Good Health Research Articles

Factors associated with oral health care behavior of people with type 2 diabetes mellitus: A hospital-based, cross-sectional study.

Oral healthcare behavior determines oral health status and the incidence of oral diseases. People with type 2 diabetes mellitus (T2DM) are at-risk of having low oral healthcare behavior and disease-related oral health. To investigate the oral health status and factors associated with oral healthcare behavior among people with T2DM in Thailand. In total, 401 people with T2DM participated in the study based on their attendance at a non-communicable disease clinic at sub-district health promotion hospitals in Bueng Kan, a north-eastern province in Thailand. A structured questionnaire was used to obtain variables of interest. Linear regression analysis at the 95% confidence interval (CI) was applied. The majority of participants were female (73.8%). More than three-quarters had more than 20 permanent teeth (77.6%), a decay missing filling tooth index was 10.6 teeth/person. Many participants had four permanent occlusal pairs (69.6%), had tooth decay (74.6%), and some participants had tooth filling (32.2%). Statistically significant factors associated with oral healthcare behavior were: having complications associated with diabetes mellitus (Beta = -0.097, 95%CI = -1.653, -0.046), oral health literacy (Beta = 0.119, 95%CI = 0.009, 0.150), educational level (Beta = 0.123, 95%CI = 0.103, 0.949), oral healthcare attitude (Beta = 0.258, 95%CI = 0.143, 0.333), and oral health services (Beta = 0.430, 95%CI = 0.298, 1.408). People with T2DM had good oral health status. People with T2DM with low oral health literacy, low attitude, and low level of oral health services were at a higher risk of poor oral healthcare behavior.

Geographical accessibility of medical resources, health status, and demand of integrated care for older people: a cross-sectional survey from Western China

BackgroundThe World Health Organization (WHO) published the Integrated Care for Older People (ICOPE) framework to help healthcare providers cope with the population aging crisis. However, the relevant evidence on the demands of older people and the compensatory capacity of the environment is limited. This study reports for the first time the level of the ICOPE demand in Western China that includes the impact of geographic accessibility of medical resources (GAMR) on ICOPE demand and the potential mechanism of health status.MethodsA cross-sectional questionnaire survey was conducted among 1200 adults aged 60 years and older selected through multi-stage stratified cluster sampling to obtain relevant data, including ICOPE demand, health status, and GAMR. Propensity score matching (PSM) was used to analyze the impact of GAMR on ICOPE demand among older people and those with different health statuses.ResultsAmong the prospective research participants, 1043 were eligible for the study. The mean score of ICOPE demand among all participants was 3.68 (standard deviation [SD] = 0.78). After adjusting for covariates between high and low GAMR groups (1:1 match), ICOPE demand was significantly higher in the low GAMR group than in the high GAMR group (average treatment effect on the treated [ATT] = 0.270, p < 0.05). For both good and poor self-rated health status, the ICOPE demand of the low GAMR group was significantly higher than that in the high GAMR group (ATT = 0.345, p < 0.05; ATT = 0.190, p < 0.05). For chronic diseases, the ICOPE demand of older people with multimorbidity in the low GAMR group was significantly higher than that in the high GAMR group (ATT = 0.318, p < 0.01).ConclusionsThe older population in Western China has a relatively high demand for ICOPE. Low GAMR is a key factor in ICOPE demand growth in this region. It accelerates demand release for both older people with multimorbidity and self-perceptions of health.

A qualitative study of coping strategies and resilience in the aftermath of childhood adversity in first-episode psychosis.

