Search results for: Gordon's 11 functional health patterns

Authors: Sarah P. Wuebbolt, Ashlee N. Sawyer-Mays

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Non-medical prescription and other drug (NMPOD) use has been a significant public health issue for the last few decades, with problematic use increasing among university students more recently. The current study focused on associations between NMPOD use and mental health, well-being, and world beliefs among young adults. Young adults (N=513) completed online questionnaires assessing stress, demographic characteristics, self-esteem, NMPOD use, coping mechanisms, and anxiety. A substantial portion of participants reported using cannabis (48.5%, n=249), while smaller portions of participants reported using stimulants (26.7%, n = 137), sedatives (17.2%, n=88), opioids (10.8%, n=55), and hallucinogens (14.4%, n=74). Five hierarchical logistic regressions were performed to determine the independent relationships between mental health, well-being, and world belief factors and NMPOD use for the five classes of substances. After controlling for demographic factors (age, gender, race/ethnicity, sexual orientation, and religious affiliation), depression was associated with increased non-medical stimulant, opioid, and cannabis use; coping self-efficacy was associated with increased hallucinogen use, and attendance of worship services was associated with decreased non-medical cannabis and hallucinogen use. Results suggest that depression was strongly associated with non-medical stimulant, opioid, and cannabis use, and attendance of worship services was protective against cannabis and hallucinogen use. To the best of our knowledge, this is one of the first studies to investigate the relationships between mental health, well-being, world beliefs, and NMPOD use among young adults. The present study illuminates future targets for intervention, such as increased access to mental health diagnosis and treatment and the exploration of the roles of religion and shared community in the prevention of drug use among young adults.

Keywords: cannabis, mental health, non-medical prescription and other drug use, world beliefs

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Authors: Schröde C., Rodriguez D., Sánchez A., Abdul Malak, Churchill J., Boksmati T., Alharbi, Alsulmi H., Maghrabi S., Mowalad, Mutwalli R., Abualnaja Y.

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Formulating a strategy for sustainable development of the Kingdom of Saudi Arabia’s coastal and marine environment is at the core of the “Marine and Coastal Protection Assessment Study for the Kingdom of Saudi Arabia Coastline (MCEP)”; that was set up in the context of the Vision 2030 by the Saudi Arabian government and aimed at providing a first comprehensive ‘Status Quo Assessment’ of the Kingdom’s marine environment to inform a sustainable development strategy and serve as a baseline assessment for future monitoring activities. This baseline assessment relied on scientific evidence of the drivers, pressures and their impact on the environments of the Red Sea and Arabian Gulf. A key element of the assessment was the cumulative pressure hotspot analysis developed for both national waters of the Kingdom following the principles of the Driver-Pressure-State-Impact-Response (DPSIR) framework and using the cumulative pressure and impact assessment methodology. The ultimate goals of the analysis were to map and assess the main hotspots of environmental pressures, and identify priority areas for further field surveillance and for urgent management actions. The study identified maritime transport, fisheries, aquaculture, oil, gas, energy, coastal industry, coastal and maritime tourism, and urban development as the main drivers of pollution in the Saudi Arabian marine waters. For each of these drivers, pressure indicators were defined to spatially assess the potential influence of the drivers on the coastal and marine environment. A list of hotspots of 90 locations could be identified based on the assessment. Spatially grouped the list could be reduced to come up with of 10 hotspot areas, two in the Arabian Gulf, 8 in the Red Sea. The hotspot mapping revealed clear spatial patterns of drivers, pressures and hotspots within the marine environment of waters under KSA’s maritime jurisdiction in the Red Sea and Arabian Gulf. The cascading assessment approach based on the DPSIR framework ensured that the root causes of the hotspot patterns, i.e. the human activities and other drivers, can be identified. The adapted CPIA methodology allowed for the combination of the available data to spatially assess the cumulative pressure in a consistent manner, and to identify the most critical hotspots by determining the overlap of cumulative pressure with areas of sensitive biodiversity. Further improvements are expected by enhancing the data sources of drivers and pressure indicators, fine-tuning the decay factors and distances of the pressure indicators, as well as including trans-boundary pressures across the regional seas.

Keywords: Arabian Gulf, DPSIR, hotspot, red sea

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Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

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Authors: Andreas Walmsley, Shobana Partington, Rebecca Armstrong, Harold Goodwin

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In the UK, more than 1 in 5 workers earn less than a living wage. The hospitality sector is particularly affected where it has been claimed two thirds of workers earn less than the living wage. The UK Government is set to introduce (April 2016) a national living wage (NLW) which is therefore likely to have a significant impact on the hospitality sector. To date limited data exists that focus on how hotels are tackling the issue, what stakeholder perceptions are towards the change in legislation, and how the NLW may affect working patterns in the sector. This study draws on interviews with a range of key stakeholders such as hotel HR and general managers as well as industry representatives to explore these issues within the broader context of responsible tourism. Data collection is still ongoing and is scheduled to be completed by the end of June 2016.

