Search results for: American health official accounts
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1476

Search results for: American health official accounts

1026 Assessment of Health and Safety Item on Construction Sites in Ondo State

Authors: Ikumapayi Catherine Mayowa

Abstract:

The well been of human beings on construction site is very important, many man power had been lost through accidents which kills or make workers physically unfit to carry out construction activities, these in turn have multiple effects on the whole economy. Thus it is necessary to put all safety items and regulations in place before construction activities can commence. This study was carried out in Ondo state of Nigeria to known and analyse the state of health and safety of construction workers in the state. The study was done using first hand observation method, 50 construction project sites were visited in 10 major towns of Ondo state, questionnaires were distributed and the results were analysed. The result show that construction workers are being exposed to a lot of construction site hazards due to lack of inadequate safety programmes and nonprovision of appropriate safety materials for workers on site. From the data gotten for each site visited and the statistical analysis, it can be concluded that occurrence of accident on construction sites depends significantly on the available safety facilities on the sites. The result of the regression statistics show that the level of significant of the dependence of occurrence of accident on the availability of safety items on site is 0.0362 which is less than 0.05 maximum significant level required. Therefore a vital way of sustaining our building strategy is by given a detail attention to provision of adequate health and safety items on construction sites which will reduce the occurrence of accident, loss of man power and death of skilled workers among others.

Keywords: Construction sites, health, safety, welfare.

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1025 Impact Assessment of Credit Policy and Medical Credit Facility (MCF) on Nigerian Private Sector Health Market: Evidence from Eight Nigerian States

Authors: Chimaobi V. Okolo, Kenneth A. Okpala, Johnbull S. Ogboi

Abstract:

A teeming set of doctors that graduated from various universities within and outside Nigeria with the hope of practicing in the country, has their hope shattered because of poor financing, lack of medical equipments and a very weak healthcare systems. Such hydra headed challenges, allows room for quackery which increasingly contributes to the cause of mortality in Nigeria. With a view of reversing the challenges of healthcare delivery and financing in Nigeria, African Health Market for Equity (AHME), a project funded by the Bill and Melinda Gates foundation [With contribution from Department For International Development (DFID)] and currently implemented in three African Countries (Nigeria, Kenya and Ghana) over a Five (5) year period supports the healthcare sector via Medical credit fund (MCF). The study examines the impact of credit policy and medical credit funding on Nigerian health market. Ordinary least square analysis, correlation and granger causality tests were employed to measure the extent to which the Nigerian healthcare market has been influenced. Medical credit fund significantly and positively influenced average monthly turnover of private healthcare providers and Commercial bank’s lending rate had a weak relationship with access to credit/approved loans (13.46%). The programme has so far made 13.91% progress, which is very poor, considering the minimum targeted private health care providers (437.6) and expected number of loan approvals (180.4) for the two years. Medical credit policy in Nigeria should be revised to include private healthcare providers in rural area for more positive impact and increased returns. Good brand advert and sensitization of the programme to stakeholders and health pressure group, and an extension of the programme beyond five years is necessary to better address the issues raised in the study.

Keywords: Credit, health market, medical credit facility, policy.

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1024 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: Health care provider, hospital, weight management, weight control.

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1023 ‘Memory Mate’ as Boundary Object in Cancer Treatment for Patients with Dementia

Authors: Rachel Hurdley, Jane Hopkinson

Abstract:

This article is based on observation of a cross-disciplinary, cross-institutional team that worked on an intervention called ‘Memory Mate’ for use in a UK Cancer Centre. This aimed to improve treatment outcomes for patients who had comorbid dementia or other memory impairment. Comorbid patients present ambiguous, spoiled identities, problematising the boundaries of health specialisms and frames of understanding. Memory Mate is theorised as a boundary object facilitating service transformation by changing relations between oncology and mental health care practice. It crosses the boundaries between oncology and mental health. Its introduction signifies an important step in reconfiguring relations between the specialisms. As a boundary object, it contains parallel, even contesting worlds, with potential to enable an eventual synthesis of the double stigma of cancer and dementia. Memory Mate comprises physical things, such as an animation, but its principal value is in the interaction it initiates across disciplines and services. It supports evolution of practices to address a newly emergent challenge for health service provision, namely the cancer patient with comorbid dementia/cognitive impairment. Getting clinicians from different disciplines working together on a practical solution generates a dialogue that can shift professional identity and change the culture of practice.

Keywords: Boundary object, cancer, dementia, interdisciplinary teams.