Exposure to adversity during childhood is associated with elevated risk for commonly occurring forms of psychopathology, especially psychotic disorders. Despite the noteworthy consequences associated with adverse childhood experiences, an inconsistent and unpredictable number of at-risk populations present with remarkably good physical and mental health outcomes that can be attributed to resilience. This study aimed to qualitatively explore the experience of childhood adverse events and coping strategies employed by individuals that promote resilience and better mental health outcomes. Fourteen individuals with a history of childhood adversity were recruited to participate using a case-study approach. A semi-structured interview guide was developed based on empirical evidence and theoretical background, and the interviews were analysed using a reflexive thematic approach. Our findings showed that the type of adversity impacted the experience of trauma, for example, the death of a caregiver versus emotional abuse or witnessing violence at home. Five coping strategies were identified (social support, religious coping, problem or emotion-focused coping, and meaning-making), with healthy controls found to identify and use these resources more than the psychosis group to promote individual well-being and better mental health outcomes. Our findings provide insights into experiences in the aftermath of childhood adversity, emphasising the need to assess the history of trauma systematically. They further underscore the importance of mental health prevention programmes bolstering individual-level coping strategies and the resources available within our environments to help them manage adversity, improve overall outcomes, and promote resilience.

What Does It Mean to 'Age Well' Among British and Javanese Older Adults? A Cross-Cultural Qualitative Study.

This study aimed to investigate perceptions of what it means to 'age well' and to explore similarities and differences between a Western and non-Western culture (Britain and Java). Qualitative interviews explored how Javanese and British older adults defined ageing well, establishing the similarities and differences between cultures. Javanese (n=14) and British (n=15) adults aged 61-80 (mean age=68) participated. The data were analysed using reflexive thematic analysis and organized with NVivo. Four themes were identified which captured what it means to age well across cultures: 1) good health is a springboard for ageing well; 2) holding a positive outlook is a decisive factor in ageing well; 3) "having enough" and "feeling safe" provide peace of mind; and 4) spirituality and religiosity provide tranquillity. Although both cultures mentioned similar factors, there were variations in the interpretations and emphasis within themes. For example, Javanese participants emphasized the importance of the social environment while British participants highlighted the physical environment. Differences between cultures are important for understanding how best to support people as they age. For example, in Java, ageing well may be best supported by providing a vibrant social environment. For people in Britain, having a safe and secure physical environment may be more important.

ADAPTATION MECHANISMS ARE USED BY THE BODY OF STUDENTS FOR RECOVERY AFTER PHYSICAL EXERTION

The study of the morphofunctional features of the body's adaptation to constantly changing living conditions is considered one of the most important problems of biology and medicine today. The effectiveness of adaptive processes in the body is the primary basis of good health and high productivity. Therefore, the resolution of the unexplained issues of this problem is important for the prevention and treatment of diseases, the search for effective rehabilitation measures. Knowledge of the laws of adaptation of the human body (athlete) to physical exertion is an objective prerequisite for the effective use of physical exercises in the rationalization of physical training aimed at preserving and strengthening people's health, increasing their work capacity, and implementing a genetically programmed longevity program. The defining function of muscle activity is the function of active adaptation of the body to constantly changing environmental conditions. The ultimate goal of this active adjustment is to maintain internal constancy environment, expanding the homeostatic limits of individual physiological constants, ensuring highly productive activity. The most effective means of adaptive change of a person's own nature is systematic physical training. High perfection of mechanisms of neurohumoral regulation functions; optimization of inter-system and intra-system connections; high development of self-regulation in the activity of functional systems. There is a direct relationship between the power of work and the perfection of mechanisms of regulation of functions: the more intensively the body functions under conditions of physical exertion, the greater the tension of regulatory systems; the more perfectly function regulation systems function, the body will be able to develop greater work capacity [1].

