Search results for: health economy

Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: adverse drug reactions, drug safety, monitoring, pharmacovigilance

Procedia PDF Downloads 191

Authors: Cátia Regina Branco da Fonseca, Maria Wany Louzada Strufaldi, Lídia Raquel de Carvalho, Rosana Fiorini Puccini

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Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Keywords: low birth weight, antenatal care, prenatal care, adequacy of health care, health evaluation, public health system

Procedia PDF Downloads 418

Authors: T. Noichl, M. Cramer, G. E. Dlugosch, I. Hosenfeld

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Teachers are exposed to a variety of stresses in their work context. These can have a negative impact on physical and psychological well-being. The online training ‘Better Living! Self-care for teachers’ is based on the training ‘Better Living! Self-care for mental health professionals’, which has been proven to be effective over a period of 3 years. The training for teachers is being evaluated for its effectiveness between October 2021 and March 2023 in a study funded by the German Federal Ministry of Education and Research. The aim of the training is to promote self-care and mindfulness among participants and thereby to foster well-being. The concept of self-care was already mentioned in antiquity and was also named as an imperative by philosophers such as Socrates and Epictetus. In the absence of a universal understanding of self-care today, the following definition was developed within the research group: Self-care is 1) facing oneself in a loving and appreciative way, 2) taking one's own needs seriously, and 3) actively contributing to one's own well-being. The study is designed as a randomized wait-control group repeated-measures design with 4 (treatment group) resp. 6 (wait-control group) measurement points. Central dependent variables are self-care, mindfulness, stress, and well-being. To assess the long-term effectiveness of training participation, these constructs are surveyed at the beginning and the end of the training as well as five weeks and one year later. Based on the results of the evaluation with mental health professionals, it is expected that participation will lead to an increase in subjective well-being, self-care, and mindfulness. The first results of the evaluation study are presented and discussed with regard to the effectiveness of the training among teachers.

Keywords: longitudinal intervention study, mindfulness, self-care, teachers’ mental health, well-being

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Authors: John Christian Lequiron, Gerry Bagtasa, Olivia Cabrera, Leoncio Amadore, Tolentino Moya

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Changes in air surface temperature play an important role in the Philippine’s economy, industry, health, and food production. While increasing global mean temperature in the recent several decades has prompted a number of climate change and variability studies in the Philippines, most studies still focus on rainfall and tropical cyclones. This study aims to investigate the trend and variability of observed air surface temperature and determine its major influencing factor/s in the Philippines. A non-parametric Mann-Kendall trend test was applied to monthly mean temperature of 17 synoptic stations covering 56 years from 1960 to 2015 and a mean change of 0.58 °C or a positive trend of 0.0105 °C/year (p < 0.05) was found. In addition, wavelet decomposition was used to determine the frequency of temperature variability show a 12-month, 30-80-month and more than 120-month cycles. This indicates strong annual variations, interannual variations that coincide with ENSO events, and interdecadal variations that are attributed to PDO and CO2 concentrations. Air surface temperature was also correlated with smoothed sunspot number and galactic cosmic rays, the results show a low to no effect. The influence of ENSO teleconnection on temperature, wind pattern, cloud cover, and outgoing longwave radiation on different ENSO phases had significant effects on regional temperature variability. Particularly, an anomalous anticyclonic (cyclonic) flow east of the Philippines during the peak and decay phase of El Niño (La Niña) events leads to the advection of warm southeasterly (cold northeasterly) air mass over the country. Furthermore, an apparent increasing cloud cover trend is observed over the West Philippine Sea including portions of the Philippines, and this is believed to lessen the effect of the increasing air surface temperature. However, relative humidity was also found to be increasing especially on the central part of the country, which results in a high positive trend of heat index, exacerbating the effects on human discomfort. Finally, an assessment of gridded temperature datasets was done to look at the viability of using three high-resolution datasets in future climate analysis and model calibration and verification. Several error statistics (i.e. Pearson correlation, Bias, MAE, and RMSE) were used for this validation. Results show that gridded temperature datasets generally follows the observed surface temperature change and anomalies. In addition, it is more representative of regional temperature rather than a substitute to station-observed air temperature.

