Search results for: health status

Authors: Michael Louis Sunaris, Robby Yussac Tallar

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The concept of sustainable river is evolving in Indonesia today. Many rivers condition in Indonesia have decreased by quality and quantity. The degradation of this condition is caused by rapid land use change as a result of increased population growth and human activity. It brings the degradation of the existing watersheds including some types of land use that an important factor in determining the status of river sustainability. Therefore, an evaluation method is required to determine the sustainability status of waterbody within watershed. The purpose of this study is to analyze various types of land use in determining the status of river sustainability. This study takes the watersheds of Citarum Upstream as a study area. The results of the analysis prove the index of sustainability status of the river that changes from good to bad or average in the rivers in the study area. The rapid and uncontrolled changes of land use especially in the upper watersheds area are the main causes that happened over time. It was indicated that the cumulative runoff coefficients were increased significantly. These situations indicated that the damage of watersheds has an impact on the water surplus or deficit problem yearly. Therefore, the rivers in Indonesia should be protected and conserved. The sustainability index of the rivers is an index to indicate the condition of watersheds by defining status of rivers in order to achieve sustainable water resource management.

Keywords: land use change, runoff coefficient, a simple index, sustainable river

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Authors: Nepton Kiani

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Dental decay is one of the most common chronic diseases worldwide and imposes significant costs annually on people and healthcare systems. Addressing this issue is among the important programs of the World Health Organization in the field of oral and dental disease prevention and health promotion. In this context, oral and dental health in vulnerable groups, especially pregnant women, is of greater importance due to the health maintenance of the mother and fetus. The aim of this study is to investigate the DMFT index and various factors affecting it in order to identify different factors influencing the process of dental decay and to take an effective step in reducing the progression of this disease, control, and prevention. In this cross-sectional descriptive study, 120 pregnant women attending Nepton Policlinica clinic in Malaga, Spain, were evaluated for the DMFT index and oral and dental hygiene. In this regard, interviews, precise observations, and data collection were used. Subsequently, data analysis was performed using SPSS software and employing correlation tests, Kruskal-Wallis, and Mann-Whitney tests. The DMFT index for pregnant women in three age groups 22-26, 27- 31, and 32-36 years was respectively 2.8, 4.5, and 5.6. The results of logistic regression analysis showed that demographic variables (age, education, job, economic status) and the frequency of brushing and flossing lead to preventive behavior up to 49.58 percent (P<0.05). Generally, the results indicated that oral and dental care during pregnancy is poor. Only a small number of pregnant women regularly used toothbrush and dental floss or visited the dentist regularly. On the other hand, poor performance in adopting oral and dental care was more observed in pregnant women with lower economic and educational status. The present study showed that raising the level of awareness and education on oral and dental health in pregnant women is essential. In this field, it is necessary to focus on conducting educational-care courses at the level of healthcare centers for midwives, healthcare personnel, and at the community level for families, to prevent and perform dental treatments before the pregnancy period

Keywords: Malaga, oral and dental health, pregnant women, Spain

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Authors: Md Monoarul Haque

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Nutritional status is a sensitive indicator of community health and nutrition among preschool children, especially the prevalence of undernutrition that affects all dimensions of human development and leads to growth faltering in early life. The present study is an attempt to assess the food intake pattern and nutritional status of pre-school Chakma tribe children. It was a cross-sectional community based study. The subjects were selected purposively. This study was conducted at Savar Upazilla of Rangamati. Rangamati is located in the Chittagong Division. Anthropometric data height and weight of the study subjects were collected by standard techniques. Nutritional status was measured using Z score according WHO classification. χ2 test, independent t-test, Pearson’s correlation, multiple regression and logistic regression was performed as P<0.05 level of significance. Statistical analyses were performed by appropriate univariate and multivariate techniques using SPSS windows 11.5. Moderate (-3SD to <-2SD) to severe underweight (<-3SD) were 23.8% and 76.2% study subjects had normal weight for their age. Moderate (-3SD to <-2SD) to severe (<-3SD) stunted children were only 25.6% and 74.4% children were normal and moderate to severe wasting were 14.7% whereas normal child was 85.3%. Significant association had been found between child nutritional status and monthly family income, mother education and occupation of father and mother. Age, sex and incomes of the family, education of mother and occupation of father were significantly associated with WAZ and HAZ of the study subjects (P=0.0001, P=0.025, P=0.001 and P=0.0001, P=0.003, P=0.031, P=0.092, P=0.008). Maximum study subjects took local small fish and some traditional tribal food like bashrool, jhijhipoka and pork very much popular food among tribal children. Energy, carbohydrate and fat intake was significantly associated with HAZ, WAZ, BAZ and MUACZ. This study demonstrates that malnutrition among tribal children in Bangladesh is much better than national scenario in Bangladesh. Significant association was found between child nutritional status and family monthly income, mother education and occupation of father and mother. Most of the study subjects took local small fish and some traditional tribal food. Significant association was also found between child nutritional status and dietary intake of energy, carbohydrate and fat.

