Search results for: women's health

Authors: Dina A. Amu, Fifi N. Afifah, Catur Rosidati, Tirton Nefianto

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Indonesia was shaken up by the avian influenza cases that had caused the country suffered losses of millions of dollars. The avian influenza case had even been suspected as a bioterrorism attack since it was an uncommon case in epidemiology. Furthermore, this avian influenza virus is a high pathogenic one and Indonesia has the highest case of fatality rate in the world. Bioterrorism threats or epidemic potential disease outbreaks currently does not exist in Tanjung Priok port yet. However, the surveillance system enhancement on epidemic potential diseases should be taken as a prevention, especially because Indonesia is currently facing the ASEAN Economic Society (AES). Therefore, this research evaluates the health surveillance system which is organized by Control, Quarantine and Surveillance Department, Health Office of Tanjung Priok Port. This study uses qualitative-evaluative method which utilizes Urgency Seriousness Growth (USG) method to determine priority issues and Root Cause analysis to determine the cause of prior problem. The result of this research shows that the implementation of epidemic potential disease surveillance in Tanjung Priok port has not done in the best possible way. It is because the lack of time allocation and the succinctness of the check list of ship's environmental health inspection. Therefore, Health Ministry of Indonesia should recruit more employees at the health office of Tanjung Priok port, hold a simulation of ship's inspection and simplify the list for ship's environmental health inspection.

Keywords: surveillance, epidemic potential disease, port health, bioterrorism

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Authors: Farshad Kalantari

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Tourism industry has gained a progressive trend within the past years, which affect the cultural exchange among different nations. It is obvious that each country has its own culture, heritage and history, which can be manifested in the population lifestyle and pattern of living. the lifestyle can be considered as an indicator for health status, as the culture may affect way of living, which known as lifestyle and its components, including dietary pattern, physical activity status and other social behaviours. As a result, it seems that each culture can transfer the lifestyle to other societies by international communications. Moreover, different regions and countries may benefit from natural resources, which can be a leading cause for tourist attraction, in the other words, natural resources and culture, can affect the tourist turnover in a region, and as a result, it can be hypothesised that it may affect the exchange of lifestyle including dietary pattern and physical activity. In the positive way, this can make a region to health pole for other nationalities to gain benefit from that culture in order to improve their quality of life and health status. In this paper has aimed to assess the effect of culture and heritage on tourism rate and the effect of natural resources along with cultural lifestyle on public health and international exchange between other regions. It was hypothesised that by using culture in a positive manner, positive aspect of lifestyle, including ancient physical activity patter, can be transfer and exchange with other regions, which can improve health status as a result. Moreover, it was focused on how to design and recruit strategies to improve the way of gaining benefits from resources and lifestyle in order to improve tourism industry and its rate, which may bring beneficial outcomes, including financial, cultural and health outcomes.

Keywords: toursim, health, culture, sport, lifestyle

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Authors: Maneka Marianne Britto, Hansraj Riteesh Bookun

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The ability of a junior doctor to deliver complex multi-disciplinary care to patients in a paradigm of respect and collaboration requires a multitude of interpersonal skills and competencies. A short survey was used to explore the perspective of allied health staff on the desirable attributes of a junior doctor which are conducive to good teamwork. 23 allied health professionals (14 nurses, 4 physiotherapists, 2 dietitians, 1 occupational therapist, 1 speech therapist and 1 audiologist) responded to this 17-item survey. There were 17 females. The mean age of the respondents was 34.9 ± 10.1 years. The salient findings of our survey are that 95% of our respondents rated friendliness and non-clinical small talk with average importance or greater. 45% of them viewed these 2 items as very important or absolutely essential. A single respondent viewed these 2 items with little importance. The other criteria which were rated with high levels of importance were the acknowledgment of allied health suggestions and good ward organizational skills. Training these collaborative skills is challenging, and an enhanced understanding of interprofessional perspectives will help a junior doctor to achieve better clinical outcomes. It is hoped that this paper will further stimulate discussion in this area and will encourage junior doctors to engage in non-clinical conversations with allied health staff in the spirit of promoting effective teamwork.

Keywords: allied health, collaboration, doctor, medicine, surgery

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Authors: S. Karthikeyan, Naveen Bindra

