Enhance Health Status Research Articles

Integrating health and social care in Brazil

Abstract Integrating health and social care is now a high priority for public health policy in high-income countries. It has received much less attention in low and middle-income country (LMIC) settings. There is particular value in assessing the potential to integrate care services for older adults, given the speed of population ageing in LMICs. The presentation provides findings of process and impact evaluations of novel local government initiatives to integrate care for older people in Brazil (drawing on a study co-funded by the UK MRC and CONFAP Brazil). Programa Maior Cuidado (PMC) was established in the Brazilian city of Belo Horizonte in 2011. It is jointly managed by the departments of health and of social assistance and involves close community-level collaboration between health posts and neighbourhood social service centres. A key element of PMC is the provision of paid trained lay carers to support family care for dependent older people in socially vulnerable families. We will present findings on the implementation process and operation of PMC, as well as its effects on the following outcomes of interest: reduced unnecessary hospitalisations, enhanced health status for older people and reduced care burden for family carers. Quasi-experimental analysis using spatial-based Propensity Score Matching shows promising results in terms of increasing planned attentions as well as access to rehabilitation services, which confirms the ability of the Program to improve interface with health services avoiding unplanned unnecessary attentions We will examine the implementation of similar interventions in other Brazilian cities, including Fortaleza and Contagem, and will study the role of national and international processes in dissemination, knowledge sharing and agenda-setting. Key messages The presentation provides findings of process and impact evaluations of novel local government initiatives to integrate care for older people in Brazil. Programme under evaluation lead to interesting outcomes of interest: reduced unnecessary hospitalisations, enhanced health status for older people and reduced care burden for family carers.

ANALISIS FAKTOR SANITASI KAPAL TERHADAP TANDA─TANDA KEBERADAAN TIKUS (Studi pada Kapal Penumpang yang Bersandar di Pelabuhan Kalianget 2019)

Ship sanitation is one of the efforts shown on environmental risk factors in shipbuilding to decide the chain of disease transmission to maintain and enhance health status. This research was conducted to see the relationship between ship sanitation and signs of existence of mice on passenger ships that lean in Kalianget Port in 2019This type of research is descriptive by using a cross sectional approach. The sample in the research was in the form of 4 passenger ships. Data collection through assessment with forms. Vessel sanitation assessment uses a pH meter, Luxmeter, and Hygrometer tool. The instrument used is a vessel sanitation inspection form and examination of signs of the presence of mice on board. The results of this study indicate that ship sanitation with signs of the presence of mice on board a passenger who has no connectionBased on the obstacles faced during the collection of vessel sanitation data and signs of the presence of rats because of the weather during the rainy season so that many ships are not operating. Suggestions that can be given from this study include the existence of research on ship sanitation implementation on signs of the presence of rats on passenger ships that lean. Keywords: Ship Sanitation, Signs of Rat Existence

Immune response and onset of protection from Bovine viral diarrhea virus 2 infection induced by modified-live virus vaccination concurrent with injectable trace minerals administration in newly received beef calves

Strategies to improve the onset of protective immunity induced by vaccination against respiratory pathogens may have a significant impact on health of newly received beef calves. The objective was to determine if the use of injectable trace minerals (ITM; Se, Zn, Cu, and Mn) concurrent with a modified-live virus (MLV) vaccine enhances the immune response and onset of protection in beef calves challenged with BVDV2 five days after vaccination. Forty-five calves were randomly assigned to one of three groups (15/group): VAC + ITM, received MLV-vaccine and ITM (Multimin®90) subcutaneously (SC); VAC + SAL, received the same vaccine and saline SC; or UNVAC, unvaccinated. Five days after vaccination (d.0), calves were challenged with BVDV2 strain 890. Health status was evaluated and blood samples were collected for leukocyte counts, BVDV1 and 2 serum neutralizing antibodies (SNA), BVDV-PCR, and percentage of CD4+, CD8+, WC1+ and CD25+ T-cells. VAC + ITM had lower health scores than UNVAC (d.8 and 9). VAC + ITM had higher BVDV1 & 2 SNA titers than VAC + SAL and UNVAC on d.21 and 28. Lymphocyte counts decreased in UNVAC but not in VAC + ITM or VAC + SAL (d.3 to 11). CD4+ T-cells significantly decreased in UNVAC and VAC + SAL (d.3). VAC + ITM had higher percentage of CD4+ T-cells than UNVAC (d.3 and 7). VAC + ITM had lower percentage of activated CD4+ and CD8+ T-cells than UNVAC (d.7). In summary, vaccination induced a rapid protection against BVDV2 infection. Administration of ITM was associated with increased SNA response to BVDV1 & 2, enhanced health status, mitigation of CD4+ T-cells decrease, and reduction of T-cell activation in calves challenged with BVDV2 five days after immunization. These results support the strategic use of ITM concurrent with vaccination, especially when a rapid protection is needed in newly received beef calves.

