Search results for: community health

Authors: Ntokozo Mthembu

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Access to relevant health indicates people’s likelihood of survival, including craft of indigenous healing and its related practitioners- izinyanga. However, the emergence of a dreaded novel corona virus - COVID-19 that has engulfed almost the whole world has necessitated the need to revisit the state of traditional healers in South Africa. This circumstance tended to expose the reality of social settings in various social structures and related policies including the manner coloniality reveal its ugly head when it comes treatment between western and African based therapeutic practices in this country. In attempting to gain a better understanding of such experiences, primary and secondary sources were consulted when collecting data that perusal of various literature in this instance including face-to-face interviews with traditional healers working on the street of Tshwane Municipality in South Africa. Preliminary findings revealed that the emergence of this deadly virus coincided with the moment when the government agenda was focussed on fulfilment of its promise of addressing the past inequity practices, including the transformation of medical sector. This scenario can be witnessed by the manner in which government and related agencies such as health department keeps on undermining indigenous healing practice irrespective of its historical record in terms of healing profession and fighting various diseases before times of father of medicine, Imhotep. Based on these preliminary findings, it is recommended that the government should hasten the incorporation of African knowledge systems especially medicine to offer alternatives and diverse to assess the underutilised indigenous African therapeutic approach and relevant skills that could be useful in combating ailments such as COVID 19. Perhaps, the plural medical systems should be recognized and related policies are formulated to guarantee mutual respect among citizens and the incorporation of healing practices in South African health sector, Africa and in the broader global community.

Keywords: indigenous healing practice, inyanga, COVID-19, therapeutic, urban, experience

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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: Josephine Wanja Nyatia

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The relationship between vegetation and soil erosion deserves attention due to its scientific importance and practical applications. A great deal of information is available about the mechanisms and benefits of vegetation in the control of soil erosion, but the effects of soil erosion on vegetation development and succession is poorly documented. Research shows that soil erosion is the most important driving force for the degradation of upland and mountain ecosystems. Soil erosion interferes with the process of plant community development and vegetation succession, commencing with seed formation and impacting throughout the whole growth phase and affecting seed availability, dispersal, germination and establishment, plant community structure and spatial distribution. There have been almost no studies on the effects of soil erosion on seed development and availability, of surface flows on seed movement and redistribution, and their influences on soil seed bank and on vegetation establishment and distribution. However, these effects may be the main cause of low vegetation cover in regions of high soil erosion activity, and these issues need to be investigated. Moreover, soil erosion is not only a negative influence on vegetation succession and restoration but also a driving force of plant adaptation and evolution. Consequently, we need to study the effects of soil erosion on ecological processes and on development and regulation of vegetation succession from the points of view of pedology and vegetation, plant and seed ecology, and to establish an integrated theory and technology for deriving practical solutions to soil erosion problems

Keywords: soil erosion, vegetation, development, seed availability

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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: Getachew Belay Kassahun

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Background: Aspartate aminotransferase to Platelet Ratio Index (APRI) currently becomes a biomarker for screening liver fibrosis since liver biopsy procedure is invasive and variation in pathological interpretation. Clinical Laboratory Standard Institute recommends establishing age, sex and environment specific reference interval for biomarkers in a homogenous population. The current study was aimed to derive community based reference interval of APRI aged between 12 and 60 years old in Mekelle city Tigrai, Northern Ethiopia. Method: Six hundred eighty eight study participants were collected from three districts in Mekelle city. The 3 districts were selected through random sampling technique and sample size to kebelles (small administration) were distributed proportional to household number in each district. Lottery method was used at household level if more than 2 study participants to each age partition were found. A community based cross sectional in a total of 534 study participants, 264 male and 270 females, were included in the final laboratory and data analysis but around 154 study participants were excluded through exclusion criteria. Aspartate aminotransferase was analyzed through Biosystem chemistry analyzer and Sysmix machine was used to analyze platelet. Man Whitney U test non parametric stastical tool was used to appreciate stastical difference among gender after excluding the outliers through Box and Whisker. Result: The study appreciated stastical difference among gender for APRI reference interval. The combined, male and female reference interval in the current study was 0.098-0.390, 0.133-0.428 and 0.090-0.319 respectively. The upper and lower reference interval of males was higher than females in all age partition and there was no stastical difference (p-value (<0.05)) between age partition. Conclusion: The current study showed using sex specific reference interval is significant to APRI biomarker in clinical practice for result interpretation.