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Introduction: To update ourselves and understand the concept of latest electronic formats available for Health care providers and how it could be used and developed as per standards. The idea is to correlate between the patients Manual Medical Records keeping and maintaining patients Electronic Information in a Health care setup in this world. Furthermore this stands with adapting to the right technology depending upon the organization and improve our quality and quantity of Healthcare providing skills. Objective: The concept and theory is to explain the terms of Electronic Medical Record (EMR), Electronic Health Record (EHR) and Personal Health Record (PHR) and selecting the best technical among the available Electronic sources and software before implementing. It is to guide and make sure the technology used by the end users without any doubts and difficulties. The idea is to evaluate is to admire the uses and barriers of EMR-EHR-PHR. Aim and Scope: The target is to achieve the health care providers like Physicians, Nurses, Therapists, Medical Bill reimbursements, Insurances and Government to assess the patient’s information on easy and systematic manner without diluting the confidentiality of patient’s information. Method: Health Information Technology can be implemented with the help of Organisations providing with legal guidelines and help to stand by the health care provider. The main objective is to select the correct embedded and affordable database management software and generating large-scale data. The parallel need is to know how the latest software available in the market. Conclusion: The question lies here is implementing the Electronic information system with healthcare providers and organisation. The clinicians are the main users of the technology and manage us to ‘go paperless’. The fact is that day today changing technologically is very sound and up to date. Basically the idea is to tell how to store the data electronically safe and secure. All three exemplifies the fact that an electronic format has its own benefit as well as barriers.

Keywords: medical records, digital records, health information, electronic record system

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Authors: Meredith Rossi, Lesley Lee, Mary Wear, Mary Van Baalen, Bradley Rhodes

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The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. A better understanding of the individual, population, and mission impacts of astronaut occupational exposures is critical to providing clinical care, targeting occupational surveillance efforts, and planning for future space exploration. The ability to characterize the risk of latent health conditions is a significant component of this understanding. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA-Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential long-term health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging populations are necessary to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography); and expanded monitoring will increase NASA’s ability to better characterize conditions resulting from astronaut occupational exposures. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of expanding the medical monitoring of former NASA astronauts under the Astronaut Occupational Health program. Increasing the breadth of monitoring services will ultimately enrich the existing evidence base of occupational health risks to astronauts. Such an expansion would therefore improve the understanding of the health of the astronaut population as a whole, and the ability to identify, mitigate, and manage such risks in preparation for deep space exploration missions.

Keywords: astronaut, long-term health, NASA, occupational health, surveillance

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Authors: Wee Tong Liaw, Elaine Wong Yee Sing

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Since 2001, many companies in Singapore have voluntarily participated in the bi-annual Singapore HEALTH Award initiated by the Health Promotion Board of Singapore (HPB). The Singapore HEALTH Award (SHA), is an industry wide award and assessment process. SHA assesses and recognizes employers in Singapore for implementing a comprehensive and sustainable health promotion programme at their workplaces. The rationale for implementing a sustained health promoting workplace and participating in SHA is obvious when company management is convinced that healthier employees, business productivity, and profitability are positively correlated. However, performing research or empirical studies on the impact of a sustained health promoting workplace on stock returns are not likely to yield any interests in the absence of a systematic and independent assessment on the comprehensiveness and sustainability of a health promoting workplace in most developed economies. The principles of diversification and mean-variance efficient portfolio in Modern Portfolio Theory developed by Markowitz (1952) laid the foundation for the works of many financial economists and researchers, and among others, the development of the Capital Asset Pricing Model from the work of Sharpe (1964), Lintner (1965) and Mossin (1966), and the Fama-French Three-Factor Model of Fama and French (1992). This research seeks to support the rationale by studying whether there is a significant relationship or impact of a sustained health promoting workplace on the performance of companies listed on the SGX. The research shall form and test hypotheses pertaining to the impact of a sustained health promoting workplace on company’s performances, including stock returns, of companies that participated in the SHA and companies that did not participate in the SHA. In doing so, the research would be able to determine whether corporate and fund manager should consider the significance of a sustained health promoting workplace as a risk factor to explain the stock returns of companies listed on the SGX. With respect to Singapore’s stock market, this research will test the significance and relevance of a health promoting workplace using the Singapore Health Award as a proxy for non-diversifiable risk factor to explain stock returns. This study will examine the significance of a health promoting workplace on a company’s performance and study its impact on stock price performance and beta and examine if it has higher explanatory power than the traditional single factor asset pricing model CAPM (Capital Asset Pricing Model). To study the significance there are three key questions pertinent to the research study. I) Given a choice, would an investor be better off investing in a listed company with a sustained health promoting workplace i.e. a Singapore Health Award’s recipient? II) The Singapore Health Award has four levels of award starting from Bronze, Silver, Gold to Platinum. Would an investor be indifferent to the level of award when investing in a listed company who is a Singapore Health Award’s recipient? III) Would an asset pricing model combining FAMA-French Three Factor Model and ‘Singapore Health Award’ factor be more accurate than single factor Capital Asset Pricing Model and the Three Factor Model itself?

