Search results for: health issues

Authors: Tania Chalton

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In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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Authors: Oluwafemi Akinlawon Atoyebi

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This paper examines alienation and fixation as critical issues of/around mental health -crisis, sickness, and healing- through ‘Bode Ojoniyi’s dramaturgy. Two of his dramatic memoirs, arguably written to address such a life-threatening crisis between him and his employer, where he externalizes perhaps his psychological crisis, are critically analysed. This is done through a reading of the three theatrical phenomena of the actor, the character, and the audience against how he plays around the concepts of alienation and fixation within the totality of his dramaturgy beyond what could be seen as a mere academic exercise. The paper situates his apt understanding of their representations as a reflective force of a consciousness that defies psychosomatic existential conflicts. It does so by adopting a qualitative method of analysis through a critical reading of the two dramatic memoirs. It also carries out a survey on the audience that experienced the performances of the memoirs and an interview with Ojoniyi. Using Jean-Paul Sartre’s Theory of Existential Consciousness, the study discovers that there is a way the three phenomena of the actor, the character, and the audience do find expression in Ojoniyi as an existential omniscient playwright-actor-character-audience who is able to transcend the parochialism of an alienated and a fixated self; that beyond the limiting artistic purview, the theatre as a stage is a phenomenon that is capable of capturing the totality of the experiences of a man in his world and that, often time, the depressed are victims of the myopic syndrome as they probably could not see or reflect on/about their realities beyond the self and the play of a casual order. The study concludes that the therapeutic effect of Ojoniyi’s dramatic memoirs, in their reading or performance, is needed by all and should be explored in proffering cures for psychosomatic patients, for it promises to be essentially useful beyond its confine –the Arts.

Keywords: alienation, fixation, the healing theatre, theatrical personalities

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Authors: Caroline Dickson

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While adolescence can be a challenging time, it may also be a time of opportunity. Whereas adolescents with a physical disability negotiate the adolescent developmental stage with similar issues to able-bodied adolescents, they additionally may encounter developmental problems which may impede their adulthood. In part due to the restricted opportunities disabled adolescents experience, they may experience difficulty with mastering this developmental stage. As is well documented, health and wellbeing are positively associated with participating in physical activity. However, the little research available suggested that Pacific adolescents generally are participating in less physical activity than adolescents of other ethnic groups. Objective/Study: The main aim of the study (from a larger mixed method study), was to explore physical activity participation in Pacific adolescent girls with a physical disability in relation to their physiological and psychological wellbeing. The qualitative descriptive study comprised of seven interviews with Pacific adolescent girls and their mothers in a family setting and also included the providers of services to Pacific girls with a physical disability. Including the providers of disability services allowed the researchers to identity a further understanding into challenges of participation for the Pacific adolescent girls and their families while the girls were attempting to participate in physical activity. The purpose of the talanoa (face-to-face interviews that were deemed informal) was to identify partaking and factors influencing participation in physical activity, whilst listening to the voices of the participants. The stories revealed the multitude of factors that influenced physical activity for the Pacific girls with a physical disability. Results: Findings from the qualitative descriptive study found that through physical activity, the Pacific adolescent girls with a physical disability experienced benefits from participation. The findings suggested that these girls wanted to participate in physical activity and clearly indicated the physical activities they preferred. Amongst the physiological and psychological benefits of the Pacific adolescents engaging in physical activity, the adolescents were able to develop positive social relationships, experience autonomy, and generally, their self-worth improved while building confidence. Nevertheless, the adolescents experienced a multitude of factors impeding their engagement in physical activity including cultural stigmas. Their participation was influenced by the interplay of a range of gender, cultural, age-related (adolescence) and socio-economic factors alongside policy and structurally related constraints. Conclusion: Physical activity has the potential to improve the general physiological and psychological health of all adolescents. It should be prioritised particularly in vulnerable populations where they may have limited access. As the Pacific adolescents with a physical activity are dependent on their families for physical activity participation, it is imperative the family be included and consulted. To increase participation, and reduce sedentary behaviours, factors influencing both participation and non-participation need to be considered.

Keywords: Pacific adolescent girls, physical activity, physical disability, qualitative descriptive study

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Authors: Martina Dickson, Lilly Tennant

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The young Emirati female university students of today are the first generation of women in the UAE for whom higher education as become not only a possibility, but almost an expectation. Young women in the UAE today make up around 77% of students in higher education institutes in the country. However, the societal expectations placed upon these women in terms of early marriage, child-bearing and rearing are similar to those placed upon their mothers and grandmothers in a time where women were not expected to go to university. A large proportion of female university students in the UAE are mothers of young children, or become mothers whilst at the university. This creates a challenging situation for young student mothers, where two weeks’ maternity leave is typical across institutions. The context of this study is in one such institution in the UAE. We have employed a mixed method approach to gathering interview data from twenty mothers, and survey data from over one hundred mothers. The main findings indicate that mothers have strong desires for their institution to support them more, for example by the provision of nursery facilities and resting areas for new mothers, and giving them greater flexibility over course selections and schedules including the provision of online learning. However, the majority felt supported on a personal level by their tutors. The major challenges which they identified in returning to college after only two weeks’ leave included the inevitable health and lack of sleep issues when caring for a newborn, struggling to catch up with missed college work and handling their course load. We also explored the women's’ home support systems which were provided from a variety of extended family, spouses and paid domestic help.

