Search results for: Health Literacy

Authors: Vivian Khamis

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Exposure to war and forced migration have been widely linked to child subsequent adaptation. What remains sparse is research spanning multiple risk and protective factors and examining their unique and relative implications to difficulties in mental health among refugee girls. This study investigated the mechanisms through which posttraumatic stress disorder (PTSD), emotion dysregulation , neuroticism, and behavioral and emotional disorders in Syrian refugee girls is impacted by exposure to war traumas, age, and other risk and protective factors such as coping styles, family relationships, and school environment. The sample consisted of 539 Syrian refugee girls who ranged in age from 7 to 18 years attending public schools in various governorates in Lebanon and Jordan. Two school counselors carried out the interviews with children at school. Results indicated that war trauma, older age, and a combination of negative copying style associated with conflict in the family could lead to an overall state of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD in refugee girls. On the other hand, lapse of time since resettlement in host country, positive copying style, cohesion, and expressiveness in the family would lead to more positive mental health status, including lower levels of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD . Enhanced understanding of the mechanistic role of risk and protective factors in contributing to difficulties in mental health in refugee girls may contribute to the development of effective interventions to target the psychological effects of the refugee experience.

Keywords: refugee girls, PTSD, emotion dysregulation, neuroticism, behavioral and emotional disorders

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Authors: Muhammad Afiq Anaqi Bin Baharudin, Muhammad Izamuddin Bin Mohd Nasir, Syarifuddin Bin Sujuanda, Muhammad Syahmi Rusyaidi Bin Sham Suddin, Danish Hakimi Bin Kamaruzaman, Muhammad Haqimi Nazim Bin Hasmanizam, Mohammad Akmal Zakwan Bin Amran, Muhammad Alparizi Bin Latif

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By improving efficiency and production, information technology (IT) has transformed working environments, but it has also created new threats to occupational safety and health (OSH). This study evaluates the literature that has already been written on the subject of IT and OSH, identifies major findings and discussion points, and highlights gaps in the material that call for additional research. The study's findings, which look at how IT affects OSH in a sizable multinational organization, are also presented in the report. According to the report, IT poses a number of OSH problems, such as ergonomic dangers, eye strain, dangers related to cybersecurity, and psychological hazards. The report suggests using tactics like providing comfortable workstations, encouraging a healthy balance between work and life, and putting strong cybersecurity safeguards in place to reduce these dangers. The implications of these findings for OSH and IT are discussed in the paper's conclusion, and it emphasizes the need for more study and action to address these dangers and promote healthy and secure working environments in the age of digitization.

Keywords: information technology, occupational safety and health (OSH), ergonomic, hazards, workplace.

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Authors: Ashraf Aly

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The aim of this study is to examine the impact of 5G communication technology radiation on human health and airport safety. The term 5G refers to the fifth generation of wireless mobile technology. The 5G wireless technology will increase the number of high-frequency-powered base stations and other devices and browsing and download speeds, as well as improve the network connectivity and play a big part in improving the performance of integrated applications, such as self-driving cars, medical devices, and robotics. 4G was the latest embedded version of mobile networking technology called 4G, and 5G is the new version of wireless technology. 5G networks have more features than 4G networks, such as lower latency, higher capacity, and increased bandwidth compared to 4G. 5G network improvements over 4G will have big impacts on how people live, business, and work all over the world. But neither 4G nor 5G have been tested for safety and show harmful effects from this wireless radiation. This paper presents biological factors on the effects of 5G radiation on human health. 5G services use C-band radio frequencies; these frequencies are close to those used by radio altimeters, which represent important equipment for airport and aircraft safety. The aviation industry, telecommunications companies, and their regulators have been discussing and weighing these interference concerns for years.

Keywords: wireless communication, radiofrequency, Electromagnetic field, environmental issues

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Authors: Duane Booysen, Ashraf Kagee

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There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.

Keywords: psychological interventions, public mental health, traumatic stress, single-case design

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Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

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Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

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Authors: Peter Unoh Bassey

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The study is predicated on the current trend of the rate of dispositional loneliness experienced by the elderly in society today as a result of the breakdown in the family attachment patterns, loss of close associates, and interpersonal conflicts. The research adopted the ex-post facto research design through a survey data collected from a total of 500 elderly comprising of both retirees and community-based elders. Both the stratified and simple sampling techniques were used to select the sample. Based on the findings, it was recommended that the elderly should be trained in acquiring specific attachment styles as well as be trained in developing appropriate social skills to counter loneliness.

