Search results for: utilization of mental health services

Authors: Ravinder Singh, Pratima Syal

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Background: The rising prevalence and incidence of Acute Pancreatitis (AP) and its associated metabolic variables known as metabolic syndrome (MetS) are common medical conditions with catastrophic consequences and substantial treatment costs. The correlation between MetS and AP, as well as their impact on Health Related Quality of Life (HRQoL) is uncertain, and because there are so few published studies, further research is needed. As a result, we planned this study to determine the relationship between MetS components impact on HRQoL in AP patients. Patients and Methods: A prospective, observational study involving the recruitment of patients with AP with and without MetS was carried out in tertiary care hospital of North India. Patients were classified with AP if they were diagnosed with two or more components of the following criteria, abdominal pain, serum amylase and lipase levels two or more times normal, imaging trans-abdominal ultrasound, computed tomography, or magnetic resonance. The National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criterion was used to diagnose the MetS. The various socio-demographic variables were also taken into consideration for the calculation of statistical significance (P≤.05) in AP patients. Finally, the correlation between AP and MetS, along with their impact on HRQoL was assessed using Student's t test, Pearson Correlation Coefficient, and Short Form-36 (SF-36). Results: AP with MetS (n = 100) and AP without MetS (n = 100) patients were divided into two groups. Gender, Age, Educational Status, Tobacco use, Body Mass Index (B.M.I), and Waist Hip Ratio (W.H.R) were the socio-demographic parameters found to be statistically significant (P≤.05) in AP patients with MetS. Also, all the metabolic variables were also found to statistically significant (P≤.05) and found to be increased in patients with AP with MetS as compared to AP without MetS except HDL levels. Using the SF-36 form, a greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with AP with MetS as compared to patients without MetS (P≤.05). Furthermore, a negative association between all metabolic variables with the exception of HDL, and AP was found to be producing deterioration in PCS and MCS. Conclusion: The study demonstrated that patients with AP with MetS had a worse overall HRQOL than patients with AP without MetS due to number of socio-demographic and metabolic variables having direct correlation impacting physical and mental health of patients.

Keywords: metabolic disorers, QOL, cost effectiveness, pancreatitis

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Authors: Anucha Taiwong, Nirobol Kanogsunthornrat

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This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.

Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis

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Authors: Takaharu Hirai, Yuta Mitobe, Hiromi Hirai

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Introduction: Eating disorders (ED) are serious psychiatric disorders that affect individuals, especially adolescents. It has been suggested that nonclinical ED-like characteristics are related to sleep problems. However, studies exploring the association between potential ED and sleep disorders have primarily been conducted in Europe and the United States. We conducted a survey of Japanese adolescents to investigate this claim. Method: In this cross-sectional study, 398 school-aged adolescents, aged 12–18 years old, matched for gender ratio, responded to a self-administered questionnaire survey. We used the Eating Attitudes Test-26 (EAT-26) and the Athens Insomnia Scale (AIS) to measure potential ED and sleep problems, respectively. In this study, participants with an EAT-26 total score of 0–19 points were classified as non-ED, while those with scores of 20 points or higher were classified as potential ED. Result: Of the 398 participants, 17 (4.3%) had an EAT-26 total score of 20 or higher. Among boys, the rate was 6 of 199 participants (3%), and among girls, the rate was 11 of 182 participants (6%). There were 89 participants (22.4%) with an AIS score of 6 points or higher, of which 36 (17.6%) were boys, and 53 (27.5%) were girls. Adolescents with potential ED had significantly higher rates of daytime sleep problems than those without ED. Further, while examining the types of sleep problems, adolescents with potential ED had greater problems with a sense of well-being and physical and mental functioning during the day. In contrast, no significant associations were found between potential ED and sleep initiation, awakenings during the night, early morning awakening, total sleep duration, or overall quality of sleep. Finally, nocturnal and daytime sleep scores were significantly associated with dieting, bulimia, and oral control EAT-26 sub-scores. Discussion: While Japanese adolescents with possible ED do not experience nighttime sleep problems, they do experience problems related to well-being and mental and physical functioning, which are indicators of daytime sleep problems. This may assist with early detection of disordered eating in adolescents. The study suggested that professionals working towards adolescent mental health issues need an approach that comprehensively integrates both sleep problems and potential ED.