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1022 Assessment of Risk of Ground Water Resources for the Emergency Supply in Relation to Their Contamination by Metals

Authors: Frantisek Bozek, Alexandr Bozek, Alena Bumbova, Jiri Dvorak, Lenka Jesonkova

Abstract:

The contamination of 15 ground water resources of a selected region earmarked for the emergency supply of population has been monitored. The resources have been selected on the basis of previous assessment of natural conditions and the exploitation of territory in their surroundings and infiltration area. Two resources out of 15 have been excluded from further exploitation, because they have not met some of the 72 assessed hygienic indicators of extended analysis. The remaining 13 resources have been the subject of health risk analysis in relation to the contamination by arsenic, lead, cadmium, mercury, nickel and manganese. The risk analysis proved that all 13 resources meet health standards with regard to the above mentioned purposefully selected elements and may thus be included into crisis plans. Water quality of ground resources may be assessed in the same way with regard to other contaminants.

Keywords: Contamination, drinking water, emergency supply, health risk, hygienic limits, metals, risk assessment.

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1021 Perceptual and Ultrasound Articulatory Training Effects on English L2 Vowels Production by Italian Learners

Authors: I. Sonia d’Apolito, Bianca Sisinni, Mirko Grimaldi, Barbara Gili Fivela

Abstract:

The American English contrast /ɑ-ʌ/ (cop-cup) is difficult to be produced by Italian learners since they realize L2-/ɑ-ʌ/ as L1-/ɔ-a/ respectively, due to differences in phonetic-phonological systems and also in grapheme-to-phoneme conversion rules. In this paper, we try to answer the following research questions: Can a short training improve the production of English /ɑ-ʌ/ by Italian learners? Is a perceptual training better than an articulatory (ultrasound - US) training? Thus, we compare a perceptual training with an US articulatory one to observe: 1) the effects of short trainings on L2-/ɑ-ʌ/ productions; 2) if the US articulatory training improves the pronunciation better than the perceptual training. In this pilot study, 9 Salento-Italian monolingual adults participated: 3 subjects performed a 1-hour perceptual training (ES-P); 3 subjects performed a 1-hour US training (ES-US); and 3 control subjects did not receive any training (CS). Verbal instructions about the phonetic properties of L2-/ɑ-ʌ/ and L1-/ɔ-a/ and their differences (representation on F1-F2 plane) were provided during both trainings. After these instructions, the ES-P group performed an identification training based on the High Variability Phonetic Training procedure, while the ES-US group performed the articulatory training, by means of US video of tongue gestures in L2-/ɑ-ʌ/ production and dynamic view of their own tongue movements and position using a probe under their chin. The acoustic data were analyzed and the first three formants were calculated. Independent t-tests were run to compare: 1) /ɑ-ʌ/ in pre- vs. post-test respectively; /ɑ-ʌ/ in pre- and post-test vs. L1-/a-ɔ/ respectively. Results show that in the pre-test all speakers realize L2-/ɑ-ʌ/ as L1-/ɔ-a/ respectively. Contrary to CS and ES-P groups, the ES-US group in the post-test differentiates the L2 vowels from those produced in the pre-test as well as from the L1 vowels, although only one ES-US subject produces both L2 vowels accurately. The articulatory training seems more effective than the perceptual one since it favors the production of vowels in the correct direction of L2 vowels and differently from the similar L1 vowels.

Keywords: L2 vowel production, perceptual training, articulatory training, ultrasound.

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1020 Health Hazards among Healthcare Workers and Associated Factors in Public Hospitals, Sana'a-Yemen

Authors: Makkia, Ahmad, Al-Falahi, Abdullah Abdelaziz Muharram

Abstract:

Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. The current study aimed to assess sng the prevalence of ‎occupational health hazards among Health care workers and associated ‎risk factors in public hospitals in Sana'a City, Yemen. Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. More the half (60.6%) of HCWs were aged between 20-30 years, 50.8% were males, 56.3% were married, and 45.5% had a diploma qualification, while 65.2% of HCWs had less than 6 years of experience. The results show a high prevalence of occupational hazards (99%); ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p > 0.05). The study revealed that occupational hazards were highly prevalent among the participants. The most common biological hazard was exposure to sharp-related injuries, while the predominant physical hazard was slip, trip, and fall incidents. Ergonomic hazards manifested as back or neck pain during work. Chemical hazards were represented by allergic reactions to medical gloves powder. Psychosocial hazards included experiencing verbal and physical harassment. In conclusion, the study emphasized the importance of raising awareness among HCWs and conducting training courses to prevent occupational hazards.

Keywords: Health workers, occupational hazard, prevalence, risk factors.