Keywords: food intake pattern, nutritional status, preschool children, Chakma ethnic community

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Authors: Sushma Ghildyal, Sanjay Kumar Singh

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The present study was undertaken with the purpose to understand the relationship of lifestyle and Socio-Economic status with child obesity among 1000 boys aged from 16 to 18 years of Varanasi District of Uttar Pradesh State in India. The study was conducted in both urban and rural area of the District. Ten schools i.e. five from urban area and five from rural area were selected by using purposive sampling. Healthy boys of class 10th, 11th and 12th were taken as subjects for the study. Prior consent was obtained from school authority. Anthropometric measurements were taken from each subject. Anthropometric measurements were Standing Height, Weight, Biceps skin folds, Triceps skin folds, Sub-scapular skin folds and Supra-iliac skin folds taken by Lange’s skin fold caliper. Lifestyle and Socio-Economic Status were obtained by questionnaires. In order to assess the BMI, Body fat %, Lifestyle and Socio-Economic Status; descriptive analyses were done. To find out the significant association of obesity with lifestyle and Socio-Economic Status Chi-square test was used. To find out significant difference between obesity of Urban and Rural children t-test was applied. Level of significance was set at 0.05 level. The conclusions drawn were: (1) The result showed that in urban area Varanasi District of Uttar Pradesh 0.6% children were in very high level adaptive lifestyle, 6.2% were in high level adaptive lifestyle, 25.4% above average level adaptive lifestyle, 47.8% moderately adaptive lifestyle, 3.6% and 0.4% low and very low level adaptive lifestyle. (2) In rural area Varanasi District of Uttar Pradesh 0.00% children were in very high level adaptive lifestyle, 9.4% were in high level adaptive lifestyle, 24.8% average level adaptive lifestyle, 47.0% moderately adaptive lifestyle, 15.2% below average and 3.0% very low level adaptive lifestyle.(3) In urban area 12.8% were in upper class Socio-Economic Status, 56.6% in upper middle class Socio-Economic Status, 30.2% in middle class Socio-Economic Status and 0.2% in lower middle class Socio-Economic Status. (4) In rural area 1.4% were in upper class Socio-Economic Status, 15.2% in upper middle class Socio-Economic Status, 51.6% in middle class Socio-Economic Status and 0.8% in lower middle class Socio-Economic Status. (5) In urban area 21.2% children of 16-18 years were obese. (6) In rural area 0.2% children of 16-18 years were obese. (7) In overall Varanasi District of Uttar Pradesh 10.7% children of 16-18 years were obese. (8) There was no significant relationship of obesity with Lifestyle of urban area children of 16-18 years. (9) There was significant relationship of obesity with Socio-Economic Status of urban area children of 16-18 years (10) There was no significant relationship of obesity with Lifestyle of rural area children of 16-18 years of Varanasi District Uttar Pradesh. (11) There was significant relationship of obesity with Socio-Economic Status of rural area children of 16-18 years. (12) Results showed significant difference between urban and rural area children of 16-18 years in respect to obesity of Varanasi District of Uttar Pradesh.

Keywords: lifestyle, obesity, rural area, socio-economic status, urban area

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Authors: Aldrin Avergas, Quennie Mariel Peñaranda, Niña Karen San Miguel, Alexis Katrina Agustin, Peralta Xusha Mae, Maria Luisa Sison

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The research is entitled “The Relationship of Socioeconomic Status and Levels of Delinquency among Senior High School Students with Secured Attachment to their Mothers”. The researchers had explored the relationship between socioeconomic status and delinquent tendencies among grade 11 students. The objective of the research is to discover if delinquent behavior will have a relationship with the current socio-economic status of an adolescent student having a warm relationship with their mothers. The researchers utilized three questionnaires that would measure the three variables of the study, namely: (1) 1SEC 2012: The New Philippines Socioeconomic Classification System was used to show the current socioeconomic status of the respondents, (2) Self-Reported Delinquency – Problem Behavior Frequency Scale was utilized to determine the individual's frequency in engaging to delinquent behavior, and (3) Inventory of Parent and Peer Attachment Revised (IPPA-R) was used to determine the attachment style of the respondents. The researchers utilized a quantitative research design, specifically correlation research. The study concluded that there is no significant relationship between socioeconomic status and academic delinquency despite the fact that these participants had secured attachment to their mother hence this research implies that delinquency is not just a problem for students belonging in the lower socio-economic status and that even having a warm and close relationship with their mothers is not sufficient enough for these students to completely be free from engaging in delinquent acts. There must be other factors (such as peer pressure, emotional quotient, self-esteem or etc.) that are might be contributing to delinquent behaviors.

Keywords: adolescents, delinquency, high school students, secured attachment style, socioeconomic status

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Authors: Oyebade K. Oyedotun

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The cardiotocogram is a technical recording of the heartbeat rate and uterine contractions of a fetus during pregnancy. During pregnancy, several complications can occur to both the mother and the fetus; hence it is very crucial that medical experts are able to find technical means to check the healthiness of the mother and especially the fetus. It is very important that the fetus develops as expected in stages during the pregnancy period; however, the task of monitoring the health status of the fetus is not that which is easily achieved as the fetus is not wholly physically available to medical experts for inspection. Hence, doctors have to resort to some other tests that can give an indication of the status of the fetus. One of such diagnostic test is to obtain cardiotocograms of the fetus. From the analysis of the cardiotocograms, medical experts can determine the status of the fetus, and therefore necessary medical interventions. Generally, medical experts classify examined cardiotocograms into ‘normal’, ‘suspect’, or ‘pathological’. This work presents an artificial neural network based decision support system which can filter cardiotocograms data, producing the corresponding statuses of the fetuses. The capability of artificial neural network to explore the cardiotocogram data and learn features that distinguish one class from the others has been exploited in this research. In this research, feedforward and radial basis neural networks were trained on a publicly available database to classify the processed cardiotocogram data into one of the three classes: ‘normal’, ‘suspect’, or ‘pathological’. Classification accuracies of 87.8% and 89.2% were achieved during the test phase of the trained network for the feedforward and radial basis neural networks respectively. It is the hope that while the system described in this work may not be a complete replacement for a medical expert in fetus status evaluation, it can significantly reinforce the confidence in medical diagnosis reached by experts.

Keywords: decision support, cardiotocogram, classification, neural networks

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Authors: Ya-Hui Wang

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Lower speech therapy rate of tracheostomized patient was noted in comparison with previous researches. This study is aim to shed light on the referral status of speech therapy in those patients in Taiwan. This study developed an analysis for the size and key characteristics of the population of tracheostomized in-patient in the Taiwan. Method: We analyzed National Healthcare Insurance data (The Collaboration Center of Health Information Application, CCHIA) from Jan 1 2010 to Dec 31 2010. Result: over ages 3, number of tracheostomized in-patient is directly proportional to age. A high service loading was observed in North region in comparison with other regions. Only 4.87% of the tracheostomized in-patients were referred for speech therapy, and 1.9% for swallow examination, 2.5% for communication evaluation.

