Search results for: infant mental health

Authors: M. Aljumaan, F. Alkhadra, A. Aldajani, M. Alarfaj, A. Alawami, Y. Aljamaan

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Introduction: The internet has been widely available with 18 million users in Saudi Arabia alone. It was shown that 58% of Saudis are using the internet as a source of health-related information which may contribute to overcrowding of the Emergency Room (ER). Not many studies have been conducted to show the effect of online searching for health related information (HRI) and its role in influencing internet users to visit various health care facilities. So the main objective is to determine a correlation between HRI website use and health care facility visits in Saudi Arabia. Methodology: By conducting a cross sectional study and distributing a questionnaire, a total number of 1095 people were included in the study. Demographic data was collected as well as questions including the use of HRI websites, type of websites used, the reason behind the internet search, which health care facility it lead them to visit and whether seeking health information on the internet influenced their attitude towards visiting health care facilities. The survey was distributed using an internet survey applications. The data was then put on an excel sheet and analyzed with the help of a biostatician for making a correlation. Results: We found 91.4% of our population have used the internet for medical information using mainly General medical websites (77.8%), Forums (34.2%), Social Media (21.6%), and government websites (21.6%). We also found that 66.9% have used the internet for medical information to diagnose and treat their medical conditions on their own while 34.7% did so due to the inability to have a close referral and 29.5% due to their lack of time. Searching for health related information online caused 62.5% of people to visit health care facilities. Outpatient clinics were most visited at 77.9% followed by the ER (27.9%). The remaining 37.5% do not visit because using HRI websites reassure them of their condition. Conclusion: In conclusion, there may be a correlation between health information website use and health care facility visits. However, to avoid potentially inaccurate medical information, we believe doctors have an important role in educating their patients and the public on where to obtain the correct information & advertise the sites that are regulated by health care officials.

Keywords: ER visits, health related information, internet, medical websites

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Authors: Murat İskender Aktaş, Selma Söyük

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The aim of this work is to specify the levels of organizational cynicism health workers. Organizational cynicism concept is evaluated in three sub-branches and these are cognitive, affective, and behavioral. The main objective of the work is to answer the questions about the relationship of demographic characteristics like sub-branches of cynicism and age, marital status, education level, total working hours, occupational groups and income levels. As works in our country are analyzed, there have been studies about cynicism in health and other sectors. However, there were no master’s thesis or organizational cynicism research found about the public health professionals. This is why the aim was chosen as to specify the levels of organizational cynicism of public health professionals. The average of the answers of the health workers to the questions about cynicism levels are 2.86. As organizational cynicism is evaluated according to the sub-branches, cognitive subscale average score is 3.21 affective subscale average score is 2.68 and behavioral subscale average score is counted as 2.67. As the results are analyzed, it is seen that the behavioral subscale has the highest average. This shows that the workers are often criticizing the internal complaints and organizational information with their friends out of the organization.

Keywords: cynicism, organizational cynicism, health care workers

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Authors: Eda Yakit Ak, Ergül Aslan

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The study was conducted using the quasi-experimental design to determine the influence of the nursing support program prepared according to the Health Belief Model on reproductive health behaviors of orthopedically disabled women in the physical therapy and rehabilitation clinic at a university hospital between August 2019-October, 2020. The research sample included 50 women (35 in the control group and 15 in the experimental group with orthopedic disability). A 3-week nursing support program was applied to the experimental group of women. To collect the data, Introductory Information Form and Scale for Determining the Protective Attitudes of Married Women towards Reproductive Health (SDPAMW) were applied. The evaluation was made with a follow-up form for four months. In the first evaluation, the total SDPAMW scores were 119.93±20.59 for the experimental group and 122.20±16.71 for the control group. In the final evaluation, the total SDPAMW scores were 144.27±11.95 for the experimental group and 118.00±16.43 for the control group. The difference between the groups regarding the first and final evaluations for the total SDPAMW scores was statistically significant (p<0.01). In the experimental group, between the first and final evaluations regarding the sub-dimensions of SDPAMW, an increase was found in the behavior of seeing the doctor on reproductive health issues, protection from reproductive organ and breast cancer, general health behaviors to protect reproductive health, and protection from genital tract infections (p<0.05). Consequently, the nursing support program based on the Health Belief Model applied to orthopedically disabled women positively affected reproductive health behaviors.