Universal Health Coverage for ASEAN: Is it possible?

Geography, society, economic development, and health outcomes vary much among theAssociation of Southeast Asian Nations (ASEAN). The health systems, structure and servicesvary considerably. As a consequence, the develpment for a Universal Health Coverage (UHC)in these countries also diverges. The objective of this article is to study the development towardthe UHC in ASEAN countries and the barriers that hinder the progress. Online and manualsearch methods were used to gather the information and ‘snowball’ further data. It is foundthat, in general, ASEAN countries have made good progress toward UHC. However, there aremajor barriers to all the countries in achieving UHC, namely 1) financial restrictions; 2) supplyside limitations: and 3) the increasing problems of non-communicable diseases, continuinginfectious diseases, and recurrence of potentially pandemic infectious illnesses. Whereas theminor obstacles are the divergence of 1) language; and 2) cultures. The ASEAN EconomicCommunity’s (AEC) aim of regional economic incorporation and a single market by 2015grants both prospects and tasks for UHC. Healthcare services have become more accessiblebut health and healthcare inequities will likely go downhill as better-off citizens of membercountries might have more benefits from the liberalization of trade plan in health. ASEAN hasnoteworthy prospective to become a power for better health in the region. It is hoped that allASEAN populations can enjoy greater health and safety standards, complete social security,and enhanced health status.

Impact of Health-Promoting Lifestyle Education Intervention on Health-Promoting Behaviors and Health Status of Postmenopausal Women: A Quasi-Experimental Study from Sri Lanka.

Health promotion through lifestyle education is an important measure to enhance health status of postmenopausal women (PMW). This study evaluated the effectiveness of health-promoting lifestyle education intervention (HPLEI) on adhering to health-promoting behaviors (HPB) and enhancing the health status in a group of Sri Lankan PMW. A quasi-experimental study was conducted with randomly selected, sociodemographic status matched, 72 PMW from two geographically separated areas in Galle District, Sri Lanka, allocated as experimental (n = 37, 54.6 ± 4.5 years) and control (n = 35, 56.5 ± 3.4 years) groups. Education intervention focused on postmenopausal health management including lifestyle modifications was performed only for the experimental group during 8 weeks, and a health education package was provided. The control group was not given any planned education programme. Both groups were followed up for a 6-month period. HPB and menopausal symptoms severity were evaluated by validated Health Promoting Lifestyle Profile-II and Menopause Rating Scale, respectively. Anthropometric adiposity indices (AAIs) including weight, body mass index (BMI), waist (WC) and hip (HC) circumferences, and waist to hip ratio (WHR); cardiovascular disease risk indicators (CVDRI) including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), total cholesterol and triglycerides, muscle strength; hand grip strength (HGS) and physical performance (PP); gait speed (GS) were measured. All parameters were evaluated before the intervention (baseline) and after follow-up of 6 months. All evaluated parameters were not different between experimental and control groups (p > 0.05) at the baseline. In the follow-up evaluation, HPB (p < 0.001), menopausal symptom scores (p < 0.001), AAI (p < 0.001), CVDRI (SBP, DBP, and FBS) (p < 0.05) and HGS and GS (p < 0.001) were significantly improved in the experimental group but not in the control group. Health education intervention focused on health-promoting lifestyle modifications is effective in improving the adherence to HPB and enhances the health status in PMW. This provides positive impact in lifestyle medicine.

