Search results for: health mental

Authors: Ronald Blough

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Hospitals, clinics, and medical facilities are the core of the Health Services sector providing 24/7 medical care to those in need. Any disruption of these important medical services highlights the vulnerabilities in the medical system. An internal or external event can create a catastrophic incident paralyzing the medical services causing the facility to shift into emergency operations with the possibility of evacuation. The hospital administrator and government officials must decide in a very short amount of time whether to shelter in place or evacuate. This presentation will identify best practice recommendations regarding the hospital evacuation decision and response analyzing previous hospital evacuations to encourage hospitals in the region to review or develop their own emergency evacuation plans.

Keywords: disaster preparedness, hospital evacuation, shelter-in-place, incident containment, health services vulnerability, hospital resources

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Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

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Authors: Viacheslav Sushko, Viktor Sushko

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Pre-cancerous breast diseases are pathological changes that precede the appearance of adenocarcinoma. The most common benign breast disease is mastopathy. We examined the life and disease history of 114 women aged 58-69 who were diagnosed with adenocarcinoma of the breast at different stages of development. They filled out the Reeder Scale to determine the level of stress. The results of the study revealed that 62 of them had mastopathy at the age of 30-45 years old. These women refused surgical treatment for mastopathy. Five to six years before their diagnosis of adenocarcinoma of the mammary gland, 84 women had experienced severe stress (death of a beloved close relative, torture accompanied by rape, prolonged stay in extreme conditions (under bombardment and bombardment). In the assessment of data from completed Reeder scales, 114 women had a high level of mental stress, with a score from 1-1.72. The 84 women who suffered from severe stress showed overeating or a significant decrease in food intake, insomnia, apathy, increased irritability and restlessness, loss of interest in sexual relationships, forgetfulness, difficulty in performing routine work, prolonged uncontrollable headaches, unexplained fatigue, heart pain, reduced capacity for work. In conclusion, it is important to provide psychotherapy for breast cancer patients as the diagnosis, and the different stages of treatment are very stressful. It is also advisable to see a psychiatrist at an early stage and prevent distress and treat precancerous breast disease.

Keywords: breast cancer, distress, mastopathy, severe stress

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Authors: Jonghoon Kim, Gilwon Yoon

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A wrist-band type biosignal measurement system and its data transfer through human body communication (HBC) were investigated. An HBC method based on pulses of ultra-wide band instead of using frequency or amplitude modulations was studied and implemented since the system became very compact and it was more suited for personal or mobile health monitoring. Our system measured photo-plethysmogram (PPG) and measured PPG signals were transmitted through a finger to a monitoring PC system. The device was compact and low-power consuming. HBC communication has very strong security measures since it does not use wireless network. Furthermore, biosignal monitoring system becomes handy because it does not need to have wire connections.

Keywords: biosignal, human body communication, mobile health, PPG, ultrawide band

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Authors: Fiona Jensen, Barb Goodwin, Nancy Kleiman, Rhonda Usunier

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Background: Clinical simulation is now a common component in many health profession curricula in preparation for clinical practice. In the Rady Faculty of Health Sciences (RFHS) college leads in simulation and interprofessional (IP) education, planned an eight hour simulated hospital day shift, where seventy students from six health professions across two campuses, learned with each other in a safe, realistic environment. Learning about interprofessional collaboration, an expected competency for many health professions upon graduation, was a primary focus of the simulation event. Method: Faculty representatives from the Colleges of Nursing, Medicine, Pharmacy and Rehabilitation Sciences (Physical Therapy, Occupation Therapy, Respiratory Therapy) and Pharmacy worked together to plan the IP event in a simulation facility in the College of Nursing. Each college provided a faculty mentor to guide the same profession students. Students were placed in interprofessional teams consisting of a nurse, physician, pharmacist, and then sharing respiratory, occupational, and physical therapists across the team depending on the needs of the patients. Eight patient scenarios were role played by health profession students, who had been provided with their patient’s story shortly before the event. Each team was guided by a facilitator. Results and Outcomes: On the morning of the event, all students gathered in a large group to meet mentors and facilitators and have a brief overview of the six competencies for effective collaboration and the session objectives. The students assuming their same profession roles were provided with their patient’s chart at the beginning of the shift, met with their team, and then completed professional specific assessments. Shortly into the shift, IP team rounds began, facilitated by the team facilitator. During the shift, each patient role-played a spontaneous health incident, which required collaboration between the IP team members for assessment and management. The afternoon concluded with team rounds, a collaborative management plan, and a facilitated de-brief. Conclusions: During the de-brief sessions, students responded to set questions related to the session learning objectives and expressed many positive learning moments. We believe that we have a sustainable simulation IP collaborative learning opportunity, which can be embedded into curricula, and has the capacity to grow to include more health profession faculties and students. Opportunities are being explored in the RFHS at the administrative level, to offer this event more frequently in the academic year to reach more students. In addition, a formally structured event evaluation tool would provide important feedback and inform the qualitative feedback to event organizers and the colleges about the significance of the simulation event to student learning.