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1019 Transforming Personal Healthcare through Patient Engagement: An In-Depth Analysis of Tools and Methods for the Digital Age

Authors: Emily Hickmann, Peggy Richter, Maren Kählig, Hannes Schlieter

Abstract:

Patient engagement is a cornerstone of high-quality care and essential for patients with chronic diseases to achieve improved health outcomes. Through digital transformation, possibilities to engage patients in their personal healthcare have multiplied. However, the exploitation of this potential is still lagging. To support the transmission of patient engagement theory into practice, this paper’s objective is to give a state-of-the-art overview of patient engagement tools and methods. A systematic literature review was conducted. Overall, 56 tools and methods were extracted and synthesized according to the four attributes of patient engagement, i.e., personalization, access, commitment, and therapeutic alliance. The results are discussed in terms of their potential to be implemented in digital health solutions under consideration of the “computers are social actors” (CASA) paradigm. It is concluded that digital health can catalyze patient engagement in practice, and a broad future research agenda is formulated.

Keywords: Chronic diseases, digitalization, patient-centeredness, patient empowerment, patient engagement.

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1018 Acceptance of Health Information Application in Smart National Identity Card (SNIC) Using a New I-P Framework

Authors: Ismail Bile Hassan, Masrah Azrifah Azmi Murad

Abstract:

This study discovers a novel framework of individual level technology adoption known as I-P (Individual- Privacy) towards health information application in Smart National Identity Card. Many countries introduced smart national identity card (SNIC) with various applications such as health information application embedded inside it. However, the degree to which citizens accept and use some of the embedded applications in smart national identity remains unknown to many governments and application providers as well. Moreover, the factors of trust, perceived risk, Privacy concern and perceived credibility need to be incorporated into more comprehensive models such as extended Unified Theory of Acceptance and Use of Technology known as UTAUT2. UTAUT2 is a mainly widespread and leading theory up to now. This research identifies factors affecting the citizens’ behavioural intention to use health information application embedded in SNIC and extends better understanding on the relevant factors that the government and the application providers would need to consider in predicting citizens’ new technology acceptance in the future. We propose a conceptual framework by combining the UTAUT2 and Privacy Calculus Model constructs and also adding perceived credibility as a new variable. The proposed framework may provide assistance to any government planning, decision, and policy makers involving e-government projects. Empirical study may be conducted in the future to provide proof and empirically validate this I-P framework.

Keywords: Unified Theory of Acceptance and Use of Technology (UTAUT) model, UTAUT2 model, Smart National Identity Card (SNIC), Health information application, Privacy Calculus Model (PCM).

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1017 Varieties of Capitalism and Small Business CSR: A Comparative Overview

Authors: S. Looser, W. Wehrmeyer

Abstract:

Given the limited research on Small and Mediumsized Enterprises’ (SMEs) contribution to Corporate Social Responsibility (CSR) and even scarcer research on Swiss SMEs, this paper helps to fill these gaps by enabling the identification of supranational SME parameters. Thus, the paper investigates the current state of SME practices in Switzerland and across 15 other countries. Combining the degree to which SMEs demonstrate an explicit (or business case) approach or see CSR as an implicit moral activity with the assessment of their attributes for “variety of capitalism” defines the framework of this comparative analysis. To outline Swiss small business CSR patterns in particular, 40 SME owner-managers were interviewed. A secondary data analysis of studies from different countries laid groundwork for this comparative overview of small business CSR. The paper identifies Swiss small business CSR as driven by norms, values, and by the aspiration to contribute to society, thus, as an implicit part of the day-to-day business. Similar to most Central European, Mediterranean, Nordic, and Asian countries, explicit CSR is still very rare in Swiss SMEs. Astonishingly, also British and American SMEs follow this pattern in spite of their strong and distinctly liberal market economies. Though other findings show that nationality matters this research concludes that SME culture and an informal CSR agenda are strongly formative and superseding even forces of market economies, nationally cultural patterns, and language. Hence, classifications of countries by their market system, as found in the comparative capitalism literature, do not match the CSR practices in SMEs as they do not mirror the peculiarities of their business. This raises questions on the universality and generalisability of unmediated, explicit management concepts, especially in the context of small firms.

Keywords: CSR, comparative study, cultures of capitalism, Small and Medium-sized Enterprises.

