Search results for: community health nursing

Authors: Lyne Chantal Boudreau, Claudine Auger, Arline Laforest

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As an English-speaking country, Canada faces challenges in French-language education. During both editions of a provincial congress on education planned and conducted under shared cultural leadership, three organizers created a Francophone space where, for the first time in the province of New Brunswick (the only officially bilingual province in Canada), a group of stakeholders from the school, post-secondary and community sectors have succeeded in contributing to reflections on specific topics by sharing winning practices to meet the challenges of learning in a minority Francophone environment. Shared cultural leadership is a hybrid between theories of leadership styles in minority communities and theories of shared leadership. Through shared cultural leadership, the goal is simply to guide leadership and to set up all minority leaderships in minority context through shared leadership. This leadership style requires leaders to transition from a hierarchical to a horizontal approach, that is, to an approach where each individual is at the same level. In this exploratory research, it has been demonstrated that shared leadership exercised under the T-learning model best fosters the mobilization of all partners in advancing in-depth knowledge in a particular field while simultaneously allowing learning of the elements related to the domain in question. This session will present how it is possible to mobilize the whole community through leaders who continually develop their knowledge and skills in their specific field but also in related fields. Leaders in this style of management associated to shared cultural leadership acquire the ability to consider solutions to problems from a holistic perspective and to develop a collective power derived from the leadership of each and everyone in a space where all are rallied to promote the ultimate advancement of society.

Keywords: education, minority context, shared leadership, t-leaning

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Authors: Clinton Adas

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Industrial animal farming contributes to numerous problems that humans face, and among these, antimicrobial resistance (AMR) has been identified by the World Health Organisation as a real possibility for the 21st Century. While numerous factors contribute to AMR, one of them is industrial animal farming and its effect on the food chain and environment. In 2017, livestock were given around 73% of all antibiotics worldwide to make them grow faster for profit purposes, to prevent illness caused by unhealthy living conditions, and to treat disease when it breaks out. Many of the antibiotics used provide little benefit to animals, and most are the same as those used by humans - including many deemed critical to human health that should be used sparingly. AMR contributes to millions of illnesses, and in 2019 was responsible for around 4.95 million deaths worldwide. It costs Europe around nine billion euros per year, while it costs the United States (US) around 20 billion dollars per year. While not a simple or quick solution, one way to begin to address the challenge of AMR and other harms from this type of farming is to focus on animal welfare as part of a One Health and Welfare approach, as better welfare requires less antibiotics usage, which may begin to break the cycle.

Keywords: animal and human welfare, industrial animal farming, antimicrobial resistance, one health and welfare, sustainable development goals

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Authors: Era Dorihi Kale, Sabina Gero, Uly Agustine

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Asylum seekers are people who come to other countries to get asylum. In line with that, they also carry the culture and health behavior of their country, which is very different from the new country they currently live in. This situation raises problems, also in the health sector. The approach taken must also be a culturally sensitive approach, where the culture and habits of the refugee's home area are also valued so that the health services provided can be right on target. Some risk factors that already exist in this group are lack of activity, consumption of fast food, smoking, and stress levels that are quite high. Overall this condition will increase the risk of an increased incidence of cardiovascular disease. This research is a descriptive and experimental study. The purpose of this study is to identify health status and develop a culturally sensitive health promotion model, especially related to the risk of cardiovascular disease for asylum seekers in detention homes in the city of Kupang. This research was carried out in 3 stages, stage 1 was conducting a survey of health problems and the risk of asylum seeker cardiovascular disease, Stage 2 developed a health promotion model, and stage 3 conducted a testing model of health promotion carried out. There were 81 respondents involved in this study. The variables measured were: health status, risk of cardiovascular disease and, health promotion models. Method of data collection: Instruments (questionnaires) were distributed to respondents answered for anamnese health status; then, cardiovascular risk measurements were taken. After that, the preparation of information needs and the compilation of booklets on the prevention of cardiovascular disease is carried out. The compiled booklet was then translated into Farsi. After that, the booklet was tested. Respondent characteristics: average lived in Indonesia for 4.38 years, the majority were male (90.1%), and most were aged 15-34 years (90.1%). There are several diseases that are often suffered by asylum seekers, namely: gastritis, headaches, diarrhea, acute respiratory infections, skin allergies, sore throat, cough, and depression. The level of risk for asylum seekers experiencing cardiovascular problems is 4 high risk people, 6 moderate risk people, and 71 low risk people. This condition needs special attention because the number of people at risk is quite high when compared to the age group of refugees. This is very related to the level of stress experienced by the refugees. The health promotion model that can be used is the transactional stress and coping model, using Persian (oral) and English for written information. It is recommended for health practitioners who care for refugees to always pay attention to aspects of culture (especially language) as well as the psychological condition of asylum seekers to make it easier to conduct health care and promotion. As well for further research, it is recommended to conduct research, especially relating to the effect of psychological stress on the risk of cardiovascular disease in asylum seekers.

