Search results for: male health awareness

Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Estibe Dagne Mekonnen

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In recent years, the prevalence of undernourishment was 30 percent for sub-Saharan Africa, compared with 16 percent for Asia and the Pacific (Ali, 2011). In Ethiopia, almost 40 percent of the total population in the country and 57 percent of Addis Ababa population lives below the international poverty line of US$ 1.25 per day (UNICEF, 2009). This study aims to analyze the determinant of household food secrity in Addis Ababa city administration. Primary data were collected from a survey of 256 households in the selected sub-city, namely Addis Ketema, Arada, and Kolfe Keranio, in the year 2022. Both Purposive and multi-stage cluster random sampling procedures were employed to select study areas and respondents. Descriptive statistics and order logistic regression model were used to test the formulated hypotheses. The result reveals that out of the total sampled households, 25% them were food secured, 13% were mildly food insecure, 26% were moderately food insecure and 36% were severely food insecure. The study indicates that household family size, house ownership, household income, household food source, household asset possession, household awareness on inflation, household access to social protection program, household access to credit and saving and household access to training and supervision on food security have a positive and significant effect on the likelihood of household food security status. However, marital status of household head, employment sector of household head, dependency ratio and household’s nonfood expenditure has a negative and significant influence on household food security status. The study finally suggests that the government in collaboration with financial institutions and NGO should work on sustaining household food security by creating awareness, providing credit, facilitate rural-urban linkage between producer and consumer and work on urban infrastructure improvement. Moreover, the governments also work closely and monitor consumer good suppliers, if possible find a way to subsidize consumable goods to more insecure households and make them to be food secured. Last but not least, keeping this country’s peace will play a crucial role to sustain food security.

Keywords: determinants, household, food security, order logit model, Addis Ababa

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Authors: Marian Emmanuel Okon

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Introduction: The Niger Delta region of Nigeria has a vast reserve of oil and gas, which has globally positioned the nation as the sixth largest exporter of crude oil. Production rapidly rose following oil discovery. In most oil producing nations of the world, the wealth generated from oil production and export has propelled economic advancement, enabling the development of industries and other relevant infrastructures. Therefore, it can be assumed that majority of the oil resource such as Nigeria’s, has the potential to improve the health of the population via job creation and derived revenues. However, the health benefits of this economic development might be offset by the environmental consequences of oil exploitation and production. Objective: This research aims to evaluate the balance between the health benefits of oil-led economic development and harmful environmental consequences of crude oil exploitation in Nigeria. Study Design: A pathway has been designed to guide data search and this study. The model created will assess the relationship between oil-led economic development and population health development via job creation, improvement of education, development of infrastructure and other forms of development as well as through harmful environmental consequences from oil activities. Data/Emerging Findings: Diverse potentially suitable datasets which are at different geographical scales have been identified, obtained or applied for and the dataset from the World Bank has been the most thoroughly explored. This large dataset contains information that would enable the longitudinal assessment of both the health benefits and harms from oil exploitation in Nigeria as well as identify the disparities that exist between the communities, states and regions. However, these data do not extend far back enough in time to capture the start of crude oil production. Thus, it is possible that the maximum economic benefits and health harms could be missed. To deal with this shortcoming, the potential for a comparative study with countries like United Kingdom, Morocco and Cote D’ivoire has also been taken into consideration, so as to evaluate the differences between these countries as well as identify the areas of improvement in Nigeria’s environmental and health policies. Notwithstanding, these data have shown some differences in each country’s economic, environmental and health state over time as well as a corresponding summary statistics. Conclusion: In theory, the beneficial effects of oil exploitation to the health of the population may be substantial as large swaths of the ‘wider determinants’ of population heath are influenced by the wealth of a nation. However, if uncontrolled, the consequences from environmental pollution and degradation may outweigh these benefits. Thus, there is a need to address this, in order to improve environmental and population health in Nigeria.

Keywords: environmental pollution, health benefits, oil-led economic development, petroleum exploitation

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Authors: Maria Albuquerque, Miguel Matias, Ângelo Sá, Juliana Sousa, Maria Manuel Mouzinho

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Obesity is a frequent disease in Portugal. The surgical treatment is very effective and has an indication when there is a failure of the medical treatment. Although massive weight loss is associated with considerable health gains, these patients are characterized by a variable degree of dermolipodistrophy. In some cases, there is even the development of physical symptoms such as intertriginous, and some degree of psychological distress is present. In almost all cases, a desire for a better body contour, which inhibits some aspects of social life, is a fact. A prospective study was made to access the impact of body contouring surgery in the quality of life of patients who underwent a massive weight lost correction surgical procedure at Centro Hospitalar de Lisboa Central between January 2020 and December 2021. The patients were submitted to the Body Q subjective questionnaire adapted for the Portuguese language and accessed for the following categories: Anguish with Appearance, Contempt with Body Image, Satisfaction with the Abdomen, and Overall Satisfaction with the Body. The questionnaire was repeated at the 6 months mark. A total of 80 patients were sampled. The sex distribution was 79 female and 1 male. The median BMI index before surgery was inferior to 28%. The pre operatory questionnaire showed high scores for Anguish with Appearance and low scores for the body image self-evaluation. Overall, there was an improvement of at least 50% in all the evaluated scores. Additionally, a correlation was found between abdominoplasty and the contempt with body image and satisfaction with the abdomen (p-value <0.05). Massive weight loss is associated with important body deformities that have a significant impact on the patient’s personal and social life. Body contouring surgery is then vital for these patients as it implicates major aesthetic and functional benefits.

