Search results for: chronic health problems

Authors: Abdolreza Esmaeilzadeh, Mehri Mirzaei

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Objective: Rheumatic disease is a chronic disease that causes pain, stiffness, swelling and limited motion and function of many joints. RA is the most common form of autoimmune arthritis, affecting more than 1.3 million Americans. Of these, about 75% are women. Materials and Methods: This study was formed due to the misconception about ANA test, which is frequently performed with methods based upon solid phase as ELISA. This experiment was conducted on 430 patients, with clinical symptoms that are likely affected with rheumatic diseases, simultaneously by means of ANA and FANA. Results: 36 cases (8.37%) of patients, despite positive ANA, have demonstrated negative results via Indirect Immunofluorescence Assay (IIFA), (false positive). 116 cases (27%) have demonstrated negative ANA results, by means of the ELISA technique, although they had positive IIFA results. Conclusion: Other advantages of IIFA are antibody titration and specific pattern detection that have the capability of distinguishing positive dsDNA results. According to the restrictions and false negative cases, in patients, IIFA test is highly recommended for these disease's diagnosis.

Keywords: autoimmune disease, IIFA, EIA, rheumatic disease

Procedia PDF Downloads 499

Authors: Joseph Udofia, Isaac Olufadewa

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Everyday, the size of Electronic Health Records data keeps increasing as new patients visit health practitioner and returning patients fulfil their appointments. As these data grow, so is their susceptibility to cyber-attacks from criminals waiting to exploit this data. In the US, the damages for cyberattacks were estimated at $8 billion (2018), $11.5 billion (2019) and $20 billion (2021). These attacks usually involve the exposure of PII. Health data is considered PII, and its exposure carry significant impact. To this end, an enhancement of Health Policy and Standards in relation to data security, especially among patients and their clinical providers, is critical to ensure ethical practices, confidentiality, and trust in the healthcare system. As Clinical accelerators and applications that contain user data are used, it is expedient to have a review and revamp of policies like the Payment Card Industry Data Security Standard (PCI DSS), the Health Insurance Portability and Accountability Act (HIPAA), the Fast Healthcare Interoperability Resources (FHIR), all aimed to ensure data protection and security in healthcare. FHIR caters for healthcare data interoperability, FHIR caters to healthcare data interoperability, as data is being shared across different systems from customers to health insurance and care providers. The astronomical cost of implementation has deterred players in the space from ensuring compliance, leading to susceptibility to data exfiltration and data loss on the security accuracy of protected health information (PHI). Though HIPAA hones in on the security accuracy of protected health information (PHI) and PCI DSS on the security of payment card data, they intersect with the shared goal of protecting sensitive information in line with industry standards. With advancements in tech and the emergence of new technology, it is necessary to revamp these policies to address the complexity and ambiguity, cost barrier, and ever-increasing threats in cyberspace. Healthcare data in the wrong hands is a recipe for disaster, and we must enhance its protection and security to protect the mental health of the current and future generations.

Keywords: cloud security, healthcare, cybersecurity, policy and standard

Procedia PDF Downloads 90

Authors: Charity Ngoatle, Tebogo M. Mothiba, Mahlapahlapana J. Themane

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Misapprehension of medications instructions due to poor health literacy is common in diabetic patients, predominantly leading to suboptimal medication therapy caused by taking less than expected, or getting inadequate medication concentration. Globally, 50% of adults have been reported to have misunderstood medication instructions which could be the cause of not using medication as prescribed. Reading material has been found not to improve people’s knowledge to the extent where they would be informed and knowledgeable about their health. This, therefore, depicts that instructive materials alone cannot improve health literacy but further patient education is still needed to explain what the information really mean. The aim of this study was to investigate patients’ interpretation of prescribed medication instructions at Makanye Clinic in Limpopo Province, South Africa. The study used a mixed method approach. A non-probability purposive and simple random sampling strategies will be used to select ten (10) participants for the pilot study. Semi-structured interviews with a guide and self- administered structured questionnaires will be used to collect data. Tesch’s eight steps for qualitative data analysis and SPSS version 24 with descriptive statistics will be adopted. The preliminary findings from other studies show that: (a) poor health literacy negatively affect medication adherence, (b) general literacy influence health literacy, and (c) there are poor health outcomes and medication adverse effects due to poor medication comprehension.

Keywords: instructions, diabetes mellitus, patients, prescribed medication

Procedia PDF Downloads 137

Authors: Shabnam Monadizadeh, Charles Kibert, Jiaxuan Li, Janghoon Woo, Ashish Asutosh, Samira Roostaei, Maryam Kouhirostami

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A significant share of the technology that has emerged over the past several decades produces electromagnetic field (EMF) radiation. Communications devices, household appliances, industrial equipment, and medical devices all produce EMF radiation with a variety of frequencies, strengths, and ranges. Some EMF radiation, such as Extremely Low Frequency (ELF), Radio Frequency (RF), and the ionizing range have been shown to have harmful effects on human health. Depending on the frequency and strength of the radiation, EMF radiation can have health effects at the cellular level as well as at brain, nervous, and cardiovascular levels. Health authorities have enacted regulations locally and globally to set critical values to limit the adverse effects of EMF radiation. By introducing a more comprehensive field of EMF radiation study and practice, architects and designers can design for a safer electromagnetic (EM) indoor environment, and, as building and construction specialists, will be able to monitor and reduce EM radiation. This paper identifies the nature of EMF radiation in the built environment, the various EMF radiation sources, and its human health effects. It addresses European and US regulations for EMF radiation in buildings and provides a preliminary action plan. The challenges of developing measurement protocols for the various EMF radiation frequency ranges and determining the effects of EMF radiation on building occupants are discussed. This paper argues that a mature method for measuring EMF radiation in building environments and linking these measurements to human health impacts occupant health should be developed to provide adequate safeguards for human occupants of buildings for future research.

