Search results for: public health interventions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13798

Search results for: public health interventions

11698 A Case Study on the Guidelines for Application of Project Management Methods in Infrastructure Projects

Authors: Fernanda Varella Borges, Silvio Burrattino Melhado

Abstract:

Motivated by the importance of public infrastructure projects in the civil construction chain, this research shows the study of project management methods and the infrastructure projects’ characteristics. The research aims at the objective of improving management efficiency by proposing guidelines for the application of project management methods in infrastructure projects. Through literature review and case studies, the research analyses two major infrastructure projects underway in Brazil, identifying the critical points for achieving its success. As a result, the proposed guidelines indicate that special attention should be given to the management of stakeholders, focusing on their knowledge and experience, their different interests, the efficient management of their communication, and their behavior in the day-by-day project management process.

Keywords: construction, infrastructure, project management, public projects

Procedia PDF Downloads 487
11697 Radiation Risks for Nurses: The Unrecognized Consequences of ERCP Procedures

Authors: Ava Zarif Sanayei, Sedigheh Sina

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Despite the advancement of radiation-free interventions in the gastrointestinal and hepatobiliary fields, endoscopy and endoscopic retrograde cholangiopancreatography (ERCP) remain indispensable procedures that necessitate radiation exposure. ERCP, in particular, relies heavily on radiation-guided imaging to ensure precise delivery of therapy. Meanwhile, interventional radiology (IR) procedures also utilize imaging modalities like X-rays and CT scans to guide therapy, often under local anesthesia via small needle insertion. However, the complexity of these procedures raises concerns about radiation exposure to healthcare professionals, including nurses, who play a crucial role in these interventions. This study aims to assess the radiation exposure to the hands and fingers of nurses 1 and 2, who are directly involved in ERCP procedures utilizing (TLD-100) dosimeters at the Gastrointestinal Endoscopy department of a clinic in Shiraz, Iran. The dosimeters were initially calibrated using various phantoms and then a group was prepared and used over a two-month period. For personal equivalent dose measurement, two TLD chips were mounted on a finger ring to monitor exposure to the hands and fingers. Upon completion of the monitoring period, the TLDs were analyzed using a TLD reader, showing that Nurse 1 received an equivalent dose of 298.26 µSv and Nurse 2 received an equivalent dose of 195.39 µSv. The investigation revealed that the total radiation exposure to the nurses did not exceed the annual limit for occupational exposure. Nevertheless, it is essential to prioritize radiation protection measures to prevent potential harm. The study showed that positioning staff members and placing two nurses in a specific location contributed to somehow equal doses. To reduce exposure further, we suggest providing education and training on radiation safety principles, particularly for technologists.

Keywords: dose measurement, ERCP, interventional radiology, medical imaging

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11696 Assessment of Very Low Birth Weight Neonatal Tracking and a High-Risk Approach to Minimize Neonatal Mortality in Bihar, India

Authors: Aritra Das, Tanmay Mahapatra, Prabir Maharana, Sridhar Srikantiah

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In the absence of adequate well-equipped neonatal-care facilities serving rural Bihar, India, the practice of essential home-based newborn-care remains critically important for reduction of neonatal and infant mortality, especially among pre-term and small-for-gestational-age (Low-birth-weight) newborns. To improve the child health parameters in Bihar, ‘Very-Low-Birth-Weight (vLBW) Tracking’ intervention is being conducted by CARE India, since 2015, targeting public facility-delivered newborns weighing ≤2000g at birth, to improve their identification and provision of immediate post-natal care. To assess the effectiveness of the intervention, 200 public health facilities were randomly selected from all functional public-sector delivery points in Bihar and various outcomes were tracked among the neonates born there. Thus far, one pre-intervention (Feb-Apr’2015-born neonates) and three post-intervention (for Sep-Oct’2015, Sep-Oct’2016 and Sep-Oct’2017-born children) follow-up studies were conducted. In each round, interviews were conducted with the mothers/caregivers of successfully-tracked children to understand outcome, service-coverage and care-seeking during the neonatal period. Data from 171 matched facilities common across all rounds were analyzed using SAS-9.4. Identification of neonates with birth-weight ≤ 2000g improved from 2% at baseline to 3.3%-4% during post-intervention. All indicators pertaining to post-natal home-visits by frontline-workers (FLWs) improved. Significant improvements between baseline and post-intervention rounds were also noted regarding mothers being informed about ‘weak’ child – at the facility (R1 = 25 to R4 = 50%) and at home by FLW (R1 = 19%, to R4 = 30%). Practice of ‘Kangaroo-Mother-Care (KMC)’– an important component of essential newborn care – showed significant improvement in postintervention period compared to baseline in both facility (R1 = 15% to R4 = 31%) and home (R1 = 10% to R4=29%). Increasing trend was noted regarding detection and birth weight-recording of the extremely low-birth-weight newborns (< 1500 g) showed an increasing trend. Moreover, there was a downward trend in mortality across rounds, in each birth-weight strata (< 1500g, 1500-1799g and >= 1800g). After adjustment for the differential distribution of birth-weights, mortality was found to decline significantly from R1 (22.11%) to R4 (11.87%). Significantly declining trend was also observed for both early and late neonatal mortality and morbidities. Multiple regression analysis identified - birth during immediate post-intervention phase as well as that during the maintenance phase, birth weight > 1500g, children of low-parity mothers, receiving visit from FLW in the first week and/or receiving advice on extra care from FLW as predictors of survival during neonatal period among vLBW newborns. vLBW tracking was found to be a successful and sustainable intervention and has already been handed over to the Government.

