Search results for: health risk map
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13078

Search results for: health risk map

10888 Testifying in Court as a Victim of Crime for Persons with Little or No Functional Speech: Vocabulary Implications

Authors: Robyn White, Juan Bornman, Ensa Johnson

Abstract:

People with disabilities are at a high risk of becoming victims of crime. Individuals with little or no functional speech (LNFS) face an even higher risk. One way of reducing the risk of remaining a victim of crime is to face the alleged perpetrator in court as a witness – therefore it is important for a person with LNFS who has been a victim of crime to have the required vocabulary to testify in court. The aim of this study was to identify and describe the core and fringe legal vocabulary required by illiterate victims of crime, who have little or no functional speech, to testify in court as witnesses. A mixed-method, the exploratory sequential design consisting of two distinct phases was used to address the aim of the research. The first phase was of a qualitative nature and included two different data sources, namely in-depth semi-structured interviews and focus group discussions. The overall aim of this phase was to identify and describe core and fringe legal vocabulary and to develop a measurement instrument based on these results. Results from Phase 1 were used in Phase 2, the quantitative phase, during which the measurement instrument (a custom-designed questionnaire) was socially validated. The results produced six distinct vocabulary categories that represent the legal core vocabulary and 99 words that represent the legal fringe vocabulary. The findings suggested that communication boards should be individualised to the individual and the specific crime. It is believed that the vocabulary lists developed in this study act as a valid and reliable springboard from which communication boards can be developed. Recommendations were therefore made to develop an Alternative and Augmentative Communication Resource Tool Kit to assist the legal justice system.

Keywords: augmentative and alternative communication, person with little or no functional speech, sexual crimes, testifying in court, victim of crime, witness competency

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10887 Hypertension and Its Association with Oral Health Status in Adults: A Pilot Study in Padusunan Adults Community

Authors: Murniwati, Nurul Khairiyah, Putri Ovieza Maizar

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The association between general and oral health is clearly important, particularly in adults with medical conditions. Many of the medical systemic conditions are either caused or aggravated by poor oral hygiene and vice versa. Hypertension is one of common medical systemic problem which has been a public health concern worldwide due to its known consequences. Those consequences must be related to oral health status as well, whether it may cause or worsen the oral health conditions. The objective of this study was to find out the association between hypertension and oral health status in adults. This study was an analytical observational study by using cross-sectional method. A total of 42 adults both male and female in Padusunan Village, Pariaman, West Sumatra, Indonesia were selected as subjects by using purposive sampling. Manual sphygmomanometer was used to measure blood pressure and dental examination was performed to calculate the decayed, missing, and filled teeth (DMFT) scores in order to represent oral health status. The data obtained was analyzed statistically using One Way ANOVA to determine the association between hypertensive adults and their oral health status. The result showed that majority age of the subjects was ranging from 51-70 years (40.5%). Based on blood pressure examination, 57.1% of subjects were classified to prehypertension. Overall, the mean of DMFT score calculated in normal, prehypertension and hypertension group was not considered statistically significant. There was no significant association (p>0.05) between hypertension and oral health status in adults.

Keywords: blood pressure, hypertension, DMFT, oral health status

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10886 Effects of Intergenerational Social Mobility on General Health, Oral Health and Physical Function among Older Adults in England

Authors: Alejandra Letelier, Anja Heilmann, Richard G. Watt, Stephen Jivraj, Georgios Tsakos

Abstract:

Background: Socioeconomic position (SEP) influences adult health. People who experienced material disadvantages in childhood or adulthood tend to have higher adult disease levels than their peers from more advantaged backgrounds. Even so, life is a dynamic process and contains a series of transitions that could lead people through different socioeconomic paths. Research on social mobility takes this into account by adopting a trajectory approach, thereby providing a long-term view of the effect of SEP on health. Aim: The aim of this research examines the effects of intergenerational social mobility on adult general health, oral health and functioning in a population aged 50 and over in England. Methods: This study is based on the secondary analysis of data from the English Longitudinal Study of Ageing (ELSA). Using cross-sectional data, nine social trajectories were created based on parental and adult occupational socio-economic position. Regression models were used to estimate the associations between social trajectories and the following outcomes: adult self-rated health, self-rated oral health, oral health related quality of life, total tooth loss and grip strength; while controlling for socio-economic background and health related behaviours. Results: Associations with adult SEP were generally stronger than with childhood SEP, suggesting a stronger influence of proximal rather than distal SEP on health and oral health. Compared to the stable high group, being in the low SEP groups in childhood and adulthood was associated with poorer health and oral health for all examined outcome measures. For adult self-rated health and edentulousness, graded associations with social mobility trajectories were observed. Conclusion: Intergenerational social mobility was associated with self-rated health and total tooth loss. Compared to only those who remained in a low SEP group over time reported worse self-rated oral health and oral health related quality of life, and had lower grip strength measurements. Potential limitations in relation to data quality will be discussed.