Keywords: biological affection, electromagnetic field, building regulation, human health, healthy building, clean construction

Procedia PDF Downloads 181

Authors: Seyedeh-Fariba Jahanbin, Hasan Yusefzadeh, Bahram Nabilou, Cyrus Alinia, Cyrus Alinia

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Background: Due to the lack of a constant Willingness to Pay per one additional Quality Adjusted Life Years gained based on the preferences of Iran’s general public, the cost-efectiveness of health system interventions is unclear and making it challenging to apply economic evaluation to health resources priority setting. Methods: We have measured this cost-efectiveness threshold with the participation of 2854 individuals from fve provinces, each representing an income quintile, using a modifed Time Trade-Of-based Chained-Approach. In this online-based empirical survey, to extract the health utility value, participants were randomly assigned to one of two green (21121) and yellow (22222) health scenarios designed based on the earlier validated EQ-5D-3L questionnaire. Results: Across the two health state versions, mean values for one QALY gain (rounded) ranged from $6740-$7400 and $6480-$7120, respectively, for aggregate and trimmed models, which are equivalent to 1.35-1.18 times of the GDP per capita. Log-linear Multivariate OLS regression analysis confrmed that respondents were more likely to pay if their income, disutility, and education level were higher than their counterparts. Conclusions: In the health system of Iran, any intervention that is with the incremental cost-efectiveness ratio, equal to and less than 7402.12 USD, will be considered cost-efective.

Keywords: willingness to Pay, QALY, chained-approach, cost-efectiveness threshold, Iran

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Authors: Adisorn Bansong, Walai Isarankura Na Ayudhaya, Aumporn Makanong

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A Development of an Instructional Model for Health Education was the aim to develop and study the effectiveness of an instructional model for health education to enhance self-regulation and learning achievement of lower secondary school students. It was the Quasi-Experimental Designs, used a Single-group Interrupted Time-series Designs, conducted by 2 phases: 1. To develop an instructional model based on Social Cognitive Theory and Strategic Life Planning. 2. To trial and evaluate effectiveness of an instructional model. The results as the following: i. An Instructional Model for Health Education consists of five main components: a) Attention b) Forethought c) Tactic Planning d) Execution and e) Reflection. ii. After an Instructional Model for Health Education has used for a semester trial, found the 4.07 percent of sample’s Self-Regulation higher and learning achievement on post-test were significantly higher than pre-test at .05 levels (p = .033, .000).

Keywords: social cognitive theory, strategic life planning, self-regulation, learning achievement

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Authors: Jeffrey Chase

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Historically the profession of Occupational Therapy was closely tied to the treatment of those suffering from mental illness; more recently, and especially in the U.S., the percentage of OTs identifying as working in the mental health area has declined significantly despite the estimate that by 2020 behavioral health disorders will surpass physical illnesses as the major cause of disability worldwide. In the U.S. less than 10% of OTs identify themselves as working with the mentally ill and/or practicing in mental health settings. Such a decline has implications for both those suffering from mental illness and the profession of Occupational Therapy. One reason cited for the decline of OT in mental health has been the limited research in the discipline addressing mental health practice. Despite significant advances in technology and growth in the field of neuroscience, major institutions and funding sources such as the National Institute of Mental Health (NIMH) have noted that research into the etiology and treatment of mental illness have met with limited success over the past 25 years. One major reason posited by NIMH is that research has been limited by how we classify individuals, that being mostly on what is observable. A new classification system being developed by NIMH, the Research Domain Criteria (RDoc), has the goal to look beyond just descriptors of disorders for common neural, genetic, and physiological characteristics that cut across multiple supposedly separate disorders. The hope is that by classifying individuals along RDoC measures that both reliability and validity will improve resulting in greater advances in the field. As a result of this change NIH and NIMH will prioritize research funding to those projects using the RDoC model. Multiple disciplines across many different setting will be required for RDoC or similar classification systems to be developed. During this shift in research methodology OT has an opportunity to reassert itself into the research and treatment of mental illness, both in developing new ways to more validly classify individuals, and to document the legitimacy of previously ill-defined and validated disorders such as sensory integration.