Keywords: hospitality, living wage, responsible tourism, tourism employment

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Authors: Charles Mazhazhate

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This study interrogates and analyses the intricate kin- and- kith network patterns of corruption and mismanagement of resources prevalent in public sector supply chains bedeviling the developing economies of Sub-Saharan Africa with particular reference to Zimbabwe. This is forcing governments to resort to harsh fiscal policies that see their citizens paying high taxes against a backdrop of incomes below the poverty datum line, and this negatively affects their quality of life. The corporate world is also affected by the various tax-regime instituted. Mismanagement of resources and corrupt practices are rampant in state-owned enterprises to the extent that institutional policies, procedures, and practices are often flouted for the benefit of a clique of individuals. This interwoven in kith and kin blood human relations in organizations where appointments to critical positions are based on ascribed status. People no longer place value in their systems to make them work thereby violating corporate governance principles. Greediness and ‘unholy friendship connections’ are instrumental in fueling the employment of people who know each other from their discrete backgrounds. Such employments or socio-metric unions are meant to protect those at the top by giving them intelligent information through spying on what other subordinates are doing inside and outside the organization. This practice has led to the underperforming of organizations as those employees with connections and their upper echelons favorites connive to abuse resources for their own benefit. Even if culprits are known, no draconian measures are employed as a deterrence measure. Public value along public sector supply chains is lost. The study used a descriptive case study research design on fifty organizations in Zimbabwe mainly state-owned enterprises. Both qualitative and quantitative instrumentations were used. Both Snowball and random sampling techniques were used. The study found out that in all the fifty SOEs, there were employees in key positions related to top management, with tentacles feeding into the law enforcement agents, judiciary, security systems, and the executive. Such employees in public seem not to know each other with but would be involved in dirty scams and then share the proceeds with top people behind the scenes. The study also established that the same employees do not have the necessary competencies, qualifications, abilities, and capabilities to be in those positions. This culture is now strong that it is difficult to bust. The study recommends recruitment of all employees through an independent employment bureau to ensure strategic fit.

Keywords: corruption, state owned enterprises, strategic fit, public sector supply chains, efficiency

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Authors: Toslim Uddin Khan, Jesmin Akter, Mohiuddin Ahmed

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Menstrual hygiene management (MHM) and personal health-care practice is a critical issue to prevent morbidity and other reproductive health complications among adolescent girls in Bangladesh. Inadequate access to water, sanitation and hygiene (WASH) facilities lead to unhealthy MHM practices that resulted in poor reproductive health outcomes. It is evident from different studies that superstitions and misconception are more common in rural communities that limit young girls’ access to and understanding of the menstrual hygiene and self care practices. The state-of-the-art approach of Social Marketing Company (SMC) is proved to be instrumental in delivering reinforcing health messages, making public health and hygiene products available at the door steps of the community through community mobilization programs in rural Bangladesh. School health program is one of the flagship interventions of SMC to equip adolescent girls and boys with correct knowledge of health and hygiene practices among themselves, their families and peers. In Bangladeshi culture, adolescent girls often feel shy to ask fathers or male family members about buying sanitary napkin from local pharmacy and they seem to be reluctant to seek help regarding their menstrual problems. A recent study reveals that 48% adolescent girls are using sanitary napkins while majority of them are unaware of menstrual hygiene practices in Bangladesh. Under school adolescent program, SMC organizes health education sessions for adolescent girls from grade seven to ten using enter-educate approach with special focus on sexual and reproductive health and menstrual hygiene issues including delaying marriage and first pregnancy. In addition, 2500 rural women entrepreneurs branded as community sales agents are also involved in disseminating health messages and selling priority health products including sanitary napkin at the household level. These women entrepreneurs are serving as a source of sustainable supply of the sanitary napkins for the rural adolescent girls and thereby they are earning profit margins on the sales they make. A recent study on the impact of adolescent program activities reveals that majority (71%) of the school adolescent girls are currently using sanitary napkins. Health education equips and empowers adolescent girls with accurate knowledge about menstrual hygiene practices and self-care as well. Therefore, engagement of female entrepreneurs in school adolescent health program at the community level is one of the promising ways to improve menstrual hygiene practices leading to increased use of sanitary napkin in rural and semi-rural communities in Bangladesh.

Keywords: school adolescent program, social marketing, women entrepreneurs, menstrual hygiene management

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Authors: María Luisa Gonzalez-SanJose, Javier Garcia-Lomillo, Raquel Del Pino, Miriam Ortega-Heras, Maria Dolores Rivero-Perez, Pilar Muñiz-Rodriguez