Keywords: simulation, collaboration, teams, interprofessional

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Authors: Gokhan Zengin, Abdurrahman Aktumsek

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The key enzyme inhibitory theory is one of the most accepted strategies in the treatment of global health problems including Alzheimer’s Disease and Diabetes mellitus. For this reason, the enzyme inhibitory potentials of different solvent extracts from Linaria genistifolia subsp. genistifolia were investigated against cholinesterase, and tyrosinase. The in vitro enzyme inhibitory potentials were measured with a microplate reader. The acetone and methanol extracts exhibited the strongest enzyme inhibitory effects on cholinesterase. However, the water extract was only active on tyrosinase. The results suggested that Linaria genistifolia subsp. genistifolia could be considered as a source of natural enzyme inhibitors for the treatment of major health problems.

Keywords: enzyme inhibitors, cholinesterase, tyrosinase, linaria, Turkey

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Authors: Shahryar Eslamitabar

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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.

Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving

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Authors: Thomas C. Nash

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New Zealand has a small, yet racially diverse, population of only 4.6 million people, consisting of a majority European immigrant population and a large indigenous Maori population. Because disparities in healthcare often exist among minority populations, it could be expected that the White and Maori populations of New Zealand would have unequal access to healthcare. In order to understand the ways these disparities may present themselves, it became important to travel to New Zealand in order to interview both Western and natural healthcare professionals, public health officials, health activists and Maori people. In observing the various mechanisms within the New Zealand healthcare system, some stand out as effective ways of alleviating the racial disparities often seen in healthcare. These include the efficiency of regional District Health Boards, the benefits of individuals making decisions regarding their treatment plans and the importance of cohesion among the Maori and White populations. In forming a conclusion around these observations, it is evident that the integration of Maori culture into contemporary New Zealand has benefited the healthcare system. This unity has generated support for non-Western medical treatments, in turn forming a healthcare system that creates low barriers to entry for non-traditional forms of healthcare. These low barriers allow individuals to allocate available healthcare resources in ways that are most beneficial for them and are consistent with their tastes and preferences, maximizing efficiency.

Keywords: alternative and complementary healthcare, low barriers to entry, Maori populations, racial cohesion

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Authors: Obinna Afamefuna Echi

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Background: The global increase in the elderly population is anticipated to reach significant levels by 2050, presenting extensive economic, social, and healthcare challenges. Age-related cognitive decline, alterations in brain anatomy, and systemic inflammation are profound concerns that diminish the quality of life and increase susceptibility to diseases like Alzheimer's and cardiovascular diseases. Resistance training is presently studied for its potential neuroprotective and anti-inflammatory benefits in older adults. Objectives: This study aimed to explore the effects of different resistance training modalities on neurotrophic factors, inflammatory markers, and cognitive functions in the elderly. Methods: A controlled trial was conducted with 60 male participants aged 60-75, assigned to either 12 weeks of high-intensity blood flow restriction training (BFRT), muscle damaging resistance training (MDRT), or a non-exercising control group. Cognitive function, neurotrophic factors such as BDNF, and inflammatory markers including IL-6 and TNF were measured before and after the intervention period. Setting: Participants were recruited from Kaunas, Lithuania, with sessions facilitated at the Lithuanian Sports University and health assessments conducted at the Lithuanian University of Health Sciences. Results: Preliminary data suggested did not show significant improvements in BDNF levels and cognitive functions in the BFRT and MDRT groups compared to controls. However, there was a notable reduction in inflammatory markers, indicating potential health benefits beyond cognitive enhancement. Conclusion: The incorporation of resistance training can be a strategic intervention to mitigate age-associated cognitive decline and systemic inflammation, thereby enhancing overall health and quality of life in older adults. The results advocate for wider adoption and further study of resistance training as a preventive measure in ageing populations. Funding: The Lithuanian Sports University, the Research Council of Lithuania and the Lithuanian University of Health Sciences.

Keywords: ageing, resistance training, BDNF, cognitive function

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Authors: B. Atli-Veltin, A. Vosteen, D. Megan, A. Jedynska, L. K. Cheng

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Composite materials combine the advantages of being lightweight and possessing high strength. This is in particular of interest for the development of large constructions, e.g., aircraft, space applications, wind turbines, etc. One of the shortcomings of using composite materials is the complex nature of the failure mechanisms which makes it difficult to predict the remaining lifetime. Therefore, condition and health monitoring are essential for using composite material for critical parts of a construction. Different types of sensors are used/developed to monitor composite structures. These include ultrasonic, thermography, shearography and fiber optic. The first 3 technologies are complex and mostly used for measurement in laboratory or during maintenance of the construction. Optical fiber sensor can be surface mounted or embedded in the composite construction to provide the unique advantage of in-operation measurement of mechanical strain and other parameters of interest. This is identified to be a promising technology for Structural Health Monitoring (SHM) or Prognostic Health Monitoring (PHM) of composite constructions. Among the different fiber optic sensing technologies, Fiber Bragg Grating (FBG) sensor is the most mature and widely used. FBG sensors can be realized in an array configuration with many FBGs in a single optical fiber. In the current project, different aspects of using embedded FBG for composite wind turbine monitoring are investigated. The activities are divided into two parts. Firstly, FBG embedded carbon composite laminate is subjected to tensile and bending loading to investigate the response of FBG which are placed in different orientations with respect to the fiber. Secondly, the demonstration of using FBG sensor array for temperature and strain sensing and monitoring of a 5 m long scale model of a glass fiber mono-pile is investigated. Two different FBG types are used; special in-house fibers and off-the-shelf ones. The results from the first part of the study are showing that the FBG sensors survive the conditions during the production of the laminate. The test results from the tensile and the bending experiments are indicating that the sensors successfully response to the change of strain. The measurements from the sensors will be correlated with the strain gauges that are placed on the surface of the laminates.