Keywords: asylum seekers, health status, cardiovascular disease, health promotion

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Authors: Heba Salama, Barry Gibson, Jennifer Burr

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Introduction: It is often argued that better oral health leads to better wellbeing, and the goal of dental care is to improve wellbeing. Notwithstanding, to our best knowledge, there is a lack of evidence to support the relationship between oral health and wellbeing. Aim: The scoping review aims to examine current definitions of health and wellbeing as well as map the evidence to examine the relationship between oral health and wellbeing. Methods: The scoping review followed the Preferred Reporting Items for Systematic Reviews Extension for Scoping Review (PRISMA-ScR). A two-phase search strategy was followed because of the unmanageable number of hits returned. The first phase was to identify how well-being was conceptualised in oral health literacy, and the second phase was to search for extracted keywords. The extracted keywords were searched in four databases: PubMed, CINAHL, PsycINFO, and Web of Science. To limit the number of studies to a manageable amount, the search was limited to the open-access studies that have been published in the last five years (from 2018 to 2022). Results: Only eight studies (0.1%) of the 5455 results met the review inclusion criteria. Most of the included studies defined wellbeing based on the hedonic theory. And the Satisfaction with Life Scale is the most used. Although the research results are inconsistent, it has generally been shown that there is a weak or no association between oral health and wellbeing. Interpretation: The review revealed a very important point about how oral health literature uses loose definitions that have significant implications for empirical research. That results in misleading evidence-based conclusions. According to the review results, improving oral health is not a key factor in improving wellbeing. It appears that investing in oral health care to improve wellbeing is not a top priority to tell policymakers about. This does not imply that there should be no investment in oral health care to improve oral health. That could have an indirect link to wellbeing by eliminating the potential oral health-related barriers to quality of life that could represent the foundation of wellbeing. Limitation: Only the most recent five years (2018–2022), peer-reviewed English-language literature, and four electronic databases were included in the search. These restrictions were put in place to keep the volume of literature at a manageable level. This suggests that some significant studies might have been omitted. Furthermore, the study used a definition of wellbeing that is currently being evolved and might not everyone agrees with it. Conclusion: Whilst it is a ubiquitous argument that oral health is related to wellbeing, and this seems logical, there is little empirical evidence to support this claim. This question, therefore, requires much more detailed consideration. Funding: This project was funded by the Ministry of Higher Education and Scientific Research in Libya and Tripoli University.

Keywords: oral health, wellbeing, satisfaction, emotion, quality of life, oral health related quality of life

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Authors: Nathaniel Carpenter

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Web-enabled systems for supporting youth mental health management in Australia are pioneering in their field; however, with their success, these systems are experiencing exponential growth in demand which is straining an already stretched service. Supporting youth mental is critical as the lack of support is associated with significant and lasting negative consequences. To meet this growing demand, and provide critical support, investigations are needed on evaluating and improving existing online support services. Improvements should focus on developing frameworks capable of augmenting and scaling service provisions. There are few investigations informing best-practice frameworks when implementing e-mental health support systems for youth mental health; there are fewer which implement machine learning or artificially intelligent systems to facilitate the delivering of services. This investigation will use a case study methodology to highlight the design features which are important for systems to enable young people to self-manage their mental health. The investigation will also highlight the current information system challenges, to include challenges associated with service quality, provisioning, and scaling. This work will propose methods of meeting these challenges through improved design, service augmentation and automation, service quality, and through artificially intelligent inspired solutions. The results of this study will inform a framework for supporting youth mental health with intelligent and scalable web-enabled technologies to support an ever-growing user base.

Keywords: artificial intelligence, information systems, machine learning, youth mental health

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Authors: Carlos Arias-Alcaide, Cristina Soguero-Ruiz, Paloma Santos-Álvarez, Adrián García-Romero, Inmaculada Mora-Jiménez

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Analysing clinical data with computers in such a way that have an impact on the practitioners’ workflow is a challenge nowadays. This paper provides a first approach for monitoring the health status of COVID-19 patients through the use of some biomarkers (blood tests) and the simplest Naïve Bayes classifier. Data of two Spanish hospitals were considered, showing the potential of our approach to estimate reasonable posterior probabilities even some days before the event.

Keywords: Bayesian model, blood biomarkers, classification, health tracing, machine learning, posterior probability

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Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores

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Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.

