews will be conducted with humanitarian actors, policymakers, and health professionals. The quantitative and qualitative data will be analysed using Statistical Package for Social Science (SPSS) 21.0 and thematic analysis, respectively. The findings of the study will be used to develop a model of care that will address the fragmentations in Nigeria's healthcare system. The findings will also inform the development of best policies and practices in the maternal health of displaced women.

Keywords: forced displacement, internally displaced women, maternal healthcare, maternal mortality

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Authors: Jacob Bogart, Adaobi Egboka

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Nigeria signed and ratified the Convention on the Rights of Persons with Disabilities in 2010, which was heralded as a much-needed step towards protecting the rights of persons with disabilities (PWDs). However, even with such progress, incarcerated PWDs have been left behind. The current legal framework in Nigeria does not consider the particular challenges PWDs face in prison nor make provisions to address them, despite the need for such reforms. Indeed, given the closed and restricted nature of prisons, and the violence that results from overcrowding, lack of supervision, and poor facilities, prisoners with disabilities often face significant challenges while incarcerated. While every prisoner is affected by these issues, PWDs are disproportionately harmed by them due to the nature of their disability. A study of four prisons in Lagos State, Nigeria was carried out by interviewing prisoners with disabilities, prison officials, advocates, and academics. The study found that for prisoners with physical disabilities, inaccessible prison facilities and a lack of mobility, hearing, or seeing assistance can often cause them to be dependent on the mercy of the other inmates for assistance in performing such basic functions as using the restroom, going to church, or washing themselves. Prison officials do not assist these PWDs or provide them with aids, such as crutches or a cane. Relatedly, prisoners with psychosocial disabilities (mental health conditions) often are not removed to health care facilities, despite a law to that effect, and are left to languish in prisons without the mental health care treatment they need. This presentation argues that reforms addressing the rights of PWDs must consider and make provisions for prisoners with disabilities, such as ensuring that prison facilities are accessible, providing PWDs with mobility, seeing or hearing aids as needed, and conducting mental health screenings for persons awaiting trial immediately upon entering the prison. These reforms, among others, are necessary first steps toward realizing the rights of prisoners with disabilities in Nigeria.

Keywords: disability rights, human rights, Lagos, Nigeria, prisoners with disabilities

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Authors: Peggy M. Randon, Lisa Randon

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Introduction: The post-COVID-19 era has presented unique challenges for addressing complex mental health issues, particularly due to exacerbated stress, increased social isolation, and disrupted continuity of care. This article outlines relevant health disparities and policy implications within the context of the United States while maintaining international relevance. Methods: A comprehensive literature review (including studies, reports, and policy documents) was conducted to examine concerns related to childhood-onset schizophrenia and the impact on patients and their families. Qualitative and quantitative data were synthesized to provide insights into the complex etiology of schizophrenia, the effects of the pandemic, and the challenges faced by socioeconomically disadvantaged populations. Case studies were employed to illustrate real-world examples and areas requiring policy reform. Results: Early intervention in childhood is crucial for preventing or mitigating the long-term impact of complex psychotic disorders, particularly schizophrenia. A comprehensive understanding of the genetic, environmental, and physiological factors contributing to the development of schizophrenia is essential. The COVID-19 pandemic worsened symptoms and disrupted treatment for many adolescent patients with schizophrenia, emphasizing the need for adaptive interventions and the utilization of virtual platforms. Health disparities, including stigma, financial constraints, and language or cultural barriers, further limit access to care, especially for socioeconomically disadvantaged populations. Policy implications: Current US health policies inadequately support patients with schizophrenia. The limited availability of longitudinal care, insufficient resources for families, and stigmatization represent ongoing policy challenges. Addressing these issues necessitates increased research funding, improved access to affordable treatment plans, and cultural competency training for healthcare providers. Public awareness campaigns are crucial to promote knowledge, awareness, and acceptance of mental health disorders. Conclusion: The unique challenges faced by children and families in the US affected by schizophrenia and other psychotic disorders have yet to be adequately addressed on institutional and systemic levels. The relevance of findings to an international audience is emphasized by examining the complex factors contributing to the onset of psychotic disorders and their global policy implications. The broad impact of the COVID-19 pandemic on mental health underscores the need for adaptive interventions and global responses. Addressing policy challenges, improving access to care, and reducing the stigma associated with mental health disorders are crucial steps toward enhancing the lives of adolescents and young adults with schizophrenia and their family members. The implementation of virtual platforms can help overcome barriers and ensure equitable access to support and resources for all patients, enabling them to lead healthy and fulfilling lives.

