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Dec 2022 DOI 10.14302/issn.2324-7339.jcrhap-22-4371
L. Nacht CarrieCorresponding author
San Diego State University, School of Public Health, San Diego, CA
Although pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV infection, only around 25% of at-risk individuals in the United States have accessed a prescription. One way to increase PrEP uptake is through the sexual health screening of patients and linkage to PrEP in primary care settings. The objective of this analysis was to assess the barriers and implementation strategies during a screening and linkage to PrEP pilot intervention. Primary care patients were screened for PrEP indication during routine primary care visits. Of the 1,225 individuals screened, 1.8% (n=22) were eligible for PrEP and from those, 77.3% (n=17) attended the specialist appointment and were prescribed PrEP. Primary care patients (n=30) and providers (n=8) then participated in semi-structured interviews assessing their experience with the pilot intervention. Using an applied thematic analytic approach, patients and providers identified barriers and related improvement strategies that could be classified into four main categories: 1) Financial Barriers: Individual- vs. Clinic-level Considerations 2) The Role of Stigma, Discomfort, and Cultural Factors 3) Logistical Hurdles and Streamlining the Intervention, and 4) The Lack of PrEP Knowledge and the Need for Education. Findings support the accepatability and feasibility of screening for PrEP in primary care along with appropriate implementation strategies. This study suggests that because of the high volume of patients seen in primary care, sexual health screenings and linkage to PrEP interventions have the potential to reduce new incident HIV infections among diverse sexual minority men.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4333
Hezagira EmeryCorresponding author
Public Health Department, Mount Kenya University Rwanda
The motivations and barriers experienced by community health workers (CHWs) during the delivery of maternal and child health (MCH) services are less documented in Rwanda. This study aimed to explore the barriers and facilitators of implementing MCH care as perceived by CHWs. A descriptive qualitative study was conducted, and Semi-structured interviews with flow-up probing questions were used to collect data. A number of 24 interviews were conducted with CHWs from three selected sectors of the Gicumbi district including four supervisors of CHWs from each selected health center and one at the district hospital. Three focus group discussions with CHWs from each site were also conducted. Ethical approval was obtained from Mount Kenya University and permission to collect data from the study sites was granted. NVIVO software was used for analysis, and then the content analysis was adopted to identify themes merging from the interviews and focus group discussions. The study findings revealed emerged factors that facilitate the CHWs to deliver MCH services to their communities: liking their work, trust by the community, respect from the community, the willingness to help, desire to gain knowledge, being human, and sacrifice for the wellness of the community. On another hand, the findings indicated that the work of CHW has various barriers including working many hours, lack of equipment, lack of knowledge, unsatisfactory salary, heavy workload, lack of working space, lack of facilitation for communication, family conflicts, lack of specified working time, and believes.
Feb 2020 DOI 10.14302/issn.2379-7835.ijn-20-3181
Barnhill KellyCorresponding author
The Johnson Center for Child Health & Development
Autism Spectrum Disorder (ASD) is a developmental disorder characterized by impaired communication and social interaction. Children with ASD are frequently diagnosed with gastrointestinal (GI) issues, including inflammatory bowel disease (IBD), gastroesophageal reflux, abdominal pain, diarrhea, and constipation, although the association between ASD and GI conditions is unclear. Underlying nutritional deficiencies are more common in children with ASD, and increase the risk of them developing medical conditions secondary to the behavioral diagnosis. This objective of this study was to examine the use of an elemental diet (ED) in the treatment of gastrointestinal disease in 5 children with ASD ages 2-21 years of age. In the study participants, the ED was well-tolerated with improvements in anthropometric measures, nutritional markers, and/or GI functioning reported after 12 weeks of intervention. Further research to advance the development of specific evidence-based guidelines in the management and treatment of gastrointestinal concerns in the ASD population is warranted.
Oct 2018 DOI 10.14302/issn.2578-8590.ipj-18-2433
Hinzpeter JaimeCorresponding author
Medical Doctor, University of Chile, Clinical Hospital, Santiago Chile
Objective: Use "The 11 +" warm-up program in female players of the National Chilean Sub-17 Football team in order to analyze morpho – physiological variables. The implementation of this training program will generate morpho – physiological changes between players exposed. Federation International Football Association (FIFA) created a training program known as the "11+", designed to amend morpho-functional parameters such as lower extremity alignment, strength, intra, and inter muscular coordination and balance, among others. Subjects: Information indicates that injuries are a serious cause of concern for the soccer clubs and therefore, it is necessary to introduce the prevention programs. Methods: 20 female players of the National Chilean Sub-17 Soccer Team, from 14 to 17 years, who trained from March 2017 to January 2018. The “The 11+” warm-up program was considering an independent variable and thigh circumference, jumping ability, speed and balance are considered dependent variables. We use The STATA 11.1 SE (Statistics / Data Analysis) program for the statistical. Results: After implementing the “The 11+” program, significant changes (p < 0.05) were observed in the morphological variables of thigh circumference and functional speed. Concerning the functional variables of jump and balance, favorable but not statistically significant. Conclusions: Application of the "The 11 +" warm-up program for 3 months in addition to proper training, generated morpho – physiological changes associated with an increase in thigh circumference and an improvement in speed. The practical utility is to improve morpho-physiological characteristics of players in a competitive area and thereby to improve the utility of athletic performance indirectly.
May 2018 DOI 10.14302/issn.2578-8590.ipj-18-2113
Hajare RahulCorresponding author
Indian Council of Medical Research, New Delhi
Isatin (1H-indole-2,3-dione ) and derivatives demonstrate a diverse array of biological activities. Isatin and 5-halo derivatives has reacted to form the schiff’s bases , mannich bases and friedal craft alkylation’s to form C-C, C-N, C=N bonds. From the spectral studies, isatin has undergoes reaction at C-3 and N-1 position and synthesized lead in present schme and seen the similarity of structure and analgesic-anti-inflammatory activity.
Dec 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1788
Lesinskiene SigitaCorresponding author
Vilnius University, Faculty of Medicine, Clinic of Psychiatry, Email: [email protected]
Integration of music therapy into medical treatment facilities is very uneven in different countries. Scientific evidence of successful examples and sharing of good practices between countries is essential for the further development of music therapy and the improvement of the quality of complex medical services. The goal of this study was to analyse the situation of music therapy implementation into the health services in Lithuania. Analysis of historical background, legislation and overview on music therapy training has been made. Music therapy in Lithuania has gone through more than thirty years of development. Acqaintance and acceptance of music therapy as a relevant and fruitful component to the complexity of the existing medical services was long but successful process. Overview of current initiatives and achievements of the implementation of music therapy into clinical practice and research has shown promissing positive results in developmental pediatrics, psychiatry, special education, neurology, neonatology, oncology, somatic and preventive medicine, rehabilitation. The Music Therapy Master program in Lithuania is being implemented. Possibilities to use music therapy as an inovative service and resourse in various medical settings are in the process of the rapid growth. Collaboration involving music therapists in interdisciplinary teams would help to achieve a comprehensive, versatile patient-centered and health-centered complex service.