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One of the most preoccupant problems related to the diet of the occidental societies is the high salt intake. In Spain, salt intake is almost twice as recommended by the World Health Organization (WHO). A lot of negative health effects of high sodium intake have been described being the hypertension, cardiovascular and coronary diseases ones of the most important. Due to this fact, government and other institutions are working on the gradual reduction of this consumption. Intake of meat products have been described as the main processed products that bring salt to the diet, followed by snacks and savory crackers. However, fortunately, the food industry has also raised awareness of this problem and is working intensely, and in recent years attempts to reduce the salt content in processed products, and is developing special lines with low sodium content. It is important to consider that processed food are the main source of sodium in occidental countries. One of the possible strategies to reduce the salt content in food is to find substitutes that can emulate their taste properties without adding much sodium or products that mask or substitute salty sensations with other flavors and aromas. In this sense, multiple products have been proposed and used until now. Potassium salts produce similar salty sensations without bring sodium, however their intake should be also limited, by healthy reasons. Furthermore, some potassium salts shows some better notes. Other alternatives are the use of flavor enhancers, spices, aromatic herbs, sea-plant derivate products, etc. The wine pomace is rich in potassium salts, content organic acid and other flavored substances, therefore it could be an interesting raw material to obtain derived products that could be useful as alternative ‘seasonings’. Considering previous comments, the main aim of this study was to evaluate the possible use of a natural seasoning, made from red wine pomace, in two different foods, crackers and burgers. The seasoning was made in the pilot plant of food technology of the University of Burgos, where the studied crackers and patties were also made. Different members of the University, students, docent and administrative personal, taste the products, and a trained panel evaluated salty intensity. The seasoning in addition to potassium contain significant levels of dietary fiber and phenolic compounds, which also makes it interesting as a functional ingredient. Both burgers and crackers made with the seasoning showed better taste that those without salt. Obviously, they showed lower sodium content than normal formulation, and were richer in potassium, antioxidant and fiber. Then, they showed lower values of the relation Na/K. All these facts are correlated with more ‘healthy’ products especially to that people with hypertension and other coronary dysfunctions.

Keywords: healthy foods, low salt, seasoning, wine pomace

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Authors: Khorief Ouissem, Sassi Boudmagh Souad, Mahimoud Aissa

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The health and safety problem in the construction companies has been a major subject of research in Algeria for many years. The latest statistics of the Algerian National Social Security Fund (CNAS) shows that a third of accidents recorded at the national level are originated from construction activities. It is becoming increasingly essential and urgent to investigate and address its causes in order to find measures to overcome the deficiencies in this area. Thus, this paper takes in investigating this problem through a study conducted in the city of Skikda, Algeria. The study was carried out through questionnaire where twenty construction companies were taking into consideration. First, the study identifies the regulations and the laws related to the health and safety in the construction sector in Algeria. Then it goes on to assess and evaluate the implementation of the identified regulations in the companies selected. The result of the assessment indicates that the majority of the construction companies considered do not meet the health and safety standards and regulations. To extract the main causes of the failure of the system to control this industry, the observations and the evaluation were analyzed using the 5M or Ichikawa diagram method. This method is based on identifying the causes of the problem in terms of purpose, the list of potential causes for families. These families often correspond to 5M (Labor, Material, Methods, Middle, and Management). Finally, having identified the primary motives, the present authors propose a list of actions to move towards a more controlled and effective health and safety system for the construction industry.

Keywords: health and safety, construction industry, performance measurement, Algeria

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Authors: Sharanya C. H., Pragathi M., Vathsala R. S., Theja K. V., Yashaswini S.

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Identifying counterfeit products have become increasingly important in the product manufacturing industries in recent decades. This current ongoing product issue of counterfeiting has an impact on company sales and profits. To address the aforementioned issue, a functional blockchain technology was implemented, which effectively prevents the product from being counterfeited. By utilizing the blockchain technology, consumers are no longer required to rely on third parties to determine the authenticity of the product being purchased. Blockchain is a distributed database that stores data records known as blocks and several databases known as chains across various networks. Counterfeit products are identified using a QR code reader, and the product's QR code is linked to the blockchain management system. It compares the unique code obtained from the customer to the stored unique code to determine whether or not the product is original.

Keywords: blockchain, ethereum, QR code

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Authors: Amir Razmjou, Elika Karbassi Yazdi

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Several direct lithium extraction (DLE) technologies have been developed for Li extraction from different brines. Although laboratory studies showed that they can technically recover Li to 90%, challenges still remain in developing a sustainable process that can serve as a foundation for the lithium dependent low-carbon economy. There is a continuing quest for DLE technologies that do not need extensive pre-treatments, fewer materials, and have simplified extraction processes with high Li selectivity. Here, an overview of DLE technologies will be provided with an emphasis on the basic principles of the materials’ design for the development of membranes with nanochannels and nanopores with Li ion selectivity. We have used a variety of building blocks such as nano-clay, organic frameworks, Graphene/oxide, MXene, etc., to fabricate the membranes. Molecular dynamic simulation (MD) and density functional theory (DFT) were used to reveal new mechanisms by which high Li selectivity was obtained.

Keywords: lithium recovery, membrane, lithium selectivity, decarbonization

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Authors: David R. LaVetter, Justin B. Homatas, Claudia Benavides Espinoza

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An increased awareness of depression rates among collegiate athletes has aided educational institutions to evaluate their mental health resources for athletes. This paper adds to our knowledge of this growing problem among collegiate athletes. National athletic associations and educational institutions are more knowledgeable of the mental health crisis facing hundreds of thousands of athletes each year, and some have implemented resources to improve mental health. However, college athletes continue to experience depressive symptoms at increasing rates. In this paper, depression rates for the vast numbers of collegiate athletes were found to be significantly greater than the general adult population. This paper used the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) method to examine the literature’s findings on depression rates among collegiate athletes. Particularly, this study answers questions related to risk factors of college athletes’ depressive symptoms. Risk factors unique to this population are also discussed. Prevalence rates by sport participant gender and sport are provided. Implementation measures in current practice at educational institutions in the U.S. are discussed to help alleviate depression rates among college athletes.