Keywords: childhood, schizophrenia, policy, United, States, health, disparities

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Authors: Md. Abdul Karim, Syed Imran Ahmed, Pandora T. Hardtman

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Informed consent is one of the basic human and ethical rights for childbearing women. It plays a central role in promoting informed decision making between patients and service providers during the labor process. It gives mothers rights to accept or reject any examination and/or procedure, increases the respect and dignity of the mother during pregnancy, delivery and postpartum care. To assess the practices of this right during normal vaginal delivery and immediate postpartum care in tertiary level hospital setting in Bangladesh, a quantitative study with cross-sectional design was conducted in Dhaka Medical College & Hospital (DMCH) and Sir Salimullah Medical College & Mitford Hospital (SSMCH) in Dhaka in November 2015. A prevalence-based sample size of 190 was calculated where prevalence, confidence interval and level of significance were at 9.7%, 98% and 5% respectively. The respondents were the mothers who gave normal vaginal childbirth within past 24 hours and received postpartum care there. They were selected through systematic random sampling technique and their face-to-face interview of 190 mothers was done using a structured questionnaire. Data were entered into the spreadsheet (MS Excel 2013 version) and descriptive analysis of findings was done. The result shows the complete absence of informed consent practices and mostly absence of consented care such as right to information, respect for choices of preferences for examination and/or procedure of childbearing women. Although 95% of the mothers were informed that they were being proceeded with normal vaginal delivery, their choice of preference was absent during the process. Only consent (not informed consent) was taken from 50%-72% mothers for examination (except breast examination ‘0%’) and 8%-83% for any procedures during postpartum care. Only one-ninth (11%) of the mothers could ask service providers regarding the services they received. No consent was taken from 3% of the mothers- neither in the labor process nor in postpartum care. This current practice doesn’t comply with the Respectful Maternity Care (RMC) Charter 2011. The issue is not even clarified in the current Standard Clinical Management Protocols of the country. So, improvement of the existing protocol and increased awareness are essential to address this right of child-bearing women and to practice it during normal vaginal delivery and postpartum care.

Keywords: informed consent, normal vaginal delivery, respectful maternity care, tertiary level hospital

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Authors: Huseyin Duran, Yesim Benal Oztekin, Kazim Kubilay Vursavus, Ilker Huseyin Celen

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There are two main approaches to manufacturing, market and usage of plant protection machinery in Turkey. The first approach is called as ‘Product Safety Approach’ and could be summarized as minimum health and safety requirements of consumer needs on plant protection equipment and machinery products. The second approach is the practices related to the Plant Protection Equipment and Machinery Directive. Product safety approach covers the plant protection machinery product groups within the framework of a new approach directive, Machinery Safety Directive (2006/42 / AT). The new directive is in practice in our country by 03.03.2009, parallel to the revision of the EU Regulation on the Directive (03.03.2009 dated and numbered 27158 published in the Official Gazette). ‘Pesticide Application for Machines’ paragraph is added to the 2006/42 / EC Machinery Safety Directive, which is, in particular, reveals the importance of primary health care and product safety issue, explaining the safety requirements for machines used in the application of plant protection products. The Ministry of Science, Industry and Technology is the authorized organizations in our country for the publication and implementation of this regulation. There is a special regulation, carried out by Ministry of Food, Agriculture and Livestock General Directorate of Food and Control, on the manufacture and sale of plant protection machinery. This regulation, prepared based on 5996 Veterinary Services, Plant Health, Food and Feed Law, is ‘Regulation on Plant Protection Equipment and Machinery’ (published on 02.04.2011 whit number 27893 in the Official Gazette). The purposes of this regulation are practicing healthy and reliable crop production, the preparation, implementation and dissemination of the integrated pest management programs and projects for the development of human health and environmentally friendly pest control methods. This second regulation covers: approval, manufacturing, licensing of Plant Protection Equipment and Machinery; duties and responsibilities of the dealers; principles and procedures related to supply and control of the market. There are no inspection procedures for the application of currently used plant protection machinery in Turkey. In this study, content and application principles of all regulation approaches currently used in Turkey are summarized.