Keywords: abdominoplasty, cruroplasty, obesity, massive weight loss

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Authors: Niveen M. Hassan-Abbas

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The COVID-19 pandemic created a range of stressors, among them difficulties related to work conditions, financial changes, lack of childcare, and confinement or isolation due to social distancing. Among families and married individuals, these stressors were often expressed in additional daily hassles, with an influence on mental health. This study examined two moderated mediation models based on Bodenmann’s systemic-transactional stress model. Specifically, the models tested the hypothesis that intra-dyadic stress mediates the association between extra-dyadic stress and mental health, while two measures of family functioning, cohesion, and flexibility, moderate the relationship between extra and intra-dyadic stress. Participants were 480 heterosexual married Palestinians from Israel who completed self-report questionnaires. The results showed partial mediation patterns supporting both models, indicating that family cohesion and flexibility weakened the mediating effect of intra-dyadic stress on the relationship between extra-dyadic stress and mental health. These findings increase our understanding of the variables that affected mental health during the pandemic and suggested that when faced with extra-dyadic stress, married individuals with good family environments are less likely to experience high levels of intra-dyadic stress, which is in turn associated with preserved mental health. Limitations and implications for planning interventions for couples and families during the pandemic are discussed.

Keywords: Palestinian families in Israel, COVID-19 pandemic, family cohesion and flexibility, extra-dyadic stress, intra-dyadic stress, mental health

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Authors: João Boaventura Branco De Matos

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Currently, in Brazil, there is a considerable collection of publications on the supplementary health sector, but the vast majority is limited to retrospective examination of the sector. The present contribution starts from the diagnosis of an overwhelming change in the role of the State and its institutions, as well as an accelerated and no less forceful change in the way of producing goods and services, resulting in a clash between these different waves (state and market). This shock produces unique energy, capable of imposing major changes in the most varied sectors. Based on this diagnosis, there was an opportunity to offer the perspective and propositional study of regulatory measures relevant to the best conduct and performance of this sector in the future.

Keywords: private health regulation, state and market, forecasts in Brazilian regulation, political economy

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Authors: Bita Rabbani, Hossein Chiti, Faranak Sharifi, Saeedeh Mazloomzadeh

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Background: Lifestyle modifications, especially improving nutritional patterns and increasing physical activity, are the most important factors in preventing obesity and metabolic syndrome in children and adolescents. For this purpose, the following interventional study was designed to investigate the effects of educational programs for students, as well as changes in diet and physical activity, on obesity and components of the metabolic syndrome. Methods: This study is part of an interventional research project (elementary school) conducted on all students of Sama schools in Zanjan and Abhar in three levels of elementary, middle, and high school, including 1000 individuals in Zanjan (intervention group) and 1000 individuals (control group) in Abhar in 2011. Interventions were based on educating students, teachers, and parents, changes in food services, and physical activity. We primarily measured anthropometric indices, fasting blood sugar, lipid profiles, and blood pressure and completed standard nutrition and physical activity questionnaires. Also, blood insulin levels were randomly measured in a number of students. Data analysis was done by SPSS software version 16.0. Results: Overall, 589 individuals (252 male, 337 female) entered the case group, and 803 individuals (344 male, 459 female) entered the control group. After two years of intervention, mean waist circumference (63.8 ± 10.9) and diastolic BP (63.8 ± 10.4) were significantly lower; however, mean systolic BP (10.1.0 ± 12.5), food score (25.0 ± 5.0) and drinking score (12.1 ± 2.3) were higher in the intervention group (p<0.001). Comparing components of metabolic syndrome between the second year and at time of recruitment within the intervention group showed that although number of overweight/obese individuals, individuals with hypertriglyceridemia and high LDL increased, abdominal obesity, high BP, hyperglycemia, and insulin resistance decreased (p<0.001). On the other hand, in the control group, number of individuals with high BP increased significantly. Conclusion: The prevalence of abdominal obesity and hypertension, which are two major components of metabolic syndrome, are much higher in our study than in other regions of country. However, interventions for modification of diet and increase in physical activity are effective in lowering their prevalence.

Keywords: metabolic syndrome, obesity, life style, nutrition, hypertension

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Authors: Ali Ashraf, Ghazaleh Aghaee, Sedigheh Samimian, Mohaya Farzin

