Health Division Research Articles

Crops for Nutrition and Health (C9) Division Paper Award

Crops for Nutrition and Health (C9) Division Paper Award

Screen time and social media exposure in children and adolescents - the landscape

Abstract Dr. Cecilia Elias is a Public Health Consultant, collaborating with the Infant, Youth, Sexual and Reproductive Health Division at the Health Directorate General, in Lisbon, Portugal. Following on from John’s introduction, Cecilia will dig deeper into the impacts of the omnipresence of social media and phones in modern society. She will provide an overview of the harms and benefits for today’s youth. She will highlight data for example on impaired development of language, cognitive and social skills from screen exposure at young ages, and increased rates of depression, anxiety, self-harm, and school refusal among adolescents with problematic social media usage, including examples of significant outcomes. Exposure to disturbing and harmful content on social media platforms like TikTok and Instagram will be covered also.

Training and mentoring of Health Workers and Cadres of Bengkulu City Health Center in Monitoring The Growth and Development of Toddlers with The SDIDTK Application

Monitoring children's growth and development is one of the basic programs implemented by Community health center (Puskesmas) to ensure a healthy life and improve children's welfare. The Bengkulu City Health Office identified limited human resources and a lack of supporting tools as inhibiting factors in achieving SDIDTK service targets. The service was carried out through training on Growth and Development Monitoring with the Android-based SDIDTK Application and field assistance. The training was held on July 24-25, 2024 with 36 participants consisting of 17 health workers, 17 cadres from 17 health centers, and 2 staff from the Family Welfare Division of the Bengkulu City Health Office at the Campus 4 Hall of Bengkulu University. The results of the pre and post-test of the training showed that 94% of participants increased their knowledge. The results of the assessment of skills in using the application showed that 100% of participants were able to do as directed. SDIDTK Kit assistance was delivered to 17 Puskesmas with the signing of the Minutes by the Head of Service implementer and staff of the Health Division of the Bengkulu City Health Office. Field assistance was carried out for 2 weeks after the training in 17 Puskesmas working areas.

The North Carolina Division of Mental Health's Strategic Plan for Limiting Substance Use Overdose Deaths.

The North Carolina Division of Mental Health, Developmental Disabilities, and Substance Use Services has implemented a strategic plan for limiting substance use overdose deaths, including increasing primary prevention and increasing public awareness of and access to evidence-based treatment options.

Peningkatan Kualitas Masyarakat dalam Pencegahan Stunting pada Ibu-Ibu dan Remaja Perempuan Gunung Pasang, Desa Suci

This community service activity aims to provide education on stunting and training on healthy food preparation for mothers in Gunung Pasang, Suci Village. The main objective of this activity is to enhance understanding and knowledge about stunting to break its cycle in Suci Village. The educational session was conducted on August 4, 2024, at the Gunung Pasang field, with 35 mothers and 10 teenage girls participating. The education included delivering materials related to stunting prevention. The results indicate a positive impact on the community, as evidenced by the increased knowledge of mothers and teenage girls, reflected in the pre-test and post-test results conducted by the health division of PPK Ormawa UKM-O Badminton. Similar counseling sessions are proposed to be held regularly to improve the quality of life of the residents, particularly the mothers and teenage girls

A 2-Day Postpartum CBT-Based Training for Nurses.

Public health nurses (PHNs) are often a first point of contact for postpartum individuals seeking mental health support, but report limited training related to mental health. To determine whether a two-day cognitive behavioral therapy (CBT)-based training program focused on postpartum maternal mental health can improve PHN perceptions of their ability to deliver CBT techniques, their confidence working with distressed clients, and with managing client resistance to treatment recommendations. A convenience sample of 45 PHNs working in the Family Health Division of Niagara Region Public Health in Ontario, Canada were assessed before and after they received a two-day CBT-based training program. Before attending training, PHNs reported their current professional position, years of experience working in public health, and any previous mental health training. Their confidence in delivering CBT techniques, working with distressed clients, and with managing client resistance to treatment recommendations was assessed pre- and post-training. Participants also rated their satisfaction with the training. Statistically significant improvements were seen in confidence using CBT techniques, and in supporting and managing distressed or resistant clients. The two-day training was highly rated overall by participants. Medium to large effect sizes were found for changes in confidence-related questions. Providing PHNs with brief CBT-based mental health-related training can increase their confidence in this aspect of their practice, and could potentially improve the quality of care they provide.