Keywords: student mothers, challenges, supports, United Arab Emirates

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Authors: Rimmy Yadav, Anmol Preet Kaur

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Big Data has demonstrated the vast potential in streamlining, deciding, spotting business drifts in different fields, for example, producing, fund, Information Technology. This paper gives a multi-disciplinary diagram of the research issues in enormous information and its procedures, instruments, and system identified with the privacy, data storage management, network and energy utilization, adaptation to non-critical failure and information representations. Other than this, result difficulties and openings accessible in this Big Data platform have made.

Keywords: big data, privacy, data management, network and energy consumption

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Authors: Priyanka R. Sagar

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

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

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Authors: Shraddha B. Rai, Mahipatsinh D. Chavda, Bharat S. Trivedi

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The aim of the present research is to study the effect of education and social belonging on well-being of youth. Well-being is one of the most important aspects of human being and the state of well-being can be attained in terms of healthy body with healthy mind. Well-being has been defined as encompassing people’s cognitive and affective evaluations of their lives. Well-being has been interchangeably used with health and quality of life. According to the WHO, the main determinants of health include the social, economic, and the physical environment and the persons individual characteristics and behaviors. WHO lists other factors that can influence the well-being of a person such as the gender, education, social support networks and health services. The main objective of the present investigation is to know the effect of education and social belonging on well-being of youth. The sample of 180 students belonging to Gujarati and English (convent) culture were selected randomly from Guajarati and English (convent) schools of Ahmedabad City of Gujarat (India). General well-being Scale by Dr. Ashok Kalia and Ms. Anita Deswal was administered to measure the Physical, Emotional, and Social and school well-being. The result shows that there is significant different found between Gujarati and English (convent) culture on Well-being in school students. SES is also affect significantly to wellbeing of students.

Keywords: culture, SES, well-being, health, quality of life

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Authors: Hsiao-Yung Wang

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This essay aims to examine how the transgender imagery has been constructed in the Taiwanese news media and its evolution from 1953 to 2016. It also explores the discourse patterns and rhetorical strategies in the transgender-related issues which contributed to levels of evaluation in forming ‘social deviance.’ Samples for analysis were selected from mainstream newspapers, including China Times, United Daily and Apple Daily. The time frame for sample selection is from August 1953 (when the first transgender case was reported in Taiwan) to June 2016. To enhance understanding of media representation as nominalistic-based, the author refers to the representative of critical rhetoric Raymie McKerrow for his study on remembrance and forgetfulness in public discourse (especially in his model of ‘critique of domination’); thereby categorizing the 64 years of transgender discourse into five periods: (1) transgender as ‘intersex’ of surgical-reparative medical treatment; (2) transgender as ‘freak gender-bender’ with criminal behaviors; (3) transgender as ‘ladyboy’ (‘katoey in a Thai term) of bar girls or sex workers; (4) transgender as ‘cross dresser’ of transvestite performance; and (5) transgender as ‘life-style or human right’ of spontaneous gender identification. Based on the research findings, this essay argues that the characterization of transgender reporting as a site for the production of compulsory sexism and gender stereotype by the specific forms of name-calling. Besides, the evolution of word-image addressing to transgender issues also pinpoints media as a reflection of fashion of the day. While the transgender imagery might be crystallized as ‘still social problems’ or ‘gender transgression’ in insidious rhetoric; and while the so-called ‘phobia’ persistently embodies in media discourse to exercise name-calling in an ambiguous (rather than in a bullying) way or under the cover of humanist-liberalist rationales, these emergent rhetorical dilemma should be resolved without any delay.

Keywords: critical rhetoric, media representation, McKerrow, nominalistic, social deviance, transgender

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Authors: Ayman M. Mansour

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In this paper, we propose an intelligent system that is used for monitoring the health conditions of Patients. Monitoring the health condition of Patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will Improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to Faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The propose system will provide an intelligent system that will generate initial diagnosing to the patient case. This will assist and advice clinicians at the point of care. The decision is based on demographic data and laboratory test results of patient data. Using such system with the ability of making medical decisions, the quality of medical care in Jordan and specifically in Tafial is expected to be improved. This will provide more accurate, effective, and reliable diagnoses and treatments especially if the physicians have insufficient knowledge.