Keywords: dispositional loneliness, mental health, elderly, cross river state

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.

Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine

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Authors: Antonio Lopez-Villegas, Daniel Catalan-Matamoros, Remedios Lopez-Liria

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Objectives: The purpose of this study was to analyze clinical data, health-related quality of life (HRQoL) and functional capacity of patients using a telemonitoring follow-up system (TM) compared to patients followed-up through standard outpatient visits (HM) 5 years after the implantation of a pacemaker. Methods: This is a controlled, non-randomised, nonblinded clinical trial, with data collection carried out at 5 years after the pacemakers implant. The study was developed at Hospital de Poniente (Almeria, Spain), between October 2012 and November 2013. The same clinical outcomes were analyzed in both follow-up groups. Health-Related Quality of Life and Functional Capacity was assessed through EuroQol-5D (EQ-5D) questionnaire and Duke Activity Status Index (DASI) respectively. Sociodemographic characteristics and clinical data were also analyzed. Results: 5 years after pacemaker implant, 55 of 82 initial patients finished the study. Users with pacemakers were assigned to either a conventional follow-up group at hospital (HM=34, 50 initials) or a telemonitoring system group (TM=21, 32 initials). No significant differences were found between both groups according to sociodemographic characteristics, clinical data, Health-Related Quality of Life and Functional Capacity according to medical record and EQ5D and DASI questionnaires. In addition, conventional follow-up visits to hospital were reduced in 44,84% (p < 0,001) in the telemonitoring group in relation to hospital monitoring group. Conclusion: Results obtained in this study suggest that the telemonitoring of users with pacemakers is an equivalent option to conventional follow-up at hospital, in terms of Health-Related Quality of Life and Functional Capacity. Furthermore, it allows for the early detection of cardiovascular and pacemakers-related problem events and significantly reduces the number of in-hospital visits. Trial registration: ClinicalTrials.gov NCT02234245. The PONIENTE study has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: cardiovascular diseases, health-related quality of life, pacemakers follow-up, remote monitoring, telemedicine

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Authors: T. J. O Ceallaigh

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Subject matter driven programs such as immersion programs are increasingly popular across the world. These programs have allowed for extensive experimentation in the realm of second language teaching and learning and have been at the centre of many research agendas since their inception. Even though immersion programs are successful, especially in terms of second language development, they remain complex to implement and not always as successful as what we would hope them to be. Among all the challenges these varied programs face, research indicates that the primary issue lies in the difficulty to create well-balanced programs where both content instruction and language/literacy instruction can be targeted simultaneously. Initial teacher education and professional development experiences are key drivers of successful language immersion education globally. They are critical to the supply of teachers with the mandatory linguistic and cultural competencies as well as associated pedagogical practices required to ensure learners’ success. However, there is a significant dearth of research on professional development experiences of immersion teachers. We lack an understanding of the nature of their expertise and their needs in terms of professional development as well as their perceptions of the primary challenges they face as they attempt to formulate a coherent pedagogy of integrated language and content instruction. Such an understanding is essential if their specific needs are to be addressed appropriately and thus improve the overall quality of immersion programs. This paper reports on immersion teacher perceptions of online professional development experiences that have a positive impact on their ability to facilitate language and content connections in instruction. Twenty Irish-medium immersion teachers engaged in the instructional integration of language and content in a systematic and developmental way during a year-long online professional development program. Data were collected from a variety of sources e.g., an extensive online questionnaire, individual interviews, reflections, assignments and focus groups. This study provides compelling evidence of the potential of online professional development experiences as a pedagogical framework for understanding the complex and interconnected knowledge demands that arise in content and language integration in immersion. Findings illustrate several points of access to classroom research and pedagogy and uncover core aspects of high impact online experiences. Teachers identified aspects such as experimentation and risk-taking, authenticity and relevance, collegiality and collaboration, motivation and challenge and teacher empowerment. The potential of the online experiences to foster teacher language awareness was also identified as a contributory factor to success. The paper will conclude with implications for designing meaningful and effective online CLIL professional development experiences.