Keywords: knowledge and attitude, nurses, pain management, practices on pain management

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Authors: Aishwarya Venkat, Anastasia Marshak, Ryan B. Simpson, Elena N. Naumova

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Livestock ownership is simultaneously linked to improved nutritional status through increased availability of animal-source protein, and increased risk of enteric infections through higher exposure to contaminated water sources. Agrarian and agro-pastoral households, especially those with cattle, goats, and sheep, are highly dependent on seasonally various environmental conditions, which directly impact nutrition and health. This study explores global spatiotemporally explicit evidence regarding the relationship between livestock ownership, enteric infections, and malnutrition. Seasonal and cyclical fluctuations, as well as mediating effects, are further examined to elucidate health and nutrition outcomes of individual and communal livestock ownership. The US Agency for International Development’s Demographic and Health Surveys (DHS) and the United Nations International Children's Emergency Fund’s Multi-Indicator Cluster Surveys (MICS) provide valuable sources of household-level information on anthropometry, asset ownership, and disease outcomes. These data are especially important in data-sparse regions, where surveys may only be conducted in the aftermath of emergencies. Child-level disease history, anthropometry, and household-level asset ownership information have been collected since DHS-V (2003-present) and MICS-III (2005-present). This analysis combines over 15 years of survey data from DHS and MICS to study 2,466,257 children under age five from 82 countries. Subnational (administrative level 1) measures of diarrhea prevalence, mean livestock ownership by type, mean and median anthropometric measures (height for age, weight for age, and weight for height) were investigated. Effects of several environmental, market, community, and household-level determinants were studied. Such covariates included precipitation, temperature, vegetation, the market price of staple cereals and animal source proteins, conflict events, livelihood zones, wealth indices and access to water, sanitation, hygiene, and public health services. Children aged 0 – 6 months, 6 months – 2 years, and 2 – 5 years of age were compared separately. All observations were standardized to interview day of year, and administrative units were harmonized for consistent comparisons over time. Geographically weighted regressions were constructed for each outcome and subnational unit. Preliminary results demonstrate the importance of accounting for seasonality in concurrent assessments of malnutrition and enteric infections. Household assets, including livestock, often determine the intensity of these outcomes. In many regions, livestock ownership affects seasonal fluxes in malnutrition and enteric infections, which are also directly affected by environmental and local factors. Regression analysis demonstrates the spatiotemporal variability in nutrition outcomes due to a variety of causal factors. This analysis presents a synthesis of evidence from global survey data on the interrelationship between enteric infections, malnutrition, and livestock. These results provide a starting point for locally appropriate interventions designed to address this nexus in a timely manner and simultaneously improve health, nutrition, and livelihoods.

Keywords: diarrhea, enteric infections, households, livestock, malnutrition, seasonality

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Authors: Ramón Cruzat, Sergio F. Ochoa, Ignacio Casas, Luis A. Guerrero, José Bravo

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Patients under health treatments that involve long stays at a hospital or health centre (e.g. cancer, organ transplants and severe burns), tend to get bored or depressed because of the lack of social interaction with family and friends. Such a situation also affects the evolution and effectiveness of their treatments. In many cases, the solution to this problem involves extra challenges, since many patients need to rest quietly (or remain in bed) to their being contagious. Considering the weak health condition in which usually are these kinds, keeping them motivated and quiet represents an important challenge for nurses and caregivers. This article presents a mobile ubiquitous game called MagicRace, which allows hospitalized kinds to interact socially with one another without putting to risk their sensitive health conditions. The game does not require a communication infrastructure at the hospital, but instead, it uses a mobile ad hoc network composed of the handheld devices used by the kids to play. The usability and performance of this application was tested in two different sessions. The preliminary results show that users experienced positive feelings from this experience.

Keywords: ubiquitous game, children's emotional support, social isolation, mobile collaborative interactions

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

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

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

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Authors: Farshad Kalantari

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

Keywords: toursim, health, culture, sport, lifestyle

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Authors: Halilu Babaji, Adamu Buba

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The proliferation of small arms and light weapons (SALW) and its illicit trafficking in West Africa and Nigeria in particular, pose a major threat to peace, security and development in the Sub-region. The high circulation of these weapons in the region is a product of the interplay of several factors, which derives principally from the internal socio-economic and political dynamics compounded by globalization. The process of globalization has congealed both time and space making it easier for ideas, goods, persons, services, information, products and money to move across borders with fewer restrictions. And this has a negative effect in the entire region making it easier for arms, ammunition, insurgents, criminal and drugs to flow within national boundaries. The failure of public security in most parts of Nigeria has lead communities to indulge in different forms of ‘self-help ‘security measures, ranging from vigilante groups to community-owned arms stockpiling. Having lost confidence in the Nigerian state, parties to some of these conflicts have become entangled in a security dilemma. The quest to procure more arms to guarantee personal and community protection from perceived and real enemies is fuelling the ‘domestic arms race ‘. Therefore, as small arms remain-and proliferate – development is impeded. The impact of SALW on economic well being and national development in Nigeria is of vast significant. Therefore the need to collect these arms in circulation in Nigeria particularly the volatile area of North-east is of very important. This will hopefully contribute to government effort in building a free, secured and peaceful society.