Keywords: adolescents, potential eating disorders, sleep problems, eating attitudes test-26

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Authors: Mohamed F. Othman

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Manchester, Britain has become the destination of immigrants from different parts of the world. As a result, it is currently home to over 150 different ethnic languages. The present study investigates minority language policy and planning at the micro-level of the city. In order to get an in-depth investigation of such a policy, it was decided to cover it from two angles: the first is the policy making process. This was aimed at getting insights on how decisions regarding the provision of government services in minority languages are taken and what criteria are employed. The second angle is the service provider; i.e. the different departments in Manchester City Council (MCC), the NHS, the courts, and police, etc., to obtain information on the actual provisions of services. Data was collected through semi-structured interviews with different personnel representing different departments in MCC, solicitors, interpreters, etc.; through the internet, e.g. the websites of MCC, NHS, courts, and police, etc.; and via personal observation of provisions of community languages in government services. The results show that Manchester’s language policy is formulated around two concepts that work simultaneously: one is concerned with providing services in community languages in order to help minorities manage their life until they acquire English, and the other with helping the integration of minorities through encouraging them to learn English. In this regard, different government services are provided in community languages, though to varying degrees, depending on the numerical strength of each individual language. Thus, it is concluded that there is awareness in MCC and other government agencies working in Manchester of the linguistic diversity of the city and there are serious attempts to meet this diversity in their services. It is worth mentioning here that providing such services in minority languages are not meant to support linguistic diversity, but rather to maintain the legal right to equal opportunities among the residents of Manchester and to avoid any misunderstanding that may result due to the language barrier, especially in such areas as hospitals, courts, and police. There is actually no explicitly-mentioned language policy regarding minorities in Manchester; rather, there is an implied or covert policy resulting from factors that are not explicitly documented. That is, there are guidelines from the central government, which emphasize the principle of equal opportunities; then the implementation of such guidelines requires providing services in the different ethnic languages.

Keywords: community language, covert language policy, micro-language policy and planning, minority language

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Authors: Vijayabhaskar Reddy Kandula, Peter Provost Taillac, Balasubramanya M. A., Ram Krishnan Nair, Gokul Toshnival, Vibhu Dhawan, Vijaya Karanam, Buffy Cramer

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Introduction: The lack of Emergency Care Services (ECS) is a cause of extensive and serious public health problems in low- and middle-income countries (LMIC), Many LMIC countries have ambulance services that allow timely transfer of ill patients but due to poor care during the ‘Golden Hour’ many deaths occur which are otherwise preventable. Lack of adequate training as evidenced by a study in India is a major reason for poor care during the ‘Golden Hour’. Adapting developed country models which includes staffing specialty-trained doctors in emergency care, is neither feasible nor guarantees cost-effective ECS. Methods: Based on our assessment and felt needs by first-line doctors providing emergency care in 2014, Rajiv Gandhi Health Sciences University’s JeevaRaksha Trust in partnership with the University of Utah, USA, designed, piloted and successfully implemented a 4-day Comprehensive-Emergency Care and Life Support course (C-ECLS) for allopathic doctors. 1730 doctors completed the 4-day course between June 2014 and December- 2020. Subsequently, we conducted a survey to investigate the utilization rates and usefulness of the training. 1662 were contacted but only 309 completed the survey. The respondents had the following designations: Senior faculty (33%), junior faculty (25), Resident (16%), Private-Practitioners (8%), Medical-Officer (16%) and not-working (11%). 51% were generalists (51%) and the rest were specialists (>30 specialties). Results: 97% (271/280) felt they are better doctors because of C-ECLS. 79% (244/309) reported that training helped to save life- specialists more likely than generalists (91% v/s 68%. P<0.05). 64% agreed that they were confident of managing COVID-19 symptomatic patients better because of C-ECLS. 27% (77) were neutral; 9% (24) disagreed. 66% agreed that training helps to be confident in managing COVID-19 critically ill patients. 26% (72) were neutral; 8% (23) disagreed. Frequency of use of C-ECLS skills: Hemorrhage-control (70%), Airway (67%), circulation skills (62%), Safe-transport and communication (60%), managing critically ill patients (58%), cardiac arrest (51%), Trauma (49%), poisoning/animal bites/stings (44%), neonatal-resuscitation (39%), breathing (36%), post-partum-hemorrhage and eclampsia (35%). Among those who used the skills, the majority (ranging from (88%-94%) reported that they were able to apply the skill more effectively because of ECLS training. Conclusion: JeevaRaksha’s C-ECLS is the world’s first comprehensive training. It improves the confidence of front-line doctors and enables them to provide quality care during the ‘Golden Hour’ of emergency. It also prepares doctors to manage unknown emergencies (e.g., COVID-19). C-ECLS was piloted in Morocco, and Uzbekistan and implemented countrywide in Bhutan. C-ECLS is relevant to most settings and offers a replicable model across LMIC.