Participation in the Gyeongsangbuk-do Health Saemaeul Program and Health Behavior Improvement Effect

Objectives The purpose of this study was to determine association between participation degree and any changes in health behaviors in the Gyeongsangbuk-do Health Saemaeul Program, a community-based health promotion project. Methods The study used surveys of the Gyeongsangbuk-do Health Saemaeul Program, in 2016, 2018 and data from KOSIS. Results The multi-level linear regression analysis was completed with a total health behavior improvement score based on the six types of health behavior changes. People with temporal participation showed a higher total health behavior improvement score than the non-participants. Females showed a higher total health behavior improvement score than males and people with any chronic diseases showed a higher total health behavior improvement score than those without. None of the community-related variables showed any statistical significances. The results of the stratified analysis according to individual and community-related variables revealed that a group with the following community-related characteristics were more likely to have a higher total health behavior improvement score according to the participation degree; (1) a higher proportion of vulnerable subjects, (2) a higher financial self-reliance, and (3) a higher participation degree with willingness. No statistical significance was revealed with the individual characteristics. Conclusions In order to enhance health status of its residents in a community-level, designing an integrated health promotion program in considering the community characteristics would be more effective. In order to improve the quality of the Gyeongsangbuk-do Saemaeul Health Program and to expand its effects, an establishment of strategic plans is required at the level of selecting the target community. Key words: Participation of resident, Health behaviors, Health village, Health Saemaeul Program

Putative impacts of phytogenic additives to ameliorate lead toxicity in animal feed.

Lead (Pb) is a toxic heavy metal and an environmental pollutant, particularly because of its anthropogenic activity. The main impacts of Pb is recognized to cause injurious influences of various levels of the tropic chain, due to bio-accumulated lead causes many health issues such as intoxication of different body organs, such as kidneys and liver, and reproductive and nervous systems. Industrial lead toxicity has reduced as a result of the attempts to decrease the lead levels in the surrounding work environment. Conversably, health risks related with long-term environmental exposure to a low dose of Pb have been steadily demonstrated. Long-term exposure to lead toxicity caused inflammatory infiltration, degenerative changes in testicular tissues, reduction in spermatocytes, necrosis of hepatocytes, degeneration in renal tubules, and renal epithelium hypertrophy. Hence, we need an influential approach to vanquish lead toxicity. This consequence has emerged the necessity for potentially safe represent remedy, favorably keeping both enhancement and chelating of the antioxidant competences. Many antioxidants have been used for chelating heavy toxic pollutants such as lead and oxidative stress released in excess during lead exposure. Several studies have stated the noticeable gathering of herbal singly or in combination in modulating lead-induced disturbances, therefore proposing great promise in enhancing health status and welfare of man as well as animals. For this, in the current review, we tried to discuss the enormous harmful influences of lead toxicity on the animal model and the disturbing truth that this detrimental toxic substance can be found quite simply in the surroundings and amplitude.

The Eco-Social Trauma Intervention Model.

We describe a transdisciplinary theory of change for interventions to promote trauma recovery that utilizes an eco-social approach to enhance health status and well-being following trauma exposures. This four-level theory of change could be applied to other population health problems, as well. This theory-development process included reviewing existing literature, identifying assumptions, defining core concepts, stating propositions, depicting concepts and propositions for clarity, and illustrating with case examples grounded in our focus on trauma. The resulting Eco-Social Trauma Intervention Model offers a framework for interventions that address the impact of trauma on the individual level through self-regulation, interpersonal level through relationships, community/organizational level through safety, and societal level through identities. Application of this model to intervention development for those affected by trauma is intended to promote resilience, recovery, posttraumatic growth, and positive adaptations to traumatic stress for populations, going beyond the current Western paradigm of treating individuals for psychopathology. The Eco-Social Trauma Intervention Model offers an adaptable transdisciplinary framework for developing and researching scalable trauma interventions for individuals, communities, and populations.

