Search results for: health and nutrition services

Authors: Panagodage Janaka Sampath Fernando

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Brain circulation has become a buzzword in the skilled migration literature. However, promoting brain circulation; returning of skilled migrants is challenging. Success stories in Asia, for instances, Taiwan, and China, are results of rigorous policy interventions of the respective governments. Nonetheless, the same policy mix has failed in other countries making it skeptical to attribute the success of brain circulation to the policy interventions per se. The paper seeks to answer whether the success of brain circulation within the Knowledge Services Industry (KSI) in Sri Lanka is a policy driven or a market driven process. Mixed method approach, which is a combination of case study and survey methods, was employed. Qualitative data derived from ten case studies of returned entrepreneurs whereas quantitative data generated from a self-administered survey of 205 returned skilled migrants (returned skilled employees and entrepreneurs) within KSI. The pull factors have driven the current flow of brain circulation within KSI but to a lesser extent, push factors also have influenced. The founding stone of the industry has been laid by a group of returned entrepreneurs, and the subsequent growth of the industry has attracted returning skilled employees. Sri Lankan government has not actively implemented the reverse brain drain model, however, has played a passive role by creating a peaceful and healthy environment for the industry. Therefore, in contrast to the other stories, brain circulation within KSI has emerged as a market driven process with minimal government interventions. Entrepreneurs play the main role in a market-driven process of brain circulation, and it is free from the inherent limitations of the reverse brain drain model such as discriminating non-migrants and generating a sudden flow of low-skilled migrants. Thus, to experience a successful brain circulation, developing countries should promote returned entrepreneurs by creating opportunities in knowledge-based industries.

Keywords: brain circulation, knowledge services industry, return migration, Sri Lanka

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Authors: Patience Oluchi Silas, Yemi Adeshina

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Financial transactions involving the use of the internet has become an important practice among commercial banks in Nigeria with the introduction of internet banking and this has improved banking efficiency in rending services to customers. However, customers in Lagos State are enslaved in the fear of insecurity, technical failure, inadequate operational facilities, including improper telecommunications and poor power supply. It is in line with this that this paper explores the obstacles faced by Lagosians, tourists, small scale business owners, companies, customers and the government's attitude in addressing the challenges associated with online banking system in Nigeria through relevant legislations. Internet banking has the potential to transform economic activity and achieve developmental goals. If the associated Challenges are addressed quickly, then it will have the desired impact on the Nigerian economy. In this study, Respondents, mostly bank employees and customers were issued well designed and structured questionnaires to effectively examine the new developments brought about by the introduction of Internet banking and the challenges inhibiting its adoption. Hypotheses were formulated to test assumptions and claims generated from the study. The results were statistically analyzed to address the issues of errors and chances, and at the end, the result of the statistical analysis shows that all especially insecurity, inadequate operational facilities and poor power supply are the significant factors affecting the adoption of internet banking services in Nigeria. The study recommends that for internet banking to assume a developmental dimension in Nigeria and for the country to be fully integrated and respected in global financial environment, the prevalent level of frauds in Lagos State and among Nigerians must first be addressed and the relevant local laws should be put in place and in consonance with international laws and conventions; get the citizens well educated on the intricacies of Internet usage and frauds.

Keywords: internet-banking, adoption, challenges, insecurity, legislation, fraud, Lagos state, statistics

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Authors: Inayat Ur Rehman, Georgia Sakellari

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Cloud computing has evolved into a vital technology for businesses, offering scalability, flexibility, and cost-effectiveness. However, maintaining high availability and optimal performance in the cloud is crucial for reliable services. This paper explores the significance of cloud monitoring and performance optimization in sustaining the high availability of cloud-based systems. It discusses diverse monitoring tools, techniques, and best practices for continually assessing the health and performance of cloud resources. The paper also delves into performance optimization strategies, including resource allocation, load balancing, and auto-scaling, to ensure efficient resource utilization and responsiveness. Addressing potential challenges in cloud monitoring and optimization, the paper offers insights into data security and privacy considerations. Through this thorough analysis, the paper aims to underscore the importance of cloud monitoring and performance optimization for ensuring a seamless and highly available cloud computing environment.

Keywords: cloud computing, cloud monitoring, performance optimization, high availability

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Authors: Shola Haruna Adeosun, F. Adebiyi Ajoke, Odedeji Adeoye

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Video billboard advertising by networks and brand switching was conceived out of inquisition at the huge billboard advertising expenditures made by the three major GSM network operators in Nigeria. The study was anchored on Lagos State Metropolis with a current census population over 1,000,000. From this population, a purposive sample of 400 was adopted, and the questionnaire designed for the survey was carefully allocated to members of this ample in the five geographical zones of the city so that each rung of the society was well represented. The data obtained were analyzed using tables and simple percentages. The results obtained showed that subscribers of these networks were hardly influenced by the video billboard advertisements. They overwhelmingly showed that rather than the slogans of the GSM networks carried on the video billboards, it was the incentives to subscribers as well as the promotional strategies of these organizations that moved them to switch from one network to another. These switching lasted only as long as the incentives and promotions were in effect. The results of the study also seemed to rekindle the age-old debate on media effects, by the unyielding schools of the theory of ‘all-powerful media’, ‘the limited effects media’, ‘the controlled effects media’ and ‘the negotiated media influence’.