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Objectives: Previous studies have indicated the positive effect of physical activity and sports on different aspects of health, such as muscle endurance and sleep cycle. However, in university students, particularly medical students, who have limited time and a stressful lifestyle, there have been limited studies exploring this matter with proven statistical results. In this regard, this study aims to find out how regular physical activity can influence the academic performance of medical students during their internship period. Methods: This was a descriptive-analytical study. Overall, 160 medical students (including 80 women and 88 men) voluntarily participated in the study. The Baecke Physical Activity Questionnaire was applied to determine the student’s physical activity levels. The student's academic performance was determined based on their total average academic scores. The data were analyzed in SPSS version 16 software using the independent t-test, Pearson correlation, and linear regression. Results: The average age of the students was 26.0±1.5 years. Eighty-eight students (52.4%) were male, and 142 (84.5%) were single. The student's mean total average academic score was 16.2±1.2, and their average physical activity score was 8.3±1.1. The student's average academic score was not associated with their gender (P=0.427), marital status (P=0.645), and age (P=0.320). However, married students had a significantly lower physical activity level compared to single students (P=0.020). The results indicated a significant positive correlation between student's physical activity levels and average academic scores (r=+0.410 and P<0.001). This correlation was independent of the student’s age, gender, and marital status based on the regression analysis. Conclusion: The results of the current study suggested that the physical activity level in medical students was low to moderate in most cases, and there was a significant direct relationship between student’s physical activity level and academic performance, independent of age, gender, and marital status.

Keywords: exercise, education, physical activity, academic performance

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Authors: Kittivate Boonyopakorn

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The purposes of this study were to find the English competence of the public health volunteers and to develop the use of their English. The samples for the study were 41 public health village volunteers at Ban Prasukchai, in Thailand. The findings showed that the sum of all scores for the pre-test was 452, while the score for the post-test was 1,080. Therefore, the results of the experiment confirm that the post-test scores (1,080) significantly are higher than the pre-test (452). The mean score (N=41) for the pre-test was 11.02 while the mean score (N=41) for the post-test was 18.10. The standard deviation for the pre-test was 2.734; however, for the post-test it was 1.934. In addition to the experts-evaluated research tools, the results of the evaluation for the structured interviews (IOC) were 1 in value. The evaluation of congruence for the content with learning objectives (IOC) were 0.66 to 1.00 in value. The evaluation of congruence for the pre and post-test with learning objectives (IOC) are 1 in value.

Keywords: finding the English competency, developing public health, village volunteers

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Authors: Martina Maria Keitsch, Sangeeta Singh

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There has been a growing recognition that sustainable development needs to consider economic, social and environmental aspects including gender. In Nepal, the majority of the population lives in rural areas, and many households do not have access to electricity. In rural areas, the difficulty of accessing energy is becoming one of the greatest constraints for improving living conditions. This is particularly true for women and children, who spent much time for collecting firewood and cooking and thus are often deprived of time for education, political- and business activities. The poster introduces an education and research project financed by the Norwegian Government. The project runs from 2015-2020 and is a collaboration between the Norwegian University of Science (NTNU) and Technology Institute of Engineering (IOE), Tribhuvan University. It has the title Master program and Research in Energy for Sustainable Social Development Energy for Sustainable Social Development (MSESSD). The project addresses engineering and architecture students and comprises several integral activities towards gender mainstreaming. The following activities are conducted; 1. Creating academic opportunities, 2. Updating administrative personnel on strategies to effectively include gender issues, 3. Integrating female and male stakeholders in the design process, 4. Sensitizing female and male students for gender issues in energy systems. The project aims to enable students to design end-user-friendly solutions which can, for example, save time that can be used to generate and enhance income. Relating to gender mainstreaming, design concepts focus on smaller-scale technologies, which female stakeholders can take control of and manage themselves. Creating academic opportunities, we have a 30% female students’ rate in each master student batch in the program with the goal to educate qualified female personnel for academia and policy-making/government. This is a very ambitious target in a Nepalese context. The rate of female students, who completed the MSc program at IOE between 1998 and January 2015 is 10% out of 180 students in total. For recruiting, female students were contacted personally and encouraged to apply for the program. Further, we have established a Master course in gender mainstreaming and energy. On an administrative level, NTNU has hosted a training program for IOE on gender-mainstreaming information and -strategies for academic education. Integrating female and male stakeholders, local women groups such as, e.g., mothers group are actively included in research and education for example in planning, decision-making, and management to establish clean energy solutions. The project meets women’s needs not just practically by providing better technology, but also strategically by providing solutions that enhance their social and economic decision-making authority. Sensitizing the students for gender issues in energy systems, the project makes it mandatory to discuss gender mainstreaming based on the case studies in the Master thesis. All activities will be discussed in detail comprising an overview of MSESSD, the gender mainstreaming master course contents’, and case studies where energy solutions were co-designed with men and women as lead-users and/or entrepreneurs. The goal is to motivate educators to develop similar forms of transnational gender collaboration.

Keywords: knowledge generation on gender mainstreaming, sensitizing students, stakeholder inclusion, education strategies for design and architecture in gender mainstreaming, facilitation for cooperation

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Authors: Muhammad Danyal Khan

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The standards of patentability are drawing a great impact upon medicine industry of Pakistan which is indirectly troubling the right to health of ordinary citizen. Globalization of intellectual property laws is directly impacting access to medicine for population in Pakistan. Pakistan has enacted Patent Ordinance 2000 to develop the standards of Patent laws in consonance with international commitments. Moreover, Pakistan is signatory to UN Millennium Development Goals (2000-2015), and three of them directly put stress upon the health standards. This article will provide a critical brief about implications of TRIPS Agreement on standards of health in Pakistan and will also propose a futuristic approach for the pharmaceutical industry. This paper will define the paradox of globalization and national preparedness on pharmaceutical patents utilizing industry statistics and case laws from Pakistan. Moreover, this work will contribute towards debate on access to medicine at legislative and interpretative levels that will further help development of equilibrium between pharmaceutical patents and right to health.