Keywords: air surface temperature, carbon dioxide, ENSO, galactic cosmic rays, smoothed sunspot number

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Authors: Mario M. J. Musonda

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Access to health care is a human right, which includes having timely access to affordable and quality essential medicines at the right place and in sufficient quantity. However, inefficient public sector supply chain management contributes to constant shortages of essential medicines at health facilities. Literature review involved a desktop study of published research studies and reports on risk management, supply chain management of essential medicines and their integration to increase the efficiency of the latter. The research was conducted on a sample population of offices under Ministry of Health Headquarters, Lusaka Provincial and District Offices, selected health facilities in Lusaka, Medical Stores Limited, Zambia Medicines Regulatory Authority and Cooperating Partners. Individuals involved in study were selected judgmentally by their functions under selection and quantification, regulation, procurement, storage, distribution, quality assurance, and dispensing of essential medicines. Structured interviews and discussions were held with selected experts and self-administered questionnaires were distributed. Collected and analysed data of 35 returned and usable questionnaires from the 50 distributed. The highest prioritised risks were; inadequate and inconsistent fund disbursements, weak information management systems, weak quality management systems and insufficient resources (HR and infrastructure) among others. The results for this research can be used to increase the efficiency of the public sector supply chain of essential medicines and other pharmaceuticals. The results of the study showed that there is need to implement effective risk management systems by participating institutions and organisations to increase the efficiency of the entire supply chain in order to avoid and/or reduce shortages of essential medicines at health facilities.

Keywords: essential medicine, risk assessment, risk management, supply chain, supply chain risk management

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Authors: E. O. Egieyeh, N. Butler, R. Coetzee, M. Van Huyssteen, A. Bheekie

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Background: High rate of maternal and child mortality is a global concern. Nationally, it constitutes one of South Africa’s quadruple burdens of diseases. Pharmacists have a crucial role in maternal and child health care delivery and as such should be equipped with adequate knowledge and skill required to contribute to maternal and child well-being. The International Pharmaceutical Federation statement of policy (2013) outlines pharmacist-led interventions in accordance with the World Health Organisation’s interventions in maternal, new-born and child health care. The South African Pharmacy Council’s guideline on Good Pharmacy Practice (2010) also stipulates the minimum standards required to participate in reproductive, maternal and child care. Pharmacy schools are obliged to train pharmacy students to meet priority health needs of the population so that graduates are ‘fit for purpose’. The purpose of the study is to evaluate the knowledge and skill of final year pharmacy students at a university in South Africa to determine their preparedness to contribute effectively to maternal and child health care. Method: A quantitative, descriptive, non-randomized baseline study was conducted among the final year students at the School of Pharmacy. Data was collected using a questionnaire designed in sections to assess knowledge of contraception, maternal and child health directed at the primary care level and framed within the scope of practice required of an entry-level generalist pharmacist. Participants’ skill in infant growth assessment was assessed in a section of the questionnaire in a written format. Participants ticked the topics they had been exposed to on a curriculum content assessment tool which was not graded. A pilot study examined the clarity and suitability of question items, and duration to complete the questionnaire. A score of 50% in each section of the questionnaire indicated a pass. The questionnaire was delivered in campus lecture venue. Results: Of the 102 students in final year, 53 (52%) students consented to participate in the study. Only 13.2% of participants scored above 50% in each section. Forty five (85%) participants scored above 50% in the contraception section while 40 (75%) scored less than 50% in the skills assessment. Less than half (45.3%) of the participants had a total score above 50%. Being a parent or working part-time as pharmacist assistance did not have any influence on the performance of the participants. Evaluation of participants’ curriculum content exposure showed differences in exposure to the various topics. Exposure to contraception teaching received the most recognition. Conclusion: Maternal and child health curriculum content should be reviewed at the university to enhance the knowledge and skill of pharmacy graduates.

Keywords: final year pharmacy students, knowledge and skill, maternal and child health, South Africa

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Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

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Background: Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental well-being, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. Methods: We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Results: Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behaviour. Heavy time commitment, negative behaviour from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. Conclusions: The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall well-being.

Keywords: helping others, prosocial behaviour, youth, mental well-being

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Authors: Erin Lynne Plettenberg, Jeremy Vickery

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In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: electronic medical records, information extraction, logic modeling, ontology, vetted web mining

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Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

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Authors: Patricia Calvo, Francisco M. Sánchez, María J. Rodríguez

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Nowadays, food intake is becoming more irregular due to changes in family organization and lifestyle. Snacking is part of the day-to-day lives of people, however, most of the snacks have a high saturated fat, salt and refined sugar content; these dietary factors are believed to have negative health consequences. For this reason, there has been an increase in consumer demand for healthy, natural and convenient foods, so the development of a significant portion of new products focuses on improving the nutritional value of food snacks through modification its nutritional composition. In this paper, a new product made from vegetables has been designed. This new product would be an ideal food format to include ingredients with positive health benefits.