Theoretical and practical approaches to improving the physical training of participants in the educational process

Introduction. Future specialists must possess not only excellent knowledge of the chosen specialty, but also be well physically prepared, understand the role of physical culture in human development, possess practical skills and abilities that ensure good health and good working capacity. The goal is to reveal the main methodological principles and means of ensuring the optimal level of physical training of students. Research results. The problem of improving the physical training of students is highlighted, the relevance of this problem at the current stage is indicated. The goal is outlined, which consists in substantiating the main methodological principles and means of ensuring the optimal level of physical training of participants in the educational process. It is noted that the effectiveness of many types of future professional activity depends significantly on physical training, which is aimed at developing and maintaining the mental and physical qualities of an individual at an optimal level. The need not only for the formation of physical readiness of future specialists, but also for improving their health and working capacity has become acute. The structure of physical training is revealed, in particular its three blocks: physical education, student sports and active leisure. The content of the classes is characterized, in particular, sets of exercises of the introductory, main and final parts of the training class are given. Conclusions. Physical training is primarily aimed at developing and maintaining the mental and physical qualities of the individual at an optimal level, strengthening health and increasing work capacity.

Self-reported oral health attitudes and behavior of dentistry students

Objectives: Dentistry students in the Philippines undergo 6 years of undergraduate dental education as their foundation to acquire the skills necessary to prevent, diagnose, and treat oral diseases, and educate their future patients. One of the learning outcomes of the entire course is to make them effective role models in the maintenance and improvement of their patient’s oral health. Throughout their undergraduate years, oral health attitudes and behaviors are formed and may be modified. This study aimed to compare 4th-year preclinical and 5th-year clinical dentistry students in terms of their oral health attitudes and behavior. Materials and Methods: The research employed a descriptive cross-sectional research design. Purposive sampling was done using the Hiroshima University-dental behavioral Inventory (HU-DBI) questionnaire. The questionnaire contains 20 questions, which focus on oral health attitudes and behavior, with a dichotomous response format of “Agree” or “Disagree,” giving one point in favor of good oral health attitudes and behavior for a maximum score of 12. Data was collected via an online survey using Google Forms shared in the appropriate year levels’ official social groups. Higher mean scores indicate good oral health attitudes and behavior. The HU-DBI scores of the two groups were compared using the Mann–Whitney U-test. Results: A total of 225 dentistry students in a Philippine private dental college answered the survey, with 119 responses from the 4th year (41% response rate) and 106 responses from the 5th year (77% response rate). The overall mean score of answers favoring good oral hygiene was marginally higher in 4th-year preclinical students (M = 7.17, Standard deviation [SD] = 1.37) than in 5th-year clinical students (M = 7.15, SD = 1.24) but showed no statistical significance in their difference, z = −0.412, P = 0.681. Conclusion: There is no significant difference in the oral health attitudes and behavior between the 4th-year preclinical students and 5th-year clinical dental students. Future researchers can look into increasing the sample size and having respondents from other dental universities to provide a wider picture at a national level. Reinforcing oral health education for clinical students may be beneficial.

Health through the eyes of youths: a qualitative study

BackgroundEmerging definitions of health have suggested a shift in focus to one’s ability to manage their health condition, function, and social determinants of health. The construct of health for youths with mental health and substance use disorders (MHSU) is complex and multi-dimensional with interplay between biological, behavioral, and social conditions. Expanding definitions of health is crucial in the measurement of health and evaluation of integrated youth services (IYS) systems for people with MHSU disorders. Hence, it is critical to understand the construct of health from the perspective of a young person living with a MHSU disorder.MethodsThis study was conducted using inductive thematic analysis. Three focus groups were conducted from July to August 2017.ResultsA total of 22 youths (17–24 years) took part in this study. Results showed that health is a multidimensional construct situated in the ecosystem of a person’s environment. Health can be understood from two macro themes: Individual health and Determinants of health. It consisted of physical health, mental health, day-to-day functioning, and being in control of your own health condition. Systemic and social factors were factors that influenced the state of health.ConclusionThis study contributes to a conceptualization of good health in youth with MHSU disorders. This conceptualization can aid in the development of more accurate measures of health and functioning and the evaluation of mental health services for youth with MHSU.