Keywords: global mental health and neuroscience, research opportunities for ot, greater integration of ot in mental health research, research and funding opportunities, research domain criteria (rdoc)

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Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: Andrea Knezevic, Padmini Pai, Julaine Allan, Katarzyna Olcoń, Louisa Smith

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Healthcare staff are on the frontline during times of disaster and are required to support the health and wellbeing of communities despite any personal adversity and trauma they are experiencing as a result of the disaster. This study explored the experiences of healthcare staff trained as ‘Wellness Warriors’ following the 2019-2020 Australian bushfires. The findings indicated that healthcare staff developed interpersonal skills around deep listening and connecting with others which allowed them to feel differently about work and restored their faith in healthcare leadership.

Keywords: Australian bushfires, burnout, health care providers, mental health, occupational trauma, post-disaster, wellbeing, workplace wellness

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Authors: Khamdan Cahyari, Gumbolo Hadi Susanto, Pratikno Hidayat, Sukirman

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University canteen waste was used as raw material to produce biogas in Faculty of Industrial Technology, Islamic University of Indonesia. This faculty was home to more than 3000 students and lecturers who work and study for 5 days/week (8 hours/day). It produced approximately 85 ton/year organic fraction of canteen waste. Yet, this waste had been dumped for years in landfill area which cause severe environmental problems. It was proposed to utilize the waste as raw material for producing renewable energy source of biogas. This research activities was meant to investigate the effect of organic loading rate (OLR) and retention time (RT) of continuous anaerobic digestion process for 200 days. Organic loading rate was set at value 2, 3, 4 and 5 g VS/l/d whereas the retention time was adjusted at 30, 24, 18 and 14.4 days. Optimum condition was achieved at OLR 4 g VS/l/d and RT 24 days with biogas production rate between 0.75 to 1.25 liter/day (40-60% CH4). This indicated that the utilization of canteen waste to produce biogas was promising method to mitigate environmental problem of university canteen waste. Furthermore, biogas could be used as alternative energy source to supply energy demand at the university. This implementation is simultaneous solution for both waste and energy problems to achieve green campus.

Keywords: canteen waste, biogas, anaerobic digestion, university, green campus

Procedia PDF Downloads 415

Authors: Thitaporn Thoopputra, Tipaporn Pongmesa, Shuchuen Li

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Aims: To evaluate the application of non-invasive diabetes risk assessment tool in community pharmacy setting. Methods: Thai diabetes risk score was applied to assess individuals at risk of developing type 2 diabetes. Interactive computer-based risk screening (IT) and paper-based risk screening (PT) tools were applied. Participants aged over 25 years with no known diabetes were recruited in six participating pharmacies. Results: A total of 187 clients, mean aged (+SD) was 48.6 (+10.9) years. 35% were at high risk. The mean value of willingness-to-pay for the service fee in IT group was significantly higher than PT group (p=0.013). No significant difference observed for the satisfaction between groups. Conclusions: Non-invasive risk assessment tool, whether paper-based or computerized-based can be applied in community pharmacy to support the enhancing role of pharmacists in chronic disease management. Long term follow up is needed to determine the impact of its application in clinical, humanistic and economic outcomes.

Keywords: community pharmacy, intervention, prevention, risk assessment, type 2 diabetes

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Authors: Y. N. Reddy

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The class of differential-difference equations which have characteristics of both classes, i.e., delay/advance and singularly perturbed behaviour is known as singularly perturbed differential-difference equations. The expression ‘positive shift’ and ‘negative shift’ are also used for ‘advance’ and ‘delay’ respectively. In general, an ordinary differential equation in which the highest order derivative is multiplied by a small positive parameter and containing at least one delay/advance is known as singularly perturbed differential-difference equation. Singularly perturbed differential-difference equations arise in the modelling of various practical phenomena in bioscience, engineering, control theory, specifically in variational problems, in describing the human pupil-light reflex, in a variety of models for physiological processes or diseases and first exit time problems in the modelling of the determination of expected time for the generation of action potential in nerve cells by random synaptic inputs in dendrites. In this paper, we envisage the use of Liouville Green Transformation to find the solution of singularly perturbed differential difference equations. First, using Taylor series, the given singularly perturbed differential difference equation is approximated by an asymptotically equivalent singularly perturbation problem. Then the Liouville Green Transformation is applied to get the solution. Several model examples are solved, and the results are compared with other methods. It is observed that the present method gives better approximate solutions.

Keywords: difference equations, differential equations, singular perturbations, boundary layer

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Authors: Noah Wayne, Andrea Tuka, Adrian Norbash, Bryan Garber, Paul Ritvo