Keywords: reference interval, aspartate aminotransferase to platelet ratio Index, Ethiopia, tigray

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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: Marybec Griffin

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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.

Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act

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Authors: Bediru Abamecha

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Background: Domestic violence is a global problem that occurs regardless of culture, ethnicity or socio-economic class. It is known to be responsible for numerous hospital visits undertaken by women. Violence on pregnant women is a health and social problem that poses particular risks to the woman and her unborn child. Objective: The Objective of this study will be to assess prevalence of domestic violence and its correalates among pregnant women in Manna Woreda of Jimma Zone. Methods: Simple Random Sampling technique will be used to select 12 kebeles (48% of the study area) and Systematic Sampling will be used to reach to the house hold in selected kebeles in manna woreda of Jimma zone, south west Ethiopia from february 15-25, 2011. An in-depth interview will be conducted on Women affairs, police office and Nurses working and minimum of 4FGD with 6-8 members on pregnant women and selected male from the community. SPSS version 16.0 will be used to enter, clean and analyze the data. Descriptive statistics such as mean or median for continuous variables and percent for categorical variables will be made. Bivariate analysis will be used to check the association between independent variables and domestic violence. Variables found to have association with domestic violence will be entered to multiple logistic regressions for controlling the possible effect of confounders and finally the variables which had significance association will be identified on basis of OR, with 95% CI. All statistical significance will be considered at p<0.05. The qualitative data will be summarized manually and thematic analysis will be performed and finally both will be triangulated.

Keywords: ante natal care, ethiopian demographic and health survey, domestic violence, statistical package for social science

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Authors: Chiou-Shiue Ko, Pei-Fang Wu, Shu-hsien Tseng

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The researchers adopted two-year action research to investigate the professional collaborative process and development in learning communities for both early childhood and early childhood special education teachers on implementing the children’s school success curriculum framework. The participating teachers were recruited from three preschool sites for this current study. Research data were collected from multiple methods in order to ensure the data quality and validity. The results showed that participating educators had achieved professional growth, and they became more aware of teaching intentions and the preparation for the curriculum. Teachers in this research become more child-focused in teaching and create opportunities for children to participate in classroom activities and routines. The researcher also finds teachers’ participation levels were driven by each individual personality; during professional growth, some teachers are more proactive and reflective, and some are not. According to the research findings, suggestions for future studies and practices are provided.

Keywords: children’s school success curriculum framework, early childhood special education, preschool education, professional learning community

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Authors: Lancer Scott

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Purpose: High quality clinical disaster medicine requires providers working collaboratively to care for multiple patients in chaotic environments; however, many providers lack adequate training. To address this deficit, we created a competency-based, 5-hour Emergency Preparedness Training (EPT) curriculum using didactics, small-group discussion, and kinetic learning. The goal was to evaluate the effect of a short course on improving provider knowledge, confidence and skills in disaster scenarios. Methods: Diverse groups of medical university students, health care professionals, and community members were enrolled between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and two live, multi-patient mass casualty incident (MCI) scenarios. The outcome measures were based on core competencies and performance objectives developed by a curriculum task force and assessed via trained facilitator observation, pre- and post-testing, and a course evaluation. Results: 708 participants completed were trained between November 2011 and August 2014, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% various other healthcare professions. 100% of participants completed the pre-test and 71.9% completed the post-test, with average correct answers increasing from 39% to 60%. Following didactics, trainees met 73% and 96% of performance objectives for the two small group exercises and 68.5% and 61.1% of performance objectives for the two MCI scenarios. Average trainee self-assessment of both overall knowledge and skill with clinical disasters improved from 33/100 to 74/100 (overall knowledge) and 33/100 to 77/100 (overall skill). The course assessment was completed by 34.3% participants, of whom 91.5% highly recommended the course. Conclusion: A relatively short, intensive EPT course can improve the ability of a diverse group of disaster care providers to respond effectively to mass casualty scenarios.

