Search results for: occupational health

Authors: Asif Khaliq, Sayeeda A. Sayed

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The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

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Authors: Saad Bin Nasir

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This study imperially evaluated of five human resource (HR) practices (Wellness program extents are Employee’s assistance program, Health care screenings, and Recreation trips, Seminars for life style, Indoor and Outdoor activities) and there likely impact on the organization productivity in Pakistani organizations. The data were gathering by administrating questionnaires. The result indicated that all five variables are positively and significantly correlated with organization productivity. Results of regressing the all variables on organization productivity show that seminars for life style and employee’s assistance program strong predictors of organization productivity.

Keywords: wellness program, organization’s productivity, employee’s assistance program, health care screening

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Authors: L. Matlawe, E. S. Idemudia

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The stability is an important topic to plan and manage the energy in the microgrids as the same as the conventional power systems. The voltage and frequency stability is one of the most important issues recently studied in microgrids. The objectives of this paper are the modeling and designing of the components and optimal controllers for the voltage and frequency control of the AC/DC hybrid microgrid under the different disturbances. Since the PI controllers have the advantages of simple structure and easy implementation, so they were designed and modeled in this paper. The harmony search (HS) algorithm is used to optimize the controllers’ parameters. According to the achieved results, the PI controllers have a good performance in voltage and frequency control of the microgrid.

Keywords: emotional abuse, employees, mental health, self-concept

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Authors: Jessica Ding

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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

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Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

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Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

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Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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Authors: Jana Djounova

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The World Health Organization proposes an average annual reference level of 100 Bq/m³ to minimize health risks due to radon exposure in buildings. However, if this cannot be achieved under the country's specific conditions, the chosen reference level should not exceed 300 Bq/m³. The World Health Organization recognized the relationship between indoor radon exposure and lung cancer, even at low doses. Radon in buildings is one of the most important indoor air pollutants, with harmful effects on the health of the population and especially children. This study presents the assessment of indoor radon concentration as air pollution and analyzes the exposure to radon of children and workers. Assessment of air pollution and exposure to indoor radon concentrations under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018 in kindergartens in two districts of Bulgaria (Razgrad and Silistra). Kindergartens were considered for the following reasons: 1these buildings are generally at the ground and/or the first floor, where radon concentration is generally higher than at upper floors; 2these buildings are attended by children, a population generally considered more sensitive to ionizing radiation, although little data is available for radon exposure. The measurements of indoor radon concentrations were performed with passive methods (CR-39 track detectors) for the period from February to May 2015. One hundred fifty-six state kindergartens on the territories of two districts in Bulgaria have been studied. The variations of radon in the children's premises vary from 9 to 1087 Bq/m³. The established arithmetic mean value of radon levels in the kindergartens in Silistra is 139 Bq/m³ and in Razgrad 152 Bq/m³, respectively. The percentage of kindergarteners, where the radon in premises exceeds the Bulgarian reference level of 300 Bq/m³, was 19%. The exposure of children and workers in those kindergartens is high, so remediation measures of air pollution had been recommended. The difference in radon concentration in kindergartens in two districts was statistically analyzed to assess the influence of geography and geology and the difference

Keywords: air pollution, radon, kindergartens, detectors

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Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

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Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint

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Authors: Ekpon Oghenetega Philip, Tayire Okabare Favour, Boye Ejobowah Thomas

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The study evaluated the resting systolic blood pressure (RSBP) and resting diastolic blood pressure (RDBP) of staff of a multi-national petroleum company in Nigeria with the aim of helping the staff maintain optimal health which is necessary to carry out their secular work. Eleven healthy male (age 36.9±10.48 years, mean±S.D) and 38 healthy female (39.99±12.23 years, mean±S.D) staff of the multi-national petroleum company performed an incremental exercise on a treadmill and cycle ergometers to determine RSBP and RDBP. An assessment of the health status of the staff of the company was carried out using a physical activity readiness questionnaire (PAR-Q) to determine their suitability for the program. Analysis of the t-test for male staff of RSBP shows that it was statistically significant with a calculated t value of 2.19, α = 0.05 and t-calculated for RSBP of female staff was 1.897, α = 0.05 showing a significance. While the t-calculated RSBP for male staff of the multi-national company is 0.44 with α =0.05 and the female RDBP is 4.129, α = 0.05 and they are all significant. It was recommended that staff of the company should regularly visit the company gym during their leisure hours to maintain optimum health.