Factors predicting the health status of caregivers of stroke survivors: A cross-sectional study.

In this cross-sectional study, we aimed to determine factors influencing the health status of caregivers of stroke survivors. A total of 126 caregivers of stroke survivors were recruited from three outpatient clinics in Thai Nguyen National General Hospital, Vietnam, from November 2016 to March 2017. Data were collected through six instruments: a demographic questionnaire, the Modified Barthel Index, the Zarit Burden Interview Scale, the Multidimensional Scale of Perceived Social Support, the Family Caregiver Conflict Scale, and the Short Form-36 Health Survey. Stepwise multiple regression was employed to analyze the data. Caregiver burden, patient's functional status, caregiver's age, and social support together explained 80.3% of the variations in health status of caregivers of stroke survivors. Caregiver burden was the strongest predictor of health status of these caregivers. Based on the findings, nurses should take caregiver's age, functional status of stroke survivors, caregiver burden, and social support into consideration when preparing family caregivers to provide care for stroke survivors. To reduce perceived caregiver burden, family support interventions should be embraced to enhance health status of the caregivers of stroke survivors.

Populations with Higher Average Intelligence Are Healthier, but Do They Smoke Fewer Cigarettes?

Societies with high intelligence quotient (IQ) practice healthier lifestyles, which results in enhanced health status and higher life expectancy. This paper attempts to examine the impact of national average IQ on level of cigarette consumption at a cross-country level. Since smoking is detrimental for human health and causes about ten percent of the total number of deaths every year worldwide, this research is deemed important. Regression analysis with robust standard errors was employed to scrutinize the effect of national IQ on cigarette consumption. After controlling for demographic factors, IQ was found to have significantly positive associations with all measures of cigarette consumption. Unlike the control variables, the positive effect of IQ on smoking was found to be robust to spatial dependence. Nevertheless, the positive effect gradually reduced as the IQ level increased. The proposed explanation is that cigarette smoking is an evolutionarily novel activity that did not previously exist in human ancestral environments. Therefore, as the IQ level rises, societies initially are more likely to appreciate and adopt the novel behavior of smoking. In high-IQ societies, the positive relationship eventually weakens as people become more aware of the health hazards of smoking.

Health Promotion at Workplace: Enhancing health status of workforce

The term “Health Promotion at Workplace” is a multidimensional concept that embraces at least two major philosophies about what health is and how it is influenced. The first philosophy sees health as largely the product of individual behaviour and as an individual responsibility. It may acknowledge the role of genetics and environment to some degree, but the type of health promotion arising from this set of beliefs focuses on individual behaviour. Consequently, the workplace is seen primarily as a venue through which various programmes can be delivered. Examples of programme areas are: fitness, stress management, smoking cessation, back care, weight reduction/nutrition, and medication. The second philosophy sees health as being influenced by a number of forces, a significant number of which are outside the individual’s control. Consequently, the workplace is seen as an influence on health in its own right.

Does Structural Social Capital Enhance Health Status? An Empirical Analysis of 60 Countries

Does Structural Social Capital Enhance Health Status? An Empirical Analysis of 60 Countries

Risks and Benefits of Food Additives - Review

Food additives are substances of natural or synthetic origin, which are added to foods to serve a certain technological or sensory function, for example, to counter food perishability and bacterial degradation, give or restore color or impart flavor to foods.These additives generally provide some type of benefit for the food producer, processor or consumer. For example: acids that may be added to prevent the growth of microorganisms that cause spoilage may also prevent the growth of microorganisms that can cause foodborne illness. Some additives are directly added to food and ingredients, while others are added indirectly through contact with packaging materials as are, for example the preservatives BHA and BHT on the inside of breakfast cereal bags.The benefit of some food additives is enhancing health status or prevents disease; most benefits reflect economic considerations for food processors and sensory attributes and convenience for consumer.