Keywords: asset pricing model, company's performance, stock prices, sustained health promoting workplace

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Authors: Sadandaula Rose Muheriwa Matemba, Alexander Glazier, Natalie M. LeBlanc

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In the United States, up to 10% of girls and 22 % of boys 10-14 years have had sex, 5% of them had their first sex before 11 years, and the age of first sexual encounter is reported to be 8 years. Over 4,000 adolescent girls, 10-14 years, become pregnant every year, and 2.6% of the abortions in 2019 were among adolescents below 15 years. Despite these negative outcomes, little research has been conducted to understand the sexual health education offered to young adolescents ages 10-14. Early sexual health education is one of the most effective strategies to help lower the rate of early pregnancies, HIV infections, and other sexually transmitted. Such knowledge is necessary to inform best practices for supporting the healthy sexual development of young adolescents and prevent adverse outcomes. This qualitative descriptive study was conducted to explore the community stakeholders’ experiences in sexual health education for young adolescents ages 10-14 and ascertain the young adolescents’ sexual health support needs. Maximum variation purposive sampling was used to recruit a total sample of 13 community stakeholders, including health education teachers, members of youth-based organizations, and Adolescent Clinic providers in Rochester, New York State, in the United States of America from April to June 2022. Data were collected through semi-structured individual in-depth interviews and were analyzed using MAXQDA following a conventional content analysis approach. Triangulation, team analysis, and respondent validation to enhance rigor were also employed to enhance study rigor. The participants were predominantly female (92.3%) and comprised of Caucasians (53.8%), Black/African Americans (38.5%), and Indian-American (7.7%), with ages ranging from 23-59. Four themes emerged: the perceived need for early sexual health education, preferred timing to initiate sexual health conversations, perceived age-appropriate content for young adolescents, and initiating sexual health conversations with young adolescents. The participants described encouraging and concerning experiences. Most participants were concerned that young adolescents are living in a sexually driven environment and are not given the sexual health education they need, even though they are open to learning sexual health materials. There was consensus on the need to initiate sexual health conversations early at 4 years or younger, standardize sexual health education in schools and make age-appropriate sexual health education progressive. These results show that early sexual health education is essential if young adolescents are to delay sexual debut, prevent early pregnancies, and if the goal of ending the HIV epidemic is to be achieved. However, research is needed on a larger scale to understand how best to implement sexual health education among young adolescents and to inform interventions for implementing contextually-relevant sexuality education for this population. These findings call for increased multidisciplinary efforts in promoting early sexual health education for young adolescents.

Keywords: community stakeholders’ perspectives, sexual development, sexual health education, young adolescents

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Authors: Yash Bingi, Yiqiao Yin

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Reduction of child mortality is an ongoing struggle and a commonly used factor in determining progress in the medical field. The under-5 mortality number is around 5 million around the world, with many of the deaths being preventable. In light of this issue, Cardiotocograms (CTGs) have emerged as a leading tool to determine fetal health. By using ultrasound pulses and reading the responses, CTGs help healthcare professionals assess the overall health of the fetus to determine the risk of child mortality. However, interpreting the results of the CTGs is time-consuming and inefficient, especially in underdeveloped areas where an expert obstetrician is hard to come by. Using a support vector machine (SVM) and oversampling, this paper proposed a model that classifies fetal health with an accuracy of 99.59%. To further explain the CTG measurements, an algorithm based on Randomized Input Sampling for Explanation ((RISE) of Black-box Models was created, called Feature Alteration for explanation of Black Box Models (FAB), and compared the findings to Shapley Additive Explanations (SHAP) and Local Interpretable Model Agnostic Explanations (LIME). This allows doctors and medical professionals to classify fetal health with high accuracy and determine which features were most influential in the process.

Keywords: machine learning, fetal health, gradient boosting, support vector machine, Shapley values, local interpretable model agnostic explanations

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Authors: Juliet Sorensen, Megan Schliep

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Introduction: After a multidisciplinary assessment of health and human rights issues in central Mali, a musical album was created in 2014 in Douentza, Mali to provide health information on female genital mutilation/cutting (FGM/C), malaria, HIV/AIDS, girls’ education, breastfeeding, and sanitation. The objective of this study was to assess the impact of this album. Methods: A mixed-methods assessment was conducted with 149 individuals across 10 villages in Douentza Cercle. Analyses focused on the association of radio listening habits, age, sex, ethnicity and education with a public health knowledge score. Results: Over 90% of respondents reported daily radio listening, many listening five or more hours per day. Potential risks of FGM/C cited by participants included death (59%), difficulty in childbirth (48%), sterility (34%), and fistula (33%); when asked about their level of control over FGM/C, 28% stated they would never cut their daughters. Being a listener for 1-5 hours per day was associated with a 11.5% higher score of 'public health knowledge' compared to those listening only a little or not at all (p < 0.01). Education (marginal versus no formal education) was associated with 7.6% increased score (p < 0.01). Conclusion: Radio appears to be a significant part of community members’ daily routines and may be a valuable medium for transmitting information, particularly for lower literacy individuals.