Keywords: refer, speech therapy, training, rehabilitation

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Authors: Won-Seok Kim, Hyung-Ik Shin

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Self-rated health (SRH) is a subjective assessment of individual health and has been identified as a strong predictor for mortality and morbidity. However few studies have been directed to the factors associated with SRH in persons with disabilities (PWD). We used data of 7th Korean national survey for 5307 PWD in 2008. Multiple logistic regression analysis was performed to find out independent risk factors for poor SRH in PWD. As a result, indicators of physical condition (poor instrumental ADL), socioeconomic disadvantages (poor education, economically inactive, low self-rated social class, medicaid in health insurance, presence of unmet need for hospital use) and social participation and networks (no use of internet service) were selected as independent risk factors for poor SRH in final model. Findings in the present study would be helpful in making a program to promote the health and narrow the gap of health status between the PWD.

Keywords: disabilities, risk factors, self-rated health, socioeconomic disadvantages, social networks

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Authors: Francesco Colcerasa, Fabio Pisani

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We contribute to the subjective well-being literature testing the relationship between life satisfaction and inequality of opportunity in health, measured through the Human Opportunity Index calculated at the national level using individual socio-economic data from the cross-country European Social Survey sample. We compute several indexes of opportunity inequality in health, each obtained according to a different combination of circumstances (gender, immigrant status, parents’ education). We find a robust and significant relationship where life satisfaction is higher in correspondence with low levels of health opportunity inequality. The result is twofold. On the one hand, the importance of the well-being of other types of inequality than income inequality emerges. On the other hand, the socioeconomic roots of inequality in health are investigated, suggesting that circumstances at birth have a role in future well-being. Several rationales for the nexus between life satisfaction and inequality of opportunity in health are possible, which we investigate by splitting the sample. Among others, we find a prominent role of pro-social preferences – formalized as interest towards own offspring (which can be interpreted as intergenerational justice) – as a mediating factor of the relationship.

Keywords: Inequality of opportunity, subjective wellbeing, health, health inequality, inequality of opportunity in health

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Authors: Kerdsiri Hongthai, Darunee Jongudomkarn, Rutja Phuphaibul

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In Thailand, many adults in rural areas migrate to seek employ¬ment resulting in skipped-generation family where grandparents care for grandchildren with no other adults present. This is a preliminary study using qualitative case study methods, aimed to explore the situations of older adult grandparents' experiences in skipped-generation family in North-East of Thailand. Data were collected by in-depth inter¬views with 6 grandparents living in skipped-generation families; 5 females and 1 males grandparents, aged 62-75, some of them have diabetes mellitus, hypertension, during November to December, 2017. The finding themes are: ‘Caught up in the middle’: the older adults were pleased to have grandchildren but, at the same time, acknowledge the burden that this placed on them, especially when the migrant children failed to send enough money back to support the family. ‘Getting bad health’: they reported to be fatigued and stressed due to burden of caring for their grandchildren without support. This situation can aggravate problems of poor health status and be worsening economic status of the grandparents. In some cases of deprivation, the grandparents feel that having to be the sole care providers of their grandchildren can negative adversely affect their mental status. It is important to find out in other sectors similar to Thailand and lead to more in-depth research to answer the research questions about policy and social support in skipped-generation family in the future.

Keywords: older adult grandparents, experiences, principle care giver, skipped-generation family

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Authors: Badino Manuel, Farias María Alejandra

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Anxiety and depression are considered the main mental health issues found in people with substance-related disorders. Furthermore, substance-related disorders, anxiety-related and depressive disorders are among the leading causes of disability and are associated with increased mortality. The co-occurrence of substance-related disorders and these mental health conditions affect the accuracy in diagnosis, treatment plan, and recovery process. The aim is to describe the prevalence of anxiety and depression in patients with substance-related disorders in a mental health service in Córdoba, Argentina. A descriptive cross-sectional study was conducted among patients with substance-related disorders (N=305). Anxiety and depression were assessed using the Patient Health Questionnaire-4 (PHQ-4) during the period from December 2021 to March 2022. For a total of 305 participants, 71,8% were male, 25,6% female and 2,6% non-binary. As regards marital status, 51,5% were single, 21,6% as a couple, 5,9% married, 15,4% separated and 5,6% divorced. In relation to education status, 26,2% finished university, 56,1% high school, 16,4% only primary school and 1,3% no formal schooling. Regarding age, 10,8% were young, 84,3% were adults, and 4,9% were elderly. In-person treatment represented 64,6% of service users, and 35,4% were conducted through teleconsultation. 15,7% of service users scored 3 or higher for anxiety, and 32,1% scored 3 or higher for depression in the PHQ-4. 13,1% obtained a score of 3 or higher for both anxiety and depression. It is recommended to identify anxiety and depression among patients with substance-related disorders to improve the quality of diagnosis, treatment, and recovery. It is suggested to apply PHQ-4, PHQ-9 within the protocol of care for these patients.

Keywords: addiction, anxiety, depression, mental health

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Authors: Ritu Sarsoha

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According to World Summit 2002 health is an integral component of sustainable development. Due to overpopulation and lack of employment opportunities in villages and small towns, the rural youth tend to migrate to the big cities causing mushrooming of slums. These slums lack most of the basic necessities of life particularly regarding environmental pollution and appropriate health care system. Present paper deals with the socio-economic and environmental status of people living in slum area of Chandigarh which has now grown as a big city today as it has become a hub for the migrants from U. P. and Bihar. Here is a case study of Colony no. 5 of Chandigarh which is divided into more than one block.