Keywords: TRIPS (Trade Related Intellectual Property Rights), patents, compulsory licensing, patent, lifesaving drugs, WTO, infringement

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Authors: Marianne Paimre

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Estonia is heralded as the most successful digital country in the world with the highly acclaimed eHealth system. Yet 40% of the 65–74-year-olds do not use the Internet at all, and digital divide between young and elderly people's use of ICT is larger than in many advanced countries. Poor access to ICT resource and insufficient digital skills can lead to detachment from digital health resources, delayed diagnoses, and increased rates of hospitalization. To reveal digital divide within the elderly population itself, the presentation focuses on the health information behavior of Estonian seniors who either continue or have stopped working after retirement to use digital health applications. The author's main interest is on access, trust, and skills to use the Internet for medical purposes. Fifteen in-depth interviews with 65+ working persons, as well as 15 interviews with full-time retirees, were conducted. Also, six think-aloud protocols were conducted. The results indicate that older adults, who due to the nature of their work, have regular access to computers, often search for health-related information online. They exposed high source criticism and were successful in solving the given tasks. Conversely, most of the fully retired older adults claimed not using computers or other digital devices and cited lack of skills as the main reason for their inactivity. Thus, when developing health applications, it should be borne in mind that the ability and willingness of older adults to use e-solutions are very different.

Keywords: digital divide, digital healthcare, health information behavior, older adults

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Authors: A. Yamaoka, S. Yukawa

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Mind wandering is a mental phenomenon of drifting away from a current task or external environment toward inner thought. This research examines the feature of mind wandering which people who have high creativity and high mental health engage in because it is expected that mind wandering which such kind of people engage in may not induce negative affect, although it can improve creativity. Sixty-seven participants were required to complete questionnaires which measured their creativity and mental health. After that, researchers conducted experience sampling method and measured the details of their mind wandering and the situation when mind wandering was generated in daily life for three days. The result showed that high creative people and high mental health people more think about positive things during mind wandering and less think about negative things. In further research, researchers will examine how to induce positive thought during mind wandering and how to inhibit negative thought during mind wandering. Doing so will contribute to improve creative problem solving without generation of negative affect.

Keywords: creativity, experience sampling method, mental health, mind wandering

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Authors: Qing Li, Maiko Kobayashi, Shigeyoshi Kumeda, Hiroko Ochiai, Toshiya Ochiai, Takashi Miura, Takahide Kagawa, Michiko Imai, Toshiaki Otsuka, Tomoyuki Kawada

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In the present study, we investigated the effects of a forest bathing program on cardiovascular and metabolic parameters. Nineteen healthy male subjects (mean age: 51.3 ± 8.8 years) were selected after obtaining informed consent. These subjects took day trips to a forest park named Akasawa Shizen Kyuyourin, Agematsu, Nagano Prefecture (situated in central Japan), and to an urban area of Nagano Prefecture as a control in August 2015. On both trips, they walked 2.6 km for 80 min each in the morning and afternoon on Saturdays. Blood and urine were sampled in the morning before and after each trip. Cardiovascular and metabolic parameters were measured. Blood pressure and pulse rate were measured by an ambulatory automatic blood pressure monitor. The Japanese version of the profile of mood states (POMS) test was conducted before, during and after the trips. Ambient temperature and humidity were monitoring during the trips. The forest bathing program significantly reduced pulse rate, and significantly increased the score for vigor and decreased the scores for depression, fatigue, and confusion in the POMS test. The levels of urinary noradrenaline and dopamine after forest bathing were significantly lower than those after urban area walking, suggesting the relaxing effect of the forest bathing program. The level of adiponectin in serum after the forest bathing program was significantly greater than that after urban area walking. There was no significant difference in blood pressure between forest and urban area trips during the trips.

Keywords: ambient temperature, blood pressure, forest bathing, forest therapy, human health, POMS, pulse rate

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Authors: Samaneh Abedini, Diana Urajnik, Nicole Naccarato