Keywords: comprehensive emergency care and life support, training, capacity building, low- and middle-income countries, developing countries

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Authors: Vandana Bali, Manab B. Bera, Parmjit S. Panesar

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Microbial production of antimicrobials as biopreservatives is the major area of focus nowadays due to increased interest of consumers towards natural and safe preservation of ready to eat food products. The agro-industrial byproduct based medium and optimized process conditions can contribute in economical production of bacteriocins. Keeping this in view, the present investigation was carried out on agro-industrial byproducts utilization for the production of bacteriocin using Enterococcus faecium BS13 isolated from local fermented food. Different agro-industrial byproduct based carbon sources (whey, potato starch liquor, kinnow peel, deoiledrice bran and molasses), nitrogen sources (soya okra, pea pod and corn steep liquor), metal ions and surfactants were tested for optimal bacteriocin production. The effect of various process parameters such as pH, temperature, inoculum level, agitation and time were also tested on bacteriocin production. The optimized medium containing whey, supplemented with 4%corn steep liquor and polysorbate-80 displayed maximum bacteriocin activity with 2% inoculum, at pH 6.5, temperature 40oC under shaking conditions (100 rpm).

Keywords: Bacteriocin, biopreservation, corn steep liquor, Enterococcus faecium, waste utilization, whey

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Authors: Carmen Cantuarias-Villessuzanne, Jeffrey Blain, Radmila Pineau

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Our research project aims at analyzing the sensitiveness of French households to urban biodiversity and urban ecosystem services (UES). Opinion surveys show that the French population is sensitive to biodiversity and ecosystem services loss, but the value given to these issues within urban fabric and real estate market lacks evidence. Using GIS data and economic evaluation, by hedonic price methods, weassess the isolated contribution of the explanatory variables of biodiversityand UES on the price of residential real estate. We analyze the variation of the valuefor three urban ecosystem services - flood control, proximity to green spaces, and refreshment - on the price of real estate whena property changes ownership. Our modeling and mapping focus on the price at theIRIS scale (statistical information unit) from 2014 to 2019. The main variables are internal characteristics of housing (area, kind of housing, heating), external characteristics(accessibility and infrastructure, economic, social, and physical environmentsuch as air pollution, noise), and biodiversity indicators and urban ecosystemservices for the Ile-de-France region. Moreover, we compare environmental values on the enhancement of greenspaces and their impact on residential choices. These studies are very useful for real estate developers because they enable them to promote green spaces, and municipalities to become more attractive.

Keywords: urban ecosystem services, sustainable real estate, urban biodiversity perception, hedonic price, environmental values

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Authors: André M. Senna, Mary L. G. S. Senna, Rosa M. Machado-de-Sena

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One of the great challenges presented in educational practice is how to ensure the students not only acquire knowledge of training courses throughout their academic life, but also how to apply it in their current professional activities. Consequently, aiming to incite changes in the education system of healthcare professionals noticed the inadequacy of the training providers to solve the social problems related to health, the education related to these procedures should initiate in the earliest years of process. Following that idea, there is another question that needs an answer: If the change in the education should start sooner, in the period of basic training of healthcare professionals, what guidelines should a permanent education program incorporate to promote changes in an already established system? For this reason, the objective of this paper is to present different views of the teaching-learning process, with the purpose of better understanding the behavior adopted by healthcare professionals, through bibliographic study. The conclusion was that more than imparting knowledge to the individual, a larger approach is necessary on permanent education programs concerning the performance of professional health services in order to foment significant changes in education.

Keywords: Health Education, continuing education, training, behavior

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Authors: Sekkal Nawel

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The Web of Things (WoT), integration of smart technologies from the Internet or network to Web architecture or application, is becoming more complex, larger, and dynamic. The WoT is associated with various elements such as sensors, devices, networks, protocols, data, functionalities, and architectures to perform services for stakeholders. These services operate in the context of the interaction of stakeholders and the WoT elements. Such context is becoming a key information source from which data are of various nature and uncertain, thus leading to complex situations. In this paper, we take interest in the development of intelligent Web services. The key ingredients of this “intelligent” notion are the context diversity, the necessity of a semantic representation to manage complex situations and the capacity to reason with uncertain data. In this perspective, we introduce a multi-layered architecture based on a generic intelligent Web service model dealing with various contexts, which proactively predict future situations and reactively respond to real-time situations in order to support decision-making. For semantic context data representation, we use PR-OWL, which is a probabilistic ontology based on Multi-Entity Bayesian Networks (MEBN). PR-OWL is flexible enough to represent complex, dynamic, and uncertain contexts, the key requirements of the development for the intelligent Web services. A case study was carried out using the proposed architecture for intelligent plant watering to show the role of proactive and reactive contextual reasoning in terms of WoT.