Keywords: healthy, pepper, dried, carotenes, polyphenols

Procedia PDF Downloads 365

Authors: Adam Bereczk

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Due to persistent socioeconomic problems regarding sustainability and labour market equilibrium in Europe, the subjects of social economy gained considerable academic attention recently. At the meantime, social enterprises pursuing the double bottom line criteria, struggling to find the proper management philosophies and strategies to make their social purpose business financially sustainable. Despite the strategic management literature was developed mainly on the bases of large corporations, in the past years, the interpretation of strategy concepts became a frequent topic in scientific discussions in the case of small and medium-sized enterprises also. The topic of strategic orientations is a good example of the trend. However, less is known about the case of social enterprises, despite the fact, the majority of them are small businesses engaged in real business activities. The main purpose of this work is to give a comprehensive summary of different perspectives regarding the interpretations of strategic orientations of social enterprises. The novelty of this work is it shows the previous outcomes and models of scholars from various fields of economic science who tried to intertwine the two spheres in different forms, methodize the findings and draw attention to the shortcomings.

Keywords: social enterprises, business sustainability, strategic orientations, literature review

Procedia PDF Downloads 263

Authors: Neha Pranav Kolhe, Harithapriya Vijaye, Arushi Kamle

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The economic growth engines are urban regions. As the economy expands, so does the need for peace and quiet, and noise pollution is one of the important social and environmental issue. Health and wellbeing are at risk from environmental noise pollution. Because of urbanisation, population growth, and the consequent rise in the usage of increasingly potent, diverse, and highly mobile sources of noise, it is now more severe and pervasive than ever before, and it will only become worse. Additionally, it will expand as long as there is an increase in air, train, and highway traffic, which continue to be the main contributors of noise pollution. The current study will be conducted in two zones of class I city of central India (population range: 1 million–4 million). Total 56 measuring points were chosen to assess noise pollution. The first objective evaluates the noise pollution in various urban habitats determined as formal and informal settlement. It identifies the comparison of noise pollution within the settlements using T- Test analysis. The second objective assess the noise pollution in silent zones (as stated in Central Pollution Control Board) in a hierarchical way. It also assesses the noise pollution in the settlements and compares with prescribed permissible limits using class I sound level equipment. As appropriate indices, equivalent noise level on the (A) frequency weighting network, minimum sound pressure level and maximum sound pressure level were computed. The survey is conducted for a period of 1 week. Arc GIS is used to plot and map the temporal and spatial variability in urban settings. It is discovered that noise levels at most stations, particularly at heavily trafficked crossroads and subway stations, were significantly different and higher than acceptable limits and squares. The study highlights the vulnerable areas that should be considered while city planning. The study demands area level planning while preparing a development plan. It also demands attention to noise pollution from the perspective of residential and silent zones. The city planning in urban areas neglects the noise pollution assessment at city level. This contributes to that, irrespective of noise pollution guidelines, the ground reality is far away from its applicability. The result produces incompatible land use on a neighbourhood scale with respect to noise pollution. The study's final results will be useful to policymakers, architects and administrators in developing countries. This will be useful for noise pollution in urban habitat governance by efficient decision making and policy formulation to increase the profitability of these systems.

Keywords: noise pollution, formal settlements, informal settlements, built environment, silent zone, residential area

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Authors: Kingkan Pongsiri

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This paper aims to study the role and activities of the participants and the impact of activities created in the local area in order to sustainably develop the local areas. This study applied both qualitative and quantitative approaches presented in descriptive style; the data was collected via survey, observation and in-depth interviews with samples. The results illustrated five sorts of roles of participants of the Cicada Walking-street and four types of creative activities; recreation based, art based, cultural based, and live events. Integration of local characteristics, arts and cultures were presented creatively and interestingly. Participants are various. The roles of the participants found in the Cicada Market are group of the property and area management, entrepreneurs, leisure (entertaining persons), local people, and tourists. The good impacts on local communities are those in terms of economy, environmental friendly and local arts and cultures promoting. On the other hand, the traffic congestion, waste and the increasing of energy consumption are negative impacts from area development.