Keywords: content and language integrated learning , immersion pedagogy, professional development, teacher language awareness

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Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

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HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

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Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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Authors: Ian Christopher Rocha

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This study aimed to determine the association of the quality of life (QOL) of the caregivers of children in need of special protection (CNSP) in child-caring institutions in Metro Manila with the levels of their role overload (RO) and role distress (RD). The CNSP in this study covered the orphaned, abandoned, abused, neglected, exploited, and mentally-challenged children. In this study, the domains of QOL included physical health (PH), psychological health, social health (SH), and living conditions (LC). It also intended to ascertain the association of their personal and work-related characteristics with their RO and RD levels. The respondents of this study were 130 CNSP caregivers in 17 residential child-rearing institutions in Metro Manila. A purposive non-probability sampling was used. Using a quantitative methodological approach, the survey method was utilized to gather data with the use of a self-administered structured questionnaire. Data were analyzed using both descriptive and inferential statistics. Results revealed that the level of RO, the level of RD, and the QOL of the CNSP caregivers were all moderate. Data also suggested that there were significant positive relationships between the RO level and the caregivers’ characteristics, such as age, the number of training, and years of service in the institution. At the same time, the findings revealed that there were significant positive relationships between the RD level and the caregivers’ characteristics, such as age and hours of care rendered to their care recipients. In addition, the findings suggested that all domains of their QOL obtained significant relationships with their RO level. For the correlations of their level of RO and their QOL domains, the PH and the LC obtained a moderate negative correlation with the RO level while the rest of the domains obtained weak negative correlations with RO level. For the correlations of their level of RD and the QOL domains, all domains, except SH, obtained strong negative correlations with the level of RD. The SH revealed to have a moderate negative correlation with RD level. In conclusion, caregivers who are older experience higher levels of RO and RD; caregivers who have more training and years of service experience the higher level of RO; and caregivers who have longer hours of rendered care experience the higher level of RD. In addition, the study affirmed that if the levels of RO and RD are high, the QOL is low, and vice versa. Therefore, the RO and RD levels are reliable predictors of the caregivers’ QOL. In relation, the caregiving situation in the Philippines revealed to be unique and distinct from other countries because the levels of RO and RD and the QOL of Filipino CNSP caregivers were all moderate in contrast with their foreign counterparts who experience high caregiving RO and RD leading to low QOL.

Keywords: quality of life, caregivers, children in need of special protection, physical health, psychological health, social health, living conditions, role overload, role distress

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Authors: Osuagwu Justine Ugochukwu

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Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought brand-new knowledge to leadership literature.

Keywords: workers performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership

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Authors: Shankar Ganesh, Rishee Patel, Vikram Dwivedi, Balakishore P., Deepak Chhabra, Anandhi Dakshinamoorthy, Parminder Kaur

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Background: The World Health Organization has recommended a moderate intensity physical activity of 150 minutes, or 75 minutes vigorous-intensity physical activity per week to achieve optimal health benefits. It is not known if Indian public who indulge in leisure time physical exercises satisfy these recommendations. Methods: This study used a questionnaire to obtain data regarding demographic details, current engagement in leisure time physical activities, and dosages of these exercises from participants between 18-64 years of age. Results: Data was collected from a total of 390 participants (231 males and 159 females). 50.76% and 34.35% o of the participants reported exercising voluntarily and for health benefits respectively. Most participants (94.61%) indicated exercising without prescription. 55.38% and 12.82% of the participants under and above 38 years of age perform moderate to vigorous intensity exercises respectively. Conclusion: The over-all results of this study indicate that the participants’ choices of leisure time physical exercises are based on their personal choices and beliefs. The exercise intensities undertaken do not meet the global recommended intensities, especially in those above 38 years of age. Professionals and facilities to engage the public in the WHO recommended intensities of physical activity needs to be established.

Keywords: physical activity, exercise, India, sedentary

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Authors: Ma. Cecilia D. Licuan

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The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

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Authors: Mustafa Jahanara

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The purpose of the research was to study the relationship between self-esteem, self-Efficacy with psychological distress in the high school teachers. A total of 245 teachers (92 male and 153 female) in the high school of Kabul and Mazar-e-Sharif from Afghanistan completed inventories General Self-Efficacy, Rosenberg Self-Esteem Scale, and General Health Questionnaire-12 and that assessed their Self-Efficacy, self-esteem with psychological distress. Correlational analysis showed that self-efficacy and self-esteem were significantly and positively correlated with each other. The results of the study indicated that psychological distress is negatively related to self-esteem, and self-efficacy. However, the findings suggest that self-esteem, and self-efficacy could influence on mental health.