Keywords: systolic blood pressure, diastolic blood pressure, exercise, pressure staff

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Authors: Elin Mordal, Meseret Tsegaye, Hirut Gemeda, Ingeborg Ulvund

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Background: Even the rural-urban gap in the provision of skilled care during childbirth has narrowed, developing countries have the highest percentage of maternal deaths. More important than uncovering deficiencies during pregnancy, is preventing situations of risk during childbirth. The aim of this study was to identify factors women in the rural area consider before they decide where to give birth. Methods: This study utilizes a qualitative descriptive design based on individual interviews with 25 women of childbearing age who has given birth at least once, where women who delivered both at home and a health centre were included. Data collection took place in rural areas around Hawassa Zuriya Worda in Ethiopia February 2015. To identify conditions associated to where women prefer to give birth a thematic analysis was carried out. Result: Experienced risks regarding child birth were the most common reason for women and their families to seek help from skilled birth attendants. Decision-making and planning were identified as a major factor contributing to where women give birth. The women’s position and responsibilities pointed to the fact that women's role is mainly to take care of children and manage the household, while husbands, mother in laws and the elderly are the family members who take most of the decisions. This includes decision about where women give birth. The infrastructure also influences where women choose to give birth. Conclusion: To further improve childbirth care in Hawassa Zuriya Worda it’s important that women get positive experiences, and are met in a safe and supportive way at Health Centers. Challenges appear to women’s autonomy, quality aspects, and infrastructure.

Keywords: childbirth, women, health care utilization, Hawassa Zuriya Worda, Ethiopia, rural area

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Authors: A. Lubis, L. Setiawati, A. R. Setyoningrum, A. Suryawan, Irwanto

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Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: asthma, chronic health problems, growth, development

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Authors: Claudia Valderrama-Ulloa, Cristian Schmitt, Juan Pablo Marchetti, Viviana Bucarey

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Access to adequate housing is a fundamental human right and a crucial factor for health. Housing should be inclusive, accessible, and able to meet the needs of all its inhabitants at every stage of their lives without hindering their health, autonomy, or independence. This article addresses the importance of designing housing for people with disabilities, which varies depending on individual abilities, preferences, and cultural considerations. Based on the components of the International Classification of Functioning, Disability and Health, wheelchair users, little people (achondroplasia), children with autism spectrum disorder and Down syndrome were characterized, and six domains of activities related to daily life inside homes were defined. The article describes the main barriers homes present for this group of people. It proposes a list of architectural and design aspects to reduce barriers to housing use. The aspects are divided into three main groups: space management, building services, and supporting facilities. The article emphasizes the importance of consulting professionals and users with experience designing for diverse needs to create inclusive, safe, and supportive housing for people with disabilities.

Keywords: achondroplasia, autism spectrum disorder, disability, down syndrome, wheelchair user

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Authors: Roya Kelishadi, Mostafa Amini-Rarani, Mostafa Qorbani

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Introduction: As a health-related behavior, physical activity (PA) has an unequal distribution relating to individual's socioeconomic status. This study aimed to assess socioeconomic inequality in PA among Iranian students and their parents at national level and according to socioeconomic status (SES) of the living regions. Method: This study was conducted as part of a national surveillance program conducted among 14400 Iranian students and their parents. Non-linear principal component analysis was used to construct the households' socioeconomic status, and the concentration index approach was applied to measure inequality in father, mother, and student’s PA. Results: The data of 13313 students and their parents were complete for the current study. At national level and SES regions, students had more PA than their parents (except in the lowest SES region), and fathers have more PA than mothers. The lowest means of mother and student's PA were find in the highest SES region. At national level, the concentration indices of father and mother’s PA were -0.050 (95 % CI: -0.067 ~ -0.030) and -0.028 (95% CI: -0.044 ~ -0.012), respectively; indicating pro-poor inequality and, the CI value of student PA was nearly equal to zero (P > 0.05). At SES regions, father and mother's PA were more concentrated in the poor, except for lower middle region. Regional concentration indices for students reveal that inequality not statistically significant at all regions. Conclusion: This study suggests that reliable evidence that comparing different aspects of inequality of PA, based on socioeconomic status and residence areas of students and their parents, could be used for better planning for health promotion programs. Moreover, given the average of mother's and student’s PA in the richer regions were low, it can be suggested that richer focused-PA planning may further increase the level of PA across higher SES and, consequently, reduce inequality in PA. These findings can be applied in the health system services.