Keywords: creative tourism activity, destination development, sustainable development, walking street

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Authors: Sonam Sandal, Susan Verghese P.

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The phrase "environmental tobacco smoke" (ETS) refers to exposure to tobacco smoke that isn't from your own smoking but instead is caused by being in close proximity to someone else's cigar, cigarette, or pipe smoke. Environmental cigarette smoke is one of the main contributors to indoor air pollution (IAP), which is exceedingly harmful to human health and results in millions of deaths each year, according to the World Health Organization. Sidestream smoke (SS), which is discharged from a cigarette's burning end in between puffs, is the primary cause of ETS. The bulk of the ETS residue is composed of gases that are produced while smoking through the cigarette paper, mainstream smoke (MS) ingested, and side stream smoke emitted while inhaling a puff from the burning end. Each of these mixtures—SS, ETS, and MS—is an aerosol composed of an IAP-causing vapor phase and a particle phase. Therefore, indoor air-cleaning equipment designed to remove particles will not significantly alter nicotine exposure but will alter the concentrations of other dangerous substances, including particulate matter (PM), PM 2.5, and PM 10. In conclusion, indoor airborne contaminants pose serious risks to human health. ETS degrades the air quality, and when someone breathes this bad air, it weakens their lungs and makes them more susceptible to COVID-19.

Keywords: pm 10, covid-19, indoor air pollution, cigarette smoke., pm 2.5

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Authors: Alejandra Cardenas, Ona Flores, Fabiola Gretzinger

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Since the 1990s, legal strategies for the promotion and protection of maternal health rights have achieved significant gains. Successful litigation in courts around the world have shown that these rights can be judicially enforceable. Governments and international organizations have acknowledged the importance of a human rights-based approach to maternal mortality and morbidity, and obstetric violence has been recognized as a human rights issue. Despite the progress made, maternal mortality has worsened in some regions of the world, while progress has stagnated elsewhere, and mistreatment in maternal care is reported almost universally. In this context, issues of maternal autonomy and decision-making during pregnancy, labor, and delivery as a critical barrier to access quality maternal health have been largely overlooked. Indeed, despite the principles of autonomy and informed consent in medical interventions being well-established in international and regional norms, how they are applied particularly during childbirth and pregnancy remains underdeveloped. National and global legal standards and decisions related to maternal health were reviewed and analyzed to determine how maternal autonomy and decision-making during pregnancy, labor, and delivery have been protected (or not) by international and national courts. The results of this legal research and analysis lead to the conclusion that a few standards have been set by courts regarding pregnant people’s rights to make choices during pregnancy and birth; however, most undermine the agency of pregnant people. These decisions recognize obstetric violence and gender-based discrimination, but fail to protect pregnant people’s autonomy, privacy, and their right to informed consent. As current human rights standards stand today, maternal health is the only field in medicine and law in which informed consent can be overridden, and patients can be forced to submit to treatments against their will. Unconsented treatment and loss of agency during pregnancy and childbirth can have long-term physical and mental impacts, reduce satisfaction and trust in health systems, and may deter future health-seeking behaviors. This research proposes a path forward that focuses on the pregnant person as an independent agent, relying on the doctrine of self-determination during pregnancy and childbirth, which includes access to the necessary conditions to enable autonomy and choice throughout pregnancy and childbirth as a critical step towards our approaches to reduce maternal mortality, morbidity, and mistreatment, and realize the promise of access to quality maternal health as a human right.

Keywords: autonomy in childbirth and pregnancy, choice, informed consent, jurisprudential analysis

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Authors: Elisenda Camprecios, Alicia Macarrila, Montse Albiol, Neus Garriga Garriga

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The loss of a child during pregnancy, or shortly after birth, is not a common occurrence, but it is a prevalent fact in our society. When this loss happens, life and death walk together. The grief that parents experience following a perinatal loss is a devastating experience. Professionals are aware that the quality of care offered during this first period is crucial to support the families experiencing a perinatal loss and meet their needs. However, it is not always easy for the health care professionals to know what to say and what to do in these difficult circumstances. Given the complexity of the Health, painful process that a family must face when is affected by such loss, we believe that the creation of a protocol that pays special attention to the emotional needs of those couples can be a very valuable tool for the professionals. The short documentary named ‘When the illusion vanished’ was created as part of the material of this protocol, which focuses on the emotional needs of the families who have suffered a perinatal loss. This video is designed to see what impact has a perinatal death and to raise awareness among professionals working in this field. The methodology is based on interviews with couples who have experienced perinatal death and to professionals who accompany families suffering from perinatal loss. The use of sensitive and empathized words, being encouraged to express feelings, respect the time, appropriate training for the professionals are some of the issues reflected in this documentary. We believe that this video has contributed to help health care professionals to empathize and understand the need to be able to accompany these families with the appropriate care, respectful, empathetic attitude and professionalism so that they can start the path to a ‘healthy’ mourning.