Keywords: evaluation, impact, video billboard, marketing, services

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Authors: Mazlynda Md Yusuf, Wafa' Mahadzir, Mohamad Yazis Ali Basah

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Nowadays, financing long-term care for elderly people is a crucial issue, either towards the family members or the care institution. Corresponding with the growing number of ageing population in Malaysia, there’s a need of concern on the uncertaintiness of future family care and the need for long-term care services. Moreover, with the increasing cost of living, children feels the urge of needing to work and receive a fixed monthly income that results to sending their elderly parents to care institutions. Currently, in Malaysia, the rates for private nursing homes can amount up to RM 4,000 per month excluding medical treatments and other recurring expenses. These costs are expected to be paid using their Employees Provident Fund (EPF) savings that they accumulate during their working years, especially for those working under private sectors. Hence, this study identifies the adequacy of EPF in funding the cost of long-term care service during old age. This study used a hypothetical simulation model to simulate different scenarios. The findings of this study could be used for individuals to prepare on the importance of planning for retirement, especially with the increasing cost of long-term care services.

Keywords: long-term care cost, employees provident fund Malaysia, ageing population, Malaysian elderly

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Authors: Ahmed Rashad Harb Riad Ismail

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The purpose of this research is to study the potential of Dynamic Pricing if deployed by mobile operators and analyse its effects from both operators and consumers side. Furthermore, to conclude, throughout the research study, the recommended conditions for successful Dynamic Pricing deployment, recommended factors identifying the type of markets where Dynamic Pricing can be effective, and proposal for a Dynamic Pricing stakeholders’ framework were presented. Currently, the mobile telecommunications industry is witnessing a dramatic growth rate in the data consumption, being fostered mainly by higher data speed technology as the 4G LTE and by the smart devices penetration rates. However, operators’ revenue from data services lags behind and is decupled from this data consumption growth. Pricing strategy is a key factor affecting this ecosystem. Since the introduction of the 4G LTE technology will increase the pace of data growth in multiples, consequently, if pricing strategies remain constant, then the revenue and usage gap will grow wider, risking the sustainability of the ecosystem. Therefore, this research study is focused on Dynamic Pricing for 4G LTE data services, researching the drivers, benefits and challenges of 4G LTE Dynamic Pricing and the feasibility of its deployment in practice from different perspectives including operators, regulators, consumers, and telecommunications equipment manufacturers point of views.

Keywords: LTE, dynamic pricing, EPC, research

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Authors: Shengdan Yang

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The outbreak of the COVID-19 pandemic in early 2020 has made public health issues to be re-examined. The value of green space configuration is an important measure of community health quality. By combining quantitative and qualitative methods, the structure and function of community green space can be better evaluated. This study selects Wuhan Kunhou Community as the site and proposes to analyze the daily health service function of the community's green infrastructure. Through GIS-based spatial analysis, case study, and field investigation, this study evaluates the accessibility of green infrastructure and discusses the ideal green space form based on health indicators. The findings show that Kunhou Community lacks access to green infrastructure and public space for daily activities. The research findings provide a bridge between public health indicators and community space planning and propose design suggestions for green infrastructure planning.

Keywords: accessibility, community health, GIS, green infrastructure

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Authors: Teresa Smith, Farrah Jacquez

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Health-risk behaviors (e.g., smoking, poor diet) directly increase the risk for chronic disease and morbidity. There is substantial evidence of a negative association between socioeconomic status (SES) and engagement in health-risk behaviors. However, due to the complexity of SES, researchers have suggested looking beyond this factor to fully understand the mechanisms that underlie engagement in health-risk behaviors. Stress is one plausible mechanism through which SES impacts health-risk behaviors. Currently, it remains unclear how stress occurring across the life course might impact health behaviors and explain the association between SES and these behaviors. To address the gaps in the literature, 172 adults between the ages of 18-49 were surveyed about their lifetime stress exposure, sociodemographic variables, and health-risk behaviors via an online recruitment portal, Prolific. Five major findings emerged from the current study. First, SES was negatively associated with engagement in health-risk behaviors and lifetime stress above and beyond current stress and other relevant demographics. Second, lifetime stress was significantly associated with health-risk behaviors above and beyond current stress and relevant demographic variables. Third, lifetime stress fully mediated the association between SES and health-risk behaviors above and beyond current stress and other demographics. Fourth, the severity of stress experienced emerged as the most significant lifetime stress variable that explains the relation between SES and health-risk behaviors. Fifth and finally, lower SES and experiencing financial and legal/crime stressors increased the likelihood of engaging in health-risk behaviors. The current study results align with previous research and suggest that stress occurring over the lifespan impacts the relation between SES and health-risk behaviors, which are in turn known to impact health outcomes. However, our findings move the current literature forward by providing a more nuanced understanding of the specific aspects of stress that influence this association. Specifically, the severity of stress experienced across the entire lifespan was the most important aspect of stress when examining the association between SES and health-risk behaviors. Further, individuals most at risk for engaging in health-risk behaviors are those of the lowest SES and experience financial and legal/crime stressors. These findings have the potential to inform interventions and policies aimed at addressing health-risk behaviors by providing a more sophisticated understanding of the impact of stress.