Keywords: concentration index, health system services, physical activity, socioeconomic inequality

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Authors: Liliana Gomez Cardona, Mary McComber, Kristyn Brown, Arlene Laliberté, Outi Linnaranta

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The history of colonialism and more contemporary political issues have resulted in the exposure of Kanien'kehá:ka: non (Kanien'kehá:ka of Kahnawake) to challenging and even traumatic experiences. Colonization, religious missions, residential schools as well as economic and political marginalization are the factors that have challenged the wellbeing and mental health of these populations. In psychiatry, screening for mental illness is often done using questionnaires with which the patient is expected to respond to how often he/she has certain symptoms. However, the Indigenous view of mental wellbeing may not fit well with this approach. Moreover, biomedical treatments do not always meet the needs of Indigenous people because they do not understand the culture and traditional healing methods that persist in many communities. Assess whether the questionnaires used to measure symptoms, commonly used in psychiatry are appropriate and culturally safe for the Mohawk in Quebec. Identify the most appropriate tool to assess and promote wellbeing and follow the process necessary to improve its cultural sensitivity and safety for the Mohawk population. Qualitative, collaborative, and participatory action research project which respects First Nations protocols and the principles of ownership, control, access, and possession (OCAP). Data collection based on five focus groups with stakeholders working with these populations and members of Indigenous communities. Thematic analysis of the data collected and emerging through an advisory group that led a revision of the content, use, and cultural and conceptual relevance of the instruments. The questionnaires measuring psychiatric symptoms face significant limitations in the local indigenous context. We present the factors that make these tools not relevant among Mohawks. Although the scale called Growth and Empowerment Measure (GEM) was originally developed among Indigenous in Australia, the Mohawk in Quebec found that this tool comprehends critical aspects of their mental health and wellbeing more respectfully and accurately than questionnaires focused on measuring symptoms. We document the process of cultural adaptation of this tool which was supported by community members to create a culturally safe tool that helps in growth and empowerment. The cultural adaptation of the GEM provides valuable information about the factors affecting wellbeing and contributes to mental health promotion. This process improves mental health services by giving health care providers useful information about the Mohawk population and their clients. We believe that integrating this tool in interventions can help create a bridge to improve communication between the Indigenous cultural perspective of the patient and the biomedical view of health care providers. Further work is needed to confirm the clinical utility of this tool in psychological and psychiatric intervention along with social and community services.

Keywords: cultural adaptation, cultural safety, empowerment, Mohawks, mental health, Quebec

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Authors: E. V. Fakhrutdinova, K. R. Maksimova, P. B. Chursin

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At the present stage of the society progress the health care is an integral part of both the economic system and social, while in the second case the medicine is a major component of a number of basic and necessary social programs. Since the foundation of the health system are highly qualified health professionals, it is logical proposition that increase of doctor`s professionalism improves the effectiveness of the system as a whole. Professionalism of the doctor is a collection of many components, essential role played by such personal-psychological factors as honesty, willingness and desire to help people, and motivation. A number of researchers consider motivation as an expression of basic human needs that have passed through the “filter” which is a worldview and values learned in the process of socialization by the individual, to commit certain actions designed to achieve the expected result. From this point of view a number of researchers propose the following classification of highly skilled employee’s needs: 1. the need for confirmation the competence (setting goals that meet the professionalism and receipt of positive emotions in their decision), 2. The need for independence (the ability to make their own choices in contentious situations arising in the process carry out specialist functions), 3. The need for ownership (in the case of health care workers, to the profession and accordingly, high in the eyes of the public status of the doctor). Nevertheless, it is important to understand that in a market economy a significant motivator for physicians (both legal and natural persons) is to maximize its own profits. In the case of health professionals duality motivational structure creates an additional contrast, as in the public mind the image of the ideal physician; usually a altruistically minded person thinking is not primarily about their own benefit, and to assist others. In this context, the question of the real motivation of health workers deserves special attention. The survey conducted by the American researcher Harrison Terni for the magazine "Med Tech" in 2010 revealed the opinion of more than 200 medical students starting courses, and the primary motivation in a profession choice is "desire to help people", only 15% said that they want become a doctor, "to earn a lot". From the point of view of most of the classical theories of motivation this trend can be called positive, as intangible incentives are more effective. However, it is likely that over time the opinion of the respondents may change in the direction of mercantile motives. Thus, it is logical to assume that well-designed system of motivation of doctor`s labor should be based on motivational foundations laid during training in higher education.