Mar 2017 DOI 10.14302/issn.2324-7339.jcrhap-17-1468
Gibb JeanCorresponding author
University of California, Los Angeles Medical Center
Successful viral load programs rely on the presence of data systems and high quality of patient data. Using a cohort of 49 patients at Partners in Hope, a large, urban HIV clinic in Malawi, we performed a quality improvement assessment of a new viral load program with a focus on accuracy of data collected from patients as well as adherence to Malawi HIV Guidelines in regard to response to elevated viral loads (≥1,000 copies/mL). Data were obtained from three parallel medical record systems to investigate the proportion of patients with a repeat viral load and whether the three data systems agreed in regard to sociodemographic and clinical data. Fewer than 30% of patients had a repeat viral load within six months, as recommended in the Malawi HIV Guidelines. There were significant problems with data agreement across the three parallel databases used for care. Date of birth was consistent for 55.1% (N=27) of patients, while a different date of birth was noted in all three sources for 10.2% of patients (N=5). Viral load data from all three sources agreed for only 2.0% of patients (N=1). For 65.3% (N=32), the viral load from the laboratory did not match the recorded viral load in the electronic or paper record. Scale-up of viral load monitoring must be accompanied by the development of data systems that support workflow from sample collection to lab and back to provider. Education of providers and strategies for data collection with minimal errors can facilitate scale-up of high quality programs.
Jun 2015 DOI 10.14302/issn.2379-7835.ijn-14-615
Prochownik KatherineCorresponding author
The Johns Hopkins University Baltimore, Maryland
Objective: To prevent childhood obesity, the Chilean government has recently implemented food regulation laws that apply to schools. This paper reviews the literature regarding the challenges in successfully integrating policies to regulate foods offered in schools. In addition, to understand some of the potential implementation barriers, a survey was conducted to evaluate how well food regulation laws were understood and implemented in Chilean schools. Methodology: A narrative literature review was conducted regarding food regulation policies in Chilean schools and potential barriers to implementation. This informed a subsequent descriptive, qualitative survey which was conducted in the Valparaíso region of Chile to examine knowledge, practices, and potential barriers to implementation of the new regulations. Twelve randomly-selected school food kiosk owners completed a survey and structured interview. Visual observations were also performed at each food kiosk. Content analysis identified trends in food items sold and determined the depth of understanding kiosk owners have of a specific new food law, "La Composición Nutricional de los Alimentos y Su Publicidad (20.606)." Key Results: 7 articles in Spanish and 10 in English were reviewed. The literature review revealed that unhealthful food options are readily available to Chilean students in school kiosks. The results of the survey and interview indicated that the school kiosk owners surveyed have a general understanding of the food law. 10 out of 12, however, were unsure of the law's exact contents. Unhealthful food options, inconsistent with regulation 20.606 were observed in all 12 visited kiosks. Conclusion: Evidence from a literature review and the survey findings confirm that unhealthful foods persist in Chilean schools, despite government food regulations. Although the majority of the school kiosk owners acknowledge law 20.606, most lack an understanding of its exact contents and their role in promoting healthier foods in schools. Further education of vendors and school administrators is needed to enhance compliance with the new Chilean food regulations.
Jun 2026
De Coninck LeenCorresponding author
Background A persistent gap remains between evidence-based health care and its application in routine practice. This challenge is particularly prominent in allied health professions like occupational therapy (OT), where interventions are complex, individualized and centred on patients' daily functioning. Objective To identify barriers, facilitators, and implementation strategies for integrating evidence-based OT interventions in multiple sclerosis (MS) rehabilitation. Methods A mapping review was conducted using searches in five databases. Eligible studies included adults with MS, examined OT interventions, and reported on factors influencing implementation. Data were extracted and categorized using Grol’s framework for barriers/facilitators and Mazza’s taxonomy for implementation strategies. Results Fifteen studies met inclusion criteria. Barriers and facilitators were identified at multiple levels of Grol’s framework: 1-Innovation-level: accessibility, feasibility, and perceived attractiveness supported implementation, particularly when interventions incorporated holistic approaches, gamification, or printed manuals. 2-Professional-level: therapists’ competencies and alignment between interventions and patients’ priorities. 3-Patient-related: facilitators included motivation, readiness to change, and peer support, whereas fatigue, pain, and cognitive challenges served as barriers. 4-Social and organizational: effective teamwork, resource availability, and flexible scheduling facilitated successful adoption. 5-Economic or political: no studies. Implementation strategies focused on using manuals, patient empowerment, gamification, and organizational supports. No financial or structural policy-level strategies were identified. Conclusion Successful implementation of evidence-based OT for MS requires multifaceted, context-sensitive strategies addressing innovation, professional, patient, and organizational determinants. Practical approaches enhance uptake, while substantial gaps persist at economic and policy levels. Strengthening these areas may improve longterm integration and sustainability of evidence-based OT in MS rehabilitation.
May 2026 DOI 10.14302/issn.2690-4837.ijip-26-6169
Ershova JuliaCorresponding author
Introduction The risk of exposure to M. tuberculosis among healthcare workers (HCW) remains a public health concern worldwide. During the COVID-19 pandemic, the Biomedical Research and Training Institute supported the Zimbabwe Ministry of Health and Child Care in strengthening infection prevention and control (IPC) practices in healthcare facilities (HCF), integrating tuberculosis (TB) infection control (TBIC) into the intervention strategy. We describe the impact of this intervention on TBIC practices and HCW screening outcomes. Methods The strategy, implemented from June 2021–September 2022, included IPC mentorship training, competency assessments, and use of a standardized risk assessment tool for progress monitoring. For the training purposes, the project developed eight practical problem-solving IPC modules including an occupational health component. Trained mentors conducted bi-monthly site support visits (SSV), used a checklist to track compliance, and assessed competencies of HCW at the targeted facilities. Facility-based risk assessments were conducted three times during the project implementation. Results During the intervention, 1,865 HCW from 105 facilities were trained. Availability and use of personal protective equipment improved by 49% and 42%, respectively. The proportion of HCF with designated areas for sputum collection increased by 43%. The proportion of HCF that screened HCW for TB increased by 42% with 3,761 HCW screened during the project period. Fourteen were diagnosed with TB and referred for care, resulting in 372 new cases per 100,000. Conclusion The implemented strategy of training, mentorship, and regular SSV strengthened TBIC measures, improved TB screening practices and case finding among HCW. Improving and maintaining practices is critical for effective TBIC.
Dec 2025 DOI 10.14302/issn.2768-5209.ijen-25-5732
S Isaac AnvyCorresponding author
The growing population demands and environmental concerns associated with traditional protein sources have prompted the exploration of alternative and sustainable food sources. The purpose of this comprehensive review is to highlight the nutritional benefits and sustainability of insect-based foods as a promising solution. Global population growth necessitates innovative approaches to meet the demand for nutritious and sustainable protein sources. There are numerous challenges associated with traditional livestock farming, including land use inefficiency, high water usage, and greenhouse gas emissions. As a result, edible insects have emerged as a viable alternative, providing proteins (35-77% of dry matter), healthy fats (10-50%), essential amino acids, and micronutrients such as iron (up to 31mg/100g) and zinc (up to 20mg/100g), vitamins, and minerals. In contrast to livestock, which requires 22,000-43,000 liters of water to produce 1 kg of beef, insect farming consumes significantly less water and land resources. Insects have the potential to address nutritional deficiencies and strengthen food security as they are recognized for sustainable production. The study thoroughly investigates the literature addressing environmental and sustainability concerns associated with edible insect farming, using a rigorous bibliometric and scientometric analysis via Vos viewer. With the help of Vos Viewer, it was possible to identify the geographical distribution of countries that contributed to the field of edible insects and their acceptance, as well as the top ten documents in this field with the most citations and mostly used keywords in this field of research. Future research and implementation strategies will be able to benefit global food security and environmental conservation through these alternative protein sources.