Keywords: social determinants of oral health, social mobility, socioeconomic position and oral health, older adults oral health

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10885 Characterization of Practices among Pig Smallholders in Cambodia and Implications for Disease Risk

Authors: Phalla Miech, William Leung, Ty Chhay, Sina Vor, Arata Hidano

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Smallholder pig farms (SPFs) are prevalent in Cambodia but are vulnerable to disease impacts, as evidenced by the recent incursion of African swine fever into the region. As part of the ‘PigFluCam+’ project, we sought to provide an updated picture of pig husbandry and biosecurity practices among SPFs in south-central Cambodia. A multi-stage sampling design was adopted to select study districts and villages within four provinces: Phnom Penh, Kandal, Takeo, and Kampong Speu. Structured interviews were conductedbetween October 2020 - May 2021 among all consenting households keeping pigs in 16 target villages. Recruited SPFs (n=176) kept 6.8 pigs on average (s.d.=7.7), with most (88%) keeping cross-bred varieties of sows (77%), growers/finishers (39%), piglets/weaners (22%), and few keeping boars (5%). Chickens (83%) and waterfowl (56%) were commonly raised and could usually contact pigs directly (79%). Pigs were the primary source of household income for 28% of participants. While pigs tended to be housed individually (40%) or in groups (33%), 13% kept pigs free-ranging/tethered. Pigs were commonly fed agricultural by-products (80%), commercial feed (60%), and, notably, household waste (59%). Under half of SPFs vaccinated their pigs (e.g., against classical swine fever, Aujesky’s, and pasteurellosis, although the target disease was often unknown). Among 20 SPFs who experienced pig morbidities/mortalities within the past 6 months, only 3 (15%) reported to animal health workers, and disease etiology was rarely known. Common biosecurity measures included nets covering pig pens (62%) and restricting access to the site/pens (46%). Boot dips (0.6%) and PPE (1.2%) were rarely used. Pig smallholdings remain an important contributor to rural livelihoods. Current practices and biosecurity challenges increase risk pathways for a range of disease threats of both local and global concern. Ethnographic studies are needed to better understand local determinants and develop context-appropriate strategies.

Keywords: smallholder production, swine, biosecurity practices, Cambodia, African swine fever

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10884 Saline Aspiration Negative Intravascular Test: Mitigating Risk with Injectable Fillers

Authors: Marcelo Lopes Dias Kolling, Felipe Ferreira Laranjeira, Guilherme Augusto Hettwer, Pedro Salomão Piccinini, Marwan Masri, Carlos Oscar Uebel

Abstract:

Introduction: Injectable fillers are among the most common nonsurgical cosmetic procedures, with significant growth yearly. Knowledge of rheological and mechanical characteristics of fillers, facial anatomy, and injection technique is essential for safety. Concepts such as the use of cannula versus needle, aspiration before injection, and facial danger zones have been well discussed. In case of an accidental intravascular puncture, the pressure inside the vessel may not be sufficient to push blood into the syringe due to the characteristics of the filler product; this is especially true for calcium hydroxyapatite (CaHA) or hyaluronic acid (HA) fillers with high G’. Since viscoelastic properties of normal saline are much lower than those of fillers, aspiration with saline prior to filler injection may decrease the risk of a false negative aspiration and subsequent catastrophic effects. We discuss a technique to add an additional safety step to the procedure with saline aspiration prior to injection, a ‘’reverse Seldinger’’ technique for intravascular access, which we term SANIT: Saline Aspiration Negative Intravascular Test. Objectives: To demonstrate the author’s (PSP) technique which adds an additional safety step to the process of filler injection, with both CaHA and HA, in order to decrease the risk of intravascular injection. Materials and Methods: Normal skin cleansing and topical anesthesia with prilocaine/lidocaine cream are performed; the facial subunits to be treated are marked. A 3mL Luer lock syringe is filled with 2mL of 0.9% normal saline and a 27G needle, which is turned one half rotation. When a cannula is to be used, the Luer lock syringe is attached to a 27G 4cm single hole disposable cannula. After skin puncture, the 3mL syringe is advanced with the plunger pulled back (negative pressure). Progress is made to the desired depth, all the while aspirating. Once the desired location of filler injection is reached, the syringe is exchanged for the syringe containing a filler, securely grabbing the hub of the needle and taking care to not dislodge the needle tip. Prior to this, we remove 0.1mL of filler to allow for space inside the syringe for aspiration. We again aspirate and inject retrograde. SANIT is especially useful for CaHA, since the G’ is much higher than HA, and thus reflux of blood into the syringe is less likely to occur. Results: The technique has been used safely for the past two years with no adverse events; the increase in cost is negligible (only the cost of 2mL of normal saline). Over 100 patients (over 300 syringes) have been treated with this technique. The risk of accidental intravascular puncture has been calculated to be between 1:6410 to 1:40882 syringes among expert injectors; however, the consequences of intravascular injection can be catastrophic even with board-certified physicians. Conclusions: While the risk of intravascular filler injection is low, the consequences can be disastrous. We believe that adding the SANIT technique can help further mitigate risk with no significant untoward effects and could be considered by all performing injectable fillers. Further follow-up is ongoing.

