Search results for: travel health

Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: Mohammed Gamil Montasser, Angelo Battaglia

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Tourism is making its presence felt across the Sultanate of Oman. The story is one of the most recognized phenomena as a sustainable solid growth and is considered a remarkable outcome for any destination. The competitive situation and challenges within the tourism industry worldwide entail a better understanding of the destination position and its image to achieve Oman’s aspiration to retain its international reputation as one of the most desirable destinations in the Middle East. To access general perceptions of Oman’s attributes, their importance and their influences among U.S. tourists, an online survey was conducted with 522 American travelers who have traveled internationally, including non-visitors, virtual-visitors and visitors to Oman. This research involved a total of 36 attributes in the survey. Participants were asked to rate their agreement on how each attribute represented Oman and how important each attribute was for selecting destinations on 5- point Likert Scale. They also indicated if each attribute has a positive, neutral or negative influence on their destination selection. Descriptive statistics and importance performance analysis (IPA) were conducted. IPA illustrated U.S. tourists’ perceptions of Oman’s destination attributes and their importance in destination selection on a matrix with four quadrants, divided by actual mean value in each grid for importance (M=3.51) and performance (M=3.57). Oman tourism organizations and destination managers may use these research findings for future marketing and management efforts toward the U.S. travel market.

Keywords: analysis of importance, performance, destination attributes, Oman's position, U.S. tourists

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Authors: Rana Praween Kumar

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Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.

Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery

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Authors: Andrea Knezevic, Padmini Pai, Julaine Allan, Katarzyna Olcoń, Louisa Smith

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Healthcare staff are on the frontline during times of disaster and are required to support the health and wellbeing of communities despite any personal adversity and trauma they are experiencing as a result of the disaster. This study explored the experiences of healthcare staff trained as ‘Wellness Warriors’ following the 2019-2020 Australian bushfires. The findings indicated that healthcare staff developed interpersonal skills around deep listening and connecting with others which allowed them to feel differently about work and restored their faith in healthcare leadership.

Keywords: Australian bushfires, burnout, health care providers, mental health, occupational trauma, post-disaster, wellbeing, workplace wellness

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Authors: Madhukar Kasarla, Sumit Fogla, Kiran Panuganti, Gaurav Jain, Abhijit Ramanujam, Astha Jain, Shashank Kraleti, Sharat Musham, Arun Chaudhury

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Patients have often chosen to travel for care — making pilgrimages to academic meccas and state-of-the-art hospitals for sophisticated surgery. This culture is still persistent in the landscape of US healthcare, with hundred thousand of visitors coming to the shores of United States to seek the high quality of medical care. One of the major challenges in this form of medical tourism has been the language barrier. Thus, an Iraqi patient, with immediate needs of communicating the healthcare needs to the treating team in the hospital, may face huge barrier in effective patient-doctor communication, delaying care and even at times reducing the quality. To circumvent these challenges, we are proposing the use of a state-of-the-art tool, Talk2All, which can translate nearly one hundred international languages (and even sign language) in real time. The tool is an easy to download app and highly user friendly. It builds on machine learning principles to decode different languages in real time. We suggest that the use of Talk2All will tremendously enhance communication in the hospital setting, effectively breaking the language barrier. We propose that vigorous incorporation of Talk2All shall overcome practical challenges in international medical and surgical tourism.

Keywords: language translation, communication, machine learning, medical tourism

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Authors: Ghorbanali Mohammadi

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Background: Due to the widespread outbreak of the COVID-19 virus, a large number of people become infected with the disease every day and go to hospitals. The acute condition of this disease has caused the death of many people. Since all the stages of treatment for these people happen in the hospitals, nurses are at the forefront of the fight against this virus. This causes nurses to suffer from physical and mental health problems. Methods: Physical and mental problems in nurses were assessed using the Depression, Anxiety and Stress Scale (DASS-42) of Lovibond (1995) and the Nordic Questionnaire. Results: 90 nurses from emergency, intensive care, and coronary care units were examined, and a total of 180 questionnaires were collected and evaluated. It was found that 37.78%, 47.78%, and 21.11% of nurses have symptoms of depression, anxiety, and stress, respectively. 40% of the nurses had physical problems. In total, 65.17% of them were involved in one or more mental or physical illnesses. Conclusions: Of the three units surveyed, the nurses in intensive care, emergency room, and coronary care units worked more than ten hours a day. Examining the interaction of physical and mental health problems indicated that physical problems can aggravate mental problems.