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Program/Intervention Description: The Canadian Armed Forces(CAF) Mental Health Clinicstreat a full spectrum of mental disorder, addictions, and psychosocial issues that include Major Depressive Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, and other diagnoses. We evaluated the feasibility of an online health coach interventiondelivering mindfulness based cognitive behavioral therapy (M-CBT) and behaviour changesupport for individuals receiving treatment at CAF Clinics. Participants were provided accounts on NexJ Connected Wellness, a digital health platform, and 16 weeks of phone-based health coaching,emphasizingmild to moderate aerobic exercise, a healthy diet, and M-CBT content. The primary objective was to assess the feasibility of the online deliverywith CAF members. Evaluation Methods: Feasibility was evaluated in terms of recruitment, engagement, and program satisfaction. Weadditionallyevaluatedhealth behavior change, program completion, and mental health symptoms (i.e. PHQ-9, GAD-7, PCL-5) at three time points. Results: Service members were referred from Vancouver, Esquimalt, and Edmonton CAF bases between August 2020 and January 2021. N=106 CAF personnel were referred, and n=77 consented.N=66 participated, and n=44 completed 4-month and follow-up measures. The platform received a mean rating of76.5 on the System Usability Scale, and health coaching was judged the most helpful program feature (95.2% endorsement), while reminders (53.7%), secure messaging (51.2%), and notifications (51.2%) were also identified. Improvements in mental health status during active interventions were observed on the PHQ-9 (-5.4, p<0.001), GAD-7 (-4.0, p<0.001), and PCL-5 (-4.1, p<0.05). Conclusion: Online health coaching was well-received amidst the COVID-19 pandemic and related lockdowns. Uptake and engagement were positively reported. Participants valuedcontacts and reported strong therapeutic alliances with coaches. Healthy diet, regular exercise, and mindfulness practice are important for physical and mental health. Engagements in these behaviors are associated with reduced symptoms. An online health coach program appears feasible for assisting Canadian Armed Forces personnel.

Keywords: coaching, CBT, military, depression, mental health, digital

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Authors: Narumon Piaseu

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This survey research was aimed to describe and compare consumption behavior of health risk food among students in Suan Sunandha Rajabhat University. Sample included 400 undergraduate students enrolled in the first semester of 2008 academic year. Data were collected by using self reported questionnaire developed by the researcher. Data were then analyzed by descriptive statistics including frequency, percentage, mean, standard deviation, and inferential statistics including independent t-test, and Oneway ANOVA. Results revealed that most of the sample were women (67%), enrolled in social related programs (74%). Approximately half of them (45.5%) stayed in dormitory. The mean of monthly income was 5,164 Baht and daily food expenditure was 114.55 Baht. Majority of them (83%) had ready-to-eat food. A major factor influencing their food selection was their parents (61%). A main reason for their food selection was food that looks good (70.75%). Almost half of them (46.25%) had heavy exercise less than 3 times per week. Regarding knowledge on health risk food, 43.5% of the sample had good knowledge. The followings were moderate (41%) and poor (41%). Most of the sample (60.75%) had consumption behavior at low risk. The following was at moderate risk (37.25%). Only 2% were at high risk. Among the sample, consumption behavior of health risk food were significantly different in years of study (F = 3.168, p = .024), daily food expenditure (F = 8.950, p <.001), and knowledge on health risk food (F = 37.856, p <.001), while no significant difference in consumption behavior of health risk food was found in those with a difference in gender, program of study, living place, and monthly income. Results indicate the importance of providing knowledge regarding health risk food for students and their parents in order to promote appropriate food consumption behavior among the students.

Keywords: food consumption, risky behavior, Suan Sunandha Rajabhat University, health risk

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Authors: Piyush Pal, Rahul Dev

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Water is essential for life and fresh water is a finite resource that is becoming scarce day by day even though it is recycled by hydrological cycle. The fresh water reserves are being polluted due to expanding irrigation, industries, urban population and its development. Contaminated water leads to several health problems. With the increasing demand of fresh water, solar distillation is an alternate solution which uses solar energy to evaporate water and then to condense it, thereby collecting distilled water within or outside the same system to use it as potable water. The structure that houses the process is known as a 'solar still'. In this paper, ‘Modified double slope solar still (MDSSS)’ & 'Modified double slope basin type multiwick solar still (MDSBMSS)' have been designed to convert saline, brackish water into drinking water. In this work two different modified solar stills are fabricated to study the performance of these solar stills. For modification of solar stills, Fibre Reinforced Plastic (FRP) and Acrylic sheets are used. The experiments in MDSBMSS and MDSSS was carried on 10 September 2015 & 5 November 2015 respectively. Performances of the stills were investigated. The amount of distillate has been found 3624 Ml/day in MDSBMSS on 10 September 2015 and 2400 Ml/day in MDSSS on 5 November 2015.

Keywords: contaminated water, conventional solar still, modified solar still, wick

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Authors: Himansu, Bedanga Talukdar

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The aim of present study is to investigate the prevalence of various health outcomes and quality of life and analyzes the moderating role of social capital on health outcomes (i.e., self-rated good health (SRH), depression, functional health and quality of life) among elderly in India. Using WHO Study on Global AGEing and adults health (SAGE) data, with sample of 6559 elderly between 50 and above (Mage=61.81, SD=9.00) age were selected for analysis. Multivariate analysis accessed the prevalence of SRH, depression, functional limitation and quality of life among older adults. Logistic regression evaluates the effect of social capital along with other co-founders on SRH, depression, and functional limitation, whereas linear regression evaluates the effect of social capital with other co-founders on quality of life (QoL) among elderly. Empirical results reveal that (74%) of respondents were married, (70%) having low social action, (46%) medium sociability, (45%) low trust-solidarity, (58%) high safety, (65%) medium civic engagement and 37% reported medium psychological resources. The multivariate analysis, explains (SRH) is associated with age, female, having education, higher social action great trust, safety and greater psychological resources. Depression among elderly is greatly related to age, sex, education and higher wealth, higher sociability, having psychological resources. QoL is negatively associated with age, sex, being Muslim, whereas positive associated with higher education, currently married, civic engagement, having wealth, social action, trust and solidarity, safeness, and strong psychological resources.