Keywords: injectable fillers, safety, saline aspiration, injectable filler complications, hyaluronic acid, calcium hydroxyapatite

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10883 Understanding the Cause(S) of Social, Emotional and Behavioural Difficulties of Adolescents with ADHD and Its Implications for the Successful Implementation of Intervention(S)

Authors: Elisavet Kechagia

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Due to the interplay of different genetic and environmental risk factors and its heterogeneous nature, the concept of attention deficit hyperactivity disorder (ADHD) has shaped controversy and conflicts, which have been, in turn, reflected in the controversial arguments about its treatment. Taking into account recent well evidence-based researches suggesting that ADHD is a condition, in which biopsychosocial factors are all weaved together, the current paper explores the multiple risk-factors that are likely to influence ADHD, with a particular focus on adolescents with ADHD who might experience comorbid social, emotional and behavioural disorders (SEBD). In the first section of this paper, the primary objective was to investigate the conflicting ideas regarding the definition, diagnosis and treatment of ADHD at an international level as well as to critically examine and identify the limitations of the two most prevailing sets of diagnostic criteria that inform current diagnosis, the American Psychiatric Association’s (APA) diagnostic scheme, DSM-V, and the World Health Organisation’s (WHO) classification of diseases, ICD-10. Taking into consideration the findings of current longitudinal studies on ADHD association with high rates of comorbid conditions and social dysfunction, in the second section the author moves towards an investigation of the transitional points −physical, psychological and social ones− that students with ADHD might experience during early adolescence, as informed by neuroscience and developmental contextualism theory. The third section is an exploration of the different perspectives of ADHD as reflected in individuals’ with ADHD self-reports and the KENT project’s findings on school staff’s attitudes and practices. In the last section, given the high rates of SEBDs in adolescents with ADHD, it is examined how cognitive behavioural therapy (CBT), coupled with other interventions, could be effective in ameliorating anti-social behaviours and/or other emotional and behavioral difficulties of students with ADHD. The findings of a range of randomised control studies indicate that CBT might have positive outcomes in adolescents with multiple behavioural problems, hence it is suggested to be considered both in schools and other community settings. Finally, taking into account the heterogeneous nature of ADHD, the different biopsychosocial and environmental risk factors that take place during adolescence and the discourse and practices concerning ADHD and SEBD, it is suggested how it might be possible to make sense of and meaningful improvements to the education of adolescents with ADHD within a multi-modal and multi-disciplinary whole-school approach that addresses the multiple problems that not only students with ADHD but also their peers might experience. Further research that would be based on more large-scale controls and would investigate the effectiveness of various interventions, as well as the profiles of those students who have benefited from particular approaches and those who have not, will generate further evidence concerning the psychoeducation of adolescents with ADHD allowing for generalised conclusions to be drawn.

Keywords: adolescence, attention deficit hyperctivity disorder, cognitive behavioural theory, comorbid social emotional behavioural disorders, treatment

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10882 The Impact of a Lower Health Literacy in the Self-Management of Patients with a Multiple Sclerosis: A Literature Review

Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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10881 Internet of Health Things as a Win-Win Solution for Mitigating the Paradigm Shift inside Senior Patient-Physician Shared Health Management

Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: health management, internet of health things, remote monitoring, senior patient

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10880 Capacity Building in Dietary Monitoring and Public Health Nutrition in the Eastern Mediterranean Region

Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

Abstract:

Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

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10879 Seroprevalence Study of Cystic Echinococcosis and Its Associated Risk Factors in Fars Province, Southern Iran

Authors: Mahmoud Reza Tahamtan, Mohammad Saleh Bahreini

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Background and Purpose: Cystic echinococcosis, caused by the larval stage of Echinococcus granulosus, is a common parasitic infection of humans and is endemic in many parts of the world, including Iran. So that, one percent of those admitted to surgery departments are hydatid cyst patients, and using the ELISA method, the infection rate has been reported in different regions of Iran from 1.2% to 21.4%. Therefore, the aim of this study was to investigate the seroepidemiology of human hydatid cysts in Fars province, southern Iran, by ELISA method. Methods: In this cross-sectional study, 600 serum samples of persons who were referred to the laboratory of Nemazi Hospital in Shiraz for normal tests were examined for the presence of specific Anti-IgG antibodies to hydatid cysts by ELISA method. During the sampling, a structured questionnaire was used to obtain social data of individuals with determinants of risk factors for Cystic echinococcosis. Finally, the results of the ELISA test, along with demographic information completed by individuals, were analyzed using SPSS software. Results: The average age of the subjects in this study was 40.01 ± 9.166. The prevalence of hydatidosis was reported as 5.66% (34/600). The disease was more in the age group of 21-30, people living in villages, working in rural areas, and people with a history of other parasitic diseases. Statistically, a significant difference was observed between the prevalence of the disease and two risk factors, contact with dogs (OR= 0.042; 95%CI: 0.014-0.12; P= 0.001) and washing vegetables with water (OR= 0.08; 95%CI: 0.011-0.56; P= 0.012). Conclusion: The present study showed that hydatid cyst disease has a significant prevalence in this area. Also, based on the results, contact with dogs and not properly washing vegetables are two important factors of disease transmission.

Keywords: Echinococcus granulosus, Cystic echinococcosis, hydatid cyst, Fars province

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10878 (Re)Assessing Clinical Spaces: How Do We Critically Provide Mental Health and Disability Support and Effective Care for Young People Who Are Impacted by Structural Violence and Structural Racism?