Keywords: depression anxiety and stress scale of Lovibond, nordic questionnaire, mental health of nurses, physical health problems in nurses

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Authors: Ons Sassi, Wahiba Ramdane Cherif-Khettaf, Ammar Oulamara

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In this paper, we consider a new real-life Heterogenous Electric Vehicle Routing Problem with Time Dependant Charging Costs and a Mixed Fleet (HEVRP-TDMF), in which a set of geographically scattered customers have to be served by a mixed fleet of vehicles composed of a heterogenous fleet of Electric Vehicles (EVs), having different battery capacities and operating costs, and Conventional Vehicles (CVs). We include the possibility of charging EVs in the available charging stations during the routes in order to serve all customers. Each charging station offers charging service with a known technology of chargers and time-dependent charging costs. Charging stations are also subject to operating time windows constraints. EVs are not necessarily compatible with all available charging technologies and a partial charging is allowed. Intermittent charging at the depot is also allowed provided that constraints related to the electricity grid are satisfied. The objective is to minimize the number of employed vehicles and then minimize the total travel and charging costs. In this study, we present a Mixed Integer Programming Model and develop a Charging Routing Heuristic and a Local Search Heuristic based on the Inject-Eject routine with three different insertion strategies. All heuristics are tested on real data instances.

Keywords: charging problem, electric vehicle, heuristics, local search, optimization, routing problem

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Authors: Amy Whelan

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This paper presents the reader with the overarching research topic: Examining the drivers to sustainable consumer behavioural intention in the Irish aviation industry. This research will examine the underlying factors that facilitate or hinder a consumer’s sustainable consumption pertaining to aviation, in order to advance the Sustainable Development Goals (SDG’s). The SDG’s were adopted by all United Nations Member States in 2015 as a call to end poverty, to protect the planet and to ensure that all people enjoy peace and prosperity by the year 2030. Consumers are becoming increasingly concerned about environmental, social and economic issues, and are willing to act on those concerns. More recently, the impact of a consumers environmental footprint has led consumers to re-evaluate their purchase habits and in some cases consumers are more willing to spend more on products and services with environmental characteristics. Accordingly, this has pushed businesses to re-examine their sustainable efforts. However, although consumers may feel a moral responsibility to live sustainably, they cannot do so without effective support from governments, NGOs and the businesses with which they interact. Through the use of Ajzen’s amended TPB model, this research seeks to understand consumers attitudes and behavioural intention towards sustainable aviation and travel and examine the attitude-behaviour gap in sustainable tourism and aviation in Ireland. This research is a mixed methods study and will include an initial elicitation study in the form of focus groups supported by a quantitative survey to inform the initial findings of this research.

Keywords: aviation, consumer behaviour, marketing, sustainability

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Authors: Dilsad Akal

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Aim: Companies communicate with each other and with their costumers via call centers. Call centers are defined as stressful because of their uncertain working hours, inadequate relief time, performance based system and heavy workload. In literature, this sector is defined as risky as mining sector by means of health and safety. The aim of this research is to enlight the relatively dark area. Subject and Methods: The collection of data for this study completed during April-May 2015 for the two selected call centers in different parts of Turkey. The applied question mostly investigated the health conditions of call center workers. Electromagnetic field measurements were completed at the same time with applying the question poll. The ratio of employee accessibility noted as 73% for the first call center and 87% for the second. Results: The results of electromagnetic field measurements were as between 371 V/m-32 V/m for the first location and between 370 V/m-61 V/m for the second. The general complaints of the employees for both workplaces can be counted as; inadequate relief time, inadequate air conditioning, disturbance, poor thermal conditions, inadequate or extreme lighting. Furthermore, musculoskeletal discomfort, stress, ear and eye discomfort are main health problems of employees. Conclusion: The measured values and the responses to the question poll were found parallel with the other similar research results in literature. At the end of this survey, a risk map of workplace was prepared in terms of safety and health at work in general and some suggestions for resolution were provided.

Keywords: call center, health and safety, electromagnetic field, risk map

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Authors: Noah Wayne, Andrea Tuka, Adrian Norbash, Bryan Garber, Paul Ritvo

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Program/Intervention Description: The Canadian Armed Forces(CAF) Mental Health Clinicstreat a full spectrum of mental disorder, addictions, and psychosocial issues that include Major Depressive Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, and other diagnoses. We evaluated the feasibility of an online health coach interventiondelivering mindfulness based cognitive behavioral therapy (M-CBT) and behaviour changesupport for individuals receiving treatment at CAF Clinics. Participants were provided accounts on NexJ Connected Wellness, a digital health platform, and 16 weeks of phone-based health coaching,emphasizingmild to moderate aerobic exercise, a healthy diet, and M-CBT content. The primary objective was to assess the feasibility of the online deliverywith CAF members. Evaluation Methods: Feasibility was evaluated in terms of recruitment, engagement, and program satisfaction. Weadditionallyevaluatedhealth behavior change, program completion, and mental health symptoms (i.e. PHQ-9, GAD-7, PCL-5) at three time points. Results: Service members were referred from Vancouver, Esquimalt, and Edmonton CAF bases between August 2020 and January 2021. N=106 CAF personnel were referred, and n=77 consented.N=66 participated, and n=44 completed 4-month and follow-up measures. The platform received a mean rating of76.5 on the System Usability Scale, and health coaching was judged the most helpful program feature (95.2% endorsement), while reminders (53.7%), secure messaging (51.2%), and notifications (51.2%) were also identified. Improvements in mental health status during active interventions were observed on the PHQ-9 (-5.4, p<0.001), GAD-7 (-4.0, p<0.001), and PCL-5 (-4.1, p<0.05). Conclusion: Online health coaching was well-received amidst the COVID-19 pandemic and related lockdowns. Uptake and engagement were positively reported. Participants valuedcontacts and reported strong therapeutic alliances with coaches. Healthy diet, regular exercise, and mindfulness practice are important for physical and mental health. Engagements in these behaviors are associated with reduced symptoms. An online health coach program appears feasible for assisting Canadian Armed Forces personnel.