Keywords: depressive symptom, functional limitation, older adults, quality of life, self rated health, social capital

Procedia PDF Downloads 225

Authors: Susana Almeida

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The right to adequate food is a human right protected under several international human rights treaties of universal or regional application. In addition, this social right is – as we intend to demonstrate – guaranteed under the Portuguese Constitution. Therefore, in order to assure the protection of this right, the Portuguese State must not only abstain from interfering with this human right (negative obligation) but also take action to secure the human right to adequate food (positive obligation). In this context, the Portuguese State has developed several governmental policies, such as taxing sugary drinks, setting the maximum amount of salt in the bread or creating the National Program for the Promotion of Healthy Food. Nevertheless, we intend to demonstrate that special attention should be given to advertising, as advertisements have an extreme influence on the consumers' decisions and hence on the food decisions. In this paper, besides explaining the cross construction of the human right to adequate food, we aim to examine the Advertising Portuguese Code and to study the several provisions that could be held by the Portuguese consumer to challenge some advertisements due to the violation of the right to health and the right to adequate food. Moreover, having in mind the influence of advertising on the food decisions and the serious problems that unhealthy food may bring (e.g., child obesity), one should ask if this legal framework should not be reviewed in order to lay out some restrictions on advertising, namely setting advices like in alcohol advertisements.

Keywords: advertising code, consumer law, right to adequate food, social human right

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Authors: Mustafa Metin Donma, Orkide Donma

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Childhood obesity is an important clinical problem because it may lead to chronic diseases during the adulthood period of the individual. Obesity is a metabolic disease associated with low-grade inflammation. The liver occurs at the center of metabolic pathways. Adropin, fibroblast growth factor-21 (FGF-21), and fetuin-A are hepatokines. Due to the immense participation of the liver in glucose metabolism, these liver-derived factors may be associated with insulin resistance (IR), which is a phenomenon discussed within the scope of obesity problems. The aim of this study is to determine the concentrations of adropin, FGF-21, and fetuin-A in childhood obesity, to point out possible differences between the obesity groups, and to investigate possible associations among these three hepatokines in obese and morbidly obese children. A total of one hundred and thirty-two children were included in the study. Two obese groups were constituted. The groups were matched in terms of mean ± SD values of ages. Body mass index values of obese and morbidly obese groups were 25.0 ± 3.5 kg/m² and 29.8 ± 5.7 kg/m², respectively. Anthropometric measurements including waist circumference, hip circumference, head circumference, and neck circumference were recorded. Informed consent forms were taken from the parents of the participants. The ethics committee of the institution approved the study protocol. Blood samples were obtained after overnight fasting. Routine biochemical tests, including glucose- and lipid-related parameters, were performed. Concentrations of the hepatokines (adropin, FGF-21, fetuin A) were determined by enzyme-linked immunosorbent assay. Insulin resistance indices such as homeostasis model assessment for IR (HOMA-IR), alanine transaminase-to aspartate transaminase ratio (ALT/AST), diagnostic obesity notation model assessment laboratory index, diagnostic obesity notation model assessment metabolic syndrome index as well as obesity indices such as diagnostic obesity notation model assessment-II index, and fat mass index were calculated using the previously derived formulas. Statistical evaluation of the study data as well as findings of the study was performed by SPSS for Windows. Statistical difference was accepted significant when p is smaller than 0.05. Statistically significant differences were found for insulin, triglyceride, high-density lipoprotein cholesterol levels of the groups. A significant increase was observed for FGF-21 concentrations in the morbidly obese group. Higher adropin and fetuin-A concentrations were observed in the same group in comparison with the values detected in the obese group (p > 0.05). There was no statistically significant difference between the ALT/AST values of the groups. In all of the remaining IR and obesity indices, significantly increased values were calculated for morbidly obese children. Significant correlations were detected between HOMA-IR and each of the hepatokines. The highest one was the association with fetuin-A (r=0.373, p=0.001). In conclusion, increased levels observed in adropin, FGF-21, and fetuin-A have shown that these hepatokines possess increasing potential going from obese to morbid obese state. Out of the correlations found with the IR index, the most affected hepatokine was fetuin-A, the parameter possibly used as the indicator of the advanced obesity stage.