Authors: Sireen Irsheid, Stephanie Keeney Parks, Michael A. Lindsey

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The medical and mental health field have been organized as reactive systems to respond to symptoms of mental health problems and disability. This becomes problematic particularly for those harmed by structural violence and racism, typically pushing us in the direction of alleviating symptoms and personalizing structural problems. The current paper examines how we assess, diagnose, and treat mental health and disability challenges in clinical spaces. We provide the readers with some context to think about the problem of racism and mental health/disability, ways to deconstruct the problem through the lens of structural violence, and recommendations to critically engage in clinical assessments, diagnosis, and treatment for young people impacted by structural violence and racism.

Keywords: mental health, disability, race and ethnicity, structural violence, structural racism, young people

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10877 Extremely Low-Frequency Magnetic Field; An Invisible Risk Association between High Power Transmission Lines and Childhood Leukemia and Adult Brain Cancer: Literature Review

Authors: Ali Azeem, Seung-Cheol Hong

Abstract:

This study focuses on the epidemiological association between childhood leukaemia & adult brain cancer to offer strong evidence that extremely low-frequency magnetic field (ELF-MF) produced from power lines caused cancer. It also gives a comprehensive literature review on epidemiological studies of ELF-MF risk associated with HVTL and childhood leukaemia & adult brain cancer. From the literature review, it is concluded that there is a weak association present between ELF-MF and childhood leukaemia. No consistent association was present between brain cancer and ELF-MF. This study is done on Scielo data and PubMed using the terms extremely low-frequency magnetic field (ELF-MF+cancer), adult brain cancer, high power transmission lines, etc., for the past 10 years.

Keywords: childhood leukaemia, high voltage transmission lines, acute lymphoblastic leukaemia, power lines

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10876 Utilizing Street Medicine to Reduce Communicable Disease Prevalence in a Cost-Effective Way

Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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10875 A Case Study on the Census of Technological Capacities in Health Care in Rural Sanitary Institutions in South Cameroon

Authors: Doriane Micaela Andeme Bikoro, Samuel Fosso Wamba, Jean Robert Kala Kamdjoug

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Currently one of the leading fields in the market of technological innovation is digital health. In developed countries, this booming innovation is experiencing an exponential speed. We understand that in developed countries, e-health could also revolutionize the practice of medicine and therefore fill the many failures observed in medical care. Everything leads to believe that future technology is oriented towards the medical sector. The aim of this work is to explore at the same time the technological resources and the potential of health care based on new technologies; it is a case study in a rural area of Southern Cameroon. Among other things, we will make a census of the shortcomings and problems encountered, and we will propose various appropriate solutions. The work methodology used here is essentially qualitative. We used two qualitative data collection techniques, direct observation, and interviews. In fact, we spent two weeks in the field observing and conducting some semi-directive interviews with some of those responsible for these health structures. This study was conducted in three health facilities in the south of the country; including two health centers and a rural hospital. Many technological failures have been identified in the day-to-day management of these health facilities and especially in the administration of health care to patients. We note major problems such as the digital divide, the lack of qualified personnel, the state of isolation of this area. This is why various proposals are made to improve the health sector in Cameroon both technologically and medically.

Keywords: Cameroon, capacities, census, digital health, qualitative method, rural area

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10874 Prompting and Encouraging Community Hydration through Education: A Realist Review and Evaluation Exploring Hydration in a Population at Risk of Frailty

Authors: Mark Davies, Carolyn Wallace, Christina Lloydwin, Tom Powell

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Background: Frailty is increasingly recognized as a public health problem within an aging population. It is often characterized as an accumulation of clinical symptoms with progressive decline. We contend that dehydration is potentially the missing link driving the cycle of frailty; it contributes to malnutrition and cognitive decline and is a risk factor for other conditions. Frailty may also impact on fluid intake in cognitively intact older adults, indicating the cyclical nature of dehydration contributing to increasing frailty. Aim: To examine the relationships between fluid, hydration, and frailty in older adults in order to determine what works, for whom, how, why, and in what circumstances. Methods: A Realist Synthesis was first undertaken with n=50 studies, leading to the development of a Refined Programme Theory (RPT) articulating what hydration interventions work, for whom, to what degree, in what contexts, and how & why. Within the subsequent evaluation, the RPT was further confirmed/refuted/refined following semi-structured interviews with n=8 participants (healthcare professionals and patients). The RAMESES Quality Standards were followed throughout the study. Results: The Refined Programme Theory (RPT) highlighted three factors that result in optimized hydration for frail older people, i.e., Developing an Understanding Around Hydration, Empowering Participation, and System Reconfiguration. Our RPT indicates that hydration interventions work by developing an understanding of the importance of hydration, mitigating physical & cognitive barriers, increasing the agency of the patient, using a prompting process to reinforce drinking behavior, and routinizing hydration as a dimension of overall care. Conclusion: The study indicates that a greater understanding of the importance of hydration is required for all parties. Patients also require physical and psychological support if they are to be active agents in meeting their hydration needs. At a wider ‘system’ level, organizations must work in an integrated manner introducing processes that enable continuing professional development (CPD), encourage ongoing holistic assessment, and routinize hydration support.