Keywords: female genital cutting, public health and social justice education, radio, Mali

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Authors: K. Masingboon, S. Duangpaeng, N. Chaiwong

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Acute myocardial infarction (AMI) is the most common cause of death among Thai with coronary heart disease (CHD). Thai AMI survivors are most likely to have impaired health-related quality of life (HRQoL) due to their lifestyle, functional, and psychological problems. Guided by the Individual and Family Self-Management Theory, this study aimed to explore HRQoL and identify its predictors among Thai AMI survivors. 155 Thai AMI survivors were recruited by stratified random sampling from three hospitals located in eastern region of Thailand. HRQol was measured using the Short Form -12 Health Survey (SF-12). The Center for Epidemiologic studies Depression Scale (CES-D) was utilized to assess the presence of depression, and the Family Support questionnaire was administered to examine family support. Results revealed that 92 percent of Thai AMI survivors reported a generally high level of HRQoL and 80 percent of them reported higher level of HRQoL in physical health and mental health dimension. Depression and family support were significantly predicted HRQoL among Thai AMI survivors and accounted for 28.5 percent of variance (p < .001). Interestingly, depression was the most significant predictors of HRQoL (β = -.65, p < .001) In conclusion, depression is a significant predictor of HRQoL in Thai AMI survivors. Increasing awareness of depression among these survivors is important. Depressive symptoms in should be routinely assessed. In addition, intervention to improve HRQoL among Thai AMI survivors should be addressed through depressive symptom management and family collaboration.

Keywords: health-related quality of life, AMI survivors, predictors, collaboration

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Authors: Leyla Sattarzadeh, Maghsoud Peeri, Mohammadali Azarbaijani, Hasan Matin Homaee

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Inflammation by various mechanisms may cause atherosclerosis. Systemic circulating inflammatory markers such as C-reactive protein (CRP), pro-inflammatory cytokines such as Interleukin-6 (IL-6) and adhesion molecules like Intracellular Adhesion Molecule-1 (ICAM-1) are the predictors of cardiovascular diseases. Regarding the conflicting results about the effect of resistance exercise training on these inflammatory markers, the present study aimed to examine the effect of eight week different patterns of resistance exercise training on CRP, IL-6 and ICAM-1 levels in healthy untrained women. 40 volunteered and healthy untrained female university students (aged: 21+ 3 yr., Body Mass Index: 21.5+ 3.5 kg/m2) were selected purposefully and divided into three groups. At the end of training protocol and after subjects drop during the protocol in upper body exercise training (n=11), lower body (n=12) completed the eight week of training period although the control group (n=7) did anything. Blood samples gathered pre and post experimental period and CRP, IL-6 and ICAM-1 levels were evaluated using special laboratory kits, then the difference of pre and post values of each indices analyzed using one way Analysis of Variance (α < 0.05). The results of one way ANOVA for difference of pre and post values of CRP and ICAM-1 showed no significant changes due to the exercise training. But there were significant differences between groups about IL-6. Tukey post- hoc test indicated that there is significant difference between the differences of pre and post values of IL-6 between lower body exercise training group and control group, and eight weeks of lower body exercise training lead to significant changes in IL-6 values. There were no changes in anthropometric indices. The findings show that the different patterns of upper and lower body exercise training by involving the different amount of muscles altered the IL-6 values in lower body exercise training group probably because of engaging the bigger amount of muscles, but showed any significant changes about CRP and ICAM-1 probably due to intensity and duration of exercise or the lower levels of these markers at baseline of healthy people.

Keywords: C-reactive protein, interleukin-6, intracellular adhesion molecule-1, resistance training

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

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A settlement strategy is to anticipate and respond the needs of existing and future communities through the provision of primary health care facilities in marginalized areas. Access to a health care network is important to improving healthcare coverage, often lacking, in developing countries. The study explores that a good sanitary system strategy of rural contexts brings advantages to an existing settlement: improving transport, communication, water and social facilities. The objective of this paper is to define a possible methodology to implement primary health care facilities in disadvantaged areas of emerging countries. In this research, we analyze the case study of Lauro de Freitas, a municipality in the Brazilian state of Bahia, part of the Metropolitan Region of Salvador, with an area of 57,662 km² and 194.641 inhabitants. The health localization system in Lauro de Freitas is an integrated process that involves not only geographical aspects, but also a set of factors: population density, epidemiological data, allocation of services, road networks, and more. Data were collected also using semi-structured interviews and questionnaires to the local population. Synthesized data suggest that moving away from the coast where there is the greatest concentration of population and services, a network of primary health care facilities is able to improve the living conditions of small-dispersed communities. Based on the health service needs of populations, we have developed a methodological approach that is particularly useful in rural and remote contexts in emerging countries.

Keywords: healthcare, settlement strategy, urban health, rural

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Authors: Julio Silva, Lia Hasenclever, Gilson G. Silva Jr.