Aug 2025 DOI 10.14302/issn.3070-1937.ijbt-25-5540
Harry Fon MbachamCorresponding author
The rising need for structured and efficient blood transfusion services in low-resource settings has driven the adoption of collaborative blood transfusion management systems (CBTMS). This study explores the functionality and impact of the Cornerstone University Blood Management System version 1.0 (CUBMS vs 1.0) in Cameroon. This study was an exploratory research design which used a system interface analysis, comparative case reviews from four countries, and literature synthesis, to reveal that CUBMS improves accessibility, data management, inventory control, emergency responsiveness, and community engagement. Despite infrastructural challenges in rural regions, the system can enhance efficiency, transparency, and safety in blood services. The success of CBTMS in Cameroon is linked to digital infrastructure, training, and culturally relevant community engagement. The Ministry of Public Health of Cameroon should prioritize the nationwide implementation of CBTMS, ensuring consistency in digital health tools.
Jul 2025 DOI 10.14302/issn.2641-4538.jphi-25-5580
Ina Grant Sagnia PhebianCorresponding author
Comprehensive Sexuality Education (CSE) is a school-based intervention aimed at correcting misinformation surrounding sexual education among youth, often influenced by social media, peer groups and misleading online content. In The Gambia, the Ministry of Basic and Secondary Education has developed and introduced a national framework to integrate CSE from Grade 4 (primary school level) to Grade 12 (senior secondary school level). This study explores the perceptions and recommendations of 50 secondary school teachers from 43 public and private schools in Region 1 on the implementation of CSE in schools. While some teachers expressed concerns that CSE might promote perverted and lewd early sexual behavior, others saw it as essential for increased awareness and youth well-being. Cultural, religious, and societal norms pose significant implementation barriers towards the implementation of CSE in schools. Teachers’ insights are vital for successful CSE delivery and educational strategy improvements.
May 2024
Mangueina DanielCorresponding author
Waterborne diseases pose a significant global public health threat, particularly in sub-Saharan Africa, where frequent outbreaks occur. These diseases stemming from contaminated drinking water, poor waste management, and insufficient hygiene contribute to high morbidity and mortality in children under 5 years old. A study addressed waterborne diseases in N'Djamena, Chad's 3rd and 9th districts, through decision-making strategies. The research employed various methods, including a household survey using questionnaires, workshops, semi-structured interviews, and focus group discussions. Additionally, documentary research provided essential data for analysing the situation of diseases in the community. Epidemiological data from 2019- 2022 indicated a substantial prevalence of diseases such as diarrhoea, dysentery, skin infections, typhoid, abdominal pain, and malaria, with notable mortality, especially among children. Among surveyed households, 50% believed the consumed water was contaminated, attributing it to faecal matter, while 28% and 22% linked the diseases to inadequate hygiene and unsanitary conditions, respectively. The study advocates for comprehensive strategies, including improving water treatment efficiency, implementing safe waste management, promoting hygiene, and vaccination. Active involvement of all stakeholders, with municipal authorities leading, is crucial for effective implementation and combating waterborne diseases.
Mar 2024 DOI 10.14302/issn.2642-3146.jec-24-4935
Yakubu SufyanCorresponding author
Promoting responsible energy usage in student hostels and residential buildings plays a crucial role in ensuring sustainable development. By implementing cost-efficient strategies for managing and conserving energy, both students and homeowners can not only reap economic and social benefits but also mitigate the adverse environmental effects associated with energy consumption. Unfortunately, student hostels and residential buildings in developing countries like Ghana are falling behind in the adoption of energy efficiency and management practices, thereby missing out on valuable implementation opportunities. This study investigates the potential for energy efficiency and conservation measures in student hostels, specifically the GETFUND hostel of the University of Energy and Natural Resources in Ghana. The hostel's monthly energy consumption is approximately 64,929.458kWh, which translates to $5,667.20. The objectives of the study include analysing the current electricity consumption pattern, identifying energy misuse, and recommending measures to save energy, as well as calculating the financial benefits of implementing energy management practices. The methodology employed is an energy audit approach. The results of this study can contribute to overall energy conservation efforts in Ghana and may be applied to other university residence halls in sub-Saharan African countries with similar climatic and energy-use characteristics. In a broader sense, the primary objective of this study is to enhance the energy efficiency of the GETFUND hostel and minimize energy wastage, resulting in substantial financial savings.
Feb 2024 DOI 10.14302/issn.2641-4538.jphi-23-4871
Mba-Oduwusi NnennaCorresponding author
Background This study evaluates the effectiveness of quality improvement (QI) strategies in mid-level private healthcare facilities in Lagos State, with a focus on the structural components, healthcare processes, and healthcare outcomes. Employing the Donabedian model, the research aims to comprehensively assess and enhance healthcare service quality in these facilities. Methods A before-and-after study design was employed, involving a baseline assessment of 321 health facilities and endline assessment of 239 healthcare facilities, and a subsequent 10 - 12-month quality improvement intervention. Data were collected using facility assessments, client exit interviews, and interviews with key stakeholders. The analysis included a before and after analysis of the structural components, healthcare processes, and healthcare outcomes. Results The study demonstrates positive outcomes in mid-level private healthcare facilities in Lagos State following quality improvement (QI) interventions. Structural components, including, improved equipment availability, and enhanced compliance with standards, showcased significant improvements. Renovations and heightened registration compliance further underscored commitment to regulatory standards. Challenges in service availability, particularly in family planning and laboratory services, were identified. Importantly, the implementation of a QI scoring system revealed an overall positive impact, with the average score rising from 69% to 74%, signifying enhanced quality across diverse priority areas. Implications These findings highlight the success of QI interventions in transforming healthcare processes and structural components. Despite notable progress, persistent challenges in specific services call for targeted interventions. The substantial increase in patient satisfaction and overall QI scores underscores the transformative potential of sustained efforts and tailored interventions in mid-level private healthcare facilities in Lagos State. Conclusions This research comprehensively evaluates the effectiveness of quality improvement strategies implemented in mid-level private healthcare facilities in Lagos State, Nigeria, utilizing the Donabedian Model as a guiding framework. The findings provide valuable insights for policy recommendations, with the aim of aligning healthcare services with the Donabedian model to ensure the provision of high-quality care in mid-level private healthcare facilities in Lagos State. This study contributes to the ongoing efforts to improve healthcare quality in Lagos State. Contribution to Knowledge The research provides empirical insights into the effectiveness of quality improvement strategies in mid-level private healthcare facilities, particularly within the context of Lagos State, Nigeria. It highlights the significance of addressing structural components, optimizing healthcare processes, and monitoring healthcare outcomes to enhance the quality of care provided, aligning with the Donabedian model. These findings offer a valuable basis for policy recommendations and further research efforts aimed at improving healthcare quality in similar settings.
Jan 2024 DOI 10.14302/issn.2692-5257.ijgp-23-4772
M. G. D. V. K KiridanaCorresponding author
Childhood obesity is on the rise, mostly in the low-income regions in South Asia including Sri Lanka. Simultaneously, undernutrition also continues to be an ongoing public health issue. The coexistence of childhood obesity with undernutrition has resulted in a double burden of malnutrition in these countries. Management of obesity in a community already affected by undernutrition is a challenging situation. At present, management of childhood obesity occurs as a hospital-based lifestyle modification intervention which cannot address all tiers in the community alike. Although national level multifaceted strategies are in place, implementation is limited due to financial constraints. In this context, the general practitioners can be considered as an important group of medical professionals who can reach families in the community. In many households in Sri Lanka, an overweight child is considered as normal and well-nourished in comparison to an underweight child. Unhealthy eating habits and force feeding have become norms in the society. Changing mindsets of people need significant time and commitment. General practitioners, in the community would be able to achieve this target through effective communication based on a nutrition sensitive approach. While uplifting the infrastructure facilities, steps have to be taken to update the knowledge and communication skills of the general practitioners on managing childhood obesity in a community affected with double burden of malnutrition. The well-equipped GP is an asset to modify the attitudes and thinking patterns of parents with regard to child nutritional problems. Childhood obesity is on the rise, mostly in the low-income regions in South Asia including Sri Lanka. Simultaneously, undernutrition also continues to be an ongoing public health issue. The coexistence of childhood obesity with undernutrition has resulted in a double burden of malnutrition in these countries. Management of obesity in a community already affected by undernutrition is a challenging situation. At present, management of childhood obesity occurs as a hospital-based lifestyle modification intervention which cannot address all tiers in the community alike. Although national level multifaceted strategies are in place, implementation is limited due to financial constraints. In this context, the general practitioners can be considered as an important group of medical professionals who can reach families in the community. In many households in Sri Lanka, an overweight child is considered as normal and well-nourished in comparison to an underweight child. Unhealthy eating habits and force feeding have become norms in the society. Changing mindsets of people need significant time and commitment. General practitioners, in the community would be able to achieve this target through effective communication based on a nutrition sensitive approach. While uplifting the infrastructure facilities, steps have to be taken to update the knowledge and communication skills of the general practitioners on managing childhood obesity in a community affected with double burden of malnutrition. The well-equipped GP is an asset to modify the attitudes and thinking patterns of parents with regard to child nutritional problems.