Keywords: orthopedically disabled, woman, reproductive health, nursing support program, health belief model

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Authors: Lateefat Amao, Misagh Faezipour

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Implementing electronic health records (EHR) in healthcare is a pivotal transition aimed at digitizing and optimizing patient health information management. The expectations associated with this transition are high, even towards other health information systems (HIS) and health technology. This multifaceted process involves careful planning and execution to improve the quality and efficiency of patient care, especially as healthcare technology is a sensitive niche. Key considerations include a thorough needs assessment, judicious vendor selection, robust infrastructure development, and training and adaptation of healthcare professionals. Comprehensive training programs, data migration from legacy systems and models, interoperability, as well as security and regulatory compliance are imperative for healthcare staff to navigate EHR systems adeptly. The purpose of this work is to offer a comprehensive review of the literature on EHR implementation. It explores the impact of this health technology on health practices, highlights challenges and barriers to its successful utility, and offers practical strategies that can impact its success in healthcare. This paper provides a thorough review of studies on the adoption of EHRs, emphasizing the wide range of experiences and results connected to EHR use in the medical field, especially across different types of healthcare organizations.

Keywords: healthcare, electronic health records, EHR implementation, patient care, interoperability

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Authors: Reihaneh Rafiemanzelat, Maryam Baradaran

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Creating healthy communities that are sustainable and livable is a desire of policy makers in European countries. Indicators have used at the level of international, national, state to evaluate the level of health in cities and regions. Therefore, there are many challenges in the assumption of health and planning indicators. This research provides an overview of health indicators used to date in Europe according to World Health Organization (WHO) strategy. It then discusses on how indicators have been successful to the creation of healthy, livable and sustainable cities in Europe. This research is based on qualitative research to review the documentary researches on health issue and urban planning. The result will show the positive and negative effects of in process indicators on European cities.

Keywords: healthy community, livability, sustainability, WHO strategy

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Authors: Nattanon Peerapen, Wanwisa Insang, Lanlalin Khumman, Wipada Juanprajak, Sikan Na Chiangmai, Wacharin Suksanan, Thanasak Tantinakom

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This research was intended to study guidelines from elderly care businesses that are continuously growing and rapidly benefitting because these businesses respond to the needs of those who cannot find time to in take care of their elderly people, including intimate care services from the caregivers, thus rapidly expanding elderly care businesses to have recently become interesting domestically and internationally. Chiang Mai is a popular choice for the businesses because of excellent weathers and simple and peaceful ways of living, thus making the businesses grow rapidly and continuously. The sample group consisted of 5 persons, executives and staff, from each of the 4 businesses that provide elderly cares chosen to interview by the researches, which were Vivo Bene Village, Baan Donsuk, PT Nursing Home, and PD Nursing Home. The interviews indicated that most elderly care businesses are located in rural areas with moving traffics, shady environments, and far from crowded urban areas since elderly people need peacefulness and clean environments that will affect their physical and mental health directly. The sections within the businesses are distinctly divided with definite duties assigned to each personnel, including welfares, remunerations, uniforms, accommodations, food and social occasions, such as birthdays or New Year festivities.

Keywords: elderly, elderly care, business strategy, success factors

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Authors: Parul Suraia, Harshit Sosan Lakra

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Indigenous communities represent some of the most marginalized populations globally, with India labeled as tribals, experiencing particularly pronounced marginalization and a concerning decline in their numbers. These communities often inhabit geographically challenging regions characterized by low population densities, posing significant challenges to providing essential infrastructure services. Jharkhand, a Schedule 5 state, is infamous for its low-level health status due to disparities in access to health care. The primary objective of this study is to investigate the spatial inequalities in healthcare accessibility among tribal populations within the state and pinpoint critical areas requiring immediate attention. Health indicators were selected based on the tribal perspective and association of Sustainable Goal 3 (Good Health and Wellbeing) with other SDGs. Focused group discussions in which tribal people and tribal experts were done in order to finalize the indicators. Employing Principal Component Analysis, two essential indices were constructed: the Tribal Health Index (THI) and the Tribal Health Intervention Index (THII). Index values were calculated based on the district-wise secondary data for Jharkhand. The bivariate spatial association technique, Moran’s I was used to assess the spatial pattern of the variables to determine if there is any clustering (positive spatial autocorrelation) or dispersion (negative spatial autocorrelation) of values across Jharkhand. The results helped in facilitating targeting policy interventions in deprived areas of Jharkhand.

