Search results for: vegetation health condition
10010 Individual and Contextual Factors Associated with Modern Contraceptive Use among Sexually Active Adolescents and Young Women in Zambia: A Multilevel Analysis
Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo
Abstract:
Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.Keywords: adolescents, young women, modern contraception use, fertility, family planning
Procedia PDF Downloads 10710009 Dust Particle Removal from Air in a Self-Priming Submerged Venturi Scrubber
Authors: Manisha Bal, Remya Chinnamma Jose, B.C. Meikap
Abstract:
Dust particles suspended in air are a major source of air pollution. A self-priming submerged venturi scrubber proven very effective in cases of handling nuclear power plant accidents is an efficient device to remove dust particles from the air and thus aids in pollution control. Venturi scrubbers are compact, have a simple mode of operation, no moving parts, easy to install and maintain when compared to other pollution control devices and can handle high temperatures and corrosive and flammable gases and dust particles. In the present paper, fly ash particles recognized as a high air pollutant substance emitted mostly from thermal power plants is considered as the dust particle. Its exposure through skin contact, inhalation and indigestion can lead to health risks and in severe cases can even root to lung cancer. The main focus of this study is on the removal of fly ash particles from polluted air using a self-priming venturi scrubber in submerged conditions using water as the scrubbing liquid. The venturi scrubber comprising of three sections: converging section, throat and diverging section is submerged inside a water tank. The liquid enters the throat due to the pressure difference composed of the hydrostatic pressure of the liquid and static pressure of the gas. The high velocity dust particles atomize the liquid droplets at the throat and this interaction leads to its absorption into water and thus removal of fly ash from the air. Detailed investigation on the scrubbing of fly ash has been done in this literature. Experiments were conducted at different throat gas velocities, water levels and fly ash inlet concentrations to study the fly ash removal efficiency. From the experimental results, the highest fly ash removal efficiency of 99.78% is achieved at the throat gas velocity of 58 m/s, water level of height 0.77m with fly ash inlet concentration of 0.3 x10⁻³ kg/Nm³ in the submerged condition. The effect of throat gas velocity, water level and fly ash inlet concentration on the removal efficiency has also been evaluated. Furthermore, experimental results of removal efficiency are validated with the developed empirical model.Keywords: dust particles, fly ash, pollution control, self-priming venturi scrubber
Procedia PDF Downloads 16410008 Illness Perception and Health-Related Quality of Life among Young Females Living with Polycystic Ovary Syndrome
Authors: Vibha Kriti
Abstract:
Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder generally found in reproductive women. It is associated with significant reproductive, metabolic, cosmetic, and psychological consequences. Objective: There is a high prevalence of PCOS found among reproductive-age women, therefore, the major objective of the present study is to identify the illness perception of PCOS women and to explore the relationship between illness perception and health-related quality of life (HRQoL). Material and Method: A cross-sectional study was conducted in a university tertiary-care center, Sir Sunder Lal Hospital, Banaras Hindu University (B.H.U). Tools used for data collection were self-structured, which included socio-demographic status, illness perception questionnaire (revised version), and short-form 36 for assessing illness perception and health-related quality of life, respectively. Statistical analysis was done by SPSS version ‘24’. Results: The results of correlation analyses indicated that there is a strong relationship between strong illness perception and HRQoL. Stepwise regression indicated that illness identity, long illness duration, and severe consequences were associated with the worse outcome on emotional functioning and on social functioning. A high score on the controllability of the disease and seeking social support was significantly related to better functioning. Conclusion: Illness perception is an important factor in self-care behaviors in PCOS females and has a strong association with health-related quality of life and has a profound effect on it.Keywords: polycystic ovary syndrome, illness perception, quality of life, young females, mental health
Procedia PDF Downloads 9310007 Anaerobic Digestion of Green Wastes at Different Solids Concentrations and Temperatures to Enhance Methane Generation
Authors: A. Bayat, R. Bello-Mendoza, D. G. Wareham
Abstract:
Two major categories of green waste are fruit and vegetable (FV) waste and garden and yard (GY) waste. Although, anaerobic digestions (AD) is able to manage FV waste; there is less confidence in the conditions for AD to handle GY wastes (grass, leaves, trees and bush trimmings); mainly because GY contains lignin and other recalcitrant organics. GY in the dry state (TS ≥ 15 %) can be digested at mesophilic temperatures; however, little methane data has been reported under thermophilic conditions, where conceivably better methane yields could be achieved. In addition, it is suspected that at lower solids concentrations, the methane yield could be increased. As such, the aim of this research is to find the temperature and solids concentration conditions that produce the most methane; under two different temperature regimes (mesophilic, thermophilic) and three solids states (i.e. 