Assessment of Water Quality and its Risk to Human Health Posed by Drinking Water from Open Sources in Jammu and Kashmir

Globally, the quality of the water has been connected to health outcomes. This study assessed the community practices surrounding water collection and storage, the physicochemical and bacteriological quality of drinking water supplied by the public health division from the point of use to the source in Anatnag, and the risks to human health associated with water consumption. A water quality assessment was performed on one hundred samples. To find out how the community moves water from its source to its point of use and stores it, questionnaires were employed. The majority of the homes (73%) do not purify their water before consumption, and many of them reported frequent interruptions in the water supply. Although total coliform and E. coli were not found in the water samples taken at the reservoir's source, It was discovered that there was significant E. Col and total coliform contamination in the samples taken from the street taps and the domestic storage containers at the point of use. During the rainy season, higher levels of E. Coli and total coliform were found than during the dry season. The amounts of trace metals in the drinking water samples fell below the World Health Organization's and Indian Standards' acceptable limit. Drinking water through ingestion and cutaneous channels has noncarcinogenic effects that are assessed using hazard quotient toxicity potential and cumulative hazard index. These effects are less than unity, which suggests that there may not be a major non-carcinogenic health risk associated with water intake. sporadic disruptions to the water supply as well as specific methods of water storage and transit by residents of the community raise the possibility of contaminated water. We suggest that the province of Kashmir receive a more steady supply of treated water and that its citizens be instructed in hygienic methods for carrying and storing drinking water from the point of origin to the place of use

Strengthening Maternal and Infant Health Resilience Before Weather and Climate Disasters: Preparedness Resources from CDC's Division of Reproductive Health.

This report describes opportunities to address emergency preparedness to incorporate the needs of pregnant and postpartum populations. This report briefly summarizes data on the impacts of weather and climate disasters on maternal and infant health and outlines opportunities for individuals, health care providers, and public health practitioners to increase capacity to prepare for these occurrences, which are becoming more frequent and costly. Specific resources from the U.S. Centers for Disease Control and Prevention's Division of Reproductive Health are shared to support individual preparedness, communication of disaster safety messages, and emergency preparedness planning capacity among health care providers and health departments.

Improving Student Lifestyles through Health Quality Assurance

This paper describes the quality assurance of health in improving the healthy lifestyle of students in Islamic boarding schools, highlighting its impact on students' comfort in learning. The research was conducted at the Nurul Jadid Islamic Boarding School. The research employed a qualitative descriptive method with a case study approach. Data collection techniques included interviews, observation, and documentation. Informants comprised health sector consultants, health division coordinators, and students selected through purposive sampling. Data analysis followed the Milles and Huberman framework, involving data presentation, reduction, and conclusion. The results indicate that the quality of health services at Nurul Jadid is well-assured, evidenced by the numerous health service programs provided by the Health Division. This research is expected to offer contributions and benefits, including (1) an assessment of the extent to which Nurul Jadid Islamic Boarding School has improved student health, (2) evaluation materials for the health service coordinator, and (3) considerations on the importance of enhancing health services for students.

The impact of decentralization of health services at the municipal level on health outcomes: evidence from China.

Under the system of health decentralization, there are differences in the level of expenditure decentralization at different levels of government, and their impact on residents' health may also be different. This paper is one of the first to evaluate the effect of decentralization of health services at the municipal level from a multi-dimensional health perspective. This paper uses the data of expenditure decentralization of health services at the municipal level to match the panel data from the China Household Panel Survey (CFPS) from 2010 to 2018, and uses the logit model, ordered logit model and two-way fixed effects model to empirically analyze the impact of health decentralization at the municipal level on health outcomes. Based on the perspective of multi-dimensional health, from the three aspects of physical health, depression status and cognitive ability, the six sub-indicators of self-rated health, BMI standards, depression scores (summation method), depression scores (factor method), phrase test scores and mathematics test scores are discussed separately. The results show that the decentralization of health services at the municipal level has a significant promotion effect on the multi-dimensional health of residents. The decentralization of health services at the municipal level has important theoretical significance for promoting the reasonable division of medical and health powers and expenditure responsibilities between provincial and municipal governments, improving the efficiency of health expenditure funds, and establishing a fiscal system that matches financial resources.