Keywords: plant protection equipment and machinery, product safety, market surveillance, inspection procedures

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Authors: Remya Radhakrishnan, Hema Perinbanathan, Anukriti Rath, Reshmi Ramachandran, Rohith Thazhathuvetil Sasindrababu, Maria Karizhenskaia

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Childhood adversities have lasting effects on health and well-being. This abstract explores the connection between adverse childhood experiences (ACEs) and health consequences, including substance abuse and obesity. Understanding the impact of childhood trauma and emphasizing the importance of culturally sensitive treatments and focused interventions help to mitigate these effects. Research consistently shows a strong link between ACEs and poor health outcomes. Our team conducted a comprehensive literature review of depression and anxiety in Canadian children and youth, exploring diverse treatment methods, including medical, psychotherapy, and alternative therapies like art and music therapy. We searched Medline, Google Scholar, and St. Lawrence College Library. Only original research papers, published between 2012 and 2023, peer-reviewed, and reporting on childhood adversities on health and its treatment methods in children and youth in Canada were considered. We focused on their significance in treating depression and anxiety. According to the study's findings, the prevalence of adverse childhood experiences (ACEs) is still a significant concern. In Canada, 40% of people report having had multiple ACEs, and 78% report having had at least one ACE, highlighting the persistence of childhood adversity and indicating that the issue is unlikely to fade off in the near future. Likewise, findings revealed that individuals who experienced abuse, neglect, or violence during childhood are likelier to engage in harmful behaviors like polydrug use, suicidal ideation, and victimization and suffer from mental health problems such as depression and post-traumatic stress disorder (PTSD).

Keywords: adverse childhood experiences (ACEs), obesity, post-traumatic stress disorder (PTSD), resilience, substance abuse, trauma-informed care

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Authors: Fujia Yang

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Alongside technological innovation, the current “double reduction” policy and English Curriculum Standards for Compulsory Education in China both emphasise and encourage appropriately integrating educational technologies into the classroom. Therefore, schools are increasingly using digital means to engage students in English reading, but the impact of such technologies on Chinese pupils’ reading achievement remains unclear. To serve as a reference for reforming English reading education in primary schools under the double reduction policy, this study investigates the effects and primary influencing factors of a specific reading programme, Accelerated Reader (AR), on Chinese primary school students’ reading achievement. A quantitative online survey was used to collect 37 valid questionnaires from teachers, and the results demonstrate that, from teachers’ perspectives, the AR program seemed to positively affect students’ reading achievement by recommending material at the appropriate reading levels and developing students’ reading habits. Although the reading enjoyment derived from the AR program does not directly influence students’ reading achievement, these factors are strongly correlated. This can be explained by the self-paced, independent learning AR format, its high accuracy in predicting reading level, the quiz format and external motivation, and the importance of examinations and resource limitations in China. The results of this study may support reforming English reading education in Chinese primary schools.

Keywords: educational technology, reading programme, primary students, accelerated reader, reading effects

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Authors: Kirsty Biggs, Peter Larsen-Disney

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Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

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Authors: Elizabeth Perry, Jylana Sheats

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Scholars posit that there is an overlap between the fields of Behavioral Economics (BE) and Behavior Science (BSci)—and that consideration of concepts from both may facilitate a greater understanding of health decision-making processes. For example, the ‘intention-action gap’ is one BE concept to explain sup-optimal decision-making. It is described as having knowledge that does not translate into behavior. Complementary best BSci practices may provide insights into behavioral determinants and relevant behavior change techniques (BCT). Within the context of BSci, this exploratory study aimed to apply a BE concept with demonstrated effectiveness in financial decision-making to a health behavior: influenza (flu) vaccine uptake. Adults aged >18 years were recruited on Amazon’s Mechanical Turk, a digital labor market where anonymous users perform simple tasks at low cost. Eligible participants were randomized into 2 groups, reviewed a scenario, and then completed a survey on the likelihood of receiving a flu shot. The ‘usual care’ group’s scenario included standard CDC guidance that supported the behavior. The ‘intervention’ group’s scenario included messaging about people who did not receive the flu shot. The framing was such that participants could learn from others’ (strangers) mistakes and the subsequent health consequences: ‘Last year, other people who didn’t get the vaccine were about twice as likely to get the flu, and a number of them were hospitalized or even died. Don’t risk it.’ Descriptive statistics and chi-square analyses were performed on the sample. There were 648 participants (usual care, n=326; int., n=322). Among racial/ethnic minorities (n=169; 57% aged < 40), the intervention group was 22% more likely to report that they were ‘extremely’ or ‘moderately’ likely to get the flu vaccine (p = 0.11). While not statistically significant, findings suggest that framing messages from the perspective of learning from the mistakes of unknown others coupled with the BCT ‘knowledge about the health consequences’ may help influence flu vaccine uptake among the study population. With the widely documented disparities in vaccine uptake, exploration of the complementary application of these concepts and strategies may be critical.