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1016 A Visual Analytics Tool for the Structural Health Monitoring of an Aircraft Panel

Authors: F. M. Pisano, M. Ciminello

Abstract:

Aerospace, mechanical, and civil engineering infrastructures can take advantages from damage detection and identification strategies in terms of maintenance cost reduction and operational life improvements, as well for safety scopes. The challenge is to detect so called “barely visible impact damage” (BVID), due to low/medium energy impacts, that can progressively compromise the structure integrity. The occurrence of any local change in material properties, that can degrade the structure performance, is to be monitored using so called Structural Health Monitoring (SHM) systems, in charge of comparing the structure states before and after damage occurs. SHM seeks for any "anomalous" response collected by means of sensor networks and then analyzed using appropriate algorithms. Independently of the specific analysis approach adopted for structural damage detection and localization, textual reports, tables and graphs describing possible outlier coordinates and damage severity are usually provided as artifacts to be elaborated for information extraction about the current health conditions of the structure under investigation. Visual Analytics can support the processing of monitored measurements offering data navigation and exploration tools leveraging the native human capabilities of understanding images faster than texts and tables. Herein, a SHM system enrichment by integration of a Visual Analytics component is investigated. Analytical dashboards have been created by combining worksheets, so that a useful Visual Analytics tool is provided to structural analysts for exploring the structure health conditions examined by a Principal Component Analysis based algorithm.

Keywords: Interactive dashboards, optical fibers, structural health monitoring, visual analytics.

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1015 Fundamental Natural Frequency of Chromite Composite Floor System

Authors: Farhad Abbas Gandomkar, Mona Danesh

Abstract:

This paper aims to determine Fundamental Natural Frequency (FNF) of a structural composite floor system known as Chromite. To achieve this purpose, FNFs of studied panels are determined by development of Finite Element Models (FEMs) in ABAQUS program. American Institute of Steel Construction (AISC) code in Steel Design Guide Series 11 presents a fundamental formula to calculate FNF of a steel framed floor system. This formula has been used to verify results of the FEMs. The variability in the FNF of the studied system under various parameters such as dimensions of floor, boundary conditions, rigidity of main and secondary beams around the floor, thickness of concrete slab, height of composite joists, distance between composite joists, thickness of top and bottom flanges of the open web steel joists, and adding tie beam perpendicular on the composite joists, is determined. The results show that changing in dimensions of the system, its boundary conditions, rigidity of main beam, and also adding tie beam, significant changes the FNF of the system up to 452.9%, 50.8%, - 52.2%, %52.6%, respectively. In addition, increasing thickness of concrete slab increases the FNF of the system up to 10.8%. Furthermore, the results demonstrate that variation in rigidity of secondary beam, height of composite joist, and distance between composite joists, and thickness of top and bottom flanges of open web steel joists insignificant changes the FNF of the studied system up to -0.02%, -3%, -6.1%, and 0.96%, respectively. Finally, the results of this study help designer predict occurrence of resonance, comfortableness, and design criteria of the studied system.

Keywords: Fundamental natural frequency, chromite composite floor system, finite element method, low and high frequency floors, comfortableness, resonance.

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1014 Perceptions and Attitudes towards Infant-s Physical Health and Caring: Immigrants and Native Born Mothers

Authors: Orly Sarid, Yana Shraga

Abstract:

Purpose: To compare attitudes and perceptions of Israeli native born mothers versus former Soviet Union (FSU) immigrant mothers regarding the physical health of their infant. Methodology: cross-sectional design. A convenience sample of 50 participants was recruited by face to face and snowball technique. A questionnaire was constructed according to the instructions of the Ministry of Health for the care and treatment of infants. The main areas explored were: sources of knowledge that the young mother acquired regarding the care of her infant, ways of caring for the infant, hygiene and sanitary habits, and the pattern of referral to health professionals. The last topic relates to emotions mothers might experience towards their infant. Results: Mothers from both cultural groups present some similar caring behaviors, which may express a universal aspect of mothers' behavior towards their infants. However, immigrant mothers differ significantly from native born by relying less on their mothers' and grandmothers' experience, they wean their infants from diapers earlier, they are stricter about hygiene and sanitary habits and they tend to consult a physician when their infant has low fever. Native born and immigrant mothers differ in their expressions of pride and wonder. Immigrant mothers report of a lesser degree of these emotions towards their infants than native born mothers. Conclusion: The theoretical model of socialization and acculturation of immigrant mothers is employed as an explanatory model for the current findings Young immigrant mothers undergo a complex acculturation process and adapt behavioral patterns in various areas to comply with Israeli norms and values, demonstrating assimilation. In other areas they adhere to the norms of their original culture.