Keywords: stress, health behaviors, socioeconomic status, health

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Authors: Adrian J. Forca, Simeon J. Cainday III

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The Jordan Water District Interactive Billing and Accounting Information Systems is designed for Jordan Water District to uplift the efficiency and effectiveness of its services to its customers. It is designed to process computations of water bills in accurate and fast way through automating the manual process and ensures that correct rates and fees are applied. In addition to billing process, a mobile app will be integrated into it to support rapid and accurate water bill generation. An interactive feature will be incorporated to support electronic billing to customers who wish to receive water bills through the use of electronic mail. The system will also improve, organize and avoid data inaccuracy in accounting processes because data will be stored in a database which is designed logically correct through normalization. Furthermore, strict programming constraints will be plunged to validate account access privilege based on job function and data being stored and retrieved to ensure data security, reliability, and accuracy. The system will be able to cater the billing and accounting services of Jordan Water District resulting in setting forth the manual process and adapt to the modern technological innovations.

Keywords: accounting, bill, information system, interactive

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Authors: Chantouch Wannathanom

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Research The study of elders’ needs in Bangkok metropolis for the options of health tourism. The objective is to study of elders’ needs in Bangkok Metropolis for the options of health tourism. The research her collected data using a questionnaire. The samples used in this research is elderly people living in the Dusit area. Of 400 people found the majority were female than male. Accounted for18 percent aged between 50-55 years, mostly undergraduate degree. Moreover, most seniors do not have underlying disease. The study found that 1. Elders’ needs in Bangkok Metropolis for the options of health tourism; 2. Tourism activity patterns that fit elderly was divided into 5 categories, including massage, massage, and herbal sauna. Practicing meditation and ascetic. The results showed that selection of elderly tourist activities by choosing healthy eating are the first. The hypothesis testing period: Elders’ needs in Bangkok Metropolis for the options of health tourism is different. The level of statistical significance .05 level.

Keywords: needs, elder, health tourism, Bangkok

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Authors: Mirjana Dokmanovic

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The paper will introduce main findings of the research of the responses of the Central European and South Eastern European (CEE/SEE) countries to the global economic and financial crisis in 2008 from human rights and gender perspectives. The research methodology included desk research and qualitative analysis of the available data, studies, statistics, and reports produced by the governments, the UN agencies, international financial institutions (IFIs) and international network of civil society organizations. The main conclusion of the study is that the governments in the region missed to assess the impacts of their anti-crisis policies both ex ante and ex post from the standpoint of human rights and gender equality. Majority of the countries have focused their efforts solely on prompting up the banking and financial sectors, and construction business sectors. The tremendous debt which the states have accumulated for the rescue of banks and industries lead to further cuts in social expenses and reduction of public services. Decreasing state support to health care and social protection and declining family incomes made social services unaffordable for many families. Thus, the economic and financial crisis stirred up the care crisis that was absorbed by women’s intensifying unpaid work within a family and household to manage household survival strategy. On the other hand, increased burden of the care work weakened the position of women in the labour market and their opportunities to find a job. The study indicates that the artificial separation of the real economy and the sphere of social reproduction still persist. This has created additional burden of unpaid work of women within a family. The aim of this paper is to introduce the lessons learnt for future: (a) human rights may not be derogated in the times of crisis; (b) the obligation of states to mitigate negative impacts of economic policies to population, particularly to vulnerable groups, must be prioritized; (c) IFIs and business sector must be liable as duty bearers with respect to human rights commitments.

Keywords: CEE/SEE region, global financial and economic crisis, international financial institutions, human rights commitments, principle of non-derogability of human rights

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Authors: Shorena Sadzaglishvili, Teona Gotsiridze, Ketevan Lekishvili, Darejan Javakhishvili, Alida Bouris

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Globally, adolescents and young people experience high levels of HIV vulnerability and risk. Estimates suggest that AIDS-related deaths among young people are increasing, suggesting poor prioritization of adolescents in national plans for HIV testing and treatment services. HIV/AIDS is currently the sixth leading cause of death in people aged 10-24 years. Among young people, street connected youth are clearly distinguished as being among the most at risk for HIV infection. The present study recognizes the urgent need to scale up effective HIV responses that are tailored to the unique needs of street connected youth for the global HIV agenda and especially, the former Soviet country - Georgia, where 'street kids' are a new phenomenon and estimated to be about 2,500. During two months trained interviewers conducted individual semi-structured qualitative interviews with 22 key informants from the local governmental and nongovernmental service organizations, including psychologists, social workers, peer educators, mobile health workers, and managers. Informants discussed social network characteristics influencing street connected youth’s sexual risk behaviors. Data were analyzed using Dedoose. It was revealed that there are three types of homogeneous networks of street-connected youth aged 10-19 based on ethnical background: (1) Georgians; (2) migrant kids of Azeri-Kurdish origin, and (3) local Roma-Moldavian kids. These networks are distinguished with various HIV risk through both risky sexual and drug-related behaviors. In addition, there are several cases of HIV infection identified through reactive social services. Street connected youth do not have basic information about the HIV related sexual, alcohol and drug behaviors nor there are any systematic programs providing HIV testing and consultation for reducing the vulnerability of HIV infection. There is a need to systematically examine street-connected youth risk-taking behaviors by applying an integrated, multilevel framework to a population at great risk of HIV. Acknowledgment: This work was supported by Shota Rustaveli National Science Foundation of Georgia (SRNSFG) [#FR 17_31], Ilia State University.