Keywords: GSM, SMS, patient, monitoring system, fuzzy logic, multi-agent system

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Authors: A. G. Margaryan

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Aims and Objectives: Assessment of health status and detection disorders of external respiration functions (ERF) during preventative medical examination among physicians of Armenia. Subjects and Methods: Overall, fifty-nine physicians (17 men and 42 women) were examined and spirometry was carried out. The average age of the physicians was 50 years old. The studies were conducted on the Micromedical MicroLab 3500 Spirometer. Results: 25.4% among 59 examined physicians are overweight; 22.0% of them suffer from obesity. Two physicians are currently smokers. About half of the examined physicians (50.8%) at the time of examination were diagnosed with some diseases and had different health-related problems (excluding the problems related to vision and hearing). FVC was 2.94±0.1, FEV1 – 2.64±0.1, PEF – 329.7±19.9, and FEV₁%/FVC – 89.7±1.3. Pathological changes of ERF are identified in 23 (39.0%) cases. 28.8% of physicians had first degree of restrictive disorders, 3.4% – first degree of combined obstructive/ restrictive disorders, 6.8% – second degree of combined obstructive/ restrictive disorders. Only three physicians with disorders of the ERF were diagnosed with chronic bronchitis and bronchial asthma. There were no statistically significant changes in ERF depending on the severity of obesity (P> 0.05). Conclusion: The study showed the prevalence of ERF among physicians, observing mainly mild and moderate changes in ERF parameters.

Keywords: Armenia, external respiration function, health status, physicians

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Authors: Nia Mair Fry, Matthew Profit, Chenfeng Li

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This work focuses on the development and implementation of a fully implicit-implicit, coupled mechanical deformation and porous flow, finite element software tool. The fully implicit software accurately predicts classical fundamental analytical solutions such as the Terzaghi consolidation problem. Furthermore, it can capture other analytical solutions less well known in the literature, such as Gibson’s sedimentation rate problem and Coussy’s problems investigating wellbore stability for poroelastic rocks. The mechanical volume strains are transferred to the porous flow governing equation in an implicit framework. This will overcome some of the many current industrial issues, which use explicit solvers for the mechanical governing equations and only implicit solvers on the porous flow side. This can potentially lead to instability and non-convergence issues in the coupled system, plus giving results with an accountable degree of error. The specification of a fully monolithic implicit-implicit coupled porous media code sees the solution of both seepage-mechanical equations in one matrix system, under a unified time-stepping scheme, which makes the problem definition much easier. When using an explicit solver, additional input such as the damping coefficient and mass scaling factor is required, which are circumvented with a fully implicit solution. Further, improved accuracy is achieved as the solution is not dependent on predictor-corrector methods for the pore fluid pressure solution, but at the potential cost of reduced stability. In testing of this fully monolithic porous media code, there is the comparison of the fully implicit coupled scheme against an existing staggered explicit-implicit coupled scheme solution across a range of geotechnical problems. These cases include 1) Biot coefficient calculation, 2) consolidation theory with Terzaghi analytical solution, 3) sedimentation theory with Gibson analytical solution, and 4) Coussy well-bore poroelastic analytical solutions.

Keywords: coupled, implicit, monolithic, porous media

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Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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Authors: Jinpa Palmo

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In many research, omega 3 fatty acid which is a polyunsaturated fatty acids is proved to be very important and essential nutrients having many different health benefits but apart from other fatty acids, it cannot be synthesise by our human body. Therefore, we have to get these fatty acids by consuming diets and supplements rich in it. Even though human beings can live by consuming other important nutrients but can live much healthier and longer by consuming omega 3 fatty acids. American heart association AHA recommends for daily intake of omega 3 fatty acids specially by those people with coronary heart disease. Fish considering as nutritional valuable animal is mostly due to its lipid content (fish oil) in which these omega 3 fatty acids are present very significantly. Fish does not actually produce these omega 3 fatty acid in their body, but receive these fatty acids through the food web in which phytoplankton are the chief source of these omega fatty acids.

Keywords: fatty acid, fish, disease, health

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Authors: Conchita Martin de Bustamante, Christopher S. Kung, Brianne Lacy, Eunsol Park, Hien Piotrowski, Mustafa Husain, Waseem Ahmed