'dry', 'semi-dry' and 'wet'). Twenty liters of GY waste was collected from a public park located in the northern district in Tehran. The clippings consisted of freshly cut grass as well as dry branches and leaves. The GY waste was chopped before being fed into a mechanical blender that reduced it to a paste-like consistency. An initial TS concentration of approximately 38 % was achieved. Four hundred mL of anaerobic inoculum (average total solids (TS) concentration of 2.03 ± 0.131 % of which 73.4% were volatile solid (VS), soluble chemical oxygen demand (sCOD) of 4.59 ± 0.3 g/L) was mixed with the GY waste substrate paste (along with distilled water) to achieve a TS content of approximately 20 %. For comparative purposes, approximately 20 liters of FV waste was ground in the same manner as the GY waste. Since FV waste has a much higher natural water content than GY, it was dewatered to obtain a starting TS concentration in the dry solid-state range (TS ≥ 15 %). Three samples were dewatered to an average starting TS concentration of 32.71 %. The inoculum was added (along with distilled water) to dilute the initial FV TS concentrations down to semi-dry conditions (10-15 %) and wet conditions (below 10 %). Twelve 1-L batch bioreactors were loaded simultaneously with either GY or FV waste at TS solid concentrations ranging from 3.85 ± 1.22 % to 20.11 ± 1.23 %. The reactors were sealed and were operated for 30 days while being immersed in water baths to maintain a constant temperature of 37 ± 0.5 °C (mesophilic) or 55 ± 0.5 °C (thermophilic). A maximum methane yield of 115.42 (L methane/ kg VS added) was obtained for the GY thermophilic-wet AD combination. Methane yield was enhanced by 240 % compared to the GY waste mesophilic-dry condition. The results confirm that high temperature regimes and small solids concentrations are conditions that enhance methane yield from GY waste. A similar trend was observed for the anaerobic digestion of FV waste. Furthermore, a maximum value of VS (53 %) and sCOD (84 %) reduction was achieved during the AD of GY waste under the thermophilic-wet condition.Keywords: anaerobic digestion, thermophilic, mesophilic, total solids concentration
Procedia PDF Downloads 14110006 Preparedness of the Mae Hong Son Province for the Aging Society
Authors: Siwaporn Mahathamnuchock, Krit Phanpanya
Abstract:
This survey study aims 1) to investigate the preparation of Mae Hong Son people for entering into the aging society 2) to study awareness of public health preparedness for the aging society of Mae Hong Son Province Administrative Organization. The samples used in this study were people aged 55-60 years in Mae Hong Province. Located at Khun Yuam Sub district, Khun Yuam District, Pang Ma Pha Sub district, Pang Ma Pha District, Thung Yao Sub district, Pai District, Mae ka Tuan Sub district, Sob Moei District, Mae Sariang Sub district, Mae Sariang District, Mae Tho Sub district, Mae La Noi District. And Huai Pha Sub district, Muang Mae Hong District. The data were collected from 1,088 people by Stratified sampling Method. The instrument used in this study were 36 items of questionnaire that contains three parts: 1) Sample’s general information 2) The Interview of Mae Hong Son people’s preparation before entering aging society. 3) The Interview about preparedness of health for the aging society of Mae Hong Son Province Administrative Organization. Then analyzed the data by using percentage and standard deviation. The research found that Mae Hong Son people are preparing for an aging society as followed; psychological, residence, physical health, careers and leisure time on a large scale with an average of 3.81 (SD=0.88), 3.66 (SD=0.99), 3.53(SD=1.04) and 3.51(SD=0.89), respectively. However finances and saving were prepared on moderate scale with an average of 2.84(SD=0.89) and in the awareness of public health preparedness for the aging society of Mae Hong Son Province Administrative Organization were moderate with an average of 2.99 (SD=1.07).Keywords: aging society, preparedness, perception, Mae Hong Son province
Procedia PDF Downloads 41210005 Relationship between Job Satisfaction, Job Stressors and Long Term Physical Morbidities among University Employees in Pakistan
Authors: Shahzad A. Mughal, Ameer A. P. Ghaloo, Faisal Laghari, Mohsin A. Mirza
Abstract:
Job satisfaction and level of job stressors among employees of a university are considered as essential factors responsible for institutional success. Job satisfaction is usually believed as a single baseline variable for the evaluation of a university human resource area. The objectives of this study were to assess the level of job satisfaction and influence of job stressors among university teachers and their association with long term physical health of the employees in government sector universities in Pakistan. A cross-sectional study was conducted on university employees including faculty members and administrative staff of three government sector universities in Sindh province of Pakistan who have completed at least ten years of their job. The study period was six months. All the employees were randomly selected. The job satisfaction scale Questionnaire with yes and no options, together with questions regarding demographic factors, job stress or other working factors and physical health issues were administered in questionnaires. These questionnaires were handed out to 100 faculty members of both genders with permanent job and 50 non faculty staff of grade 17 and above with permanent employment status. Students’ T test and one way ANOVA was applied to categorical variables and Pearson’s correlation analysis was performed to evaluate the correlations between study variables. 121 successful responses were obtained (effective respondent rate 80.6%). The average score of overall job satisfaction was 65.6%. Statistical analysis revealed that the job satisfaction and work related stressors had negative impact on overall health status of the employees with resultant less efficacy and mental stress. The positive relation was perceived by employees for organizational support and high income with job satisfaction. Demographic features such as age and female gender were also linked to the level of job satisfaction and health related issues. The total variation among all responses regarding correlation between job satisfaction job stressors and health related issues was 55%. A study was conducted on University employees of government sector Universities in Pakistan, regarding association of job satisfaction and job stressors with long term physical health of the employees. Study revealed a moderate level of job satisfaction among the employees of all universities included in this study. Attitude and personal relations with heads of the departments and institution along with salary packages were considered as biggest job stressors related correlated directly with physical health. Demographic features and gender were associated factors for job satisfaction. Organizational support was the strongest factor for job satisfaction and results pointed out that by improving support level from University may improve the quality of job satisfaction and overall health of employees.Keywords: job satisfaction, organizational support, physical health, university employees
Procedia PDF Downloads 25210004 A Nutritional Wellness Program for Overweight Health Care Providers in Hospital Setting: A Randomized Controlled Trial Pilot Study
Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang
Abstract:
Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.Keywords: weight management, weight control, health care providers, hospital
Procedia PDF Downloads 24310003 Exhaust Gas Cleaning Systems on Board Ships and Impact on Crews’ Health: A Feasibility Study Protocol
Authors: Despoina Andrioti Bygvraa, Ida-Maja Hassellöv, George Charalambous
Abstract:
Exhaust gas cleaning systems, also known as scrubbers, are today widely used to allow for the use of High Sulphur Heavy Fuel Oil and still comply with the regulations limiting sulphur content in marine fuels. There are extensive concerns about environmental consequences, especially in the Baltic Sea, from the wide-scale use of scrubbers, as the wash water is acidic (ca pH 3) and contains high concentrations of toxic, carcinogenic, and mutagenic substances. The aim of this feasibility study is to investigate the potential adverse effects on seafarers’ health with the ultimate goal of raising awareness of chemical-related health and safety issues in the shipping environment. The project got funding from the Swedish Foundation. The team will extend previously compiled data on scrubber wash water concentrations of hazardous substances and pH to include the use of strong base in closed-loop scrubbers, and scoping assessment on handling and disposing practices. Based on the findings (a), a systematic review of risk assessment will follow to show the risk of exposures, the establishment of the hazardous levels for human health as well as the respective prevention practices. In addition, the researchers will perform (b) a systematic review to identify facilitators and barriers of the crew on compliance with the safe handling of chemicals. The study will run for 12 months, delivering (a) a risk assessment inventory with risk exposures and (b) a course description of safe handling practices. This feasibility study could provide valuable knowledge on how pollutants found in scrubbers should be considered from a human health perspective to facilitate evidence-based informed decisions in future technology- and policy development to make shipping a safer, healthier, and more attractive workplace.Keywords: health and safety, seafarers, scrubbers, chemicals, risk exposures
Procedia PDF Downloads 5810002 Identifying Indicative Health Behaviours and Psychosocial Factors Affecting Multi-morbidity Conditions in Ageing Populations: Preliminary Results from the ELSA study of Ageing
Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer
Abstract:
Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors
Procedia PDF Downloads 9210001 Management in the Transport of Pigs to Slaughterhouses in the Valle De Aburrá, Antioquia
Authors: Natalia Uribe Corrales, María Fernanda Benavides Erazo, Santiago Henao Villegas
Abstract:
Introduction: Transport is a crucial link in the porcine chain because it is considered a stressful event in the animal, due to it is a new environment, which generates new interactions, together with factors such as speed, noise, temperature changes, vibrations, deprivation of food and water. Therefore, inadequate handling at this stage can lead to bruises, musculoskeletal injuries, fatigue, and mortality, resulting in canal seizures and economic losses. Objective: To characterize the transport and driving practices for the mobilization of standing pigs directed to slaughter plants in the Valle de Aburrá, Antioquia, Colombia in 2017. Methods: A descriptive cross-sectional study was carried out with the transporters arriving at the slaughterhouses approved by National Institute for Food and Medicine Surveillance (INVIMA) during 2017 in the Valle de Aburrá. The process of obtaining the samples was made from probabilistic sampling. Variables such as journey time, mechanical technical certificate, training in animal welfare, driving speed, material, and condition of floors and separators, supervision of animals during the trip, load density and mortality were analyzed. It was approved by the ethics committee for the use and care of animals CICUA of CES University, Act number 14 of 2015. Results: 190 trucks were analyzed, finding that 12.4% did not have updated mechanical technical certificate; the transporters experience in pig’s transportation was an average of 9.4 years (d.e.7.5). The 85.8% reported not having received training in animal welfare. Other results were that the average speed was 63.04km/hr (d.e 13.46) and the 62% had floors in good condition; nevertheless, the 48% had bad conditions on separators. On the other hand, the 88% did not supervise their animals during the journey, although the 62.2% had an adequate loading density, in relation to the average mortality was 0.2 deaths/travel (d.e. 0.5). Conclusions: Trainers should be encouraged on issues such as proper maintenance of vehicles, animal welfare, obligatory review of animals during mobilization and speed of driving, as these poorly managed indicators generate stress in animals, increasing generation of injuries as well as possible accidents; also, it is necessary to continue to improve aspects such as aluminum floors and separators that favor easy cleaning and maintenance, as well as the appropriate handling in the density of load that generates animal welfare.Keywords: animal welfare, driving practices, pigs, truck infrastructure
Procedia PDF Downloads 20810000 Mental Health Impacts of COVID-19 on Diverse Youth and Families in Canada
Authors: Lucksini Raveendran
Abstract:
Introduction: This mixed-methods study focuses on the experiences of ethnocultural youth and families in Canada, identifying key barriers and opportunities to inform service programming and policies that can better meet their mental health needs during the COVID-19 pandemic and beyond. Methods: Mental Health Commission of Canada's Headstrong initiative administered the youth survey (April – June 2020) and family survey (June – August 2020) with a total sample size of 137 and 481 respondents, respectively. Thematic analysis was conducted to identify key challenges faced, coping strategies used, and help-seeking behaviours. A similar approach was also applied to the family survey data, but instead, a representative sample was collated to analyze geographically variable and ethnically diverse subgroups. Results and analysis: Multiple challenges have impacted families, including increased feelings of loneliness and distress from border travel restrictions, especially among those navigating pregnancy alone or managing children with developmental needs, which is often understudied. Also, marginalized groups were disproportionately affected by inequitable access to communication technologies, further deepening the digital divide. Some reported living in congregated homes