Keywords: slum, socio-economic, environment pollution, health

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Authors: Zeyad Suleiman Bataineh

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Introduction: civilian wars are associated with severe humanitarian effects that include loss of individuals and properties. Psychological dimensions are also included depression. Objectives: the main objectives of the present study were to investigate the depression level among Syrian patients who visited internal medicine clinics and other related variables. Methods and subjects: this study was conducted based on cross sectional study design. A total of 175 patients were involved. Patients were asked to fill a questionnaire to assess the level of depression that include demographic variables such as gender, age, educational level, and social status. Beck Aaron scale for depression was used. Participation in this study was voluntary, and all patients were informed about their rights to withdraw from the study without being negatively affected. Data were entered into excel spreading sheet for all participants. SPSS version 21 was used to analyze data. Data were described as means, the standard deviation for linear variables, frequencies, and percentages for categorical variables. The relationships between variables were evaluated using independent t test and One Way ANOVA test. Significance was considered at α≤0.05. Results: Depression was found in 152 (87%) of participants. The majority of participants with depression had moderate to severe depression. Depression was significantly associated gender, age, educational level, and social status (p<0.05). Conclusion: psychological rehabilitation is required for patients who experienced civilian wars.

Keywords: mental health, deprssion, health system, psychological dimension

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Authors: Lin Fu-Gong

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Background: As WHO announced, people with intellectual disability (ID) were vulnerable to mental health problems. And there were few custom-made mental health scales for those people to monitor their mental health. Those people with mental problems often accompanied worse prognosis and usually became to be a heavier burden on the caregivers. Purpose: In this study, we intend to develop a psychopathy scale as a practical tool for monitoring the mental health for people with ID living in institute. Methods: In this study, we adopt the Psychopathology Inventory for Mentally Retarded Adults developed by professor Matson with certified reliability and validity in Western countries with Dr. Matson’s agreement in advance. We first translated the inventory into Chinese validated version considering the domestic culture background in the past year. And the validity and reliability evaluation of mental health status using this inventory among the people with intellectual living in the institute were done. Results: The inventory includes eight psychiatric disorder scales as schizophrenic, affective, psychosexual, adjustment, anxiety, somatoform, personality disorders and inappropriate mental adjustment. Around 83% of 40 invested people, who randomly selected from the institute, were found to have at least one disorder who were recommended with medical help by two evaluators. Among the residents examined, somatoform disorder and inappropriate mental adjustment were most popular with 60% and 78% people respectively. Conclusion: The result showed the prevalence psychiatric disorders were relatively high among people with ID in institute and the mental problems need to be further cared and followed for their mental health. The results showed that the psychopathology inventory was a useful tool for institute caregiver, manager and for long-term care policy to the government. In the coming stage, we plan to extend the use of the valid Chinese version inventory among more different type institutes for people with ID to establish their dynamic mental health status including medical need, relapse and rehabilitation to promote their mental health.

Keywords: intellectual disability, psychiatric disorder, psychopathology inventory, mental health, the institute

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Authors: Daisy Saikia

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Long-term maternal health issues with Caesarean section deliveries are significant. Thus, this study aims to investigate the prevalence of caesarean section deliveries in India and to comprehend its associated predictors in light of the high caesarean section delivery rate. The study uses data from the fifth National Family Health Surveys (NFHS-5) round. Specifically, live births to women aged 15-49 in the 5 years preceding the survey. Binary logistic regression was used to check the adjusted effects of the predictor variables on caesarean section delivery. STATA/SE v16.0 was used for the data analysis with a 5% significance level. Twenty-two per cent of the live births to women were delivered by caesarean section. There was socio-economic, demographic and geographical variation in the prevalence of caesarean section delivery in India. Increasing age, body mass index, marital status, mother’s occupation and education, birth order, place of delivery, full ANC, non-tribal status, wealth quintile and region are significantly associated with caesarean section deliveries in India. Caesarean section deliveries should only be performed when essential from a medical perspective, and regions, where the rate is too high, should follow the guidelines. Additionally, it needs to be investigated whether private hospitals compel patients to have caesarean section deliveries to increase their revenue. Thus, these unnecessary deliveries must be examined immediately for safe childbirth and the wellness of both mother and child.

Keywords: caesarean section, delivery, maternal health, India

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Authors: Habtamu Fufa, Yemane Berhane

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Child under nutrition has long-term consequences for intellectual ability, economic productivity, reproductive performance and susceptibility to metabolic and cardiovascular disease. The unacceptably high prevalence of malnutrition in young children of the region has not changed much over the last decades, which could make the achievement of the corresponding Millennium Development Goals very unlikely. Despite the well-documented problems of child malnutrition in Sub-Saharan Africa, there is few systematic review of evidences on determinants of child malnutrition in the region. The current available evidence on determinants of child under nutrition in Sub-Saharan Africa is systematically reviewed. The method used in searching relevant literature was using bio medical databases PUBMED, Google scholar and the website of the World Health Organization on nutrition using the following key words: "Determinants “, "Child Malnutrition", and "Sub- Saharan Africa". The search was limited to articles published in and after 1995 up to date. In all the reviewed articles, the data were analyzed using multivariate regression analysis and or odds ratios for significance of determinants in child malnutrition. Synthesis of 40 published articles from various countries of the region is done and noted that household economic status, maternal education, disease, breastfeeding practices, age and sex of a child, birth interval and residential areas were found to be determinants of child under nutrition. Poverty remains the main factor of malnutrition in Sub-Saharan Africa and poor education of parents aggravates the malnutrition through perpetuation of poor nutrition practices. Male children under five years are the most affected ones. Understanding of these determinants of poor nutritional attainment would provide insights in designing interventions for reducing the high levels of child malnutrition in this region. Large-scale multi-sectoral community-based interventions are urgently needed for a sustainable improvement of child nutritional & health status in Sub-Saharan Africa.