Translation and cross-cultural adaptation of the Get Active Questionnaire for Pregnancy in Colombian Spanish.

To ensure safe, optimal, and personalized physical activity, exercise, or sport during pregnancy, the Canadian Society for Exercise Physiology, the Society of Obstetricians and Gynaecologists of Canada, the College of Family Physicians of Canada, and the Women's Health Division of the Canadian Physiotherapy Association, developed the Get Active Questionnaire for Pregnancy (GAQ_P) as a pre-assessment to identify women who may have a relative or absolute contraindication to prenatal exercise that requires further consultation with a health professional to determine if exercise can or should be continued or initiated during pregnancy. This study aims to translate and cross-culturally adapt the GAQ_P for use in Colombian Spanish. The original instrument was developed in English and French for the evaluation of the health of pregnant women before the beginning of physical activity and the guidelines for the same. Ten steps were followed according to the International Society for Pharmacoeconomics and Outcomes Research Translation and Cultural Adaptation guidelines, with the participation of four experts. The comprehensibility of the instrument was 99%, which shows a high percentage of intelligibility of the document. This article describes the translation and cross-cultural adaptation of the GAQ_P for use in Colombian Spanish, contributing positively to pre-exercise screening during pregnancy in Colombia.

30 years of youth system of care lessons learned – a qualitative study of Hawaiʻi’s partnership with the Substance Abuse and Mental Health Services Administration

BackgroundThe Hawaiʻi State Department of Health, Child and Adolescent Mental Health Division (CAMHD) has maintained a longstanding partnership with Substance Abuse and Mental Health Services Administration (SAMHSA) to enhance capacity and quality of community-based mental health services. The current study explored CAMHD’s history of SAMHSA system of care (SOC) awards and identified common themes, lessons learned, and recommendations for future funding.MethodsEmploying a two-phase qualitative approach, the study first conducted content analysis on seven final project reports, identifying themes and lessons learned based on SOC values and principles. Subsequently, interviews were conducted with 11 system leaders in grant projects and SOC award projects within the state. All data from project reports and interview transcripts were independently coded and analyzed using rapid qualitative analysis techniques.ResultsContent validation and interview coding unveiled two content themes, interagency collaboration and youth and family voice, as areas that required long-term and consistent efforts across multiple projects. In addition, two general process themes, connection and continuity, emerged as essential approaches to system improvement work. The first emphasizes the importance of fostering connections in family, community, and culture, as well as within workforce members and child-serving agencies. The second highlights the importance of nurturing continuity throughout the system, from interagency collaboration to individual treatment.ConclusionsThe study provides deeper understanding of system of care evaluations, offering guidance to enhance and innovate youth mental health systems. The findings suggest that aligning state policies with federal guidelines and implementing longer funding mechanisms may alleviate administrative burdens.

Epidemiological study of the occurrence of measles in children aged 0-15 years in the Banalia Health Zone (DR Congo) during 2022

Introduction: In 2021, the Banalia Health Zone experienced two measles epidemics with a vaccine completeness rate of 69% according to data provided by the Tshopo Provincial Health Division. The aim of the study was to list the epidemiological characteristics of measles cases in the Banalia Health Zone, to determine the incidence of measles in children aged 0-15 years, and to analyze the vaccination status of children with measles. Methodology: This was a retrospective descriptive study, based on the acquisition of data from the medical records of the targeted children or from data registers at the time of submission. A total of 3,968 children with measles were selected from the various health centers and areas of the Banalia Health Zone. Results: We observed that 64.6% of the subjects in the study were aged between 0 and 5 years; 40.77% of measles cases were recorded in September 2022. The measles vaccination rate was 39.19% and the case fatality rate was 2.8%. The Panga 2 axis had the highest number of measles cases, with a prevalence rate of 29.03%. Conclusion: Measles is a major cause of morbidity and mortality in the Banalia Health Zone. The age group most affected is 0-5 years. Vaccination and surveillance systems need to be strengthened to reduce the growing risk posed by measles.

Can hospitalists improve COVID-19 vaccination rates?

Three years after the start of the SARS-CoV-2 virus (COVID-19) pandemic, its effects continue to affect society and COVID-19 vaccination campaigns continue to be a topic of controversy and inconsistent...

Vitamin D Deficiency as a Risk Factor of Tinnitus: An Epidemiological Study.