Keywords: Fiber Bragg Gratings, embedded sensors, health monitoring, wind turbine towers

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Authors: Toledo-Fernandez Aldebaran

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Introduction: One of the least explored cognitive functions in relation with depression is the one related to musical stimuli. Music perception and memory can become impaired as well. The term amusia is used to define a type of agnosia caused by damage to basic processes that creates a general inability to perceive music. Therefore, the main objective is to explore performance-based and self-report deficits in music perception and memory on people with major depressive disorder (MDD). Method: Data was collected through April-October 2021 recruiting people who met the eligibility criteria and using the Montreal Battery of Evaluation of Amusia (MBEA) to evaluate performance-based music perception and memory, along with the module for depression of the Mini International Neuropsychiatric Interview, and the Amusic Dysfunction Inventory (ADI) which evaluates the participants’ self-report concerning their abilities in music perception. Results: 64 participants were evaluated. The main study, referring to analyzing the differences between people with MDD and the control group, only showed one statistical difference on the Interval subtest of the MBEA. No difference was found in the dimensions assessed by the ADI. Conclusion: Deficits in interval perception can be explained by mental fatigue, to which people with depression are more vulnerable, rather than by specific deficits in musical perception and memory associated with depressive disorder. Additionally, significant associations were found between musical deficits as observed by performance-based evidence and music dysfunction according to self-report, which could suggest that some people with depression are capable of detecting these deficits in themselves.

Keywords: depression, amusia, music, perception, memory

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Authors: Bahareh Montakhabi

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Earthquake is known as one of the deadliest natural disasters, with a high potential for damage to life and property. Some of Iran's cities were completely destroyed after major earthquakes, and the people of the region suffered a lot of mental, financial and psychological damage. Tehran is one of the cities located on the fault line. According to experts, the only city that could be severely damaged by a moderate earthquake in Earthquake Engineering Intensity Scale (EEIS) (70% destruction) is Tehran because Tehran is built precisely on the fault. Seismic risk assessment (SRA) of cities in the scale of urban areas and neighborhoods is the first phase of the earthquake crisis management process, which can provide the information required to make optimal use of available resources and facilities in order to reduce the destructive effects and consequences of an earthquake. This study has investigated strategies to promote safety and reduce the vulnerability of worn-out urban textures in the District 12 of Tehran to the potential risk of earthquake aimed at prioritizing the factors affecting the vulnerability of worn-out urban textures to earthquake crises and how to reduce them, using the analytical-exploratory method, analytical hierarchy process (AHP), Expert choice and SWOT technique. The results of SWAT and AHP analysis of the vulnerability of the worn-out textures of District 12 to internal threats (1.70) and external threats (2.40) indicate weak safety of the textures of District 12 regarding internal and external factors and a high possibility of damage.

Keywords: risk management, vulnerability, worn-out textures, earthquake

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Authors: Kholil, Ario Bimo, Hifni Alifahmi, Soecahyadi, Husen Money

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The number of smokers in Indonesia currently reached 66 million (25.09%) of the total number of smokers reaching 264 million. The government (central and local governments) have issued various rules to reduce the number of smokers, but the results are still not effective; in fact, the number of smokers continues to increase every year. This study aims to determine the influence of demographics, economy, health, and the role of government on the awareness of smokers in reducing the dangers of cigarettes. Data collection was carried out through a questionnaire distributed to 255 randomly selected respondents and data analysis using SEM (Structural Equation Model). The results of the analysis show that economic and socio-cultural factors do not directly affect the awareness of reducing the dangers of cigarettes. But indirectly, its influence becomes significant through intervening variables of communication strategies. Meanwhile, health factors and the government's role have a very significant influence both directly and indirectly on reducing the dangers of cigarettes. Thus, the main strategy to build awareness of smokers in reducing the dangers of smoking is building an effective communication strategy through three main factors: (1) health, (2) government regulations and (3) the economy.

Keywords: harm reduction, awareness, communication strategy, SEM

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Authors: Adeniyi Onasanya, Maher Elshakankiri

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In recent years, the Internet of Things (IoT) has constituted a driving force of modern technological advancement, and it has become increasingly common as its impacts are seen in a variety of application domains, including healthcare. IoT is characterized by the interconnectivity of smart sensors, objects, devices, data, and applications. With the unprecedented use of IoT in industrial, commercial and domestic, it becomes very imperative to harness the benefits and functionalities associated with the IoT technology in (re)assessing the provision and positioning of healthcare to ensure efficient and improved healthcare delivery. In this research, we are focusing on two important services in healthcare systems, which are cancer care services and business analytics/cloud services. These services incorporate the implementation of an IoT that provides solution and framework for analyzing health data gathered from IoT through various sensor networks and other smart devices in order to improve healthcare delivery and to help health care providers in their decision-making process for enhanced and efficient cancer treatment. In addition, we discuss the wireless sensor network (WSN), WSN routing and data transmission in the healthcare environment. Finally, some operational challenges and security issues with IoT-based healthcare system are discussed.