Keywords: neonatal loss, midwifery, perinatal bereavement, perinatal loss

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Authors: Adama NS Bah

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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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Authors: Mohammed A. Alhoot, Rathika A/P Nagarajan

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Climate change and variability are affecting human health and diseases direct or indirectly through many mechanisms. Change in rain pattern, an increase of temperature and humidity are showing an increased trend in Malaysia. This will affect the biological, physical and chemical component of water through different pathways and will enhance the risk of waterborne diseases. Besides, the warm temperature and humid climate provide very suitable conditions for the growth of pathogenic bacteria. This study is intended to highlight the relationship between the climate changes and the incidence food and water associated infections. Incidences of food and water associated infection and climate data were collected from Malaysian Ministry of health and Malaysian Metrological Department respectively. Maximum and minimum temperature showed high correlation with incidence of typhoid, hepatitis A, dysentery, food poisoning (P value <0.05 significant with 2 tailed / 0.5<[r]). Heavy rainfall does not associated with any outbreaks. Climate change brings out new challenges in controlling food and water associated infections. Adaptation strategies should involve all key stakeholders with a strong regional cooperation to prevent and deal with cross-boundary health crises. Moreover, the role of health care personnel at local, state and national levels is important to ensure the success of these programmes. As has been shown herein, climate variability is an important element influencing the food and water associated epidemiology in Malaysia. The results of this study are crucial to implementing climate changes as a factor to reduce any future outbreaks.

Keywords: climate change, typhoid, hepatitis A, dysentery, food poisoning

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Authors: Sze Wai Veera Fung, Peter W. Ferretto

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Since the economic reform in 1980s, many men and women of the southern dialect Dong minority have migrated to coastal cities for employment. Responding to the outgoing providers of the families, women, especially those at the middle age, resort to the informal home-based services and goods production for income generation. Homework, therefore, becomes a key economic strategy in supporting the household expenses in rural China, where formal employment is often inadequate for local women. This paper seeks to examine the intersection between gender and household strategy in the broader economic context of rural China. Based on the interviews and site survey in Tongdao Dong Autonomous County, the study analyses the variety of the home-based production activities, the experience of women in the production process, and the impact on familial relation and gender division of labor at home. The objective of this research is to advance the understanding of the informal economic landscape in the contemporary rural China, through which an alternative and possibly a more appropriate mode of development can be investigated.

Keywords: gender relation, home-based production, household strategy, informal economy, rural China, dong minority

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Authors: C. Bamrungbutr, J. Sillitoe

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Maritime transportation has been a crucial part of world economics. Recently, researchers have put effort into studying the mechanisms of how a regional port, in the shadow of a nearby predominant port, can compete and grow. However, limited research has focused on the competition issues for a shadow port which is a capital city port. This study will thus focus on this question of the growth of a capital city port which is under the shadow of the adjacent capital city port by using the two capital city ports of Thailand; Bangkok port (the former main port) and Laem Chabang port (the current main port). For this work, a framework of opportunity capture will be used, and five groups of port development experts (government, council, logistics provider, academia and industry) will be interviewed. The responses will be analysed using the noticing, collecting and thinking model. The resulting analysis will be appropriate for use in developing guidelines for the future management of a range of shadow ports established in a capital city, enabling them to operate in a competitive environment more effectively. The resultant growth of these ports will be a significant factor in increasing the competitiveness of a nation’s maritime transport industry and eventually lead to a boost in the national economy.