Keywords: weak newborn tracking, very low birth weight babies, newborn care, community response

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11695 Consumers’ Perceptions of Non-Communicable Diseases and Perceived Product Value Impacts on Healthy Food Purchasing Decisions

Authors: Khatesiree Sripoothon, Usanee Sengpanich, Rattana Sittioum

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The objective of this study is to examine the factors influencing consumer purchasing decisions about healthy food. This model consists of two latent variables: Consumer Perception relating to NCDs and Consumer Perceived Product Value. The study was conducted in the northern provinces of Thailand, which are popular with tourists and have received support from the government for health tourism. A survey was used as the data collection method, and the questionnaire was applied to 385 tourists. An accidental sampling method was used to identify the sample. The statistics of frequency, percentage, mean, and structural equation model were used to analyze the data obtained. Additionally, all factors had a significant positive influence on healthy food purchasing decisions (p<0.01) and were predictive of healthy food purchasing decisions at 46.20 (R2=0.462). Also, these findings seem to underline a supposition that consumer perceptions of NCDs and perceived product value are key variables that strengthens the competitive effects of a healthy-friendly business entrepreneur. Moreover, reduce the country's public health costs for treating patients with the disease of NCDs in Thailand.

Keywords: healthy food, perceived product value, perception of non-communicable diseases, purchasing decisions

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11694 The Disease That 'Has a Woman Face': Feminization of HIV/AIDS in Nagaland, North-East India

Authors: Kitoholi V. Zhimo

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Unlike the cases of cases of homosexuals, haemophilic and or drug users in USA, France, Africa and other countries, in India the first case of HIV/AIDS was detected in heterosexual female sex workers (FSW) in Chennai in 1986. This image played an important role in understanding HIV/AIDS scenario in the country. Similar to popular and dominant metaphors on HIV/AIDS such as ‘gay plague’, ‘new cancer’, ‘lethal disease’, ‘slim disease’, ‘foreign disease’, ‘junkie disease’, etc. around the world, the social construction of the virus was largely attributed to women in India. It was established that women particularly sex workers are ‘carrier’ and ‘transmitter’ of virus and were categorised as High Risk Groups (HRG’s) alongside homosexuals, transgenders and injecting drug users. Recent literature reveals growing rate of HIV infection among housewives since 1997 which revolutionised public health scenario in India. This means shift from high risk group to general public through ‘bridge population’ encompassing long distance truckers and migrant labours who at the expense of their nature of work and mobility comes in contact with HRG’s and transmit the virus to the general public especially women who are confined to the domestic space. As HIV epidemic expands, married women in monogamous relationship/marriage stand highly susceptible to infection with limited control, right and access over their sexual and reproductive health and planning. In context of Nagaland, a small state in North-eastern part of India HIV/AIDS transmission through injecting drug use dominated the early scene of the epidemic. However, paradigm shift occurred with declining trend of HIV prevalence among injecting drug users (IDU’s) over the past years with the introduction of Opioid Substitution Therapy (OST) and easy access/availability of syringes and injecting needles. Reflection on statistical data reveals that out of 36 states and union territories in India, the position of Nagaland in HIV prevalence among IDU’s has significantly dropped down from 6th position in 2003 to 16th position in 2017. The present face of virus in Nagaland is defined by (hetero) sexual mode of transmission which accounts for about 91% of as reported by Nagaland state AIDS control society (NSACS) in 2016 wherein young and married woman were found to be most affected leading to feminization of HIV/AIDS epidemic in the state. Thus, not only is HIV epidemic feminised but emerged victim to domestic violence which is more often accepted as normal part of heterosexual relationship. In the backdrop of these understanding, the present paper based on ethnographic fieldwork explores the plight, lived experiences and images of HIV+ve women with regard to sexual and reproductive rights against the backdrop of patriarchal system in Nagaland.

Keywords: HIV/AIDS, monogamy, Nagaland, sex worker disease, women

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11693 Critical Approach to Define the Architectural Structure of a Health Prototype in a Rural Area of Brazil

Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: architectural typology, developing countries, local construction techniques, primary health care.

Procedia PDF Downloads 317
11692 Enterprise Risk Management, Human Capital and Organizational Performance: Insights from Public Listed Companies

Authors: Omar Moafaq Saleh Aljanabi, Noradiva Hamzah, Ruhanita Maelah

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In today’s challenging global economy, which is driven by information and knowledge, risk management is undergoing a great change, as organizations shift from traditional and compartmental risk management to an enterprise-wide approach. Enterprise risk management (ERM), which aims at increasing the sustainability of an organization and achieving competitive advantage, is gaining global attention and fast becoming an essential concern in all industries. Furthermore, in order to be effective, ERM should be managed by managers with high-level skills and knowledge. Despite the importance of the knowledge embedded in, there remains a paucity of evidence concerning how human capital could influence the organization’s ERM. Responses from 116 public listed companies (PLCs) on the main market of Bursa Malaysia were analyzed using Structural Equation Modelling (SEM). This study found that there is a significant association between ERM and organizational performance. The results also indicate that human capital has a positive moderating effect on the relationship between ERM and performance. The study contributes to the ERM literature by providing empirical evidence on the relationship between ERM, human capital, and organizational performance. Findings from this study also provide guidelines for managers, policy makers, and the regulatory bodies, to evaluate the ERM practices in PLCs.

Keywords: enterprise risk management, human capital, organizational performance, Malaysian public listed companies

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11691 In the Eyes of Basilyo at Crispin: A Phenomenological Lived Experience of the Filipino Children of Parents with Mental Illness

Authors: Cely D. Magpantay, Geolynne Marie Adel, Cire-rine Mae Concepcion, Dessa Jean Orcajada, Jorgette Andrea Santos, Orian Laurace Canaman

Abstract:

Mental illness initiative is very relevant in promoting the Mental Health Bill act of 2017. In the Philippines alone, the public is more open and receptive to people at risks with a mental condition. Although it is uncommon that parents can become more psychologically unfit compared to their children, research shows that parents who are suffering from mental illness have a more significant negative effect than another family member. The impact of parent’s mental health can put their children more susceptible to acquire the same disorder. The aim of the study is to explore the lived experiences of children whose parents suffered from mental illness. It discusses how their parent's mental condition in, anyway, affects their psychological development. Using Phenomenological Qualitative Research, an in-depth, interview was conducted to five (5) consenting adults who lived with their parents diagnosed with a mental disorder. Results are clustered into four themes. The first theme is the negative emotion towards parents, the second theme is the psychosocial dynamics in caring for the patient, third is accepting the disease, and fourth is a general perspective on the family. Each themes is validated by experts and the participants. This theme generates subcomponent like isolation, shallow relationship and debt of gratitude. Along with these themes comes the fear of having a family emerged. There is a growing need to strengthen the family ties even more because of parent’s mental illness. Therefore, parental mental illness has an effect on the children’s psychological and social development.

