Search results for: fiscal health

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

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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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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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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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Authors: Rachel Hurdley, Jane Hopkinson

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

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

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

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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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Authors: Ismail Bile Hassan, Masrah Azrifah Azmi Murad

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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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Authors: F. M. Pisano, M. Ciminello

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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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Authors: Orly Sarid, Yana Shraga

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

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

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

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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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Authors: Marijana Ivanov, Roman Šubić

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This study analyzes the critical gaps in the architecture of European stability and the expected role of the banking union as the new important step towards completing the Economic and Monetary Union that should enable the creation of safe and sound financial sector for the euro area market. The single rulebook together with the Single Supervisory Mechanism and the Single Resolution Mechanism - as two main pillars of the banking union, should provide a consistent application of common rules and administrative standards for supervision, recovery and resolution of banks – with the final aim of replacing the former bail-out practice with the bail-in system through which possible future bank failures would be resolved by their own funds, i.e. with minimal costs for taxpayers and real economy. In this way, the vicious circle between banks and sovereigns would be broken. It would also reduce the financial fragmentation recorded in the years of crisis as the result of divergent behaviors in risk premium, lending activities and interest rates between the core and the periphery. In addition, it should strengthen the effectiveness of monetary transmission channels, in particular the credit channels and overflows of liquidity on the money market which, due to the fragmentation of the common financial market, has been significantly disabled in period of crisis. However, contrary to all the positive expectations related to the future functioning of the banking union, major findings of this study indicate that characteristics of the economic system in which the banking union will operate should not be ignored. The euro area is an integration of strong and weak entities with large differences in economic development, wealth, assets of banking systems, growth rates and accountability of fiscal policy. The analysis indicates that low and unbalanced economic growth remains a challenge for the maintenance of financial stability and this problem cannot be resolved just by a single supervision. In many countries bank assets exceed their GDP by several times and large banks are still a matter of concern, because of their systemic importance for individual countries and the euro zone as a whole. The creation of the Single Supervisory Mechanism and the Single Resolution Mechanism is a response to the European crisis, which has particularly affected peripheral countries and caused the associated loop between the banking crisis and the sovereign debt crisis, but has also influenced banks’ balance sheets in the core countries, as the result of crossborder capital flows. The creation of the SSM and the SRM should prevent the similar episodes to happen again and should also provide a new opportunity for strengthening of economic and financial systems of the peripheral countries. On the other hand, there is a potential threat that future focus of the ECB, resolution mechanism and other relevant institutions will be extremely oriented towards large and significant banks (whereby one half of them operate in the core and most important euro area countries), and therefore it remains questionable to what extent will the common resolution funds will be used for rescue of less important institutions. Recent geopolitical developments will be the optimal indicator to show whether the previously established mechanisms are sufficient enough to maintain the adequate financial stability in the euro area market.

Keywords: Banking Union, financial integration, single supervisory mechanism (SSM).

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Authors: Ju-Chun Chien

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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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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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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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Authors: A. G. Margaryan

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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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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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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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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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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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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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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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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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Authors: Arie Pujiwati, Kengo Nakamura, Noriaki Watanabe, Takeshi Komai

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Coal mining is well known to cause considerable environmental impacts, including trace element contamination of soil. This study aimed to assess the trace element (As, Cd, Co, Cu, Ni, Pb, Sb, and Zn) contamination of soil in the vicinity of coal mining activities, using the case study of Asam-asam River basin, South Kalimantan, Indonesia, and to assess the human health risk, incorporating total and bioavailable (water-leachable and acid-leachable) concentrations. The results show the enrichment of As and Co in soil, surpassing the background soil value. Contamination was evaluated based on the index of geo-accumulation, I_geo and the pollution index, PI. I_geo values showed that the soil was generally uncontaminated (I_geo ≤ 0), except for elevated As and Co. Mean PI for Ni and Cu indicated slight contamination. Regarding the assessment of health risks, the Hazard Index, HI showed adverse risks (HI > 1) for Ni, Co, and As. Further, Ni and As were found to pose unacceptable carcinogenic risk (risk > 1.10^-5). Farming, settlement, and plantation were found to present greater risk than coal mines. These results show that coal mining activity in the study area contaminates the soils by particular elements and may pose potential human health risk in its surrounding area. This study is important for setting appropriate countermeasure actions and improving basic coal mining management in Indonesia.

Keywords: Coal mine, risk, soil, trace elements.

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Authors: Hiroaki Hirose, Hiroshi Ikeda, Isao Takeda

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The Japanese version of the SF-36 has been employed to assess individuals’ health-related QOL (HRQOL). This study aimed to clarify the HRQOL of motorists with a spinal cord injury, in order to compare these individuals' SF-36 scores and national standard values. A total of 100 motorists with a spinal cord injury participated in this study. Participants’ HRQOL was evaluated using the Japanese version of the SF-36 (second edition). The score for each subscale was standardized based on data on the Japanese population. The average scores for NPF, NRP, NBP, NGH, NVT, NSF, NRE, and NMH were 10.9, 41.8, 45.9, 47.1, 46.1, 46.7, 46.0, and 47.4 points, respectively. Subjects showed significantly lower scores for NPF and NRP compared with national standard values, which were both ≤ 45.0 points, but relatively normal scores for the other items: NBP, NGH, NVT, NSF, NRE and NMH (> 45.0 points). The average scores for PCS, MCS and RCS were 21.9, 56.0, and 50.0 points, respectively. Subjects showed a significantly lower PCS score (≤ 20.0 points); however, the MCS score was higher (> 55.0 points) along with a relatively normal RCS score in these individuals (= 50.0 points).