Sep 2023 DOI 10.14302/issn.3070-2232.jf-23-4696
Baron ByronCorresponding author
Small island states, such as Malta face numerous, unique challenges in relation to agricultural sustainability, with solutions amenable to larger states being unfit given the particular characteristics of the island. These include the poor soil conditions, the limited water resources, the aging farmer population, farming being mainly part-time, and most farmers having no formal training. Currently farmers practice intensive agriculture to achieve higher crop productivity at lower production costs by relying heavily on agri-chemicals and over-extracting groundwater. This destroys the Maltese natural environment and urges for the development and implementation of sustainable agriculture practices, whereby traditional farming is supplemented with sustainable alternatives such that local agriculture remains productive in the long-term while safeguarding the local environment. Here we outline some of the critical issues that urgently need to be addressed and potential ways forward in relation to soil, water and biodiversity, implementing permaculture principles in small-scale, practical actions in order to improve the sustainability of local agricultural through a combination of scientific evidence, agricultural technology and traditional practices.
Sep 2023 DOI 10.14302/issn2474-9273.jbtm-23-4712
Erika HumphreysCorresponding author
The effectiveness of treating anxiety with Reiki is explored within ten quantitative studies. Methodology utilized for a critical appraisal and systematic review of the literature is explained with inclusion and exclusion criteria. Theoretical framework for the project is grounded in the work of Hildegard Peplau, whose nursing theory based on the therapeutic use of self is foundational for Reiki implementation. A thorough critique of the literature is conducted for key components of robustness and believability. This critique is conducted using a structured guide addressing synthesized strengths and weaknesses of the body of literature. A synthesis of the literature explores the findings of the studies. This synthesis reports on Reiki’s effectiveness in treating anxiety within a variety of patient settings and populations, its effect on subscales of anxiety, physiological manifestations of anxiety and pain associated with anxiety. Cultural considerations effecting Reiki’s potential effectiveness are discussed. Gaps in the literature are examined, including the studies’ narrow sample population, lack of participant exclusionary factors for controlled outcome data, and the lack of studies across time. Implications for future research are discussed with recommendations for expanded research that includes a broader variety of settings, age groups, and patient diagnoses, including anxiety disorders, for research data that is transferable. Implications for further practice for the advanced practice registered nurse (APRN) are explored, with the potential benefits for both providers and patients, including improved patient satisfaction and expansion of provider treatment modalities.
Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4115
Whegang Youdom SolangeCorresponding author
The University of Dschang Taskforce for the Elimination of COVID-19 (UNITED#COVID-19) .
Background Cameroon is battling against the novel coronavirus (COVID-19) pandemic. Although several control measures have been implemented, the epidemic continues to progress. This paper analyses the evolution of the pandemic in Cameroon and attempts to provide insight on the evolution of COVID-19 within the country’s population. Methods A susceptible-infected-recovered-dead (SIRD)-like model coupled with a discrete time-dependent Markov chain was applied to predict COVID-19 distribution and assess the risk of death. Two main assumptions were examined in a 10-state and 3-state Markov chain: i) a recovered person can get infected again; ii) the person will remain recovered. The COVID-19 data collected in Cameroon during the period of March 6 to July 30, 2020 were used in the analysis. Results COVID-19 epidemic showed several peaks. The reproductive number was 3.08 between May 18 and May 31; 2.75 between June 1 and June 25, and 2.84 between June 16 and June 24. The number of infected individuals ranged from 17632 to 26424 (June 1 to June 15), and 28100 to 36628 (June 16 to June 24). The month of January 2021 was estimated as the last epidemic peak. Under the assumption that a recovered person will get infected again with probability 0.15, 50000 iterations of the Markov chain (10 and 3- state) demonstrated that the death state was the most probable state. The estimated lethality rate was 0.44, 95%CI=0.10%-0.79%. Mean lethality rate assuming ii) was 0.10. Computation of transition probabilities from reported data revealed a significant increase in the number of active cases throughout July and August, 2020, with a mean lethality rate of 3% by September 2020. Conclusion Multiple approaches to data analysis is a fundamental step for managing and controlling COVID-19 in Cameroon. The rate of transmission of COVID-19 is growing fast because of insufficient implementation of public health measures. While the epidemic is spreading, assessment of major factors that contribute to COVID-19-associated mortality may provide the country’s public health system with strategies to reduce the burden of the disease. The model outputs present the threatening nature of the disease and its consequences. Considering the model outputs and taking concrete actions may enhance the implementation of current public health intervention strategies in Cameroon. Strict application of preventive measures, such as wearing masks and social distancing, could be reinforced before and after the opening of learning institutions (schools and universities) in the 2020/2021 calendar year and next.
Apr 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3741
Assegid SahiluCorresponding author
MD, MPH, Associate Professor of Epidemiology Jimma University, Jimma, Ethiopia
Background Ethiopia confirmed its 1st case of COVID-19 on Friday 13th February 2020. The burden increased dramatically by August/2020. The conditions that led to this rise were not reviewed. Objective To exploreCOVID-19 related phenomena in Ethiopia during 2019-2020. Materials and Methods Review of journals, books, and letters to editors, e-sources, news, personal experiences, observations, and communications. Results The zoonotic source of SARS- CoV-2 (Severe Acute Respiratory Distress Syndrome- Coronavirus-2) is not confirmed. The precedent events; and exact mechanism of COVID-19 is not clear. Dynamic models were required on the time line of dynamics of COVID-19; dynamics of infectiousness of COVID-19, and mechanism of transmission of COVID-19. Incubatory carriers might have been missed. Screening based on temperature had been problematic. The time spent in the development of diagnostic test for COVID-19 might have contributed to the early spread. Uninterrupted flights to China during the epidemic by Ethiopian Airlines as well as uninterrupted domestic flights; IDP (Internally Displaced People); and others put Ethiopia (and other countries) at great risk. Demographic adjustment may not be applicable for Ethiopia due to lack of census which had to be conducted every 10 year, was conducted only in 2007. This adds to the problem of error projection. The impact of HIV (Human Immuno-Deficiency Virus Disease) and war in Ethiopia before 2000 might have had affected people who would be now old age and who would be at the most risk of death. This made the impact of COVID-19 to appear low as revealed by the lower number of COVID-related deaths in Ethiopia. There were also hesitations inconsistencies in case definitions; implementations of quarantine; and burial regulations. Conclusion Even though uninhibited foreign flight to China as well as domestic flights; inconsistencies in the implementation of regulations pertaining to COVID-19 have contributed to COVID- 19 emergence in Ethiopia, the absence of census; the demographic impact of HIV and war before 2000 might have made the impact of COVID-19 to appear low as revealed by the lower number of COVID-related deaths in Ethiopia. Recommendation Accurate and current evaluation of the impact of COVID-19 in Ethiopia may require the absence of census; demographic consequences of HIV; and war before 2000 into consideration.