Keywords: Attitudes, immigrant mothers, infant, physical health

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1013 Forecast of the Small Wind Turbines Sales with Replacement Purchases and with or without Account of Price Changes

Authors: V. Churkin, M. Lopatin

Abstract:

The purpose of the paper is to estimate the US small wind turbines market potential and forecast the small wind turbines sales in the US. The forecasting method is based on the application of the Bass model and the generalized Bass model of innovations diffusion under replacement purchases. In the work an exponential distribution is used for modeling of replacement purchases. Only one parameter of such distribution is determined by average lifetime of small wind turbines. The identification of the model parameters is based on nonlinear regression analysis on the basis of the annual sales statistics which has been published by the American Wind Energy Association (AWEA) since 2001 up to 2012. The estimation of the US average market potential of small wind turbines (for adoption purchases) without account of price changes is 57080 (confidence interval from 49294 to 64866 at P = 0.95) under average lifetime of wind turbines 15 years, and 62402 (confidence interval from 54154 to 70648 at P = 0.95) under average lifetime of wind turbines 20 years. In the first case the explained variance is 90,7%, while in the second - 91,8%. The effect of the wind turbines price changes on their sales was estimated using generalized Bass model. This required a price forecast. To do this, the polynomial regression function, which is based on the Berkeley Lab statistics, was used. The estimation of the US average market potential of small wind turbines (for adoption purchases) in that case is 42542 (confidence interval from 32863 to 52221 at P = 0.95) under average lifetime of wind turbines 15 years, and 47426 (confidence interval from 36092 to 58760 at P = 0.95) under average lifetime of wind turbines 20 years. In the first case the explained variance is 95,3%, while in the second – 95,3%.

Keywords: Bass model, generalized Bass model, replacement purchases, sales forecasting of innovations, statistics of sales of small wind turbines in the United States.

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1012 Management of Municipal Solid Waste in Baghdad, Iraq

Authors: Ayad Sleibi Mustafa, Ahmed Abdulkadhim Mohsin, Layth Noori Ali

Abstract:

The deterioration of solid waste management in Baghdad city is considered as a great challenge in terms of human health and environment. Baghdad city is divided into thirteen districts which are distributed on both Tigris River banks. The west bank is Al-Karkh and the east bank is Al-Rusafa. Municipal Solid Waste Management is one of the most complicated problems facing the environment in Iraq. Population growth led to increase waste production and more load of the waste to the limited capacity infrastructure. The problems of municipal solid waste become more serious after the war in 2003. More waste is disposed in underground landfills in Baghdad with little or no concern for both human health and environment. The results showed that the total annually predicted solid waste is increasing for the period 2015-2030. Municipal solid waste in 2030 will be 6,427,773 tons in Baghdad city according to the population growth rate of 2.4%. This increase is estimated to be approximately 30%.

Keywords: Municipal solid waste, solid waste composition and characteristics, Baghdad city, environment, human health.

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1011 Monitoring the Fiscal Health of Taiwan’s Local Government: Application of the 10-Point Scale of Fiscal Distress

Authors: Yuan-Hong Ho, Chiung-Ju Huang

Abstract:

This article presents a monitoring indicators system that predicts whether a local government in Taiwan is heading for fiscal distress and identifies a suitable fiscal policy that would allow the local government to achieve fiscal balance in the long run. This system is relevant to stockholders’ interest, simple for national audit bodies to use, and provides an early warning of fiscal distress that allows preventative action to be taken.

Keywords: Fiscal distress, fiscal health, monitoring signals, 10-point scale.

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1010 Profile of Viral Hepatitis in Saudi Arabia

Authors: A. A. Alshabanat, R. B. Albacker, A. A. Basalama, A. A. Bin Salamah, A. S. Alfrayh

Abstract:

The study was conducted to investigate the profile of hepatitis in Kingdom of Saudi Arabia, and to determine which age group hepatitis viruses most commonly infect. The epidemiology of viral hepatitis in Saudi Arabia has undergone major changes, concurrent with major socioeconomic developments over the last two to three decades. This disease represents a major public health problem in Saudi Arabia resulting in the need for considerable healthcare resources. A retrospective cross sectional analysis of the reported cases of viral hepatitis was conducted based on the reports of The Ministry of Health in Saudi Arabia about Hepatitis A, B and C infections in all regions from the period of January 2006 to December 2010. The study demonstrated that incidence of viral Hepatitis is decreasing, except for Hepatitis B that showed minimal increase. Of hepatitis A, B, and C, Hepatitis B virus (HBV) was the most predominant type, accounting for (53%) of the cases, followed by Hepatitis C virus (HCV) (30%) and HAV (17%). HAV infection predominates in children (5–14 years) with 60% of viral hepatitis cases, HBV in young adults (15–44 years) with 69% of viral hepatitis cases, and HCV in older adults (>45 years) with 59% of viral hepatitis cases. Despite significant changes in the prevalence of viral hepatitis A, B and C, it remains a major public health problem in Saudi Arabia; however, it showed a significant decline in the last two decades that could be attributed to the vaccination programs and the improved health facilities. Further researches are needed to identify the risk factors making a specific age group or a specific region in Saudi Arabia targeted for a specific type of hepatitis viruses.