Factors Associated with Perceived Health Status of the Vietnamese Older People

This study, using data from the Vietnam Aging Survey (VNAS) in 2011 with 2789 persons aged from 60 to 108, explored the factors associated with the perceived health status of the Vietnamese older people. Using logistic regression analysis, the study found that there were no statistically significant differences between older people in their perceived health status in terms of age group, gender, marital status, and living area. In contrast, however, the study also found that reading ability, working status, morbidity, activities in daily living, experience of domestic violence, household income, and satisfaction with housing conditions were strongly correlated with older people’s perceived health status. Based on these findings, the study provided a set of recommendations for developing and implementing policies in order to enhance health status of the Vietnamese older people.

Effectiveness of Lafiska exercise on risk of fall, balance, and health status in the elderly

This study aims to investigate the effectiveness of Latihan Fisik Lansia "elderly physical exercise" on the balance status, risk of fall, and health status of institutionalized older adults. A quasi-experimental design was applied measuring pre-test and post-test outcomes in a control group to determine the effectiveness of the intervention in the interventional group. Eighty participants from Panti Sosial Tresna Werdha Budi Mulia 1 Cipayung were divided into an inter-ventional group with 39 older adults (70.3 ± 8.13 years) and a control group with 41 older adults (69.88 ± 8.71 years). Trained facilitators guided the exercise during 16 sessions over eight weeks, each having duration of 50 min, with a small group consisting of 10-12 participants. This study used Morse Fall Scale to measure risk of fall, Berg Balance Scale to measure balance status, and SF-12 to measure health status. Lafiska had an impact on lowering risk of fall, enhancing balance status, and enhancing health status (P value <.0001). Lafiska is a viable exercise option for older adults with independent mobility, as well as older adults with assistive devices.

Responsiveness and MCID Estimates for CAT, CCQ, and HADS in Patients With COPD Undergoing Pulmonary Rehabilitation: A Prospective Analysis

ObjectivesPulmonary rehabilitation enhances health status and mood status in patients with chronic obstructive pulmonary disease (COPD). The aim was to determine the responsiveness of St. George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), COPD Clinical Questionnaire (CCQ), and Hospital Anxiety and Depression Scale (HADS) to pulmonary rehabilitation in patients with COPD, and estimate minimum clinically important differences (MCIDs) for CAT, CCQ, and HADS. DesignA prospective analysis. MCIDs were estimated with anchor-based (anchor: SGRQ) and distribution-based methods. Newly estimated MCIDs were compared to known MCID estimates from a systematic literature search. SettingNewly estimated MCIDs were calculated in patients treated in pulmonary rehabilitation. ParticipantsA subsample of 419 individuals with COPD (55.4% male, mean age 64.3 ± 8.8 years) were included from the Chance study. MeasurementsHealth status was measured with SGRQ, CAT, and CCQ, before and after pulmonary rehabilitation. Mood status was assessed using HADS. Results419 patients with COPD (forced expiratory volume in the first second 37.3% ± 12.1% predicted) completed pulmonary rehabilitation. SGRQ (−9.1 ± 14.0 points), CAT (−3.0 ± 6.8 points), CCQ (−0.6 ± 0.9 points), HADS-Anxiety (−1.7 ± 3.7 points), and HADS-Depression (−2.1 ± 3.7 points) improved significantly. New MCIDs were estimated for CAT (range: −3.8 to −1.0 points), CCQ (range: −0.8 to −0.2 points), HADS-Anxiety (range: −2.0 to −1.1 points), and HADS-Depression (range: −1.8 to −1.4 points). ConclusionsThe SGRQ, CAT, CCQ, and HADS are responsive to pulmonary rehabilitation in patients with COPD. We propose MCID estimates ranging between −3.0 and −2.0 points for CAT; −0.5 and −0.3 points for CCQ, −1.8 and −1.3 points for HADS-Anxiety, and −1.7 and −1.5 points for HADS-Depression.