Keywords: high school teachers, self-esteem, self-efficacy, psychological distress

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Authors: Zain Ul Hassan, Muhammad Zain Ul Abadin, Muhammad Zubair Khan

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Unmanned aerial vehicles (UAVs) have now become of predominant importance for various operations, and an immense amount of work is going on in this specific category. The structural stability and life of these UAVs is key factor that should be considered while deploying them to different intelligent operations as their failure leads to loss of sensitive real-time data and cost. This paper presents an applied research on the development of a structural health monitoring system for a UAV designed and fabricated by deploying modular approach. Firstly, a modular UAV has been designed which allows to dismantle and to reassemble the components of the UAV without effecting the whole assembly of UAV. This novel approach makes the vehicle very sustainable and decreases its maintenance cost to a significant value by making possible to replace only the part leading to failure. Then the SHM for the designed architecture of the UAV had been specified as a combination of wings integrated with strain gauges, on-board data logger, bridge circuitry and the ground station. For the research purpose sensors have only been attached to the wings being the most load bearing part and as per analysis was done on ANSYS. On the basis of analysis of the load time spectrum obtained by the data logger during flight, fatigue life of the respective component has been predicted using fracture mechanics techniques of Rain Flow Method and Miner’s Rule. Thus allowing us to monitor the health of a specified component time to time aiding to avoid any failure.

Keywords: fracture mechanics, rain flow method, structural health monitoring system, unmanned aerial vehicle

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Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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Authors: Abdirahim Mohamed, Sarita Rana Chhetri, Michael Sleath, Nadia Saleem

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Rationale: Internet usage has been very much integrated into our daily lives. Internet usage within a neurodevelopmental disorder population is also on the increase. Nevertheless, there is very little empirical research on how this population virtually protect themselves; along with how their parents can keep them safe online. This topic was an ever-growing concern to the parents within our services and in many cases would add to the stresses and mental health of parents. This ignited an idea within our team to conduct research to explore the perceived online risks within this population and how they keep themselves safe. In conjunction, we also explored how parents and caregivers monitor and safeguard their young people to the potential threats online. Our hypothesis was that the perceived risks will heavily outnumber the safeguarding measures implemented by this population. Method: Within the Coventry and Warwickshire NHS Partnership Trust Child and Adolescent Mental Health Service (CAMHS), we distributed qualitative questionnaires to all the clinical bases (N=80). Questions explored topics such as daily internet usage, safeguarding measures, and perceived threats. The researchers requested for all CAMHS clinicians to identify participants. Participants in this study were accessing CAMHS for neurodevelopmental specific interventions. Results: The data were analysed using both Excel and SPSS. Within SPSS, a MANOVA was conducted and found a significant difference between safeguarding measures and perceived online risks within responses (p ≤ 0.5). This supports our hypothesis that participants in this population are well versed in the safeguarding issues of the internet; however, struggle to implement appropriate preventative measures. Data were also screened using Excel and found that all parents and carers stated they 'monitored their child’s internet use'. Conclusion: Data suggest that parents/carers may require more specific intervention to equip them with preventative measures due to the clear discrepancy between perceived risks and safeguarding measures. More research may also need to be conducted around this area to determine appropriate methodology to explore this topic further.

Keywords: Internet, health , how safe are we , internet health check

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Authors: Sandra Soca Lozano, Teresa Isabel Lozano Pérez, Germain Weber

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Cancer is a chronic disease of high prevalence in children and adolescents. Medical care in Cuba is carried out by a multidisciplinary team and family is the mediator between this team and the patient. Around this disease, there are interwoven many stereotypes and taboos by its relation to death. In this research report, we describe the work paradigm of psychological care to patients suffering from these diseases in the University Pediatric Hospital Juan Manuel Márquez of Havana, Cuba. We present the psychosocial factors that must be taken into account to provide comprehensive care and ensuring the quality of life of patients and their families. We also present the factors related to the health team and the management of information done with the patient. This is a descriptive proposal from the working experience accumulated in the named institution and in the review of the literature. As a result of this report we make a proposal of teamwork and the aspects in which psychological intervention should be continue performing in terms of increasing the quality of the care made by the health team. We conclude that it is necessary to continue improving the information management of children and adolescents with theses health problems and took into account their right to autonomy.