Keywords: street connected youth, social networks, HIV/AIDS, HIV testing

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Authors: Fawzia Mohammed Idris

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Zakat is an Islamic procedure for wealth distribution as a social protection mechanism for needy people. This study aimed to assess the possibility to expand the share of fund for national health insurance fund from zakat funds allocated for poor people by measuring the reduction of poverty that result from the investing on direct payment to the needy or by covering them in social health insurance. This study used stata regression as a statistical analysis tool and the finding clarified that there is no significant relationship between the poverty rate as the main indicator and, the number of poor people covered by national health insurance on one hand and the number of benefits poor people from the distribution of zakat fund. This study experienced many difficulties regarding the quality and the consistency of the data. The study suggested that a joint mission between national health insurance fund and zakat chamber to conduct study to assess the efficient use of zakat fund allocated to poor people.

Keywords: health finance, poverty, social health insurance, zakat

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Authors: Dona Ghosh, Zakir Husain

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In India, the increase in share of aged has generated many social and economic issues, of which health concerns is a major challenge that society must confront in coming years. Self-reported health (SRH) is a popular health measure in this regard but has been questioned in recent years due to its heavy dependence on the socioeconomic status. So, the validity of SRH, as a measure of health status during old age, is needed to be verified. This paper emphasizes on the self-reported health and related inconsistent responses among elderly in India. The objective of the study is bifurcated into two parts: firstly, to identify the socioeconomic determinants of subjective health status and its change over time; and secondly, to analyse the role of the socioeconomic components in providing inconsistent responses regarding the health status of elderly. Inconsistency in response can rise in two ways: positive response bias (if an individual has a health problem but reports his/her health as good) and negative response bias (if bad health is reported even if there is no health problem). However, in the present study, we focus only on the negative response bias of elderly individuals. To measure the inconsistencies in responses, self-reported health is compared with two types of physical health conditions – existence of chronicle ailment and physical immobility. Using NSS dataset of 60th and 71st rounds, the study found that subjective health has worsened over time in both rural and urban areas. Findings suggest that inconsistency in responses, related to chronic ailment, vary across social classes, living environments, geographical regions, age groups and education levels. On the contrary, variation in inconsistent responses regarding physical mobility is quite rare and difficult to explain by socioeconomic characteristics because most of the indicators are found to be insignificant in this regard. The findings indicate that in case of chronicle ailment, inconsistency between objective and subjective health status largely depends on socioeconomic conditions but the importance of such factors disappears for physical immobility.

Keywords: India, aging, self-reported health, inconsistent responses

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Authors: Farjina Malek, Julie King, Niki Edwards

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Across the globe more than a billion people live with a disability and a further billion people, mostly carers, are indirectly impacted. While prevalence data is problematic, it is estimated that more than 15% of the population in Bangladesh live with a disability. Disability service infrastructure in Bangladesh is under-developed; and consequently, the onus of care falls on family, especially on mothers. Within the caring role, mothers encounter many challenging experiences which are not only due to the lack of support delivered through the Bangladeshi health care system but also related to the existence of stigma and perception around disability in the Bangladeshi society. Within this perception, the causes of disability are mostly associated with 'God’s will'; 'possession of ghosts on the disabled person'; and 'karma or the result of past sins of the family members especially the mothers'. These beliefs are likely to have a significant impact on the well-being of mothers and their caring experience of children with disability. This is an ongoing qualitative study which is conducting in-depth interviews with 30 mothers from five districts (Dhaka, Mymensingh, Manikganj, Tangail, and Gazipur) of Bangladesh with the aim to explore the impact of social perception and stigma around physical disability on the caring role of the mothers of children with physical disability. The major findings of this study show that the social perception around disability and the social expectation from a mother regarding her caring role have a huge impact on the well-being of mothers. Mothers are mostly expected to take their child on their lap to prove that they are ‘good mother’. These practices of lifting their children with physical disability and keeping them on the lap for a long time often cause chronic back pain of the mothers. Existing social beliefs consider disability as a ‘curse’ and punishment for the ‘sins’ of the family members, most often by the mother. Mothers are blamed if they give birth to ‘abnormal’ children. This social construction creates stigma, and thus, the caring responsibility of mothers become more challenging. It also encourages the family and mothers to hide their children from the society and to avoid seeking accessible disability services. The mothers also compromise their careers and social interaction as they have to stay with their children at home, and that has a significant impact on personal wellbeing, income, and empowerment of the mothers. The research is informed by intersectional theory and employed an interpretive phenomenological methodology to explore mothers’ experience of caring their children with physical disability, and the contribution and impact of key relationships within the family and the intersection with community and services.