Keywords: motivation, quality of working life, health system, personal-psychological factors, motivational structure

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Authors: Alhage Drammeh

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The research is on the occurrence of certain diseases among children in rural and far-flung parts of the Gambia and the extent to which they are caused by lack of access to clean water. A baseline survey was used to discover, describe, and explain the actual processes. The paper explains the purpose of the research, which is majorly to improve the health condition of children, especially those living in rural communities. The paper also gives a brief overview of the socio-economic situation of The Gambia, emphasizing its status as a Least Developed Country (LDC) and the majority of its population living below the poverty line, with women and children hardest hit. The research used as case studies of two rural communities in the Gambia -Basse Dampha Kunda Village and Foni Besse. Data was collected through oral interviews and medical tests conducted among people in both villages, with an emphasis on children. The demographic detail of those tested is tabulated for a clearer understanding. The results were compared, revealing that skin rashes, hepatitis, and certain other diseases are more prevalent in communities lacking access to safe drinking water. These results were also presented in a tabular form. The study established how some policy failures and neglect on the part of the Government of The Gambia are imperiling the health of many rural dwellers in the country, the most glaring being that the research team was unable to test water samples collected from the two communities, as there are no laboratory reagents for testing water anywhere in The Gambia. Many rural communities lack basic amenities, especially clean and potable water, as well as health facilities. The study findings also highlighted the need for healthcare providers and medical NGOs to voice the plight of rural dwellers and collaborate with the government to set up health facilities in rural areas of The Gambia.

Keywords: jaundice, skin rashes, children, rural communities, the Gambia, causes

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Authors: Arun Kumar, Neelesh Haulder

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This paper identifies and resolves some key issues relating to a specific aspect within the supply chain logistics of the public health care industry in the Republic of Mauritius. The analysis and the proposed solution are performed using soft systems methodology (SSM). Through the application of this relevant systematic approach at problem solving, the aim is to obtain an in-depth analysis of the problem, incorporating every possible world view of the problem and consequently to obtain a well explored solution aimed at implementing relevant changes within the current supply chain logistics of the health care industry, with the purpose of tackling the key identified issues.

Keywords: soft systems methodology, CATWOE, healthcare, logistics

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Authors: Kristine Demilou D. Santiago

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An access to a high-quality health care system is what sets apart industrialized nations, such as the United States from other developing countries, which in this case is specifically pertaining to their older population. But what was the underrated factor in the sphere of quality healthcare rendered to elderly people in the Western context? Will this salient factor could push conviction to prorogue the existing gaps between self-denial patient-client and cheek by jowl medications? Are the natural socio-environmental approaches of caregiving the protracted remedy to healthcare disparities for aging population considering their day to day living? The conceptual framework of this model is primarily associated with addressing health and illness of human beings considering the biological, psychological and socio-environmental factors around them. The relevance of biopsychosocial formulation advancing each of the characteristics in the Biopsychosocial (BPS) model in a balance contemplation is the tumult of this study in an attempt to respond to prevailing disparities in caregiving services for old-aged patients on a day to day living. Caregiving services have been the medium path connecting between the patient and its prescribed medications. Moreover, caregivers serve as positive reinforcers in a patient’s environment. Therefore, caregivers play an important role in healthcare delivery to patients. They are considered significant people whom their acts will give an impact to a patient’s view in life. This research study intends to present the supreme importance of biopsychosocial assessment to old-aged patients with mental health illness and conditions. Biopsychosocial assessment will secure the quality of full medication to an old-aged adult suffering from a mental illness. This is because it offers a recognizably wholesome approach to medical healing of old-aged adult patients. The principle of biopsychosocial supersedes the biomedicine being offered to old-aged adults having mental illness, but it does not take away the high relevance of scientific biomedicine in healing patients. The framework presented an overlapping participation of each of its factors in its BPS model that affects in general a person’s health. The correlation between the biological (physiological), psychological (mental) and social (environment) in a person’s health condition requires equal attention according to BPS, and it always coexist with each other. Indisputably said, bio-medicine has been and is being in its unceasing endeavor to provide scientifically proven health care medications for every individual seeking medical treatments. As we grow older and eventually reach the other side of the median population, not only our physiological aspects change, our psychological and socio-environmental changes happen too. Caregiving is a salient responsibility taking place on these inevitable changes.