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Objective: To explore the comorbidity of mental health conditions (major depressive disorder, borderline personality disorder, generalized anxiety disorder, and schizophrenia) with opioid use disorder in people incarcerated at a large urban jail. Background Schizophrenia, depression, bipolar disorder, and anxiety are all serious mental health conditions that are highly prevalent amongst incarcerated patients. However, it is seldom the only disorder these patients are suffering from. According to the US Department of Justice, about half of US prisoners, both at the state and federal level, suffer from substance use disorders. Although the opioid epidemic has been studied greatly in the recent years amongst the general population, little has been explored on how the opioid crisis has affected incarcerated patients in local jails, particularly regarding which of these patients are most susceptible. Method The cohort consisted of 507 people incarcerated at a large county jail who were evaluated by mental health providers in December 2020. A retrospective review was performed to evaluate associations between mental health diagnoses, substance use disorder, and other demographic variables. Results Participants had been diagnosed with various mental health conditions, including MDD (22.6%, n = 115), GAD (33.7%, n = 171), Schizophrenia (15.2%, n = 77) and BPD (27%, n = 137). Preliminary Chi square tests were conducted for these conditions against marijuana, alcohol, cocaine, opioid, methamphetamine, benzodiazepines, and sedative use disorders. The results showed significant associations between Schizophrenia (p = 0.013), GAD (p M 0.001), and MDD (p = 0.029) with opioid use disorders. Conclusions Determining the extent of these comorbid substance use and mental health disorders within an incarcerated population can help influence treatment plans for future incarcerated patients. Many federal and state jail systems lack pharmacological substance use intervention and the prevalence of these co-morbid conditions can shed light on the importance of treating conditions concurrently upon intake.

Keywords: mental health conditions, opioids, substance use disorder, comorbidity

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Authors: Sonia Lippke, Eric Rost, Volker Cihlar

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Objective: To examine the interrelation of physical activity with work-related variables in older individuals to determine pathways to promote the maintenance of an aging workforce’s ability and motivation to work. Design/methodology/approach: An interview-study was conducted with N=5,002 community-dwelling people aged 55 to 70 years (for T1). N=2,501 (50%) were interviewed 3 years later again (T2). Correlation-, Chi²-, MANOVA and moderated mediation analyses were performed. Findings: The less people worked, the more physically active they were. Working was only related to calendar age but not to subjective age. Men and women only differed in working hours and an interaction of gender and pension regarding working hours and subjective health revealed: Controlled for calendar age, the amount of worked hours while receiving pension was about the same in men and women, however, men worked significantly more hours if they did not receive pension. The relationship between physical activity and worked hours was mediated by life investment and subjective health in women, and by subjective health in men. Practical implications: Developing good health through performing physical activity should be done as part of work-place health promotion or by work organization and HR management to enable, and motivate older individuals to work even when receiving pension. Thus, such initiates should not only offered for younger and middle aged employees. Physical activity and company-facilitated sports activities can be an integral part in this. Originality/value: This is the first study testing these mechanisms in this age group, indicating the importance of not only understanding physical activity as a time challenge to work but also the potential to protect workability and to work aside from receiving pension.

Keywords: life investment, moderated mediation, physical activity, older workers, subjective health

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Authors: Ahlam Alnatour

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Background: To our knowledge, there is lack of studies that describe the experience of studying health promotion courses using an interactive approach, and compare students’ and teachers perceptions about this method of teaching. The purpose of this study is to provide a comparison between student and teacher experiences and perspectives in learning health promotion course using interactive learning. Design: A descriptive qualitative design was used to provide an in-depth description and understanding of students’ and teachers experiences and perceptions of learning health promotion courses using an interactive learning. Study Participants: About 14 fourteen students (seven male, seven female) and eight teachers at governmental university in northern Jordan participated in this study. Data Analysis: Conventional content analysis approach was used for participants’ scripts to gain an in-depth description for both students' and teacher’s experiences. Results: The main themes emerged from the data analysis describing the students’ and teachers perceptions of the interactive health promotion class: teachers’ and students positive experience in adopting interactive learning, advantages and benefits of interactive teaching, barriers to interactive teaching, and suggestions for improvement. Conclusion: Both teachers and students reflected positive attitudes toward interactive learning. Interactive learning helped to engage in learning process physically and cognitively. Interactive learning enhanced learning process, promote student attention, enhanced final performance, and satisfied teachers and students accordingly. Interactive learning approach should be adopted in teaching graduate and undergraduate courses using updated and contemporary strategies. Nursing scholars and educators should be motivated to integrate interactive learning in teaching different nursing courses.

Keywords: interactive learning, nursing, health promotion, qualitative study

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Authors: Eman Alatawi

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The world is currently experiencing an upsurge in the number of international migrants, which has reached 281 million worldwide; in particular, both the UK and Saudi Arabia have recently been faced with an unprecedented number of immigrants. As a result, the media in these two countries is constantly posting news about the issue, and newspapers, in particular, play a vital role in shaping the public’s view of immigration issues. Because the media is an influential tool in society, it has the ability to construct a specific image of migrants and influence public opinion concerning immigrant groups. However, most of the existing studies have addressed the plight of migrants in the UK, Europe, and the US, and few have considered the Middle East; specifically, there is a pressing need for studies that focus on the press in Saudi Arabia, which is one of the main countries that is experiencing immigration at a tremendous rate. This paper employs critical discourse analysis (CDA) to examine the depiction of migrants in the British and Saudi Arabian media in order to explore the involvement of three linguistic features in the media’s representation of migrant-related topics. These linguistic features are the names, metaphors, and collocations that the press in the UK and in Saudi Arabia uses to describe migrants; the impact of these depictions is also considered. This comparative study could create a better understanding of how the Saudi Arabian press presents the topic of migrants and immigration, which will assist in extending the understanding of migration discourses beyond an Anglo-centric viewpoint. The main finding of this study was that both British and Saudi Arabian newspapers tended to represent migrants’ issues by painting migrants in a negative light through the use of negative references or names, metaphors, and collocations; furthermore, the media’s negative stereotyping of migrants was found to be consistent, which could have an influence on the public’s opinion of these minority groups. Such observations show that the issue is not as simple as individuals, press systems, or political affiliations.