Organic trace mineral supplementation enhances local and systemic innate immune responses and modulates oxidative stress in broiler chickens

The effect of organic trace mineral supplementation on performance, intestinal morphology, immune organ weights (bursa of Fabricius and spleen), expression of innate immune response related genes, blood heterophils/lymphocytes ratio, chemical metabolic panel, natural antibodies (IgG), and oxidative stress of broiler chickens was studied. A total of 1,080 day-old male broilers were assigned to 1 of 3 dietary treatments, which included basal diet with Monensin (control), control diet supplemented with bacitracin methylene disalicylate (BMD), and BMD diet supplemented with organic trace minerals (OTM). No difference in feed conversion ratio was observed among treatments; ileum histomorphological analysis showed a lower crypt depth, higher villi height/crypt depth ratio, and lower villi width in the OTM treatment compared to control. Furthermore, OTM treatment resulted in higher uric acid and lower plasma malondehaldehyde (MDA), indicating lower oxidative stress. Gene expression analysis showed that OTM treatment resulted in up-regulations of TLR2 bin the ileum, and TLR2b, TLR4, and IL-12p35 in the bursa of Fabricius, and down-regulation of TLR2b and TLR4 in the cecal tonsils. In the spleen, OTM treatment resulted in up-regulation of IL-10. In conclusion, OTM supplementation to broiler diets may have beneficial effects on intestinal development, immune system status, and survival by improving ileum histomorphological parameters, modulation of Toll-like receptors and anti-inflammatory cytokines, and decreasing level of MDA, which in conjunction could enhance health status.

Examining Associations between Health Information Seeking Behavior and Adult Education Status in the U.S.: An Analysis of the 2012 PIAAC Data.

This paper presents data from the Program for the International Assessment of Adult Competencies with a focus on the interrelationships among health information seeking behavior (HISB), and health status or use of preventive health measures for U.S. adults both with and without a high school diploma. Key results of ordinal and binary logistic regression analyses indicated that, after controlling for demographic factors, (1) adults with a high school diploma use more text-based health information sources while adults without a high school diploma use more oral sources, (2) using the Internet as a source of health information is more strongly related to reporting excellent/very good health status than having a high school diploma, (3) those without a high school diploma who use the Internet report the largest increase in health status over any other health information source, and (4) for those with learning disability or vision problem, a high facility in reading English is an important predictor of whether the Internet is used as a health information source. The Internet appears to play a key role in both enhancing health status and enabling use of preventive measures for those with and without a high school diploma; although, individuals without a high school diploma who use the Internet for health information derive substantial benefit in health status.

Factors Affecting Activities of Daily Living, Depression and Life Satisfaction among Aged Women

Purpose: The purpose of this study was to identify the impact of activities of daily living, instrumental activities of daily living and depression on life satisfaction among aged women. Methods: The sample consisted of 309 aged women of over 60. Data were analyzed using t-test, ANOVA, Pearson correlation coefficient and multiple regression analysis. Results: Significant factors affecting the life satisfaction were spouse, religion, perceived health status, age, and depression. The most significant variables among them were depression and perceived health status. The explanatory power on life satisfaction was 57% in regression model. Conclusion: Depression and perceived health status are important variables to influence on life satisfaction. Therefore, it is suggested that nursing intervention to reduce or prevent depression and enhance health status should be developed to promote quality of life in aged women.

P2P-based u-health cluster service model for silver generation in PBR platform

As the number of the silver generation increases, u-health service has evolved into more preventive services accessible in any type of service environment based on service platforms from the previous treatment and management-oriented services for specific diseases. U-health service used to solely provide remote diagnosis and counseling or biometrics monitoring, facing limitations in preventing or managing potential chronic disease cases. In this recognition, the research seeks to propose a P2P-based u-health cluster service model for silver generation in PBR(Personal Bio Record) platform. The proposed u-health service herein utilizes PCs and smart phones to provide health, dietary and exercise information regardless of time and space. Based on the PBR platform, the system effectively connects the EMR system and users’ service systems in order to understand service targets’ lifestyle patterns and offer further customized services. This u-health cluster service model is expected to realize useful services to user in a multi-platform environment and contribute to enhanced health status of senior patients with chronic disease.