Keywords: arms, development, proliferation, security

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Authors: Ali Fuad Ashour

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Introduction: Contrary to the common belief that physical training for multiple sclerosis (MS) patients might exacerbate fatigue and provoke other symptoms of the illness, it is now widely accepted that exercise can be actually beneficial in terms of activities of daily living, reduced fatigue, and improved quality of life. The aim of this study was to assess the attitude of MS patients toward exercise. Methodology: 112 MS patients who were recruited from the local community participated in this study. We utilised a self-developed questionnaire targeting attitudes and perceptions of MS patients towards physical exercise. The questionnaire was piloted and tested for validity and reliability. Results: Before being diagnosed with MS, 49.9% of our MS patients’ respondents used to engage in different types of physical activities and sports, namely aerobics/walking (35.3%), stretching exercise (18.7%), and strengthening exercise (11.4%). After being diagnosed with MS, 40.8% of our sample showed determination to remain physically active. The interest in sports activities was consistent after the diagnoses with MS and included aerobics/walking (33.8%), stretching exercise (22.6%), and strengthening exercise (19.7%). Discussion: The Kuwaiti respondents thought that lack of encouragement was the main reason for them not exercise. Aptly put, if they try to exercise, they will be discouraged by the loved ones lest the worse happens. On the other side, British patients are generally aware of the benefits of physical and mental health-promoting activities; they can seek help from a wide range of professionals and are more actively involved in the management of their condition. It is therefore important that the benefits of physical activity are promoted among MS patients, and that attitude towards MS and MS patients is changed through education.

Keywords: perception, multiple sclerosis, exercise, physical training

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Authors: S. Karthikeyan, Naveen Bindra

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

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

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Authors: Deshar Bashu Dev

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In this modern age, most people in developed and developing countries are affected by mental illness. There are many mental illnesses, and their differing symptoms impact peoples’ lives in different ways. These illnesses affect the way people think and feel, as well as how they behave with others. Mental illness results from compound interactions between the mind, body, and environment. New technologies and sciences make the world a better place. These technologies are becoming smarter and are being developed every day to help make daily life easier However, people suffer from mental illness in every part of the world. The philosophy propounded by the Buddha, Buddhism, teaches that all life is connected, from the microcosm to macrocosm. In the 2,500 years that elapsed since the death of the Buddha, his disciples have spread his teachings and developed sophisticated psycho-therapeutic methodologies. We can find many examples in Buddhist texts and in the modern age where Buddhist philosophy modern science could not solve. The Noble Eightfold Path, which is one of the main philosophies of Buddhism; it eradicates hatred and ill will and cultivates good deeds, kindness, and compassion. Buddhism, as a practice of dialectic conversation and mindfulness training, is full of rich therapeutic tools that the mental health community has adopted to help people. Similarly, Buddhist meditation is very necessary; it purifies thoughts and avoids unnecessary thinking. This research aims to study different causes of mental illness; analyzes the different approaches to eradicate mental illness problems and provides conclusions and recommendations present solutions through Buddhism in this modern age.