Keywords: college athletes, depression, risk factors, mental health

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Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

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Authors: Yusra Yahya

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In this paper, a new spell-out mechanism is developed and defended. This mechanism builds on the role of phase heads as both the loci of spell-out features and the transfer triggers via either Phase Impenetrability Condition 1 (PIC1) and/or Phase Impenetrability Condition 2 (PIC2). The assumption here is that phase heads, mainly v*, can regulate the spell-out process by deciding both the type of spell-out applying and the timing of spell-out relevant. This paper also proposes a new form of the constraint Wrap call it Wrap-XP’ and it is assumed to apply to IP as a functional maximal projection. This extension is shown to fall as a natural result once we assume the new theory of phases and multiple spell-out. Moreover, it is proposed in this work that some forms of XP movement are not motivated by an EPP feature of a strong phase head mainly v*, but they are rather motivated by a last resort strategy to accomplish the spell-out instruction of this phase head.

Keywords: linguistics, syntax, phonology, phase theory, optimality theory

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Authors: Prosper Tafadzwa Denhere, Ephias Ruhode, Munyaradzi Zhou

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Health Information Systems (HISs) interoperability is emerging to be the future of modern healthcare systems Enterprise Architecture (EA), where healthcare entities are seamlessly interconnected to share healthcare data. The reality that the healthcare industry has been characterised by an influx of fragmented stand-alone e-Health systems, which present challenges of healthcare information sharing across platforms, desires much attention for systems integration efforts. The lack of an EA conceptual framework resultantly crates the need for investigating an ideal solution to the objective of Health Information Systems interoperability development assessment. The study takes a qualitative exploratory approach through a design science research context. The research aims to study the various themes withdrawn from the literature that can help in the assessment of interoperable HISs development through a literature study. Themes derived from the study include HIS needs, HIS readiness, HIS constraints, and HIS technology integration elements and standards tied to the EA development architectural layers of The Open Group Architecture Framework (TOGAF) as an EA development methodology. Eventually, the themes were conceptualised into a framework reviewed by two experts. The essence of the study was to provide a framework within which interoperable EA of HISs should be developed.

Keywords: enterprise architecture, eHealth, health information systems, interoperability

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Authors: Xin Wang, Yuanzhong Wang

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Pipa is one of the most important Chinese traditional plucked instruments, but its directivity has never been measured systematically. In western, directivity of loudness for western instruments is deeply researched through analysis of sound pressure level, whereas the directivity of timbre is seldom studied. In this paper, a new method for directivity of timbre was proposed, and horizontal directivity patterns of loudness and timbre of Pipa were measured. Directivity of Pipa radiation was measured in an anechoic room. The sound of Pipa played by a musician was recorded simultaneously by 32 microphones with Pipa in the center. The measuring results were examined through listening test. According to the measurement of Pipa directivity radiation, we put forward the best localization of Pipa in the Chinese traditional orchestra and the optimal recording region.

Keywords: directivity, Pipa, roughness, listening test

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Authors: Gracie Tredget, Raymond McGrath, Karen Ang, Julie Williams, Nick Sevdalis, Fiona Gaughran, Jorge Aria de la Torre, Ioannis Bakolis, Andy Healey, Zarnie Khadjesari, Euan Sadler, Natalia Stepan

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Background: Preventable physical health problems have been found to increase morbidity rates amongst adults living with serious mental illness (SMI). Community mental health clinicians have a role in identifying, and preventing physical health problems worsening, and supporting primary care services to administer routine physical health checks for their patients. However, little is known about how mental health staff perceive and approach their role when providing physical healthcare amongst patients with SMI, or the impact these attitudes have on routine practice. Methods: The present study involves a prospective service evaluation specific to Adult Community Mental Health Services at South London and Maudsley NHS Foundation Trust (SLaM). A qualitative methodology will use semi-structured interviews, focus groups and observations to explore attitudes, perceptions and experiences of staff, patients, and carers (n=64) towards physical healthcare, and barriers or facilitators that impact upon it. 1South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK 2 Centre for Implementation Science, King’s College London, London, SE5 8AF, UK 3 Psychosis Studies, King's College London, London, SE5 8AF, UK 4 Department of Biostatistics and Health Informatics, King’s College London, London, SE5 8AF, UK 5 Kings Health Economics, King's College London, London, SE5 8AF, UK 6 Behavioural and Implementation Science (BIS) research group, University of East Anglia, Norwich, UK 7 Department of Nursing, Midwifery and Health, University of Southampton, Southampton, UK 8 Mind and Body Programme, King’s Health Partners, Guy’s Hospital, London, SE1 9RT *[email protected] Analysis: Data from across qualitative tasks will be synthesised using Framework Analysis methodologies. Staff, patients, and carers will be invited to participate in co-development of recommendations that can improve routine physical healthcare within Adult Community Mental Health Teams at SLaM. Results: Data collection is underway at present. At the time of the conference, early findings will be available to discuss. Conclusions: An integrated approach to mind and body care is needed to reduce preventable deaths amongst people with SMI. This evaluation will seek to provide a framework that better equips staff to approach physical healthcare within a mental health setting.