Keywords: public health, decision-making, vaccination, behavioral science

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Authors: Oznur Ispir, S. Duygulu

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Health institutions are the places where fast and efficient decisions are required and mistakes and uncertainties are not tolerated due to the urgency of the services provided within the body of these institutions. Thus, in those institutions where patient care services are targeted to be provided quality and safety, the nurses attending the decisions, creating the solutions for problems, taking initiative and bearing the responsibility of results in brief having the control over practices are needed. Control over nursing practices is defined as affecting the employment and work environment at the unit level of the institution, perceived freedom for organizing and evaluating nursing practices, the ability to make independent decisions about patient care and accountability for the results of such decisions. This study scrutinizes the concept of control over nursing practices (organizational autonomy), which is frequently confused with other concepts (autonomy) in the literature, by reviewing the literature and making suggestions to improve nurses’ control over nursing practices.

Keywords: control over nursing practice, nurse, nursing, organizational autonomy

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Authors: Ella Tyuryumina, Alexey Neznanov

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This study is an attempt to obtain reliable data on the natural history of breast cancer growth. We analyze the opportunities for using classical mathematical models (exponential and logistic tumor growth models, Gompertz and von Bertalanffy tumor growth models) to try to describe growth of the primary tumor and the secondary distant metastases of human breast cancer. The research aim is to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoMPaS and corresponding software. We are interested in: 1) modelling the whole natural history of the primary tumor and the secondary distant metastases; 2) developing adequate and precise CoMPaS which reflects relations between the primary tumor and the secondary distant metastases; 3) analyzing the CoMPaS scope of application; 4) implementing the model as a software tool. The foundation of the CoMPaS is the exponential tumor growth model, which is described by determinate nonlinear and linear equations. The CoMPaS corresponds to TNM classification. It allows to calculate different growth periods of the primary tumor and the secondary distant metastases: 1) ‘non-visible period’ for the primary tumor; 2) ‘non-visible period’ for the secondary distant metastases; 3) ‘visible period’ for the secondary distant metastases. The CoMPaS is validated on clinical data of 10-years and 15-years survival depending on the tumor stage and diameter of the primary tumor. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer growth models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. The CoMPaS model and predictive software: a) fit to clinical trials data; b) detect different growth periods of the primary tumor and the secondary distant metastases; c) make forecast of the period of the secondary distant metastases appearance; d) have higher average prediction accuracy than the other tools; e) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoMPaS: the number of doublings for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases. The CoMPaS enables, for the first time, to predict ‘whole natural history’ of the primary tumor and the secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on the primary tumor sizes. Summarizing: a) CoMPaS describes correctly the primary tumor growth of IA, IIA, IIB, IIIB (T1-4N0M0) stages without metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and inception of the secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, metastases in lymph nodes, primary tumor, survival

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Authors: Ssekamanya, Mastura Badzis, Khamsiah Ismail, Dayang Shuzaidah Bt Abduludin

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With rising incidents of school violence worldwide, educators and researchers are trying to understand and find ways to enhance the safety of children at school. The purpose of this study was to investigate the extent to which the demographic variables of gender, age, length of service, position, academic qualification, and school location predicted teachers’ awareness about school safety practices in Malaysian primary schools. A stratified random sample of 380 teachers was selected in the central Malaysian states of Kuala Lumpur and Selangor. Multiple regression analysis revealed that none of the factors was a good predictor of awareness about school safety training, delivery methods of school safety information, and available school safety programs. Awareness about school safety activities was significantly predicted by school location (whether the school was located in a rural or urban area). While these results may reflect a general lack of awareness about school safety among primary school teachers in the selected locations, a national study needs to be conducted for the whole country.

Keywords: school safety awareness, predictors of school safety, multiple regression analysis, malaysian primary schools

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Authors: Muhammad Fawad

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Monitoring and structural health assessment are the primary requirements for the performance evaluation of damaged bridges. This paper highlights the case study of a damaged Reinforced Concrete (RC) bridge structure where the Finite element (FE) modelling of this structure was done using the material properties extracted by the in-situ testing. Analysis was carried out to evaluate the bridge damage. On the basis of FE analysis results, this study proposes a proper Structural Health Monitoring (SHM) system that will extend the life cycle of the bridge with minimal repair costs and reduced risk of failure. This system is based on the installation of three different types of sensors: Liquid Levelling sensors (LLS) for measurement of vertical displacement, Distributed Fiber Optic Sensors (DFOS) for crack monitoring, and Weigh in Motion (WIM) devices for monitoring of moving loads on the bridge.

Keywords: bridges, reinforced concrete, finite element method, structural health monitoring, sensors

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