Keywords: smart web service, the web of things, context reasoning, proactive, reactive, multi-entity bayesian networks, PR-OWL

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Authors: McKenzie S. Braley, Lesley Jessiman

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If language reveals internal psychological processing, then it is also likely that language use in autobiographical memory transcripts may be used as a window into attachment style and related personality features. The current study, therefore, examined the possible associations between attachment style, negative affectivity, social inhibition, and linguistic features extracted from autobiographical memory transcripts. Young adult participants (n = 61) filled out attachment and personality questionnaires, and orally reported a relationship-related memory. Memories were audio-recorded and later transcribed verbatim. Using a computerized linguistic extraction tool, positive affect words, negative affect words, and cognition words were extracted. Spearman’s rank correlation coefficients revealed that attachment anxiety was negatively correlated with cognition words (r2 = -0.26, p = 0.047) and that negative affectivity was negatively correlated with positive affect words (r2 = -0.32, p = 0.012). The findings suggest that attachment style and personality are associated with speech styles indicative of both emotionality and depth of processing. Because attachment styles, negative affectivity, and social inhibition are associated with poor mental health outcomes, analyses of key linguistics features in autobiographical memory narratives may provide reliable screening tools for mental wellbeing.

Keywords: attachment style, autobiographical memory, language, negative affectivity, social inhibition

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Authors: Priyanka R. Sagar

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Social economic status (SES) is a variable that denotes the social standing of a person in society, and quality of life is a measure of health, happiness, and comfort of an individual. During early 2020, the world was stuck by the blow of the COVID-19 pandemic resulting in minimal or no economic activities to takes place. The present research paper is an attempt to analyze the socioeconomic status and quality of life of construction workers dwelling in the sub-urban areas of Hoskote located in the Bengaluru rural district pre and post-COVID-19. It also tries to analyze the difference in these variables pre and post-COVID-19. The study uses a retrospective design and data collected through a questionnaire survey from the respondents of Hoskote. A total of 100 samples were collected, out of which 73% were men and 27% were women. The mean age group of the participants is 41.04 ± 6.97 years. The overall analysis of the study shows that there is a significant difference in the socioeconomic status of construction workers pre and post-COVID-19. The study shows SES of the workers pre-pandemic is higher than post-pandemic. The other variable is quality of life which consists of physical health, psychological health, social relationships, and environmental domains. The study depicts that the psychological domain alone has been impacted by the pandemic; workers had better mental health pre-COVID-19. The other domains, i.e., physical health, social relationship, and environment, remain unaffected.

Keywords: socio-economic status, quality of life, construction workers, COVID-19

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Authors: Soo-Bi Lee, Jun Young Jeong, Zehgn Lin, Chenminxi

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Background: In South Korea, a problematic phenomenon has recently arisen whereby adult children continue to receive parentalcaregivingin some cases. These phenomena has been shown to affect the mental health of mothers. Study Goals: The purposes of this study are to verify whether the mediating effects of stress on the relationship between a woman’s care burden for their adult children and depression are moderated by their satisfaction about their husbands’ sharing of the caregiving. Methodology: This study analyzed 3,053 married women with adult children using the most recent data from the “Korean Longitudinal Survey of Women & Families 7th(2018)" conducted at the national level. The analysis was conducted using the SPSS Process Macro Model 7 to verify the moderated mediating effects and subsequently confirm their significance based on the bootstrapping method. Results and Implications: (1) Stress was identified a mediating factor in the relationship between the care burden for adult children and depression; and (2) the mediating effects of stress on depression from the burden of caring for adult children are modulated by the woman's satisfaction with her husband’s sharing of the care burden. In other words, the higher the caring burden of adult children, the higher the mother's stress, which increases depression. At this time, the higher the their satisfaction with the husband's share of care in the path of mother's care burden and stress, the lower the mother's stress and, ultimately, the depression be alleviated. Conclusion: Programs that promote the mental health of married women heavily with the caring burden for their adult children, as well as those that improve social awareness regarding husbands' sharing of the care burden, should be implemented. Also, social welfare policy alternatives are needed at the national level to reduce the caring burden caused by adult children.

Keywords: married women, adult children care burden, stress, depression, satisfaction with husbands sharing of the care

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Authors: Dania Baaboud, Renad Al-zahrani, Mahnoor Khan, Riya Afroz

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Flo is a smart period-tracking tool that uses artificial intelligence (AI) to offer individualized reproductive health predictions and insights. Flo makes very accurate predictions about menstrual cycles, ovulation, and fertility windows by evaluating user inputs, including cycle duration, symptoms, and patterns. Its machine learning algorithms are constantly evolving, providing personalized health recommendations, instructional materials, and early identification of possible health abnormalities such as reproductive problems and hormone imbalances. Flo, which was introduced in 2015 and upgraded with AI in 2017, is a revolutionary use of technology in healthcare that empowers people to make knowledgeable decisions regarding their well-being. Despite its advantages, our study included drawbacks, such as limited access to premium services and a small sample size. While highlighting unique characteristics, a comparative comparison with similar applications such as Clue and Glow confirmed Flo's outstanding AI integration for individualized healthcare. All things considered, Flo is a prime example of how AI can be used to tackle intricate biological processes, giving consumers the ability to efficiently control their reproductive health and opening the door for improvements in individualized medical technology.