Keywords: IoT, smart health care system, business analytics, (wireless) sensor network, cancer care services, cloud services

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Authors: Peninah Agaba, Monica Magadi, Bev Orton

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Uganda is one of the countries with high maternal mortality (336/100,000) where adolescents account for 24 percent of the total maternal deaths. Research shows that use of maternal health services may prevent some of these deaths and good provider attitudes attract adolescents to use the services. However, poor health provider’s attitudes discourage adolescents from seeking the services during the maternity period. This study explores the experiences of unmarried female adolescents at the health facilities during the maternity period. The study population is unmarried adolescent girls aged 10-19 years who were pregnant or had given birth within three years before the interview. This is a special interest group that requires attention throughout this period. Most of the pregnancies among unmarried adolescents are unwanted; as a result, many of them have been abused and neglected by parents and close family members including partners who deny fatherhood of the pregnancy/child. These adolescents hope to find comfort from health providers like being listened to during counseling, not abused and judged; unfortunately this is not the case always. The research was approved by the University of Hull, School of Education and Social Sciences ethics review committee, Mildmay Uganda Research Ethics Committee and Uganda National Council of Science and Technology. The study was carried out in Bushenyi and Kibale districts in Western Uganda. Fourteen in-depth interviews and seven focus group discussions were completed in the local languages and later transcribed to English language. Thematic analysis to identify the themes was done. Adolescents were aged 16-19 years, two had become pregnant before 15 years. Most had not completed secondary education; none had tertiary education and three of the 14 IDI adolescent participants wanted to get pregnant. Analysis shows varied experiences; most adolescents were abused verbally and physically by the health providers due to their young age of pregnancy, lack of essential items during this period (maternity dresses, children clothes, delivery kit) and fear of labour pains. Another cause for abuse was these adolescents coming for antenatal care with no partners yet the implementation of a policy on increasing male involvement in reproductive health in Uganda requires them to attend antenatal care with their partners and most of these unmarried adolescents have no partners to accompany them. Despite the above challenges, the study also identified the care some of these unmarried adolescents received during the maternity visits for example they were not abused, were provided with appropriate information and supported with child care. The study identified abuse and support the unmarried adolescents received during the maternity period. Efforts to provide adolescents with adequate information including what to expect during labour by providers and provision of basic needs are essential. Health providers should have trainings on client care especially how to embrace unmarried adolescents when they come to access maternity services. More so, the policy on improving male involvement in RH issues need to be considerate of unmarried adolescents who in most cases do not have the partners to go with to access maternity care.

Keywords: abuse, maternity care, Uganda, unmarried, adolescents

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Authors: Martina Curtin, Rosalind Herman

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Background: Deaf children can experience difficulties with understanding how social interaction works, particularly when communicating with unfamiliar hearing people. Deaf children often struggle with integrating into a mainstream, hearing environments. These negative experiences can lead to social isolation, depression and other mental health difficulties later in life. smiLE Therapy (Schamroth, 2015) is a video-based social communication intervention that aims to teach deaf children skills to confidently communicate with unfamiliar hearing people. Although two previous studies have reported improvements in communication skills immediately post intervention, evidence for maintenance of gains or generalisation of skills (i.e., the transfer of newly learnt skills to untrained situations) has not to date been demonstrated. Parental involvement has been shown to support deaf children’s therapy outcomes. Therefore, this study added parent training to the therapy children received to investigate the benefits to generalisation of children’s skills. Parents were also invited to present their perspective on the training they received. Aims: (1) To assess pupils’ progress from pre- to post-intervention in trained and untrained tasks, (2) to investigate if training parents improved their (a) understanding of their child’s needs and (b) their skills in supporting their child appropriately in smiLE Therapy tasks, (3) to assess if parent training had an impact on the pupil’s ability to (a) maintain their skills in trained tasks post-therapy, and (b) generalise their skills in untrained, community tasks. Methods: This was a mixed-methods, repeated measures study. 31 deaf pupils (aged between 7 and 14) received an hour of smiLE Therapy per week, for 6 weeks. Communication skills were assessed pre-, post- and 3-months post-intervention using the Communication Skills Checklist. Parents were then invited to attend two training sessions and asked to bring a video of their child communicating in a shop or café. These videos were used to assess whether, after parent training, the child was able to generalise their skills to a new situation. Finally, parents attended a focus group to discuss the effectiveness of the therapy, particularly the wider impact, i.e., more child participation within the hearing community. Results: All children significantly improved their scores following smiLE therapy and maintained these skills to high level. Children generalised a high percentage of their newly learnt skills to an untrained situation. Parents reported improved understanding of their child’s needs, their child’s potential and in how to support them in real-life situations. Parents observed that their children were more confident and independent when carrying out communication tasks with unfamiliar hearing people. Parents realised they needed to ‘let go’ and embrace their child’s independence and provide more opportunities for them to participate in their community. Conclusions: This study adds to the evidence base on smiLE Therapy; it is an effective intervention that develops deaf children’s ability to interact competently with unfamiliar, hearing, communication partners. It also provides preliminary evidence of the benefits of parent training in helping children to generalise their skills to other situations. These findings will be of value to therapists wishing to develop deaf children’s communication skills beyond the therapy setting.