Keywords: lived experience in Philippines, mental health, parental mental illness, psychosocial dynamics

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11690 An Interactive User-Oriented Approach to Optimizing Public Space Lighting

Authors: Tamar Trop, Boris Portnov

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Public Space Lighting (PSL) of outdoor urban areas promotes comfort, defines spaces and neighborhood identities, enhances perceived safety and security, and contributes to residential satisfaction and wellbeing. However, if excessive or misdirected, PSL leads to unnecessary energy waste and increased greenhouse gas emissions, poses a non-negligible threat to the nocturnal environment, and may become a potential health hazard. At present, PSL is designed according to international, regional, and national standards, which consolidate best practice. Yet, knowledge regarding the optimal light characteristics needed for creating a perception of personal comfort and safety in densely populated residential areas, and the factors associated with this perception, is still scarce. The presented study suggests a paradigm shift in designing PSL towards a user-centered approach, which incorporates pedestrians' perspectives into the process. The study is an ongoing joint research project between China and Israel Ministries of Science and Technology. Its main objectives are to reveal inhabitants' perceptions of and preferences for PSL in different densely populated neighborhoods in China and Israel, and to develop a model that links instrumentally measured parameters of PSL (e.g., intensity, spectra and glare) with its perceived comfort and quality, while controlling for three groups of attributes: locational, temporal, and individual. To investigate measured and perceived PSL, the study employed various research methods and data collection tools, developed a location-based mobile application, and used multiple data sources, such as satellite multi-spectral night-time light imagery, census statistics, and detailed planning schemes. One of the study’s preliminary findings is that higher sense of safety in the investigated neighborhoods is not associated with higher levels of light intensity. This implies potential for energy saving in brightly illuminated residential areas. Study findings might contribute to the design of a smart and adaptive PSL strategy that enhances pedestrians’ perceived safety and comfort while reducing light pollution and energy consumption.

Keywords: energy efficiency, light pollution, public space lighting, PSL, safety perceptions

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11689 Modernization from Above: The (re-)Creation of National Identity through Westernization in Mubarak-era Cairo

Authors: Mariam Aref Mahmoud

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A myth surrounding the development of Cairo bases itself in the Fatimid era when the city, as we know it today, was built. Surrounding the city was a wall meant to protect the main center from any possible attack. The effects of global hierarchies of power extend further than labor regulations and trade statistics. Beyond that, they form dialectical oppositions between local and global identities within urban space. As such, those in power often aim to claim national identity as what they perceive to be the most nationally beneficial strategy. These claims over perceptions of national identity take over the streets, the advertisements, and the parks and eventually make their way into the different forms of media. Often, these claims take over the main planning goals of the city. Whether it is through the control over which sounds are allowed to be produced in public space, what type of people are encouraged to enter which spaces, or other forms of performing local and national identity, public space, property, and land have often been used as a method to present to both the public and the global population what people in power wish for these spaces to represent. In Egypt, these developments have been changing since the end of colonial rule. In particular, this paper will analyze how Hosni Mubarak, and to a certain extent Anwar el-Sadat, enacted neoliberal designs dedicated towards modernization in order to present an image of a Cairo that is not uniquely Egyptian but essentially Western cosmopolitan - a Cairo that belongs to a globalized world.

Keywords: Egypt, imperialism, westernization, housing

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11688 Beyond the White Cube: A Study on the Site Specific Curatorial Practice of Kochi Muziris Biennale

Authors: Girish Chandran, Milu Tigi

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Brian O'Doherty's seminal essay, Inside the white Cube theorized and named the dominant mode of display and exhibition of Modern Art museums. Ever since the advent of Biennales and other site-specific public art projects we have seen a departure from the white cube mode of exhibition. The physicality, materiality and context within which an artwork is framed has a role in the production of meaning of public art. Equally, artworks contribute to the meaning and identity of a place. This to and fro relationship between the site and artwork and its influence on the sense of place and production of meaning is being explored in this paper in the context of Kochi Muziris Biennale (KMB). Known as the Peoples biennale with over 5 lakh visitors, it is India's first Biennale and its largest art exhibition of contemporary art. The paper employs place theory and contemporary curatorial theories to present the case. The KMB has an interesting mix of exhibition spaces which includes existing galleries and halls, site-specific projects in public spaces, infill developments and adaptive reuse of heritage and other unused architecture. The biennale was envisioned as an event connecting to the history, socio-political peculiarities of the cultural landscape of Kerala and more specifically Kochi. The paper explains the role of spatial elements in forming a curatorial narrative connected to the above mentioned ambitions.The site-specific nature of exhibition and its use of unused architecture helps in the formation of exhibition spaces unique in type and materiality. The paper argues how this helps in the creation of an 'archeology of the place'. The research elucidates how a composite nature of experience helps connect with the thematic ambitions of the Biennale and how it brings about an aesthetics distinct to KMB.