Keywords: Flo, period-tracking app, period symptoms, women’s health, machinery

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa, Annabella Habinka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to a lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. We aimed at; i) increase awareness and understanding of teledermatology among prison health workers and ii) improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons. Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prison staff with AD. We conducted five days of training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient-Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: We have the very first iconographic atlas of the main dermatoses in pigmented African skin. We increased; i) the proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80%; ii) the proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year; iii) increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year and iv)Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year. Our study contributes to the use, evaluation, and verification of the use of teledermatology to increase access to specialist dermatology services to the most hard to reach areas and vulnerable populations such as that of prisoners.

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Mohsen Maraoui

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In the face of the growth in the quantity of data produced, several methods and techniques appear to remedy the problems of processing and analyzing large amounts of information mainly in the field of teaching. In this paper, we propose an intelligent cloud-based teaching system for E-learning content services. This system makes easy the manipulation of various educational content forms, including text, images, videos, 3 dimensions objects and scenes of virtual reality and augmented reality. We discuss the integration of institutional and external services to provide personalized assistance to university members in their daily activities. The proposed system provides an intelligent solution for media services that can be accessed from smart devices cloud-based intelligent service environment with a fully integrated system.

Keywords: cloud computing, e-learning, indexation, IoT, learning in Arabic language, smart tools

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Authors: Esther Moraleda Sepúlveda, Soraya Delgado Matute, Paula Salido Escudero, Raquel Mimoso García, M Cristina Alcón Lancho

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Although there is some consensus when it comes to establishing the lexicon as one of the strengths of language in people with Down Syndrome (DS), little is known about its evolution throughout development and changes based on age. The objective of this study was to find out if there are differences in receptive vocabulary between adolescence and adulthood. In this research, 30 people with DS between 11 and 40 years old, divided into two age ranges (11-18; 19 - 30) and matched in mental age, were evaluated through the Peabody Vocabulary Test. The results show significant differences between both groups in favor of the group with the oldest chronological age and a direct correlation between chronological age and receptive vocabulary development, regardless of mental age. These data support the natural evolution of the passive lexicon in people with DS.

Keywords: down syndrome, language, receptive vocabulary, adolescents, adults

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Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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Authors: Lucia Mavudzi

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Socioeconomic and demographic factors influence male attendance of antenatal care (ANC) activities which are beneficial in improving maternal health and birth outcome. When a male, as the head of the family is expected to solely make decisions of how finances are managed, when and where health services are sought, it impacts on the woman’s health seeking behavior. Using the data from the Zimbabwe Demographic and Health Survey 2010-2011 this paper seeks to assess the prevalence of male ANC attendance in Zimbabwe and factors that influence male ANC attendance. We hypothesized that socioeconomic and demographic factors do not influence male ANC attendance. To achieve the objectives of this paper, descriptive analysis was used to describe the characteristics of men and the Binomial logistic modelling was used to assess the relationship between male ANC attendance and selected socioeconomic and demographic factors. Male ANC attendance was used as the dependent variable, and the independent variables are age, marital status, place of residence, wealth, education, religion and employment. A high percentage of males did not attend ANC with their pregnant partners. Religion, education, and place of residence were found to be significantly associated with male ANC attendance. There was no evidence to show that there was a difference in male ANC attendance by employment, marital status, and age. Findings from this paper are relevant to public health. They will be used to develop strategies and intervention programs to improve pregnant women’s attendance of ANC attendance by involving men in maternal health.

Keywords: antenatal care, male participation, maternal health, socio-economic and demographic factors

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Authors: Cam-Duc Au, Philippe Krahnhof, Lars Klingenberger

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German banks are experiencing harsh times due to rising costs and declining profits. On the one hand, acquisition costs for new customers are increasing because of the rise of innovative FinTechs, which entered the market with one specific goal: disrupting the whole financial services industry by occupying parts of the value chain. On the other hand, the COVID-19 pandemic, as well as an overall low level of interest rates, cause the traditional source of bank income to still drain. Consequently, traditional banks must rethink their strategies or their identity, so to speak, because they go beyond their traditional offering of products and services. Having said that, banks may create new sources of income to stabilize their economic situation and replenish profits. The given paper aims to research the opportunities of establishing an ecosystem model. In doing so, the paper contributes to the current literature debate and provide reference points for traditional banks to start. Firstly, a systematic literature review introduces a selection of research works the author regards as significant. In the following step, quantitative data from an online survey with bank clients are analysed by means of descriptive statistics to show the perspective of Germans with regards to an ecosystem offering. The final research findings indicate that the surveyed retail banking clients express interest in the new offer, whereas non-financial products and services are of lower interest than their financial pendants.