Keywords: severe mental illness, physical healthcare, adult community mental health, nursing

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Authors: Aliya Moreira, Blake Duffy, Sam Kosinski, Kate Heckman, Erika Steensma

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Introduction: The One Health initiative promotes recognition of the interrelatedness between people, animals, plants, and their shared environment. The field of comparative medicine studies the similarities and differences between humans and animals for the purpose of advancing medical sciences. Currently, medical school education is narrowly focused on human anatomy and physiology, but as the COVID-19 pandemic has demonstrated, a holistic understanding of health requires comprehension of the interconnection between health and the lived environment. To prepare future physicians for unique challenges from emerging zoonoses to climate change, medical students can benefit from exposure to and experience with One Health and Comparative Medicine content. Methods: In January 2020, an elective course for medical students on One Health and Comparative Medicine was created to provide medical students with the background knowledge necessary to understand the applicability of animal and environmental health in medical research and practice. The 2-week course was continued in January 2021, with didactic and experiential activities taking place virtually due to the COVID-19 pandemic. In response to student feedback, lectures were added to expand instructional content on zoonotic and wildlife diseases for the second iteration of the course. Other didactic sessions included interprofessional lectures from 20 physicians, veterinarians, public health professionals, and basic science researchers. The first two cohorts of students were surveyed regarding One Health and Comparative Medicine concepts at the beginning and conclusion of the course. Results: 16 medical students have completed the comparative medicine course thus far, with 87.5% (n=14) completing pre-and post-course evaluations. 100% of student respondents indicated little to no exposure to comparative medicine or One Health concepts during medical school. Following the course, 100% of students felt familiar or very familiar with comparative medicine and One Health concepts. To assess course efficacy, questions were evaluated on a five-point Likert scale. 100% agreed or strongly agreed that learning Comparative Medicine and One Health topics augmented their medical education. 100% agreed or strongly agreed that a course covering this content should be regularly offered to medical students. Conclusions: Data from the student evaluation surveys demonstrate that the Comparative Medicine course was successful in increasing medical student knowledge of Comparative Medicine and One Health. Results also suggest that interprofessional training in One Health and Comparative Medicine is applicable and useful for medical trainees. Future iterations of this course could capitalize on the inherently interdisciplinary nature of these topics by enrolling students from veterinary and public health schools into a longitudinal course. Such recruitment may increase the course’s value by offering multidisciplinary student teams the opportunity to conduct research projects, thereby strengthening both the individual learning experience as well as sparking future interprofessional research ventures. Overall, these efforts to educate medical students in One Health topics should be reproducible at other institutions, preparing more future physicians for the diverse challenges they will encounter in practice.

Keywords: medical education, interprofessional instruction, one health, comparative medicine

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Authors: Jenny Lee

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Fat Studies is emerging as an interdisciplinary area of study, intersecting with Gender Studies, Sociology, Human Development and the Creative Arts. A focus on weight loss, and, therefore, fat hatred, has resulted in a form of discriminatory institutional practice that impacts women in the Western world. This focus is sanctioned by a large dieting industry, medical associations, the media, and at times, government initiatives. This paper will discuss the emergence of the so-called ‘Obesity Epidemic’ in Australia and the Western world and the stereotypes that thin equals healthy and fat equals unhealthy. This paper will argue that, for those with a health focus, ‘Health at every size’ is a more effective principle, which involves striving for healthy living, without a focus on weight loss. This discussion will contextualise an autoethnographic exploration of how fat acceptance and Health at Every Size can be encouraged through fat activism and fat political art. As part of this paper, a selection of the recent performance, writing and art in Australia will be presented, including Aquaporko, the fat femme synchronised swim team and VaVaBoomBah, the Melbourne fat burlesque performances.

Keywords: activism, fat, health, obesity, performance

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Ashis Pradhan, Mohan P. Pradhan

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Pattern Matching is useful for recognizing character in a digital image. OCR is one such technique which reads character from a digital image and recognizes them. Line segmentation is initially used for identifying character in an image and later refined by morphological operations like binarization, erosion, thinning, etc. The work discusses a recognition technique that defines a set of morphological operators based on its orientation in a character. These operators are further categorized into groups having similar shape but different orientation for efficient utilization of memory. Finally the characters are recognized in accordance with the occurrence of frequency in hierarchy of significant pattern of those morphological operators and by comparing them with the existing database of each character.

Keywords: binary image, morphological patterns, frequency count, priority, reduction data set and recognition

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Authors: Koel Chakraborty

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This paper critically examines the role of ‘disclosure and visibility’ of sexual minorities in a heteronormative organizational setting. The paper wishes to comment on the importance of promoting ‘visibility’ as an important catalyst in increasing the efficacy of outreach programs as part of diversity management practices as well as increasing the efficacy of teams. The aim of the research is to assess the pitfalls of not bringing ‘one’s authentic or whole self’ to work. In doing so, it will address whether Inclusive Leadership at the top propels employees to come out. The paper finally discusses and recommends strategies that could be helpful toward attaining and improving the visibility factor at a cross-functional level. This is a qualitative research with interviews and surveys conducted in inclusive workplace environments across various private sector companies in India.