Keywords: Epidemiology, Hepatitis, Saudi Arabia.

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1009 A Location-Allocation-Routing Model for a Home Health Care Supply Chain Problem

Authors: Amir Mohammad Fathollahi Fard, Mostafa Hajiaghaei-Keshteli, Mohammad Mahdi Paydar

Abstract:

With increasing life expectancy in developed countries, the role of home care services is highlighted by both academia and industrial contributors in Home Health Care Supply Chain (HHCSC) companies. The main decisions in such supply chain systems are the location of pharmacies, the allocation of patients to these pharmacies and also the routing and scheduling decisions of nurses to visit their patients. In this study, for the first time, an integrated model is proposed to consist of all preliminary and necessary decisions in these companies, namely, location-allocation-routing model. This model is a type of NP-hard one. Therefore, an Imperialist Competitive Algorithm (ICA) is utilized to solve the model, especially in large sizes. Results confirm the efficiency of the developed model for HHCSC companies as well as the performance of employed ICA.

Keywords: Home health care supply chain, location-allocation-routing problem, imperialist competitive algorithm, optimization.

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1008 Factors Determining Intention to Pursue Genetic Testing for People in Taiwan

Authors: Ju-Chun Chien

Abstract:

The Ottawa Charter for Health Promotion proposed that the role of health services should shift the focus from cure to prevention. Nowadays, besides having physical examinations, people could also conduct genetic tests to provide important information for diagnosing, treating, and/or preventing illnesses. However, because of the incompletion of the Chinese Genetic Database, people in Taiwan were still unfamiliar with genetic testing. The purposes of the present study were to: (1) Figure out people’s attitudes towards genetic testing. (2) Examine factors that influence people’s intention to pursue genetic testing by means of the Health Belief Model (HBM). A pilot study was conducted on 249 Taiwanese in 2017 to test the feasibility of the self-developed instrument. The reliability and construct validity of scores on the self-developed questionnaire revealed that this HBM-based questionnaire with 40 items was a well-developed instrument. A total of 542 participants were recruited and the valid participants were 535 (99%) between the ages of 20 and 86. Descriptive statistics, one-way ANOVA, two-way contingency table analysis, Pearson’s correlation, and stepwise multiple regression analysis were used in this study. The main results were that only 32 participants (6%) had already undergone genetic testing; moreover, their attitude towards genetic testing was more positive than those who did not have the experience. Compared with people who never underwent genetic tests, those who had gone for genetic testing had higher self-efficacy, greater intention to pursue genetic testing, had academic majors in health-related fields, had chronic and genetic diseases, possessed Catastrophic Illness Cards, and all of them had heard about genetic testing. The variables that best predicted people’s intention to pursue genetic testing were cues to action, self-efficacy, and perceived benefits (the three variables all correlated with one another positively at high magnitudes). To sum up, the HBM could be effective in designing and identifying the needs and priorities of the target population to pursue genetic testing.

Keywords: Genetic testing, intention to pursue genetic testing, Taiwan, health belief model.

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1007 Comparison of Bayesian and Regression Schemes to Model Public Health Services

Authors: Sotirios Raptis

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Bayesian reasoning (BR) or Linear (Auto) Regression (AR/LR) can predict different sources of data using priors or other data, and can link social service demands in cohorts, while their consideration in isolation (self-prediction) may lead to service misuse ignoring the context. The paper advocates that BR with Binomial (BD), or Normal (ND) models or raw data (.D) as probabilistic updates can be compared to AR/LR to link services in Scotland and reduce cost by sharing healthcare (HC) resources. Clustering, cross-correlation, along with BR, LR, AR can better predict demand. Insurance companies and policymakers can link such services, and examples include those offered to the elderly, and low-income people, smoking-related services linked to mental health services, or epidemiological weight in children. 22 service packs are used that are published by Public Health Services (PHS) Scotland and Scottish Government (SG) from 1981 to 2019, broken into 110 year series (factors), joined using LR, AR, BR. The Primary component analysis found 11 significant factors, while C-Means (CM) clustering gave five major clusters.

Keywords: Bayesian probability, cohorts, data frames, regression, services, prediction.