Keywords: mother, family carer, physical disability, children, social stigma, key relationship

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Authors: Azza A. Ali, Asmaa Abdelaty, Mona G. Khalil, Mona M. Kamal, Karema Abu-Elfotuh

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Background: Aluminium (Al) is known as a neurotoxin environmental pollutant that can cause certain diseases as Dementia, Alzheimer's disease, and Parkinsonism. It is widely used in antacid drugs as well as in food additives and toothpaste. Stresses have been linked to cognitive impairment; Social isolation (SI) may exacerbate memory deficits while protein malnutrition (PM) increases oxidative damage in cortex, hippocampus and cerebellum. The risk of cognitive decline may be lower by maintaining social connections. Epigallocatechin-3-gallate (EGCG) is the most abundant catechin in green tea and has antioxidant, anti-inflammatory and anti-atherogenic effects as well as health-promoting effects in CNS. Objective: To study the influence of different stressful conditions as social isolation, electric shock (EC) and inadequate Nutritional condition as PM on neurotoxicity induced by Al in rats as well as to investigate the possible protective effect of EGCG in these stressful and PM conditions. Methods: Rats were divided into two major groups; protected group which was daily treated during three weeks of the experiment by EGCG (10 mg/kg, IP) or non-treated. Protected and non-protected groups included five subgroups as following: One normal control received saline and four Al toxicity groups injected daily for three weeks by ALCl3 (70 mg/kg, IP). One of them served as Al toxicity model, two groups subjected to different stresses either by isolation as mild stressful condition (SI-associated Al toxicity model) or by electric shock as high stressful condition (EC- associated Al toxicity model). The last was maintained on 10% casein diet (PM -associated Al toxicity model). Isolated rats were housed individually in cages covered with black plastic. Biochemical changes in the brain as acetyl cholinesterase (ACHE), Aβ, brain derived neurotrophic factor (BDNF), inflammatory mediators (TNF-α, IL-1β), oxidative parameters (MDA, SOD, TAC) were estimated for all groups. Histopathological changes in different brain regions were also evaluated. Results: Rats exposed to Al for three weeks showed brain neurotoxicity and neuronal degenerations. Both mild (SI) and high (EC) stressful conditions as well as inadequate nutrition (PM) enhanced Al-induced neurotoxicity and brain neuronal degenerations; the enhancement induced by stresses especially in its higher conditions (ES) was more pronounced than that of inadequate nutritional conditions (PM) as indicated by the significant increase in Aβ, ACHE, MDA, TNF-α, IL-1β together with the significant decrease in SOD, TAC, BDNF. On the other hand, EGCG showed more pronounced protection against hazards of Al in both stressful conditions (SI and EC) rather than in PM .The protective effects of EGCG were indicated by the significant decrease in Aβ, ACHE, MDA, TNF-α, IL-1β together with the increase in SOD, TAC, BDNF and confirmed by brain histopathological examinations. Conclusion: Neurotoxicity and brain neuronal degenerations induced by Al were more severe with stresses than with PM. EGCG can protect against Al-induced brain neuronal degenerations in all conditions. Consequently, administration of EGCG together with socialization as well as adequate protein nutrition is advised especially on excessive Al-exposure to avoid the severity of its neuronal toxicity.

Keywords: environmental pollution, aluminum, social isolation, protein malnutrition, neuronal degeneration, epigallocatechin-3-gallate, rats

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Authors: Chang Li-Yu

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Aims: This study investigates the impact of psychological capital on the mental health of economically disadvantaged youth and examines whether family cohesion acts as a mediating variable between psychological capital and mental health. Methods: The sample for the study was drawn from the "Taiwan Poverty Children's Database: Survey on the Living Trends of Disadvantaged Children and Youth." The data analysis methods included descriptive statistics, confirmatory factor analysis, and structural equation modeling. Results: The results indicated that both psychological capital and family cohesion can significantly negatively predict mental health, with psychological capital significantly positively predicting family cohesion. The mediation effect analysis revealed that family cohesion fully mediates the relationship between psychological capital and mental health, meaning that psychological capital influences mental health through family cohesion. Recommendations: Based on these findings, the study concretely discusses the significance of psychological capital and family cohesion for the mental health of economically disadvantaged youth and offers suggestions for psychological counseling, therapy, and future research.

Keywords: psychological capital, mental health, economically disadvantaged youth, family cohesion

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Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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Authors: Dingiswayo Likhona, Arko-Cobbah Emmanuel, Carolina Pohl, Nthabiseng Z. Mokoena, Jolly Musoke

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A distinct strain of Klebsiella pneumoniae (K. pneumoniae), referred to as hypervirulent (hvKp), is associated with invasive infections such as an invasive pyogenic liver abscess in young and healthy individuals. In South Africa, limited information is known about the prevalence and virulence of this hvKp strain. Thus, this study aimed to determine the prevalence of hvKp and virulence-associated factors in K. pneumoniae isolates from one of the largest Tertiary hospitals in a South African province. A total of 74 K. pneumoniae isolates were received from Pelonomi National Health Laboratory Services (NHLS), Bloemfontein. Virulence-associated genes (rmpA, capsule serotype K1/K2, iroB, and irp2) were screened, and the virulence of hvKp vs. classical Klebsiella pneumoniae (cKp) was investigated using Caenorhabditis elegans nematode model. The iutA (aerobactin transporter) gene was used as a primary biomarker of hvKp. An average of 12% (9/74) of cases were defined as hvKp. Moreover, hvKp was found to be significantly more virulent in vivo Caenorhabditis elegans relative to cKp. The virulence-associated genes (rmpA, iroB, hmv phenotype, and capsule K1/K2) were significantly (p< 0.05) associated with hvKp. Findings from this study confirm the presence of hvKp in one large Tertiary hospital in South Africa. However, the low prevalence and mild to moderate clinical presentation suggest a marginal threat to public health. Further studies in different settings are required to establish the true potential impact of hvKp in developing countries.