Keywords: LGBT, diversity, organisation, leadership

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Authors: Muntanavadee Maytapattana

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The purposes of the study were to evaluate the effectiveness of the Parent Training Program for Obesity Reduction (PTPOR) on health behaviors of school-age children. An Ecological Systems Theory (EST) was approached the study and a randomized control trial was used in this study. Participants were school-age overweight or obese children and their parents. One hundred and one parent-child dyads were recruited and random assigned into the PTPOR (N=30), Educational Intervention or EI (N=32), and control group (N=39). The parents in the PTPOR group participated in five sessions including an educational session, a cooking session, aerobic exercise training, 2-time group discussion sessions, and 4-time telephoned counseling sessions. Repeated Measure ANCOVA was used to analyze data. The results presented that the outcomes of the PTPOR group were better than the EI and the control groups at 1st, 8th, and 32nd weeks after finishing the program such as child exercise behavior (F(2,97) = 3.98, p = .02) and child dietary behavior (F(2,97) = 9.42, p = .00). The results suggest that nurses and health care providers should utilize the PTPOR for child weight reduction and for the health promotion of a lifestyle among overweight and obese children.

Keywords: parent training program, obesity reduction, child health behaviors, school-age children

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Authors: Jia-Jin He, Tzu-Yuan Stessa Chao

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It is generally accepted that community residents with abundant open space have better health status on average, and thus more and more cities around the world began their pursuit of the greatest possible amount of green space within urban areas through urban planning approach. Nevertheless, only a few studies managed to provide empirical evidence regarding the actual relationship between 'providing' green space and 'improving' human health at city level. There is also lack of evidence of direct positive improvement of health by increasing the amount of green space. For urban planning professional, it is important to understand citizens’ usage behaviour towards green space as a critical evidence for future planning and design strategies. There is a research need to further investigate the amount of green space, user behaviour of green spaces and the health outcome of urban dwellers. To this end, we would like to find out other important factors for urban dwellers’ usage behaviours of green spaces. 'Average green spaces per person' is one of the National well-being Indicators in Taiwan as in many other countries. Through our preliminary research, we collected and analyzed the official data of planned open space coverages, average life expectancy, exercise frequency and obesity ratio in all cities of Taiwan. The study result indicates an interesting finding that Kaohsiung city, the second largest city in Taiwan, tells a completely different story. Citizens in Kaosiung city have more open spaces than any other city through urban planning, yet have relatively unhealthy condition in contrary. Whether it pointed out that the amount of the open spaces per person has would not direct to the health outcome. Therefore, the pre-established view which states that open spaces must have positive effects on human health should be examined more prudently. Hence, this paper intends to explore the relationship between user behaviour of open spaces and citizens’ health conditions by critically analyzing past related literature and collecting selective data from government health database in 2015. We also take Kaohsiung city, as a case study area to conduct statistical analysis first followed by questionnaire survey to gain a better understanding. Finally, we aim to feedback our findings to the current planning system in Taiwan for better health promotion urbanized areas.

Keywords: open spaces, urban planning systems, healthy cities, health outcomes

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Authors: Vincent Andrew Cappellano

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In the early phases of critical infrastructure system design, translating distributed computing requirements to an architecture has risk given the multitude of approaches (e.g., cloud, edge, fog). In many systems, a single requirement for system uptime / availability is used to encompass the system’s intended operations. However, when architected systems may perform to those availability requirements only during normal operations and not during component failure, or during outages caused by adversary attacks on critical infrastructure (e.g., physical, cyber). System designers lack a structured method to evaluate availability requirements against candidate system architectures through deep degradation scenarios (i.e., normal ops all the way down to significant damage of communications or physical nodes). This increases risk of poor selection of a candidate architecture due to the absence of insight into true performance for systems that must operate as a piece of critical infrastructure. This research effort proposes a process to analyze critical infrastructure system availability requirements and a candidate set of systems architectures, producing a metric assessing these architectures over a spectrum of degradations to aid in selecting appropriate resilient architectures. To accomplish this effort, a set of simulation and evaluation efforts are undertaken that will process, in an automated way, a set of sample requirements into a set of potential architectures where system functions and capabilities are distributed across nodes. Nodes and links will have specific characteristics and based on sampled requirements, contribute to the overall system functionality, such that as they are impacted/degraded, the impacted functional availability of a system can be determined. A machine learning reinforcement-based agent will structurally impact the nodes, links, and characteristics (e.g., bandwidth, latency) of a given architecture to provide an assessment of system functional uptime/availability under these scenarios. By varying the intensity of the attack and related aspects, we can create a structured method of evaluating the performance of candidate architectures against each other to create a metric rating its resilience to these attack types/strategies. Through multiple simulation iterations, sufficient data will exist to compare this availability metric, and an architectural recommendation against the baseline requirements, in comparison to existing multi-factor computing architectural selection processes. It is intended that this additional data will create an improvement in the matching of resilient critical infrastructure system requirements to the correct architectures and implementations that will support improved operation during times of system degradation due to failures and infrastructure attacks.