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A high prevalence of mental health problems was observed in marginalized youth living in underserved regions of Ontario during the COVID-19 pandemic. To address this issue, a growing number of community-based traditional mental health services are offering digital mental health resources due to their accessibility, affordability, and scalability. The feasibility of providing these resources in underserved regions has been examined by researchers rather than by representatives of effective services within a mental health system. Indeed, digitalized mental health contents are not routinely embedded within local mental health organizations' services in Northern Ontario, where they can make a substantial impact. To date, many technology-based mental health initiatives have not been effectively implemented in this region. The obstacles associated with implementing digitalized mental health resources in Northern Ontario may be unique to that region. Thus, specific context-based considerations might need to be applied for developing and implementing digital resources by regional mental health organizations in Northern Ontario. The target population was child-serving organizations situated in northeastern Ontario, specifically within Greater Sudbury and the Sudbury District. A sample of six organizations were selected with representation from the mental health, social, and healthcare sectors. The project supervisor was in a unique position to access the organizations by virtue of existing relationships with the practice and lay communities at large. Thus, recruitment was conducted through professional outreach in partnership with the Center for Rural and Northern Health Research (CRaNHR). Semi-structured interviews were conducted with 1-2 key personnel (e.g., administrator, clinician) from participating organizations. Audio recordings from the semi-structured interviews were transcribed verbatim and thematically analyzed supported by NVivo. Thematic analysis of the data resulted in a total of 13 excerpts which were categorized into two major themes including 1) digital mental health services as a valuable resource for organizations both during and after the pandemic, and 2) barriers and facilitators to a successful implementation of digital mental health resources in northern Ontario. Four secondary themes were identified: 1) perceived barriers to implementation of digital mental health resources to the offered services by mental health agencies; 2) acceptability and feasibility of digital health sources for people living in northern Ontario; 3) data security, safety, and risk; and 4) connecting with clients. The employees of mental health organizations in northern Ontario considered digital mental health resources as generally acceptable to youth. However, they raised several concerns that may affect their implementation into routine practice and service delivery. The implementation of digital systems should be simple and straightforward and should enhance rather than hinder clinical workflows for staff. A clear plan for implementing technological services is also required for the successful adoption of digital systems. For successful adoption and implementation of digital systems, staff views must be considered.

Keywords: COVID-19 pandemic, digital mental health resources, Ontario, underserved

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Authors: Afrah S. M. Al-Mahfadi

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Climate change is a global issue that has significant impacts on water resources, resulting in environmental, economic, and political consequences. Groundwater reserves, particularly in coastal areas, are facing depletion, leading to serious problems in regions such as Yemen. This study focuses on the western coastal region of Yemen, which already faces risks such as water crises, food insecurity, and widespread poverty. Climate change exacerbates these risks by causing high temperatures, sea level rise, inadequate sea level rise, and inadequate environmental policies. Research Aim: The aim of this research is to provide a comprehensive overview of the impact of climate change on the western coastal region of Yemen. Specifically, the study aims to analyze the relationship between climate change and the loss of fresh groundwater resources in this area. Methodology: The research utilizes a combination of a literature review and three case studies conducted through site visits. Arch-GIS mapping is employed to analyze and visualize the relationship between climate change and the depletion of fresh groundwater resources. Additionally, data on precipitation from 1981 to 2020 and scenarios of projected sea level rise (SLR) are considered. Findings: The study reveals several future issues resulting from climate change. It is projected that the annual temperature will increase while the rainfall rate will decrease. Furthermore, the sea level is expected to rise by approximately 0.30 to 0.72 meters by 2100. These factors contribute to the loss of wetlands, the retreat of shorelines and estuaries, and the intrusion of seawater into the coastal aquifer, rendering drinking water from wells increasingly saline. Data Collection and Analysis Procedures: Data for this research are collected through a literature review, including studies on climate change impacts in coastal areas and the hydrogeology of the study region. Furthermore, three case studies are conducted through site visits. Arch-GIS mapping techniques are utilized to analyze the relationship between climate change and the loss of fresh groundwater resources. Historical precipitation data from 1981 to 2020 and scenarios of projected sea level rise are also analyzed. Questions Addressed: (1) What is the impact of climate change on the western coastal region of Yemen? (2) How does climate change affect the availability of fresh groundwater resources in this area? Conclusion: The study concludes that the western coastal region of Yemen is facing significant challenges due to climate change. The projected increase in temperature, decrease in rainfall, and rise in sea levels have severe implications, such as the loss of wetlands, shorelines, and estuaries. Additionally, the intrusion of seawater into the coastal aquifer further exacerbates the issue of saline drinking water. Urgent measures are needed to address climate change, including improving water management, implementing integrated coastal zone planning, raising awareness among stakeholders, and implementing emergency projects to mitigate the impacts. Recommendations: To mitigate the adverse effects of climate change, several recommendations are provided. These include improving water management practices, developing integrated coastal zone planning strategies, raising awareness among all stakeholders, improving health and education, and implementing emergency projects to combat climate change. These measures aim to enhance adaptive capacity and resilience in the face of future climate change impacts.

Keywords: climate change, groundwater, coastal wetlands, Yemen

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Authors: Dilek Ozturk, Narin Ozturk, Zeliha Pala Kara, Engin Kaptan, Serap Sancar Bas, Nurten Ozsoy, Alper Okyar