Keywords: deaf children, generalisation, parent involvement, social communication

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Authors: Pelin Kinay, Andy P. Morse, Elmer V. Villanueva, Karyn Morrissey, Philip L Staddon, Shanzheng Zhang, Jingjing Liu

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The present study aims to evaluate the climate change and health related knowledge, attitudes and practices (KAP) of the elderly population (60 years plus) in Hefei and Suzhou cities of China (n=300). This cross-sectional study includes 150 participants in each city. Data regarding demographic characteristics, KAP, and climate change perceptions were collected using a semi-structured questionnaire. When asked about the potential impacts of climate change over 79% of participants stated that climate change affected their lifestyle. Participants were most concerned about storms (51.7%), food shortage (33.3%) and drought (26%). The main health risks cited included water contamination (32%), air pollution related diseases (38.3%) and lung disease (43%). Finally, a majority (68.3%) did not report receiving government assistance on climate change issues. Logistic regression models were used to analyse the data in order to understand the links between socio-demographical factors and KAP of the participants. These findings provide insights for potential adaptation strategies targeting the elderly. It is recommended that government should take responsibility in creating awareness strategies to improve the coping capacity of elderly in China to climate change and its health impacts and develop climate change adaptation strategies.

Keywords: China, climate change, elderly, KAP

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Authors: Pooja Rawat, Rakhi Tyagi

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Globally, almost 3 billion people rely on biomass (wood, charcoal, dung and crop residues) and coal as their primary source of domestic energy. Cooking and heating with solid fuels on open fire give rise to major pollutants. Women are primarily affected by these pollutants as they spend most of their time in the house. The WHO World Health Report 2002 estimates that indoor air pollution (IAP) is responsible for 2.7% of the loss of disability adjusted life years (DALYs) worldwide and 3.7% in high mortality developing countries. Indoor air pollution has the potential to not only impact health, but also impact the general economic well-being of the household. Exposure to high level of household pollution lead to acute and chronic respiratory conditions (e.g.: pneumonia, chronic obstructive pulmonary disease, lung cancer and cataract). There has been many strategies for reducing IAP like subsidize cleaner fuel technologies, for example use of kerosene rather than traditional biomass fuels. Another example is development, promotion of 'improved cooking stoves'. India, likely ranks second- distributing over 12 million improved stoves in the first seven years of a national program to develop. IAP should be reduced by understanding the welfare effects of reducing IAP within households and to understanding the most cost effective way to reduce it.

Keywords: open fire, indoor pollution, lung diseases, indoor air pollution

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Authors: Daniel Motlhanka, Neo Kerebotswe

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The strong and long history of use of medicinal plants in Botswana to address existing and emerging health threats provides undebatable evidence for their potential as innovative therapeutic tools. The prevalence of emerging health threats, such as COVID-19 and hard-to-treat non-communicable diseases, warrants the scientific community to revisit and exploit ethnopharmacology for its potential as a source of therapeutic tools. Many studies conducted on bioactivity-guided bioassays of ethnobotanical resources have proved a number of health beneficial properties of these plants, such as free radical scavenging, anti-inflammatory, antimicrobial and, most importantly, the capability of medicinal plants to alleviate oxidative stress. In this work, a number of medicinal plants used in Botswana traditional medicine were investigated for both their free radical scavenging capability and total phenolic contents using the Free Radical Scavenging Power (FRSP) and Folin Ciocalteau (FC) method. At 100 micrograms/ml all the studied plants expressed above 90% Scavenging power and expressed total phenolic contents between 5000- 8890 mg/L.GAE. These plants are promising tools for engineering active therapeutic tools against life-threatening diseases of oxidative stress origin.

Keywords: oxidative stress, non-communicable diseases, total phenolics, ethnobotanicals

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Authors: Jennifer Walinga, Samantha Heron

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The goal of the study was to inform the design of effective leadership and mentorship development programming for sport science leaders within the network of Canadian sport institutes and centers. The LEAD (Learn, Engage, Accelerate, Develop) program was implemented to equip sport science leaders with the leadership knowledge, skills, and practice to foster a high - performance culture, enhance the daily training environment, and contribute to optimal performance in sport. After two years of delivery, this analysis of LEAD’s effect on individual and organizational health and performance factors informs the quality of future deliveries and identifies best practice for leadership development across the Canadian sport system and beyond. A larger goal for this project was to inform the public sector more broadly and position sport as a source of best practice for human and social health, development, and performance. The objectives of this study were to review and refine the LEAD program in collaboration with Canadian Sport Institute and Centre leaders, 40-50 participants from three cohorts, and the LEAD program advisory committee, and to trace the effects of the LEAD leadership development program on key leadership mentorship and organizational health indicators across the Canadian sport institutes and centers so as to capture best practice. The study followed a participatory action research framework (PAR) using semi structured interviews with sport scientist participants, program and institute leaders inquiring into impact on specific individual and organizational health and performance factors. Findings included a strong increase in self-reported leadership knowledge, skill, language and confidence, enhancement of human and organizational health factors, and the opportunity to explore more deeply issues of diversity and inclusion, psychological safety, team dynamics, and performance management. The study was significant in building sport leadership and mentorship development strategies for managing change efforts, addressing inequalities, and building personal and operational resilience amidst challenges of uncertainty, pressure, and constraint in real time.