Keywords: Health-related QOL (HRQOL), SF-36, motorist, spinal cord injury, Japan.

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Authors: Rossi A. Hassad

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There is widespread emphasis on reform in the teaching of introductory statistics at the college level. Underpinning this reform is a consensus among educators and practitioners that traditional curricular materials and pedagogical strategies have not been effective in promoting statistical literacy, a competency that is becoming increasingly necessary for effective decision-making and evidence-based practice. This paper explains the historical context of, and rationale for reform-oriented teaching of introductory statistics (at the college level) in the health, social and behavioral sciences (evidence-based disciplines). A firm understanding and appreciation of the basis for change in pedagogical approach is important, in order to facilitate commitment to reform, consensus building on appropriate strategies, and adoption and maintenance of best practices. In essence, reform-oriented pedagogy, in this context, is a function of the interaction among content, pedagogy, technology, and assessment. The challenge is to create an appropriate balance among these domains.

Keywords: Reform-oriented, reform, introductory statistics, health, behavioral sciences, evidence-based, psychology, teaching, learning.

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Authors: B. Parchem, M. Watanabe, D. Modrakovic, L. Mathew, A. Franklin, M. Cao, R. E. Broudy

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Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

Keywords: Executive functioning, cognitive-behavioral therapy, dialectical behavior therapy, mindfulness, adult group therapy.

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Authors: Tamara Anderson, Neela Badrie

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Consumers are demanding novel beverages that are healthier, convenient and have appealing consumer acceptance. The objectives of this study were to investigate the effects of adding grape polyphenols and the influence of presenting health claims on the sensory acceptability of wines. Fresh red sorrel calyces were fermented into wines. The total soluble solids of the pectinase-treated sorrel puree were from 4°Brix to 23.8°Brix. Polyphenol in the form of grape pomace extract was added to sorrel wines (w/v) in specified levels to give 0. 25. 50 and 75 ppm. A focus group comprising of 12 panelists was use to select the level of polyphenol to be added to sorrel wines for sensory preference The sensory attributed of the wines which were evaluated were colour, clarity, aroma, flavor, mouth-feel, sweetness, astringency and overall preference. The sorrel wine which was most preferred from focus group evaluation was presented for hedonic rating. In the first stage of hedonic testing, the sorrel wine was served chilled at 7°C for 24 h prior to sensory evaluation. Each panelist was provided with a questionnaire and was asked to rate the wines on colour, aroma, flavor, mouth-feel, sweetness, astringency and overall acceptability using a 9-point hedonic scale. In the second stage of hedonic testing, the panelist were instructed to read a health abstract on the health benefits of polyphenolic compounds and again to rate sorrel wine with added 25 ppm polyphenol. Paired t-test was used for the analysis of the influence of presenting health information on polyphenols on hedonic scoring of sorrel wines. Focus groups found that the addition of polyphenol addition had no significant effect on sensory color and aroma but affected clarity and flavor. A 25 ppm wine was liked moderately in overall acceptability. The presentation of information on the health benefit of polyphenols in sorrel wines to panelists had no significant influence on the sensory acceptance of wine. More than half of panelists would drink this wine now and then. This wine had color L 19.86±0.68, chroma 2.10±0.12, hue° 16.90 ±3.10 and alcohol content of 13.0%. The sorrel wine was liked moderately in overall acceptability with the added polyphenols.

Keywords: Sorrel wines, Roselle Hibiscus sabdariffa L, novel wine, polyphenols, health benefits, physicochemical properties.

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Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

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Dropout rates in higher educational institutions pose significant challenges for both students and institutions, with poor mental health (MH) emerging as a key risk factor. Healthcare college students, including medical students, are particularly vulnerable to MH issues due to the demanding academic schedules they face. Poor mental health (MH) would be considered as a key risk factor for dropout from higher educational institutions that pose significant challenges for both students and institutions. And, inadequate food access (FA) has been related to poor MH. Given that targeted students may experience multiple risk factors for poor MH and vulnerable FA, the study aims to clarify the relationship between MH and FA to enhance student well-being. A cross-sectional design was used to explore the association between MH status and FA among 421 students (147 male, 274 female). Participants completed two questionnaires assessing MH and FA during winter 2022. The mean MH score was 6.7 ± 4.6, with higher scores indicating worse MH (max. score 27). While year-round FA showed no significant association with MH, FA during winter was significantly associated with MH (p = 0.01). Although car ownership did not directly impact MH, it was significantly associated with FA (p < 0.01), thus indirectly influencing MH. Our findings underscore the importance of FA in promoting MH, particularly during winter. Adopting a lifestyle that facilitates easier FA may be beneficial for MH, given its indirect association with MH outcomes. These insights emphasize the significance of addressing FA-related challenges to enhance student’s mental well-being.

Keywords: Mental health, food access, co-medical students, lifestyle.

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