Keywords: representation, migrants, the UK press, Saudi Arabia press, cross-linguistic, discourse analysis

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Authors: Le Jiang, Chua Jinxing

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Introduction: The recent outbreak of Ebola virus disease in the west Africa has drawn global concern. With a high fatality rate and direct human-to-human transmission, it has spread between countries and caused great damages for patients and family who are affected. Being the designated hospital to manage epidemic outbreak in Singapore, Tan Tock Seng Hospital (TTSH) is facing great challenges in preparation and managing of potential outbreak of emerging infectious disease such as Ebola virus disease. Aim: We conducted an infection control drill in TTSH emergency department to assess the readiness of healthcare and allied health workers in managing suspected Ebola patients. It also helps to review current Ebola clinical protocol and work instruction to ensure more smooth and safe practice in managing Ebola patients in TTSH emergency department. Result: General preparedness level of staffs involved in managing Ebola virus disease in TTSH emergency department is not adequate. Knowledge deficits of staffs on Ebola personal protective equipment gowning and degowning process increase the risk of potential cross contamination in patient care. Loopholes are also found in current clinical protocol, such as unclear instructions and inaccurate information, which need to be revised to promote better staff performance in patient management. Logistic issues such as equipment dysfunction and inadequate supplies can lead to ineffective communication among teams and causing harm to patients in emergency situation. Conclusion: The infection control drill identified the need for more well-structured and clear clinical protocols to be in place to promote participants performance. In addition to quality protocols and guidelines, systemic training and annual refresher for all staffs in the emergency department are essential to prepare staffs for the outbreak of Ebola virus disease. Collaboration and communication with allied health staffs are also crucial for smooth delivery of patient care and minimising the potential human suffering, properties loss or injuries caused by disease. Therefore, more clinical drills with collaboration among various departments involved are recommended to be conducted in the future to monitor and assess readiness of TTSH emergency department in managing Ebola virus disease.

Keywords: ebola, emergency department, infection control drill, Tan Tock Seng Hospital

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Authors: Trianasari, Gede Adi Yuniarta

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The tourism industry has been widely recognized as one of the world’s largest industries and is expected to have continuous growth. While it has positive impacts especially on the job markets and economic aspect, this industry also brings serious environmental impacts that may not be neglected. As such, the tourism industry is faced with increasing demands and challenges to deal with the environmental issues. Corporate Social Responsibility (CSR) is a way to show the firms’ concern on the societal and environmental aspects. In line with the increasing pressure on such responsibilities, a growing number of firms have involved in CSR activities. In Bali, the majority of both chained and locally owned hotels have shown their efforts on CSR practices. However, little is known about what and how they perform or implement such program especially within the environmental aspect. The importance of understanding what they focus on lays in the identification of areas that have received sufficient treatment and those that require more attention. Furthermore, also, it is especially essential considering that Bali is one of the worldly known destinations that have been facing numerous crucial issues on environment that may threaten the sustainability of the island and its people. This paper reports on the results of a study exploring the practices of CSR in hotels in Bali. Data were collected from 49 hotel managers and human resource managers in Bali across four major tourist areas, using semi structured interview method. The analysis was conducted qualitatively. The results showed that all hotels under study have implemented CSR activities in which environment was found to be the second key aspect, following the activities directly related to community aspect. Moreover, there were five major types of environmental action identified: beach cleaning, replantation, marine conservation, turtle conservation, mangrove, and garbage management. These findings suggest that hotels in Bali under study have shown their concern on the environment, however, less attention was given on attempt to reduce the environmental impacts of their operations. Mapping the types of environmental related CSR activities enhances the knowledge of and gives lights into the CSR literature especially from the perspective of Eastern practice.