Keywords: sport leadership, sport science leader, leadership development, professional development, sport education, mentorship

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Authors: Sudha Subramani, Hua Wang

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Domestic Violence (DV) against women is now recognized to be a serious and widespread problem worldwide. There is a growing concern that violence against women has a global public health impact, as well as a violation of human rights. From the existing statistical surveys, it is revealed that there exists a strong relationship between DV and health issues of women like bruising, lacerations, depression, anxiety, flashbacks, sleep disturbances, hyper-arousal, emotional distress, sexually transmitted diseases and so on. This social problem is still considered as behind the closed doors issue and stigmatized topic. Women conceal their sufferings from family and friends, as they experience a lack of trust in others, feelings of shame and embarrassment among the society. Hence, women survivors of DV experience some barriers in seeking the support of specialized services such as health care access, crisis support, and legal guidance. Fortunately, with the popularity of social media like Facebook and Twitter, people share their opinions and emotional feelings to seek the social and emotional support, for sympathetic encouragement, to show compassion and empathy among the public. Considering the DV, social media plays a predominant role in creating the awareness and promoting the support services to the public, as we live in the golden era of social media. The various professional people like the public health researchers, clinicians, psychologists, social workers, national family health organizations, lawyers, and victims or their family and friends share the unprecedentedly valuable information (personal opinions and experiences) in a single platform to improve the social welfare of the community. Though each tweet or post contains a less informational value, the consolidation of millions of messages can generate actionable knowledge and provide valuable insights about the public opinion in general. Hence, this paper reports on an exploratory analysis of the effectiveness of social media for unobtrusive assessment of attitudes and awareness towards DV. In this paper, mixed methods such as qualitative analysis and text mining approaches are used to understand the social media disclosures of DV through the lenses of opinion sharing, anonymity, and support seeking. The results of this study could be helpful to avoid the cost of wide scale surveys, while still maintaining appropriate research conditions is to leverage the abundance of data publicly available on the web. Also, this analysis with data enrichment and consolidation would be useful in assisting advocacy and national family health organizations to provide information about resources and support, raise awareness and counter common stigmatizing attitudes about DV.

Keywords: domestic violence, social media, social stigma and support, women health

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Authors: Selina Schwaabe

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Community pharmacies deliver high-quality health care and are responsible for medication safety. During the pandemic, accessibility to the nearest pharmacy became more essential to get vaccinated against Covid-19 and to get medical aid. The government's goal is to ensure nationwide, reachable, and affordable medical health care services by pharmacies. Therefore, the density of community pharmacies matters. Overall, the density of community pharmacies is fluctuating, with slightly decreasing tendencies in some countries. So far, the literature has shown that changes in the system affect prices and density. However, a European overview of the development of the density of community pharmacies and its triggers is still missing. This research is essential to counteract against decreasing density consulting in a lack of professional health care through pharmacies. The analysis focuses on liberal versus regulated market structures, mail-order prescription drug regulation, and third-party ownership consequences. In a panel analysis, the relative influence of the measures is examined across 27 European countries over the last 21 years. In addition, the paper examines seven selected countries in depth, selected for the substantial variance in their pharmacy system: Germany, Austria, Portugal, Denmark, Sweden, Finland and Poland. Overall, the results show that regulated pharmacy markets have over 10.75 pharmacies/100.000 inhabitants more than liberal markets. Further, mail-order prescription drugs decrease the density by -17.98 pharmacies/100.000 inhabitants. Countries allowing third-party ownership have 7.67 pharmacies/100.000 inhabitants more. The results are statistically significant at a 0.001 level. The output of this analysis recommends regulated pharmacy markets, with a ban on mail-order prescription drugs allowing third-party ownership to support nationwide medical health care through community pharmacies.

Keywords: community pharmacy, market conditions, pharmacy, pharmacy market, pharmacy lobby, prescription, e-prescription, ownership structures

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Authors: Christine Hough, Eddie Abbott-Halpin, Tariq Mahmood, Jessica Giles

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This paper draws together the findings from two research studies, each undertaken with cohorts of South Asian Muslim respondents located in the North of England between 2017 and 2019. The first study, entitled Faith Family and Crime (FFC), investigated the extent to which a Muslim family’s social and health well-being is affected by a family member’s involvement in the Criminal Justice System (CJS). This study captured a range of data through a detailed questionnaire and structured interviews. The data from the interview transcripts were analysed using open coding and an application of aspects of the grounded theory approach. The findings provide clear evidence that the respondents were neither well-informed nor supported throughout the processes of the CJS, from arrest to post-sentencing. These experiences gave rise to mental and physical stress, potentially unfair sentencing, and a significant breakdown in communication within the respondents’ families. They serve to highlight a particular aspect of complexity in the current needs of those South Asian Muslim families who find themselves involved in the CJS and is closely connected to family structure, culture, and faith. The second study, referred to throughout this paper as #ImamsBritain (that provides the majority of content for this paper), explores how Imams, in their role as community faith leaders, can best address the complex – and changing - needs of South Asian Muslims families, such as those that emerged in the findings from FFC. The changing socio-economic and political climates of the last thirty or so years have brought about significant changes to the lives of Muslim families, and these have created more complex levels of social, cultural, and faith-based needs for families and individuals. As a consequence, Imams now have much greater demands made of them, and so their role has undergone far-reaching changes in response to this. The #ImamsBritain respondents identified a pressing need to develop a wider range of pastoral and counseling skills, which they saw as extending far beyond the traditional role of the Imam as a religious teacher and spiritual guide. The #ImamsBritain project was conducted with a cohort of British Imams in the North of England. Data was collected firstly through a questionnaire that related to the respondents’ training and development needs and then analysed in depth using the Delphi approach. Through Delphi, the data were scrutinized in depth using interpretative content analysis. The findings from this project reflect the respondents’ individual perceptions of the kind of training and development they need to fulfill their role in 21st Century Britain. They also provide a unique framework for constructing a professional guide for Imams in Great Britain. The discussions and critical analyses in this paper draw on the discourses of professionalization and pastoral care and relevant reports and reviews on Imam training in Europe and Canada.