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1006 Knowledge, Perceptions and Acceptability to Strengthening Adolescents’ Sexual and Reproductive Health Education amongst Secondary Schools in Gulu District

Authors: Lule Herman, E. Ovuga, M. Mshilla, S. Ojara, G. Kimbugwe, A. P. Adrawa, N. Mahuro

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Adolescents in Northern Uganda are at risk of teenage pregnancies, unsafe abortions and sexually transmitted infections (STIs). There is silence on sex both at home and school. This cross sectional descriptive analytical study interviews a random sample of 827 students and 13 teachers on knowledge, perception and acceptability to a comprehensive adolescent sexual and reproductive health education in “O” and “A” level secondary schools in Gulu District. Quantitative data was analyzed using SPSS 16.0. Directed content analysis of themes of transcribed qualitative data was conducted manually for common codes, sub-categories and categories. Of the 827 students; 54.3% (449) reported being in a sexual relationship especially those aged 15-17 years. Majority 96.1% (807) supported the teaching of a comprehensive ASRHE, citing no negative impact 71.5% (601). Majority 81.6% (686) agreed that such education could help prevention of STIs, abortions and teenage pregnancies, and that it should be taught by health workers 69.0% (580). Majority 76.6% (203) reported that ASRHE was not currently being taught in their schools. Students had low knowledge levels and misconceptions about ASRHE. ASRHE was highly acceptable though not being emphasized; its success in school settings requires multidisciplinary culturally sensitive approaches amongst which health workers should be frontiers.

Keywords: Acceptability, ASRHE, Knowledge, Perception.

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1005 Social Health and Adaptation of Armenian Physicians

Authors: A. G. Margaryan

Abstract:

Ability of adaptation of the organism is considered as an important component of health in maintaining relative dynamic constancy of the hemostasis and functioning of all organs and systems. Among the various forms of adaptation (individual, species and mental), social adaptation of the organism has a particular role. The aim of this study was to evaluate the subjective perception of social factors, social welfare and the level of adaptability of Armenian physicians. The survey involved 2,167 physicians (592 men and 1,575 women). According to the survey, most physicians (75.1%) were married. It was found that 88.6% of respondents had harmonious family relationships, 7.6% of respondents – tense relationships, and 1.0% – marginal relationships. The results showed that the average monthly salary with all premium payments amounted to 88 263.6±5.0 drams, and 16.7% of physicians heavily relied on the material support of parents or other relatives. Low material welfare was also confirmed by the analysis of the living conditions. Analysis of the results showed that the degree of subjective perception of social factors of different specialties averaged 11.3±3.1 points, which corresponds to satisfactory results (a very good result – 4.0 points). The degree of social adaptation of physicians on average makes 4.13±1.9 points, which corresponds to poor results (allowable less than 3.0 points). The distribution of the results of social adaptation severity revealed that the majority of physicians (58.6%) showed low social adaptation, average social adaptation is observed in 22.4% of the physicians and high adaptation – in only 17.4% of physicians. In conclusions, the findings of this study suggest that the degree of social adaptation of currently practicing physicians is low.

Keywords: Physician's health, social adaptation, social factor, social health.

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1004 Surface Water Pollution by Open Refuse Dumpsite in North Central of Nigeria

Authors: Abimbola Motunrayo Folami, Ibironke Titilayo Enitan, Feroz Mohomed Swalaha

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Water is a vital resource that is important in ensuring the growth and development of any country. To sustain the basic human needs and the demands for agriculture, industry, conservational and ecosystem, enough quality and quantity water is needed. Contamination of water resources is now a global and public health concern. Hence, this study assessed the water quality of Ndawuse River by measuring the physicochemical parameters and heavy metals concentrations of the river using standard methods. In total, 16 surface water samples were obtained from five locations along the river, from upstream to downstream as well as samples from the dumpsite. The results obtained were compared with the standard limits set by both the World Health Organization and the Federal Environmental Protection Agency for domestic purposes. The results of the measured parameters indicated that biological oxygen demand (85.88 mg/L), turbidity (44.51 NTU), Iron (0.014 - 3.511 mg /L) and chromium (0.078 - 0.14 mg /L) were all above the standard limits. The results further showed that the quality of surface water is being significantly affected by human activities around the Ndawuse River which could pose an adverse health risk to several communities that rely on this river as their primary source of water. Therefore, there is a need for strict enforcement of environmental laws to protect the aquatic ecosystem and to avoid long term cumulative exposure risk that heavy metals may pose on human health.

Keywords: Abuja, contaminants, heavy metals, Ndawuse River, Nigeria, surface water.

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1003 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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1002 Adverse Drug Reactions Monitoring in the Northern Region of Zambia

Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: Assessments, evaluation, monitoring, pharmacovigilance.