Keywords: clinical disaster medicine, training, hospital preparedness, surge capacity, education, curriculum, research, performance, training, student, physicians, nurses, health care providers, health care

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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: 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: Prasansha Kumari

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This research intends to identify and analyze the new trends of usage the traditional farming methods to modern paddy cultivation. Information gathered through conducting interviews with total of 200 farmers in selected paddy cultivation areas in Kurunegalla district. As well as this research utilized by case study and observation in Ulpotha Traditional Village, Galgamuwa of Sri Lanka. Secondary data collected from books, articles, relevant websites and other relevant documents. Collected data analyzed by descriptive research methodology. Outcomes are there is growing interest in usage the traditional farming methods to the small consumption level paddy lands that have emerged during the last few decades as well as the research revealed that traditional farming method has identified the ecofriendly farming practices to restrict long term side effects inherited from the modern methods. The study finds out the demand of traditional rice varieties has been growing among the community as health and nutrition purpose.

Keywords: traditional farming, organic, inorganic, paddy cultivation

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Authors: Eze Chinwe Catherine, Orji Nkiru Marykate, Anyaegbunam L. C., Igbodika M.C.

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Uterine Leiomyomata (ULs) are the most frequently occurring pelvic and gynaecologic tumors in premenopausal women, occurring globally with a prevalence of 21.4%. UL represents a major public health problem in African women; therefore, this study aimed to reveal public health impact and risk factors associated with uterine leiomyomata among women in Imo state. A convenience sample of 2965 women was studied for gynaecological cases from October 2020 to March 2021 at the selected clinics of study. Eligible women were recruited to participate in a non interventional descriptive cross-sectional study. Data on socio demographic and gynaecological characteristics, BMI, parity, age, age at menarche, knowledge, attitudes, and perception were collected using a structured questionnaire, guided interviews, anthropometrics, and haematological tests. These were analyzed using SPSS Version 23. Associations between continuous variables were analysed appropriately and tested at 95% confidence level and standard error of 5%. A total of 652(22.0%) were diagnosed having uterine Leiomyomata (UL), and the overall prevalence of UF at clinics/Diagnostic centre in Imo State was 22%. A total of 652 women (46.1%) responded. More than half of the women had a parity of zero (1623: 54.8%), 664 (22.4%) had a parity of 1-2, and 491 (16.6%) had a parity of 3-4. Majority (68.6%) indicated that they experience an irregular menstrual cycle, and a similar proportion (67%) number experience pelvic pain. Age was found as a significant associating factor of uterine fibroids in this study (p=0.046, χ2= 6.158), lowest among the women between 16 to 25 years old and highest among the women between 36 – 45 years of age. The rate of UF was found to be 62.1% on the studied women menarche age of 11 years old or less while it was approximately 18% among the women whose age at menarche were at least 14 years old. Education ((p=0.003, χ²= 13.826), residency (p=0.066, χ²= 3.372). BMI (p= 0.000, χ²=102.36) were significantly associated with the risk of UL. Some of the Clinical presentation includes anaemia, abdominal pelvic mass, and infertility. The poor positive perception was obtained on the general perception (16.7%) as well as on treatment seeking behavior (28%). The study concluded that UL had a significant impact on health related quality of life on respondents due to its relatively high prevalence and their probable impact on patient’s quality of life.UL was especially prevalent in women aged between 36 to 45 years, nulliparous women, and women of higher BMI. Community enlightenment to enhance knowledge, attitude, and perception on fibroids and risk factors necessary to ensure early diagnosis and presentation, including patient centered treatment option.