Keywords: biopsychosocial formulation, caregiving through natural approaches, US health care, BPS in caregiving, caregiving for aging population

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Authors: Ekhlas Al Gamal, Tony Long

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The impact on the parents of caring for a child with cancer was intense and wide-ranging. A high level of distress and low level or resilience remains during treatment. Even completion of treatment can be a time of increased anxiety and stress for parents particularly with worries about recurrence or relapse. The purpose of this study to examine the associations between parental satisfactions with healthcare provided for their child and the impact of being a caregiver for a child with cancer. Methodology: A descriptive, correlational and cross-sectional design was employed using data from Arabic versions of self-report questionnaires which were administered to 113 parents with children with cancer in Jordan during 2015. Findings: the result indicated that Family relationship functioning was ranked as the highest (better functioning) domain while daily activities were ranked as the lowest (poorer functioning) domain. Parents were generally satisfied with the health care provided, but their emotional needs were not met adequately. Parents with better social functioning were more satisfied in all areas of healthcare satisfaction other than emotional needs and communication. Parents who had a child with more emotional and behavioural problems were more likely to experience a negative impact on the family and a poor level of family functioning. Conclusion and Significance: Nurses and other health care providers should emphasis on family centred approach rather than child centred approach.

Keywords: parents, children, cancer, Jordan

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Authors: Maretha Le Roux, Corinna Walsh, Mariette M. Nel

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Introduction: The first 1000 days from conception to 24 months, is a critical period for healthy growth and development. In South Africa, stunting is a major public health issue with significant health consequences. We determined associations between demographic, health and anthropometric indicators of mothers and their infants. Methods: A cross-sectional study was conducted in all districts in the Northern Cape. All mothers with 5-7 week old babies visiting PHC facilities could participate. A questionnaire was completed in a structured interview with each mother. Weight and length of the baby at birth and at 6 weeks were used to determine stunting, while weight and height of the mother were measured for body mass index (BMI). Results: Eight hundred questionnaires were completed in 92 facilities. The median age of mothers was 26 years (range 10-46 years), and 44,9% were married. Almost 40% relied on a government grant as main source of income. Two-thirds (64,9%) had not planned the pregnancy, and 19.4% had a Caesarian section. Although 79% breastfed exclusively, more than a quarter (26,1%) smoked cigarettes or used snuff during pregnancy, while 9,4% drank alcohol. At birth, 17.7% of boys and 13.0% of girls were stunted (height-for-age below -2SD from the WHO reference values), while at 6 weeks this had increased to 30.8% of boys and 14.1% of girls. In terms of mothers, 25,4% were classified as obese and 24,6% as overweight at 6 weeks. Compared to babies that were not stunted, significantly more babies of mothers that were older, overweight, used ART, relied on a grant and smoked/snuffed during pregnancy were stunted. Conclusion: To address stunting, interventions aimed at encouraging healthy lifestyles with the emphasis on maintaining a healthy weight, healthy eating and smoking cessation before pregnancy are urgently required.

Keywords: growth, health, South Africa, stunting

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Authors: Mohammad Mosaddik Rahman

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This study embarks on an exploratory journey to assess the pervasive issue of heavy metal contamination in the water bodies along Chittagong Coast, Bangladesh. Situated along the mesmerizing Bay of Bengal, known for its potential as an emerging tourist haven, economic zone, ship breaking yard, confronts significant environmental hurdles. The core of these challenges lies in the contamination from heavy metals such as lead, cadmium, chromium, and mercury, which detrimentally impact both the ecological integrity and public health of the region. This contamination primarily stems from industrial activities, particularly those involving metallurgical and chemical processes, which release these metals into the environment, leading to their accumulation in soil and water bodies. The study's primary aim is to conduct a thorough assessment of heavy metal pollution levels, alongside an analysis of nutrient variations, focusing on nitrates and nitrites. Methodologically, the study leverages systematic sampling and advanced analytical tools like the Hach 3900 spectrophotometer to ensure precise and reliable data collection. The implications of heavy metal presence are multifaceted, affecting microbial and aquatic life, and posing severe health risks to the local population, including respiratory problems, neurological disorders, and an increased risk of cancer. The results of this study highlight the urgent need for effective mitigation strategies and regulatory measures to address this critical issue. By providing a comprehensive understanding of the environmental and public health implications of heavy metal contamination in Chittagong Coast, this research endeavours to serve as a catalyst for change, emphasising the need for pollution control and advancements in water management policies. It is envisioned that the outcomes of this study will guide stakeholders in collaborating to develop and implement sustainable solutions, ultimately safeguarding the region’s environment and public health.