Nov 2020 DOI 10.14302/issn.2575-1212.jvhc-20-3598
Mersha Cherinnat TesfayeCorresponding author
Bako Agricultural Research Center
A cross-sectional study was conducted from November 2017 to March 2018 to determine the prevalence of ovine fasciolosis in the Community Based Horro Sheep Breeding site at Horro district, Horro Guduru Wollega zone, Ethiopia. Coprological examination was performed on a total of 390 sheep at the study area. Age, sex, body condition score and peasant association were taken into consideration as rik factors. An overall prevalence of fasciolosis 45.4% 95% CI (40.41 50.36 was found on the basis of coprological examinations. The prevalence of fasciolosis findings according to PAs were (41.5%) in Laku Ingu and (48.2%) in Gitilo Dole. Statistical analysis of the prevalence among study site (PAs) showed insignificant difference P=0.102 (P>0.05), but significant difference (P<0.05) was observed between animal age groups (P=0.032, with a prevalence of 37.2% in young and 49.8% in adult) and body condition scores (P=0.001, with a prevalence of 57.9%, 43.5% and 29.9% in sheep with poor, medium and good body condition score, respectively. There was insignificance difference (P>0.05) in sex group of study animals in which the prevalence was 47.6% in female and 38.8% in male. Therefore further studies on the epidemiology, seasonal dynamic of the disease, the snail intermediate host and impacts of the infection in animal production with implementations of strategic intervention is necessary.
Oct 2020 DOI 10.14302/issn.2768-0207.jbr-20-3568
Mango LucioCorresponding author
Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy
The Coronavirus emergency represents an epochal challenge for all world health organizations. In these times of profound destabilization of healthcare organizations, become urgent some thoughts on how to deal with the organization and re-engineering process as well as on concepts, relatively new, such as "resilience" and "business continuity". The company management need having to predict, design and plan a profound process of change in their Clinical and Corporate Governance. With the implementation of phases 2 and 3 of management of the pandemic and the coexistence of doctors and citizens with the new Coronavirus, it has become a priority to develop territorial models of assistance to established or suspected Covid patients, starting with the creation of monitoring networks based on the model of the “sentinel” general practitioner. One of the main concerns of Healthcare, since the beginning of the Covid-19 emergency has been to get closer to the citizen-patient. It is therefore necessary to find stimuli to restart with new methods of care, new health and social-health services, moving the current care paradigm for Covid-19 from the hospital to the territory, optimizing the constituent elements of the districts, primary care and general practice in a multidisciplinary approach.
Sep 2020 DOI 10.14302/issn.2377-2549.jndc-20-3516
Bhargava AksheyCorresponding author
Ex. Rajasthan Pollution Control Board, CEPT University, India
Municipal solid waste generation and disposal is a problem not only in India but all over the world. Presently majority of such waste is being dumped indiscriminately over vacant lands causing problems of odor, methane generation leading to air pollution, leaching effect polluting ground water and runoff polluting water bodies. Technological options are available to treat this solid waste and convert it into usable products but the biggest problem is its segregation preferably at the source of generation or even at the disposal area. Municipal solid waste generated in India consists of 15 percent non biodegradable which has high calorific contents and can be converted into power generation. Remaining 85 percent is degradable which can either be converted into compost or bio fuels. Under the present context, sustainable municipal waste management strategy needs to be evolved and put in place with effective implementation to address the issue of environmental pollution. An attempt has therefore been made by the authors of the present paper to take up a case study of Kanpur, India for managing such wastes having sustainable approach. The authors have worked out trends of population starting from the year 1951 and projected to 2051. Similarly waste generation trends established on the lines of population. An effort has also been made as to how much compost, bio fuel and power can be generated along with economic value to make it sustainable on a time scale.
Jul 2020 DOI 10.14302/issn.2831-8846.j3dpa-20-3438
Shirbhate NimishaCorresponding author
Department of Mechanical Engineering, LT College of Engineering, Koparkhairne, Navi Mumbai, India
Bone Scaffold is a three-dimensional porous construction which provides support to promote natural cell growth in damaged or broken section of bone. In recent years researchers from various departments like biomedical, mechanical, orthopedics, have shown significant interest in adopting ‘Bone Scaffolds’ as a promising treatment for bone defects. ‘Bone Scaffold’ is a honeycomb-like architecture composes of bio-compatible material having grater advantages over current grafting solution. In this paper, the authors try to review the available e-articles in an organized way on the bone scaffold in the field of biomedical implants with 3D printing. The selected literature mainly focuses on the biocompatible material and various advanced manufacturing methods used for manufacturing / preparing of bone scaffolds. This article tries to padding the gap between theoretical and actual implementation of ‘Bone Scaffolds’ by properly analyzing selected research and allowing future opportunities for reinventing the new possibilities in the field of biomedical.
Aug 2019 DOI 10.14302/issn.2640-690X.jfm-19-2989
Blondon K.Corresponding author
Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland
Background Medication adherence remains a challenge for patient management. Changes in the drug regimen after a hospital stay can lead to confusion or misunderstandings. We implemented a structured patient-centered interview during which a computer-generated individualized medication plan was discussed and provided to patients at discharge. Objective To explore whether a medication plan can be a quality indicator, in terms of its content (quality) and its implementation in the resident’s workflow (feasibility). Methods An observational mixed method study with interviews of 174 patients from general internal medicine wards at 1 week and 1 month after discharge, and of 91 physicians at baseline. We report the quality of the medication plan in terms of content and state of completion. We describe feasibility for residents to complete this plan, as well as patient and resident satisfaction with the plan. Results 83% of participants received a medication plan. Physicians verified renal function (83%) to adapt doses but did not regularly assess for medication interactions (43%). Incomplete plans (61%), were due to blanks when physicians considered the information irrelevant for their patients. Error rate was <3%. Patients reported low use of their plan after discharge (64% found it useful after 1 week, whereas only 37% used it when taking their medication 1 week after discharge). Conclusion Although the plans were considered useful by both patients and physicians, their implementation could have been optimized by considering the overall process (creation to patient use). Mobile apps could help fill gaps in supporting patients for medication adherence.
Jul 2019 DOI 10.14302/issn.2379-7835.ijn-19-2721
Habulembe Mugode RaiderCorresponding author
National Food and Nutrition Commission, Lusaka, Zambia
Introduction In the past several decades, Zambia has suffered high levels of under nutrition particularly stunting among children below 5 years of age. Although appropriate complementary feeding practices are reported to reduce child deaths by 6%, they have not received the adequate attention from programme officers and caregivers in terms of implementation. Objectives The objective was to investigate issues surrounding the common complementary feeding practices practised by caregivers of children below five years in health facilities and areas where high rates of malnutrition admission come from. Design A cross sectional research using both qualitative and quantitative methods. The study used mostly proportions based mostly on global indicators on complementary feeding. Qualitative data was also analysed according to themes of global complementary feeding indicators Setting The study was conducted in five hospitals, namely Arthur Davison, Solwezi Central, Kabwe and Livingstone General, and University Teaching Hospital. Subjects The target populations were mothers whose children were admitted for malnutrition and those with children 0-59 months living in communities with the highest number of malnourished cases admitted to selected hospitals Results About45.2% (190) of caregivers introduced liquids before six months of age and 7.6% (32) after 6 months attributing child thirst, medication and advice from health worker as the main reasons. Slightly above half (54.2% of 224) of mothers/caregivers used cups to feed their babies. The use of feeding bottles was still common (8.2% of 34). Responsibility to feed the child is mostly left to the mother (86.4%, 362). In addition, children were being feed about 2.67 (SD 0-72) per day. Conclusions Child feeding practices were still poor. This contributes to poor child growth and health. More interventions should be planned to improve child care behaviour.