Keywords: fibroids, prevalence, risk factors, body mass index, menarche, anaemia, KAP

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Authors: Iram Zahair, Tanith Rose, Oyinlola Oyebode, Stephen Clayton, Iman Ghosh, Michelle Maden, Ben Barr

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Background: Gastrointestinal infections exert a significant public health burden on UK healthcare services and the community. However, there are conflicting findings on where ethnic inequalities are likely to persist. This systematic review aimed to identify studies that ascertain differences in the incidence and prevalence of gastrointestinal infections within and between UK ethnic groups and explore possible explanations for heterogeneity observed within the literature. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance, a systematic review methodology was used. Medline, Web of Science, CINAHL Plus, and grey literature were searched from 1980 to 2021 for studies reporting an association between ethnicity and gastrointestinal infections in UK population samples. Two reviewers independently screened the articles and conducted quality appraisals; data extraction was undertaken by one reviewer and verified by two reviewers (PROSPERO CRD 42021240714). A narrative synthesis was undertaken to synthesise the study findings. Results: The searches identified 8134 studies; 13 met the inclusion criteria. 12 out of 13 studies found a difference in the prevalence of gastrointestinal infections between different ethnic groups. UK ethnic minorities, predominantly men and children of Asian ethnicity, had an increased risk of infection than the white British majority in 12 studies; the Pakistani ethnic group had a higher risk of infection in three out of 13 studies. Studies reported that age and sex confounded the relationship between ethnicity and gastrointestinal infections. At the same time, the country of birth, socioeconomic status, and geographical location of ethnic groups mediated this association and significantly explained the heterogeneity observed across the studies. Harvest plots supported the textual synthesis. Conclusion: This systematic review elucidates the lack of extensive UK quantitative evidence examining the association between ethnicity and gastrointestinal infections. Insights into gastrointestinal infections and ethnicity's association can help address policy actions to mitigate the inequalities identified within and between UK ethnic groups.

Keywords: ethnic and racial populations, public health, public health policy, systematic review

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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: Martina Curtin, Rosalind Herman

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Background: Deaf children can experience difficulties with understanding how social interaction works, particularly when communicating with unfamiliar hearing people. Deaf children often struggle with integrating into a mainstream, hearing environments. These negative experiences can lead to social isolation, depression and other mental health difficulties later in life. smiLE Therapy (Schamroth, 2015) is a video-based social communication intervention that aims to teach deaf children skills to confidently communicate with unfamiliar hearing people. Although two previous studies have reported improvements in communication skills immediately post intervention, evidence for maintenance of gains or generalisation of skills (i.e., the transfer of newly learnt skills to untrained situations) has not to date been demonstrated. Parental involvement has been shown to support deaf children’s therapy outcomes. Therefore, this study added parent training to the therapy children received to investigate the benefits to generalisation of children’s skills. Parents were also invited to present their perspective on the training they received. Aims: (1) To assess pupils’ progress from pre- to post-intervention in trained and untrained tasks, (2) to investigate if training parents improved their (a) understanding of their child’s needs and (b) their skills in supporting their child appropriately in smiLE Therapy tasks, (3) to assess if parent training had an impact on the pupil’s ability to (a) maintain their skills in trained tasks post-therapy, and (b) generalise their skills in untrained, community tasks. Methods: This was a mixed-methods, repeated measures study. 31 deaf pupils (aged between 7 and 14) received an hour of smiLE Therapy per week, for 6 weeks. Communication skills were assessed pre-, post- and 3-months post-intervention using the Communication Skills Checklist. Parents were then invited to attend two training sessions and asked to bring a video of their child communicating in a shop or café. These videos were used to assess whether, after parent training, the child was able to generalise their skills to a new situation. Finally, parents attended a focus group to discuss the effectiveness of the therapy, particularly the wider impact, i.e., more child participation within the hearing community. Results: All children significantly improved their scores following smiLE therapy and maintained these skills to high level. Children generalised a high percentage of their newly learnt skills to an untrained situation. Parents reported improved understanding of their child’s needs, their child’s potential and in how to support them in real-life situations. Parents observed that their children were more confident and independent when carrying out communication tasks with unfamiliar hearing people. Parents realised they needed to ‘let go’ and embrace their child’s independence and provide more opportunities for them to participate in their community. Conclusions: This study adds to the evidence base on smiLE Therapy; it is an effective intervention that develops deaf children’s ability to interact competently with unfamiliar, hearing, communication partners. It also provides preliminary evidence of the benefits of parent training in helping children to generalise their skills to other situations. These findings will be of value to therapists wishing to develop deaf children’s communication skills beyond the therapy setting.