Keywords: shadow port, Bangkok Port, Laem Chabang Port, port competition

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Authors: Sara Zatir, Kouide Brahimi, Amira Zatir

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The planning and the environment have long evolved at the same two parallel tracks. But today, we can design a layout without addressing its environmental impact on the landscape. And the role of The documents of the regulatory planning is to control the urbanization of a common and its effects indirectly on the urban environment, but what about the urban landscape? Algeria is like many countries in the world leans primarily on developing sustainable economy, it was officially declared in the Maghreb countries, with the enactment of Law No. 01-20 of 12 December 2001 on the organization and sustainable development of the territory, one of the purposes of this law is the protection, mapping values and rational use of, natural resources, heritage and the natural preservation for future generations. However, Algeria initiatives have recently been undertaken but it still have some infancy which can be detected by the cavity between the delineation instruments,regulations and. In this context, we should note the important role of public authorities in the situation of the living and its future. The idea is to find a balance from the unbalanced conditions (between present and future generations, between economic needs, and the needs of environmental protection and cultural, between individual and collective interests) and to develop new strategies management laws and the urban landscape.

Keywords: Algeria, sustainable, development urban landscapes, laws

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Authors: Joël Passicousset, David Gilbert, Chloé Chervier-Legourd, Emmanuel Caron-Garant, Didier Labarre

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Living soil agriculture tries to reconciliate food production while improving soil health, soil biodiversity, soil fertility and more generally attenuating the inherent environmental drawbacks induced by modern agriculture. Using appropriate organic materials as soil amendments has a role to play in the aim of increasing the soil organic matter, improving soil fertility, sequestering carbon, and diminishing the dependence on both mineral fertilizer and pesticides. Insect farming consists in producing insects that can be used as a rich-in-protein and entomo-based food. Usually, detritivores are chosen, thus they can be fed with food wastes, which contributes to circular economy while producing low-carbon food. This process also produces frass, made of insect feces, exuvial material, and non-digested fibrous material, that have valuable fertilizer and biostimulation properties. But frass, used as a sole fertilizer on a crop may be not completely adequate for plants’ needs. This is why this project considers black soldier fly (termed BSF, one of the three main insect species grown commercially) frass as a complementary fertilizer, both in organic and in conventional contexts. Three kinds of experiments are made to understand the behaviour of fertilizer treatments based on frass incorporation. Lab-scale mineralization experiments suggest that BSF frass alone mineralizes more slowly than chicken manure alone (CM), but at a ratio of 90% CM-10% BSF frass, the mineralization rate of the mixture is higher than both frass and CM individually. For example, in the 7 days following the fertilization with same nitrogen amount introduced among treatments, around 80% of the nitrogen content supplied through 90% CM-10% BSF frass fertilization is present in the soil under mineral forms, compared to roughly 60% for commercial CM fertilization and 45% with BSF-frass. This suggests that BSF frass contains a more recalcitrant form of organic nitrogen than CM, but also that BSF frass has a highly active microbiota that can increase CM mineralization rate. Consequently, when progressive mineralization is needed, pure BSF-frass may be a consistent option from an agronomic aspect whereas, for specific crops that require spikes of readily available nitrogen sources (like cranberry), fast release 90CM-10BSF frass biofertilizer are more appropriate. Field experiments on cranberry suggests that, indeed, 90CM-10BSF frass is a potent candidate for organic cranberry production, as currently, organic growers rely solely on CM, whose mineralization kinetics are known to imperfectly match plant’s needs, which is known to be a major reason that sustains the current yield gap between conventional and organic cranberry sectors.

Keywords: soil mineralization, biofertilizer, BSF-frass, chicken manure, soil functions, nitrogen, soil microbiota

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Authors: Rajeshwari Biradar

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Background: The anecdotal evidences indicate that utilization of HIV services especially in Government facilities is affected by stigma and discrimination among HIV positive female sex workers (FSWs) in Karnataka. To our knowledge, there is no quantitative study on this issue. In this study an attempt is made to examine these aspects among positive FSWs exposed to prevention programs. Methods: This is a cross‐ sectional quantitative survey of HIV positive FSWs in the 3 districts of northern Karnataka using a structured questionnaire. The list of HIV Positive FSWs was organized by stratification, and 607 positive FSWs were selected using a systematic random selection. The data were analyzed using both bivariate and multivariate statistical techniques. Results: Half of the sex workers (52%) are traditional (devadasi, dedicated to the temple), 22% are widowed and the mean age is 33 years. The FSWs practice sex work on an average 13 days a month with 2.3 clients per day and was in sex work for about 13 years. Almost all of them (97%) used condom with the clients they had on the last day of sex work. About 74% were ever registered in the ART center and 47% of them reported being ever on ART, of which 6% dropped out. Multivariate results support the hypothesis that the interventions addressing stigma and discrimination enabled accessing health services in the government facilities (AOR=1.37; p=0.17). Conclusions: Based on the results of the study, programs addressing stigma, discrimination and positive prevention can be implemented in places where government health services are not utilized by HIV positive FSWs. However, the study may be limited by the fact that majority of the FSWs entered into sex work through the traditional devadasi system, which may not be the case in other parts of India.