Keywords: criminal justice system, faith and culture, Imams, Muslim community leadership, professionalization, South Asian family structure

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Authors: Sharon Harel, Rachel Kizony, Yoram Feldman, Gabi Zeilig, Mordechai Shani

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Multiple Sclerosis (MS) is a neurological disease that may cause restriction in participation in daily activities of young adults. Main symptoms include fatigue, weakness and cognitive decline. The appearance of symptoms, their severity and deterioration rate, change between patients. The challenge of health services is to provide long-term rehabilitation services to people with MS. The objective of this presentation is to describe a course of tele-rehabilitation service of a woman with MS. Methods; R is a 48 years-old woman, diagnosed with MS when she was 22. She started to suffer from weakness of her non-dominant left upper extremity about ten years after the diagnosis. She was referred to the tele-rehabilitation service by her rehabilitation team, 16 years after diagnosis. Her goals were to improve ability to use her affected upper extremity in daily activities. On admission her score in the Mini-Mental State Exam was 30/30. Her Fugl-Meyer Assessment (FMA) score of the left upper extremity was 48/60, indicating mild weakness and she had a limitation of her shoulder abduction (90 degrees). In addition, she reported little use of her arm in daily activities as shown in her responses to the Motor Activity Log (MAL) that were equal to 1.25/5 in amount and 1.37 in quality of use. R. received two 30 minutes on-line sessions per week in the tele-rehabilitation service, with the CogniMotion system. These were complemented by self-practice with the system. The CogniMotion system provides a hybrid (synchronous-asynchronous), the home-based tele-rehabilitation program to improve the motor, cognitive and functional status of people with neurological deficits. The system consists of a computer, large monitor, and the Microsoft’s Kinect 3D sensor. This equipment is located in the client’s home and connected to a clinician’s computer setup in a remote clinic via WiFi. The client sits in front of the monitor and uses his body movements to interact with games and tasks presented on the monitor. The system provides feedback in the form of ‘knowledge of results’ (e.g., the success of a game) and ‘knowledge of performance’ (e.g., alerts for compensatory movements) to enhance motor learning. The games and tasks were adapted for R. motor abilities and level of difficulty was gradually increased according to her abilities. The results of her second assessment (after 35 on-line sessions) showed improvement in her FMA score to 52 and shoulder abduction to 140 degrees. Moreover, her responses to the MAL indicated an increased amount (2.4) and quality (2.2) of use of her left upper extremity in daily activities. She reported high level of enjoyment from the treatments (5/5), specifically the combination of cognitive challenges while moving her body. In addition, she found the system easy to use as reflected by her responses to the System Usability Scale (85/100). To-date, R. continues to receive treatments in the tele-rehabilitation service. To conclude, this case report shows the potential of using tele-rehabilitation for people with MS to provide strategies to enhance the use of the upper extremity in daily activities as well as for maintaining motor function.

Keywords: motor function, multiple-sclerosis, tele-rehabilitation, daily activities

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Authors: Emmylou Rahtz, Sarah Goldingay, Sara Warber, Ann Arbor, Paul Dieppe

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Introduction: Lourdes is a Catholic, Marian healing venue in South West France. Many miraculous cures have been attributed to visits there. In addition, many visitors seem to experience improvements in health and wellbeing, in the absence of a cure of disease. We wanted to investigate that phenomenon. Methods: We spent 10 days in Lourdes in 2017, carrying out ethnographic research, talking to many visitors, and carrying out formal, recorded interviews with several pilgrims, doctors, nurses, helpers, and priests. Results: Profound experiences and improvements in health and wellbeing were commonly reported. A number of ‘noetic’ experiences were also described. The paper will illustrate these phenomena. In addition, many participants in the research talked about why being in Lourdes was so beneficial to them. The community spirit, ethos of prayer, flow, synchronicity, and ability to find new meaning for life’s ills were cited as likely reasons. Conclusions: We believe that the ‘real miracle’ of Lourdes is the fact that of the many hundreds of thousands of people who go there each year, many find great benefit in health and wellbeing. It is likely that this is due to the ethos of the place, the community spirit, non-judgmental approach and loving acceptance of all aspects of humanity. Acknowledgments: We thank the BIAL foundation for generous funding of this research, and Dr. Alessandro de Franciscis and his team for facilitating our work, as well as all those who participated.