Keywords: public art, curatorial practice, architecture, place, contemporary art, site specificity

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11687 The Impact of Covid-19 on Anxiety Levels in the General Population of the United States: An Exploratory Survey

Authors: Amro Matyori, Fatimah Sherbeny, Askal Ali, Olayiwola Popoola

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Objectives: The study evaluated the impact of COVID-19 on anxiety levels in the general population in the United States. Methods: The study used an online questionnaire. It adopted the Generalized Anxiety Disorder Assessment (GAD-7) instrument. It is a self-administered scale with seven items used as a screening tool and severity measure for generalized anxiety disorder. The participants rated the frequency of anxiety symptoms in the last two weeks on a Likert scale, which ranges from 0-3. Then the item points are summed to provide the total score. Results: Thirty-two participants completed the questionnaire. Among them, 24 (83%) females and 5 (17%) males. The age range of 18-24-year-old represented the most respondents. Only one of the participants tested positive for the COVID-19, and 39% of them, one of their family members, friends, or colleagues, tested positive for the coronavirus. Moreover, 10% have lost a family member, a close friend, or a colleague because of COVID-19. Among the respondents, there were ten who scored approximately five points on the GAD-7 scale, which indicates mild anxiety. Furthermore, eight participants scored 10 to 14 points, which put them under the category of moderate anxiety, and one individual who was categorized under severe anxiety scored 15 points. Conclusions: It is identified that most of the respondents scored the points that put them under the mild anxiety category during the COVID-19 pandemic. It is also noticed that severe anxiety was the lowest among the participants, and people who tested positive and/or their family members, close friends, and colleagues were more likely to experience anxiety. Additionally, participants who lost friends or family members were also at high risk of anxiety. It is obvious the COVID-19 outcomes and too much thinking about the pandemic put people under stress which led to anxiety. Therefore, continuous assessment and monitoring of psychological outcomes during pandemics will help to establish early well-informed interventions.

Keywords: anxiety and covid-19, covid-19 and mental health outcomes, influence of covid-19 on anxiety, population and covid-19 impact on mental health

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11686 A Comparative Study of Optimization Techniques and Models to Forecasting Dengue Fever

Authors: Sudha T., Naveen C.

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Dengue is a serious public health issue that causes significant annual economic and welfare burdens on nations. However, enhanced optimization techniques and quantitative modeling approaches can predict the incidence of dengue. By advocating for a data-driven approach, public health officials can make informed decisions, thereby improving the overall effectiveness of sudden disease outbreak control efforts. The National Oceanic and Atmospheric Administration and the Centers for Disease Control and Prevention are two of the U.S. Federal Government agencies from which this study uses environmental data. Based on environmental data that describe changes in temperature, precipitation, vegetation, and other factors known to affect dengue incidence, many predictive models are constructed that use different machine learning methods to estimate weekly dengue cases. The first step involves preparing the data, which includes handling outliers and missing values to make sure the data is prepared for subsequent processing and the creation of an accurate forecasting model. In the second phase, multiple feature selection procedures are applied using various machine learning models and optimization techniques. During the third phase of the research, machine learning models like the Huber Regressor, Support Vector Machine, Gradient Boosting Regressor (GBR), and Support Vector Regressor (SVR) are compared with several optimization techniques for feature selection, such as Harmony Search and Genetic Algorithm. In the fourth stage, the model's performance is evaluated using Mean Square Error (MSE), Mean Absolute Error (MAE), and Root Mean Square Error (RMSE) as assistance. Selecting an optimization strategy with the least number of errors, lowest price, biggest productivity, or maximum potential results is the goal. In a variety of industries, including engineering, science, management, mathematics, finance, and medicine, optimization is widely employed. An effective optimization method based on harmony search and an integrated genetic algorithm is introduced for input feature selection, and it shows an important improvement in the model's predictive accuracy. The predictive models with Huber Regressor as the foundation perform the best for optimization and also prediction.

Keywords: deep learning model, dengue fever, prediction, optimization

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11685 Perspective of Community Health Workers on The Sustainability of Primary Health Care

Authors: Dan Richard D. Fernandez

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This study determined the perspectives of community health workers’ perspectives in the sustainability of primary health care. Eight community health workers, two community officials and a rural health midwife in a rural community in the in the Philippines were enjoined to share their perspectives in the sustainability of primary health care. The study utilized the critical research method. The critical research assumes that there are ‘dominated’ or ‘marginalized’ groups whose interests are not best served by existing societal structures. Their experiences highlighted that the challenges of their role include unkind and uncooperative patients, the lack of institutional support mechanisms and conflict of their roles with their family responsibilities. Their most revealing insight is the belief that primary health care is within their grasp. Finally, they believe that the burden to sustain primary health care rests on their shoulders alone. This study establishes that Multi-stakeholder participation is and Gender-sensitivity is integral to the sustainability of Primary Health Care. It also observed that the ingrained Expert-Novice or Top-down Management Culture and the marginalisation of BHWs within the system is a threat to PHC sustainability. This study also recommends to expand the study and to involve the local government units and academe in lobbying the integration of gender-sensitivity and multi-stake participatory approaches to health workforce policies. Finally, this study recognised that the CHWs’ role is indispensable to the sustainability of primary health care.

Keywords: community health workers, multi-stakeholder participation, sustainability, gender-sensitivity

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11684 Patient Engagement in Healthcare and Health Literacy in China: A Survey in China

Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

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Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29),the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

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11683 Cercarial Diversity in Freshwater Snails from Selected Freshwater Bodies and Its Implication for Veterinary and Public Health in Kaduna State, Nigeria

Authors: Fatima Muhammad Abdulkadir, D. B. Maikaje, Y. A. Umar

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A study conducted to determine cercariae diversity and prevalence of trematode infection in freshwater snails from six freshwater bodies selected by systematic random sampling in Kaduna State was carried from January 2013 to December 2013. Freshwater snails and cercariae harvested from the study sites were morphologically identified. A total of 23,823 freshwater snails were collected from the six freshwater bodies: Bagoma dam, Gimbawa dam, Kangimi dam, Kubacha dam, Manchok water intake and Saminaka water intake. The observed freshwater snail species were: Melanoides tuberculata, Biomphalaria pfeifferi, Bulinus globosus, Lymnaea natalensis, Physa sp., Cleopatra bulimoides, Bellamya unicolor and Lanistes varicus. The freshwater snails were exposed to artificial bright light from a 100 Watt electric bulb in the laboratory to induce cercarial shedding. Of the total freshwater snails collected, 10.55% released one or more types of cercariae. Seven morphological types of cercariae were shed by six freshwater snail species namely: Brevifurcate-apharyngeate distome, Amphistome, Gymnocephalus, Longifurcate-pharyngeate monostome, Longifurcate-pharyngeate distome, Echinostome and Xiphidio cercariae. Infection was monotype in most of the freshwater snails collected; however, Physa species presented a mixed infection with Gymnocephalus and Longifurcate-pharyngeate distome cercariae. B. globosus and B. pfeifferi were the most preferred intermediate hosts with the prevalence of 13.48% and 13.46%, respectively. The diversity and prevalence of cercariae varied among the six freshwater bodies with Manchok water intake having the highest infestation (14.3%) and the least recorded in Kangimi dam (3.9%). There was a correlation trend between the number of freshwater snails and trematode infection with Manchok exhibiting the highest and Bagoma none. The highest cercarial diversity was observed in B. pfeifferi and B. globosus with four morphotypes each, and the lowest was in M. tuberculata with one morphotype. The general distribution of freshwater snails and the trematode cercariae they shed suggests the risk of human and animals to trematodiasis in Manchok community. Public health education to raise awareness on individual and communal action that may control snail breeding sites, prevent transmission and provide access to treatment should be intensified.