Keywords: adropin, fetuin A, fibroblast growth factor-21, insulin resistance, pediatric obesity

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Authors: Md. S. Sabuz

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Bangladesh, a South Asian developing country, has achieved a remarkable breakthrough in health indicators during the last four decades despite immense income inequality. This phenomenon results in the mystical exclusion of marginalized people from obtaining health care facilities. However, the persistence of exclusion of the disadvantaged remains troubling. Exclusion occurs from occupational inferiority, pay and wage differences, educational backwardness, gender disparity to urban-rural complexity and eliminate the unprivileged from seeking and availing the health services. Evidence from Bangladesh shows that many sick people prefer to die at home without securing medical services because in previous times they were not treated well, not because the medical facilities were inadequate or antediluvian but the socio-economic class allows them to receive obdurate treatment. Furthermore, government and policymakers have given enormous emphasis on infrastructural development and achieving health indicators instead of ensuring quality services and inclusiveness of people from all spheres. Therefore, it is high time to address the issues concerning this and highlight the impact of economic status on health status in a sociological perspective. The objective of this study is to consider ways of assessing and exploring the impact of economic status for instance: occupational status, pay and wage variable, on health status in the context of Bangladesh. The hypotheses are that there are a significant number of factors affecting economic status which are impactful for health status eventually, but acute income inequality is a prominent factor. Illiteracy, gender disparity, remoteness, incredibility on services, superior costs, superstition etc. are the dominant indicators behind the economic factors influencing the health status. The chosen methodologies are a qualitative and quantitative approaches to accomplish the research objectives. Secondary sources of data will be used to conduct the study. Surveys will be conducted on the people who have ever been through the health care facilities and people from the different socio-economic and cultural backgrounds. Focus group discussions will be conducted to acquire the data from different cultural and regional citizens. The findings show that 48% of people who are from disadvantaged communities have been deprived of proper health care facilities. The general reasons behind this are the higher cost of medicines and other equipment. A significant number of people are unaware of the appropriate facilities. It was found that the socio-economic variables are the main influential factors that work as the driving force for both economic dimension and health status. Above all regional variables and gender, dimensions have an enormous effect on determining the health status of an individual or community. Amidst many positive achievements for example decrease in the child mortality rate, an increase in the immunization programs of the child etc., the inclusiveness of all classes of people in health care facilities has been overshadowed in Bangladesh. However, this phenomenon along with the socio-economic and cultural phenomena significantly demolishes the quality and inclusiveness of the health status of people.

Keywords: cultural context of health, economic status, gender and health, rural health care

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Authors: Mohamed Eladham Fadl M. E. Fadl

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In Egypt, wastewater has been used for irrigation in areas with fresh water scarcity. However, continuous applications may cause potential risks. Thus, the current study aims at screening the impacts of long-term wastewater irrigation on soil pollution and human health due to the exposure of heavy metals. Soils of nine sites in Al-Qalyubiyah Governorate, Egypt were sampled and analyzed for different properties. Wastewater resulted in a build-up of metals in soils. The pollution index (PI) showed the order of Cd > Pb > Ni > Zn. The integrated pollution index of Nemerow’s (IPIN) exceeded the safe limit of 0.7. The enrichment factor (EF) surpassed 1.0 value proving anthropogenic effects. The geo-accumulation index (Igeo) indicated that Pb, Ni, and Zn-induced none to moderate pollution, while high threats were associated with Cd. The calculated hazard index proved a potential health risk for humans, particularly children. It is recommended to perform a treatment to the wastewater used in irrigation to avoid such threats.

Keywords: pollution, health risks, heavy metals, effluent, irrigation, GIS techniques

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Authors: Mansoor Aslamzai, Delaqa Del, Sayed Azam Sajid

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Introduction: Though moral disorders have a high burden, there is no separate topic regarding this problem in the International Classification of Diseases (ICD). Along with the modification of WHO ICD-11, spirituality can prevent the rapid progress of such derangement as well. Objective: This study evaluated the effects of bad moral characters on health, as well as carried out the role of spirituality in the improvement of immorality. Method: This narrative article review was accomplished in 2020-2021 and the articles were searched through the Web of Science, PubMed, BMC, and Google scholar. Results: Based on the current review, most experimental and observational studies revealed significant negative effects of unwell moral characters on the overall aspects of health and well-being. Nowadays, a lot of studies established the positive role of spirituality in the improvement of health and moral disorder. The studies concluded, facilities must be available within schools, universities, and communities for everyone to learn the knowledge of spirituality and improve their unwell moral character world. Conclusion: Considering the negative relationship between unwell moral characters and well-being, the current study proposes the addition of moral disorder as a separate topic in the WHO International Classification of Diseases. Based on this literature review, spirituality will improve moral disorder and establish excellent moral traits.

Keywords: bad moral characters, effect, health, spirituality and well-being

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Authors: Akinsola Oluwatosin, Udofia Samuel, Odofin Mayowa