Keywords: mental illness, Buddhism, mindfulness, Buddhist practices

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Authors: Melissa Dorsey

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Moral distress and compassion fatigue plague nurses in the Cardiothoracic Intensive Care Unit (CTICU) and cause an unnecessary level of turnover. Dueling Burnout describes an initiative that was implemented in the CTICU to reduce the level of burnout the nurses endure by encouraging dual roles with collaborating departments. Purpose: Critical care nurses are plagued by burnout, moral distress, and compassion fatigue due to the intensity of care provided. The purpose of the dual role program was to decrease these issues by providing relief from the intensity of the critical care environment while maintaining full-time employment. Relevance/Significance: Burnout, moral distress, and compassion fatigue are leading causes of Cardiothoracic Critical Care (CTCU) turnover. A contributing factor to burnout is the workload related to serving as a preceptor for a constant influx of new nurses (RN). As a result of these factors, the CTICU averages 17% nursing turnover/year. The cost, unit disruption, and, most importantly, distress of the clinical nurses required an innovative approach to create an improved work environment and experience. Strategies/Implementation/Methods: In May 2018, a dual role pilot was initiated for nurses. The dual role constitutes .6 full-time equivalent hours (FTE) worked in CTICU in combination with .3 FTE worked in the Emergency Department (ED). ED nurses who expressed an interest in cross-training to CTICU were also offered the dual role opportunity. The initial hypothesis was that full-time employees would benefit from a change in clinical setting leading to increased engagement and job satisfaction. The dual role also presents an opportunity for professional development through the expansion of clinical skills in another specialty. Success of the pilot led to extending the dual role to areas beyond the ED. Evaluation/Outcomes/Results: The number of dual role clinical nurses has grown to 22. From the dual role cohort, only one has transferred out of CTICU. This is a 5% turnover rate for this group of nurses as compared to the average turnover rate of 17%. A role satisfaction survey conducted with the dual role cohort found that because of working in a dual role, 76.5% decreased their intent to leave, 100% decreased their level of burnout, and 100% reported an increase in overall job satisfaction. Nurses reported the ability to develop skills that are transferable between departments. Respondents emphasized the appreciation gained from working in multiple environments; the dual role served to transform their care. Conclusions/Implications: Dual role is an effective strategy to retain experienced nurses, decrease burnout and turnover, improve collaboration, and provide flexibility to meet staffing needs. The dual role offers RNs an expansion of skills, relief from high acuity and orientee demands, while improving job satisfaction.

Keywords: nursing retention, burnout, pandemic, strategic staffing, leadership

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Authors: O. Nthoi-Molefe, V. Makwinja

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In the North West district of Botswana, Heritage tourism has the potential to offer tremendous economic and social opportunities for local communities in terms of supporting Tourism product development and entrepreneurship. This paper Identifies that Cultural Heritage Entrepreneur brings to the market goods and services, organizes and runs cultural heritage in a commercial or non-profit manner depending on characteristics of cultural resources identified. Data was collected through a series of focus group discussions that included sixteen village community members within the region. Data collected was transcribed and then further analyzed thematically to bring forward results to be analysed. Using Tsodilo Hills World Heritage Site as a case study, the researchers acknowledged that Cultural Heritage Entrepreneurs in that area should use a creative approach in order toidentify suitable solutions for financing different tourism activities starting with sponsored events, grant funds, donations, including the benefits of financial opportunities brough be foreign visitors and domestic tourists alike. The researchers also identified a need for specialized training for the identified entrepreneurs in order to maintain quality services of tourism products and sites (interpretation), information for tourists, visitation services, diversification, and upgrading of the heritage experience. The research reveals that the identified Cultural Heritage Entrepreneurs prefer economic motivation, exploitation over the cultural value of their resources, further calling for recommendations of the research that emphasize on the need for detailed training on how to valorize their cultural resources for the growth of Tourism in the area.

Keywords: education, community development, entrepreneurship, cultural tourism

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Authors: Rebecca Laycock

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Many Urban Agriculture (UA) initiatives, including community/allotment gardens, Community Supported Agriculture, and community/social farms, depend on volunteers. However, initiatives supported or run by volunteers are often faced with a high turnover of labour as a result of the involvement of episodic volunteers (a term describing ad hoc, one-time, and seasonal volunteers), leading to challenges with maintaining project continuity and retaining skills/knowledge within the initiative. This is a notable challenge given that food growing is a knowledge intensive activity where the fruits of labour appear months or sometimes years after investment. Participatory Action Research (PAR) is increasingly advocated for in the field of UA as a solution-oriented approach to research, providing concrete results in addition to advancing theory. PAR is a cyclical methodological approach involving researchers and stakeholders collaboratively 'identifying' and 'theorising' an issue, 'planning' an action to address said issue, 'taking action', and 'reflecting' on the process. Through iterative cycles and prolonged engagement, the theory is developed and actions become better tailored to the issue. The demand for PAR in UA research means that understanding how to use PAR with episodic volunteers is of critical importance. The aim of this paper is to explore (1) the challenges of doing PAR in UA initiatives with episodic volunteers, and (2) how PAR can be harnessed to advance sustainable development of UA through theoretically-informed action. A 2.5 year qualitative PAR study on three English case study student-led food growing initiatives took place between 2014 and 2016. University UA initiatives were chosen as exemplars because most of their volunteers were episodic. Data were collected through 13 interviews, 6 workshops, and a research diary. The results were thematically analysed through eclectic coding using Computer-Assisted Qualitative Data Analysis Software (NVivo). It was found that the challenges of doing PAR with transient participants were (1) a superficial understanding of issues by volunteers because of short term engagement, resulting in difficulties ‘identifying’/‘theorising’ issues to research; (2) difficulties implementing ‘actions’ given those involved in the ‘planning’ phase often left by the ‘action’ phase; (3) a lack of capacity of participants to engage in research given the ongoing challenge of maintaining participation; and (4) that the introduction of the researcher acted as an ‘intervention’. The involvement of a long-term stakeholder (the researcher) changed the group dynamics, prompted critical reflections that had not previously taken place, and improved continuity. This posed challenges for providing a genuine understanding the episodic volunteering PAR initiatives, and also challenged the notion of what constitutes an ‘intervention’ or ‘action’ in PAR. It is recommended that researchers working with episodic volunteers using PAR should (1) adopt a first-person approach by inquiring into the researcher’s own experience to enable depth in theoretical analysis to manage the potentially superficial understandings by short-term participants; and (2) establish safety mechanisms to address the potential for the research to impose artificial project continuity and knowledge retention that will end when the research does. Through these means, we can more effectively use PAR to conduct solution-oriented research about UA.