Keywords: hypervirulent klebsiella pneumoniae, virulence, caenorhabditis elegans, aerobactin (iutA)

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Authors: Yonathan Audhitya Suthihono, Ratih Dyah Kusumastuti

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The radiology department in a tertiary referral hospital faces service operation challenges such as huge and various patient arrival, which can increase the probability of patient queuing. During the COVID-19 pandemic, it is mandatory to apply social distancing protocol in the radiology department. A strategy to prevent the accumulation of patients at one spot would be required. The aim of this study is to identify an alternative solution which can reduce the patient’s waiting time in radiology department. Discrete event simulation (DES) is used for this study by constructing several improvement scenarios with Arena simulation software. Statistical analysis is used to test the validity of the base case scenario model and to investigate the performance of the improvement scenarios. The result of this study shows that the selected scenario is able to reduce patient waiting time significantly, which leads to more efficient services in a radiology department, be able to serve patients more effectively, and thus increase patient satisfaction. The result of the simulation can be used by the hospital management to improve the operational performance of the radiology department.

Keywords: discrete event simulation, hospital management patient queuing model, radiology department services

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Authors: Chander Shekhar, Jeetendra Yadav, Shaziya Allarakha

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Hypertension has been described as an 'iceberg disease' as those who suffered are ignored and hence usually seek healthcare services at a very late stage. It is estimated that more than 2 million Indians are suffering from hypertensive heart disease that contributed to above 0.13 million deaths in 2016. The paper study aims to know the prevalence of Hypertension in India and its variation by socioeconomic backgrounds and to find out risk factors discriminating hypertension with special emphasis on consumption of tobacco and alcohol among men aged 15-54 years in India. The paper uses NFHS (2015-16) data. The paper used binary logistic regression and discriminant analysis to find significant predictors and discriminants of interest. The prevalence of hypertension was 16.5% in the study population. The results suggest that consumption of alcohol and tobacco are significant discriminant characteristics in carrying hypertension irrespective of what socioeconomic background characteristic he possesses.

Keywords: hypertention, alcohol, tobacco, discriminant

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Authors: Mbadugha Esther Ifeoma

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Soybeans, like other legumes are rich in nutrients. However, the nutrient profile of soybeans differs in some important ways from most other legumes. Among other nutrients, soy is high in protein, carbohydrates, and fibers, is rich in vitamins, minerals and unsaturated fatty acids and is low in saturated fatty acids. Because of its high nutritional value, it has been rated to be equivalent to meats, eggs and milk. Soy has many health benefits including prevention of coronary heart disease, prevention of cancer growth, improvement of cognitive function, promotion of bone health, prevention of obesity, prevention of type II diabetes and promotion of growth of normal floras in the colon. Soybean consumption is also associated with some side effects which include allergy, flatulence and abdominal discomfort. Nurses/health care providers should therefore, educate clients on the precautionary measures to be taken in preparing soy food products in order to reduce to the barest minimum the side effects, while encouraging them to include soy as part of their daily meals for optimal health and vitality.

Keywords: health benefit, health education, nutritional benefit, soybeans

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Authors: I Putu Yuda Hananta, Inke Kusumastuti

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The latest Indonesian Biology and Behavior Surveillance (IBBS) conducted by Indonesian Ministry of Health reported a large proportion of men who have sex with men (MSM) engaging in oral sex in their recent sexual history. While it is considered as a pleasuring and safe, oral sex might facilitate the transmission of various sexually transmitted infection (STI) pathogens. This study was aimed to investigate the oral sex practice among MSM in Indonesian urban settings to help delineate demographic and behavior determinants of such practice. In 2014, 501 MSM in 8 clinic-based and outreach STI services were recruited in Jakarta, Yogyakarta and Denpasar, Indonesia. Respondents completed a self-administered questionnaire inquiring about their demographics and sexual history. Median age (interquartile range) of the respondents was 27 (24-30) years; most completed senior high school (54.3%), worked in informal jobs (57.9%), and single (60.9%); and 32.3% reported receiving money in exchange for sex. Oral sex was practiced by most respondents: insertive only (10.0%), receptive only (6.0%), and both (82.4%). A separate multivariable analysis was performed using logistic regression to identify the determinants for receptive and insertive oral sex. Factors associated with receptive oral sex were having more than 10 sex partner(s) in the preceding 6 months vs 1 partner, adjusted odds ratio (aOR) [95% CI]=3.40 [1.22-9.42], p=0.03; and history of receptive-insertive anal sex vs no history, aOR=4.37 [1.76-10.82], p=0.01. Factors associated with insertive oral sex were receiving money for sex vs. not receiving, aOR=2.98 [1.10-8.04], p=0.02; and history of receptive-insertive anal sex vs. no history, aOR=2.10 [0.51-8.74], p<0.001. Only a few respondents reported consistent condom use (11.6% and 12.0% for receptive and insertive oral sex, respectively). Our findings demonstrated that while oral sex is a common practice among MSM, the consistency of condom use in oral sex is very low. In addition, certain sex behavior (number of sex partners, sex work and history of anal sex) were associated with oral sex, and this might need to be addressed during health promotion efforts on STI prevention through oral-genital contact.