Keywords: banking, ecosystem, disruptive innovation, digital offering, open-banking-strategy, financial services industry

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Authors: S. O. Ayansina, O. A. Adekunle

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There is an increasing demand for a functional extension delivery services in Nigeria with a view to meet up with the food and fiber needs of the ever growing population of human and animal respectively. The study was therefore designed to examine the farmers’ preference for public and private extension services in Southwestern Nigeria, specifically to determine the farmers’ level of participation in the two types of organizations involved and also to evaluate the Performance level of personnel in the two organizations in order to ascertain the beneficiaries’ satisfaction. A multi-stage random sampling technique was used to samples 30 respondents from each of the three selected organizations in each of the three states sampled in Southwestern Nigeria. Hence, 270 respondents were sampled for the study. Data collected were analyzed with Kruskal Wallis one-way Analysis of variance to test the difference between the participation of beneficiaries in the public and private extension services and the level of benefit accrued from the two organizations involved in the study. Results generally revealed that private organizations were performing better and were more preferred by the beneficiaries. Results of the tested hypotheses as shown by Kruskal Wallis test of difference (x2=0.709) indicates no significant difference between farmers’ participation in the extension services of public and private organizations but however shows significant difference (X2=12.074) in the benefits achieved by respondents in the two organizations, such benefits include: increased quantity of Crop produced, farm income, skill acquisition, and improved Education in private extension organizations. Based on this result, it could be inferred that beneficiaries generally preferred private extension organizations because of their effectiveness and vibrancy in programme administration. Public extension is therefore recommended for general overhauling and possibly “merging” of public and private sectors in order to cater for teeming population of farmers demanding for efficient and functional extension services to better their lots both in production and processing.

Keywords: public and private involvement, extension services, farmers’ preferences, Kruskal Wallis Test

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Authors: Brenda R. Berca, Jessica S. Vieira, Lucas G. Candido, Matheus C. Ferreira, Paulo S. A. Lopes Filho, Rafaella O. Baracho

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This study aims to estimate the economic value environmental services sustained by Flamboyant Lourival Louza Municipal Park in Goiânia, Goiás, Brazil. The Flamboyant Park is one of the most relevant urban parks, and it is located near a stadium, a shopping center, and two supercenters. In order to define the methods used for the valuation of Flamboyant Park, the first step was carrying out bibliographical research with the view to better understand which method is most feasible to valuate the Park. Thus, the following direct methods were selected: travel cost, hedonic pricing, and contingent valuation. In addition, an indirect method (replacement cost) was applied at Flamboyant Park. The second step was creating and applying two surveys. The first survey aimed at the visitors of the park, addressing socio-economic issues, the use of the Park, as well as its importance and the willingness the visitors, had to pay for its existence. The second survey was destined to the existing trade in the Park, in order to collect data regarding the profits obtained by them. In the end, the characterization of the profile of the visitors and the application of the methods of contingent valuation, travel cost, replacement cost and hedonic pricing were obtained, thus monetarily valuing the various ecosystem services sustained by the park. Some services were not valued due to difficulties encountered during the process.

Keywords: contingent valuation, ecosystem services, economic environmental valuation, hedonic pricing, travel cost

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Authors: Iman Shabanzadeh

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In terms of its geopolitical position, Iran has been one of the main centers of migration movements in the world in recent decades. However, the policy makers' lack of preparation in completing the cycle of social integration of these immigrants, especially the second and third generation, has caused these people to always be prone to leave the country and immigrate to developed and industrialized countries. In this research, the issue of integration of immigrants in Iran from the perspective of four indicators, "Identity Documents", "Access to Banking Services", "Access to Health and Treatment Services" and "Obtaining a Driver's License" will be analyzed. The research method is descriptive-analytical. To collect information, library and document sources in the field of laws and regulations related to immigrants' rights in Iran, semi-structured interviews with experts have been used. The investigations of this study show that none of the residence documents of immigrants in Iran guarantee the full enjoyment of basic citizenship rights for them. In fact, the function of many of these identity documents, such as the census card, educational support card, etc., is only to prevent crossing the border, and none of them guarantee the basic rights of citizenship. Therefore, for many immigrants, the difference between legality and illegality is only in the risk of crossing the border, and this has led to the spread of the habit of illegal presence for them. Despite this, it seems that there is no clear and coherent policy framework around the issue of foreign immigrants in the country. This policy incoherence can be clearly seen in the diversity and plurality of identity and legal documents of the citizens present in the country and the policy maker's lack of planning to integrate and organize the identity of this huge group. Examining the differences and socioeconomic inequalities between immigrants and the native Iranian population shows that immigrants have been poorly integrated into the structures of Iranian society from an economic and social point of view.