Jan 2019 DOI 10.14302/issn.2693-1176.ijgh-18-2523
Nour KareenCorresponding author
University of Sherbrooke and CISSS Montérégie-Centre
This study explores the effects of the collaborative model of health impact assessment (HIA), as deployed in Monteregie (Quebec), on the development, adoption and implementation of municipal projects that include health considerations. Nine HIA processes were studied in nine territories and 35 individuals were interviewed. Data collection was based on the six steps of contribution analysis, and included document analysis, semi-structured interviews, and on-site observations. The study design is cross-sectional design were every HIA was analysed at least six month after completion. The individuals interviewed where those implicated into the HIA process (no matter at what point of the process). No exclusion criteria were applied considering that all points of view were important for this analysis. The Contribution Analysis (CA) was used to analyze the data. The study results emerged form by the interviews, the field observations and document analysis. They showed that the HIAs had varying results. First, the actors involved acquired new knowledge. However, the HIAs had little impact in terms of increasing the municipal actors’ awareness of health issues. Rather, it helped them acquire arguments for raising awareness among and convincing their municipal council members of the merits of certain actions and their potential positive impacts on citizens’ health. In fact, the HIAs were generally undertaken by municipal actors already aware of the importance of promoting citizen health. Second, as observed in the document, in a few of the HIAs, some recommendations were integrated into planning documents, but usually, as reported by the actor, the HIA report constituted an additional planning document and was not merged with the original planning documents. Lastly, following the HIAs, document analysis and interviews showed that most of the municipal actors continued to include health considerations in their subsequent planning of public policies and projects. Prerequisites for effective HIA include the presence of municipal actors, who are aware of the importance of their role in their local population’s health, municipal policies that include health considerations, and the municipality’s active participation in the HIA process. This study sheds light on the complexity of the factors that ensure HIA impact on municipal decision making and decisions. The particularities of each HIA process play a major role.
Aug 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2223
Jnr. John Elvis HaganCorresponding author
Neurocognition and Action - Biomechanics"- Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, 33501 Bielefeld, Germany
Marijuana utilization among school aged adolescents is major public and mental health concern in Ghana and other developing countries, with the rate of usage soaring high among school going adolescents. The objective of this study was to investigate the prevalence of marijuana utilization among selected Junior High School (JHS) students in the Central Region of Ghana and explore the relative impact of psychosocial factors accounting for its usage. Using a descriptive cross-sectional survey design with the Global School Based Survey GSHS questionnaire, a sample of 1400 school going adolescents students were drawn using multistage sampling procedure. Frequencies, percentages and binary logistic regression results indicated marijuana utilization prevalence of 9% (n = 122). Statistically, gender (OR = 0.52, 95% CI= 0.35 - .765, p = 0.001), religious affiliation (OR = 1.76, 95% CI = 1.0 - 2.95, p = 0.034), socioeconomic background (OR = 0.52, 95% CI = 0.33 - 1.23, p = 0.004) and geographical location (OR = 0.53, 95% CI = 0.31 - .886, p = 0.016) significantly predicted marijuana utilization among school aged adolescents. No statistically significant variations were found in the odds of students’ marijuana usage for age (OR = 1.15, 95% CI = 0.69 - 1.88, p = 0.590), parental communication (OR = 0.83, 95% CI = 0.56 - 1.23, p = 0.348) and academic performance (OR = 1.09, 95% CI = 0.66 -1.80, p = 0.744). Findings suggest that school based research should reflect and perhaps replicate existing prevalence, patterns of marijuana and other drug use through multiple school surveys nationwide. This pathway may provide useful information towards the design, evaluation and implementation of drug prevention cognitive-behavioural interventions and the development of stringent drug regulative standards.
Dec 2017 DOI 10.14302/issn.3066-8042.jac-17-1693
Mackenzie GenevieveCorresponding author
ADHD and Literacy Lab, Ontario Institute for Studies in Education
Individuals with ADHD may benefit from assistive technologies (ATs). ATs include FM systems, MontivAIDR, Time Aids, iSelfControl and Kurzweil. Eligibility for acquiring these ATs is discussed first. The importance of eligibility is highlighted because the review of the literature suggests that these ATs may promote academic success among students with ADHD. Unfortunately, most of the research on the efficacy of ATs is directed at learning disabilities. Consequently, a review of ATs that support students with learning disabilities is provided with the overarching goal to encourage researchers to determine how ATs that support students with learning disabilities may also support students with ADHD. Finally, we discuss the ways in which ATs can maintain their efficacy over time for students with ADHD through the implementation of a Response to Intervention (RTI) framework. Concluding remarks will follow.
Dec 2017 DOI 10.14302/issn.2381-862X.jwrh-17-1822
B BergerCorresponding author
Faculty of Health, Universität Witten-Herdecke, Herdecke, Germany.
Objective Because of the increased demand for the availability of independent information regarding the efficacy, the lack of efficacy and the possible harm of medical interventions, the study aims to evaluate the information package „Menopause", published by the German Institute for Quality in Healthcare (IQWiG). Methods: Qualitative, guideline-based interviews, carried out in n=41 women (40-63 years). The analysis of transcripts was carried out according to Mayring. Results Information perception of women who could use the material could be summarized into the following: (1) Information were perceived as independent and deemed trustworthy. (2) Scientific study results were unknown but welcomed. (3) Decision aids are useful but need further communicative support. (4) Women requested suggestions for empowerment and self-help. (5) Some women are better accessible through experiences. (6) Women who did not take on any information presented in the material. Conclusions: Through evidence-based health information (EBHI) and decision aids interviewed women can be enabled to make informed decisions concerning their health care. Health information should include the relevant context factors. However, not all women could be reached. Practice implications Not only the implementation of independent EBHI into the structure of healthcare but also communicative services including biographical aspects and self-help strategies are needed.
Dec 2017
Yi SiyanCorresponding author
Public Health Program, Touro University California, Vallejo, CA, the United States
This paper aims to examine the challenges and implications of the Village and Commune Safety Policy (VCSP) on harm-reduction programs and describe lessons learned from a harm-reduction program within the context of the VCSP in Cambodia. Data were collected from a monitoring and evaluation database and reports of a drop-in center that provides a wide range of harm-reduction services. In addition, qualitative data were collected through key informant interviews and focus group discussions with 38 participants including people who use drugs (PWUD) and people who inject drugs (PWID). Desk reviews and consultative meetings with key stakeholders were also conducted. In total, 496 PWUD were registered into the program between 2010 and 2012, of which 22.4% were PWID, and 15.0% were women. The mean age of participants was 26 years old. HIV prevalence among PWUD was 1.0% compared to 16.2% among PWID. Remarkable achievements were observed such as high uptake of services by PWUD and PWID with active referrals to methadone maintenance treatment (MMT) and voluntary HIV confidential counseling and testing (VCCT). However, distribution of clean needles and syringes in communities was limited. Also, the newly initiated needle and syringe program (NSP) based in pharmacies failed to reach PWUD and PWID. Appropriate coordination and collaboration with law enforcement and authorities were observed given the complexity of the VCSP. However, the implementation of the VCSP poses challenges including NSP and accessibility to harm reduction services. For future successes of harm-reduction programs, it is important to maintain close coordination and collaboration between program implementers and local authorities with mutual understanding and flexibility.