Keywords: coaching, CBT, military, depression, mental health, digital

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Authors: Narumon Piaseu

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This survey research was aimed to describe and compare consumption behavior of health risk food among students in Suan Sunandha Rajabhat University. Sample included 400 undergraduate students enrolled in the first semester of 2008 academic year. Data were collected by using self reported questionnaire developed by the researcher. Data were then analyzed by descriptive statistics including frequency, percentage, mean, standard deviation, and inferential statistics including independent t-test, and Oneway ANOVA. Results revealed that most of the sample were women (67%), enrolled in social related programs (74%). Approximately half of them (45.5%) stayed in dormitory. The mean of monthly income was 5,164 Baht and daily food expenditure was 114.55 Baht. Majority of them (83%) had ready-to-eat food. A major factor influencing their food selection was their parents (61%). A main reason for their food selection was food that looks good (70.75%). Almost half of them (46.25%) had heavy exercise less than 3 times per week. Regarding knowledge on health risk food, 43.5% of the sample had good knowledge. The followings were moderate (41%) and poor (41%). Most of the sample (60.75%) had consumption behavior at low risk. The following was at moderate risk (37.25%). Only 2% were at high risk. Among the sample, consumption behavior of health risk food were significantly different in years of study (F = 3.168, p = .024), daily food expenditure (F = 8.950, p <.001), and knowledge on health risk food (F = 37.856, p <.001), while no significant difference in consumption behavior of health risk food was found in those with a difference in gender, program of study, living place, and monthly income. Results indicate the importance of providing knowledge regarding health risk food for students and their parents in order to promote appropriate food consumption behavior among the students.

Keywords: food consumption, risky behavior, Suan Sunandha Rajabhat University, health risk

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Authors: Jeremy Schultz

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The purpose of this study was to understand the perceptions of vineyard managers in the Krasnodar Region of Southern Russia located between the city of Kransnodar and the Black Sea. In recent years, wine tourism throughout the region has seen tremendous growth due in part to the concurrent growth in the number of tourists vacationing at the Black Sea. This trend has contributed to the development of large-scale wine operations developing in numerous rural locations along the tourists’ travel path. Niche areas of tourism, such as wine tourism, have proven to provide economic viability for rural communities all around the world. Understanding their shared group characteristics while honoring their unique qualities as individuals aids in responsible wine tourism development that provides a sense of well-being for the communities and stakeholders involved. Semi-structured interviews and lived experience methodologies were used in locations that were associated with wine food tourism operations. By understanding management perspectives, it lends insight into sustainable destination management and wine tourism product development, furthering our progress toward ethical, responsible, and financially feasible operations. This research also represents a collaborative effort between Russia and the United States that supports an agenda of sustainable destination development and management. As a global community, we need to continue to investigate stakeholder perceptions and strategic management techniques that best support the pillars upon which responsible tourism was founded.

Keywords: wine tourism, tourism development, Russia, rural tourism

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Authors: Zhiyuan Du, Baisravan Hom Chaudhuri, Pierluigi Pisu

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In connected vehicle systems where wireless communication is available among the involved vehicles and intersection controllers, it is possible to design an intersection coordination strategy that leads the connected and automated vehicles (CAVs) travel through the road intersections without the conventional traffic light control. In this paper, we present a distributed coordination strategy for the CAVs at multiple interconnected intersections that aims at improving system fuel efficiency and system mobility. We present a distributed control solution where in the higher level, the intersection controllers calculate the road desired average velocity and optimally assign reference velocities of each vehicle. In the lower level, every vehicle is considered to use model predictive control (MPC) to track their reference velocity obtained from the higher level controller. The proposed method has been implemented on a simulation-based case with two-interconnected intersection network. Additionally, the effects of mixed vehicle types on the coordination strategy has been explored. Simulation results indicate the improvement on vehicle fuel efficiency and traffic mobility of the proposed method.