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The aim of this paper is to check possible convergence in health measures (aged-standard rate of morbidity and mortality) for communicable diseases between developed and developing countries, conditional to productive structures features. Understanding the interrelations between health patterns and economic development is particularly important in the context of low- and middle-income countries, where economic development comes along with deep social inequality. Developing countries with less diversified productive structures (measured through complexity index) but high heterogeneous inter-sectorial labor productivity (using as a proxy inter-sectorial coefficient of variation of labor productivity) has on average low health levels in communicable diseases compared to developed countries with high diversified productive structures and low labor market heterogeneity. Structural heterogeneity and productive diversification may have influence on health levels even considering per capita income. We set up a panel data for 139 countries from 1995 to 2015, joining several data about the countries, as economic development, health, and health system coverage, environmental and socioeconomic aspects. This information was obtained from World Bank, International Labour Organization, Atlas of Economic Complexity, United Nation (Development Report) and Institute for Health Metrics and Evaluation Database. Econometric panel models evidence shows that the level of communicable diseases has a positive relationship with structural heterogeneity, even considering other factors as per capita income. On the other hand, the recent process of convergence in terms of communicable diseases have been motivated for other reasons not directly related to productive structure, as health system coverage and environmental aspects. These evidences suggest a joint dynamics between the unequal distribution of communicable diseases and countries' productive structure aspects. These set of evidence are quite important to public policy as meet the health aims in Millennium Development Goals. It also highlights the importance of the process of structural change as fundamental to shift the levels of health in terms of communicable diseases and can contribute to the debate between the relation of economic development and health patterns changes.

Keywords: economic development, inequality, population health, structural change

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Authors: Adekunle Kolawole Ojo, Idowu Peter Adebayo, Egwuche Sylvester O.

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Chronic Kidney Disease (CKD) is a significant cause of morbidity and mortality across developed and developing nations and is associated with increased risk. There are no existing electronic means of capturing and monitoring CKD in Nigeria. The work is aimed at developing a spatial data model that can be used to implement renal registries required for tracking and monitoring the spatial distribution of renal diseases by public health officers and patients. In this study, we have developed a spatial data model for a functional renal registry.

Keywords: renal registry, health informatics, chronic kidney disease, interface

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Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

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Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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Authors: Liaquat Ali, Khurshid Natasha

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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

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Authors: Iris W. A. Boot, Anke Wesselius, Maurice P. Zeegers

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Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus , thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk. Individual dietary data were pooled from three cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose–response relationships (Model 1) were examined using a nonparametric test for trend. In total, 2,871 cases and 522,364 non-cases were included in the analyses. The present study showed an overall increased BC risk for high dietary vitamin D intake (HR: 1.14, 95% CI: 1.03-1.26). A similar increase BC risk with high vitamin D intake was observed among women and for the non-muscle invasive BC subtype, (HR: 1.41, 95% CI: 1.15-1.72, HR: 1.13, 95% CI: 1.01-1.27, respectively). High calcium intake decreased the BC risk among women (HR: 0.81, 95% CI: 0.67-0.97). A combined inverse effect on BC risk was observed for low vitamin D intake and high calcium intake (HR: 0.67, 95% CI: 0.48-0.93), while a positive effect was observed for high vitamin D intake in combination with low, moderate and high phosphorus (HR: 1.31, 95% CI: 1.09-1.59, HR: 1.17, 95% CI: 1.01-1.36, HR: 1.16, 95% CI: 1.03-1.31, respectively). Combining all nutrients showed a decreased BC risk for low vitamin D intake, high calcium and moderate phosphor intake (HR: 0.37, 95% CI: 0.18-0.75), and an increased BC risk for moderate intake of all the nutrients (HR: 1.18, 95% CI: 1.02-1.38), for high vitamin D and low calcium and phosphor intake (HR: 1.28, 95% CI: 1.01-1.62), and for moderate vitamin D and calcium and high phosphorus intake (HR: 1.27, 95% CI: 1.01-1.59). No significant dose-response analyses were observed. The findings of this study show an increased BC risk for high dietary vitamin D intake and a decreased risk for high calcium intake. Besides, the study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Keywords: bladder cancer, nutritional oncology, pooled cohort analysis, vitamin D

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Authors: Lin Fu-Gong

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Background: As WHO announced, people with intellectual disability (ID) were vulnerable to mental health problems. And there were few custom-made mental health scales for those people to monitor their mental health. Those people with mental problems often accompanied worse prognosis and usually became to be a heavier burden on the caregivers. Purpose: In this study, we intend to develop a psychopathy scale as a practical tool for monitoring the mental health for people with ID living in institute. Methods: In this study, we adopt the Psychopathology Inventory for Mentally Retarded Adults developed by professor Matson with certified reliability and validity in Western countries with Dr. Matson’s agreement in advance. We first translated the inventory into Chinese validated version considering the domestic culture background in the past year. And the validity and reliability evaluation of mental health status using this inventory among the people with intellectual living in the institute were done. Results: The inventory includes eight psychiatric disorder scales as schizophrenic, affective, psychosexual, adjustment, anxiety, somatoform, personality disorders and inappropriate mental adjustment. Around 83% of 40 invested people, who randomly selected from the institute, were found to have at least one disorder who were recommended with medical help by two evaluators. Among the residents examined, somatoform disorder and inappropriate mental adjustment were most popular with 60% and 78% people respectively. Conclusion: The result showed the prevalence psychiatric disorders were relatively high among people with ID in institute and the mental problems need to be further cared and followed for their mental health. The results showed that the psychopathology inventory was a useful tool for institute caregiver, manager and for long-term care policy to the government. In the coming stage, we plan to extend the use of the valid Chinese version inventory among more different type institutes for people with ID to establish their dynamic mental health status including medical need, relapse and rehabilitation to promote their mental health.