Keywords: healing, miracles, noetic experiences, wellbeing

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Authors: Kalpana Rajouriya, Ajay Taneja

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The objective of the present study is to investigate the regional and lobar deposition of size-segregated PM in respiratory tract of human body. PM in different fractions is monitored using the Grimm portable environmental dust monitor during winter season in Firozabad; a Glass city of India. PM10 concentration (200.817g/m³) was 4.46 and 2.0 times higher than the limits prescribed by WHO (45g/m⁻³) and NAAQS (100g/m⁻³) government agencies. PM2.5 concentration (83.538 g/m3) was 5.56 and 1.39 times higher from WHO (15g/m-3) and NAAQS (60g/m⁻³) limits. Results inferred that PM10 and PM2.5 was highest deposited in head region (0.3477-0.5622 & 0.366-0.4704) followed by pulmonary region, especially in the 9-21year old persons. The variation in deposition percentage in our study is mainly due to the airway geometry, PM size, and its deposition mechanisms. The coarse fraction, due to its large size, cannot follow the airway path and mostly gets deposited by inertial impaction in the head region and its bifurcations. The present study results inferred that Coarse and fine PM deposition was highly visualized in 9 (8.45610⁻⁴ g, 2.91110⁻⁴g) year and 3 (1.49610⁻⁴ g, 8.59310⁻⁵g) month age category. So, the 9year children and 3month infants category have high level of health risk.

Keywords: particulate matter, MPPD model, regional deposition, lobar deposition, health risk

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Authors: Can Mungan, Gokhan Kilic

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Structural engineers and tunnel owners have good reason to attach importance to the assessment and inspection of tunnels. Regular inspection is necessary to maintain and monitor the health of the structure not only at the present time but throughout its life cycle. Detection of flaws within the structure, such as corrosion and the formation of cracks within the internal elements of the structure, can go a long way to ensuring that the structure maintains its integrity over the course of its life. Other issues that may be detected earlier through regular assessment include tunnel surface delamination and the corrosion of the rebar. One advantage of new technology such as the ground penetrating radar (GPR) is the early detection of imperfections. This study will aim to discuss and present the effectiveness of GPR as a tool for assessing the structural integrity of the heavily used tunnel. GPR is used with various antennae in frequency and application method (2 GHz and 500 MHz GPR antennae). The paper will attempt to produce a greater understanding of structural defects and identify the correct tool for such purposes. Conquest View with 3D scanning capabilities was involved throughout the analysis, reporting, and interpretation of the results. This study will illustrate GPR mapping and its effectiveness in providing information of value when it comes to rebar position (lower and upper reinforcement). It will also show how such techniques can detect structural features that would otherwise remain unseen, as well as moisture ingress.

Keywords: tunnel, GPR, health monitoring, moisture ingress, rebar position

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Authors: Chih-Hsing Lin, Wen-Ching Chen, Chih-Ting Kuo, Gang-Neng Sung, Chih-Chyau Yang, Chien-Ming Wu, Chun-Ming Huang

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This paper proposes a cellular-based structure health monitoring device (HMD) for temporary bridge monitoring without the requirement of power line and internet service. The proposed HMD includes sensor node, power module, cellular gateway, and rechargeable batteries. The purpose of HMD focuses on short-term collection of civil infrastructure information. It achieves the features of low cost by using three 1-axis accelerometers with data synchronization problem being solved. Furthermore, instead of using data acquisition system (DAQ) sensed data is transmitted to Host through cellular gateway. Compared with 3-axis accelerometer, our proposed 1-axis accelerometers based device achieves 50.5% cost saving with high sensitivity 2000mv/g. In addition to fit different monitoring environments, the proposed system can be easily replaced and/or extended with different PCB boards, such as communication interfaces and sensors, to adapt to various applications. Therefore, with using the proposed device, the real-time diagnosis system for civil infrastructure damage monitoring can be conducted effectively.

Keywords: cellular-based structural health monitoring, cost-effective 1-axis accelerometers, short-term monitoring, structural engineering

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Authors: Shaneil Taylor

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Gender-based violence is a reflection of the inequalities that are associated within a society between the men and women that affects the health, dignity, security and autonomy of its victims. There are various determinants that contribute to the health risk of young women who have experienced sexual violence, in countries that have a high prevalence rate for HIV. For instance, in South Africa, where the highest prevalence rate for HIV is among young women, their susceptibility to the virus has been increased by sexual violence and cultural inequalities. Therefore, this study is a review of literature that explores how gender-based violence increases the possibility for HIV/AIDS among young women in South Africa.

Keywords: gender-based violence, HIV/AIDS transmission, risky sexual behavior, young women

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Authors: Yeliz Ekinci, Melis Koyuncu

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Successful planning of solid waste management systems requires successful prediction of the amount of solid waste generated in an area. Waste management planning can protect the environment and human health, hence it is tremendously important for countries. The lack of information in waste generation can cause many environmental and health problems. Turkey is a country that plans to join European Union, hence, solid waste management is one of the most significant criteria that should be handled in order to be a part of this community. Solid waste management system requires a good forecast of solid waste generation. Thus, this study aims to forecast solid waste generation in Turkey. Artificial Neural Network and Linear Regression models will be used for this aim. Many models will be run and the best one will be selected based on some predetermined performance measures.

Keywords: forecast, solid waste generation, solid waste management, Turkey

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