Keywords: sex work, HIV/AIDS, female sex workers, health

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Authors: Ngabilas Salama

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Background: Indonesia has the 2nd highest number of incidents of tuberculosis (TB). It accounts for 1.020.000 new cases per year, only 30% of which has been reported. To find the lost 70%, a massive active case discovery was conducted through two programs: Ketuk Pintu Layani Dengan Hati (KPLDH) and Kader Juru Pemantau Batuk (Jumantuk cadres), who also plays a role in child TB screening. Methods: Data was collected and analyzed through Tuberculosis Integrated Online System from 2014 to 2017 involving 129 DOTS facility with 86 primary health centers in East Jakarta. Results: East Jakarta consists of 2.900.722 people. KPLDH program started in February 2016 consisting of 84 teams (310 people). Jumantuk cadres was formed 4 months later (218 orang). The number of new TB cases in East Jakarta (primary health center) from 2014 to June 2017 respectively is as follows: 6.499 (2.637), 7.438 (2.651), 8.948 (3.211), 5.701 (1.830). Meanwhile, the percentage of child TB case discovery in primary health center was 8,5%, 9,8%, 12,1% from 2014 to 2016 respectively. In 2017, child TB case discovery was 13,1% for the first 3 months and 16,5% for the next 3 months. Discussion: Increased TB incidence rate from 2014 to 2017 was 14,4%, 20,3%, and 27,4% respectively in East Jakarta, and 0,5%, 21,1%, and 14% in primary health center. This reveals the positive role of KPLDH and Jumantuk in TB detection and reporting. Likewise, these programs were responsible for the increase in child TB case discovery, especially in the first 3 months of 2017 (Ketuk Pintu TB Day program) and the next 3 months (active TB screening). Conclusion: KPLDH dan Jumantuk are actively involved in increasing TB case discovery in both adults and children.

Keywords: tuberculosis, case discovery program, primary health center, cadre

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Authors: Md. Rashel Sheikh

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The shipbuilding industry in Bangladesh had become a fast-growing industry in recent years when it began to export newly built ships. The various activities of shipbuilding industries in their limited, confined spaces added occupational worker exposures to chemicals, dusts, and metal fumes. The aim of this literature search is to identify the potential sources of occupational health hazards in shipyards and to promote the regulation of appropriate personal protective equipment (PPE) for the workers. In shipyards, occupational workers are involved in various activities, such as the manufacture, repair, maintenance, dismantling of boats and ships, building small ocean-going vessels and ferries. The occupational workers in the shipbuilding industry suffer from a number of hazardous issues, such as asthma, dermatitis, hearing deficits, and musculoskeletal disorders. The use of modern technologies, such as underwater plasma welding, electron beam welding, and friction stir welding and laser cutting and welding, and appropriate PPE (i.e., long-sleeved shirt and long pants, shoes plus socks, safety masks, chemical resistant gloves, eyewear, face shield, and respirators) can help reduce the occupational exposure to environmental hazards created by different activities in the shipyards. However, most shipyards in Bangladesh use traditional methods, e.g., flame cutting and arc, that add hazardous waste and pollutants to the environment in and around the shipyard. The safety and security of occupational workers in the shipyard workplace are very important. It is the primary responsibility of employers to ensure the safety and security of occupational workers in the shipyards. Employers must use advanced technologies and supply adequate and appropriate PPE for the workers. There are a number of accidents and illnesses that happen daily in the shipyard industries in Bangladesh due to the negligence and lack of adequate technologies and appropriate PPE. In addition, there are no specific regulations and implementations available to use the PPE. It is essential to have PPE regulations and strict enforcement for the adoption of PPE in the shipbuilding industries in Bangladesh. Along with the adoption of PPE with regular health examinations, health education to the workers regarding occupational hazards and lifestyle diseases are also important and require reinforcement. Monitoring health and safety hazards in shipyards are essential to enhance worker protection, and ensure worker safety, and mitigate workplace injuries and illnesses.