Keywords: Cercariae, diversity, freshwater snails, prevalence, trematodiasis

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11682 Zoonotic Risk Practices in Rural Households in the Penka-Michel Health District (West Cameroon)

Authors: Namekong Fokeng Armand

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Background: Zoonoses are nowadays a serious public health problem in both developing and developed countries. They contribute to increase the economic burden. In case of emergence, rural populations are the most affected, hence the need to investigate risk practices in rural households of Penka-Michel (West Cameroon). Methods: This cross-sectional study was conducted from October to November 2021 among 200 heads of households living in the Penka-Michel health district (West Cameroon). It was done using a pre-tested and validated questionnaire, allowing to obtain socio-demographic, economic data, and data on zoonotic risk practices. Results: The participants [women (56%), men (44%)] worked mainly in the informal private sector (53%) and practiced agriculture secondarily (90%). Their highest level of education, for the most part, was a secondary school (50%); the average household size was 06 persons with a monthly income > 36270 FCFA (72%). 74% of household heads thought that animals can transmit diseases, and 17% had heard about zoonotic diseases through the media (65%). Rats caught in households (60%) were consumed there (74%), as was bush meat (61%) or dog meat (18%). For family food (90%), animals were slaughtered within the household (97%), rarely preceded by a veterinary inspection (6%). 87% of households practiced traditional rites with animal blood, 65% shared the same habitat as their animals, 41% did not systematically wash their hands after handling animals. More than 50% of households owned one or more dogs, usually strays (41%) and 48% of which were vaccinated (rabies). Many households had at least one: poultry (98%); pig (50%); dog (57%), cat (52%). 25% of households slaughtered sick animals for consumption, and 27% ate dead animals. Conclusion: This study identified numerous zoonotic risk practices in households in the Penka-Michel health district (West Cameroon). Concerted, multisectoral communication / awareness-raising actions are needed to break with these practices.

Keywords: zoonoses, risky practices, rural households, penka-michel, cameroon

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11681 Safety Assessment of Traditional Ready-to-Eat Meat Products Vended at Retail Outlets in Kebbi and Sokoto States, Nigeria

Authors: M. I. Ribah, M. Jibir, Y. A. Bashar, S. S. Manga

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Food safety is a significant and growing public health problem in the world and Nigeria as a developing country, since food-borne diseases are important contributors to the huge burden of sickness and death of humans. In Nigeria, traditional ready-to-eat meat products (RTE-MPs) like balangu, tsire, guru and dried meat products like kilishi, dambun nama, banda, were reported to be highly appreciated because of their eating qualities. The consumption of these products was considered as safe due to the treatments that are usually involved during their production process. However, during processing and handling, the products could be contaminated by pathogens that could cause food poisoning. Therefore, a hazard identification for pathogenic bacteria on some traditional RTE-MPs was conducted in Kebbi and Sokoto States, Nigeria. A total of 116 RTE-MPs (balangu-38, kilishi-39 and tsire-39) samples were obtained from retail outlets and analyzed using standard cultural microbiological procedures in general and selective enrichment media to isolate the target pathogens. A six-fold serial dilution was prepared and using the pour plating method, colonies were counted. Serial dilutions were selected based on the prepared pre-labeled Petri dishes for each sample. A volume of 10-12 ml of molten Nutrient agar cooled to 42-45°C was poured into each Petri dish and 1 ml each from dilutions of 102, 104 and 106 for every sample was respectively poured on a pre-labeled Petri plate after which colonies were counted. The isolated pathogens were identified and confirmed after series of biochemical tests. Frequencies and percentages were used to describe the presence of pathogens. The General Linear Model was used to analyze data on pathogen presence according to RTE-MPs and means were separated using the Tukey test at 0.05 confidence level. Of the 116 RTE-MPs samples collected, 35 (30.17%) samples were found to be contaminated with some tested pathogens. Prevalence results showed that Escherichia coli, salmonella and Staphylococcus aureus were present in the samples. Mean total bacterial count was 23.82×106 cfu/g. The frequency of individual pathogens isolated was; Staphylococcus aureus 18 (15.51%), Escherichia coli 12 (10.34%) and Salmonella 5 (4.31%). Also, among the RTE-MPs tested, the total bacterial counts were found to differ significantly (P < 0.05), with 1.81, 2.41 and 2.9×104 cfu/g for tsire, kilishi, and balangu, respectively. The study concluded that the presence of pathogenic bacteria in balangu could pose grave health risks to consumers, and hence, recommended good manufacturing practices in the production of balangu to improve the products’ safety.