Keywords: frailty, dehydration, older adults, realist review, realist evaluation

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10873 Creative Applications for Socially Assistive Robots to Support Mental Health: A Patient-Centered Feasibility Study

Authors: Andreas Kornmaaler Hansen, Carlos Gomez Cubero, Elizabeth Jochum

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The use of the arts in therapy and rehabilitation is well established, and there is growing recognition of the value of the arts for improving health and well-being across diverse populations. Combining arts with socially assistive robots is a relatively under-explored research area. This paper presents the results of a feasibility study conducted within an existing arts and health program to scope the possibility of combining visual arts with socially assistive robots to promote mental health and well-being. Using a participatory research design with participant-led perspectives, we present the results of our feasibility study with a collaborative drawing robot among an adult population with mild to severe mental illness. We identify key methodological challenges and advantages of working with participatory and human-centered approaches. Based on the results of three pilot workshops with participants and lay health workers, we outline suggestions for authentic engagement with real stakeholders toward the development of socially assistive robots in community health contexts. Working closely with a patient population at all levels of the research process is key for developing tools and interventions that center patient experience and priorities while minimizing the risks of alienating patients and communities.

Keywords: arts and health, visual art, health promotion, mental health, collaborative robots, creativity, socially assistive robots

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10872 Determining the Presence of Brucella abortus Antibodies by the Indirect Elisa Method in Bovine Bulk Milk and Risk Factors in the Peri-Urban Zones of Bamenda Cameroon

Authors: Cha-ah C. N., Awah N. J., Mouiche M. M. M.

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Brucellosis is a neglected zoonotic disease of animals and man caused by bacteria of genus Brucella. Though eradicated in some parts of the world, it remains endemic in sub-Saharan Africa including Cameroon. The aim of this study was to contribute to the epidemiology of brucellosis in the North-West region of Cameroon by detecting the presence of anti-Brucella antibodies in bovine bulk milk as this serves as a route of transmission from animals to man. A cross sectional study was conducted to determine the prevalence of Brucella abortus antibodies in bovine bulk milk in the peri-urban zones of Bamenda. One hundred bulk milk samples were collected from 100 herds and tested by milk I-ELISA test. The conducted study revealed the presence of anti-Brucella abortus antibodies in bovine bulk milk. The study revealed that bovine brucellosis is widespread in animal production systems in this area. The animal infection pressure in these systems has remained strong due to movement of livestock in search of pasture, co-existence of animal husbandry, communal sharing of grazing land, concentration of animals around water points, abortions in production systems, locality of production systems and failure to quarantine upon introduction of new animals. The circulation of Brucella abortus antibodies in cattle farms recorded in the study revealed potential public health implication and suggest economic importance of brucellosis to the cattle industry in the Northwest region of Cameroon. The risk for re-emergence and transmission of brucellosis is evident as a result of the co-existence of animal husbandry activities and social-cultural activities that promote brucellosis transmission. Well-designed countrywide, evidence-based studies of brucellosis are needed. These could help to generate reliable frequency and potential impact estimates, to identify Brucella reservoirs, and to propose control strategies of proven efficacy.

Keywords: brucellosis, bulk milk, northwest region Cameroon, prevalence

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10871 Antioxidant Activity of Probiotic Lactic Acid Bacteria and Their Application in Fermented Milk Products

Authors: Vitheejongjaroen P., Jaisin Y., Pachekrepapol U., Taweechotipatr M.

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Lactic acid bacteria (LAB) are the most common type of microorganisms that had been used as probiotics also known for many beneficial health effects. The antioxidant activity of LAB is associated with numerous health-protective effects. This research aimed to investigate the antioxidant activity of lactic acid bacteria isolated from Thai sour pork sausage for their application in fermented milk products. Antioxidant activity determined by DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging assay showed that the isolate FN33-7, as 1 of 8 isolated exhibited scavenging activity in intact cell 5-7%, and supernatant 13-16%, intracellular cell free extract 42-48% respectively. This isolate was identified using 16S ribosomal DNA sequence analysis as Lactobacillus plantarum. The effect of milk fermented with L. plantarum FN33-7 on microbial count, pH and syneresis was assessed during refrigerated storage period of 28 days. The strain showed increased viability, pH level decreased, while syneresis increased. These results are similar to dairy products fermented with commercial starter cultures. Additionally, microstructure analysis of fermented milk by fluorescent microscopy showed that curd structure appeared to be dense and less porous in this fermented milk than commercial yogurt. The results of this study indicated that L. plantarum FN33-7 was a good probiotic candidate to be used in cultured milk products to reduce the risk of diseases caused by oxidative stress.

Keywords: Lactobacillus plantarum, probiotics, free radical, antioxidant, oxidative stress, fermented milk products

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10870 Trusting Smart Speakers: Analysing the Different Levels of Trust between Technologies

Authors: Alec Wells, Aminu Bello Usman, Justin McKeown

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The growing usage of smart speakers raises many privacy and trust concerns compared to other technologies such as smart phones and computers. In this study, a proxy measure of trust is used to gauge users’ opinions on three different technologies based on an empirical study, and to understand which technology most people are most likely to trust. The collected data were analysed using the Kruskal-Wallis H test to determine the statistical differences between the users’ trust level of the three technologies: smart speaker, computer and smart phone. The findings of the study revealed that despite the wide acceptance, ease of use and reputation of smart speakers, people find it difficult to trust smart speakers with their sensitive information via the Direct Voice Input (DVI) and would prefer to use a keyboard or touchscreen offered by computers and smart phones. Findings from this study can inform future work on users’ trust in technology based on perceived ease of use, reputation, perceived credibility and risk of using technologies via DVI.