Keywords: connected vehicles, automated vehicles, intersection coordination systems, multiple interconnected intersections, model predictive control

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Authors: Waepa Wanhussen

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The Ministry of Public Health has established policies accelerating health promotion to prevent public health problems in five border provinces of Thailand. One of these policies employs the religion to guide the community development and solve health issues consistent with the lifestyle and culture of those people. This policy is an important strategy to solve the problems due to the unrest and conflicts in the southern border provinces. This participatory action research aimed to develop mosques as healthy religion places in Narathiwat Province. In the development, the participatory action, consisting of 5 stages, was conducted from October 2012 - May 2013. Stage I: Conducting a survey for problems and needs for developing healthy religion places by employing community participation. Stage II: Analyzing problems and situations at a workshop containing informal interviews and group conversations with 200 participants (health providers at district level, Imams (the Muslim leaders), and community leaders). Stage III: Planning for developing healthy religion places by health providers, Imams, community leaders. Stage IV: Implementing the plan according to the conditions of problems and needs of the community in order to develop healthy religion places. Stage V: Evaluating the implementation by using the instrument, a criteria of being healthy religion place, for collecting data. Data were analyzed by using percentage. It was found that out of 630 mosques 575 (90.12%) passed the criteria of being a healthy religion place. Among these mosques, 190 mosques (30.15%) were in good and very good level, in which, after the implementation, the number of being good and very good healthy mosques increased by 22.58%. The researcher suggested that the developing sustainably healthy religion places require the participation of residences in the community and agencies such as local government, the Islamic Council of Narathiwat Province, and Council of Culture of Narathiwat Province. The healthy religion places can be used to strengthen and sustain health promotion and disease prevention in the community as health learning centers.

Keywords: healthy religion places, development of community participation, nursing informatics, health

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Authors: Himansu, Bedanga Talukdar

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The aim of present study is to investigate the prevalence of various health outcomes and quality of life and analyzes the moderating role of social capital on health outcomes (i.e., self-rated good health (SRH), depression, functional health and quality of life) among elderly in India. Using WHO Study on Global AGEing and adults health (SAGE) data, with sample of 6559 elderly between 50 and above (Mage=61.81, SD=9.00) age were selected for analysis. Multivariate analysis accessed the prevalence of SRH, depression, functional limitation and quality of life among older adults. Logistic regression evaluates the effect of social capital along with other co-founders on SRH, depression, and functional limitation, whereas linear regression evaluates the effect of social capital with other co-founders on quality of life (QoL) among elderly. Empirical results reveal that (74%) of respondents were married, (70%) having low social action, (46%) medium sociability, (45%) low trust-solidarity, (58%) high safety, (65%) medium civic engagement and 37% reported medium psychological resources. The multivariate analysis, explains (SRH) is associated with age, female, having education, higher social action great trust, safety and greater psychological resources. Depression among elderly is greatly related to age, sex, education and higher wealth, higher sociability, having psychological resources. QoL is negatively associated with age, sex, being Muslim, whereas positive associated with higher education, currently married, civic engagement, having wealth, social action, trust and solidarity, safeness, and strong psychological resources.

Keywords: depressive symptom, functional limitation, older adults, quality of life, self rated health, social capital

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Authors: Md. S. Sabuz

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Bangladesh, a South Asian developing country, has achieved a remarkable breakthrough in health indicators during the last four decades despite immense income inequality. This phenomenon results in the mystical exclusion of marginalized people from obtaining health care facilities. However, the persistence of exclusion of the disadvantaged remains troubling. Exclusion occurs from occupational inferiority, pay and wage differences, educational backwardness, gender disparity to urban-rural complexity and eliminate the unprivileged from seeking and availing the health services. Evidence from Bangladesh shows that many sick people prefer to die at home without securing medical services because in previous times they were not treated well, not because the medical facilities were inadequate or antediluvian but the socio-economic class allows them to receive obdurate treatment. Furthermore, government and policymakers have given enormous emphasis on infrastructural development and achieving health indicators instead of ensuring quality services and inclusiveness of people from all spheres. Therefore, it is high time to address the issues concerning this and highlight the impact of economic status on health status in a sociological perspective. The objective of this study is to consider ways of assessing and exploring the impact of economic status for instance: occupational status, pay and wage variable, on health status in the context of Bangladesh. The hypotheses are that there are a significant number of factors affecting economic status which are impactful for health status eventually, but acute income inequality is a prominent factor. Illiteracy, gender disparity, remoteness, incredibility on services, superior costs, superstition etc. are the dominant indicators behind the economic factors influencing the health status. The chosen methodologies are a qualitative and quantitative approaches to accomplish the research objectives. Secondary sources of data will be used to conduct the study. Surveys will be conducted on the people who have ever been through the health care facilities and people from the different socio-economic and cultural backgrounds. Focus group discussions will be conducted to acquire the data from different cultural and regional citizens. The findings show that 48% of people who are from disadvantaged communities have been deprived of proper health care facilities. The general reasons behind this are the higher cost of medicines and other equipment. A significant number of people are unaware of the appropriate facilities. It was found that the socio-economic variables are the main influential factors that work as the driving force for both economic dimension and health status. Above all regional variables and gender, dimensions have an enormous effect on determining the health status of an individual or community. Amidst many positive achievements for example decrease in the child mortality rate, an increase in the immunization programs of the child etc., the inclusiveness of all classes of people in health care facilities has been overshadowed in Bangladesh. However, this phenomenon along with the socio-economic and cultural phenomena significantly demolishes the quality and inclusiveness of the health status of people.