Keywords: deaf children, generalisation, parent involvement, social communication

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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: Sireen Irsheid, Stephanie Keeney Parks, Michael A. Lindsey

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The medical and mental health field have been organized as reactive systems to respond to symptoms of mental health problems and disability. This becomes problematic particularly for those harmed by structural violence and racism, typically pushing us in the direction of alleviating symptoms and personalizing structural problems. The current paper examines how we assess, diagnose, and treat mental health and disability challenges in clinical spaces. We provide the readers with some context to think about the problem of racism and mental health/disability, ways to deconstruct the problem through the lens of structural violence, and recommendations to critically engage in clinical assessments, diagnosis, and treatment for young people impacted by structural violence and racism.

Keywords: mental health, disability, race and ethnicity, structural violence, structural racism, young people

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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: Muhlisin, Moh. Sofyan Budiarto

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Corporate social responsibility (CSR) initiatives based on charity and philanthropy have not alleviated many sustainable environmental issues, particularly in industrial towns. The collaborative governance strategy is seen to be an option for resolving difficulties of coordination and communication between businesses, the government, and the community so that the goals of urban environmental management can be met via collaborative efforts. The purpose of this research is to identify the different forms of environmental CSR implementation by corporate entities and to create a CSR collaborative governance model in environmental management. This qualitative investigation was carried out in 2020 in Cilegon City, one of Indonesia’s industrial cities. To investigate their support, a total of 20 informants from three stakeholder groups, namely the government, corporate entities, and the community, were questioned. According to the study’s findings, cleaner production, eco-office, energy and natural resource conservation, waste management, renewable energy, climate change adaptation, and environmental education are all examples of CSR application in the environmental sector. The environmental potential of CSR implementation is to create collaborative governance. The role of business entities in providing the beginning circumstances is critical, while the government offers facilitative leadership and the CSR forum launches institutional design. These three factors are crucial to the efficiency of collaborative governance in industrial cities' environmental management.

Keywords: collaborative governance, CSR forum, environmental CSR, industrial city

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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: Sa’idu A. Abdullah, Jafar Lawan, A. U. Adamu, Fowotade, S. A., Hamisu Abdu

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Scarcity of quality water in many communities compels inhabitants to use any available water resources for domestic, recreational, industrial and agricultural purposes. Global concern on the potential health hazards of anthropogenic inputs into our ecosystems imposes the need for constant monitoring of levels of pollutants in order to ensure compliance with internationally acceptable criteria. In this research, assessment of bioaccumulation of Cd, Co, Cu, Pb and Zn was carried out using tissues of Ipomoea batatas (sweet potato) and Manihot esculenta (cassava) irrigated with water from Muhammad Ayuba Dam in Kazaure, Jigawa State. The metal concentrations were determined using Flame Atomic Absorption Spectrophotometer (FAAS). The result of the analysis revealed the presence of the metals in varying concentrations. Cd and Co showed higher concentrations in the tubers of Manihot esculenta but all the other investigated metals were more concentrated in the leaves of the plant. Cd and Cu on the other hand showed higher concentration in the root of Ipomoea batatas while the remaining investigated metals were concentrated more in the leaves of the plant. The result of analysis of water samples from five sampling stations in the Dam showed the presence of the metals as follows: Cd, (0.063±0.02 mg/L), Co (0.086±0.03 mg/L), Cu (0.167±0.08 mg/L), Pb (0.22±0.01 mg/L) and Zn (0.047±0.01 mg/L) respectively. The results of bioaccumulation studies using the Bioaccumulation Factors (BAF) index indicated Ipomoea batatas to have higher bioaccumulation potential for Cd, Co and Cu while Pb and Zn were more accumulated in Manihot esculenta. The levels of the metals in both the water samples and plant tissues were all below the WHO permissible limit. This is indicative that the inhabitants of the community under investigation are not at any health risk.