Keywords: tribal health, health spatial disparities, health status, Jharkhand

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Authors: Liron Hoch

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Traditional religious and spiritual texts offer a surprising wealth of relevant theoretical and practical knowledge about human behavior. This wellspring may contribute significantly to expanding our current body of knowledge in the social sciences and criminology in particular. In Jewish religious texts, specifically by Maimonides, we can find profound analyses of human traits and guidelines for a normative way of life. Among other things, modern criminological literature attempts to link certain character traits and divergent behaviors. Using the hermeneutic phenomenological approach, we analyzed the writings of Maimonides, mainly Laws of Human Dispositions, in order to understand Moses ben Maimon's (1138–1204) view of character traits. The analysis yielded four themes: (1) Human personality between nature and nurture; (2) The complexity of human personality, imbalance and criminality; (3) Extremism as a way to achieve balance; and (4) The Middle Way, flexibility and common sense. These themes can serve therapeutic purposes, as well as inform a rehabilitation model. Grounded in a theoretical rationale about the nature of humans, this model is designed to direct individuals to balance their traits by self-reflection and constant practice of the Middle Way. The proposal we will present is that implementing this model may promote normative behavior and thus contribute to rehabilitating offenders.

Keywords: rehabilitation, traits, offenders, maimonides, middle way

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Authors: S. Wietrzychowski

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The following review has identified specific programs, as well as the elements of these programs, that have been shown to be most effective in preventing suicide in schools. Suicide is an issue that affects many students each year. Although this is a prominent issue, there are few prevention programs used within schools. The primary objective of most prevention programs is to reduce risk factors such as depression and hopelessness, and increase protective factors like support systems and help-seeking behaviors. Most programs include a gatekeeper training model, education component, peer support group, and/or counseling/treatment. Research shows that some of these programs, like the Signs of Suicide and Youth Aware of Mental Health Programme, are effective in reducing suicide behaviors and increasing protective factors. These programs have been implemented in many countries across the world and have shown promising results. Since schools can provide easy access to adolescents, implement education programs, and train staff members and students how to identify and to report suicide behaviors, school-based programs seem to be the best way to prevent suicide among adolescents. Early intervention may be an effective way to prevent suicide. Although, since early intervention is not always an option, school-based programs in high schools have also been shown to decrease suicide attempts by up to 50%. As a result of this presentation, participants will be able to 1.) list at least 2 evidence-based suicide prevention programs, 2.) identify at least 3 factors which protect against suicide, and 3.) describe at least 3 risk factors for suicide.

Keywords: school, suicide, prevention, programs

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Authors: Andrew Enaifoghe

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Women's roles in the past and modern society were typically subordinate to men. This form of discrimination against women prevented them from taking on leadership roles as they were considered male roles. However, some theories, like social thought, suggest that human minds form a map during socialization, where each category of things/objects is represented in schemata or nodes. These representations or nodules are interrelated, subject to their probability of developing together and formed based on previous experiences. The consequences of gender roles and the threat of stereotyping in the workplace have been debated by the researcher. The study also looks at the effects of stereotypes beyond test performance and the submission of socio-cultural briefs low-cost interventions in the working environment through organizational and intercultural communication. This study adopted a qualitative research method with a systematic document analysis, which allows researchers to study by consulting and making sense of written materials available in the public or private domain. The study employed the Social Identity Theory (SIT) and Organizational Control Theory to conceptualize this paper. The study discovered that when women use an interpersonally oriented leadership style in male-dominated industries, they have been found to suffer from high levels of mental ill-health and continue to endure significant amounts of pressure from their professions.

Keywords: gender roles, stereotyping, organizational, intercultural communication

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Authors: Murniwati, Nurul Khairiyah, Putri Ovieza Maizar

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The association between general and oral health is clearly important, particularly in adults with medical conditions. Many of the medical systemic conditions are either caused or aggravated by poor oral hygiene and vice versa. Hypertension is one of common medical systemic problem which has been a public health concern worldwide due to its known consequences. Those consequences must be related to oral health status as well, whether it may cause or worsen the oral health conditions. The objective of this study was to find out the association between hypertension and oral health status in adults. This study was an analytical observational study by using cross-sectional method. A total of 42 adults both male and female in Padusunan Village, Pariaman, West Sumatra, Indonesia were selected as subjects by using purposive sampling. Manual sphygmomanometer was used to measure blood pressure and dental examination was performed to calculate the decayed, missing, and filled teeth (DMFT) scores in order to represent oral health status. The data obtained was analyzed statistically using One Way ANOVA to determine the association between hypertensive adults and their oral health status. The result showed that majority age of the subjects was ranging from 51-70 years (40.5%). Based on blood pressure examination, 57.1% of subjects were classified to prehypertension. Overall, the mean of DMFT score calculated in normal, prehypertension and hypertension group was not considered statistically significant. There was no significant association (p>0.05) between hypertension and oral health status in adults.