Keywords: architecture, resiliency, availability, cyber-attack

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Authors: Elucir Gir, Myllena Nilce de Freitas Surmano, Laelson Rochelle Milanês Sousa, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira E Silva, Renata Karina Reis

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Objective: To analyze the factors associated with the worsening of the quality of life of health professionals in the Southeast region of Brazil during the COVID-19 pandemic and its associated factors. Method: Analytical cross-sectional study carried out with health professionals from the southeastern region of Brazil. Data collection took place through an online survey with a form stored on the Survey Monkey platform. Bivariate analysis was used, and the chi-square test was adopted, followed by the multiple binary logistic regression model based on the stepwise method. Results: 3,493 health professionals participated in the study. Factors associated with worsening quality of life were: Professional Category (Nursing assistant) [OR 1.851 (95%CI 1.035-3.311) p= 0.038]; types of people who provided care (people in general) [OR 1.445 (95%CI 1.072-1.945) p=0.015]; Supply of good quality PPE by the institution where he works (no) [OR 1.595 (CI 95% 1.144-2.223) p= 0.006] and Supply of good quality PPE by the institution where he works (in part) [OR 1.563 (CI 95% 1.257-1.943) p < 0.001]. Conclusion: The factors associated with the worsening of the quality of life of health professionals during the COVID-19 pandemic were: Professional Category (Nursing assistant); types of people who provided assistance (people in general); Supply of sufficient PPE by the institution where you work (no) and Supply of good quality PPE by the institution where you work (in part). Future studies should investigate to what extent QoL can be improved based on modifiable factors.

Keywords: COVID-19, quality of life, health professionals, respiratory infections

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Authors: Andra Vidyarini

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Adolescence is a transition period in which various changes occur, both biologically, intellectually and psychosocially. Changes in adolescents, one of which is a change in food consumption patterns that make adolescents vulnerable to nutritional problems that can affect their growth and health in the future. Nutritional problems in adolescents have increased from year to year and one of the causes is the low diversity and quality of consumption. The diversity and quality of consumption can be seen through the Individual Dietary Diversity Score and the Healthy Eating Index. Currently, in Indonesia, data on the diversity and quality of food consumption, especially among adolescents, are still scarce. In general, the purpose of this study is to describe the diversity and quality of adolescent food consumption and the relationship between the diversity and quality of food consumption with nutritional status. This study is a cross-sectional study by looking at the diversity and quality of consumption of adolescents aged 15-17 years. The total number of subjects in this study amounted to 70 teenagers. This research was conducted online via a google form. Data analysis in this study was univariate and bivariate. The results showed that the diversity of the subject's food consumption was in the diverse and very diverse category with an average of 6. However, the quality was still not good, whereas it was still in the bad and moderate categories with an average of 12.93. The nutritional status of the majority of the subjects was in the normal category and overweight to obese. The implementation of blended learning where there are still limited face-to-face meetings at school can be the reason why teenagers' food consumption is more diverse than when they are face-to-face schools. In addition, changes in people's diet during the pandemic also influenced the results of the study. The change in pattern is a change in eating habits to three times a day with menu choices ranging from rice, meat, fish, bean and vegetables. Analysis of the relationship between the diversity and quality of food consumption shows that the diversity of consumption has a significant relationship with the quality of food consumption with a p-value of 0.002 (p<0.05). Meanwhile, the diversity and quality of food consumption have no significant relationship with nutritional status, with p values 0.777 and 0.251 (>0.05), respectively. This shows that the diversity of food consumption is directly proportional to the quality of consumption, where if you have a variety of food consumption, the quality or in terms of portions and weight are also sufficient in accordance with the recommendations of PGRS.

Keywords: healthy eating index (HEI), food diversity, quality of consumption, adolescent

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Authors: Da Tao, Mingfu Qin, Wenkai Li, Tieyan Wang

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While the use of electronic personal health portals has gained increasing popularity in the healthcare industry, users usually experience difficulty in comprehending and correctly responding to personal health information, partly due to inappropriate or poor presentation of the information. The way personal health information is visualized may affect how users perceive and assess their personal health information. This study was conducted to examine the effects of information visualization format and visualization mode on the comprehension and perceptions of personal health information among personal health information users with eye tracking techniques. A two-factor within-subjects experimental design was employed, where participants were instructed to complete a series of personal health information comprehension tasks under varied types of visualization mode (i.e., whether the information visualization is static or dynamic) and three visualization formats (i.e., bar graph, instrument-like graph, and text-only format). Data on a set of measures, including comprehension performance, perceptions, and eye movement indicators, were collected during the task completion in the experiment. Repeated measure analysis of variance analyses (RM-ANOVAs) was used for data analysis. The results showed that while the visualization format yielded no effects on comprehension performance, it significantly affected users’ perceptions (such as perceived ease of use and satisfaction). The two graphic visualizations yielded significantly higher favorable scores on subjective evaluations than that of the text format. While visualization mode showed no effects on users’ perception measures, it significantly affected users' comprehension performance in that dynamic visualization significantly reduced users' information search time. Both visualization format and visualization mode had significant main effects on eye movement behaviors, and their interaction effects were also significant. While the bar graph format and text format had similar time to first fixation across dynamic and static visualizations, instrument-like graph format had a larger time to first fixation for dynamic visualization than for static visualization. The two graphic visualization formats yielded shorter total fixation duration compared with the text-only format, indicating their ability to improve information comprehension efficiency. The results suggest that dynamic visualization can improve efficiency in comprehending important health information, and graphic visualization formats were favored more by users. The findings are helpful in the underlying comprehension mechanism of visualized personal health information and provide important implications for optimal design and visualization of personal health information.