Keywords: direct voice input, risk, security, technology, trust

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10869 Subsidying Local Health Policy Programs as a Public Management Tool in the Polish Health Care System

Authors: T. Holecki, J. Wozniak-Holecka, P. Romaniuk

Abstract:

Due to the highly centralized model of financing health care in Poland, local self-government rarely undertook their own initiatives in the field of public health, particularly health promotion. However, since 2017 the possibility of applying for a subsidy to health policy programs has been allowed, with the additional resources to be retrieved from the National Health Fund, which is the dominant payer in the health system. The amount of subsidy depends on the number of inhabitants in a given unit and ranges about 40% of the total cost of the program. The aim of this paper is to assess the impact of newly implemented solutions in financing health policy on the management of public finances, as well as on the activity provided by local self-government in health promotion. An effort to estimate the amount of expenses that both local governments, and the National Health Fund, spent on local health policy programs while implementing the new solutions. The research method is the analysis of financial data obtained from the National Health Fund and from local government units, as well as reports published by the Agency for Health Technology Assessment and Pricing, which holds substantive control over the health policy programs, and releases permission for their implementation. The study was based on a comparative analysis of expenditures on the implementation of health programs in Poland in years 2010-2018. The presentation of the results includes the inclusion of average annual expenditures of local government units per 1 inhabitant, the total number of positively evaluated applications and the percentage share in total expenditures of local governments (16 voivodships areas). The most essential purpose is to determine whether the assumptions of the subsidy program are working correctly in practice, and what are the real effects of introducing legislative changes into local government levels in the context of public health tasks. The assumption of the study was that the use of a new motivation tool in the field of public management would result in multiplication of resources invested in the provision of health policy programs. Preliminary conclusions show that financial expenditures changed significantly after the introduction of public funding at the level of 40%, obtaining an increase in funding from own funds of local governments at the level of 80 to 90%.

Keywords: health care system, health policy programs, local self-governments, public health management

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10868 Assessment and Prevalence of Burnout Syndrome and the Coping Strategies among Nurses in Lagos University Teaching Hospital, Lagos, Nigeria

Authors: Calassandra Nwokoro

Abstract:

Introduction: The nursing profession requires a lot of commitment, effort, and time to efficiently manage patients and provide them quality healthcare services, this work load may eventually cause the nurses to become burned out and experience psychological distress. This study assessed the prevalence of burnout, risk factors, and the coping strategies among nurses working in Lagos University Teaching Hospital (LUTH), Lagos state, Nigeria. Methodology: A descriptive cross-sectional study design was conducted among 308 nurses working in LUTH. Simple random sampling was used in selection of study respondents. The questionnaire comprised three parts; the sociodemographic characteristics of the respondents, the extent of burnout syndrome using the Maslach Burnout Inventory, and the coping strategies used among the respondents using the BRIEF-COPE Inventory. Results: This study revealed relatively high levels of burnout among the nurses in LUTH with a prevalence of 16.9%, 31.2% and 20.1% for high emotional exhaustion, high depersonalization and reduced professional accomplishment respectively. It also showed that burnout was significantly associated with long working hours. Religion was found to be the most commonly used coping strategy overall, while emotional support was the most frequently used coping strategy among nurses who had burnout. Conclusion: This study has revealed a relatively high prevalence of burnout among the nurses in Lagos University Teaching Hospital. In order to minimize the negative health impacts of burnout, the government should collaborate with psychologists and psychiatrists to implement regular stress management and stress inoculation programs for nurses and other health professionals in the country.

Keywords: burnout, nurses, coping strategies, healthcare

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10867 Machine Learning Methods for Flood Hazard Mapping

Authors: Stefano Zappacosta, Cristiano Bove, Maria Carmela Marinelli, Paola di Lauro, Katarina Spasenovic, Lorenzo Ostano, Giuseppe Aiello, Marco Pietrosanto

Abstract:

This paper proposes a novel neural network approach for assessing flood hazard mapping. The core of the model is a machine learning component fed by frequency ratios, namely statistical correlations between flood event occurrences and a selected number of topographic properties. The proposed hybrid model can be used to classify four different increasing levels of hazard. The classification capability was compared with the flood hazard mapping River Basin Plans (PAI) designed by the Italian Institute for Environmental Research and Defence, ISPRA (Istituto Superiore per la Protezione e la Ricerca Ambientale). The study area of Piemonte, an Italian region, has been considered without loss of generality. The frequency ratios may be used as a standalone block to model the flood hazard mapping. Nevertheless, the mixture with a neural network improves the classification power of several percentage points, and may be proposed as a basic tool to model the flood hazard map in a wider scope.

Keywords: flood modeling, hazard map, neural networks, hydrogeological risk, flood risk assessment

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10866 Housing Security System and Household Entrepreneurship: Evidence from China

Authors: Wangshi Yong, Wei Shi, Jing Zou, Qiang Li, Yilin Tian

Abstract:

With the advancement of the reform of China’s housing security system, the impact is becoming increasingly profound. This paper explores the relationship between the housing security system and household entrepreneurship on the 2017 China Household Finance Survey (CHFS) and conducts a large number of robustness checks, including PSM and IV estimation. The results show that the assistance of the housing security system will significantly promote family entrepreneurship, increasing the probability of entrepreneurship by 2%. Its internal mechanism is mainly achieved by relaxing liquidity constraints and increasing household social capital. However, the risk preference effect has not existed. Heterogeneity analysis shows that the positive impact of the housing security system on family entrepreneurship is mainly reflected in areas with high housing prices and incomes, as well as households with long-term security and social or commercial insurance. Meanwhile, it also verifies that the positive externalities of the housing security system will also positively affect active entrepreneurial motivation, entrepreneurial intensity, and entrepreneurial innovation.