Keywords: CSR, exploratory study, sustainable tourism, tourist object

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Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Razia Sultana, Md Faroque Miah

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Mental health remains a significant global public health challenge, profoundly affecting millions worldwide. In Bangladesh, the situation is dire, with the National Mental Health Survey 2018-19 indicating that 19% of adults suffer from any kind of mental disorders, including severe mental disorder of around 2%. Despite these high prevalence rates, there is a substantial treatment gap in low- and middle-income countries, including Bangladesh, where up to 92% of individuals with mental illnesses do not receive adequate care. This gap is exacerbated by social barriers such as stigma, discrimination, social exclusion, poverty, homelessness, and human rights violations. To address these challenges, the SAJIDA Foundation launched the Proshanti in November 2022. Proshanti is a community based supportive housing intervention designed to provide cost-effective, sustainable, long-term care for individuals with chronic mental illnesses. It aims to rehabilitate participants by improving their mental health, quality of life, and equipping them with skills necessary for independent living and social mobility. Currently, Proshanti operates seven houses in Manikganj and Habiganj districts of Bangladesh, accommodating up to 40 individuals. Over a two-year period, individuals have received personalized support from trained personal assistants and care coordinators, regular health checkups, and opportunities for vocational training and community engagement. In this presentation, we will present the outcome of such intervention on individual’s functionality, quality of life and psychological health generated from 24 months of journey. Additionally, a qualitative approach will be employed to understand the facilitators and barriers of program implementation. The Proshanti program represents a promising model for addressing the significant mental health treatment gap in Bangladesh at the community level. Our findings will provide crucial insights into the program's feasibility, effectiveness, and the factors influencing its implementation, potentially guiding future mental health interventions in similar contexts.

Keywords: mental health, community based supportive housing, treatment gap, bangladesh

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Authors: Uday S. Goel, G. Senthil Kumar, Biswajit Ghosh, V. V. Mahashabde, Dhirendra Kumar, H. Manjunath, Ritesh Kumar, Mahesh Bhagwat, Subodh Pandey

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Tata Steel Bhushan Steel Ltd.(TSBSL)’s Hot Mill at Angul , Orissa , India, was facing shape issues in Hot Rolled (HR) coils. This was resulting in a defect called as ‘Ridge’, which was appearing in subsequent cold rolling operations at various cold mills (CRM) and external customers. A collaborative project was undertaken to resolve this issue. One of the reasons identified was the strange drop in thermal crown after rolling of 20-25 coils in the finishing mill (FM ) schedule. On the shop floor, it was observed that work roll temperatures in the FM after rolling were very high and non uniform across the work roll barrel. Jammed work roll cooling nozzles, insufficient roll bite lubrication and inadequate roll cooling water quality were found to be the main reasons. Regular checking was initiated to check roll cooling nozzles health, and quick replacement done if found jammed was implemented. Improvements on roll lubrication, especially flow rates, was done. Usage of anti-peeling headers and inter stand descaling was enhanced. A subsequent project was also taken up for improving the quality of roll cooling water. Encouraging results were obtained from the project with a reduction in rejection due to ridge at CRM’s by almost 95% of the pre project start levels. Poor profile occurrence of HR coils at HSM was also reduced from a high of 32% in May’19 to <1% since Apr’20.

Keywords: hot rolling flat, shape, ridge, work roll, roll cooling nozzle, lubrication

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Authors: Silvia Maria Moya

Abstract:

After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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Authors: James Semmens, James Boyd, Anna Ferrante, Katrina Spilsbury, Sean Randall, Adrian Brown

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‘Big data’ is a relatively new concept that describes data so large and complex that it exceeds the storage or computing capacity of most systems to perform timely and accurate analyses. Health services generate large amounts of data from a wide variety of sources such as administrative records, electronic health records, health insurance claims, and even smart phone health applications. Health data is viewed in Australia and internationally as highly sensitive. Strict ethical requirements must be met for the use of health data to support health research. These requirements differ markedly from those imposed on data use from industry or other government sectors and may have the impact of reducing the capacity of health data to be incorporated into the real time demands of the Big Data environment. This ‘big data revolution’ is increasingly supported by national governments, who have invested significant funds into initiatives designed to develop and capitalize on big data and methods for data integration using record linkage. The benefits to health following research using linked administrative data are recognised internationally and by the Australian Government through the National Collaborative Research Infrastructure Strategy Roadmap, which outlined a multi-million dollar investment strategy to develop national record linkage capabilities. This led to the establishment of the Population Health Research Network (PHRN) to coordinate and champion this initiative. The purpose of the PHRN was to establish record linkage units in all Australian states, to support the implementation of secure data delivery and remote access laboratories for researchers, and to develop the Centre for Data Linkage for the linkage of national and cross-jurisdictional data. The Centre for Data Linkage has been established within Curtin University in Western Australia; it provides essential record linkage infrastructure necessary for large-scale, cross-jurisdictional linkage of health related data in Australia and uses a best practice ‘separation principle’ to support data privacy and security. Privacy preserving record linkage technology is also being developed to link records without the use of names to overcome important legal and privacy constraint. This paper will present the findings of the first ‘Proof of Concept’ project selected to demonstrate the effectiveness of increased record linkage capacity in supporting nationally significant health research. This project explored how cross-jurisdictional linkage can inform the nature and extent of cross-border hospital use and hospital-related deaths. The technical challenges associated with national record linkage, and the extent of cross-border population movements, were explored as part of this pioneering research project. Access to person-level data linked across jurisdictions identified geographical hot spots of cross border hospital use and hospital-related deaths in Australia. This has implications for planning of health service delivery and for longitudinal follow-up studies, particularly those involving mobile populations.