Keywords: blood pressure, hypertension, DMFT, oral health status

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Authors: Alejandra Letelier, Anja Heilmann, Richard G. Watt, Stephen Jivraj, Georgios Tsakos

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Background: Socioeconomic position (SEP) influences adult health. People who experienced material disadvantages in childhood or adulthood tend to have higher adult disease levels than their peers from more advantaged backgrounds. Even so, life is a dynamic process and contains a series of transitions that could lead people through different socioeconomic paths. Research on social mobility takes this into account by adopting a trajectory approach, thereby providing a long-term view of the effect of SEP on health. Aim: The aim of this research examines the effects of intergenerational social mobility on adult general health, oral health and functioning in a population aged 50 and over in England. Methods: This study is based on the secondary analysis of data from the English Longitudinal Study of Ageing (ELSA). Using cross-sectional data, nine social trajectories were created based on parental and adult occupational socio-economic position. Regression models were used to estimate the associations between social trajectories and the following outcomes: adult self-rated health, self-rated oral health, oral health related quality of life, total tooth loss and grip strength; while controlling for socio-economic background and health related behaviours. Results: Associations with adult SEP were generally stronger than with childhood SEP, suggesting a stronger influence of proximal rather than distal SEP on health and oral health. Compared to the stable high group, being in the low SEP groups in childhood and adulthood was associated with poorer health and oral health for all examined outcome measures. For adult self-rated health and edentulousness, graded associations with social mobility trajectories were observed. Conclusion: Intergenerational social mobility was associated with self-rated health and total tooth loss. Compared to only those who remained in a low SEP group over time reported worse self-rated oral health and oral health related quality of life, and had lower grip strength measurements. Potential limitations in relation to data quality will be discussed.

Keywords: social determinants of oral health, social mobility, socioeconomic position and oral health, older adults oral health

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Authors: Kaili C. Zhang

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Mental well-being is an integral part of university students’ overall well-being and has been a matter of increasing concern in the UK. This study addressed the impact of university experience on students by investigating the changes students experience in their beliefs, lifestyles, and well-being during their first year of study, as well as the factors contributing to such changes. Using a longitudinal two-wave mixed method design, this project identified importantfactors that contribute to or inhibit these changes. Implications for universities across the UK are discussed.

Keywords: subjective well-being, beliefs, lifestyles, university students

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Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: health management, internet of health things, remote monitoring, senior patient

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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Authors: Doriane Micaela Andeme Bikoro, Samuel Fosso Wamba, Jean Robert Kala Kamdjoug

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Currently one of the leading fields in the market of technological innovation is digital health. In developed countries, this booming innovation is experiencing an exponential speed. We understand that in developed countries, e-health could also revolutionize the practice of medicine and therefore fill the many failures observed in medical care. Everything leads to believe that future technology is oriented towards the medical sector. The aim of this work is to explore at the same time the technological resources and the potential of health care based on new technologies; it is a case study in a rural area of Southern Cameroon. Among other things, we will make a census of the shortcomings and problems encountered, and we will propose various appropriate solutions. The work methodology used here is essentially qualitative. We used two qualitative data collection techniques, direct observation, and interviews. In fact, we spent two weeks in the field observing and conducting some semi-directive interviews with some of those responsible for these health structures. This study was conducted in three health facilities in the south of the country; including two health centers and a rural hospital. Many technological failures have been identified in the day-to-day management of these health facilities and especially in the administration of health care to patients. We note major problems such as the digital divide, the lack of qualified personnel, the state of isolation of this area. This is why various proposals are made to improve the health sector in Cameroon both technologically and medically.