Keywords: heavy metal, environmental health, pollution control policies, shipbreaking yard

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Authors: Bilal Okudan, Omur F. Karakullukcu, Yusuf Can

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Work motivation is one of the fundamental elements that determine the attitudes and performance of employees towards work. In this sense, work motivation depends not only on individual and occupational factors but also on employees' perception of organizational climate and organizational trust. Organizations that are aware of this have begun to do more research on work motivation in recent years to ensure that employees have the highest possible performance. In this framework of the purpose of this study is to examine the effect of sports employees' perceptions of organizational climate and organizational trust on work motivation. In the study, it has also been analyzed if there is any significant difference in the department of sports services’ employees’ organizational climate and organizational trust perception, and work motivation levels in terms of gender, age, duty status, year of service and level of education. 278 sports managers, who work in the department of sports service’s central and field organization at least as a chief in the manager position, have been chosen with random sampling method and they have voluntarily participated in the study. In the study, the organizational climate scale which was developed by Bilir (2005), organizational trusts scale developed by koksal (2012) and work motivation scale developed by Mottaz J. Clifford (1985) have been used as a data collection tool. The questionnaire form used as a data collection tool in the study includes a personal information form consisting of 5 questions; questioning gender, age, duty status, years of service and level of education. In the study, Pearson Correlation Analysis has been used for defining the correlation among organizational climate, organizational trust perceptions and work motivation levels in sports managers and regression analysis has been used to identify the effect of organizational climate and organizational trust on work motivation. T-test for binary grouping and ANOVA analysis have been used for more than binary groups in order to determine if there is any significant difference in the level of organizational climate, organizational trust perceptions and work motivations in terms of the participants’ duty status, year of service and level of education. According to the research results, it has been found that there is a positive correlation between the department of sports services’ employees’ organizational climate, organizational trust perceptions and work motivation levels. According to the results of the regression analysis; it is understood that the sports employees’ perception of organizational climate and organizational trust are two main factors which affects the perception of work motivation. Also, the results show that there is a significant difference in the level of organizational climate and organizational trust perceptions and work motivations of the department of sports services’ employees in terms of duty status, year of service, and level of education; however, the results reveal that there is no significant difference in terms of age groups and gender.

Keywords: sports manager, organizational climate, organizational trust, work motivation

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Authors: Sara E. Baumann, Megan A. Rabin, Mary Hawk, Bhimsen Devkota, Kajol Upadhyaya, Guna Raj Shrestha, Brigit Joseph, Annika Agarwal, Jessica G. Burke

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In Nepal, prevailing sociocultural norms associated with menstruation prompt adherence to stringent rules that limit participation in daily activities. Chhaupadi is a specific menstrual tradition in Nepal in which women and girls segregate themselves and follow a series of restrictions during menstruation. Despite having numerous physical and mental health implications, extant interventions have yet to sustainably address the harms associated with chhaupadi. In this study, the authors describe insights garnered from a collaboration with community members in Dailekh district, who formulated their own approaches to mitigate the adverse facets of chhaupadi. Envisaged as an entry point to improve women’s menstrual health experiences, this investigation employed an approach that uses Human-centered Design and a community-engaged approach. The authors conducted a four-day design workshop which unfolded in two phases: The Discovery Phase, to uncover chhaupadi context and key stakeholders, and the Design Phase, to design contextually relevant interventions. Diverse community-members, including those with lived experience practicing chhaupadi, developed five intervention concepts: 1) harnessing Female Community Health Volunteers as role models, for counseling, and raising awareness; 2) focusing on mothers and mother’s groups to instigate behavioral shifts; 3) engaging the broader community in behavior change efforts; 4) empowering fathers to effect change in their homes through counseling and education; and 5) training and emboldening youth to advocate for positive change through advocacy in their schools and homes. This research underscores the importance of employing multi-level approaches tailored to specific stakeholder groups, given Nepal’s rich cultural diversity. The engagement of Female Community Health Volunteers emerged as a promising yet underexplored intervention concept for chhaupadi, warranting broader implementation. Crucially, it is also imperative for interventions to prioritize tackling deleterious aspects of the chhaupadi tradition, emphasizing safety considerations, all while acknowledging chhaupadi’s entrenched cultural history; for some, there are positive aspects of the tradition that women and girls wish to preserve.