Keywords: data integration, data linkage, health planning, health services research

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Authors: Doreen Mekunda

Abstract:

This paper is built on the premise that the current socio-political crisis in the two restive regions of Cameroon, though enveloped with destructive and devastating trends (effects) on both property and human lives, is not without its strengths and merits. It is incontestable that many cultures, to a greater extent, are going to be destroyed as people forcibly move from war-stricken habitats to non-violent places. Many cultural potentials, traditional shrines, artifacts, art, and crafts, etc., are unknowingly or knowingly disfigured, and many other ugly things will, by the end of the crisis, affect the cultures of these two regions under siege and of the receiving population. A plethora of other problems like the persecution of Internally Displaced Persons (IDPs) for being displaced and blamed for increased crime rates and the existence of cultural and ethnic differences that produce both inter-tribal and interpersonal conflicts and conflicts between communities will abound. However, there is the emergence of rapid literature, and other forms of cultural productions, whether written or oral, is visible, thereby precipitating a rich cultural diversity due to the coming together of a variety of cultures of both the IDPs and the receiving populations, rapid urbanization, improvement of health-related issues, the rebirth of indigenous cultural practices, the development of social and lingua-cultural competences, dependence on alternative religions, faith and spirituality. Even financial and economic dependence, though a burden to others by IDPs, has its own merits as it improves the living standards of the IDPs. To be able to obtain plausible results, cultural materialism, which is a literary theory that hinges on the empirical study of socio-cultural systems within a materialist infrastructure-super-structure framework, is employed together with the postcolonial theory. Postcolonial theory because the study deals with postcolonial experiences/tenets of migration, hybridity, ethnicity, indignity, language, double consciousness, migration, center/margin binaries, and identity, amongst others. The study reveals that the involuntary movement of persons from their habitual homes brings about movement in cultures, thus, the emergence of new cultures. The movement of people who hold fast to their cultural heritage can only influence new forms of literature, the development of new communication competences, the rise of alternative religion, faith and spirituality, the re-emergence of customary and traditional legal systems that might have been abandoned for the new judicial systems, and above all the revitalization of traditional health care systems.

Keywords: alternative religion, emergence, socio-political crisis, spirituality, lingua-cultural competences

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Authors: Chris Preston

Abstract:

As we devise ever more sophisticated methods of on-line marketing, devising systems that are able to reach into the everyday lives of consumers, we are confronted by a generation of children who face unprecedented intervention by commercial organisations into young minds, via electronic devices, and whether by computer, tablet or phone, such children have been somehow reduced to the status of their devices, with little regard for their well being as individuals. This discussion paper seeks to draw attention to such practice and questions the ethics of digital marketing methods.

Keywords: online marketing to children, online research of children, online targeting of children, consumer rights, ethics

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Authors: Li Hoon Lim, Nur Farhanah Said, Katie Simmons, Eric Pei Ping Pang, Sharon Mei Mei Wong

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Background and Purpose: Research regarding the sexual impact of breast cancer treatment on Asian women is both sensitive and scarce. This study aims to assess and evaluate the sexual health needs and concerns of breast cancer radiotherapy patients. It is hoped that awareness will be increased and an appropriate intervention can be developed to address the needs of future breast cancer patients. Methods: 110 consecutive unselected breast cancer patients were recruited prospectively. Questionnaires were administered once for patient undergoing radiotherapy to the breast. This study employed an anonymous questionnaire; any breast radiotherapy patient who can read English can voluntarily receive and complete the survey. The questionnaire consisted of items addressing demographics, potential informational needs, and educational preferences. Results: Patients’ interest to address sexual concerns decreases with age (p=0.024). Coherently, sexual concerns of patients are reported to decrease with age (p=0.015) where 70% of all respondents below age 50 [age 20-29 (60%); 30-39 (56.3%); 40-49(55.1%)] have started to have sexual concerns regarding their treatment effects on their sexual health. Patients who underwent breast conservation surgery (42.2%) and reconstruction surgery (83.3%) were more likely to have concerns about sexual health versus patients who underwent mastectomy (36.7%) (p=0.032). 74.2% of patients with sexual concern regardless of age would initiate conversation with their healthcare providers (p < 0.001). Conclusions: The results showed a staggering interest of female patients wanting information on this area which would not only boost their confidence and body image but also address concerns of the effect of breast radiotherapy on sexual health during their treatment.