Keywords: intellectual disability, psychiatric disorder, psychopathology inventory, mental health, the institute

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Authors: Anvi Kumar

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This paper explores the attitudes and awareness of multiple generations ranging from Boomers I to GenZ (i.e. from 1954 to 2012) towards mental health issues. A convenient sample of 191 people was gathered in India aged 11-77. 20 people each were considered from 5 generational cohorts, namely- Boomers I, Boomers II, Gen X, Millennials, and Gen Z. The study tool comprised a survey that included demographic questions and the Community Attitude towards Mental Illness (CAMI) scale by Taylor & Dear (1981). Descriptive statistics, ANOVA, and Bonferonni’s post-hoc analysis have been used to perform the analysis. The findings reveal that the level of kindness towards those who struggle with mental health varies through certain age groups. An overall sense of exclusion of those struggling with mental health is prevalent among all age groups. GenZ’s awareness of mental health issues is primarily via social media, as against the rest of the generations seeking it from close relatives and friends. The study’s findings suggest a need to investigate further the quality of mental health knowledge content and its consumption pattern. Understanding the dynamics of information sharing and the potential for biases requires further discovery.

Keywords: attitude, behaviour, mental illness, Gen Z, millennials, Gen Y, multi-generations, generational differences

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Authors: Chisom N. Nwaigwe, Blessing N. Egbulefu, Angela Uwakwem

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A study on Stress and its’ effect on the health of workers in Federal Medical Centres in Nigeria is presented. The aim is to evaluate how much stress related hazards health workers in our tertiary health institutions are exposed to and to create awareness and reduce the rate at which stress affect the health of the working population in Nigeria, using workers in Federal Medical Centre, Umuahia as a case study. The descriptive survey design was adopted with the aid of 100 questionnaires delivered to the respondents in order to obtain first-hand information. From the findings, the major causes of stress were identified as inadequate staffing, unresolved family problems and psychological/cultural factors like the return of a lactating mother to work after three months post-delivery. The effects of stress on the workers were identified as hypertension, poor job performances, depression, asthma, and peptic ulcers. The study recommended instituting counseling units for stress management, holding seminars on stress management and increasing the salary scale (remuneration) and proper roster planning as solutions to stress reduction in our hospitals. This study is important to management in planning staffing, roaster, and a rehabilitation programme for her staff.

Keywords: stress, causes, effects, workers

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Authors: Yasser Sanad, Thu Trang Dao

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Introduction: Implementing the One Health (OH) approach requires an integrated, interdisciplinary, and cross-sectoral methodology. OH is a key tool for developing and implementing programs and projects and includes developing ambitious policies that consider the common needs and benefits of human, animal, plant, and ecosystem health. OH helps humanity readjust its path to environmentally friendly and impartial sustainability. As co-leader of the Global Health Security Agenda’s Zoonotic Disease Action Package, Vietnam pioneered a strong OH approach to effectively address early waves of the COVID-19 outbreak in-country. Context and Aim: The repeated surges in COVID-19 in Vietnam challenged the capabilities of the national system and disclosed the gaps in multi-sectoral coordination and resilience. To address this, FHI 360 advocated for the standardization of the OH platform by government actors to increase the resiliency of the system during and post COVID-19. Methods: FHI 360 coordinated technical resources to develop and implement evidence-based OH policies, promoting high-level policy dialogue between the Ministries of Health, Agriculture, and the Environment, and policy research to inform developed policies and frameworks. Through discussions, an OH-building Partnership (OHP) was formed, linking climate change, the environment, and human and animal health. Findings: The OHP Framework created a favorable policy environment within and between sectors, as well as between governments and international health security partners. It also promoted strategic dialogue, resource mobilization, policy advocacy, and integration of international systems with National Steering Committees to ensure accountability and emphasize national ownership. Innovative contribution to policy, practice and/or research: OHP was an effective evidence-based research-to-policy platform linking to the National One Health Strategic Plan (2021-2025). Collectively they serve as a national framework for the implementation and monitoring of OH activities. Through the adoption of policies and plans, the risk of zoonotic pathogens, environmental agent spillover, and antimicrobial resistance can be minimized through strengthening multi-sectoral OH collaboration for health security.