Keywords: comprehensive care, management of information, psychosocial factors, right to autonomy

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Authors: Henok Metaferia Gebremariam

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Worldwide, considerable resources are spent implementing public health interventions that are interrupted soon after the initial funding ends. However, ambiguity remains as to how health programs can be effectively sustained over time because of the diversity of perspectives, definitions, study methods, outcomes measures and timeframes. From all the above-mentioned research challenges, standardized measures of sustainability should ultimately become a key research issue. To resolve this key challenge, the objective of the study was to adapt a tool for measuring the program’s capacity for sustainability and evaluating its reliability and validity. To adapt and validate the tool, a cross-sectional and cohort study design was conducted at 26 programs in Addis Ababa between September 2014 and May 2015. An adapted version of the tool after the pilot test was administered to 220 staff. The tool was analyzed for reliability and validity. Results show that a 40-item PSAT tool had been adapted into the Amharic version with good internal consistency (Cronbach’s alpha= 0.80), test-retest reliability(r=0.916) and construct validity. Factor analysis resulted in 7 components explaining 56.67 % of the variance. In conclusion, it was found that the Amharic version of PAST was a reliable and valid tool for measuring the program’s capacity for sustainability.

Keywords: program sustainability, public health interventions, reliability, validity

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Authors: Shagufta Jahangir, Raisa Jahangir, Nadeemullah

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In many societies sports is considered inappropriate for women. It traditionally associated with mascunity. The proposed study aims at undertaking a critical situation analysis of sports women in Pakistan from a gender perspective by examining various aspects of sports women by gender including wrong social values, unstable economical position, wrong religious perspective and the role of media towards women in sports, while sports can provide a channel for informing women about their social and legal rights as well as their health issues, productive health and others. A major concern of the study is to identify the basic causes which depriving Pakistani women from sports. The Human Rights Commission of Pakistan and the Joint Action Committee for People’s Rights organized a symbolic mini marathon on 21 May 2005 in Pakistan to challenge arbitrary curbs on women’s public participation in sport and to highlight rising violence against women. Historically, sport has engaged the perception of gender-hierarchy in order to reproduce the ideology of male superiority, a notion which is often translated into ‘usual superiority’ within the superior communal order. However, it is argued here that we are presently in a state of communal instability with esteem to women's participation in sport.

Keywords: mascunity, gender, productive health, inappropriate, rights

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Authors: Francisco Fernandez de Castro

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The Conditional Cash Transfer (CCT) model gives monetary transfers to beneficiary families on the condition that they take specific education and health actions. According to the economic rationale of CCTs the poor need incentives to invest in their human capital because they are trapped by a lack of information and misleading beliefs. If left to their own decision, the poor will not be able to choose what is in their best interests. The basic assumption of the CCT model is that the poor need incentives to take care of their own education and health-nutrition. Due to the incentives (income cash transfers and conditionalities), beneficiary families are supposed to attend doctor visits and health talks. Children would stay in the school. These incentivized behaviors would produce outcomes such as better health and higher level of education, which in turn will reduce poverty. Based on a grounded theory approach to conduct a two-year period of qualitative data collection in northern Mexico, this study shows that this explanation is incomplete. In addition to the information failure and inadequate beliefs, there are structural barriers in everyday life of households that make health-nutrition and education investments difficult. In-depth interviews and observation work showed that the program takes for granted local conditions in which beneficiary families should fulfill their co-responsibilities. Data challenged the program’s assumptions and unveiled local obstacles not contemplated in the program’s design. These findings have policy and research implications for the CCT agenda. They bring elements for late programming due to the gap between the CCT strategy as envisioned by policy designers, and the program that beneficiary families experience on the ground. As for research consequences, these findings suggest new avenues for scholarly work regarding the causal mechanisms and social processes explaining CCT outcomes.

Keywords: conditional cash transfers, incentives, poverty, structural barriers

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Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: V. Esteves