Keywords: Cameroon, capacities, census, digital health, qualitative method, rural area

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Authors: Soheila Sadeghi

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— The growing integration of Artificial Intelligence (AI) into Human Resources (HR) processes has transformed the way organizations manage recruitment, performance evaluation, and employee engagement. While AI offers numerous advantages—such as improved efficiency, reduced bias, and hyper-personalization—it raises significant concerns about employee well-being, job security, fairness, and transparency. The study examines how AI shapes employee perceptions, job satisfaction, mental health, and retention. Key findings reveal that: (a) while AI can enhance efficiency and reduce bias, it also raises concerns about job security, fairness, and privacy; (b) transparency in AI systems emerges as a critical factor in fostering trust and positive employee attitudes; and (c) AI systems can both support and undermine employee well-being, depending on how they are implemented and perceived. The research introduces an AI-employee well-being Interaction Framework, illustrating how AI influences employee perceptions, behaviors, and outcomes. Organizational strategies, such as (a) clear communication, (b) upskilling programs, and (c) employee involvement in AI implementation, are identified as crucial for mitigating negative impacts and enhancing positive outcomes. The study concludes that the successful integration of AI in HR requires a balanced approach that (a) prioritizes employee well-being, (b) facilitates human-AI collaboration, and (c) ensures ethical and transparent AI practices alongside technological advancement.

Keywords: artificial intelligence, human resources, employee well-being, job satisfaction, organizational support, transparency in AI

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Authors: T. Holecki, J. Wozniak-Holecka, P. Romaniuk

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Due to the highly centralized model of financing health care in Poland, local self-government rarely undertook their own initiatives in the field of public health, particularly health promotion. However, since 2017 the possibility of applying for a subsidy to health policy programs has been allowed, with the additional resources to be retrieved from the National Health Fund, which is the dominant payer in the health system. The amount of subsidy depends on the number of inhabitants in a given unit and ranges about 40% of the total cost of the program. The aim of this paper is to assess the impact of newly implemented solutions in financing health policy on the management of public finances, as well as on the activity provided by local self-government in health promotion. An effort to estimate the amount of expenses that both local governments, and the National Health Fund, spent on local health policy programs while implementing the new solutions. The research method is the analysis of financial data obtained from the National Health Fund and from local government units, as well as reports published by the Agency for Health Technology Assessment and Pricing, which holds substantive control over the health policy programs, and releases permission for their implementation. The study was based on a comparative analysis of expenditures on the implementation of health programs in Poland in years 2010-2018. The presentation of the results includes the inclusion of average annual expenditures of local government units per 1 inhabitant, the total number of positively evaluated applications and the percentage share in total expenditures of local governments (16 voivodships areas). The most essential purpose is to determine whether the assumptions of the subsidy program are working correctly in practice, and what are the real effects of introducing legislative changes into local government levels in the context of public health tasks. The assumption of the study was that the use of a new motivation tool in the field of public management would result in multiplication of resources invested in the provision of health policy programs. Preliminary conclusions show that financial expenditures changed significantly after the introduction of public funding at the level of 40%, obtaining an increase in funding from own funds of local governments at the level of 80 to 90%.

Keywords: health care system, health policy programs, local self-governments, public health management

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Authors: Dongjoo Chin

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The purpose of this study was to investigate the effectiveness of an Early Intensive Behavioral Intervention (EIBI) program on infants with autism spectrum disorder (ASD) and to explore the factors predicting the effectiveness of the program, focusing on the infant's age, language ability, problem behaviors, and parental stress. 19 pairs of infants aged between 2 and 5 years who have had been diagnosed with ASD, and their parents participated in an EIBI program at a clinic providing evidence-based treatment based on applied behavior analysis. The measurement tools which were administered before and after the EIBI program and compared, included PEP-R, a curriculum evaluation, K-SIB-R, K-Vineland-II, K-CBCL, and PedsQL for the infants, and included PSI-SF and BDI-II for the parents. Statistical analysis was performed using a sample t-test and multiple regression analysis and the results were as follows. The EIBI program showed significant improvements in overall developmental age, curriculum assessment, and quality of life for infants. There was no difference in parenting stress or depression. Furthermore, measures for both children and parents at the start of the program predicted neither PEP-R nor the degree of improvement in curriculum evaluation measured six months later at the end of the program. Based on these results, the authors suggest future directions for developing an effective intensive early intervention (EIBI) program for infants with ASD in Korea, and discuss the implications and limitations of this study.