Keywords: breast cancer, breast radiotherapy, sexual health, sexual impact

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Authors: N. A. Parvin, E. B. Ferranti, L. A. Chapman, C. A. Pfrang

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This study intends to investigate the effects of the Urban Heat Island on public health in Birmingham. Birmingham is located at the center of the West Midlands and its weather is Highly variable due to geographical factors. Residential developments, road networks and infrastructure often replace open spaces and vegetation. This transformation causes the temperature of urban areas to increase and creates an "island" of higher temperatures in the urban landscape. Extreme heat in the urban area is influencing public health in the UK as well as in the world. Birmingham is a densely built-up area with skyscrapers and congested buildings in the city center, which is a barrier to air circulation. We will investigate the city regarding heat and cold-related human mortality and other impacts. We are using primary and secondary datasets to examine the effect of population shift and land-use change on the UHI in Birmingham. We will also use freely available weather data from the Birmingham Urban Observatory and will incorporate satellite data to determine urban spatial expansion and its effect on the UHI. We have produced a temperature map based on summer datasets of 2020, which has covered 25 weather stations in Birmingham to show the differences between diurnal and nocturnal summer and annual temperature trends. Some impacts of the UHI may be beneficial, such as the lengthening of the plant growing season, but most of them are highly negative. We are looking for various effects of urban heat which is impacting human health and investigating mitigation options.

Keywords: urban heat, public health, climate change

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Authors: Emy Nayana Pinto, Denise Bomtempo Birche De Carvalho

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In the present study, the harmful use of illicit drugs is seen as a public health problem and as one of the expressions of the social question, since its consequences fall mainly on the poorer classes of the population. This perspective is a counterpoint to the dominant paradigm on illicit drug policy at the global level, whose centrality lies within the criminal justice arena. The 'drug problem' is internationally combated through fragmented approaches that focus its actions on banning and criminalizing users. In this sense, the research seeks to answer the following key questions: What are the influences of the prohibitionism in the recommendations of the United Nations (UN), the World Health Organization (WHO), and the formulation of drug policies in member countries? What are the actors that have been provoking the prospect of breaking with the prohibitionist paradigm? What is the WHO contribution to the rupture with the prohibitionist paradigm and the displacement of the drug problem in the field of public health? The general objective of this work is to seek evidence from the perspective of rupture with the prohibitionist paradigm in the field of drugs policies at the global and regional level, through analysis of documents of the World Health Organization (WHO), between the years of 2001 to 2016. The research was carried out in bibliographical and documentary sources. The bibliographic sources contributed to the approach with the object and the theoretical basis of the research. The documentary sources served to answer the research questions and evidence the existence of the perspective of change in drug policy. Twenty-two documents of the UN system were consulted, of which fifteen had the contribution of the World Health Organization (WHO). In addition to the documents that directly relate to the subject of the research, documents from various agencies, programs, and offices, such as the Joint United Nations Program on HIV/AIDS (UNAIDS) and the United Nations Office on Drugs and Crime (UNODC), which also has drugs as the central or transversal theme of its performance. The results showed that from the 2000s it was possible to find in the literature review and in the documentary analysis evidence of the critique of the prohibitionist paradigm parallel to the construction of a new perspective for drug policy at the global level and the displacement of criminal justice approaches for the scope of public health, with the adoption of alternative and pragmatic interventions based on human rights, scientific evidence and the reduction of social damages and health by the misuse of illicit drugs.

Keywords: illicit drugs, international organizations, prohibitionism, public health, World Health Organization

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Authors: Gábor Kocsmárik

Abstract:

The topic of this is coercive measures against assets in which the factor of the procedure contains a foreign element. We speak of cross-border enforcement if the debtor or the property requesting enforcement or subject to enforcement is not located in the bordering country. Given that the jurisdiction of a country cannot extend beyond its borders, the cooperation of nations and the mutual recognition of their decisions are necessary to eliminate this. In addition, it is essential to create framework rules that are binding and enforceable for each country participating in the convention. During the study, some conventions between countries that are still in force will be presented, which can serve as a starting point for dealing with existing problems.

Keywords: law, execution, civil procedure law, international

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Authors: Cheryl M. Bowen

Abstract:

Understanding that children thrive in a multi-systems approach to mental health development, a growing number of schools often promote school-based positive youth development however, there is scant empirical evidence investigating effective school-based “wraparound” mental health services for low income, Latinx children and their families. This 10-month case study utilizes a sample of 281 low-income, Latinx parents and their children, and 23 K-5th grade teachers living in northern California to test the hypothesis that a school-based mental health program can strengthen students’ developmental asset attainment and positively impact the school environment. The study utilized triangulated data to ascertain the effects of two program levels - (a) mental health and (b) positive child development services. All services were site-based and meant to target a wide variety of families. Findings from the study report that the universal mental health program increased the developmental asset attainment in 5 out of 8 thriving indicators thus transforming the child within his/her environment. Data collected from the administrative referral report demonstrate that the project also positively impacted the school climate. Parents and teachers felt more connected to the school, and referrals were down for discipline (35%), academics (66%), and suspensions (51%). The study concludes that a transformational ecology model of positive child development is the most effective means to nurture connections to all socializing agencies in a child’s ecosystem.

Keywords: case study, child development, positive youth development, developmental assets, ecological systems theory

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