Keywords: ready-to-eat meat products, retail outlets, public health, safety assessment

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11680 Emotional Intelligence and Leadership Profiles among Students’ Representative Council of Malaysian Public Universities

Authors: R. A. Harun, N. M. Ishak, N. Yusoff, S. Amat

Abstract:

This quantitative research is aimed to identify the level of leadership quality and emotional intelligence for members of Students' Representatives Council (SRC) of Malaysian Public Universities (MPU). The variables include the leadership quality and emotional quotient (EQ). 238 SRC members in MPU were selected as subjects of the study. Data were collected using two instruments i.e. Malaysian Emotional Quotient Inventory (MEQI) and Ayu-Noriah Leadership Audit Trail Inventory (Ayu-Noriah, LATI). Data were analyzed using descriptive (mean and percentage). Research findings showed that the subjects scored highly in four out of five EQ domains (Self-Regulations, Self-Motivation, Empathy and Social Skills). However, the subjects scored medium to low in Self-Awareness. Analysis on the sub domains (a total of 28 sub domains) showed that the subjects scored high in 17 sub domains for EQ, whilst another 11 were at medium level. The overall analysis indicates that the subjects have high level of EQ. Findings on their leadership qualities showed that they obtained high scores in all seven factors that were measured i.e. Strategy and Leadership Model, Recruit, Review Performance and Honor, Deploy Strategically, Developing, Engage and Retain and Built HR Capabilities/Line Ownership. The overall score for leadership qualities was found to be high.

Keywords: emotional intelligence, leadership, students representative council, Malaysian public universities

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11679 Networks, Regulations and Public Action: The Emerging Experiences of Sao Paulo

Authors: Lya Porto, Giulia Giacchè, Mario Aquino Alves

Abstract:

The paper aims to describe the linkage between government and civil society proposing a study on agro-ecological agriculture policy and urban action in São Paulo city underling the main achievements obtained. The negotiation processes between social movements and the government (inputs) and its results on political regulation and public action for Urban Agriculture (UA) in São Paulo city (outputs) have been investigated. The method adopted is qualitative, with techniques of semi-structured interviews, participant observation, and documental analysis. The authors conducted 30 semi-structured interviews with organic farmers, activists, governmental and non-governmental managers. Participant observation was conducted in public gardens, urban farms, public audiences, democratic councils, and social movements meetings. Finally, public plans and laws were also analyzed. São Paulo city with around 12 million inhabitants spread out in a 1522 km2 is the economic capital of Brazil, marked by spatial and socioeconomic segregation, currently aggravated by environmental crisis, characterized by water scarcity, pollution, and climate changes. In recent years, Urban Agriculture (UA) social movements gained strength and struggle for a different city with more green areas, organic food production, and public occupation. As the dynamics of UA occurs by the action of multiple actresses and institutions that struggle to build multiple senses on UA, the analysis will be based on literature about solidarity economy, governance, public action and networks. Those theories will mark out the analysis that will emphasize the approach of inter-subjectivity built between subjects, as well as the hybrid dynamics of multiple actors and spaces in the construction of policies for UA. Concerning UA we identified four main typologies based on land ownership, main function (economic or activist), form of organization of the space, and type of production (organic or not). The City Hall registers 500 productive unities of agriculture, with around 1500 producers, but researcher estimated a larger number of unities. Concerning the social movements we identified three categories that differ in goals and types of organization, but all of them work by networks of activists and/or organizations. The first category does not consider themselves as a movement, but a network. They occupy public spaces to grow organic food and to propose another type of social relations in the city. This action is similar to what became known as the green guerrillas. The second is configured as a movement that is structured to raise awareness about agro-ecological activities. The third one is a network of social movements, farmers, organizations and politicians that work focused on pressure and negotiation with executive and legislative government to approve regulations and policies on organic and agro-ecological Urban Agriculture. We conclude by highlighting how the interaction among institutions and civil society produced important achievements for recognition and implementation of UA within the city. Some results of this process are awareness for local production, legal and institutional recognition of the rural zone around the city into the planning tool, the investment on organic school public procurements, the establishment of participatory management of public squares, the inclusion of UA on Municipal Strategic Plan and Master Plan.

Keywords: public action, policies, agroecology, urban and peri-urban agriculture, Sao Paulo

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11678 Rural-To-Urban Migrants' Experiences with Primary Care in Four Types of Medical Institutions in Guangzhou, China

Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

Abstract:

Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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11677 The Impact of Housing Design on the Health and Well-Being of Populations: A Case-Study of Middle-Class Families in the Metropolitan Region of Port-Au-Prince, Haiti

Authors: A. L. Verret, N. Prince, Y. Jerome, A. Bras

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The effects of housing design on the health and well-being of populations are quite intangible. In fact, healthy housing parameters are generally difficult to establish scientifically. It is often unclear the direction of a cause-and-effect relationship between health variables and housing. However, the lack of clear and definite measurements does not entail the absence of relationship between housing, health, and well-being. Research has thus been conducted. It has mostly aimed the physical rather than the psychological or social well-being of a population, given the difficulties to establish cause-effect relationships because of the subjectivity of the psychological symptoms and of the challenge in determining the influence of other factors. That said, a strong relationship has been exposed between light and physiology. Both the nervous and endocrine systems, amongst others, are affected by different wavelengths of natural light within a building. Daylight in the workplace is indeed associated to decreased absenteeism, errors and product defects, fatigue, eyestrain, increased productivity and positive attitude. Similar associations can also be made to residential housing. Lower levels of sunlight within the home have been proven to result in impaired cognition in depressed participants of a cross-sectional case study. Moreover, minimum space (area and volume) has been linked to healthy housing and quality of life, resulting in norms and regulations for such parameters for home constructions. As a matter of fact, it is estimated that people spend the two-thirds of their lives within the home and its immediate environment. Therefore, it is possible to deduct that the health and well-being of the occupants are potentially at risk in an unhealthy housing situation. While the impact of architecture on health and well-being is acknowledged and considered somewhat crucial in various countries of the north and the south, this issue is barely raised in Haiti. In fact, little importance is given to architecture for many reasons (lack of information, lack of means, societal reflex, poverty…). However, the middle-class is known for its residential strategies and trajectories in search of better-quality homes and environments. For this reason, it would be pertinent to use this group and its strategies and trajectories to isolate the impact of housing design on the overall health and well-being. This research aims to analyze the impact of housing architecture on the health and well-being of middle-class families in the metropolitan region of Port-au-Prince. It is a case study which uses semi-structured interviews and observations as research methods. Although at an early stage, this research anticipates that homes affect their occupants both psychologically and physiologically, and consequently, public policies and the population should take into account the architectural design in the planning and construction of housing and, furthermore, cities.