Keywords: child malnutrition, determinants, Sub-Saharan Africa, health status

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Authors: Andi Tenri Ayu Rahman, Citrakesumasari, Devintha Virani

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Breast milk is the complex biological fluid mix of macronutrient and micronutrient that are considered as perfect food for babies. Zinc has a role in various biological functions and physical growth. This research aims to know the average zinc (Zn) micronutrients content of breast milk by determinants of infant (birth weight) and mother (nutritional status and food intake) and description of the pattern of mothers breastfeeding. The type of research used is observational analytic with cross-sectional study design. The population was 41 mothers in Kassi-Kassi health center within one month. Sample research is mothers who gave birth at term and breastfed her baby. Sampling was done with random sampling technique involving 37 people. Samples of breast milk were analyzed in the laboratory by using the method of Atomic Absorption Spectrofotometry (AAS). This research find that from the samples (n=37) the average contents of zinc in the breast milk is 0,88±0,54 mg/L with the highest value on the group of low birth weight babies (1,13 ± 0,67mg/L), mothers who had normal nutritional status (0,981 ± 0,514 mg/L) and intake low zinc (0,94 ± 0,54 mg/L). Regarding breastfeeding pattern, 67,6% of the samples had had breastfeeding experience and 81,1% of breastfed more than eight times a day. In summary, the highest average value of the zinc content of breast milk was in the group of low birth weight babies, mother with normal nutritional status, and mothers having relatively low intake pattern.

Keywords: zinc, breastmilk, mother, baby

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Authors: Murtadha Kareem, Oliver Faust

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Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

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Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: Shradha Parsekar, Suma Nair, Ajay Bailey, Binu V. S.

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Background: Concealing of cancer-related information is seen in many low-and-middle-income countries and may be associated with multiple factors. Comparatively, there is lack of information about, how breast cancers diagnosed women disclose cancer-related information to their social contacts and vice versa. To get more insights on the participant’s experience, opinions, expectations, and attitudes, a qualitative study is a suitable approach. Therefore, this study involving in-depth interviews was planned to lessen this gap. Methods: Interviews were conducted separately among breast cancer patients and their caregivers with semi-structured qualitative interview guide. Purposive and convenient sampling was being used to recruit patients and caregivers, respectively. Ethical clearance and permission from the tertiary hospital were obtained and participants were selected from the Udupi district, Karnataka, India. After obtaining a list of breast cancer diagnosed cases, participants were contacted in person and their willingness to take part in the study was taken. About 39 caregivers and 35 patients belonging to different breast cancer stages were recruited. Interviews were recorded with prior permission. Data was managed by Atlas.ti 8 software. The recordings were transcribed, translated and coded in two cycles. Most of the patients belonged to stage II and III cancer. Codes were grouped together into to whom breast cancer status was concealed to and underneath reason for the same. Main findings: followings are the codes and code families which emerged from the data. 1) Concealing the breast cancer status from social contacts other than close family members (such as extended family, neighbor and friends). Participants perceived the reasons as, a) to avoid questions which people probe (which doesn’t have answers), b) to avoid people paying courtesy visit (to inquire about the health as it is Indian culture to visit the sick person) making it inconvenient for patient and caregivers have to offer something and talk to them, c) to avoid people getting shocked (react as if cancer is different from other diseases) or getting emotional/sad, or getting fear of death d) to avoid getting negative suggestion or talking anything in front of patient as it may affect patient negatively, e) to avoid getting stigmatized, f) to avoid getting obstacle in child’s marriage. 2) Participant concealed the breast cancer status of young children as they perceived that it may a) affect studies, b) affect emotionally, c) children may get scared. 3) Concealing the breast cancer status from patients as the caregivers perceived that they have fear of a) worsening patient’s health, b) patient getting tensed, c) patient getting shocked, and d) patient getting scared. However, some participants stressed important in disclosing the cancer status to social contact/patient to make the people aware of the disease. Conclusion: The news of breast cancer spreads like electricity in the wire, therefore, patient or family avoid it for many reasons. Although, globally, due to physicians’ ethical obligations, there is an inclination towards more disclosure of cancer diagnosis and status of prognosis to the patient. However, it is an ongoing argument whether patient/social contacts should know the status especially in a country like India.

Keywords: breast cancer, concealing cancer status, India, qualitative study

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Authors: Bo-Jian Wu, Si-Heng Wu

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Objectives: Frailty is a condition of a person who has chronic health problems complicated by a loss of physiological reserve and deteriorating functional abilities. The frailty syndrome was defined by Fried and colleagues, i.e., weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. However, to our best knowledge, there have been rare studies exploring the prevalence of frailty and its association with falls in patients with schizophrenia. Methods: A total of 559 hospitalized patients were recruited from a public psychiatric hospital in 2013. The majority of the subjects were males (361, 64.6%). The average age was 53.5 years. All patients received the assessment of frailty status defined by Fried and colleagues. The status of a fall within one year after the assessment of frailty, clinical and demographic data was collected from medical records. Logistic regression was used to calculate the odds ratio of associated factors. Results : A total of 9.2% of the participants met the criteria of frailty. The percentage of patients having a fall was 7.2%. Age were significantly associated with frailty (odds ratio = 1.057, 95% confidence interval = 1.025-1.091); however, sex was not associated with frailty (p = 0.17). After adjustment for age and sex, frailty status was associated with a fall (odds ratio = 3.62, 95% confidence interval = 1.58-8.28). Concerning the components of frailty, decreased grip strength (odds ratio = 2.44, 95% confidence interval = 1.16-5.14), slow gait speed (odds ratio = 2.82, 95% confidence interval = 1.21-6.53), and low physical activity (odds ratio = 2.64, 95% confidence interval = 1.21-5.78) were found to be associated with a fall. Conclusions: Our findings suggest the prevalence of frailty was about 10% in hospitalized patients with chronic patients with schizophrenia, and frailty status was significant with a fall in this group. By using the status of frailty, it may be beneficial to potential target candidates having fallen in the future as early as possible. The effective intervention of prevention of further falls may be given in advance. Our results bridge this gap and open a potential avenue for the prevention of falls in patients with schizophrenia. Frailty is certainly an important factor for maintaining wellbeing among these patients.