with regular conflicts, thus leading to increased anxiety and exposure to violence. For many families, urbanicity and ethnicity played a key role in how families reported coping with feelings of uncertainty while managing work commitments, navigating community resources, fulfilling care responsibilities, and homeschooling children of all ages. Despite these challenges, there was evidence of post-traumatic growth and building community resiliency. Conclusions and implications for policy, practice, or additional research: There is a need to foster opportunities to promote and sustain mental health, wellness, and resilience for families through social connections. Also, intersectionality must be embedded in the collection, analysis, and application of data to improve equitable access to evidence-based and recovery-oriented mental health supports among diverse families in Canada. Lastly, address future research on the long-term COVID-19 impacts of travel border restrictions on family wellness.Keywords: mental health, youth mental health, family wellness, health equity
Procedia PDF Downloads 949999 The Catalytic Properties of PtSn/Al2O3 for Acetic Acid Hydrogenation
Authors: Mingchuan Zhou, Haitao Zhang, Hongfang Ma, Weiyong Ying
Abstract:
Alumina supported platinum and tin catalysts with different loadings of Pt and Sn were prepared and characterized by low temperature N2 adsorption/desorption, H2-temperature programed reduction and CO pulse chemisorption. Pt and Sn below 1% loading were suitable for acetic acid hydrogenation. The best performance over 0.75Pt1Sn/Al2O3 can reach 87.55% conversion of acetic acid and 47.39% selectivity of ethanol. The operating conditions of acetic acid hydrogenation over 1Pt1Sn/Al2O3 were investigated. High reaction temperature can enhance the conversion of acetic acid, but it decreased total selectivity of ethanol and acetyl acetate. High pressure and low weight hourly space velocity were beneficial to both conversion of acetic acid and selectivity to ethanol.Keywords: acetic acid, hydrogenation, operating condition, PtSn
Procedia PDF Downloads 3569998 Exploring the Influence of Culture on Dietary Practices and Ethnic Inequality in Health among Migrant Nigerians in the UK
Authors: Babatunde Johnson
Abstract:
The rate of diseases and death from preventable diseases among ethnic minority groups is high when compared with the wider white population in the UK. This can be due in part to the diet consumed and various cultural reasons. Changes in dietary practices and the health of ethnic minority groups can be caused by the adoption of food practices of the host culture after migration (acculturation) and generational differences among migrants. However, understanding how and why these changes occur is limited due to the challenges of data collection in research. This research utilizes the interpretive phenomenological approach, coupled with Bourdieu’s theory used as the conceptual framework, and seeks an in-depth understanding of how adult immigrant Nigerians in the UK interpret their experience of the influence of ethnic and prevailing cultures on their dietary practice. Recruiting participants from a close-knit community, such as the Nigerian population in the UK, can be complex and problematic and is determined by the accessibility to the community. Although complex, the researcher leveraged the principles of Patient and Public Involvement (PPI) in gaining access to participants within the Nigerian community. This study emphasizes the need for a culturally tailored and community-centered approach to interventions geared toward the reduction of ethnic health inequality in the UK other than the existing practice, which focuses on better healthy eating through the improvement of skills and knowledge about food groups.Keywords: culture, dietary practice, ethnic minority, health inequality
Procedia PDF Downloads 869997 Occupational Health Services (OHS) in Hong Kong Hospitals and the Experience of Nurses: A Mixed Methods Study
Authors: Wong Yat Cheung Maggie
Abstract:
Occupational Safety and Health Ordinance (OS&HO) (Chap 509) was enacted in 1997, OHS in HK should be growing and maturing, with a holistic approach to occupational health and safety in the workplace including physical, mental, social and spiritual well-being. The question is “How effective are OHSPs in meeting the current needs of HK health workers?” This study was designed to explore the issue for the first time, to empirically analyse the views of those who work in the system. The study employed a mixed method approach to collect various data from Occupational Health Service Providers (OHSPs), Occupational Health Service Consumers (OHSC): Registered nurses working in the hospital setting. This study was designed in two phases and two stages. Phase I Stage I was a paper survey to collect the data on OHSP. Then Phase I Stage II was a follow-up interview. Phase II Stage I was a paper survey to collect the data on OHSC. Then Phase II Stage II was a follow-up focus group study on OHSC for further clarification of the Phase II and Stage I result. The Phase I result reflects HK OHSPs point of view and their experience in the existing OHS practice in the local hospitals. It reflects various styles of reporting systems, staff profiles background and resource in providing OHS in HK hospitals. However, the basic OHS concern is similar between hospitals. In general, the OHS policies and procedures are available on site even though they may have different foci. The Phase II result is reflecting the HKs OHSCs echoes the OHSP feedback at providing of OHS, OHS concern and related policies and procedure are available on site. However, the most significant feedback from the OHSC at Phase II Stage II shows, nurses experienced various OHS concern most commonly work stress, workplace harassment and back strain without formal or official report to the related parties. The lack of reporting was due to the management handling attitude, stakeholders’ compliance and term of definition still have room to be improved even the related policies and procedures are available on site.Keywords: occupational health service, registered nurse, Hong Kong hospital, mixed method
Procedia PDF Downloads 3329996 A Quality Improvement Approach for Reducing Stigma and Discrimination against Young Key Populations in the Delivery of Sexual Reproductive Health and Rights Services
Authors: Atucungwiire Rwebiita
Abstract:
Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach
Procedia PDF Downloads 1739995 Green Design Study of Prefabricated Community Control Measures in Response to Public Health Emergencies
Authors: Enjia Zhang
Abstract:
During the prevention and control of the COVID-19 pandemic, all communities in China were gated and under strict management, which was highly effective in preventing the spread of the epidemic from spreading. Based on the TRIZ theory, this paper intends to propose green design strategies of community control in response to public health emergencies and to optimize community control facilities according to the principle of minimum transformation. Through the questionnaire method, this paper investigates and summarizes the situation and problems of community control during the COVID-19 pandemic. Based on these problems, the TRIZ theory is introduced to figure out the problems and associates them with prefabricated facilities. Afterward, the innovation points and solutions of prefabricated community control measures are proposed by using the contradiction matrix. This paper summarizes the current situation of community control under public health emergencies and concludes the problems such as simple forms of temporary roadblocks, sudden increase of community traffic pressure, and difficulties to access public spaces. The importance of entrance and exit control in community control is emphasized. Therefore, the community control measures are supposed to focus on traffic control, and the external access control measures, including motor vehicles, non-motor vehicles, residents and non-residents access control, and internal public space access control measures, including public space control shared with the society or adjacent communities, are proposed in order to make the community keep the open characteristics and have the flexibility to deal with sudden public health emergencies in the future.Keywords: green design, community control, prefabricated structure, public health emergency
Procedia PDF Downloads 1299994 Structure and Tribological Properties of Moisture Insensitivity Si Containing Diamond-Like Carbon Film
Authors: Mingjiang Dai, Qian Shi, Fang Hu, Songsheng Lin, Huijun Hou, Chunbei Wei
Abstract:
A diamond-like carbon (DLC) is considered as a promising protective film since its high hardness and excellent tribological properties. However, DLC films are very sensitive to the environmental condition, its friction coefficient could dramatic change in high humidity, therefore, limited their further application in aerospace, the watch industry, and micro/nano-electromechanical systems. Therefore, most studies focus on the low friction coefficient of DLC films at a high humid environment. However, this is out of satisfied in practical application. An important thing was ignored is that the DLC coated components are usually used in the diversed environment, which means its friction coefficient may evidently change in different humid condition. As a result, the invalidation of DLC coated components or even sometimes disaster occurred. For example, DLC coated minisize gears were used in the watch industry, and the customer may frequently transform their locations with different weather and humidity even in one day. If friction coefficient is not stable in dry and high moisture conditions, the watch will be inaccurate. Thus, it is necessary to investigate the stable tribological behavior of DLC films in various environments. In this study, a-C:H:Si films were deposited by multi-function magnetron sputtering system, containing one ion source device and a pair of SiC dual mid-frequent targets and two direct current Ti/C targets. Hydrogenated carbon layers were manufactured by sputtering the graphite target in argon and methane gasses. The silicon was doped in DLC coatings by sputtering silicon carbide targets and the doping content were adjusted by mid-frequent sputtering current. The microstructure of the film was characterized by Raman spectrometry, X-ray photoelectron spectroscopy, and transmission electron microscopy while its friction behavior under different humidity conditions was studied using a ball-on-disc tribometer. The a-C:H films with Si content from 0 to 17at.% were obtained and the influence of Si content on the structure and tribological properties under the relative humidity of 50% and 85% were investigated. Results show that the a-C:H:Si film has typical diamond-like characteristics, in which Si mainly existed in the form of Si, SiC, and SiO2. As expected, the friction coefficient of a-C:H films can be effectively changed after Si doping, from 0.302 to 0.176 in RH 50%. The further test shows that the friction coefficient value of a-C:H:Si film in RH 85% is first increase and then decrease as a function of Si content. We found that the a-C:H:Si films with a Si content of 3.75 at.% show a stable friction coefficient of 0.13 in different humidity environment. It is suggestion that the sp3/sp2 ratio of a-C:H films with 3.75 at.% Si was higher than others, which tend to form the silica-gel-like sacrificial layers during friction tests. Therefore, the films deliver stable low friction coefficient under controlled RH value of 50 and 85%.Keywords: diamond-like carbon, Si doping, moisture environment, table low friction coefficient
Procedia PDF Downloads 3659993 Assessing the Quality of Maternity Care in Sub-Saharan Africa Using the Donabedian Quality of Care Framework: A Systematic Scoping Review
Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson
Abstract:
Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum
Procedia PDF Downloads 729992 Assessment of Utilization of Provider Initiated HIV Testing and Counseling and Associated Factors among Adult out Patient Department Patients in Wonchi Woreda, South West Shoa Zone, Central Ethiopia
Authors: Dinka Fikadu, Mulugeta Shegaze
Abstract:
Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.Keywords: utilization, human immune deficiency, testing, provider, initiate
Procedia PDF Downloads 3039991 Schizophrenia in Childhood and Adolescence: Research Topics and Applied Methodology
Authors: Jhonas Geraldo Peixoto Flauzino, Pedro Pompeo Boechat Araujo, Alexia Allis Rocha Lima, Giovanna Biângulo Lacerda Chaves, Victor Ryan Ferrão Chaves
Abstract:
Schizophrenia is characterized as a set of psychiatric signs and symptoms (syndrome) that commonly erupt in the stages of adolescence or early adulthood, being recognized as one of the most serious diseases, as it causes important problems during the life of the patient. carrier - both in mental health and in physical health and in social life. Objectives: This is an integrative literature review that aimed to verify what has been produced of scientific knowledge in the field of child and adolescent psychiatry regarding schizophrenia in these stages of life, correlated to the most discussed themes and methodologies of choice for the preparation of studies. Methods: Articles were selected from the following databases: Virtual Health Library and CAPES Journal Portal, published in the last five years; and on Google Scholar, published in 2021, totaling 62 works, searched in September 2021. Results: The studies focus mainly on diagnosis through the DSM-V (25.8%), on drug treatment (25.8%) and in psychotherapy (24.2%), most of them in the literature review format: integrative (27.4%) and systematic (24.2%). Conclusion: The themes and study methods are redundant, and do not cover in depth the immense aspects that encompass Schizophrenia in Childhood and Adolescence, giving attention to the disease in a general way or focusing on the adult patient.Keywords: schizophrenia, mental health, childhood, adolescence
Procedia PDF Downloads 1849990 Optimization and Evaluation of 177lu-Dotatoc as a Potential Agent for Peptide Receptor Radionuclide Therapy
Authors: H. Yousefnia, MS. Mousavi-Daramoroudi, S. Zolghadri, F. Abbasi-Davani
Abstract:
High expression of somatostatin receptors on a wide range of human tumours makes them as potential targets for peptide receptor radionuclide tomography. A series of octreotide analogues were synthesized while [DOTA-DPhe1, Tyr3]octreotide (DOTATOC) indicated advantageous properties in tumour models. In this study, 177Lu-DOTATOC was prepared with the radiochemical purity of higher than 99% in 30 min at the optimized condition. Biological behavior of the complex was studied after intravenous injection into the Syrian rats. Major difference uptake was observed compared to 177LuCl3 solution especially in somatostatin receptor-positive tissues such as pancreas and adrenal.Keywords: Biodistribution, 177Lu, Octreotide, Syrian rats
Procedia PDF Downloads 4489989 A Hazard Rate Function for the Time of Ruin
Authors: Sule Sahin, Basak Bulut Karageyik
Abstract:
This paper introduces a hazard rate function for the time of ruin to calculate the conditional probability of ruin for very small intervals. We call this function the force of ruin (FoR). We obtain the expected time of ruin and conditional expected time of ruin from the exact finite time ruin probability with exponential claim amounts. Then we introduce the FoR which gives the conditional probability of ruin and the condition is that ruin has not occurred at time t. We analyse the behavior of the FoR function for different initial surpluses over a specific time interval. We also obtain FoR under the excess of loss reinsurance arrangement and examine the effect of reinsurance on the FoR.Keywords: conditional time of ruin, finite time ruin probability, force of ruin, reinsurance
Procedia PDF Downloads 4069988 Air Pollution: The Journey from Single Particle Characterization to in vitro Fate
Authors: S. Potgieter-Vermaak, N. Bain, A. Brown, K. Shaw
Abstract:
It is well-known from public news media that air pollution is a health hazard and is responsible for early deaths. The quantification of the relationship between air quality and health is a probing question not easily answered. It is known that airborne particulate matter (APM) <2.5µm deposits in the tracheal and alveoli zones and our research probes the possibility of quantifying pulmonary injury by linking reactive oxygen species (ROS) in these particles to DNA damage. Currently, APM mass concentration is linked to early deaths and limited studies probe the influence of other properties on human health. To predict the full extent and type of impact, particles need to be characterised for chemical composition and structure. APMs are routinely analysed for their bulk composition, but of late analysis on a micro level probing single particle character, using micro-analytical techniques, are considered. The latter, single particle analysis (SPA), permits one to obtain detailed information on chemical character from nano- to micron-sized particles. This paper aims to provide a snapshot of studies using data obtained from chemical characterisation and its link with in-vitro studies to inform on personal health risks. For this purpose, two studies will be compared, namely, the bioaccessibility of the inhalable fraction of urban road dust versus total suspended solids (TSP) collected in the same urban environment. The significant influence of metals such as Cu and Fe in TSP on DNA damage is illustrated. The speciation of Hg (determined by SPA) in different urban environments proved to dictate its bioaccessibility in artificial lung fluids rather than its concentration.Keywords: air pollution, human health, in-vitro studies, particulate matter
Procedia PDF Downloads 2259987 A Decadal Flood Assessment Using Time-Series Satellite Data in Cambodia
Authors: Nguyen-Thanh Son
Abstract:
Flood is among the most frequent and costliest natural hazards. The flood disasters especially affect the poor people in rural areas, who are heavily dependent on agriculture and have lower incomes. Cambodia is identified as one of the most climate-vulnerable countries in the world, ranked 13th out of 181 countries most affected by the impacts of climate change. Flood monitoring is thus a strategic priority at national and regional levels because policymakers need reliable spatial and temporal information on flood-prone areas to form successful monitoring programs to reduce possible impacts on the country’s economy and people’s likelihood. This study aims to develop methods for flood mapping and assessment from MODIS data in Cambodia. We processed the data for the period from 2000 to 2017, following three main steps: (1) data pre-processing to construct smooth time-series vegetation and water surface indices, (2) delineation of flood-prone areas, and (3) accuracy assessment. The results of flood mapping were verified with the ground reference data, indicating the overall accuracy of 88.7% and a Kappa coefficient of 0.77, respectively. These results were reaffirmed by close agreement between the flood-mapping area and ground reference data, with the correlation coefficient of determination (R²) of 0.94. The seasonally flooded areas observed for 2010, 2015, and 2016 were remarkably smaller than other years, mainly attributed to the El Niño weather phenomenon exacerbated by impacts of climate change. Eventually, although several sources potentially lowered the mapping accuracy of flood-prone areas, including image cloud contamination, mixed-pixel issues, and low-resolution bias between the mapping results and ground reference data, our methods indicated the satisfactory results for delineating spatiotemporal evolutions of floods. The results in the form of quantitative information on spatiotemporal flood distributions could be beneficial to policymakers in evaluating their management strategies for mitigating the negative effects of floods on agriculture and people’s likelihood in the country.Keywords: MODIS, flood, mapping, Cambodia