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The study is aimed at assessing the Geographic Information System (GIS)-based spatial analysis of Survival Pattern and Treatment Outcomes of Multi-Drug Resistant Tuberculosis (MDR-TB) cases for Lagos, Nigeria, with an objective to inform priority areas for public health planning and resource allocation. Multi-drug resistant tuberculosis (MDR-TB) develops due to problems such as irregular drug supply, poor drug quality, inappropriate prescription, and poor adherence to treatment. The shapefile(s) for this study were already georeferenced to Minna datum. The patient’s information was acquired on MS Excel and later converted to . CSV file for easy processing to ArcMap from various hospitals. To superimpose the patient’s information the spatial data, the addresses was geocoded to generate the longitude and latitude of the patients. The database was used for the SQL query to the various pattern of the treatment. To show the pattern of disease spread, spatial autocorrelation analysis was used. The result was displayed in a graphical format showing the areas of dispersing, random and clustered of patients in the study area. Hot and cold spot analysis was analyzed to show high-density areas. The distance between these patients and the closest health facility was examined using the buffer analysis. The result shows that 22% of the points were successfully matched, while 15% were tied. However, the result table shows that a greater percentage of it was unmatched; this is evident in the fact that most of the streets within the State are unnamed, and then again, most of the patients are likely to supply the wrong addresses. MDR-TB patients of all age groups are concentrated within Lagos-Mainland, Shomolu, Mushin, Surulere, Oshodi-Isolo, and Ifelodun LGAs. MDR-TB patients between the age group of 30-47 years had the highest number and were identified to be about 184 in number. The outcome of patients on ART treatment revealed that a high number of patients (300) were not ART treatment while a paltry 45 patients were on ART treatment. The result shows the Z-score of the distribution is greater than 1 (>2.58), which means that the distribution is highly clustered at a significance level of 0.01.

Keywords: tuberculosis, patients, treatment, GIS, MDR-TB

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Authors: Salwa S. Dawaki, Init Ithoi, Sa’adatu I. Yelwa

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Introduction: Parasitic infections are major public health problems worldwide, particularly in developing countries. Two third of the world population is infected while about 3 billion are at risk of parasitic infections. It is demonstrated that most parasitic infections occur as multiple infections especially among poor and rural communities of most countries in the tropical regions. Parasitic infections are endemic in Nigeria, yet multiple infections are rarely reported. The study aimed to estimate the prevalence and identify factors associating with multiple parasitic infections among rural population in Kano State Nigeria. Methodology: A cross-sectional survey was conducted from June to August 2013 in rural Kano State, Nigeria. Three samples stool, urine, and blood were collected from each of the 551 volunteers aged between one and ninety years old recruited for the survey. A pre-tested questionnaire was used to obtain epidemiological data. Data were analysed using appropriate descriptive, univariate and multivariate logistic regression methods. Major findings: The participants were 61.7% male, 38.3% female, and 69.0% were adults of 15 years and above. Overall, 463 (84%) were infected with parasitic infections among which 60.9% had multiple infections. A total of 15 parasitic species were recovered, and up to 8 different parasitic species were found concurrently in a single host. Plasmodium was the most common parasite followed by Blastocystis, Entamoeba species, and hookworms. It was found that presence of an infected family member (P = 0.017; OR = 1.52; 95% CI = 1.08, 2.13) and not wearing shoes outside home (P = 0.043; OR = 1.50; 95% CI = 1.01, 2.18) significantly associated with higher risk of having multiple parasitic infections among the studied population. Conclusion: Parasitic infections pose a public health challenge in the rural community of Kano. Multiple parasitic infections are highly prevalent and presence of an infected family member as well as not wearing proper foot wear outside home increases the risk of infection. Poor hygiene, unfavourable socioeconomic conditions, and culture promote survival and transmission of parasites. There is a need for implementation of integrated approach aimed at controlling or eliminating the infections with emphasis on public awareness.

Keywords: multiple infections, parasitic infections, poor hygiene, risk of infection

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Authors: Jing Ren, Guifeng Han

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The mental health of most college students in China is negative due to the multiple pressures of academics, life, and employment. The problem of psychological stress has been widely discussed and needs to be resolved immediately. Therefore, six typical green spaces in Chongqing University, China, were selected to explore the relationship between eight environmental characteristics and students' stress relief. A path analysis model is established using Amos26.0 to explain the paths for environmental characteristics influencing psychological stress relief. The results show that (1) tree species diversity (TSD) has a positive effect on stress relief, thus green coverage ratio (GCR), the proportion of water area (WAP), visual green index (VGI), and color richness (CR) have both positive and negative effects; (2) CR could reduce stress directly and indirectly, while GCR, TSD, WAP, and VGI could only reduce stress indirectly, and the most effective path is TSD→extent→stress relief; (3) CR can reduce stress more greatly for males than females, CR and VGI have better effects for art students than science students. The study can provide a theoretical reference for planning and designing campus living environments to improve students' mental health.

Keywords: public health, residential environment, space planning and management, mental health, path analysis

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Authors: Racheal Ayanga, Nancy Katumba Muwangala, Jane Babirye, Harriet Kivumbi

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Background: Deaf adolescents are vulnerable. Deafness limits their access to resources that are accessed by their hearing peers. There is minimal attention placed on the SRH needs of persons with disabilities, especially in developing countries. We sought to assess barriers to access of SRH education and services for deaf adolescents in Uganda. Methods: We performed a cross sectional study using a questionnaire on knowledge of and access to SRH education and services from a selected sample of deaf adolescents aged 13-19 years at Wakiso Secondary school for the deaf. A consecutive sample of eligible participants was asked to join the study after obtaining informed consent until the target sample size was reached. Results: From 01 Jul 2022 to 30 Jan 2023, 70 quantitative interviews were conducted. Participants’ mean age was 17 years, and 66% were female. 89% had heard about several components of SRH. 99% reported a need for education and services but had challenges with access 85% of the time. 54% reported receipt of education and services from government or private facilities, and the rest from friends, parents, siblings, teachers and the internet. Conclusion: Government needs to look into availing tailored, sustainable SRH education/services to deaf adolescents at health facilities and teach health workers sign language. SRH education to parents, teachers and communities of deaf adolescents improves access in hard-to-reach areas. Integration of services into routine health care is key in creating and improving models of access to wider communities of persons with disabilities to improve their mental health.