Keywords: fall, frailty, schizophrenia, Taiwan

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Authors: Rubisha Adhikari, Rajani Shah

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Introduction: Aging is a natural, global and inevitable phenomenon every single person has to go through, and nobody can escape the process. One of the emerging challenges to public health is to improve the quality of later years of life as life expectancy continues to increase. Quality of life (QoL) has grown to be a key goal for many public health initiatives. Population aging has become a global phenomenon as they are growing more quickly in emerging nations than they are in industrialized nations, leaving minimal opportunities to regulate the consequences of the demographic shift. Methods: A community-based descriptive analytical approach was used to examine the quality of life and associated factors among elderly people. A mixed method was chosen for the study. For the quantitative data collection, a household survey was conducted using the WHOQOL-OLD tool. In-depth interviews were conducted among twenty participants for qualitative data collection. Data generated through in-depth interviews were transcribed verbatim. In-depth interviews lasted about an hour and were audio recorded. The in-depth interview guide had been developed by the research team and pilot-tested before actual interviews. Results: This study result showed the association between quality of life and socio-demographic variables. Among all the variables under socio-demographic variable of this study, age (ꭓ2=14.445, p=0.001), gender (ꭓ2=14.323, p=<0.001), marital status (ꭓ2=10.816, p=0.001), education status (ꭓ2=23.948, p=<0.001), household income (ꭓ2=13.493, p=0.001), personal income (ꭓ2=14.129, p=0.001), source of personal income (ꭓ2=28.332,p=<0.001), social security allowance (ꭓ2=18.005,p=<0.001), alcohol consumption (ꭓ2=9.397,p=0.002) are significantly associated with quality of life of elderly. In addition, affordability (ꭓ2=12.088, p=0.001), physical activity (ꭓ2=9.314, p=0.002), emotional support (ꭓ2=9.122, p=0.003), and economic support (ꭓ2=8.104, p=0.004) are associated with quality of life of elderly people. Conclusion: In conclusion, this mixed method study provides insight into the attributes of the quality of life of elderly people in Nepal and similar settings. As the geriatric population is growing in full swing, maintaining a high quality of life has become a major challenge. This study showed that determinants such as age, gender, marital status, education status, household income, personal income, source of personal income, social security allowance and alcohol consumption, economic support, emotional support, affordability and physical activity have an association with quality of life of the elderly.

Keywords: ageing, chitwan, elderly, health status, quality of life

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Authors: Lei Ye, Min Liu, Yong-Li Gao, Jun Zhang

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Purpose: The aims of the study are to investigate the status of health-promoting lifestyle and to compare the healthy lifestyle of emergency nurses in different levels of hospitals in Sichuan province, China. The investigation is mainly about the health-promoting lifestyle, including spiritual growth, health responsibility, physical activity, nutrition, interpersonal relations, stress management. Then the factors were analyzed influencing the health-promoting lifestyle of emergency nurses in hospitals of Sichuan province in order to find the relevant models to provide reference evidence for intervention. Study Design: A cross-sectional research method was adopted. Stratified cluster sampling, based on geographical location, was used to select the health facilities of 1389 emergency nurses in 54 hospitals from Sichuan province in China. Method: The 52-item, six-factor structure Health-Promoting Lifestyle Profile II (HPLP- II) instrument was used to explore participants’ self-reported health-promoting behaviors and measure the dimensions of health responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management. Demographic characteristics, education, work duration, emergency nursing work duration and self-rated health status were documented. Analysis: Data were analyzed through SPSS software ver. 17.0. Frequency, percentage, mean ± standard deviation were used to describe the general information, while the Nonparametric Test was used to compare the constituent ratio of general data of different hospitals. One-way ANOVA was used to compare the scores of health-promoting lifestyle in different levels hospital. A multiple linear regression model was established. P values which were less than 0.05 determined statistical significance in all analyses. Result: The survey showed that the total score of health-promoting lifestyle of nurses at emergency departments in Sichuan Province was 120.49 ± 21.280. The relevant dimensions are ranked by scores in descending order: interpersonal relations, nutrition, health responsibility, physical activity, stress management, spiritual growth. The total scores of the three-A hospital were the highest (121.63 ± 0.724), followed by the senior class hospital (119.7 ± 1.362) and three-B hospital (117.80 ± 1.255). The difference was statistically significant (P=0.024). The general data of nurses was used as the independent variable which includes age, gender, marital status, living conditions, nursing income, hospital level, Length of Service in nursing, Length of Service in emergency, Professional Title, education background, and the average number of night shifts. The total score of health-promoting lifestyle was used as dependent variable; Multiple linear regression analysis method was adopted to establish the regression model. The regression equation F = 20.728, R2 = 0.061, P < 0.05, the age, gender, nursing income, turnover intention and status of coping stress affect the health-promoting lifestyle of nurses in emergency department, the result was statistically significant (P < 0.05 ). Conclusion: The results of the investigation indicate that it will help to develop health promoting interventions for emergency nurses in all levels of hospital in Sichuan Province through further research. Managers need to pay more attention to emergency nurses’ exercise, stress management, self-realization, and conduct intervention in nurse training programs.