Procedia PDF Downloads 1269986 Environment Patterns and Mental Health of Older Adults in Long-Term Care Facilities: The Role of Activity Profiles
Authors: Shiau-Fang Chao, Yu-Chih Chen
Abstract:
Owing to physical limitations and restrained lifestyle, older long-term care (LTC) residents are more likely to be affected by their environment than their community-dwelling counterparts. They also participate fewer activities and experience worse mental health than healthy older adults. This study adopts the ICF model to determine the extent to which the clustered patterns of LTC environment and activity participation are associated with older residents’ mental health. Method: Data were collected from a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis (LPA) and latent class analysis (LCA) were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the relationships among environment profiles, activity profiles, and mental health. Results: LPA identified three mutually exclusive environment profiles (Low-, Moderate-, and High-Support Environment) based on the physical, social, and attitudinal environmental domains, consolidated from 12 environmental measures. LCA constructed two distinct activity profiles (Low- and High-Activity Participation) across seven activity domains (outdoor, volunteer-led leisure, spiritual, household chores, interpersonal exchange, social, and sedentary activity) that were factored from 20 activities. Compared to the Low-Support Environment class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in the Moderate- and High-Support Environment classes were more likely to be in the “High Activity” class, which in turn, exhibited better mental health. Conclusion: This study advances the current knowledge through rigorous methods and study design. The study findings lead to several conclusions. First, this study supports the use of ICF framework to institutionalized older individuals with functional limitations and demonstrates that both measures of environment and activity participation can be refined from multiple indicators. Second, environmental measures that encompass the physical, social, and attitudinal domains would provide a more comprehensive assessment on the place where an older individual embeds. Third, simply counting activities in which an older individual participates or considering a certain type of activity may not capture his or her way of life. Practitioners should not only focus on group or leisure activities within the institutions; rather, more efforts should be made to consider residents’ preferences for everyday life and support their remaining ability by encouraging continuous participation in activities they still willing and capable to perform. Fourth, environment and activity participation are modifiable factors which have greater potential to strengthen older LTC residents’ mental health, and activity participation should be considered in the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents’ mental health.Keywords: activity, environment, mental health, older LTC residents
Procedia PDF Downloads 1979985 Human Health Risk Assessment of Mercury-Contaminated Soils in Alebediah Mining Community, Sudan
Authors: Ahmed Elwaleed, Huiho Jeong, Ali H. Abdelbagi, Nguyen Thi Quynh, Koji Arizono, Yasuhiro Ishibashi
Abstract:
Artisanal and small-scale gold mining (ASGM) poses substantial risks to both human health and the environment, particularly through contamination of soil, water, and air. Prolonged exposure to ASGM-contaminated soils can lead to acute or chronic mercury toxicity. This study assesses the human health risks associated with mercury-contaminated soils and tailings in the Alebediah mining community in Sudan. Soil samples were collected from various locations within Alebediah, including ASGM areas, farmlands, and residential areas, along with tailings samples commonly found within ASGM sites. The evaluation of potential health risks to humans included the computation of the estimated daily intake (AvDI), the hazard quotient (HQ), and the hazard index (HI) for both adults and children. The primary exposure route identified as potentially posing a significant health risk was the volatilization of mercury from tailings samples, where mercury concentrations reached up to 25.5 mg/kg. In contrast, other samples within the ASGM area showed elevated mercury levels but did not present significant health risks, with HI values below 1. However, all areas indicated HI values above 1 for the remaining exposure routes. The study observed a decrease in mercury concentration with increasing distance from the ASGM community. Additionally, soil samples revealed elevated mercury levels exceeding background values, prompting an assessment of contamination levels using the enrichment factor (EF). The findings indicated that farmlands and residential areas exhibited depleted EF, while areas surrounding the ASGM community showed none to moderate pollution. In contrast, ASGM areas exhibited significant to extreme pollution. A GIS map was generated to visually depict the extent of mercury pollution, facilitating communication with stakeholders and decision-makers.Keywords: mercury pollution, artisanal and small-scale gold mining, health risk assessment, hazard index, soil and tailings, enrichment factor
Procedia PDF Downloads 839984 Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on Health-Related Quality of Life among Post-Acute Coronary Syndrome Patients: A Randomized Controlled Trial
Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell
Abstract:
Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI
Procedia PDF Downloads 1679983 Investigating Physician-Induced Demand among Mental Patients in East Azerbaijan, Iran: A Multilevel Approach of Hierarchical Linear Modeling
Authors: Hossein Panahi, Firouz Fallahi, Sima Nasibparast
Abstract:
Background & Aim: Unnecessary growth in health expenditures of developing countries in recent decades, and also the importance of physicians’ behavior in health market, have made the theory of physician-induced demand (PID) as one of the most important issues in health economics. Therefore, the main objective of this study is to investigate the hypothesis of induced demand among mental patients who receive services from either psychologists or psychiatrists in East Azerbaijan province. Methods: Using data from questionnaires in 2020 and employing the theoretical model of Jaegher and Jegers (2000) and hierarchical linear modeling (HLM), this study examines the PID hypothesis of selected psychologists and psychiatrists. The sample size of the study, after removing the questionnaires with missing data, is 45 psychologists and 203 people of their patients, as well as 30 psychiatrists and 160 people of their patients. Results: The results show that, although psychiatrists are ‘profit-oriented physicians’, there is no evidence of inducing unnecessary demand by them (PID), and the difference between the behavior of employers and employee doctors is due to differences in practice style. However, with regard to psychologists, the results indicate that they are ‘profit-oriented’, and there is a PID effect in this sector. Conclusion: According to the results, it is suggested that in order to reduce competition and eliminate the PID effect, the admission of students in the field of psychology should be reduced, patient information on mental illness should be increased, and government monitoring and control over the national health system must be increased.Keywords: physician-induced demand, national health system, hierarchical linear modeling methods, multilevel modela
Procedia PDF Downloads 1369982 Co-design Workshop Approach: Barriers and Facilitators of Using IV Iron in Anaemic Pregnant Women in Malawi - A Qualitative Study
Authors: Elisabeth Mamani-Mategula
Abstract:
Background: Anaemia has significant consequences on both the mother and child's health as it results in maternal haemorrhage, low childbirth weight, premature delivery, poor organ development, and infections at birth and hence the need for treatment. In low-middle income countries, anaemic pregnant women are recommended to take 30 mg to 60 mg of elemental iron daily throughout pregnancy which are often poorly tolerated and adhered to. A potential alternative to oral iron is intravenous (IV) iron which allows the saturation of the body’s iron stores quickly. Currently, a randomised controlled trial on the Effect of intravenous iron on Anaemia in Malawian Pregnant women (REVAMP) is underway. Since this is new in Africa and Malawi is the second country to implement it, its acceptability to both the providers and end-users is not known. Suppose the use of IV iron during pregnancy would be acceptable in Malawi, it could change how we treat and manage pregnant women with anaemia and be scaled up throughout Malawi to improve maternal and child health. Objectives: To identify the barriers and facilitators of implementing IV iron in the Malawian healthcare system and identify ‘touchpoints’ and co-develop strategies to support and inform the implementation of the trial Methodology: A qualitative study was conducted with policymakers, government partners, and health managers through in-depth interviews to identify barriers and facilitators relating to the implementation of IV iron in the health system of Malawi. From the interviews, touchpoints were identified that formed the basis of the discussion in further discussing the barriers and suggested solutions in the co-design workshops with the community members and the health workers, respectively. We purposively recruited 20 health workers (10 male, 10 Female). 20 community members (10 male, 10 female) were recruited randomly. Data was collected through group discussions and interactive sessions and was recorded through audios, flip charts, and sticky notes. We familiarized ourselves with the data and identified themes. Results: Two co-design workshops were conducted with different community members and different health worker carders. Identified individual factors included lack of knowledge about anaemia, lack of male involvement, the attitude of health workers and patient non-compliance with appointments. Community factors included myths and misconceptions about IV iron, including associating the use of IV iron with vampirism and covid 19 vaccination. Health system factors identified were a shortage of staff and equipment, unfamiliarity with IV iron and its cost. Discussion: The use of IV iron, as suggested by the community members and health workers, demands civic education through bringing awareness to end-users and training to providers. Through these co-design workshops, community sensitization and awareness, briefing and training of health workers and creation of educational materials were done.Keywords: acceptability, IV iron, barriers, facilitators, co-design
Procedia PDF Downloads 1299981 The Effects of the Parent Training Program for Obesity Reduction on Child Waist Circumference and Health Behaviors of Pre-School Children at the Samut-Songkhram Kindergarten School, Samut-Songkhram Province, Thailand
Authors: Muntanavadee Maytapattana
Abstract:
This research aims to study the effects of the Parent Training Program for Obesity Reduction (PTPOR) on child waist circumference and health behaviors of pre-school children at the Samut-Songkhram kindergarten school, Samut-Songkhram province, Thailand. The objective of this research is to evaluate the effectiveness of the PTPOR on child waist circumference and health behaviors of the pre-school children. The conceptual framework of this study is developed on the basis of the Ecological Systems Theory (EST), not only do the individual factors such as child characteristics and child risk factors contribute to the child’s weight status, but also other factors such as parenting style and family characteristics, as well as community and demographic factors. This research is a quasi-experimental study. Participants were pre-school overweight and obese children and their parents. Forty-one parent-child dyads were recruited into the program. Parents participated in two sessions including an educational session and a group discussion session. Research methodology uses Paired-Samples t-test to determine the difference between groups in the mean scores of the outcome variables of the children and parents. The research results show that there was significant difference between child waist circumferences mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child waist circumference was decrease after finishing the program. And there was no significant difference between child exercise health behaviors mean score at the baseline and finishing the program at the 0.05 level; however, mean score of the child exercise behavior was increase after finishing the program. Meanwhile, there was significant difference between child dietary health behavior mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child dietary was increase after finishing the program.Keywords: PTPOR, child waist circumference, child health behaviors, pre-school children
Procedia PDF Downloads 570