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Most physiological processes oscillate in a rhythmic manner in mammals including metabolism and energy homeostasis, locomotor activity, hormone secretion, immune and endocrine system functions. Endocrine body rhythms are tightly regulated by the circadian timing system. The hypothalamic-pituitary-thyroid (HPT) axis is under circadian control at multiple levels from hypothalamus to thyroid gland. Since circadian timing system controls a variety of biological functions in mammals, circadian rhythms of biological functions may modify the drug tolerability/toxicity depending on the dosing time. Selective mTOR (mammalian target of rapamycin) inhibitor everolimus is an immunosuppressant and anticancer agent that is active against many cancers. It was also found to be active in medullary thyroid cancer. The aim of this study was to investigate the dosing time-dependent toxicity of everolimus on the thyroid gland and hormones in mice. Healthy C57BL/6J mice were synchronized with 12h:12h Light-Dark cycle (LD12:12, with Zeitgeber Time 0 – ZT0 – corresponding to Light onset). Everolimus was administered to male (5 mg/kg/day) and female mice (15 mg/kg/day) orally at ZT1-rest period- and ZT13-activity period- for 4 weeks; body weight loss, clinical signs and possible changes in serum thyroid hormone levels (TSH and free T4) were examined. Histological alterations in the thyroid gland were evaluated according to the following criteria: follicular size, colloid density and viscidity, height of the follicular epithelium and the presence of necrotic cells. The statistical significance between differences was analyzed with ANOVA. Study findings included everolimus-related diarrhea, decreased activity, decreased body weight gains, alterations in serum TSH levels, and histopathological changes in thyroid gland. Decreases in mean body weight gains were more evident in mice treated at ZT1 as compared to ZT13 (p < 0.001, for both sexes). Control tissue sections of thyroid glands exhibited well-organized histoarchitecture when compared to everolimus-treated groups. Everolimus caused histopathological alterations in thyroid glands in male (5 mg/kg, slightly) and female mice (15 mg/kg; p < 0.01 for both ZT as compared to their controls) irrespective of dosing-time. TSH levels were slightly decreased upon everolimus treatment at ZT13 in both males and females. Conversely, increases in TSH levels were observed when everolimus treated at ZT1 in both males (5 mg/kg; p < 0.05) and females (15 mg/kg; slightly). No statistically significant alterations in serum free T4 levels were observed. TSH and free T4 is clinically important thyroid hormones since a number of disease states have been linked to alterations in these hormones. Serum free T4 levels within the normal ranges in the presence of abnormal serum TSH levels in everolimus treated mice may suggest subclinical thyroid disease which may have repercussions on the cardiovascular system, as well as on other organs and systems. Our study has revealed the histological damage on thyroid gland induced by subacute everolimus administration, this effect was irrespective of dosing time. However, based on the body weight changes and clinical signs upon everolimus treatment, tolerability for the drug was best following dosing at ZT13 in both male and females. Yet, effects of everolimus on thyroid functions may deserve further studies regarding their clinical importance and chronotoxicity.

Keywords: circadian rhythm, chronotoxicity, everolimus, thyroid gland, thyroid hormones

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Authors: C. C .D. Kulathilake, M. Jayatilake, T. Takahashi

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The myocardium is composed of specialized muscle which relies mainly on fatty acid and sugar metabolism and it is widely contribute to the heart functioning. The changes of the cardiac energy-producing system during heart failure have been proved using autoradiography techniques. This study focused on evaluating sugar and fatty acid metabolism in myocardium as cardiac energy getting system using heart-accumulated radiopharmaceuticals. Two sets of autoradiographs of heart cross sections of Lewis male rats were analyzed and the time- accumulation curve obtained with use of the MATLAB image processing software to evaluate fatty acid and sugar metabolic functions.

Keywords: autoradiographs, fatty acid, radiopharmaceuticals, sugar

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Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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Authors: Jane Oliver, Angeline Ferdinand, Jessica Kaufman, Peta Edler, Nicole Allard, Margie Danchin, Katherine B. Gibney

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Background: The cohealth Health Concierge program operated in Melbourne, Australia, from July 2020 to 30 June 2022. The program was designed to provide place-based peer-to-peer COVID-19 education and support to culturally and linguistically diverse residents of high-rise public housing estates. During this time, the COVID-19 public health response changed frequently. We conducted a mixed-methods evaluation to determine the program’s impact on residents’ trust, engagement and communication with health services and public health activities. Methods: The RE-AIM model was used to assess program reach, effectiveness, adoption, implementation and maintenance and the evaluation was informed by a Project Reference Group including end-users. Data were collected between March and May 2022 in four estates where the program operated. We surveyed 301 residents, conducted qualitative interviews with 32 stakeholders and analyzed data from 20,901 forms reporting interactions between Health Concierges and residents collected from August 2021 to May 2022. These forms outlined the support provided by Health Concierges during each interaction. Results: Overall, the program was effective in guiding residents to testing and vaccination services and facilitating COVID-19 safe practices. Nearly two-thirds (191; 63.5%) of the 301 surveyed participants reported speaking with a Health Concierge in the previous six months, and some described having meaningful conversations with them. Despite this, many of the interactions residents described having with Health Concierges were superficial. When considering surveyed participants’ responses to the adapted Public Health Disaster Trust Scale, the mean score across all estates was 2.3 (or slightly more than ‘somewhat confident’) in public health authorities’ ability to respond to a localized infectious disease outbreak. While the program was valued during the rapidly changing public health response, many felt it had failed to evolve in the ‘living with COVID’ phase. Some residents expressed frustration with Health Concierges’ having perceived inactive, passive roles - although other residents felt Health Concierges were helpful and appreciated them. A perception that the true impact of Health Concierges’ work was underrecognized was widely voiced by health staff. All 20,901 Interaction Forms identified COVID-19-related supports provided to residents; almost all included provision of facemasks and/or hand sanitiser and 78% identified additional supports that were also provided, most frequently provision of other health information. Conclusions: The program disseminated up-to-date information to a diverse population within a rapidly changing public health setting. Health Concierges were able promote COVID-19-safe behaviours, including vaccine uptake, and link residents with support services. We recommend the program be revised and continued. New programs that draw on the Health Concierge model may be valuable in supporting future pandemic responses and should be considered in preparedness planning.