Sep 2017 DOI 10.14302/issn.2474-7785.jarh-17-1727
Akazawa ManabuCorresponding author
Public Health and Epidemiology, Meiji Pharmaceutical University
Background: Healthcare services provided to patients should vary depending on disease severity. However, disease severity bias, a type of selection bias, is a commonly encountered problem in administrative database studies. Herein, we selected chronic obstructive pulmonary disease (COPD), which commonly affects elderly Japanese citizens, for the development and validation of a severity classification system based on a health insurance claims database. Methods: Patients who received COPD-related diagnostic codes in 2011 were selected from a commercially based health insurance claims database. COPD patients were randomly divided into two groups to develop and validate severity scores. A principal component analysis was used to estimate factor loadings used to weight calculations of COPD severity scores. Score validity was evaluated using a linear trend test to predict COPD treatment costs and acute exacerbation events. Results: Using records from 880 patients, ten variables were created: acute exacerbation events, emphysema diagnoses, laboratory test and oxygen therapy procedures, prescribed anticholinergic, inhaled corticosteroid (ICS), short acting beta-agonist, and long acting bronchodilator (LABA) agents, asthma diagnosis and patient birth years. Factor loadings from LABA and ICS prescriptions had the strongest impacts on estimated severity scores (0.50 and 0.49, respectively). Among 300 validation group patients, scores were found to associate with increasing trends of median costs and exacerbation risks (p for trend < 0.05). Conclusions: Estimatedseverity scores would help to predict COPD-related medical costs and exacerbation events. For further clinical implementation, this classification system should be re-evaluated using clinical lung functions information indicative COPD severity and treatment choices.
Aug 2017 DOI 10.14302/issn.2574-612X.ijpr-17-1634
Mroczek BożenaCorresponding author
The functioning of medical professionals in their work environment is determined by many factors, among them social competence. The Aim of this Study was toanalyze how social competence is related to behaviors and experiences in the context of burnout syndrome, experienced by physicians, nurses, and paramedics in Poland with regard to sociodemographic factors. Methods. The study was conducted in 2015-2016. It involved 432 medical workers, including 29.7% physicians, 36.96% nurses, and 33.3% paramedics. The median age was 38.00. Over half (38.9%) of those surveyed were employed in hospitals, 6.9% in primary care centers, 18.3% in emergency ambulance service. The Social Competence Questionnaire (SCQ), the Work-Related Behaviour and Experience Patterns - AVEM questionnaire, and a self-developed questionnaire were applied. Results. Symptoms of burnout syndrome (Type B and A) were observed in one-fourth of medical workers. 31.8% of all participants presented Type G (p < 0.0001). Behavior types prevailing in particular groups were as follows: paramedics ― Type G and Type S; physicians ― Type A and Type B, and nurses ― Type B and Type G. The general competence level correlated with Type G (p = 0.05), and I competence correlated negatively with Type B (p = 0.02). Conclusions: The problem of burnout syndrome, diagnosed on the basis of work-related behaviors and experiences, is weighty and requires implementation of holistic therapeutic and prophylactic solutions addressed to healthcare professionals. Competence in intimate and social exposure situations, as well as competence in situations requiring assertiveness significantly protect medical workers against burnout syndrome.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-16-1354
Frumence GastoCorresponding author
Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Tanzania.
Tanzania is among the developing countries experiencing rapid growth of an ageing population, which has an implication in healthcare expenditure especially in resource poor settings where majority of elderly people cannot afford to pay for the cost of accessing health services. The country has developed the Tanzania National Health Policy (2007) and National Ageing Policy (2003), which, among other things, recognize the importance of having a healthcare system that provides free basic services to the vulnerable elderly population. This study aimed at exploring health service providers’ and managers’ perspectives on the factors facilitating or prohibiting access to health services among elderly people in Tanzania. The study adopted a qualitative approach and data were collected using semi-structured interviews. A total of 24 in-depth interviews were conducted with district healthcare managers, heads of public healthcare facilities, and health service providers. The data generated were analysed for themes and patterns. The results show that Tanzania’s healthcare system has made some efforts to implement the national exemption policy to ensure better access to health services for the elderly. Some of these efforts include: having in place a system to identify and exempt elderly people from paying for health services and giving them special priority during treatment. However, there are some barriers hindering elderly people’s access to health services. Among others include: lack of specific consultation rooms and doctors for serving the elderly, and lack of sufficient drugs and other medical equipment in most government-owned healthcare facilities. In summary, the healthcare system has created a good environment for the implementation of exemption policy aiming at enhancing accessibility of health services among the elderly population in the country. However, such environment cannot function effectively without addressing the identified barriers. It is recommended that the government should allocate adequate human and non-human resources to the healthcare system to enable it to function effectively, including the provision of health services to the elderly.
May 2017 DOI 10.14302/issn.2470-0436.jos-17-1479
Chen Ying-LingCorresponding author
University of Tennessee Space Institute, 411 B. H. Goethert Parkway, Tullahoma.
This study investigated the feasibility of using three-dimensional (3D) technology as a multi-functional visual stimulus to assist the clinical eye exam. Specifically, we examined: (1) whether the receding movement of a 3D fixation target into distance could relax the accommodation of non-cycloplegic hyperopic subjects so that accurate refraction measurements could be achieved; (2) the feasibility of using the left-eye and right-eye images from the 3D monitor as the light source to perform swinging-flashlight pupil tests; and (3) the implementation of 3D technology to interrupt the binocular visual/motor fusion as required for the clinical cover test to identify strabismus. Using a 3D TV to provide visual stimuli and a photoscreening (PS) device, near-infrared (NIR) eye images were acquired and analyzed for each of the three objectives. The result of accommodation test showed that with visual stimuli, the maximal hyperopic refractions could more accurately suggest the patients’ true refractions and the more hyperopic patients responded more to the 3D projected distance. However the very mild hyperopia did not show significant response. The pilot tests also showed distinguishable normal and abnormal pupillary responses with 3D image illumination and also the difference in phoria and tropia in the ocular alignment test using 3D stimuli.
Dec 2016 DOI 10.14302/issn.2381-862X.jwrh-15-846
Rafie SallyCorresponding author
UC San Diego Health
Sexual assault is a serious problem in the United States. It is crucial that the medical management of these patients is adequate. The Centers for Disease Control and Prevention (CDC) provides guidelines for appropriate management of these patients. The purpose of this study is to evaluate medical management of survivors of sexual assault at an academic medical center and identify opportunities for improvements in care. We conducted a retrospective, chart review study of patients aged 12 years and older presenting at an academic medical center following sexual assault or rape between 2009 and 2013. Descriptive statistical tests were used to analyze the data. A total of 29 females and 5 males were identified. The majority of patients presented to the medical center within 24 hours of sexual assault or rape and typically presented to the emergency department. Empiric treatment for infections were 8.8% for Hepatitis B, 29.4% for human immunodeficiency virus, 20.6% for gonorrhea, 17.6% for chlamydia, and 8.8% for trichomonas. Among women of reproductive age, 28.0% were provided with emergency contraception. This study found inconsistency in the medical management of sexual assault survivors. Among this small sample size, many patients were not provided with recommended medical treatments. With this knowledge, the medical center plans to implement institutional guidelines and a corresponding order set in the computerized prescriber order entry system to standardize the medical management of sexual assault survivors and educate healthcare professionals. Future studies are warranted to evaluate the impact of standardized guidelines and order set implementation.