Keywords: the housing security system, household entrepreneurship, social capital, liquidity constraints, risk preference

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10865 Rising STI Prevalence among MSM Clients in Calabar, Nigeria: A Call to Action

Authors: Ugoh Kelechi Melford, Anene O.

Abstract:

Introduction: Evidence has shown that there are increasing rates of new HIV and other STI infections occurring among Men who have Sex with Men (MSM) in Nigeria, with the prevalence 3 times higher than the general population as reported by the 2011 National Integrated Bio Behavioral Surveillance Survey. The poor state of health care and support services hinders our effort to control the high rates of these new infections among MSM. Methods: The Initiative for Improved Male Health (IMH-Initiative) works to provide a safe space for young MSM living with HIV to access comprehensive palliative care and support, as well as referrals for other services through drama and dance competitions. An STI assessment was conducted in IMH-Initiative’s Community Center in Calabar, for gay men and other MSM. An STI history was conducted for all clients who visited the community clinic specifically for HCT and STI counseling and referrals within a 5 month period, and their data were collated. Results: 61 MSM were diagnosed, and reported the following in the last 6 months. 49 where living with HIV. 46 had previous histories of untreated anal warts. 20 had previous histories of treated Gonorrhea by self-medication and herbs. 21 had untreated boils and rashes around the genitals. 10 clients where living with HIV, and reported untreated penile and rectal gonorrhea. All clients indicated that there were not comfortable discussing STI infections with staff of public hospitals. Conclusion: It is evident that a reasonable number of STI infections among MSM are not completely treated or ignored. This thereby increases the individual’s risk of HIV infection, and cripples HIV prevention programming in Nigeria. HIV programs targeting MSM must incorporate STI syndromic management, so as to increase access to non-stigmatized diagnosis and treatment of STIs. Also, access to STI drugs for clients cannot be overemphasized.

Keywords: MSM, IBBSS, STI, IMH

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10864 The Use of Hec Ras One-Dimensional Model and Geophysics for the Determination of Flood Zones

Authors: Ayoub El Bourtali, Abdessamed Najine, Amrou Moussa Benmoussa

Abstract:

It is becoming more and more necessary to manage flood risk, and it must include all stakeholders and all possible means available. The goal of this work is to map the vulnerability of the Oued Derna-region Tagzirt flood zone in the semi-arid region. This is about implementing predictive models and flood control. This allows for the development of flood risk prevention plans. In this study, A resistivity survey was conducted over the area to locate and evaluate soil characteristics in order to calculate discharges and prevent flooding for the study area. The development of a one-dimensional (1D) hydrodynamic model of the Derna River was carried out in HEC-RAS 5.0.4 using a combination of survey data and spatially extracted cross-sections and recorded river flows. The study area was hit by several extreme floods, causing a lot of property loss and loss of life. This research focuses on the most recent flood events, based on the collected data, the water level, river flow and river cross-section were analyzed. A set of flood levels were obtained as the outputs of the hydraulic model and the accuracy of the simulated flood levels and velocity.

Keywords: derna river, 1D hydrodynamic model, flood modelling, HEC-RAS 5.0.4

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10863 Medical Experience: Usability Testing of Displaying Computed Tomography Scans and Magnetic Resonance Imaging in Virtual and Augmented Reality for Accurate Diagnosis

Authors: Alyona Gencheva

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The most common way to study diagnostic results is using specialized programs at a stationary workplace. Magnetic Resonance Imaging is presented in a two-dimensional (2D) format, and Computed Tomography sometimes looks like a three-dimensional (3D) model that can be interacted with. The main idea of the research is to compare ways of displaying diagnostic results in virtual reality that can help a surgeon during or before an operation in augmented reality. During the experiment, the medical staff examined liver vessels in the abdominal area and heart boundaries. The search time and detection accuracy were measured on black-and-white and coloured scans. Usability testing in virtual reality shows convenient ways of interaction like hand input, voice activation, displaying risk to the patient, and the required number of scans. The results of the experiment will be used in the new C# program based on Magic Leap technology.