Keywords: human-centered design, menstrual health, Nepal, community-engagement, intervention development, women's health, rural health

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Authors: Drishti Sharma, Mona Duggal

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Background: WhatsApp can serve as a cost-effective, scalable, convenient, and popular medium for public health management related communication in the developing world where the existing system of communication is top-down and slow. The product supports sending and receiving a variety of media: text, photos, videos, documents, and location, as well as voice/video calls. With growing number of users of smartphones and improving access and penetration of internet, the scope of information technology remains immense in resolving the hurdles faced by traditional public health system. Poor infrastructure, gap in digital literacy, faulty documentation, strict organizational hierarchy and slow movement of information across desks and offices- all these, make WhatsApp an efficient prospect to complement the existing system for communication, feedback and leadership for public health system in India. Objective: This study investigates the benefits, challenges and limitations associated with WhatsApp usage as a public health management tool. Methods: The study was conducted within the Chandigarh Union Territory. We used a qualitative approach and conducted individual semi-structured interviews and group interviews (n = 10). Participants included medical officers (n 20), Program managers (n = 4), academicians (n=2) and administrators (n=2). Thematic and content qualitative analyses were conducted. Message log of the WhatsApp group of one of the health program was assessed. Results: Medical Officers said that WhatsApp helped them remain in touch with the program officer. They could easily give feedback and highlight those challenges which needed immediate intervention from the program managers, hence they felt supported. Also, the application helped them share pictures of their activities (meetings and field activities) with the group which they thought inspired others and gave themselves immense satisfaction. Also, it helped build stronger relationships and better coordination among themselves, the same being important in team events. For program managers, it had become a portal for coordinating large scale campaigns. Its reach and the fact that the feedback is real-time make WhatsApp ideal for district level events. Though the easy informal connectivity made them answerable to their staff but it also provided them with flexibility in operations. It turned out to be an important portal for sharing outcome and goals related feedback (both positive and negative) to the team. To be sure, using WhatsApp for the purpose of public health program presents considerable challenges, including technological barriers, organizational challenges, gender issues, confidentiality concerns and unplanned aftereffects. Nevertheless, its advantages in a low-cost setting make it an efficient alternative. Conclusion: WhatsApp has become an integral part of our lives. Use of this app for public health program management within closed groups looks promising and useful. At the same time, addressing the challenges involved would make its usage safer.

Keywords: communication, mobile technology, public health management, WhatsApp

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Authors: Joelle Fong

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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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Authors: Lin Tang, Xiaoxia Guo, Lingling Zhang

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Recent vaccine scandals overshadowed China’s accomplishment of public health, triggering discussions on the causes of vaccine incidents. Through legal interpretation of selected vaccine incidents and analysis of systemic vulnerabilities in vaccine circulation and lot release, a panoramic review of legislative progresses in the vaccine administration sheds the light on this debate. In essence, it is the combination of the lagging legal system and the absence of information technology infrastructure in the process of vaccine administration reform that has led to the recurrence of vaccine incidents. These findings have significant implications for further improvement of vaccine administration and China’s participation in global healthcare.

Keywords: legislation, lot release, public health, reform, vaccine administration, vaccine circulation

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Authors: Adem Rama, Rabiha Seboussi, Mahmoud Muhamadin, Sultan Alzarooni, Fatima Mohamed, Khuloud Al Ali

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To assess public health hazards associated with the occurrence of Antibiotics and AFM1 residues in UHT milk, a survey was carried out in Sharjah, UAE. In the present study, a total of 42 UHT milk samples analyzed were from different commercial brands manufactured in industrial dairy units in the UAE and from foreign producers. Milk samples were collected for four months (January to April 2020). The occurrence and concentration range of Antibiotics (Streptomycin and Gentamycin) and AFM1 in the samples were investigated by applying the ELISA method. According to the methodology used in this study, in total, 2 (5%) out of 42(95%) samples tested positive on the presence of AFM1. While, 1(2.4%) out of 41(97.6%) positive samples were found to contain Streptomycin and Gentamycin, respectively. The positive incidence of AFM1 in the UHT milk samples ranged from 58.8 to 1074 µg/L, for Streptomycin from up to 1004 µg/L, and Gentamycin up to 6909 µg/L. There were no positive samples found in locally produced UHT milk. AFM1 and antibiotic levels in positive samples UHT milk samples exceeded the maximum tolerable limits as set by the European Union - EC guidelines/standards. These levels in the samples show a presence of contaminants that might constitute a human health risk in Sharjah. The results of this study imply that more emphasis should be given to the routine inspection of milk and dairy products in the Sharjah region.