Keywords: community garden, continuity, first-person research, higher education, knowledge retention, project management, transience, university

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Authors: Evelyn Bilias-Lolis, Emily Louise Winter

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Schools have a responsibility to implement school-wide frameworks that actively prevent, detect, and support all aspects of child development and learning. Such efforts can range from individual or classroom-level supports to school-wide primary prevention practices for the school’s infrastructure or climate. This study assessed the perceptions of educators across a variety of disciplines in Connecticut (i.e., elementary and secondary education, special education, school psychology, and school social work) on the perceived impact of their beliefs, language, and behavior about food and body consciousness on student self-image and school climate. Participants (N=50) completed a short electronic questionnaire measuring perceptions of how their behavior can influence their students’ opinions about themselves, their emerging self-image, and the overall climate of the school community. Secondly, the beliefs that were directly assessed in the first portion of the survey were further measured through the use of applied social vignettes involving students directly or as bystanders. Preliminary findings are intriguing. When asked directly, 100% of the respondents reported that what they say to students directly could influence student opinions about themselves and 98% of participants further agreed that their behavior both to and in front of students could impact a student’s developing self-image. Likewise, 82% of the sample agreed that their personal language and behavior affect the overall climate of a school building. However, when the above beliefs were assessed via applied social vignettes depicting routine social exchanges, results were significantly more widespread (i.e., results were evenly dispersed among levels of agreement and disagreement across participants in all areas). These preliminary findings offer humble but critical implications for informing integrated school wellness frameworks that aim to create body-sensitive school communities. Research indicates that perceptions about body image, attitudes about eating, and the onset of disordered eating practices surface in school-aged years. Schools provide a natural setting for instilling foundations for child wellness as a natural extension of existing school climate reform efforts. These measures do not always need to be expansive or extreme. Rather, educators have a ripe opportunity to become champions for health and wellness through increased self-awareness and subtle shifts in language and behavior. Future psychological research needs to continue to explore this line of inquiry using larger and more varied samples of educators in order to identify needs in teacher training and development that can yield positive and preventative health outcomes for children.

Keywords: body-sensitive schools, integrated school health, school climate reform, teacher awareness

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Authors: Milca F. Coelho, K. Bousson, Kawser Ahmed

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To accurately track an aerospace vehicle in a time-critical situation and in a highly nonlinear environment, is one of the strongest interests within the aerospace community. The tracking is achieved by estimating accurately the state of a moving target, which is composed of a set of variables that can provide a complete status of the system at a given time. One of the main ingredients for a good estimation performance is the use of efficient estimation algorithms. A well-known framework is the Kalman filtering methods, designed for prediction and estimation problems. The success of the Kalman Filter (KF) in engineering applications is mostly due to the Extended Kalman Filter (EKF), which is based on local linearization. Besides its popularity, the EKF presents several limitations. To address these limitations and as a possible solution to tracking problems, this paper proposes the use of the Ensemble Kalman Filter (EnKF). Although the EnKF is being extensively used in the context of weather forecasting and it is being recognized for producing accurate and computationally effective estimation on systems with a very high dimension, it is almost unknown by the tracking community. The EnKF was initially proposed as an attempt to improve the error covariance calculation, which on the classic Kalman Filter is difficult to implement. Also, in the EnKF method the prediction and analysis error covariances have ensemble representations. These ensembles have sizes which limit the number of degrees of freedom, in a way that the filter error covariance calculations are a lot more practical for modest ensemble sizes. In this paper, a realistic simulation of a radar tracking was performed, where the EnKF was applied and compared with the Extended Kalman Filter. The results suggested that the EnKF is a promising tool for tracking applications, offering more advantages in terms of performance.