Keywords: behavior, Indonesia, men who have sex with men, oral sex

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Authors: Elizabeth Grier, Meg Gemmill, Mary Martin, Leora Reiter, Herman Tang, Alexandra Donaldson, Isis Lunsky, Mia Wu

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Background: Individuals with Cerebral Palsy (CP) and/or IDD face numerous physical and mental health challenges, including difficulty accessing effective palliative care. The aim of this study is to assess the knowledge and comfort of healthcare providers in providing community-based palliative care for patients with Cerebral Palsy (CP) and severe to profound Intellectual and Developmental Disabilities (IDD). Methods: This study includes a mixed methods approach obtaining both quantitative and qualitative data. Quantitative data from palliative care practitioners was obtained through an online survey assessing comfort in symptom management, grief assessment, and goals of care discussion. This survey was distributed to physicians and allied health practitioners across Canada through the College of Family Physicians of Canada Member Interest Groups for Palliative Care and for IDD. Survey results guided the development of a semi-structured interview template, which was used to conduct a focus group on the same topic. Participants were four palliative care providers (3 physicians and one spiritual care practitioner). The focus group transcript is currently undergoing thematic analysis using NVivo 12 software. Results: 57 palliative care practitioners completed the survey. 87% of participants indicated they have provided palliative care services for persons with CP and/or IDD. Findings suggest practitioners are somewhat confident in identifying specific physical symptoms (dyspnea, pressure ulcers) but less confident in identifying physical/emotional pain, addressing grief, and prognosticating life expectancy in this population. 54% of responses indicated they had little/no training on palliating those with CP or IDD, and 45% somewhat or strongly disagree members of their profession can manage symptoms for this population. Focus group analysis is underway, and results will be available at the time of the poster presentation. Conclusion: Persons with CP and IDD are more likely to experience severe health inequities when accessing palliative care. Results of this study suggest further education is needed for palliative care professionals to address the barriers and challenges in providing palliative care to this patient population.

Keywords: palliative care, symptom management, health equity, community healthcare, intellectual and developmental disabilities

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Authors: Muhammad Kashif Fida

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In the bank, teller’s job (cash officer) is highly important and critical as at one end it requires soft and brisk customer services and on the other side, handling cash with integrity. It is always challenging for recruiters to hire competent and trustworthy tellers. According to author’s knowledge, there is no comprehensive test available that may provide assistance in recruitment in Pakistan. So there is a dire need of a psychometric battery that could provide support in recruitment of potential candidates for the teller’ position. So, the aim of the present study was to construct ABL-Teller Aptitude Test (ABL-TApT). Three major phases have been designed by following American Psychological Association’s guidelines. The first phase was qualitative, indicators of the test have been explored by content analysis of the a) teller’s job descriptions (n=3), b) interview with senior tellers (n=6) and c) interview with HR personals (n=4). Content analysis of above yielded three border constructs; i). Personality, ii). Integrity/honesty, iii). Professional Work Aptitude. Identified indicators operationalized and statements (k=170) were generated using verbatim. It was then forwarded to the five experts for review of content validity. They finalized 156 items. In the second phase; ABL-TApT (k=156) administered on 323 participants through a computer application. The overall reliability of the test shows significant alpha coefficient (α=.81). Reliability of subscales have also significant alpha coefficients. Confirmatory Factor Analysis (CFA) performed to estimate the construct validity, confirms four main factors comprising of eight personality traits (Confidence, Organized, Compliance, Goal-oriented, Persistent, Forecasting, Patience, Caution), one Integrity/honesty factor, four factors of professional work aptitude (basic numerical ability and perceptual accuracy of letters, numbers and signature) and two factors for customer services (customer services, emotional maturity). Values of GFI, AGFI, NNFI, CFI, RFI and RMSEA are in recommended range depicting significant model fit. In third phase concurrent validity evidences have been pursued. Personality and integrity part of this scale has significant correlations with ‘conscientiousness’ factor of NEO-PI-R, reflecting strong concurrent validity. Customer services and emotional maturity have significant correlations with ‘Bar-On EQI’ showing another evidence of strong concurrent validity. It is concluded that ABL-TAPT is significantly reliable and valid battery of tests, will assist in objective recruitment of tellers and help recruiters in finding a more suitable human resource.

Keywords: concurrent validity, construct validity, content validity, reliability, teller aptitude test, objective recruitment

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Authors: García López

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The Government Departments of Health have the task of informing and educating citizens about public health issues. For this, they use channels like Twitter, key in the search for health information and the propagation of content. The tweets, important in the virality of the content, may contain emotions that influence the contagion and exchange of knowledge. The goal of this study is to perform an analysis of the emotional projection of health information shared on Twitter by official American accounts: the disease control account CDCgov, National Institutes of Health, NIH, the government agency HHSGov, and the professional organization PublicHealth. For this, we used Tone Analyzer, an International Business Machines Corporation (IBM) tool specialized in emotion detection in text, corresponding to the categorical model of emotion representation. For 15 days, all tweets from these accounts were analyzed with the emotional analysis tool in text. The results showed that their tweets contain an important emotional load, a determining factor in the success of their communications. This exposes that official accounts also use subjective language and contain emotions. The predominance of emotion joy over sadness and the strong presence of emotions in their tweets stimulate the virality of content, a key in the work of informing that government health departments have.