Keywords: agriculture, bioaccumulation, heavy metal, plant tissues

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Authors: Dogan Can Hatunoglu, Cengiz Hakan Gurkanlı, Hatice Merve Demirci

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Today, the maker movement is regarded as a socio-cultural movement that represents designing and building objects for innovations. In these creativity-based activities of the movement, individuals from different backgrounds such as; inventors, programmers, craftspeople, DIY’ers, tinkerers, engineers, designers, and hackers, form a community and work collaboratively for mutual, open-source innovations. Today, with the accessibility of recently emerged technologies and digital fabrication tools, the Maker Movement is continuously expanding its scope and has evolved into a new experience, and for many, it is now considered as new kind of industrial revolution. In this new experience, makers create new things within their community by using new digital tools and technologies in spots called makerspaces. In these makerspaces, activities of learning, experience sharing, and mentoring are evolved into maker events. Makers who share common interests in making benefit from makerspaces as meeting and working spots. In literature, there are many sources on Maker Movement, maker communities, and their activities, especially in the field of business administration. However, there is a gap in the literature about the maker communities in Turkey. This research aims to be an information source on the dynamics and process design of “making” activities in Turkish maker communities and also aims to provide insights to sustain and enhance local maker communities in the future. Within this aim, semi-structured interviews were conducted with founders and facilitators from selected Turkish maker communities. (1) The perception towards Maker Movement, makers, activity of making, and current situation of maker communities, (2) motivations of individuals who participate the maker communities, and (3) key drivers (collaboration and decision-making in design processes) of maker activities from the perspectives of main actors (founders, facilitators) are all examined deeply with question on personal experiences and perspectives. After a qualitative approached data analysis concerning the maker communities in Turkey, this research reveals that there are two main conclusions regarding (1) the foundation of the Turkish maker mindset and (2) emergence of self-sustaining communities.

Keywords: Maker Movement, maker community, makerspaces, open-source design, sustainability

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Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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Authors: Adegboyega Adeolapo Ola, Gerelene Jagganath

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One of the greatest challenges of human right in the world, especially African states is the use of child soldiers in armed conflict, constituting a major source of destruction of lives and properties. Mostly, they are in developing countries with the situation in Sub-Saharan Africa, the abduction and employment of children as soldiers is a form of exploitative labour that is tantamount to slavery. Since the end of cold war, Child soldier has increased in Africa countries like Angola, Liberia, Sierra Leone and Uganda. This study examines the main cause of the recruitment and use of child soldiers and its challenges to human right. It further assesses the role of international regional bodies and various governments in curbing child soldiers with a view to proffer suggestions on how to address some of the resultant threat of human right. The study posits that the control of small arms and light weapons is essential in curtailing the spread of child soldier and abuse of human right. This hopefully should result in the sustainability of human/child right in African continent. It is a recommendation of this study that, in order to sustain human right in the region, all Africa leaders, government and regional bodies; such as African Union, Economic Community of West African States, South African Development Community among others, should cooperate and work together to address the issue of illicit small arms, which could eventually lead to child soldier.

Keywords: arms control, child soldier, human right, small arms

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Authors: Sarah Reker, Christiane H. Kellner