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1001 Analysis of Security Vulnerabilities for Mobile Health Applications

Authors: Y. Cifuentes, L. Beltrán, L. Ramírez

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The availability to deploy mobile applications for health care is increasing daily thru different mobile app stores. But within these capabilities the number of hacking attacks has also increased, in particular into medical mobile applications. The security vulnerabilities in medical mobile apps can be triggered by errors in code, incorrect logic, poor design, among other parameters. This is usually used by malicious attackers to steal or modify the users’ information. The aim of this research is to analyze the vulnerabilities detected in mobile medical apps according to risk factor standards defined by OWASP in 2014.

Keywords: mHealth apps, OWASP, protocols, security vulnerabilities, risk factors.

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1000 Helping Others and Youth Mental Health: A Qualitative Study Exploring Perspectives of Youth Engaging in Prosocial Activities

Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

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Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental wellbeing, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behavior. Heavy time commitment, negative behavior from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall wellbeing.

Keywords: Helping others, prosocial behavior, youth, mental wellbeing.

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999 Hybrid Knowledge Approach for Determining Health Care Provider Specialty from Patient Diagnoses

Authors: Erin Lynne Plettenberg, Jeremy Vickery

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In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: Ontology, logic modeling, electronic medical records, information extraction, vetted web mining.

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998 The Quality of Fishery Product on the Moldovan Market, Regulations, National Institutions, Controls and Non-Compliant Products

Authors: Mihaela Munteanu (Pila), Silvius Stanciu

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This paper presents the aspects of the official control of fishery in the Republic of Moldova. Currently, the regulations and the activity of national institutions with responsibilities in the field of food quality are in a process of harmonization with the European rules, aiming at European integration, quality improvement and providing a higher level of food safety. The National Agency for Food Safety is the main national body with responsibilities in the field of food safety. In the field of fishery products, the Agency carries out an intensive activity of informing the citizen and controlling the products marketed. The paper presents the dangers related to the consumption of fish and fishery products traded on the national market, the sanitary-veterinary inspections conducted by the profile institution and the improper situations identified. The national market of fishery products depends largely on imports, mainly focused on ocean fish. The research carried out has shown that during the period 2011-2018, following the inspections carried out on fishery products traded on the national market, a number of inconsistencies have been identified. Thus, indigenous products were frequently detected with sensory characteristics unfit for consumption, and being commercialized in inappropriate locations or contaminated with chemical pollutants. On import products controlled, the most frequent inconsistent situations have been represented by inconsistent sensory aspects and by parasite contamination. Taking into account the specific aspects of aquatic products, including the high level of alterability, special conditions of growth, marketing, culinary preparation and consumption are necessary in order to decrease the risk of disease over the population. Certificates, attestations and other documents certifying the quality of batches, completed by additional laboratory examinations, are necessary in order to increase the level of confidence on the quality of products marketed in the Republic. The implementation of various control procedures and mechanisms at national level, correlated with the focused activity of the specialized institutions, can decrease the risk of contamination and avoid cases of disease on the population due to the consumption of fishery products.

Keywords: Fishery products, food safety, insurance, inspection, Republic of Moldova.

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997 Variations of Body Mass Index with Age in Masters Athletes (World Masters Games)

Authors: Walsh Joe, Climstein Mike, Heazlewood Ian Timothy, Burke Stephen, Kettunen Jyrki, Adams Kent, DeBeliso Mark

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Whilst there is growing evidence that activity across the lifespan is beneficial for improved health, there are also many changes involved with the aging process and subsequently the potential for reduced indices of health. The nexus between health, physical activity and aging is complex and has raised much interest in recent times due to the realization that a multifaceted approached is necessary in order to counteract a growing obesity epidemic. By investigating age based trends within a population adhering to competitive sport at older ages, further insight might be gleaned to assist in understanding one of many factors influencing this relationship. BMI was derived using data gathered on a total of 6,071 masters athletes (51.9% male, 48.1% female) aged 25 to 91 years ( =51.5, s =±9.7), competing at the Sydney World Masters Games (2009). Using linear and loess regression it was demonstrated that the usual tendency for prevalence of higher BMI increasing with age was reversed in the sample. This trend in reversal was repeated for both male and female only sub-sets of the sample participants, indicating the possibility of improved prevalence of BMI with increasing age for both the sample as a whole and these individual subgroups. This evidence of improved classification in one index of health (reduced BMI) for masters athletes (when compared to the general population) implies there are either improved levels of this index of health with aging due to adherence to sport or possibly the reduced BMI is advantageous and contributes to this cohort adhering (or being attracted) to masters sport at older ages. Demonstration of this proportionately under-investigated World Masters Games population having an improved relationship between BMI and increasing age over the general population is of particular interest in the context of the measures being taken globally to curb an obesity epidemic.

Keywords: Aging, masters athlete, Quetelet Index, sport.

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