Keywords: emotions in tweets, emotion detection in the text, health information on Twitter, American health official accounts, emotions on Twitter, emotions and content

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Authors: Sithandazile Masuku

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Introduction: Public health approaches to offender mental health are driven by international policies and frameworks in response to the disproportionately large representation of people with mental health problems within the offender pathway compared to the general population. Public health service innovations include mental health courts in the US, restorative models in Singapore and, liaison and diversion services in Australia, the UK, and some other European countries. Mental health nurses are at the forefront of offender health service innovations. In the U.K. context, police custody has been identified as an early point within the offender pathway where nurses can improve outcomes by offering assessments and share information with criminal justice partners. This scope of nursing practice has introduced challenges related to skills and support required for nurses working at the interface of health and the criminal justice system. Parallel literature exploring experiences of nurses working in forensic settings suggests the presence of compassion fatigue, burnout and vicarious trauma that may impede risk harm to the nurses in these settings. Published research explores mainly service-level outcomes including monitoring of figures indicative of a reduction in offending behavior. There is minimal research exploring the experiences of liaison and diversion nurses who are situated away from a supportive clinical environment and engaged in complex autonomous decision-making. Aim: This paper will share qualitative findings (in progress) from a PhD study that aims to explore the experiences of liaison and diversion nurses in one service in the U.K. Methodology: This is a qualitative interview study conducted using an Interpretative Phenomenological Analysis to gain an in-depth analysis of lived experiences. Methods: A purposive sampling technique was used to recruit n=8 mental health nurses registered with the UK professional body, Nursing and Midwifery Council, from one UK Liaison and Diversion service. All participants were interviewed online via video call using semi-structured interview topic guide. Data were recorded and transcribed verbatim. Data were analysed using the seven steps of the Interpretative Phenomenological Analysis data analysis method. Emerging Findings Analysis to date has identified pertinent themes: • Difficulties of meaning-making for nurses because of the complexity of their boundary spanning role. • Emotional burden experienced in a highly emotive and fast-changing environment. • Stress and difficulties with role identity impacting on individual nurses’ ability to be resilient. • Challenges to wellbeing related to a sense of isolation when making complex decisions. Conclusion Emerging findings have highlighted the lived experiences of nurses working in liaison and diversion as challenging. The nature of the custody environment has an impact on role identity and decision making. Nurses left feeling isolated and unsupported are less resilient and may go on to experience compassion fatigue. The findings from this study thus far point to a need to connect nurses working in these boundary spanning roles with a supportive infrastructure where the complexity of their role is acknowledged, and they can be connected with a health agenda. In doing this, the nurses would be protected from harm and the likelihood of sustained positive outcomes for service users is optimised.

Keywords: liaison and diversion, nurse experiences, offender health, staff wellbeing

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Authors: Sushil K. Sharma, Jeff Zhang, Saeed Tabar

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Worldwide, several governments are utilizing the Internet of Things (IoT) and other information and communication technologies (ICTs) to create smart city infrastructures to improve both the quality of government services and citizen welfare. Over 700 cities from around the world have already started implementing their smart city projects. Smart City utilizes the network of connected things, or the Internet of Things (IoT), that interconnects devices and various components across city infrastructure, making them work together seamlessly to enhance the quality, performance, and interactivity of urban services, optimize resources, and reduce costs. Without developing smart cities, the accelerating growth of cities, and their disproportionate consumption of physical and social resources are unsustainable. In 2016, the Indian Government released a list of 100 cities with the intention of kick-starting the process of developing them into 'smart cities’ as part of the Smart Cities Mission. This study reports the progress and challenges of Smart City projects in India. The data were collected through the city/state government websites, media reports, and focus group discussions/interviews. The preliminary results indicate that smart city projects are not only behind in their implementation and scope but also lacks the sincerity for its implementation.

Keywords: smart city, smart government, Internet of Things, digital government

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Authors: Cheng-Yu Tsai, Chiung-En Huang, Ming-Tsang Wu

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The purpose of this study was to investigate the relationships among leisure motivation, leisure attitude, and health promotion lifestyle. The participants were recruited from a convenience sampling that subjects were at least 55 years of age in Tainan City, Taiwan. Three hundred survey instruments were distributed, and 227 effective instruments were returned, for an effective rate of 75.7%. The collected data were analyzed statistically. The findings of this research were as follows: 1.There is significantly correlated between leisure motivation and leisure attitude. 2. There is significantly correlated between leisure attitude and health promotion lifestyle. 3. There is significantly correlated between leisure motivation and health promotion lifestyle.

Keywords: leisure motivation, leisure attitude, health promotion lifestyle, tourism

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Authors: Khalid Ishola Bello

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Many religions and cultures believe in the existence of invisible beings who co-exist with man on earth. Muslims, for example, believe in malaikah (Angel) and jinn (demon), who have their source of creation from light and flame, respectively. Jinn, according to Islamic texts, possesses unique characteristics which give them an advantage over the man. Invisibility, transforming into or taking possession of another being are parts of advantages jinn have above man. Hence, jinn can attack man and truncate his well-being by causing malfunction of his physiological and psychological realms, which may go beyond physical health care. It is on this background that this paper aims to articulate the possibility of a demonic attack on human health and the care processes recommended by Islam to heal and restore well-being of the victim. Through analysis of the inductive, deductive, and historical approaches, the process of ruqyah (healing method based on recitation of the Qur’an) and hijamah (cupping) therapies shall be analyzed. The finding shows the efficacy of Islamic remedies to demonic possession, which usually complicates health challenges in the care of man. This alternative approach is therefore recommended for holistic health care since physical health care cannot fix spiritual health challenges.

Keywords: wellbeing, healthcare, demonic possession, cupping, jinn

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