Keywords: applied behavior analysis, autism spectrum disorder, early intensive behavioral intervention, parental stress

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Authors: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

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The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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Authors: Husham Bayazed, Fatimah Yousif

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Purpose of Presentation: The infant immune system has a reputation for being weak and underdeveloped when compared to the adult immune system, but the comparison isn’t quite fair. At the start, as the COVID-19 pandemic drags on and evolves, many Pediatricians and kids' parents have been left with renewed questions about the consequences and sequel of infection on children and the steps to be taken if their child has the symptoms of COVID-19 or tests positive. Recent Findings Literature reviews and recent studies revealed that children are better than adults at controlling SARS-CoV-2. There was conflicting evidence on age-related differences in ACE2 expression in the nose and lungs. But scientists who measured the ‘viral load’ in children's upper airways have seen no clear difference between children and adults. Moreover, the hypothesis is that kids might be more exposed to other coronaviruses common cold, with a production of ready protective antibodies to lock on to the pandemic coronavirus. But the evidence suggests that adults also have this immunity too. Strikingly, these ‘cross-reactive’ antibodies don’t offer any special protection. Summary One of the few silver linings of the Covid-19 pandemic is that children are relatively spared. The kid's Innate Immunity is hardly the whole story, the innate immune response against SARS-CoV-2 infection is early initiative calm with low immunological tone to prevent an overactive immunity and with rapidly repair damage to the lungs in contrast to stormy waves in adults. Therefore, Kids are at much lower risk of Covid-19 infection, and they are still winning the battle against Covid-19 with their innate immunity.

Keywords: Covid-19, kids, ACE2 receptors, immunity

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Authors: Ibragim Issabekov, Byron Crape, Lyazzat Toleubekova

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Background: Palliative care substantially improves the quality of life of terminally-ill patients. Symptom control is one of the keystones in the management of patients in palliative care settings, lowering distress as well as improving the quality of life of patients with end-stage diseases. The most common symptoms causing significant distress for patients are pain, nausea and vomiting, increased respiratory secretions and mental health issues like depression. Aims are: 1. to identify best practices in symptom management in palliative patients in accordance with internationally approved guidelines and compare aforementioned with actual practices in Kazakhstan; to evaluate the criteria for assessing symptoms in terminally-ill patients, 2. to review the availability and utilization of pharmaceutical agents for pain control, management of excessive respiratory secretions, nausea, and vomiting, and delirium and 3. to develop recommendations for the systematic approach to end-of-life symptom management in Kazakhstan. Methods: The use of qualitative research methods together with systematic literature review have been employed to provide a rigorous research process to evaluate current approaches for symptom management of palliative patients in Kazakhstan. Qualitative methods include in-depth semi-structured interviews of the healthcare professionals involved in palliative care provision. Results: Obstacles were found in appropriate provision of palliative care. Inadequate education and training to manage severe symptoms, poorly defined laws and regulations for palliative care provision, and a lack of algorithms and guidelines for care were major barriers in the effective provision of palliative care. Conclusion: Assessment of palliative care in this medium-income transitional-economy country is one of the first steps in the initiation of integration of palliative care into the existing health system. Achieving this requires identifying obstacles and resolving these issues.

Keywords: end-of-life care, middle income country, palliative care, symptom control

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Authors: Sohail Bawani, Kausar S. Khan, Rozina Karmaliani, Shehnaz Mir

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Action research (AR) is one of the types of health systems research (HSR), and participatory action research (PAR) is known for being effective in health systems strengthening (HSS). The current literature on PAR for HSS cites numerous examples and case studies that led to improve health services; build child health information system; increase knowledge and awareness of people about health problems, and identify pathways for institutional and policy change by engaging people in research. But examples of marginalized communities being agents of change in health governance are not common in health systems research (HSR). This approach to PAR is at the heart of Paolo Freire’s Social Transformation Theory and Critical Consciousness building, which was used to design a community-based PAR study in the Northern/mountainous areas of Pakistan. The purpose of the study was to understand the place and role of marginalized communities in strengthening existing health governance structure (health facility and village health committees and health boards) by taking marginalized communities as partners. Community meetings were carried out to identify who is living at the social, political, cultural and economic margins in 40 different villages. Participatory reflection and analysis (PRA) tools were used during the meeting to facilitate identification. Focus group discussions were conducted with marginalized groups using PRA tools and family ethnographies with marginalized families identified through group discussions. Findings of the study revealed that for the marginalized health systems constitute more than just delivery of health services, but it also embraces social determinants that surround systems and its governance. The paper argues that from Frerian perspective people’s participation should not only be limited to knowledge generation. People must be seen active users of the knowledge that they generate for achieving better health outcomes that they want to achieve in the time to come. PAR provides a pathway to the marginalized in playing a role in health governance. The study dissemination planned shall engage the marginalized in a dialogue with service providers so that together a role for the marginalized can be outlined.