Keywords: immigrants, social integration, citizen services, structural inequality

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Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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Authors: Evrim Genc Kumtepe, Elif Toprak, Aylin Ozturk, Gamze Tuna, Hakan Kilinc, Irem Aydin Menderis

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Support services are very significant elements for all educational institutions in general; however, for distance learners, these services are more essential than traditional (face-to-face) counterparts. One of the most important reasons for this is that learners and instructors do not share the same physical environment and that distance learning settings generally require intrapersonal interactions rather than interpersonal ones. Some learners in distance learning programs feel isolated. Furthermore, some fail to feel a sense of belonging to the institution because of lack of self-management skills, lack of motivation levels, and the need of being socialized, so that they are more likely to fail or drop out of an online class. In order to overcome all these problems, support services have emerged as a critical element for an effective and sustainable distance education system. Within the context of distance education support services, it is natural to include technology-based and web-based services and also the related materials. Moreover, institutions in education sector are expected to use information and communication technologies effectively in order to be successful in educational activities and programs. In terms of the sustainability of the system, an institution should provide distance education services through ICT enabled processes to support all stakeholders in the system, particularly distance learners. In this study, it is envisaged to develop a model based on the current support services literature in the field of open and distance learning and the applications of the distance higher education institutions. Specifically, content analysis technique is used to evaluate the existing literature in the distance education support services, the information published on websites, and applications of distance higher education institutions across the world. A total of 60 institutions met the inclusion criteria which are language option (English) and availability of materials in the websites. The six field experts contributed to brainstorming process to develop and extract codes for the coding scheme. During the coding process, these preset and emergent codes are used to conduct analyses. Two coders independently reviewed and coded each assigned website to ensure that all coders are interpreting the data the same way and to establish inter-coder reliability. Once each web page is included in descriptive and relational analysis, a model of support services is developed by examining the generated codes and themes. It is believed that such a model would serve as a quality guide for future institutions, as well as the current ones.

Keywords: support services, open education, distance learning, support model

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Authors: Joanne M. Emmens

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This paper makes use of the case notes of a single psychoanalytically informed psychotherapy of a now 72-year-old man over a four-year period to explore the potential of qualitative data to be incorporated into a research methodology that can contribute theory and knowledge to the wider professional community involved in mental health care. The clinical material arising out of any psychoanalysis provides a potentially rich source of clinical data that could contribute valuably to our historical understanding of both individual and societal traumata. As psychoanalysis is primarily an investigation, it is argued that clinical case material is a rich source of qualitative data which has relevance for sociological and historical understandings and that it can potentially aluminate important ‘gaps’ and collective blind spots that manifest unconsciously and are a contributing factor in the transmission of trauma, silently across generations. By attending to this case material the hope is to illustrate the value of using a psychoanalytic centred methodology. It is argued that the study of individual defences and the manner in which they come into consciousness, allows an insight into group defences and the unconscious forces that contribute to the silencing or un-noticing of important sources (or originators) of mental suffering.

Keywords: dream furniture (Bion) and psychotic functioning, reverie, screen memories, selected fact

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Authors: Ananta R. Adhikari

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In today's era, polymer composite utilization has witnessed a significant increase across various fronts of material science advancement. Despite the development of many highly sophisticated technologies aimed at modifying polymer composites, there persists a quest for a technology that is straightforward, energy-efficient, easily controllable, cost-effective, time-saving, and environmentally friendly. Microwave technology has emerged as a major technique in material synthesis and modification due to its unique characteristics such as rapid, selective, uniform heating, and, particularly, direct heating based on molecular interaction. This study will be about the utilization of microwave energy as an alternative technique for material processing. Specifically, we will explore ongoing research conducted in our laboratory, focusing on its applications in the medical field.

Keywords: polymer composites, material processing, microstructure, microwave radiation

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Authors: Abera Kotu, Girma Tesema, Mitiku Tadesse

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This study investigated ACE supported instruction and pre-service mathematics teachers’ mental construction in solving equations and inequalities. A mixed approach with concurrent parallel design was employed. It was conducted on two intact groups of regular first-year pre-service mathematics teachers at Fiche College of Teachers’ Education in which one group was assigned as an intervention group and the other group as a comparison group using the lottery method. There were 33 participants in the intervention and 32 participants in the comparison. Six pre-service mathematics teachers were selected for interview using purposive sampling based on pre-test results. An instruction supported with ACE cycle was given to the intervention group for two weeks duration of time. Written tasks, interviews, and observations were used to collect data. Data collected from written tasks were analyzed quantitatively using independent samples t-test and effect size. Data collected from interviews and observations were analyzed narratively. The findings of the study uncovered that ACE-supported instruction has a moderate effect on Pre-service Mathematics Teachers’ levels of conceptualizations of action, process, object, ad schema. Moreover, the ACE supported group out scored and performed better than the usual traditional method supported groups across the levels of conceptualization. The majority of pre-service mathematics teachers’ levels of conceptualizations were at action and process levels and their levels of conceptualization were linked with genetic decomposition more at action and object levels than object and schema. The use of ACE supported instruction is recommended to improve pre-service mathematics teachers’ mental construction.