Keywords: milk, contaminant residues, ELISA, public health, Sharjah

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Authors: Charlotte Zamani

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Children's and young people’s (CYP’s) perspectives on using client preference tools are central to understanding youth mental health therapy engagement. This systematic literature review attempts to understand the meanings of CYP using preference tools that may allow greater connection with the therapeutic process. Following a systematic search using PRISMA guidelines, seven studies were identified that reported qualitative feedback on preferred treatment options or activities within therapy. The data were analysed using interpretative phenomenological analysis (IPA). Three group experiential themes were found: ‘Tailor my support’, ‘My autonomy leads to greater engagement’ and ‘Preferences facilitate my authentic self’. CYP is broadly divided into those who thrive in decision-making and those who require more support. Being offered a choice in therapy delivery provides easier access and means more freedom for CYP. Preferences in therapy appeared to enable greater self-knowledge and a deeper connection to the therapeutic process. The therapist is integral in using preference tools in therapy. Youth feedback is currently limited, yet essential and ethical in order to understand critical factors of CYP engagement and for future research.

Keywords: child and adolescent, client preferences, mental health therapy, qualitative

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Authors: Marco Vinicio Félix Lerma, Efrain Rubio Rosas, Fernando Ricardez Rueda, Victor Manuel Castaño Meneses

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This paper reports a spectral analysis of the exposure levels of radiofrequency electromagnetic fields originating from a wide variety of telecommunications sources present in an urban area of Lagos de Moreno, Jalisco, Mexico. The electromagnetic characterization of the urban zone under study was carried out by measurements in 118 sites. Measurements of TETRA,ISM434, LTE800, ISM868, GSM900, GSM1800, 3G UMTS,4G UMTS, Wlan2.4, LTE2.6, DECT, VHF Television and FM radio signals were performed at distances ranging over 10 to 1000m from 87 broadcasting towers concentrated in an urban area of about 3 hectares. The aim of these measurements is the evaluation of the electromagnetic fields power levels generated by communication systems because of their interaction with the human body. We found that in certain regions the general public exposure limits determined by ICNIRP (International Commission of Non Ionizing Radiation Protection) are overpassed from 5% up to 61% of the upper values, indicating an imminent health public hazard, whereas in other regions we found that these limits are not overpassed. This work proposes an electromagnetic pollution classification for urban zones according with ICNIRP standards. We conclude that the urban zone under study presents diverse levels of pollution and that in certain regions an electromagnetic shielding solution is needed in order to safeguard the health of the population that lives there. A practical solution in the form of paint coatings and fiber curtains for the buildings present in this zone is also proposed.

Keywords: electromagnetic field, telecommunication systems, electropollution, health hazards

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Authors: Senait Belay Adugna, Mirutse Giday, Tsegahun Manyazewal

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Background: The emergence and resurgence of zoonotic diseases have continued to be a major threat to global health and the economy. Developing countries are particularly vulnerable due to agricultural expansions and the domestication of animals by humans. Scientifically sound clinical trials are important to find better ways to prevent, diagnose, and treat zoonotic diseases, while there is a lack of evidence to inform the clinical trials’ capacity and practice in countries highly affected by the diseases. This study aimed to investigate researchers’ perceptions and experiences in conducting clinical trials on zoonotic diseases in Ethiopia. Methods: This study employed a descriptive, qualitative study design. It included major academic and research institutions in Ethiopia that had active engagements in veterinary and public health research. It included the National Veterinary Institute, the National Animal Health Diagnostic and Investigation Center, the College of Veterinary Medicine at Addis Ababa University, the Ethiopian Public Health Institute, the Armauer Hansen Research Institute, and the College of Health Sciences at Addis Ababa University. In-depth interviews were conducted with 14 senior researcher investigators in the institutions who hold a proven exhibit primarily leading research activities or research units. Data were collected from October 2019 to April 2020. Data analysis was undertaken using open code 4.03 for qualitative data analysis. Results: Five major themes, with 18 sub-themes, emerged from the in-depth interview in connection. These were: challenges in the prevention, control, and treatment of zoonotic diseases; One Health approach to mitigate zoonotic diseases; personal and institutional experiences in conducting clinical trials on zoonotic diseases; barriers in conducting clinical trials towards zoonotic diseases; and strategies that promote conducting clinical trials on zoonotic diseases. Conducting clinical trials on zoonotic diseases in Ethiopia is hampered by a lack of clearly articulated ethics and regulatory frameworks, trial experts, financial resources, and good governance. Conclusions: In Ethiopia, conducting clinical trials on zoonotic diseases deserves due attention. Strengthening institutional and human resources capacity is a precondition to harnessing effective implementation of clinical trials on zoonotic diseases in the country. In Ethiopia, where skilled human resource is scarce, the One Health approach has the potential to form multidisciplinary teams to systematically improve clinical trials capacity and outcomes in the country.

Keywords: Ethiopia, clinical triak, zoonoses, disease

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