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As products of participatory culture, internet memes represent a global form of interaction with online culture. These digital objects draw upon a rich historical engagement with remix practices that dates back decades: from the copy and paste practices of Dadaism and punk to the re-appropriation techniques of the Situationist International; memes echo a long established form of cultural creativity that pivots on the art of the remix. Online culture has eagerly embraced the changes that the Web 2.0 afforded in terms of making use of remixing as an accessible form of societal expression, bridging these remix practices of the past into a more widely available and accessible platform. Memes embody the idea of 'intercreativity', allowing global creative collaboration to take place through networked digital media; they reflect the core values of participation and interaction that are present throughout much internet discourse whilst also existing in a historical remix continuum. Memes hold the power of cultural symbolism manipulated by global audiences through which societies make meaning, as these remixed digital objects have an elasticity and low literacy level that allows for a democratic form of cultural engagement and meaning-making by and for users around the world. However, because memes are so elastic, their ability to be re-appropriated by other powers for reasons beyond their original intention has become evident. Recently, corporations have made use of internet memes for advertising purposes, engaging in the circulation and re-appropriation of internet memes in commercial spaces – which has, in turn, complicated this relation between online users and memes' democratic possibilities further. By engaging in a widespread online ethnography supplemented by in-depth interviews with meme makers, this research was able to not only track different online meme use through commercial contexts, but it also allowed the possibility to engage in qualitative discussions with meme makers and users regarding their perception and experience of these varying commercial uses of memes. These can be broadly put within two categories: internet memes that are turned into physical merchandise and the use of memes in advertising to sell other (non-meme related) products. Whilst there has been considerable acceptance of the former type of commercial meme use, the use of memes in adverts in order to sell unrelated products has been met with resistance. The changes in reception regarding commercial meme use is dependent on ideas of cultural ownership and perceptions of authorship, ultimately uncovering underlying socio-cultural ideologies that come to the fore within these overlapping contexts. Additionally, this adoption of memes by corporate powers echoes the recuperation process that the Situationist International endured, creating a further link with older remix cultures and their lifecycles.

Keywords: commodification, internet culture, memes, recuperation, remix

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Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

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Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

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Authors: Omari W. Keeles

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Attention to social class and race processes could illuminate within- group differences in Black students' experiences that help explain variation in adjustment. Of interest is how social class relates to development of intragroup connections with other Black students on campus in ways that promote or inhibit well-being. The present study’s findings suggest that students from lower class backgrounds may be more restrictive or limited in opportunities around their intragroup friendship networks than more affluent students. Furthermore, Black social relationship networks were related to positive mental health adjustment important to healthy psychological functioning and development.

Keywords: black students, social class, homophily, psychological adjustment

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Authors: Serena Gomez, Raeesa Tanseen, Netra Shaligram, Nithin Francis, Sandesh B. J.

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The human gut consists of a community of microbes which has a lot of effects on human health disease. Metabolic modeling can help to predict relative populations of stable microbes and their effect on health disease. In order to study and visualize microbes in the human gut, we developed a tool that offers the following modules: Build a tool that can be used to perform Flux Balance Analysis for microbes in the human gut using the Artificial Bee Colony optimization algorithm. Run simulations for an individual microbe in different conditions, such as aerobic and anaerobic and visualize the results of these simulations.

Keywords: microbes, metabolic modeling, flux balance analysis, artificial bee colony

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Authors: Hafiz Arbab Sakandar

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Time-restricted intermittent fasting (TRIF) impacts host’s physiology and health. Plenty of health benefits have been reported for TRIF in animal models. However, limited studies have been conducted on humans especially in underdeveloped economies. Here, we designed a study to investigate the impact of TRIF/Ramadan fasting (16:8) on the modulation of gut-microbiome structure, metabolic pathways, and predicted metabolites and explored the correlation among them at different time points (during and after the month of Ramadan) in Pakistani Expats living in China. We observed different trends of Shannon-Wiener index in different subjects; however, all subjects showed substantial change in bacterial diversity with the progression of TRIF. Moreover, the changes in gut microbial structure by the end of TRIF were higher vis-a-vis in the beginning, significant difference was observed among individuals. Additionally, metabolic pathways analysis revealed that amino acid, carbohydrate and energy metabolism, glycan biosynthesis metabolism of cofactors and vitamins were significantly affected by TRIF. Pyridoxamine, glutamate, citrulline, arachidonic acid, and short chain fatty acid showed substantial difference at different time points based on the predicted metabolism. In conclusion, these results contribute to further our understanding about the key relationship among, dietary intervention (TRIF), gut microbiome structure and function. The preliminary results from study demonstrate significant potential for elucidating the mechanisms underlying gut microbiome stability and enhancing the effectiveness of microbiome-tailored interventions among the Pakistani populace. Nonetheless, extensive, and rigorous large-scale research on the Pakistani population is necessary to expound on the association between diet, gut microbiome, and overall health.

Keywords: gut microbiome, health, fasting, functionality

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