Keywords: Kalman filter, nonlinear state estimation, optimal tracking, stochastic environment

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Authors: Wee Tong Liaw, Elaine Wong Yee Sing

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

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

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Authors: Yash Bingi, Yiqiao Yin

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

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

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Authors: Louis Kusi Frimpong, Martin Oteng-Ababio

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The problem of crime and insecurity in urban environments are often complex, multilayered, multidimensional and sometimes interwoven. It is from this perspective that recent approaches and strategies aimed at responding to crime and insecurity have looked at the problem from a social, economic, spatial and institutional point of view. In Ghana, there is much understanding of how various elements of the social and spatial setting influence crime and safety concerns of residents in urban areas. However, little research attention has been given to the institutional dimension of the problem of crime and insecurity in urban Ghana. In particular, scholars and policymakers in the area of safety and security have scarcely interrogated the forms of collaboration that exist between the various formal and informal institutions and how gaps and lapses in this collaboration influence vulnerability to crime and feelings of insecurity. Using Sekondi-Takoradi as a case study and drawing on both primary and secondary data, this paper assesses the activities of various institutions both formal and informal in crime control and prevention in the Sekondi-Takoradi metropolis, the third largest city in Ghana. More importantly, the paper seeks to address gaps in the institutional arrangement and coordination between and among institutions at the forefront of crime prevention efforts in the metropolis and by extension Ghanaian cities. The study found that whiles there is some form of collaboration between the police and the community, little collaboration existed between planning authorities and the police on the one hand, and the community on the other hand. The paper concludes that in light of the complex nature of a crime, institutional coordination and an inclusive approach involving formal and informal will be critical in promoting safer cities in Ghana.

Keywords: crime prevention, coordination, Ghana, institutional arrangement

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Authors: Mapule Maema

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The paper aims to highlight the role that community activism has played in promoting social justice around housing issues in the Western Cape. The Western Cape is one of the largest spatially segregated provinces in South Africa which continues to exhibit grave inequalities between cities, townships and farms. These inequalities cut across intersectional issues such as, race, class, gender, and politics. The main challenges facing marginalized communities in the Western Cape include access to housing, land and basic services. This is not peculiar to only the Western Cape, the entire country is facing similar challenges however the Western Cape is seen as a fasted urbanizing province in the country due to tourism. Various social movements have been formed across the country to counter these challenges, however, this paper focuses on the resilience communities have fostered despite the myriad housing and spatial crisis they are faced with. The paper focuses on the Legal Resource’s Centre’s clients from an informal settlement called Imizamo Yethu based in Hout Bay Valley area. The 18 hectare settlement houses approximately 33600 people. On the 21st July 2017, Hout Bay experienced violent protests following an eviction order passed by the City of Cape Town. The protest was characterized by tensions within the community regarding the super-blocking initiative which aims to establish roads in informal settlements to ensure basic services. Residents against the process argued that there were no proper consultations done to educate them on what this process entailed. Public participation is one of the objectives the municipalities aim to promote however it remains a great challenge. In order to highlight the experiences of the LRC clients in relation to what motivated their involvement in the movement, how it felt their participation, and aspirations, the paper will employ qualitative research methods. Qualitative research methods enable the researcher to get a deeper and nuanced understanding of the social world in the eyes of those who experienced it. It is a flexible methodology that enables one to also understand social processes and the significance they generate. Data will be collected through the use of the World Cafe as a focus group method. The World Café is a simple, effective and flexible format for hosting group dialogue. The steps taken when setting up a World Café includes the following: setting the context (why you are bringing people together and what you want to achieve), create hospitality space (make participants feel at home and free to discuss issues), explore questions that matter, connect diverse perspectives (the opportunity to actively contribute your thinking), listen together for patterns and insights, share collective discoveries and learnings. Secondary data will be used to augment the data collected. Stories of impact will be drawn from the exercises. This paper will contribute to the discourse of sustainable housing and urban development and the research outputs will be disseminated to the public for learning.

Keywords: community activism, influence, social justice, development

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Authors: Demelash Kassaye Debalkie

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The primary objective of this study is to report the tributes that are significantly impeding the Ethiopian police's ability to provide quality services to the people. Policing in Ethiopia started in the medieval period. However, modern policing was introduced instead of vigilantism in the early 1940s. The progress counted since the date police became modernized is, however, under contention when viewed from the standpoint of officers’ development and technologies in the 21st century. The police in Ethiopia are suffering a lot to be set free from any form of political interference by the government and to be loyal to impartiality, equity, and justice in enforcing the law. Moreover, the institutional competence of the police in Ethiopia is currently losing its power derived from the constitution as a legitimate enforcement agency due to the country’s political landscape encouraging ethnic-based politics. According to studies, the impact of ethnic politics has been a significant challenge for police in controlling conflicts between two ethnic groups. The study used qualitative techniques and data was gathered from key informants selected purposely. The findings indicate that governments in the past decades were skeptical about establishing a constitutional police force in the country. This has certainly been one of the challenges of pluralizing the police: building police-community relations based on trust. The study conducted to uncover the obstructions has finally reported that the government’s commitment to form a non-partisan, functionally decentralized, and operationally demilitarized police force is too minimal and appalling. They mainly intend to formulate the missions of the police in accordance with their interests and political will to remain in power. It, therefore, reminds the policymakers, law enforcement officials, and the government in power to revise its policies and working procedures already operational to strengthen the police in Ethiopia based on public participation and engagement.