Keywords: eye tracking, information comprehension, personal health information, visualization

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Authors: Paramita Banerjee, K. R. S. Chandrakumar, G. P. Das

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Bulk MgH2 has drawn much attention for the purpose of hydrogen storage because of its high hydrogen storage capacity (~7.7 wt %) as well as low cost and abundant availability. However, its practical usage has been hindered because of its high hydrogen desorption enthalpy (~0.8 eV/H2 molecule), which results in an undesirable desorption temperature of 3000C at 1 bar H2 pressure. To surmount the limitations of bulk MgH2 for the purpose of hydrogen storage, a detailed first-principles density functional theory (DFT) based study on the structure and stability of neutral (Mgm) and positively charged (Mgm+) Mg nanoclusters of different sizes (m = 2, 4, 8 and 12), as well as their interaction with molecular hydrogen (H2), is reported here. It has been found that due to the absence of d-electrons within the Mg atoms, hydrogen remained in molecular form even after its interaction with neutral and charged Mg nanoclusters. Interestingly, the H2 molecules do not enter into the interstitial positions of the nanoclusters. Rather, they remain on the surface by ornamenting these nanoclusters and forming new structures with a gravimetric density higher than 15 wt %. Our observation is that the inclusion of Grimme’s DFT-D3 dispersion correction in this weakly interacting system has a significant effect on binding of the H2 molecules with these nanoclusters. The dispersion corrected interaction energy (IE) values (0.1-0.14 eV/H2 molecule) fall in the right energy window, that is ideal for hydrogen storage. These IE values are further verified by using high-level coupled-cluster calculations with non-iterative triples corrections i.e. CCSD(T), (which has been considered to be a highly accurate quantum chemical method) and thereby confirming the accuracy of our ‘dispersion correction’ incorporated DFT calculations. The significance of the polarization and dispersion energy in binding of the H2 molecules are confirmed by performing energy decomposition analysis (EDA). A total of 16, 24, 32 and 36 H2 molecules can be attached to the neutral and charged nanoclusters of size m = 2, 4, 8 and 12 respectively. Ab-initio molecular dynamics (AIMD) simulation shows that the outermost H2 molecules are desorbed at a rather low temperature viz. 150 K (-1230C) which is expected. However, complete dehydrogenation of these nanoclusters occur at around 1000C. Most importantly, the host nanoclusters remain stable up to ~500 K (2270C). All these results on the adsorption and desorption of molecular hydrogen with neutral and charged Mg nanocluster systems indicate towards the possibility of reducing the dehydrogenation temperature of bulk MgH2 by designing new Mg-based nano materials which will be able to adsorb molecular hydrogen via this weak Mg-H2 interaction, rather than the strong Mg-H bonding. Notwithstanding the fact that in practical applications, these interactions will be further complicated by the effect of substrates as well as interactions with other clusters, the present study has implications on our fundamental understanding to this problem.

Keywords: density functional theory, DFT, hydrogen storage, molecular dynamics, molecular hydrogen adsorption, nanoclusters, physisorption

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Authors: Gabriela Ilie, Robert D. H. Rutledge

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A review of the literature reveals a need for longitudinal studies to properly understand the quality of life of prostate cancer survivors during their prostate cancer journey in order to identify opportunities for patient support and care during prostate cancer survivorship. In this study, mental health and relationship satisfaction were assessed longitudinally and by treatment modality among a population-based sample of Canadian adult men with a history of prostate cancer diagnosis. A total of 98 men, aged 51 or older with a history of prostate cancer completed an on-line 15-minute survey between May 2017 and February 2018, assessing mental health (Kessler Psychological Distress Scale) and relationship satisfaction (Dyadic Adjustment Scale) at baseline and at three months post-treatment with either active or nonactive prostate cancer treatment. Almost 1 in 6 men in this sample screened positive for mental health issues (17.34%, n=17) irrespective of treatment modality and most (n=11) were not currently on medication for depression, anxiety or both. Mental health outcomes were poorer for men with multimorbidity. For every instance of screening positive for mental health issues, 2.021 (95% CI:1.1 to 3.8) times more comorbidities were recorded. Relationship satisfaction and dyadic cohesion were statistically significantly lower from first assessment to 3 months for men who underwent multiple treatment modalities (surgery and radiation with hormonal therapy). Relationship satisfaction was also lower at 3 months for men who underwent radiation therapy. Almost 1 in 2 men in this sample (74%) indicated they did not attend a prostate cancer support group. Results suggest that treatment for mental health is underutilized in men with prostate cancer. Men who undergo multiple forms of active treatment appear more vulnerable to relationship dissatisfaction and feeling disconnected from their partner. Data points to important opportunities for patient education and care support during survivorship.

Keywords: prostate cancer survivorship, mental health, quality of life, relationship satisfaction

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Authors: Harini Aiyer, Kalyani Premkumar

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Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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