Keywords: community health, COVID-19 pandemic, infectious diseases, public health, community health workers

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Authors: Elizabeth F. Rodrigues, Julia da R. Mattos, Naira Q. Leitão, Roberta T. da Cunha

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The business strategy of many companies has two factors in common: the search for the competitive edge and its long term maintenance. The thing that differentiates the companies’ performance in their abilities to set the right strategy, which depends on their capacity to analyze and apply all sort of management support tools. In this context, the sponsorship of events stands out as an important way to increase brand awareness, especially when it is a worldwide event, such as Rio 2016 Olympic and Paralympic Games. This paper will present the case of a car maker company, which chose to invest on sponsorship as a way to reach its goals and grow in the brazilian market.

Keywords: strategy, sponsorship, events, management

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Authors: Endah Tri Lestari, Mustafa Mahmud Amin, Elmeida Effendy

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Background: Vitamin D levels with schizophrenia is lower than the control due to lifestyle and physical health factors such as smoking, increases of body mass index, inactivity, and social withdrawal including decreases of sunlight exposure. Asia has the lowest average of vitamin D serum levels and Europe with lighter colored skin has higher serum levels of vitamin D. Indonesia is a tropical region in the area of the equator, and has only two seasons: the rainy season and summer. The Indonesian people are known as a nation that has a diversity of ethnic groups that exist in many areas. Each tribe has differences in living habits. Ethnic diversity, culture, religion, customs, geographical location, this is reflected in our daily lives that will affect the levels of vitamin D in patients with schizophrenic. Individuals with darker skin tend to be deficient in vitamin D and increases the chance of schizophrenia than the general population. Aims: To determine the difference of vitamin D serum by ethnicity between Bataknese and Malayan schizophrenic patient. Methods: This study was an analytical study to recruited 60 subjects of schizophrenic male patient (30 Bataknese and 30 Malayan), aged between 15 to 55 years old, period at May - November 2016, the acute phase with no agitation. Statistical analysis was using T- independent test. Blood sample for vitamin D serum was using ELFA method. Results: The vitamin D serum levels were lower in Bataknese ethnic group schizophrenic patients in highland than Malayan ethnic group in lowland, reaching statistically (22.9±3.33 ng/ml) vs (27.9±4.19 ng/ml) p < 0,001. Conclusion: There are significant differences of vitamin D serum Status by Ethnicity between Bataknese in the Highland and Malayan in the Lowland on Schizophrenic Patient in North Sumatera.

Keywords: schizophrenia, serum vitamin D, ethnicity

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Authors: F.Sadoughi, A. Sarsarshahi, L, Eerfannia, S.M.A. Khatami

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Hospital information systems with lots of ability would lead to health care quality improvement. Evaluation of this system has done according different method and criteria. The main goal of present study is to prioritize the most important factors which are influence these systems evaluation. At the first step, according relevant literature, three main factor and 29 subfactors extracted. Then, study framework was designed. Based on analytical hierarchical process (AHP), 28 paired comparisons with Saaty range, in a questionnaire format obtained. Questionnaires were filled by 10 experts in health information management and medical informatics field. Human factors with weight of 0.55 were ranked as the most important. Organization (0.25) and technology (0.14) were in next place. It seems MADM methods such as AHP have enough potential to use in health research and provide positive opportunities for health domain decision makers.

Keywords: Analytical hierarchy process, Multiple criteria decision-making (MCDM), Hospital information system, Evaluation factors

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Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

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Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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Authors: Orathai Srithongtham, Ubonsri Thabuddha

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The youth with HIV positive is not difference from the general youth in term of sexual needs. Sexual health is crucial the most to support the youth with HIV positive to be sexual well-being. This study aims to elucidate the sexual health on protection from STDs (Sexual Transmitted Diseases) and HIV transmission and to explain sexual risk behavior of the youth with HIV positive. The target group was the youth with HIV positive about 23 cases from two provinces in northeastern part of Thailand. Qualitative method was applied for collecting data by in-depth interview. Content analysis was use for data analysis. The youth with HIV positive was protection from STDs and HIV transmission by using the condom during sexual activity. The reason to deny the condom use were ashamed, condom is not a part of life, no have fit size, and the youth fear to stigmatized as a mental disorder and fear to stigmatized as going to fuck someone. The youth who trust with nurse in clinic was dare to request the condom by face. Sexual activity without condom use is sexual risk behavior. The major causes were couple trust and the sexual enjoyment first and sexual active competition with friend without condom use. The concern on HIV was the boyfriend or girlfriend not accepts the HIV positive people, worry about the HIV transmutation, and finally not compliance to ARV drug. The youth with HIV positive was lacking of the knowledge on sexual health on the issues of access to condom and the concern to keep on relationship with the boyfriend or girlfriend. This concern issues was led to the non-adherence of ARV drug and HIV distribution. To provide the sexual health service is more essential to the youth with HIV positive.