Keywords: cultural context of health, economic status, gender and health, rural health care

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Authors: Mohamed Eladham Fadl M. E. Fadl

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In Egypt, wastewater has been used for irrigation in areas with fresh water scarcity. However, continuous applications may cause potential risks. Thus, the current study aims at screening the impacts of long-term wastewater irrigation on soil pollution and human health due to the exposure of heavy metals. Soils of nine sites in Al-Qalyubiyah Governorate, Egypt were sampled and analyzed for different properties. Wastewater resulted in a build-up of metals in soils. The pollution index (PI) showed the order of Cd > Pb > Ni > Zn. The integrated pollution index of Nemerow’s (IPIN) exceeded the safe limit of 0.7. The enrichment factor (EF) surpassed 1.0 value proving anthropogenic effects. The geo-accumulation index (Igeo) indicated that Pb, Ni, and Zn-induced none to moderate pollution, while high threats were associated with Cd. The calculated hazard index proved a potential health risk for humans, particularly children. It is recommended to perform a treatment to the wastewater used in irrigation to avoid such threats.

Keywords: pollution, health risks, heavy metals, effluent, irrigation, GIS techniques

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Authors: Mansoor Aslamzai, Delaqa Del, Sayed Azam Sajid

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Introduction: Though moral disorders have a high burden, there is no separate topic regarding this problem in the International Classification of Diseases (ICD). Along with the modification of WHO ICD-11, spirituality can prevent the rapid progress of such derangement as well. Objective: This study evaluated the effects of bad moral characters on health, as well as carried out the role of spirituality in the improvement of immorality. Method: This narrative article review was accomplished in 2020-2021 and the articles were searched through the Web of Science, PubMed, BMC, and Google scholar. Results: Based on the current review, most experimental and observational studies revealed significant negative effects of unwell moral characters on the overall aspects of health and well-being. Nowadays, a lot of studies established the positive role of spirituality in the improvement of health and moral disorder. The studies concluded, facilities must be available within schools, universities, and communities for everyone to learn the knowledge of spirituality and improve their unwell moral character world. Conclusion: Considering the negative relationship between unwell moral characters and well-being, the current study proposes the addition of moral disorder as a separate topic in the WHO International Classification of Diseases. Based on this literature review, spirituality will improve moral disorder and establish excellent moral traits.

Keywords: bad moral characters, effect, health, spirituality and well-being

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Authors: Jing Ren, Guifeng Han

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The mental health of most college students in China is negative due to the multiple pressures of academics, life, and employment. The problem of psychological stress has been widely discussed and needs to be resolved immediately. Therefore, six typical green spaces in Chongqing University, China, were selected to explore the relationship between eight environmental characteristics and students' stress relief. A path analysis model is established using Amos26.0 to explain the paths for environmental characteristics influencing psychological stress relief. The results show that (1) tree species diversity (TSD) has a positive effect on stress relief, thus green coverage ratio (GCR), the proportion of water area (WAP), visual green index (VGI), and color richness (CR) have both positive and negative effects; (2) CR could reduce stress directly and indirectly, while GCR, TSD, WAP, and VGI could only reduce stress indirectly, and the most effective path is TSD→extent→stress relief; (3) CR can reduce stress more greatly for males than females, CR and VGI have better effects for art students than science students. The study can provide a theoretical reference for planning and designing campus living environments to improve students' mental health.

Keywords: public health, residential environment, space planning and management, mental health, path analysis

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Authors: Racheal Ayanga, Nancy Katumba Muwangala, Jane Babirye, Harriet Kivumbi

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Background: Deaf adolescents are vulnerable. Deafness limits their access to resources that are accessed by their hearing peers. There is minimal attention placed on the SRH needs of persons with disabilities, especially in developing countries. We sought to assess barriers to access of SRH education and services for deaf adolescents in Uganda. Methods: We performed a cross sectional study using a questionnaire on knowledge of and access to SRH education and services from a selected sample of deaf adolescents aged 13-19 years at Wakiso Secondary school for the deaf. A consecutive sample of eligible participants was asked to join the study after obtaining informed consent until the target sample size was reached. Results: From 01 Jul 2022 to 30 Jan 2023, 70 quantitative interviews were conducted. Participants’ mean age was 17 years, and 66% were female. 89% had heard about several components of SRH. 99% reported a need for education and services but had challenges with access 85% of the time. 54% reported receipt of education and services from government or private facilities, and the rest from friends, parents, siblings, teachers and the internet. Conclusion: Government needs to look into availing tailored, sustainable SRH education/services to deaf adolescents at health facilities and teach health workers sign language. SRH education to parents, teachers and communities of deaf adolescents improves access in hard-to-reach areas. Integration of services into routine health care is key in creating and improving models of access to wider communities of persons with disabilities to improve their mental health.