Keywords: participatory action research, health systems, marginalized, health services

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Authors: Ari Istiany, Guspri Devi Artanti, M. Si

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Based on the results Riskesdas, it is known that breastfeeding awareness about the importance of exclusive breastfeeding is still low at only 15.3 %. These conditions resulted in a very infant at risk for infectious diseases, such as diarrhea and acute respiratory infection. Therefore, the aim of this study to evaluate the video development about exclusive breastfeeding as a nutrition education media for posyandu cadre. This research used development methods for making the video about exclusive breastfeeding. The study was conducted in urban areas Rawamangun, East Jakarta. Respondents of this study were 1 media experts from the Department of Educational Technology - UNJ, 2 subject matter experts from Department of Home Economics - UNJ and 20 posyandu cadres to assess the quality of the video. Aspects assessed include the legibility of text, image display quality, color composition, clarity of sound, music appropriateness, duration, suitability of the material and language. Data were analyzed descriptively likes frequency distribution table, the average value, and deviation standard. The result of this study showed that the average score assessment according to media experts, subject matter experts, and posyandu cadres respectively was 3.43 ± 0.51 (good), 4.37 ± 0.52 (very good) and 3.6 ± 0.73 (good). The conclusion is on exclusive breastfeeding video as feasible as a media for nutrition education. While suggestions for the improvement of visual media is multiply illustrations, add material about the correct way of breastfeeding and healthy baby pictures.

Keywords: exclusive breastfeeding, posyandu cadre, video, nutrition education

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Authors: Marsha R. Lawrence

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Introduction: In February and March of 2020, many Black Americans in Albany, Georgia, were impacted by COVID-19 compared to the rest of the country. Due to misinformation and distrust in the community, citizens were not able to make good health decisions regarding COVID-19. The city of Albany applied for a grant with the Department of Health and Human Services, specifically the Office of Minority Health and it was approved. The city of Albany partnered with Albany State University to administer the grant and implementation ensued. Method: An eleven-page electronic and paper cross-sectional survey was given to participants. Albany State University recruited community partners like health care organizations and faith-based organizations to reach the citizens of Albany, Georgia. These partners reached participants through creative community activities to educate participants about COVID-19 and provide incentives to receive a vaccine. Data collection is still in progress because activities are ongoing. Anticipated Results: By December 2023, we anticipate results of the number of participants who accepted vaccines based on participants who stated providers checked their understanding, participants who were satisfied with communication regarding COVID-19 health information about the vaccine, and participants who were involved in decisions regarding the COVID-19 vaccine. Conclusion: Health communication is a subsection of health literacy. At this point, approximately 4000 individuals have received information and education about COVID-19 in the Albany area. We expect building trusting relationships played an important part in the increase in knowledge and vaccination in Albany, Georgia.

Keywords: health literacy, health communication, vaccination, COVID-19

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Authors: Yuliya E. Leshchenko, Tatyana S. Ostapenko

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Language variation is a widespread linguistic phenomenon which can affect different levels of a language system: phonological, morphological, lexical, syntactic, etc. It is obvious that the scope of possible standard alternations within a particular language is limited by a variety of its norms and regulations which set more or less clear boundaries for what is possible and what is not possible for the speakers. The possibility of lexical variation (alternate usage of lexical items within the same contexts) is based on the fact that the meanings of words are not clearly and rigidly defined in the consciousness of the speakers. Therefore, lexical variation is usually connected with unstable relationship between words and their referents: a case when a particular lexical item refers to different types of referents, or when a particular referent can be named by various lexical items. We assume that the scope of lexical variation in bilingual speech is generally wider than that observed in monolingual speech due to the fact that, besides ‘lexical item – referent’ relations it involves the possibility of cross-language variation of L1 and L2 lexical items. We use the term ‘cross-language variation’ to denote a case when two equivalent words of different languages are treated by a bilingual speaker as freely interchangeable within the common linguistic context. As distinct from code-switching which is traditionally defined as the conscious use of more than one language within one communicative act, in case of cross-language lexical variation the speaker does not perceive the alternate lexical items as belonging to different languages and, therefore, does not realize the change of language code. In the paper, the authors present research of lexical variation of adult Komi-Permyak – Russian bilingual speakers. The two languages co-exist on the territory of the Komi-Permyak District in Russia (Komi-Permyak as the ethnic language and Russian as the official state language), are usually acquired from birth in natural linguistic environment and, according to the data of sociolinguistic surveys, are both identified by the speakers as coordinate mother tongues. The experimental research demonstrated that alternation of Komi-Permyak and Russian words within one utterance/phrase is highly frequent both in speech perception and production. Moreover, our participants estimated cross-language word combinations like ‘маленькая /Russian/ нывка /Komi-Permyak/’ (‘a little girl’) or ‘мунны /Komi-Permyak/ домой /Russian/’ (‘go home’) as regular/habitual, containing no violation of any linguistic rules and being equally possible in speech as the equivalent intra-language word combinations (‘учöтик нывка’ /Komi-Permyak/ or ‘идти домой’ /Russian/). All the facts considered, we claim that constant concurrent use of the two languages results in the fact that a large number of their words tend to be intuitively interpreted by the speakers as lexical variants not only related to the same referent, but also referring to both languages or, more precisely, to none of them in particular. Consequently, we can suppose that bilingual mental lexicon includes an extensive ‘fused’ zone of lexical representations that provide the basis for cross-language variation in bilingual speech.