Keywords: augmented reality, computed tomography, magic leap, magnetic resonance imaging, usability testing, VTE risk

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10862 Predictors of Sexually Transmitted Infection of Korean Adolescent Females: Analysis of Pooled Data from Korean Nationwide Survey

Authors: Jaeyoung Lee, Minji Je

Abstract:

Objectives: In adolescence, adolescents are curious about sex, but sexual experience before becoming an adult can cause the risk of high probability of sexually transmitted infection. Therefore, it is very important to prevent sexually transmitted infections so that adolescents can grow in healthy and upright way. Adolescent females, especially, have sexual behavior distinguished from that of male adolescents. Protecting female adolescents’ reproductive health is even more important since it is directly related to the childbirth of the next generation. This study, thus, investigated the predictors of sexually transmitted infection in adolescent females with sexual experiences based on the National Health Statistics in Korea. Methods: This study was conducted based on the National Health Statistics in Korea. The 11th Korea Youth Behavior Web-based Survey in 2016 was conducted in the type of anonymous self-reported survey in order to find out the health behavior of adolescents. The target recruitment group was middle and high school students nationwide as of April 2016, and 65,528 students from a total of 800 middle and high schools participated. The study was conducted in 537 female high school students (Grades 10–12) among them. The collected data were analyzed as complex sampling design using SPSS statistics 22. The strata, cluster, weight, and finite population correction provided by Korea Center for Disease Control & Prevention (KCDC) were reflected to constitute complex sample design files, which were used in the statistical analysis. The analysis methods included Rao-Scott chi-square test, complex samples general linear model, and complex samples multiple logistic regression analysis. Results: Out of 537 female adolescents, 11.9% (53 adolescents) had experiences of venereal infection. The predictors for venereal infection of the subjects were ‘age at first intercourse’ and ‘sexual intercourse after drinking’. The sexually transmitted infection of the subjects was decreased by 0.31 times (p=.006, 95%CI=0.13-0.71) for middle school students and 0.13 times (p<.001, 95%CI=0.05-0.32) for high school students whereas the age of the first sexual experience was under elementary school age. In addition, the sexually transmitted infection of the subjects was 3.54 times (p < .001, 95%CI=1.76-7.14) increased when they have experience of sexual relation after drinking alcohol, compared to those without the experience of sexual relation after drinking alcohol. Conclusions: The female adolescents had high probability of sexually transmitted infection if their age for the first sexual experience was low. Therefore, the female adolescents who start sexual experience earlier shall have practical sex education appropriate for their developmental stage. In addition, since the sexually transmitted infection increases, if they have sexual relations after drinking alcohol, the consideration for prevention of alcohol use or intervention of sex education shall be required. When health education intervention is conducted for health promotion for female adolescents in the future, it is necessary to reflect the result of this study.

Keywords: adolescent, coitus, female, sexually transmitted diseases

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10861 A Comparative Analysis of Clustering Approaches for Understanding Patterns in Health Insurance Uptake: Evidence from Sociodemographic Kenyan Data

Authors: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

Abstract:

The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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10860 An Investigation into the Levels of Human Development, Contraceptives’ Usage and Maternal Health in Indian States

Authors: Divyanshi Singh

Abstract:

Women’s right to have choices, sense of self-worth and their right to have access to opportunities have been a subject of serious concern. The health of women and their children in Indian society is adversely affected by the woman’s inferior status within households. The level of human development in society is a reflection of the better status of a woman, which has a clear impact on the usage of contraceptive methods and maternal health. The study is an attempt to assess the performance of Indian states on the parameters of levels of development and to see how the developmental trajectory is influencing the choice for contraception and maternal health. The objective of the paper is to study the relationship between usage of contraception, maternal health and levels of human development in Indian states. Data from NFHS-4th round, AHS (2012-13) and census 2011 is used. Three indicators of human development (effective literacy, infant mortality and gross district domestic product) have been taken. Maternal health for the study has been measured in MMR, IMR and pregnancy resulted in abortions, stillbirths and miscarriage. The multiple regression analysis has been done to analyze the relationship between them. The Developmental factor is found to be greatly influencing the choice of family planning and thus they both show strong relation with maternal health.

Keywords: human development, contraceptive usage, maternal health, effective literacy

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10859 Following the Caravans: Interdisciplinary Study to Integrate Chinese and African Relations in Ethiopia

Authors: E. Mattio

Abstract:

The aim of this project is to study the Chinese presence in Ethiopia, following the path of the last salt caravans from Danakil to Tigray region. Official estimates of the number of Chinese in Africa vary widely; on the continent, there are increasingly diverse groups of Chinese migrants in terms of language, dialect, class, education, and employment. Based on this and on a very general state of the art, it was decided to increase the studies on this phenomenon, documenting the extraction of salt and following the sellers in the north of the country. The project is unique and allows you to admire a landscape that will soon change, due to the construction of infrastructure that is changing the dynamics of movement and sales. To carry out this study, interdisciplinary investigation methods were integrated, such as landscape archeology, historiographic research, participatory anthropology, geopolitics, and cultural anthropology and ethnology. There are two main objectives of the research. The first was an analysis of risk perceptions to predict what will happen to these populations and how the territory will be modified, trying to monitor the growth of infrastructure in the country and the effects it will have on the population. Thanks to the use of GIS, some roads created by Chinese companies that worked in the area have been georeferenced. The second point was to document the life and rituals of Ethiopian populations, in order not to lose the aspects of uniqueness that risk being lost. The local interviews have garnered impressions and criticisms from the local population to understand whether the Chinese presence is perceived as a threat or a solution. Among the most exclusive interviews, there are those made to Afar leaders in the Logya area and some Coptic representatives in the Wukro area. To make this project even more unique, the Coptic rituals of Gennà and Timkat have been documented, unique expressions of a millennial tradition. The aim was to understand whether the Maoist presence began to influence the religious rites and forms of belief present in the country.

Keywords: China, Ethiopia, GIS, risk perceptions

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