Keywords: one health, national policies, health security, COVID-19, Vietnam

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Authors: Nureni A. Yekini, Isaac T. Babalola, Edwin E. Aighokhan, Agnes K. Akinwole, N. Stephen Igwe

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Survey was conducted to gather information on potential adverse health effects of Mobile Phones, and Telecommunication Tower Base Stations in Nigeria. Data was sourced from two sampled populations. Firstly from the people living in close proximity to base stations, and secondly from cell phone users. Questionnaire was used to gathered information from 574 people on thirteen non-specific health symptoms. Data obtained was presented and analyzed. The analysis shows that people living close to the based stations over a long period of time with or without cell phone, and also the heavy phone users with close proximity to the base stations are liable to have some potential health hazards, such as fatigue, sleep disturbances, headaches, feeling of discomfort, difficulty in concentrating, depression, memory loss, visual disruptions, irritability, hearing disruptions, skin problems, cardiovascular disorders, and dizziness.

Keywords: health hazards, wireless base stations, phone users, mobile phones, Nigeria

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Authors: Muhammad Fawad

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Monitoring and structural health assessment are the primary requirements for the performance evaluation of damaged bridges. This paper highlights the case study of a damaged Reinforced Concrete (RC) bridge structure where the Finite element (FE) modelling of this structure was done using the material properties extracted by the in-situ testing. Analysis was carried out to evaluate the bridge damage. On the basis of FE analysis results, this study proposes a proper Structural Health Monitoring (SHM) system that will extend the life cycle of the bridge with minimal repair costs and reduced risk of failure. This system is based on the installation of three different types of sensors: Liquid Levelling sensors (LLS) for measurement of vertical displacement, Distributed Fiber Optic Sensors (DFOS) for crack monitoring, and Weigh in Motion (WIM) devices for monitoring of moving loads on the bridge.

Keywords: bridges, reinforced concrete, finite element method, structural health monitoring, sensors

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Authors: E. Knisel, H. Rupprich, A. Heissel

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Health Literacy is defined as the degree to which people have the capacity to obtain and understand information to make health decisions. Illustrated are three levels of health literacy: (1) Functional literacy refers to the transmission of information about e. g. physical activity and nutrition; (2) interactive literacy implies the development of personal and social skills to adopt health-related behaviour and (3) critical health literacy indicates advanced cognitive skills connected with personal empowerment to critically analyse health information, to define self-determined goals and taking action in various situations accordingly. The achievement of the third level refers to self-determination and autonomy which should be outcomes of exercise programs for overweight children as health-related behaviour change will occur and persist if it is autonomously motivated. Method: We adopted a quasi-experimental design with group (autonomy supportive coaching, control) and session (pre-test, intervention, post-test, and follow-up-test). Overweight and obese children and adolescents at the age of 8-14 years (N=40) received a 6-month (20 sessions) exercise program with autonomy supportive coaching implemented by the coaches and sandwiched between pre-test and post-test. All participants (N=92) completed the German version of the Basic Needs Satisfaction Scale Sport and Exercise. Additionally, we assessed the engagement in the exercise program by the MVPA (Moderate-to-Vigorous Physical Activity) and by the adherence and drop-out-rate. Results: Participants in the intervention group perceived their autonomy as moderate in the post-test and the follow-up-test. However, the psychological intervention failed to develop a high autonomy, as both groups show moderate perceived autonomy from the pre-test to the post-test. Participants in the intervention group were higher engaged in MVPA in the exercise program and they attend the program more regularly. Discussion: Young overweight and obese children and adolescents can acquire autonomy using autonomy supporting coaching. However, research identifying the extent they achieve critical health literacy is required to implement an autonomy-supportive coaching style into exercise programs for this target group.

Keywords: autonomy support, coaching, health literacy, health promotion

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Authors: Ming Ma, Zhenyu Cai, Rui Li

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People are more vulnerable to health problems than ever before, such as overweight and obesity due to the change of built environment. In the high-rise buildings, the core-tube layout is closely associated with user’s physical activities which will affect human’s health in a long-term. As for the white-collars who spends the amount of time working in the office tower, using staircase seems to provide an opportunity for them to increase the physical activities in the workplaces. This paper is aiming to find out the specific relationship between health and core-tube in the office tower through analyzing the correlation between staircase’s layout and user’s health. The variables of staircase’s layout are consisted of two indicators: plan layout and space design, including nine factors while health variable is applying BIM as the only main factor. 14 office towers in downtown Shanghai are selected as the research samples because of its typical users’ pattern and similar core-tube layout. In the result, it is obvious that the users from these 14 cases have higher BMI than average partly because that the staircases are mainly designed for emergency and fire instead of daily use. After the regression and correlation analysis of the variables of health and staircases, it’s found that users’ BMI is significantly associated with the factors of floor guide-signs and distance from lobby to the staircase. In addition, the factors of comfort level of staircase such as width and daylighting have a certain correlation with users’ BMI.