Vitamin D deficiency as a risk factor of tinnitus has not been well known. We tried to evaluate the association between the serum 25-(OH) vitamin D levels and tinnitus among the Korean population to propose the possible role of serum vitamin D in patients with tinnitus. This cross-sectional study investigated the potential risk factors of tinnitus in relation to serum 25(OH)D levels within the Korean population. It encompassed a health interview, nutrition assessment, and a health examination. Data was sourced from the KNHANES V (2010-2012), conducted by the Division of Health and Nutritional Survey under the Korean Centers for Disease Control and Prevention (KCDCP). Participants were chosen from various sampling units categorized by geography, gender, and age group. The selection was facilitated through household registries using a stratified, multistage, clustered probability sampling approach. Data of 16 408 subjects were collected in this study. There were significant differences in gender, economic status, educational level, and sun exposure duration between the tinnitus and non-tinnitus groups. Serum 25(OH) vitamin D level between hearing loss and normal hearing was also significantly different. The logistic regression models with serum 25(OH) vitamin D quartile and tinnitus as the dependent variable, which were controlled for age, sex, smoking status, BMI, diabetes, hypertension, sun exposure, regular exercise, income, and education, eventually demonstrated that serum vitamin D deficiency and low sun exposure duration significantly increased the risk of tinnitus development. This study demonstrated a significant association between serum vitamin D levels and tinnitus, driven by large epidemiological data. The results of our study provide baseline data for further research to investigate the role of vitamin D in the pathogenesis and management of tinnitus.

Consumers’ perception of piped water supply and their willingness to pay for improved water supply: evidence from an Eastern Indian state

ABSTRACT The objectives of the study are to analyse the perception of consumers on piped water supply, the consumers’ willingness to pay for improved water supply, and the factors that affect it. The sample unit is the consumer household of the public health divisions. The sample size is 181. A multistage random sampling procedure was adopted to choose the sample household. Descriptive statistics and structural equation models are used to analyse the data. This study found that consumer satisfaction is influenced by water supply quantity, pressure, timing, and visual aspects. The main factors causing interruptions include pipeline breakage, cyclone impact, summer water depletion, construction work, motor damage, and reservoir cleaning. Households are not well-informed about advance payment, its benefits, and the proper procedure for obtaining a receipt. Household income, education, satisfaction with water quality, the period of the service association, supply water price, and sufficiency of water during summer directly affect consumers’ willingness to pay. Discontent with appearance and taste affects quality dissatisfaction and indirectly willingness to pay.

Lower Limb Paralysis Associated with Chikungunya in Kinshasa, the Democratic Republic of the Congo: Survey Report.

Polio-associated paralysis is one of the diseases under national surveillance in the Democratic Republic of the Congo (DRC). Although it has become relatively rare due to control measures, non-polio paralysis cases are still reported and constitute a real problem, especially for etiological diagnosis, which is necessary for better management and response. From September 2022 to April 2023, we investigated acute flaccid paralysis (AFP) cases in Kinshasa following an alert from the Provincial Division of Health. All suspected cases and their close contacts were investigated and sampled. Among the 57 sampled patients, 21 (36.8%) were suspects, and 36 (63.2%) were contacts. We performed several etiological tests available in the laboratory, targeting viruses, including Poliovirus, Influenza virus, SARS-CoV-2, Enterovirus, and arboviruses. No virus material was detected, but the serological test (ELISA) detected antibodies against Chikungunya Virus, i.e., 47.4% (27/57) for IgM and 22.8% (13/57) for IgG. Among suspected cases, we detected 33.3% (7/21) with anti-Chikungunya IgM and 14.3% (3/21) of anti-Chikungunya IgG. These results highlight the importance of enhancing the epidemiological surveillance of Chikungunya.

HEALTH COMMUNICATION STRATEGY FOR ENDING OPEN DEFECATION IN A RIVERSIDE COMMUNITY: A CASE STUDY IN MALANG DISTRICT, INDONESIA

Objective: Goal 6.2 of the SDGs emphasizes the importance of safe sanitation and ending open defecation in promoting health and well-being. This study analyzes health communication strategies for ending open defecation (OD) in a riverside community and identifies communication elements impeding the outcome.
 