Sep 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1189
Martin KarenCorresponding author
School of Population Health (M431), The University of Western Australia
Objectives: This pilot study explored post-traumatic stress symptoms (PTSS) and moderate to severe psychological distress in a small sample of urban community-living adolescents seeking asylum in Australia. The study also examined the relationships between post-traumatic stress symptoms (PTSS) and psychological distress and school and family support and connectedness. Method: A cross-sectional survey examined PTSS (Abbreviated PTSD Checklist), psychological distress (Kessler-5) and school connectedness (California Healthy Kids Survey)53 in 27 adolescents seeking asylum (ages 12-17, mean 15.4) attending two independent secondary schools in Perth, the capital city of Western Australia. Results: In the sample, 63.0% (n=17, 1 missing) of adolescents exceeded the PTSS threshold (i.e. screened positive for Post-traumatic Stress Disorder) and 66.7% (n=18) exceeded the Kessler -5 threshold indicating moderate to severe psychological distress. Overall, 51.9 % (n=14, 1 missing) of adolescents screened above both thresholds suggesting co-occurrence of PTSD and moderate to severe psychological distress. Boys (x̄=15.0, SD=2.9) experienced higher psychological distress scores than girls (x̄=12.1, SD=4.5; p=0.071). Higher perceived support by an adult in school (r=0.13), and at home (r=0.28) were weakly associated with lower PTSS. Less time in Australia was weak-moderately associated with higher psychological distress (r=0.35). Weak associations between higher psychological distress and age (r=0.17) and those who felt more supported by an adult at home (r=0.17) were detected. Conclusion: Approximately two thirds of this group of community-living adolescents who were seeking asylum experienced post- traumatic stress symptoms or psychological distress; and more than one half experienced both. These pilot research findings suggest that adolescents who are seeking asylum and living in the Australian community are at risk of experiencing PTSD and moderate to severe psychological distress; research incorporating larger samples and longitudinal measurement is required. Screening, clinical assessment and examination of the immediate and long term impact, as well as implementation and evaluation of evidence-based mental health interventions, within these populations is also recommended.
Jul 2016 DOI 10.14302/issn.2474-7785.jarh-16-1123
P. Howard ElizabethCorresponding author
Northeastern University School of Nursing
This article describes COLLAGE 360, a person‑centered care model for older adults that integrates comprehensive assessment, goal‑setting, and coordinated community services. The approach seeks to promote health and function while reducing fragmentation across medical and social supports. Early implementation experience outlines feasibility and pathways to measure outcomes and scale within aging networks.
Jul 2016 DOI 10.14302/issn.2474-3585.jpmc-16-1118
Shelli Stephens-StidhamCorresponding author
We used the five dimensions of the RE-AIM model to evaluate a smoke alarm (SA) installation program called Operation Installation (OI), which was implemented in 36 high risk census tracts in Dallas, TX, from 2001-2011. More than 20,000 SAs were installed in 8,134 houses through OI. The RE-AIM model showed that the program had a modest reach into the target population (26.5%), and a relatively high effectiveness (63%) at preventing deaths and injuries in program houses. Adoption and implementation remained high throughout the time period. Individual level maintenance of SAs was high initially (91.8%), but rapidly declined and was only 20% after 10 years. Application of the RE-AIM model to evaluate this long-term SA installation program highlighted areas that warranted improvement, especially for the dimensions of Reach and individual-level Maintenance. The model may be useful for evaluating the impact of other injury prevention programs.
Feb 2016 DOI 10.14302/issn.2379-7835.ijn-16-924
Arlappa NimmathotaCorresponding author
Division of Community Studies, National Institute of Nutrition (NIN), Hyderabad, Telangana, India.
Objectives: Vitamin A deficiency (VAD) among the rural pre-school children in India is continues to be a major nutritional problem of public health significance, even after the implementation of national vitamin A prophylaxis programme for more than four decades. The aim of the study was to assess the prevalence of vitamin A deficiency among rural pre-school children of South India. Methodology: A community based cross-section study; adopting multi-stage random sampling procedure was carried out by the National Nutrition Monitoring Bureau (NNMB) among rural pre-school children of four South Indian states viz. Kerala, Tamil Nadu, Andhra Pradesh and Karnataka during 2003-05. A total of 35,480 (Boys: 18,216; Girls: 17,264) rural children of 1-5 year age group was covered for this study. Key Results: The prevalence of Bitot’s spot, an objective ocular sign of VAD among the rural pre-school children of South Indian was 0.6% (95%CI:0.5-0.7). Similarly, the proportion of children with sub-clinical VAD was 59.3%, suggestive of a severe public health problem. In general, the prevalence of VAD was significantly higher (p<0.001) among the children of socio-economically marginalized sections of the communities, labourers, illiterate mothers and those residing in the households with no sanitary latrine. Conclusion: The prevalence of clinical and sub-clinical VAD among the rural pre-school children of south India is suggestive of a public health concern. Therefore, rural communities are encouraged to consume diets rich in pre-formed and pro-vitamin A and administer periodic massive dose vitamin A solution to the children of under five for the prevention and control of VAD.
Dec 2015 DOI 10.14302/issn.2470-0436.jos-15-818
Arlappa NimmathotaCorresponding author
National Institute of Nutrition (Indian Council of Medical Research), Hyderabad, India.
Purpose: Vitamin A deficiency (VAD) is still a major nutritional problem of public health importance among the rural pre-school children in India, even after the implementation national vitamin A prophylaxis programme for prevention of nutritional blindness and ICDS have been in operation for more than three decades. The purpose of this communication is to assess the prevalence of ocular manifestations of vitamin A deficiency among rural pre-school children of north India. Methods: A community based cross-section study; adopting multi-stage random sampling procedure was carried out by NNMB among rural pre-school children of four north Indian states viz. Maharashtra, Madhya Pradesh, Orissa and West Bengal. A total of 36,111 rural pre-school children of 1-5years (Boys: 18408; Girls: 17703) were covered for this study. Results: The prevalence of conjunctival xerosis (2.5%), the first ocular sign of VAD and Bitot’s spot (0.9%), an objective ocular sign of VAD was higher than the cut-off values suggestive of public health nutritional problem among the rural children. While, the prevalence of night blindness, the first symptom VAD was reported among 0.5% of rural children. Similarly, the proportion of rural pre-school children with sub-clinical VAD was 64%, suggestive of severe public health importance. Conclusion: The prevalence of ocular manifestation and sub-clinical vitamin A deficiency was high among the rural children of north India. Therefore, rural communities are encouraged to consume diets rich in vitamin A and administer massive dose vitamin A solution to the children of under five for the prevention and control of vitamin A deficiency and its adverse impact on child morbidity and mortality.
Sep 2013 DOI 10.14302/issn.2324-7339.jcrhap-13-268
J. Card JosefinaCorresponding author
Sociometrics Corporation, Los Altos, CA
Established in 1996 with funding from CDC and NIH, the HIV/AIDS Prevention Program Archive (HAPPA) is now the biggest private sector collection of HIV-related evidence-based behavioral interventions (EBIs). Each EBI in HAPPA has been determined by a distinguished Scientist Expert Panel to have demonstrated efficacy in preventing HIV or its risk-related behaviors in the United States. The multimedia replications kits contain everything that a new site would need to implement an EBI such as a user guide that gives an overview of the program and the evidence of its effectiveness; a facilitator’s manual that gives step-by-step implementation protocols for each session; and session implementation materials referenced in the facilitator's manual such as slides, video clips, participant handouts, activity masters, checklists, and homework assignments for the next session. The program packages also contain evaluation materials such as surveys and questionnaires that were used in the original demonstration of effectiveness and that may be used to re-evaluate the program as implemented in a new setting. Recently, we have expanded HAPPA’s scope to include HIV EBIs developed globally and to include evidence-based structural interventions (effective in modifying the physical, social, cultural, political, economic, legal, and/or policy aspects of the HIV risk environment). This paper describes HAPPA’s procedures for identifying, selecting, acquiring and packaging HIV EBIs. It also provides comprehensive lists of evidence-based HIV behavioral and structural interventions and gives information on how to access EBI program packages for implementation in new settings.