Keywords: shipbuilding Industries, health education, occupational health hazards, personal protective equipment, shipyard workers, occupational workers, shipyards

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Authors: Monday Dickson

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Shortly before the end of the second world war, allied leaders and other western powers designed an economic regime that would foster, among other things, global economic reconstruction, prosperity and overall development of countries of the world. They founded both the World Bank and the International Monetary Fund (IMF), with a general consensus that while the latter should specialize in monitoring global and national economies and acting as a lender of last resort, the former should focus on fighting poverty and promoting development. In setting the rules for world trade, the General Agreement on Trade and Tariffs (GATT) evolved into the World Trade Organisation (WTO). This paper, therefore, examines the impact of the activities of these institutions on the transformation and development aspirations of countries of the Third World. The study adopts the descriptive and analytical methods of investigation and derived relevant secondary data from books, journal articles, encyclopedia as well as reports from countries of the Third World. Findings show that rather than fostering poverty reduction and overall development as envisaged, the activities of global economy system leads to the “development of underdevelopment” of the Third World Countries. The strategic options that are available to countries of the Third World derived from the ability of the national governments to develop programmes of systematic exploration and exploitation of vital indices of relations with strategic countries to advance their development agenda.

Keywords: development, global economic system, prosperity, third world

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Authors: Murat Sengoz, Mustafa Kemal Topcu

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This study aims to contribute to efforts of Turkey to increase research and development to overcome mid-income level trap by discussing regulations on patenting and licensing. Knowledge and technology transfer from universities to business world is attached great significance to increase innovation. Through literature survey, it is observed that the States accomplished to boost the economy and increase welfare by the Bayh-Dole Act enacted in 1980. Thus, this good practice is imitated by other nations to make technological developments. The Act allows universities to acquire patent right in research programs funded by government to increase technology transfer from universities whilst motivating real sector to use research pools in the universities. An act similar with Bayh-Dole could be beneficial to Turkey since efforts in Turkey are to promote research, development and innovation. Towards this end, the impact of Bayh-Dole Act on the patent system for universities in the Sates is deliberately examined, applicability in Turkey is discussed. However, it is conceded that success rate of applying Bayh-Dole Act in Turkey would be low once Turkey mainly differs from the States regarding social, economic and cultural traits.

Keywords: Bayh-Dole Act, knowledge transfer, license, patent, spin-off

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Authors: Alexiou Dimitra, Fragkaki Maria

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The objective of the paper is the study of geographic, economic and educational variables and their contribution to determine the position of each member-state among the EU-28 countries based on the values of seven variables as given by Eurostat. The Data Analysis methods of Multiple Factorial Correspondence Analysis (MFCA) Principal Component Analysis and Factor Analysis have been used. The cross tabulation tables of data consist of the values of seven variables for the 28 countries for 2014. The data are manipulated using the CHIC Analysis V 1.1 software package. The results of this program using MFCA and Ascending Hierarchical Classification are given in arithmetic and graphical form. For comparison reasons with the same data the Factor procedure of Statistical package IBM SPSS 20 has been used. The numerical and graphical results presented with tables and graphs, demonstrate the agreement between the two methods. The most important result is the study of the relation between the 28 countries and the position of each country in groups or clouds, which are formed according to the values of the corresponding variables.

Keywords: Multiple Factorial Correspondence Analysis, Principal Component Analysis, Factor Analysis, E.U.-28 countries, Statistical package IBM SPSS 20, CHIC Analysis V 1.1 Software, Eurostat.eu Statistics

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Authors: Mduduzi Nhlozi

Abstract:

Food insecurity continues to persist in rural areas of South Africa today. A number of factors can be attributed to this including declining rural economies, rising unemployment, natural disasters such as drought as well as shifting cultural norms, values, traditions and beliefs. This paper explores mechanisms used by rural households to achieve food security in the midst of various threats and risks to their livelihoods. The study used semi-structured questionnaire to collect information on lived experiences of households in their quest to access and ensure availability of food. The paper finds that households use a number of food strategies namely economy-related, culture-related and rite-of-passage related strategies to achieve food security. The thrust of argument in the paper is that there is a need for food security studies to move beyond the orthodox, economic analytic framework, towards new institutional economics, focusing on local governance and socio-cultural systems supporting households to achieve food security. It advocates for localised food security plans to be developed by local municipalities to improve food security status for rural households.

Keywords: household, food insecurity, food strategies, new institutional economics, umkhanyakude

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