Keywords: architectural design, health and well-being, middle-class housing, Port-au-Prince, Haiti

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11676 Realizing the National Disaster Management Policy of Sri Lanka through Public Private Partnerships

Authors: K. W. A. M. Kokila, Matsui Kenichi

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Sri Lanka’s disaster management policy aims to protect lives and developments in disaster affected areas by effectively using resources for disaster risk reduction, emergency management, and community awareness. However, funding for these action programs has posed a serious challenge to the country’s economy. This paper examines the extent to which private-public partnerships (PPPs) can facilitate and expedite disaster management works. In particular, it discusses the results of the questionnaire survey among policymakers, government administrators, NGOs, and private businesses. This questionnaire was conducted in 2017. All respondents were selected based on their experience in PPP projects in the past. The survey focused on clarifying the effectiveness of past PPP projects as well as their efficiency and transparency. The respondents also provided their own opinions and suggestions to improve the future PPP projects in Sri Lanka. The questionnaire was distributed to fifteen persons. The results show that almost all respondents think that PPP projects are beneficial and important for future disaster risk management in Sri Lanka. The respondents, however, showed some reservation about effectiveness and transparency of the PPP process. This paper also discusses the results on the respondents’ perceptions about their capacity regarding human resources and management. This paper, overall, sheds light on technological, financial and human resource management practices in developed countries as well as policy and legislation provisions regarding PPP projects.

Keywords: disaster management, policy, private public partnership, projects

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11675 Investigating the performance of machine learning models on PM2.5 forecasts: A case study in the city of Thessaloniki

Authors: Alexandros Pournaras, Anastasia Papadopoulou, Serafim Kontos, Anastasios Karakostas

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The air quality of modern cities is an important concern, as poor air quality contributes to human health and environmental issues. Reliable air quality forecasting has, thus, gained scientific and governmental attention as an essential tool that enables authorities to take proactive measures for public safety. In this study, the potential of Machine Learning (ML) models to forecast PM2.5 at local scale is investigated in the city of Thessaloniki, the second largest city in Greece, which has been struggling with the persistent issue of air pollution. ML models, with proven ability to address timeseries forecasting, are employed to predict the PM2.5 concentrations and the respective Air Quality Index 5-days ahead by learning from daily historical air quality and meteorological data from 2014 to 2016 and gathered from two stations with different land use characteristics in the urban fabric of Thessaloniki. The performance of the ML models on PM2.5 concentrations is evaluated with common statistical methods, such as R squared (r²) and Root Mean Squared Error (RMSE), utilizing a portion of the stations’ measurements as test set. A multi-categorical evaluation is utilized for the assessment of their performance on respective AQIs. Several conclusions were made from the experiments conducted. Experimenting on MLs’ configuration revealed a moderate effect of various parameters and training schemas on the model’s predictions. Their performance of all these models were found to produce satisfactory results on PM2.5 concentrations. In addition, their application on untrained stations showed that these models can perform well, indicating a generalized behavior. Moreover, their performance on AQI was even better, showing that the MLs can be used as predictors for AQI, which is the direct information provided to the general public.

Keywords: Air Quality, AQ Forecasting, AQI, Machine Learning, PM2.5

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11674 Presenting of 'Local Wishes Map' as a Tool for Promoting Dialogue and Developing Healthy Cities

Authors: Ana Maria G. Sperandio, Murilo U. Malek-Zadeh, João Luiz de S. Areas, Jussara C. Guarnieri

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Intersectoral governance is a requirement for developing healthy cities. However, this achievement is difficult to be succeeded, especially in regions at low resources condition. Therefore, it was developed a cheap investigative procedure to diagnose sectoral wishes related to urban planning and health promotion. This procedure is composed of two phases, which can be applied to different groups in order to compare the results. The first phase is a conversation guided by a list of questions. Some of those questions aim to gather information about how individuals understand concepts such as healthy city or a health promotion and what they believe that constitutes the relation between urban planning and urban health. Other questions investigate local issues, and how citizens would like to promote dialogue between sectors. At second phase individuals stand around the investigated city (or city region) map and are asked to represent their wishes on it. They can represent it by writing text notations or inserting icons on it, with the latter representing a city element, for example, some trees, a square, a playground, a hospital, a cycle track. After groups had represented their wishes, the map can be photographed, and then the results from distinct groups can be compared. This procedure was conducted at a small city in Brazil (Holambra), in 2017 which is the first out of four years of the mayor’s term. The prefecture asked for this tool in order to make Holambra become a city of Potential Healthy Municipalities Network in Brazil. Two sectors were investigated: the government and the urban population. By the end of our investigation, the intersection from the group (i.e., population and government) maps was accounted for creating a map of common wishes. Therefore, the material produced can be used as a guide for promoting dialogue between sectors and as a tool of monitoring politics progress. The report of this procedure was directed to public managers, so they could see the common wishes between themselves and local populations, and use this tool as a guide for creating urban politics which intends to enhance health promotion and to develop a healthy city, even at low resources condition.

Keywords: governance, health promotion, intersectorality, urban planning

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11673 Teacher Mental Health during Online Teaching

Authors: Elisabeth Desiana Mayasari, Laurensia Aptik Evanjeli, Brigitta Erlita Tri Anggadewi

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The condition of the COVID-19 pandemic demands adaptation in various aspects of human life, including in the field of education. Teachers are expected to do distance learning or Learning From Home (LFH). The teacher said that he experienced stress, anxiety, feeling depressed, and afraid based on the interview. Learning adaptations and pandemic situations can impact the mental health of teachers, so the purpose of this study is to determine the mental health of teachers while teaching online. This research was conducted with a quantitative approach using a survey method. The subjects in this study were 330 elementary school teachers under the auspices of a foundation in Yogyakarta. Teachers' mental health was measured using the Indonesian version of The Mental Health Inventory (MHI-38), which has a reliability of 0.888. The results showed that the teachers generally had a good mental health condition marked by a lower negative aspect score than the positive aspect. In addition, the overall mental health aspect shows that some teachers have better mental health when compared to the average score, as well as higher positive aspect scores in all sub-aspects.