Keywords: sexual and reproductive health, deaf, adolescents, education, services, disabilities, mental health, hard-to-reach areas

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Authors: Wee Tong Liaw, Elaine Wong Yee Sing

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The main objective and focus of this study are to establish the significance of a sustained health promoting workplace on stock and portfolio returns focusing on companies listed on the Singapore stock exchange, using a two-factor model comprising of the single factor CAPM and a 'health promoting workplace' factor. The 'health promoting workplace' factor represents the excess returns derived between two portfolios of component stocks that, when combined, would represent a top tier stock market index in Singapore, namely the STI index. The first portfolio represents companies that are independently assessed by the Singapore’s Health Award, SHA, to have a sustained and comprehensive health promoting workplace (SHA-STI portfolio) and the second portfolio represents companies that had not been independently assessed (Non-SHA STI portfolio). Since 2001, many companies in Singapore have voluntarily participated in the bi-annual Singapore HEALTH Award initiated by the Health Promotion Board of Singapore (HPB). The Singapore HEALTH Award (SHA), is an industry-wide award and assessment process. SHA assesses and recognizes employers in Singapore for implementing a comprehensive and sustainable health promotion programme at their workplaces. When using a ten year holding period instead of a one year holding period, excess returns in the SHA-STI portfolio over Non-SHA STI portfolio were consistently being observed over all test periods, during 2001 to 2013. In addition, when applied to the SHA-STI portfolio, results from the Two Factor Model consistently revealed higher explanatory powers across all test periods for the portfolio as well as all the individual component stocks in SHA-STI portfolio, than the single factor CAPM model. However, with respect to attaining higher level of achievement in the Singapore Health Award, this study did not show any incentive for selecting listed companies that have achieved a higher level of award. Results from this study would give further insights to investors and fund managers alike who intend to consider health promoting workplace as a risk factor in their stock or portfolio selection process, in particular for investors who have a preference for STI’s component stocks and with a longer investment horizon. Key micro factors like management abilities, business development strategies and production capabilities that meet the needs of market would create the demand for a company’s product(s) or service(s) and consequently contribute to its top line and profitability. Thereafter, the existence of a sustainable health promoting workplace would be a key catalytic factor in sustaining a productive workforce needed to support the continued success of a profitable business.

Keywords: asset pricing model, company's performance, stock returns, financial risk factor, sustained health promoting workplace

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Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: Beatrice Adeoye

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Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

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Authors: Dušica Kovačević

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This study explores the influence of destructive groups on the mental health and social integration of high school students in Loznica, Serbia. Despite increasing concerns, there is a significant lack of research on the impact of these groups on adolescents in this region. This qualitative study aims to fill this gap by examining the prevalence of destructive groups, their psychological effects on students, and their broader social implications. Data were collected through surveys and in-depth interviews with high school students, educators, and mental health professionals. The study focuses on key mental health indicators, such as anxiety, depression, and identity formation, alongside social factors, including peer relationships and community engagement. Additionally, it defines coping mechanisms and supporting strategies employed by students affected by these groups. The findings reveal substantial psychological and social challenges faced by students exposed to destructive groups, including increased levels of anxiety and depression, disrupted identity development, and impaired social integration. Insights into the personal experiences of these students provide a detailed understanding of the groups’ impact, underscoring the need for targeted interventions. This research offers evidence-based recommendations for educators, mental health practitioners, and policymakers. It emphasizes the importance of developing effective educational programs and support services to enhance the well-being of high school advocates for proactive measures to protect adolescent mental health and promote healthy social values within educational and community settings.