Keywords: bilingualism, bilingual mental lexicon, code-switching, lexical variation

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Authors: Tadewos Awugchew Wudineh

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Health and safety issues have always been a major problem and concern in the building construction industry. The health and safety regulations are stated to eliminate the potential hazards and to reduce the consequential risks. However, the importance of the regulations seems to be overlooked in building construction sites of Hawassa City. Accordingly, many companies don’t follow the regulations as construction workers are more likely to be injured and killed by construction accident than any other type of employment. This paper aimed to identify factors that affect the implementation of construction health and safety regulations, their effects and mitigation measures in building construction project sites of Hawassa City. To reach this objective, a review of literature as well as the Ethiopian construction health and safety regulations have been undertaken. Mainly a five-point Likert scale questionnaire was distributed, and statistical analysis was used to summarize, interpret the data, and to find the significances of the responses. In addition, interviews were carried out. Accordingly, the findings indicate that the top factors which affect the implementation of CHS regulations are, availability and development of a clear health and safety policy, health and safety inspections by top management, conducting health and safety training and orientation, provision of healthy and safe working environment and employment of trained safety officers. The study revealed that implementation or non-implementation of CHS regulations have effects on the worker’s productivity, job satisfaction, rate of accidents, and cost greatly. Thus, the suggestion to minimize the impact on worker’s job performance are, developing of a clear health and safety policy, management commitment towards implementation of health and safety regulations, health and safety education and training and conducting regular health and safety inspections. It was concluded from the study that good implementation of health and safety regulations are the results from administrative and management commitment which calls for more attention to be paid to improve the implementation of CHS regulations in building construction sites of Hawassa City.

Keywords: construction health and safety regulations, effects, factors, mitigation

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Authors: Michel Mikhail

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Introduction: Values, which are the guiding principles and beliefs of our lives, have an influence on one’s psychological health. This study aims to investigate how Schwartz’s four higher-order values (conservation, openness to change, self-transcendence, and self-enhancement) and religious values influence psychological health among the Arab population. Methods: A total of 1,023 respondents from nine Arab countries aged 18 to 71 filled out an online survey with measures of the following constructs: Schwartz’s four higher-order values (Portrait Value Questionnaire-21), religious values (Sahin’s Index of Islamic Moral Values), and general psychological health (General Health Questionnaire-28). Results: Two models of multiple regression were conducted to investigate the relationships between values and psychological health. Higher conservation, self-enhancement, and religious values were significantly associated with better psychological health, with conservation losing significance after adding religious values to the model. All of Schwartz’s four values were found to have a significant relationship with religious values. More self-enhancement and conservation values were associated with higher identification of religious values, and the opposite was true for the other two values. Conclusion: The findings challenged existing assumptions that conservation values relate negatively to psychological health. This finding could be explained by the congruence of conservation values and the Arab culture. The most powerful relationships were those of self-enhancement and religious values, both of which were positively associated with psychological health. As such, therapists should be aware to reconsider biases against religious or conservation values and rather pay attention to their potential positive influence over one’s psychological health.

Keywords: counseling psychology, counseling and cultural values, counseling and religious values, psychotherapy and Arab values

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