Keywords: mental health, teacher, COVID-19 pandemic, MHI-38

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11672 Problems of Music Teachers in Public Education in Poland – Sketches from Interview Analysis

Authors: Elżbieta Frołowicz

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Throughout the ages, pedeutological reflection has been accompanied by numerous controversies resulting from public discourse of social, economic and political forces. According to accepted ideologies or represented interests, these forces generate various visions of self, which should be the result of the educational process at school. Accuracy of visions is particularly important in times of fast and significant socio-cultural changes witnessed by us. The teacher – also the music teacher – is responsible for accomplishing them. The author tries to characterize the group of music teachers and some contexts of their functioning in modern Polish schools based on literature analysis and according to results of her research conducted in the years 2013-2014 and ten years later (2023-2024). The source of analysis material is mostly interviews with music teachers from different types of elementary schools in Poland. This research used a partially structured individual depth interview to ensure a quality encounter between two personalities during a personal conversation. Interviews were conducted with 8 people in 2013-2014 and with 7 in 2023-24. Music teachers' problems have remained essentially unchanged over the decade. In an attempt to formulate some general conclusions, the author offers an assertion that the functioning of music teachers at school is vastly restrained by the coercion of an institution and is not compatible with the present requirements in which they operate.

Keywords: educational strategies, interview, music teacher, public education

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11671 Addressing Rural Health Challenges: A Flexible Modular Approach for Resilient Healthcare Services

Authors: Pariya Sheykhmaleki, Debajyoti Pati

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Rural areas in the United States face numerous challenges in providing quality and assessable primary healthcare services, especially during emergencies such as natural disasters or pandemics. This study showcases a cutting-edge flexible module that aims to overcome these challenges by offering adaptable healthcare facilities capable of providing comprehensive health services in remote and disaster-prone regions. According to the Health Resources and Services Administration (HRSA), approximately 62 million Americans, or 1 in 5 individuals, live in areas designated as Health Professional Shortage Areas (HPSAs) for primary care. These areas are characterized by limited access to healthcare facilities, shortage of healthcare professionals, transportation barriers, inadequate healthcare infrastructure, higher rates of chronic diseases, mental health disparities, and limited availability of specialized care, including urgent circumstances like pandemics that can exacerbate this issue. To address these challenges, the literature study began by examining primary health solutions in very remote areas, e.g., spaceships, to identify the state-of-the-art technologies and the methods used to facilitate primary care needs. The literature study on flexibility in architecture and interior design was also adapted to develop a conceptual design for rural areas. The designed flexible module provides an innovative solution. This module can be prefabricated as all parts are standardized. The flexibility of the module allows the structure to be modified based on local and geographical requirements as well as the ability to expand as required. It has been designed to stand either by itself or work in tandem with public buildings. By utilizing sustainable approaches and flexible spatial configurations, the module optimizes the utilization of limited resources while ensuring efficient and effective healthcare delivery. Furthermore, the poster highlights the key features of this flexible module, including its ability to support telemedicine and telehealth services for all five levels of urgent care conditions, i.e., from facilitating fast tracks to supporting emergency room services, in two divided zones. The module's versatility enables its deployment in rural areas located far from urban centers and disaster-stricken regions, ensuring access to critical healthcare services in times of need. This module is also capable of responding in urban areas when the need for primary health becomes vastly urgent, e.g., during a pandemic. It emphasizes the module's potential to bridge the healthcare gap between rural and urban areas and mitigate the impact of rural health challenges.

Keywords: rural health, healthcare challenges, flexible modular design, telemedicine, telehealth

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11670 Pregnancy Outcomes among Syrian Refugee and Jordanian Women: A Comparative Study

Authors: Karimeh Alnuaimi, Manal Kassab, Reem Ali, Khitam Mohammad, Kholoud Shattnawi

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Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.

Keywords: pregnancy, Syrian refugee, Jordanian women, comparative study

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11669 Mercury (Hg) Concentration in Fish Marketed in the São Luís Fish Market (MA) and Potential Exposure of Consumers

Authors: Luiz Drude de Lacerda, Kevin Luiz Cordeiro Ferrer do Carmo, Victor Lacerda Moura, Rayone Wesley Santos de Oliveira, Moisés Fernandes Bezerra

Abstract:

Fish is a food source well recognized for its health benefits. However, the consumption of fish, especially carnivorous species, is the main path of human exposure to Hg, a widely distributed pollutant on the planet and that accumulates along food chains. Studies on the impacts on public health by fish intake show existing toxic risks even when at low concentrations. This study quantifies, for the first time, the concentrations of Hg in muscle tissue of the nine most commercialized fish species in the fish market of São Luís (MA) in north Brazil and estimates the consequent human exposure through consumption. Concentrations varied according to trophic level, with the highest found in the larger carnivorous species; the Yellow hake (Cynoscion acoupa) (296.4 ± 241.2 ng/g w.w) and the Atlantic croaker (Micropogonias undulatus) (262.8 ± 89.1 ng/g w.w.), whereas the lowest concentrations were recorded in iliophagous Mullets (Mugil curema) (20.5 ± 9.6 ng/g w.w.). Significant correlations were observed between Hg concentrations and individual length in only two species: the Flaming catfish (Bagre marinus) and the Atlantic bumper (Chloroscombrus crysurus). Given the relatively uniform size of individuals of the other species and/or the small number of samples, this relationship was not found for the other species. The estimated risk coefficients, despite the relatively low concentrations of Hg, suggest that yellow hake and Whitemouth croaker (Micropogonias furnieri), fish most consumed by the local population, present some risk to human health (> 1) HQ and THQ, depending on the frequency of their consumption.

Keywords: contamination, fish, human exposure, risk assessment

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