Keywords: adolescents, mental health, destructive groups, social integration, qualitative study, high school students, Serbia

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Authors: Nadeesha Sewwandi, Dilini Shashikala, Rajarathnam Kanapathy, Shivakumaran Viyasan, Saman Kumara, Duminda Guruge

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Introduction: Nutrition is fundamental for good health and development during the early years of life. This study describes how rural community does interventions for improving the nutrition and health of children less than 5 year ages using health promotion approach and this study was conducted with children society and mothers groups in a rural village called Welankulama in Sri Lanka. Methodology: The details got from Public Health Midwife in this village showed there were malnourished children under 5 years age. So, we discussed this problem with the children society, mothers groups and identified the determinants with them. Then they wanted to address some of the determinants that they prioritized from their discussions. ‘Evening school’ was a new place to this village to do collective feeding for small children. ‘Mobile library’ was another new concept in this village and nutrition books, evidence collection were there to read for villagers. Mothers marked the foods given to their kids in a book called ‘Nutrition book’. And also mothers tend to mark the level of eating foods to motivate their children in a ‘Hapana calendar’. Results: In terms of results, malnourished children under 5 years age got reduced and the number of children having illnesses got reduced. Marking nutrition book and ‘Hapana calendar’ were become as trend among mothers. Apart from the above, there was good improvement of physical, social and emotional wellbeing of children. Children who received early stimulation with nutrition supplements had better outcomes than children who only received nutrition supplements, thereby amplifying the impact of nutrition. Conclusion: Health promotion interventions are helped to change nutritional behaviors of early childhood in rural community and it makes children healthier and better able to learn.

Keywords: early childhood, nutrition, determinants, health promotion process

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Authors: Alexandra P. Alexandropoulou, Andreas Fousteris, Eleni Didaskalou, Dimitrios A. Georgakellos

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As urbanization is becoming a major stress factor not only for the urban environment but also for the wellbeing of city dwellers, incorporating the issues of urban health in strategic city planning and policy-making has never been more relevant. The impact of urbanization can vary from low to severe and relates to all non-communicable diseases caused by the different functions of cities. Air pollution, noise pollution, water and soil pollution, availability of open green spaces, and urban heat island are the major factors that can compromise citizens' health. Urban health describes the effects of the social environment, the physical environment, and the availability and accessibility to health and social services. To assess the quality of urban wellbeing, all urban characteristics that might have an effect on citizens' health must be considered, evaluated, and introduced in integrated local planning. A series of indices and indicators can be used to better describe these effects and set the target values in policy making. Local strategic planning is one of the most valuable development tools a local city administration can possess; thus, it has become mandatory under Greek law for all municipalities. It involves a two-stage procedure; the first aims to collect, analyse and evaluate data on the current situation of the city (administrative data, population data, environmental data, social data, swot analysis), while the second aims to introduce a policy vision described and supported by distinct (nevertheless integrated) actions, plans and measures to be implemented with the aim of city development and citizen wellbeing. In this procedure, the element of health is often neglected or under-evaluated. A relative survey was conducted among all Greek local authorities in order to shed light on the current situation. Evidence shows that the rate of incorporation of health in strategic planning is lacking behind. The survey also highlights key hindrances and concerns raised by local officials and suggests a path for the way forward.

Keywords: urban health, strategic planning, local authorities, integrated development

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Authors: Ammar Ali Saleh Jaber, Amer Hayat Khan, Syed Azhar Syed Sulaiman

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Tuberculosis (TB) is considered as a major disease that affects daily activities and impairs health-related quality of life (HRQoL). The impact of TB on HRQoL can affect treatment outcome and may lead to treatment defaulting. Therefore, this study aims to evaluate the HRQoL of TB treatment lost to follow-up during and after treatment in Yemen. For this aim, this prospective study enrolled a total of 399 TB lost to follow-up patients between January 2011 and December 2015. By applying HRQoL criteria, only 136 fill the survey during treatment. Moreover, 96 were traced and fill out the HRQoL survey. All eight HRQol domains were categorized into the physical component score (PCS) and mental component score (MCS), which were calculated using QM scoring software. Results show that all lost to follow-up TB patients reported a score less than 47 for all eight domains, except general health (67.3) during their treatment period. Low scores of 27.9 and 29.8 were reported for emotional role limitation (RE) and mental health (MH), respectively. Moreover, the mental component score (MCS) was found to be only 28.9. The trace lost follow-up shows a significant improvement in all eight domains and a mental component score of 43.1. The low scores of 27.9 and 29.8 for role emotion and mental health, respectively, in addition to the MCS score of 28.9, show that severe emotional condition and reflect the higher depression during treatment period that can result to lost to follow-up. The low MH, RE, and MCS can be used as a clue for predicting future TB treatment lost to follow-up.

Keywords: Yemen, tuberculosis, health-related quality of life, Khat

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Authors: Tassana Boontong, Vilaivan Thongcharoen, Orapan Thosingha, Suphamon Chansakul, Anorut Jenwitheesuk, Chanin Chakkrapopyodhin, Isara Phiwchai, Mattika Chaichan, Rungnapha Khiewchaum