 Methodology:. Using a qualitative approach, the data were collected through a forum group discussion (FGD), in-depth interviews, and observations. Fourteen people attended the FGD, including village government leaders, community and religious leaders, health cadres, people with OD habits, a midwife. Eight people were interviewed, including the head of the primary health center, the head of the environmental health division at Malang District Health Office, village government leaders, community and religious leaders, a sanitarian, and people with OD habits.
 
 Findings: The triggering method was combined with a customized communication strategy to promote OD behavior change. The study identifies challenges to achieving promotion objectives, such as villagers' distrust of some assisting team members due to a lack of training or workshops, the 'no subsidy' messages were ineffective because the local government granted latrine for the poor before, the use of face-to-face communication as a sole channel was found ineffective due to unreliable sources and a large number of participants, there is no regulation to sustain behavioral change.
 
 Suggestions: This study recommends training or workshops for community members who serve as the triggering team, encouraging self-built latrines through a financing plan and latrine models tailored to villagers' capabilities and preferences, combining face-to-face communication with villagers' preferred media, and issuing a regulation governing penalties for offenders.

Mobile resonance frequency breathing smartphone application to support recovery among people with opioid use disorder: Study protocol for feasibility study.

Experiencing drug cravings is an aspect of substance use disorders that frequently compromises the recovery efforts of people who use drugs. Most treatment approaches that address drug cravings either involve cognitive strategies or medication. Few interventions directly address the physiological aspects of craving, such as increased heart rate. Previous research has demonstrated that slow-paced breathing may be effective in managing drug cravings by manipulating an individual's heart rate. The purpose of this paper is to describe a study protocol for an intervention that offers resonance frequency breathing training for managing cravings via a smartphone application (app). This trial is registered in ClinicalTrials.gov (Identifier: NCT05830773). The intervention focuses on persons in recovery from opioid use disorder who receive services from the Texas Health and Human Service Commission Recovery Support Services division. Participants will be trained to use Camera Heart Rate Variability (CHRV), a resonance frequency breathing app. The CHRV app measures heart rate and the volumetric variations of blood circulation. When experiencing stress, anxiety, or cravings, participants will use the app to practice breathing exercises. Participants (N = 60) will also complete surveys at baseline, 4 weeks, and 8 weeks; the survey questions, covers demographic characteristics, personal trauma history, substance use experience, and utilization of substance use treatment services. The surveys will also include psychosocial measures of craving, stress, and anxiety to allow the study team to assess changes between baseline and study completion. Participants who complete the full 8-week intervention will be invited to participate in a 30-minute interview about their experience with the app. Interviews will provide details on implementation outcomes, including acceptability, appropriateness, and feasibility. Many evidence-based interventions for opioid use require interpersonal communication with individuals in one's recovery network. However, individuals may be unable to engage others in their recovery network in the moments when they are experiencing cravings or stress- and anxiety-related triggers. Therefore, recovery support interventions that emphasize individual self-management of cravings, stress, and anxiety when they occur can empower individuals in recovery and enhance existing interventions.

Multidisciplinary atopic dermatitis program: A novel approach to managing difficult-to-control atopic dermatitis patients.

Disease improvement for difficult-to-control pediatric atopic dermatitis may be more challenging to achieve when directed by single specialties due to disjointed and conflicting dialogue with patients. The Multidisciplinary Atopic Dermatitis Program (MADP) was developed through collaborations with the Rady Children's Hospital and UC San Diego Health Divisions of Dermatology, Allergy & Immunology and Clinical Pharmacy, to create team-based evaluation and management of children and adolescents with atopic dermatitis (AD). The MADP allows concurrent, comprehensive evaluations by multiple specialists to develop treatment plans. The program includes extensive patient education to support shared decision making, incorporating patient and family's perspectives along with those of clinical experts into their care. Objective severity measures and patient reported outcome data were collected, along with assessment of patient and family satisfaction with the MADP. Data showed significant improvement in AD severity as assessed by providers, patients and families by the first follow-up visit. BSA mean percentage decreased by up to 56% by the 7th visit, and pruritus (NRS), CLDQI and POEM mean scores decreased by more than 4 points, 12 points, and over 11 points, respectively. After management was initiated in the MADP, 72.73% of patients achieved an EASI 50 and 47.73% achieved an EASI 75 from a baseline mean of 21.7. Patients who continued in clinic beyond the second visit showed further clinically significant decreases in disease measures. The multidisciplinary approach shows success in the treatment of difficult-to-control AD patients with improvements in clinician and patient reported outcome measures.