Keywords: sexual health, sexual risk behavior, youth, HIV

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Authors: Itamir de Morais Barroca Filho, Cephas A. S. Barreto, Ramon Malaquias, Cezar Miranda Paula de Souza, Arthur Costa Gorgônio, João C. Xavier-Júnior, Mateus Firmino, Fellipe Matheus Costa Barbosa

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Information and Communication Technologies (ICT) in healthcare are crucial for efficiently delivering medical healthcare services to patients. These ICTs are also known as e-health and comprise technologies such as electronic record systems, telemedicine systems, and personalized devices for diagnosis. The focus of e-health is to improve the quality of health information, strengthen national health systems, and ensure accessible, high-quality health care for all. All the data gathered by these technologies make it possible to help clinical staff with automated decisions using machine learning. In this context, we collected patient data, such as heart rate, oxygen saturation (SpO2), blood pressure, respiration, and others. With this data, we were able to develop machine learning models for patients’ risk of death and estimate the length of stay in ICU beds. Thus, this paper presents the methodology for applying machine learning techniques to develop these models. As a result, although we implemented these models on an IoT healthcare platform, helping clinical staff in healthcare in an ICU, it is essential to create a robust clinical validation process and monitoring of the proposed models.

Keywords: ICT, e-health, machine learning, ICU, healthcare

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Authors: Xiaowen Zhang, Wanda Luen-Wun Siu

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The paper reviews the insights gained in combating COVID-19 in the US, Japan, and China. After evaluation and investigation, we found that China’s and Japan’s experience of fighting COVID-19 is commendable. The Chinese government and the Japanese administration have implemented highly effective governance and public health course of action to fight COVID-19. Government-led epidemic control with a staunch belief in science can roll out effective pandemic control strategies. In contrast, the US failed to react to COVID-19 effectively. The relaxed public health measures of ending shutdowns prematurely were not working. When the US keeps business open after the spring shutdown, COVID-19 cases are soaring. Such experiences inform us effective governance and a mandatory and stricter approach can better curb a pandemic than milder measures in handling a public health emergency. And China and Japan, where collectivistic culture reins, can better maneuver a public health crisis with collective efforts.

Keywords: US, China, Japan, COVID-19

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Authors: Chasity O'Connell

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The use of social media and networking sites play a significant role in the lives of adolescents and adults. While research supports that social support and connectedness in general is beneficial; the nature of communication and interaction through social media and its subsequent benefits and impacts could be arguably different. As such, this research aims to explore a specific facet of social media interaction called fear of missing out, or 'FOMO' and investigate its relationship within the context of life stressors, social media usage, anxiety and depressive-symptoms, mindfulness, and psychological well-being. FOMO is the 'uneasy and sometimes all-consuming feeling that you’re missing out—that your peers are doing, in the know about, or in possession of more or something better than you'. Research suggests that FOMO can influence an individual’s level of engagement with friends and social media consumption, drive decisions on participating in various online or offline activities, and ultimately impact mental health. This study hopes to explore the potentially mitigating influence of mindfulness and values-based interventions in reducing the discomfort and distress that can accompany FOMO and increase the sense of psychological well-being in allowing for a more thoughtful and deliberate engagement in life. This study will include an intervention component wherein participants (comprised of university students and adults in the community) will partake in a six-week, group-based intervention focusing on learning practical mindfulness skills and values-exploration exercises (along with a waitlist control group). In doing so, researchers hope to understand if interventions centered on increasing one’s awareness of the present moment and one’s internal values impact decision-making and well-being with regard to social interaction and relationships.

Keywords: FOMO, mindfulness, values, stress, psychological well-being, intervention, distress

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Authors: Fairuz Fadzilah Rahim

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Introduction: Indigenous adolescents are at higher risk of dog associated zoonotic infections (DAZI) as they live closely with free-roaming dogs and have limited access to veterinary care. This study aims to determine the effectiveness of health education interventions towards knowledge, attitudes, and preventive practices (KAP) of adolescents on DAZI. Methods: This one-group pre-and post-intervention study in 5 months period was conducted among Jahai adolescents aged 12 years and above. Jahai is one of the three major tribes of indigenous people in Peninsular Malaysia. Health education intervention programs using posters, slide presentations, comics, video clips, and discussion on DAZI were employed. Repeated measures of within-subjects analysis were used to identify the pre- and post- KAP of the adolescents. Results: There were 54 adolescents participated in this study with a mean age of 15.72 (SD: 2.49) and equal proportions of males (50%) and females (50%). Among the adolescents, 22.2% were married, 5.6% were illiterate, and 44.4% not continuing education at the time of data collection. The majority of them keep dogs as pets (64.8%), and few used dogs for hunting (11.1%). There was significant increase in mean scores of knowledge (F = 40.92, p < 0.001) and attitudes (F = 6.43, p = 0.014) of the adolescents. However, the preventive practices towards DAZI showed non-significant improvement on the intervention. Conclusions: The health education intervention programs showed to be effective in improving the attitudes and practices related to dog associated zoonotic infections. Emphasis on sustained health education programs is important to foster good health and wellbeing of the indigenous community.

Keywords: adolescent health, dog associated infection, zoonotic, KAP, indigenous

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Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

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The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20^th week of pregnancy up to 12^th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12^th and 24^th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

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