Keywords: sexual and reproductive health, deaf, adolescents, education, services, disabilities, mental health, hard-to-reach areas

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Authors: Wee Tong Liaw, Elaine Wong Yee Sing

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The main objective and focus of this study are to establish the significance of a sustained health promoting workplace on stock and portfolio returns focusing on companies listed on the Singapore stock exchange, using a two-factor model comprising of the single factor CAPM and a 'health promoting workplace' factor. The 'health promoting workplace' factor represents the excess returns derived between two portfolios of component stocks that, when combined, would represent a top tier stock market index in Singapore, namely the STI index. The first portfolio represents companies that are independently assessed by the Singapore’s Health Award, SHA, to have a sustained and comprehensive health promoting workplace (SHA-STI portfolio) and the second portfolio represents companies that had not been independently assessed (Non-SHA STI portfolio). 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. When using a ten year holding period instead of a one year holding period, excess returns in the SHA-STI portfolio over Non-SHA STI portfolio were consistently being observed over all test periods, during 2001 to 2013. In addition, when applied to the SHA-STI portfolio, results from the Two Factor Model consistently revealed higher explanatory powers across all test periods for the portfolio as well as all the individual component stocks in SHA-STI portfolio, than the single factor CAPM model. However, with respect to attaining higher level of achievement in the Singapore Health Award, this study did not show any incentive for selecting listed companies that have achieved a higher level of award. Results from this study would give further insights to investors and fund managers alike who intend to consider health promoting workplace as a risk factor in their stock or portfolio selection process, in particular for investors who have a preference for STI’s component stocks and with a longer investment horizon. Key micro factors like management abilities, business development strategies and production capabilities that meet the needs of market would create the demand for a company’s product(s) or service(s) and consequently contribute to its top line and profitability. Thereafter, the existence of a sustainable health promoting workplace would be a key catalytic factor in sustaining a productive workforce needed to support the continued success of a profitable business.

Keywords: asset pricing model, company's performance, stock returns, financial risk factor, sustained health promoting workplace

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Authors: Szu-Yin Chu

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Self-determination has been particularly influential in obtaining a better quality of life through successful transition processes for students with disabilities. The development of self-determination through learning has raised attention at an early age. This study used a survey questionnaire to construct the understanding of the self-determination in Taiwan, learn the perspectives about the environmental and situational contexts where the respondents expect children to display self-determination skills in different cultures. Specifically, the research questions are: (a) What are Taiwanese families’ general perspectives about the development of foundations of self-determination for young children with special needs? and (b) how does families’ demographic background (i.e., income level, educational background) and child characteristics (i.e., age, emotional or behavior problems) impact Taiwanese families’ perspectives on the foundations of self-determination across three critical components (i.e., choice-making and problem-solving, self-regulation, and engagement) for young children with special needs? Data from 125 participants were gathered and analyzed. The findings suggested that Taiwanese families showed very positive attitudes toward promoting a foundation of self-determination for young children with special needs. Families’ income level and child’s severity of emotional/behavioral problems were two variables that were found to impact families’ views on their child’s foundational self-determination skills. Implications for future research and practice in supporting families to promote foundations of self-determination for young children with special needs will be provided.

Keywords: disabilities, self-determination, Taiwan, young children

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Authors: John O. Akindoyo, M. D. H. Beg, Suriati Binti Ghazali, Nitthiyah Jeyaratnam

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Regeneration of bone due to the many health challenges arising from traumatic effects of bone loss, bone tumours and other bone infections is fast becoming indispensable. Over the period of time, some approaches have been undertaken to mitigate this challenge. This includes but not limited to xenografts, allografts, autografts as well as artificial substitutions like bioceramics, synthetic cements and metals. However, most of these techniques often come along with peculiar limitation and problems such as morbidity, availability, disease transmission, collateral site damage or absolute rejection by the body as the case may be. Hydroxyapatite (HA) is very compatible and suitable for this application. However, most of the common methods for HA synthesis are expensive and environmentally unfriendly. Extraction of HA from bio-wastes have been perceived not only to be cost effective, but also environment-friendly. In this research, HA was produced from bio-waste: namely bovine bones through a combination of hydrothermal chemical processes and ordinary calcination techniques. Structure and property of the HA was carried out through different characterization techniques (such as TGA, FTIR, DSC, XRD and BET). The synthesized HA was found to possess similar properties to stoichiometric HA with highly desirable thermal, degradation, structural and porous properties. This material is unique for its potential minimal cost, environmental friendliness and property controllability. It is also perceived to be suitable for tissue and bone engineering applications.

Keywords: biomaterial, biopolymer, bone, hydroxyapatite

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Authors: Beatrice Adeoye

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Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

Procedia PDF Downloads 385