Keywords: ACE teaching cycle, APOS theory, mental construction, genetic composition

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Authors: Emanuela Zilli, Antonio Madia, Milvia Marchiori, Paola Anello, Chiara Cabbia, Emanuela Velo, Delia Campagnolo, Michele Scomazzon, Emanuela Salvatico, S. Tikvina, Antonio Miotti

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Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Antiviral medicines can cure more than 95% of cases of hepatitis C infection, but access to diagnosis and treatment remains low. The ULSS 6 Euganea – Health Trust has implemented a campaign to eradicate hepatitis C in the province of Padua (North-East of Italy), which can be subdivided into three areas: North (300.000 inhabitants), Centre (400.000) and South (300.000). In September 2021, the project was launched in the Northern area; a set of brochures was distributed in outpatient services, general practitioners’ clinics and offices, community pharmacy services, social health districts, and through social networks. The Hepatology Service contacted 460 patients selected by the Clinical Laboratory (positivity for HCV antibodies): 83 patients (18.0%) had been already cured of HCV infection, missing or deceased; 377 patients (82.0%) met the criteria to be eligible for HCV eradication therapy and were therefore included in a Day Service specific agenda and followed by a multidisciplinary team of healthcare professionals, with a dedicated telephone line. Haemato-chemical tests, general medical check-ups and ultrasound tests with fibroscan were performed. Patients were tested for Sars-CoV-2 positivity; those not yet vaccinated against Covid-19 were encouraged to complete the vaccination scheme. All 377 patients (100%) received HCV eradication therapy at the community pharmacy service; a detailed explanation of how to take their medication was provided. At the end of the first phase, Covid-19 vaccination rate was 100% (377/377), including patients already vaccinated and new-vaccinated. Check-up appointments were arranged after 2 or 3 months, according to the treatment plan. The awareness campaign and the organization of HCV eradication therapy service by ULSS 6 Euganea are proving to be effective; the project is now going to be applied to Central and Southern areas of the province (1.132 patients).

Keywords: public health, HCV-eradication, Covid-19 emergency, health communication strategies

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Authors: Petra Gajdačová

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The presented research deals with a complex evaluation of after-harvest remnants utilization for particleboard production. Agricultural crops that are in the Czech Republic widely grown are in the scope of interest. Researches dealing with composites from agricultural rests solved mostly physical and mechanical properties of produced materials. For the commercialization of these results, however, one another step is essential. It is needed to evaluate the composites production from agricultural rests more comprehensive, take into account all aspects that affect their production, not only material characteristics of produced composites. In this study, descriptive, comparative and synthesis methods were used. Results of this research include a supply stability forecast, technical and technological differences of production of particleboards from agricultural rests and quantification of an economical potential of the agricultural rests.

Keywords: agricultural crops, annual plant, composite material, particleboard

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Authors: Shusmita Khan, Shams El Arifeen, Kanta Jamil

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Background: Nutrition transition in Bangladesh has progressed across various relevant socio-demographic contextual issues. For a developing country like Bangladesh, its is believed that, overnutrition is less prevalent than undernutrition. However, recent evidence suggests that a rapid shift is taking place where overweight is subduing underweight. With this rapid increase, for Bangladesh, it will be challenging to achieve the global agenda on halting overweight and obesity. Methods: A secondary analysis was performed from six successive national demographic and health surveys to get the trend on undernutrition and overnutrition for women from reproductive age. In addition, national relevant policy papers were reviewed to determine the countries readiness for whole of the systems approach to tackle this epidemic. Results: Over the last decade, the proportion of women with low body mass index (BMI<18.5), an indicator of undernutrition, has decreased markedly from 34% to 19%. However, the proportion of overweight women (BMI ≥25) increased alarmingly from 9% to 24% over the same period. If the WHO cutoff for public health action (BMI ≥23) is used, the proportion of overweight women has increased from 17% in 2004 to 39% in 2014. The increasing rate of obesity among women is a major challenge to obstetric practice for both women and fetuses. In the long term, overweight women are also at risk of future obesity, diabetes, hyperlipidemia, hypertension, and heart disease. These diseases have serious impact on health care systems. Costs associated with overweight and obesity involves direct and indirect costs. Direct costs include preventive, diagnostic, and treatment services related to obesity. Indirect costs relate to morbidity and mortality costs including productivity. Looking at the Bangladesh Health Facility Survey, it is found that the country is bot prepared for providing nutrition-related health services, regarding prevention, screening, management and treatment. Therefore, if this nutrition transition is not addressed properly, Bangladesh will not be able to achieve the target of the NCD global monitoring framework of the WHO. Conclusion: Addressing this nutrition transition requires contending ‘malnutrition in all its forms’ and addressing it with integrated approaches. Whole of the systems action is required at all levels—starting from improving multi-sectoral coordination to scaling up nutrition-specific and nutrition-sensitive mainstreamed interventions keeping health system in mind.

Keywords: nutrition transition, Bangladesh, health system, undernutrition, overnutrition, obesity

Procedia PDF Downloads 288