Keywords: emergency nurse, health-promoting lifestyle profile II, health behaviors, lifestyle

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Authors: Yao Song

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Objectives: We aimed to explore the clinicodemographic characteristics and prognosis of grey zone squamous cell cancer (GZSCC) located in the overlapping or ambiguous area of the oral cavity and oropharynx and to identify valuable factors that would improve its differential diagnosis and prognosis. Methods: Information of GZSCC patients in the Surveillance, Epidemiology, and End Results (SEER) database was compared to patients with an oral cavity (OCSCC) and oropharyngeal (OPSCC) squamous cell carcinomas with corresponding HPV status, respectively. Kaplan-Meier method with log-rank test and multivariate Cox regression analysis were applied to assess associations between clinical characteristics and overall survival (OS). A predictive model integrating age, gender, marital status, HPV status, and staging variables was conducted to classify GZSCC patients into three risk groups and verified internally by 10-fold cross validation. Results: A total of 3318 GZSCC, 10792 OPSCC, and 6656 OCSCC patients were identified. HPV-positive GZSCC patients had the best 5-year OS as HPV-positive OPSCC (81% vs. 82%). However, the 5-year OS of HPV-negative/unknown GZSCC (43%/42%) was the worst among all groups, indicating that HPV status and the overlapping nature of tumors were valuable prognostic predictors in GZSCC patients. Compared with the strategy of dividing GZSCC into two groups by HPV status, the predictive model integrating more variables could additionally identify a unique high-risk GZSCC group with the lowest OS rate. Conclusions: GZSCC patients had distinct clinical characteristics and prognoses compared with OPSCC and OCSCC; integrating HPV status and other clinical factors could help distinguish GZSCC and predict their prognosis.

Keywords: GZSCC, OCSCC, OPSCC, HPV

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Authors: Mary Ann L. Halliday, Zoengpari Gohain

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The stigma associated with HIV-AIDS negatively affect mental health and ability to effectively manage the disease. While the number of People living with HIV/AIDS (PLHIV) has been increasing day by day in Mizoram (a small north-eastern state in India), research on HIV/AIDS stigma has so far been limited. Despite the potential significance of Internalized HIV Stigma (IHS) in the lives of PLHIV, there has been very limited research in this area. It was therefore, felt necessary to explore the internalized HIV stigma, mental health, coping and perceived social support of PLHIV in Aizawl District, Mizoram. The present study was designed with the objectives to determine the degree of IHS, to study the relationship between the socio-demographic characteristics and level of IHS, to highlight the mental health status, coping strategies and perceived social support of PLHIV and to elucidate the relationship between these psychosocial variables. In order to achieve the objectives of the study, six hypotheses were formulated and statistical analyses conducted accordingly. The sample consisted of 300 PLWHA from Aizawl District, 150 males and 150 females, of the age group 20 to 70 years. Two- way classification of “Gender” (male and female) and three-way classification of “Level of IHS” (High IHS, Moderate IHS, Low IHS) on the dependent variables was employed, to elucidate the relationship between Internalized HIV Stigma, mental health, coping and perceived social support of PLHIV. The overall analysis revealed moderate level of IHS (67.3%) among PLHIV in Aizawl District, with a small proportion of subjects reporting high level of IHS. IHS was found to be significantly different on the basis of disclosure status, with the disclosure status of PLHIV accounting for 9% variability in IHS.  Results also revealed more or less good mental health among the participants, which was assessed by minimal depression (50.3%) and minimal anxiety (45%), with females with high IHS scoring significantly higher in both depression and anxiety (p<.01). Examination of the coping strategies of PLHIV found that the most frequently used coping styles were Acceptance (91%), Religion (84.3%), Planning (74.7%), Active Coping (66%) and Emotional Support (52.7%). High perception of perceived social support (48%) was found in the present study. Correlation analysis revealed significant positive relationships between IHS and depression as well as anxiety (p<.01), thus revealing that IHS negatively affects the mental health of PLHIV. Results however revealed that this effect may be lessened by the use of various coping strategies by PLHIV as well as their perception of social support.

Keywords: Aizawl, anxiety, depression, internalized HIV stigma, HIV/AIDS, mental health, mizoram, perceived social support

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Authors: Rock-Hyun Choi, Won-Seok Kang, Chang-Sik Son

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Physical activity is important for healthy living. Recently wearable devices which motivate physical activity are quickly developing, and become cheaper and more comfortable. In particular, fitness trackers provide a variety of information and need to provide well-analyzed, and user-friendly results. In this study, frequency analysis was performed to classify various data sets of Fitbit into simple activity status. The data from Fitbit cloud server consists of 263 subjects who were healthy factory and office workers in Korea from March 7th to April 30th, 2016. In the results, we found assumptions of activity state classification seem to be sufficient and reasonable.

Keywords: activity status, fitness tracker, heart rate, steps

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Authors: Warsi A. Ibrahim, Qureshi A. Ambrina, Younus M. Anjum

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Introduction: Oral lesions related to commercially available Smokeless Tobacco (ST), such as, Pan, Gutka, Mahwa, Naswar is considered a serious challenge for dental health care providers in Pakistan. Majority of labored Pakistani population consume ST, where public transporters and drivers are no exception. It was necessary to identify individuals of this particular population group and screen their oral health and early signs of pre-cancerous lesions so that appropriate preventive measures could be taken to reduce the burden on health providers. Aim of Study: To estimate Prevalence of ST consumption and perception of use, and to evaluate Oral Health status among public drivers of Karachi. Material & methods: A cross-sectional study survey was conducted over duration of 2 months, through convenient sampling. Sample size (n=615) of public drivers (age > 18 years) all over Karachi was gathered. A structured proforma was used to record socio-demographics, addiction profile, perception of use and oral health status (oral lesions, oral sub-mucosal fibrosis and dental caries) of study participants. Data was entered and analyzed using SPSS version 16.0 using descriptive statistics only. Results: Prevalence of ST consumption among the study participants was figured to 92.5%. Out of these almost 70% suffered from one or the other form of oral lesion(s). Four major types of ST consumption were observed out of which 60 % of oral lesion were related to Gutka chewers showing early signs of oral cancer. In addition, occurrence of Oral sub-mucosal fibrosis (OSF) was found to be significantly high around 54.8%. Overall dental caries status was also high, showing on an average 5 teeth of an individual were decayed, missing or filled deviating from WHO normal criteria (mean < 3). It was thus proven from the study that public drivers relied on oral tobacco consumption because it helps them ‘Improve consciousness’ (p-value: < 0.01; using chi-square test). Multivariate analysis showed that there were higher prevalence of smokeless tobacco among highway drivers versus local drivers (A.O.R: 2.82 [0.83-9.61], p-value: < 0.01) Conclusion: Smokeless tobacco (ST) consumption has a direct effect on oral health. However, the type of ST, the duration of consumption are factors which are directly related to the severity. Moreover, Gutka may be considered as having most lethal effects on oral health which may lead to oral cancer and affect individual’s quality of life. Specific preventive programs must be undertaken to reduce the consumption of Gutka among public transporters and drivers.