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According to Thailand health policy, subdistrict health promoting hospitals (SHPHs) serve as forefront facilities for inclusive health care service. Those services include health promotion, disease prevention, primary medical care and rehabilitation. However, SHPHs residing in some distant area, such as SHPHs residing on the islands, would deliver different services relevant to health needs of the local people and the tourists. This research aimed to study health care delivery services at SHPHs on the islands in Thailand. Data were collected using questionnaires. The result revealed that in Thailand, there are 58 SHPHs on the islands. During data collection process, the researchers were not allowed to collect data in 5 SHPHs in the southern part due to Covid-19 pandemic. The report is based on 53 SHPHs on the islands. Numbers of health care personnel were 201, 72.14 % were female, with the ages ranged from 22 to 60 years (mean = 35.56 years). About 53% were community health personnel, while 26.08% were professional nurses. In regard to work experiences, the range of year varied from less than 1 year to 30 years, with the mean of 8.36 years. The majority of their responsibilities focused on providing primary medical care (86.34%), caring of people with chronic illnesses (85.30%) and providing medical care procedures for patients with chronic illnesses at home (84.36%). Nurses were main health care personnel in performing primary medical care. Due to difficulty transportation from the islands to the mainland, nurses had to provide prompt emergency medical care while the patients arrived with emergency and critical illnesses such as severe head trauma, stroke or coronary artery disease. Although some medical procedures were complex and not covered by nursing and midwifery license, they decided to protect patients from life- threatening conditions and make them stable before transportation. In SHPHs, the workload exceeded manpower, health care personnel had to work overtime almost every day. In the famous tourist islands, health care personnel had to carry 3-4 folds of their workload during the holidays because of the large crowds of foreign and Thai tourists. It is recommended that SHPHs on the islands should scale up the level of services to cover advanced medical care. Health care personnel, in particular, professional nurses, should be equipped with emergency and critical care skills. The expected outcomes of the services should emphasize on rescuing patients with emergency and life-threatening illnesses and providing comprehensive care for people living on or visiting the islands.

Keywords: distant area, islands, sub district health promoting hospital, heath care services, Thailand

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Authors: Hakan Akin

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The aim of this study was to examine the policy making process in Turkish Health System. This policy making process will be examined through public policy change theories. Since political actors played in the formulation of public policies also explains the type of policy change, this actors will be inspected in the supranational and national basis. Also the transformation of public policy in the Turkish health care system will be analysed under the concepts of New right ideology, neo-liberalism, neo-conservatism and governance. And after this analyse, the outputs and outcomes of this transformation will be discussed in the context of developing countries.

Keywords: policy transfer, policy diffusion, policy convergence, new right, governance

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Authors: Awatef Ahmed Ben Ramadan, Aqsa Arshad

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Background: There is a huge Muslim migration movement to North America and Europe for several reasons, primarily refuge from war areas and partly to search for better work and educational chances. There are always concerns regarding first-Generation Immigrant women's health and computer literacy, an adequate understanding of the health systems, and the use of the existing healthcare technology and services effectively and efficiently. Language proficiency level, preference for cultural and traditional remedies, socioeconomic factors, fear of stereotyping, limited accessibility to health services, and general unfamiliarity with the existing health services and resources are familiar variables among these women. Aims: The current study aims to assess the health and digital literacy of first-generation Muslim women in Atlanta city. Also, the study aims to examine how the COVID-19 pandemic has encouraged the use of health information technology and increased technology awareness among the targeted women. Methods: The study design is cross-sectional correlational research. The study will be conducted to produce preliminary results that the investigators want to have to supplement an NIH grant application about leveraging information technology to reduce the health inequalities amongst the first-generation immigrant Muslim women in Atlanta City. The investigators will collect the study data in two phases using different tools. Phase one was conducted in June 2022; the investigators used tools to measure health and digital literacy amongst 42 first-generation immigrant Muslim women. Phase two was conducted in November 2022; the investigators measured the Knowledge, Attitude, and Practice (KAP) of using health information technology such as telehealth from a sample of 45 first-generation Muslim immigrant women in Atlanta; in addition, the investigators measured how the current pandemic has affected their KAP to use telemedicine and telehealth services. Both phases' study participants were recruited using convenience sampling methodology. The investigators collected around 40 of 18 years old or older first-generation Muslim immigrant women for both study phases. The study excluded Immigrants who hold work visas and second-generation immigrants. Results: At the point of submitting this abstract, the investigators are still analyzing the study data to produce preliminary results to apply for an NIH grant entitled "Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional)". This research will be the first step of a comprehensive research project to assess and measure health and digital literacy amongst a vulnerable community group. The targeted group might have different points of view from the U.S.-born inhabitants on how to: promote their health, gain healthy lifestyles and habits, screen for diseases, adhere to health treatment and follow-up plans, perceive the importance of using available and affordable technology to communicate with their providers and improve their health, and help in making serious decisions for their health. The investigators aim to develop an educational and instructional health mobile application considering the language and cultural factors that affect immigrants' ability to access different health and social support sources, know their health rights and obligations in their communities, and improve their health behavior and behavior lifestyles.

Keywords: first-generation immigrant Muslim women, telehealth, COVID-19 pandemic, health information technology, health and digital literacy

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