Keywords: office tower, staircase, design, obesity, physical activity

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: data integrity, data integrity challenges, hospital information systems, South Africa

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Authors: Jie Li, Nick Manning

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The mass rural-urban migrants in China associated with the urbanization processes bear significant implications on public health, which is an important yet under-researched area. Urban social and built environment, such as noise, air pollution, high population density, and social segregation, has the potential to contribute to mental illness. In China, rural-urban migrants are also faced with institutional discrimination tied to the hukou (household registration) system, through which they are denied of full citizenship to basic social welfare and services, which may elevate the stress of urban living and exacerbate the risks to mental illness. This paper aims to link the sociospatial exclusion, everyday life experiences and its mental health consequences on rural to urban migrants living in the mega-city of Shanghai. More specifically, it asks what the daily experience of being a migrant in Shanghai is actually like, particularly regarding sources of stress from housing, displacement, service accessibility, and cultural conflict, and whether these stresses affect mental health? Secondary data from literature review on migration, urban studies, and epidemiology research, as well as primary data from preliminary field trip observations and interviews are used in the analysis.

Keywords: migration, urbanisation, mental health, China

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Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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Authors: Felipa de Mello-Sampayo

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The aim of this study is to undertake, from patient’s perspective, the timing and probability of using teledermatology, comparing it with a conventional referral system. The dynamic stochastic model’s main value-added consists of the concrete application to patients waiting for dermatology surgical intervention. Patients with low health level uncertainty must use teledermatology treatment as soon as possible, which is precisely when the teledermatology is least valuable. The results of the model were then tested empirically with the teledermatology network covering the area served by the Hospital Garcia da Horta, Portugal, links the primary care centers of 24 health districts with the hospital’s dermatology department via the corporate intranet of the Portuguese healthcare system. Health level volatility can be understood as the hazard of developing skin cancer and the trend of health level as the bias of developing skin lesions. The results of the survival analysis suggest that the theoretical model can explain the use of teledermatology. It depends negatively on the volatility of patients' health, and positively on the trend of health, i.e., the lower the risk of developing skin cancer and the younger the patients, the more presurgical teledermatology one expects to occur. Presurgical teledermatology also depends positively on out-of-pocket expenses and negatively on the opportunity costs of teledermatology, i.e., the lower the benefit missed by using teledermatology, the more presurgical teledermatology one expects to occur.

Keywords: teledermatology, wait time, uncertainty, opportunity cost, survival analysis

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Authors: Wipakon Sonsnam, Kanya Napapongsa

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The quantitative aim of the study; 1) health conditions, to examine the state of health of the aging, 2) perceived of self-efficacy, self-care of aging ,3) perceived of social support of the aging, 4) to examine factors associated with self-efficacy in enhancing the health and self-care when illness. 100 samples selected from communities in Dusit, Bangkok, 2014 by random sampling. The questionnaires were used to collect data have 5-point rating scale, consisting of strongly agree, agree, undecided, disagree, and strongly disagree; approved content valid by 3 experts, reliability coefficients alpha was .784 for perceived of self-efficacy, self-care of aging and .827 for perceived of social support of the aging. ST-5, 2Q used for collect mental health. The ability to engage in a daily routine was collected by Barthel ADL index. Founding, the sample group were female (68%). (33%) of them were in the age of 60-65. Most of them were married and still live with their spouse (55%) and do not work (38%). The average annual income was less than 10,000 baht supported by child. Most people think that income was adequate (49.0%) and Satisfaction (61.0%). Most of aging caring them-self, followed by them spouse (26%). Welfare of the public had supported, living for the aging (100%), followed by Join and health volunteers in communities (23%). In terms of health, (53%) of the sample group feels health was fair, hypertension was the most common health condition among sample group (68%), following by diabetes (55%). About eyesight, (42%) have visual acuity. (59.0%) do not need hearing aids. 84% have more than 20 teeth remaining, and have no problem with chewing (61%). In terms of Ability to engage in a daily routine, most of people (84%) in sample group are in type 1. (91%) of the participants don’t have bladder incontinence. For mental condition, (82%) do not have insomnia. (87%) do not have anxiety. (96%) do not have depression. However, (77%) of the sample group is facing stress. In terms of environment in home, bathroom in the home (90.0%) and floor of bathroom was slippery (91.0%). (48%) of the sample group has the skills of how to look after themselves while being sick, and how to keep up healthy lifestyle. Besides, some other factors, such as gender, age and educational background are related to the health perception. The statistical significance was <0.05. Suggestion: The instruments available to national standards such as ST-5, 2Q and Barthel ADL index. Reliability coefficients alpha was .784 for perceived of self-efficacy, self-care of aging and .827 for perceived of social support of the aging. The instrument used to collect perceived of social support must be further developed to study level of influence of social support that affect the health of elderly.

Keywords: ้health status, perception of aging, self-efficacy, social support

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