Keywords: community, constitution, Ethiopia, law enforcement

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Authors: Eke Balla Sophie Michelle

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Forest provides a wide range of environmental goods and services among which, biodiversity or consumption goods and constitute public goods. Despite the importance of non-timber forest products (NTFPs) in sustaining livelihood and poverty smoothening in rural communities, they are highly depleted and poorly conserved. Yokadouma is a town where NTFPs is a renewable resource in active exploitation. It has been found that such exploitation is done in the same conditions as other localities that have experienced a rapid depletion of their NTFPs in destination to cities across Cameroon, Central Africa, and overseas. Given these realities, it is necessary to access the consequences of this overexploitation through negative effects on both the population and the environment. Therefore, to enhance participatory conservation initiatives, this study determines the household’s willingness to pay in community forest (CF) of Morikouali-ye, eastern region of Cameroon, for sustainable exploitation of NTFPs using contingent valuation method (CVM) through two approaches, one parametric (Logit model) and the other non-parametric (estimator of the Turnbull lower bound). The results indicate that five species are the most collected in the study area: Irvingia gabonensis, the Ricinodendron heudelotii, Gnetum, the Jujube and bark, their sale contributes significantly to 41 % of total household income. The average willingness to pay through the Logit model and the Turnbull estimator is 6845.2861 FCFA and 4940 FCFA respectively per household per year with a social cost of degradation estimated at 3237820.3253 FCFA years. The probability to pay increases with income, gender, number of women in the household, age, the commercial activity of NTFPs and decreases with the concept of sustainable development.

Keywords: non timber forest product, contingent valuation method, willingness to pay, sustainable development

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Authors: Mária Ildikó Farkas

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Kokugaku of the Edo period can be seen as a key factor of defining cultural (and national) identity in the 18th and early 19th century based on Japanese cultural heritage. Kokugaku focused on Japanese classics, on exploring, studying and reviving (or even inventing) ancient Japanese language, literature, myths, history and also political ideology. ‘Japanese culture’ as such was distinguished from Chinese (and all other) cultures, ‘Japanese identity’ was thus defined. Meiji scholars used kokugaku conceptions of Japan to construct a modern national identity based on the premodern and culturalist conceptions of community. The Japanese cultural movement of the 18-19th centuries (kokugaku) of defining cultural and national identity before modernization can be compared not to the development of Western Europe (where national identity strongly attached to modern nation states) or other parts of Asia (where these emerged after the Western colonization), but rather with the ‘national awakening’ movements of the peoples of East Central Europe, a comparison which have not been dealt with in the secondary literature yet. The role of a common language, culture, history and myths in the process of defining cultural identity – following mainly Miroslav Hroch’s comparative and interdisciplinary theory of national development – can be examined compared to the movements of defining identity of the peoples of East Central Europe (18th-19th c). In the shadow of a cultural and/or political ‘monolith’ (China for Japan and Germany for Central Europe), before modernity, ethnic groups or communities started to evolve their own identities with cultural movements focusing on their own language and culture, thus creating their cultural identity, and in the end, a new sense of community, the nation. Comparing actual texts (‘narratives’) of the kokugaku scholars and Central European writers of the nation building period (18th and early 19th centuries) can reveal the similarities of the discourses of deliberate searches for identity. Similar motives of argument can be identified in these narratives: ‘language’ as the primary bearer of collective identity, the role of language in culture, ‘culture’ as the main common attribute of the community; and similar aspirations to explore, search and develop native language, ‘genuine’ culture, ‘original’ traditions. This comparative research offering ‘development patterns’ for interpretation can help us understand processes that may be ambiguously considered ‘backward’ or even ‘deleterious’ (e.g. cultural nationalism) or just ‘unique’. ‘Cultural identity’ played a very important role in the formation of national identity during modernization especially in the case of non-Western communities, who had to face the danger of losing their identities in the course of ‘Westernization’ accompanying modernization.

Keywords: cultural identity, Japanese modernization, kokugaku, national awakening

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

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

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

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

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

Keywords: healthcare, settlement strategy, urban health, rural

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

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

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

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