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From the perspective of people with disabilities, inequalities can also emerge from spatial segregation, the lack of social contacts or limited economic resources. In order to reduce or even eliminate these disadvantages and increase general well-being, community-based participation as well as decentralisation efforts within exclusively residential homes is essential. Therefore, the new research project “Index for participation development and quality of life for persons with disabilities”(TeLe-Index, 2014-2016), which is anchored at the Technische Universität München in Munich and at a large residential complex and service provider for persons with disabilities in the outskirts of Munich aims to assist the development of community-based living environments. People with disabilities should be able to participate in social life beyond the confines of the institution. Since a diverse society is a society in which different individual needs and wishes can emerge and be catered to, the ultimate goal of the project is to create an environment for all citizens–regardless of disability, age or ethnic background–that accommodates their daily activities and requirements. The UN-Convention on the Rights of Persons with Disabilities, which Germany also ratified, postulates the necessity of user-centered design, especially when it comes to evaluating the individual needs and wishes of all citizens. Therefore, a multidimensional approach is required. Based on this insight, the structure of the town-like center will be remodeled to open up the community to all people. This strategy should lead to more equal opportunities and open the way for a much more diverse community. Therefore, macro-level research questions were inspired by quality of life theory and were formulated as follows for different dimensions: •The user dimension: what needs and necessities can we identify? Are needs person-related? Are there any options to choose from? What type of quality of life can we identify? The economic dimension: what resources (both material and staff-related) are available in the region? (How) are they used? What costs (can) arise and what effects do they entail? •The environment dimension: what “environmental factors” such as access (mobility and absence of barriers) prove beneficial or impedimental? In this context, we have provided academic supervision and support for three projects (the construction of a new school, inclusive housing for children and teenagers with disabilities and the professionalization of employees with person-centered thinking). Since we cannot present all the issues of the umbrella-project within the conference framework, we will be focusing on one project more in-depth, namely “Outpatient Housing Options for Children and Teenagers with Disabilities”. The insights we have obtained until now will enable us to present the intermediary results of our evaluation. The most central questions pertaining to this part of the research were the following: •How have the existing network relations been designed? •What meaning (or significance) does the existing service offers and structures have for the everyday life of an external residential group? These issues underpinned the environmental analyses as well as the qualitative guided interviews and qualitative network analyses we carried out.

Keywords: decentralisation, environmental analyses, outpatient housing options for children and teenagers with disabilities, qualitative network analyses

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Authors: Elizabeth M. Seabrook, Nikki S. Rickard

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Examining time-dependent measures of emotion such as variability, instability, and inertia, provide critical and complementary insights into mental health status. Observing changes in the pattern of emotional expression over time could act as a tool to identify meaningful shifts between psychological well- and ill-being. From a practical standpoint, however, examining emotion dynamics day-to-day is likely to be burdensome and invasive. Utilizing social media data as a facet of lived experience can provide real-world, temporally specific access to emotional expression. Emotional language on social media may provide accurate and sensitive insights into individual and community mental health and well-being, particularly with focus placed on the within-person dynamics of online emotion expression. The objective of the current study was to examine the dynamics of emotional expression on the social network platform Facebook for active users and their relationship with psychological well- and ill-being. It was expected that greater positive and negative emotion variability, instability, and inertia would be associated with poorer psychological well-being and greater depression symptoms. Data were collected using a smartphone app, MoodPrism, which delivered demographic questionnaires, psychological inventories assessing depression symptoms and psychological well-being, and collected the Status Updates of consenting participants. MoodPrism also delivered an experience sampling methodology where participants completed items assessing positive affect, negative affect, and arousal, daily for a 30-day period. The number of positive and negative words in posts was extracted and automatically collated by MoodPrism. The relative proportion of positive and negative words from the total words written in posts was then calculated. Preliminary analyses have been conducted with the data of 9 participants. While these analyses are underpowered due to sample size, they have revealed trends that greater variability in the emotion valence expressed in posts is positively associated with greater depression symptoms (r(9) = .56, p = .12), as is greater instability in emotion valence (r(9) = .58, p = .099). Full data analysis utilizing time-series techniques to explore the Facebook data set will be presented at the conference. Identifying the features of emotion dynamics (variability, instability, inertia) that are relevant to mental health in social media emotional expression is a fundamental step in creating automated screening tools for mental health that are temporally sensitive, unobtrusive, and accurate. The current findings show how monitoring basic social network characteristics over time can provide greater depth in predicting risk and changes in depression and positive well-being.

Keywords: emotion, experience sampling methods, mental health, social media

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