Keywords: smokeless tobacco, oral lesions, drivers, public transporters

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Authors: Folorunsho J. O., Umar M. A.

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Access to potable water supply in both the rural and urban regions of the world has been neglected, and this has severely affected man and the aesthetics of the natural environment of man. This has further worsened the issue of diseases prevalence. This study considered the effects of inadequate domestic water supply on human health in selected neighbourhoods of Lokoja. The study used descriptive statistics such as relative frequencies, percentages and inferential statistics to analyse the data obtained through the use of structured questionnaire. The results revealed that the females and male constituted 56% and 44% of the respondents respectively; 62% of the respondents married and 32% are unmarried; respondents between ages 31 and 40 years constitute majority of the study population, while respondents with tertiary education constituted 35%, and those with secondary education were 32% of the total respondents. Furthermore, civil servants constituted 40% and unemployed 16% of the total respondents. In terms of monthly income, 40% of the respondents was found to earn between ₦31,000 - 40,000 monthly. On the perception of households on the availability and adequacy of domestic water supply, the study revealed that 64.7% of the respondents have pipe-borne water as their main source of water supply, with only 28.5% out of the 64.7% have pipe-borne water supply daily. On the relationship between water supply characteristics and health status among households, the result shows that 76% of the respondents perceived a strong relationship between water supply and health status. Cumulatively, 67% of the respondents confirm that both the quality and quantity of water supplied play a critical role in determining health status of residents of the study area. The respondents also reported skin diseases (96%), diarrhoea (96%), malaria (91%), cholera (67%), dysentery (67%), and respiratory diseases (67%) as the most perceived and experienced in the area, the disease rate in the prevalence order of malaria (81%), diarrhoea (61%), skin diseases (58%), cholera (34%), dysentery (31%) and respiratory disease (14%) respectively. Finally, the results further showed how households cope with inadequate water supply with 52% of the respondents confirm that they regularly treat their water before it was deployed for domestic uses, while 35%, 26%, 25%, 10% and 4% of the 52% respectively, adopted boiling, addition of alums, filtering with fabrics, chlorination and bleaching as the preferred treatment methods. The study thus recommended policy options that will aggressively launch adequate potable water supply infrastructure in the study area.Keywords: Potable Water, Supply, Human Health, Perception, Chlorination

Keywords: potable water, human health, perception, chlorination

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Authors: Mithlesh Chourase

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Health of the transgender is as important as any other population sub-groups. However, little is known about the issues of mental health problems and health seeking behaviour of transgender in India. This paper examines the depression, stigma problem and suicidality (risk of suicide) among the transgender people in Mumbai city. The study used the primary survey data conducted in Mumbai city among the transgender community with a total sample of 120 among the transgender. Both qualitative and quantitative data was collected on demographic and socio-economic characteristic, general health and sexual health problems, mental health and health seeking behaviour among transgender. The quantitative results revealed that among the transgender, the prevalence of depression was very high. In this community 58.3% and 45.8 % of the transgender were suffered from depression and stigma problem respectively. On the other hand 42% and 48% of the transgender attempted suicide and experienced discrimination in the society. The qualitative results also revealed that the transgender were suffered from physical violence especially due to being a transgender, stressed due to being a transgender, experienced discrimination everywhere, experienced sexual health problems especially HIV, partner problem etc. As a result the prevalence of depression, self-harm attempt and suicidal attempt was common among this community.

Keywords: transgender, depression, Mumbai, mental health

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Authors: Ni Wayan Sinthia Widiastuti, Komang Rahayu Indrawati

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The increasing number of tourists coming to Bali, causing accommodation facilities, such as hotels have increased. The existence of hotel needs will be the source of labor and cost efficiency, so that hotel management employs employees with different working status. The hospitality industry is one of the sectors that require organizational citizenship behavior because, the main goal of every hotel, in general, was to provide the best service and quality to tourists. The purpose of this study was to determine the differences in organizational citizenship behavior based on work status of employees at the Hotel in Bali in terms of quality of work life. Research sample was chosen randomly through two-stage cluster sampling which succeeds to obtain 126 samples from 11 hotels in Denpasar, Bali. The subjects consisted of 64 employees with Employment Agreement of Uncertain Time or who is often called a permanent employee and 62 employees with Employment Agreement of Certain Time or better known as contract employees, outsourcing, and daily workers. Instruments in this study were the scale of organizational citizenship behavior and the scale of quality of work life. The results of ANCOVA analysis showed there were differences in organizational citizenship behavior based on employee work status in terms of quality of work life. Differences in organizational citizenship behavior and quality of work life based on work status of employees using comparative test was analysis by independent sample t-test shows there were differences in organizational citizenship behavior and quality of work life between employees with different working status in hotels in Bali. The result of the regression analysis showed the functional relationship between quality of work life and organizational citizenship behavior.

Keywords: hotel in Bali, organizational citizenship behavior, quality of work life, work status of employees

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