CARDIOVASCULAR CONSIDERATIONS IN ANTIDEPRESSANT THERAPY: SINUS ARREST DUE TO SERTRALINE

Abstract A 39–year–old Caucasian woman with a silent cardiac anamnesis and no family history of cardiovascular diseases, and a history of mood disorder treated with Sertraline for about 1 month, went to the Emergency Department reporting several syncopal episode, all with rapid and complete recovery of consciousness. In the Emergency Department, another syncopal episode occurred in the supine position, characterized by sinus bradycardia evolving into a brief asystole, with spontaneous restoration of normal sinus rhythm. Admitted to the Cardiovascular Intensive Care Unit, the patient showed no abnormalities in laboratory testsas well as in echocardiography results. The patient received appropriate hydration, and home medication was discontinued. A non–contrast head CT scan showed no acute lesions. Cardiac MR revealed normal morpho–functional findings, with no evidence of myocardial edema or pericardial effusion and no pathological late gadolinium enhancement areas. Brain MRI demonstrated normal anatomical and functional findings, with no signal abnormalities. Considering the patient‘s young age and the suspicion of an iatrogenic origin of the rhythm disorder, the decision to postpone pacemaker implantation was made, and cardiac electrical activity was monitored using a loop recorder. At the one–month follow–up, the patient, who had been off Sertraline since admission, was in good health, reporting no further syncopal or pre–syncopal episodes. Loop recorder monitoring revealed no significant arrhythmias. The only relevant anamnestic data was the use of Sertraline, and the application of the Adverse Drug Reaction Probability Scale suggests that the iatrogenic origin of this event as a pharmacological adverse effect is at least probable (score: 7). Limited literature connects Sertraline directly to documented cases of asystole, but reports indicate that drugs in the same pharmacological class may induce cardiac rhythm disturbances, including tachyarrhythmias and bradyarrhythmias. This case draws attention to sinus arrest during sertraline therapy and how an appropriate pharmacological washout led to the resolution of the pathology.

DOUBLE ST–ELEVATION, DOUBLE OCCLUSION?

Abstract Case Presentation A 71–year–old woman was referred to our outpatient clinic for two episodes of chest pain during last two days. Her past medical history was remarkable for arterial hypertension, obesity, diabetes mellitus type 2 treated by oral hypoglycaemic agents complicated by diabetic maculopathy. Diagnostic Work–Up At the presentation, the patient was symptomathic for chest pain, hemodynamically stable. The ECG showed synus rhythm, left–axis deviation, Q wave and ST–elevation from V2 to V5 and in DIII and ST–elevation in DII and aVF (FIGURE 1). Transthoracic echocardiography revealed concentric hypertrophy, mildly reduced LV ejection fraction (EF 45%) with akinesia of intreventricular septum and apex, without severe valvulopathies and no pericardial effusion. Given the clinical data the patient was addressed to urgent coronary angiography that showed LAD occlusion at the end of his proximal tract and right coronary artery occlusion at the beggining of his second tract (FIGURE 2); furthermore omo and etero–coronaric collaterals for right coronary artery area were detected. By using a workhorse guidewire flow was restored in both coronary arteries and PTCA was performed with 3 DES on LAD and other 2 DES on right coronary artery (FIGURE 3). The patient was transferred to our coronaric intensive unit care after the procedure; no complications were noticed during the hospitalization. A week after the patient was discharged in good general health. Conclusion Multiple simultaneous coronary occlusions are reported in literature, yet the accurate incidence and physiopathology of this occurrence is still uncertain. Probably the symphathetic system activation caused by first coronary occlusion could promote an increased basal platelets activation and then the second coronary occlusion. Our case shows that during coronary angiography identifying a culprit lesion may be delicate and cardiologists should be prepared to manage multiple coronary occlusions.

CARDIOVASCULAR TOXICITY IN METASTATIC PROSTATE CANCER TREATMENT: BALANCING RISKS, TREATING CONSEQUENCES

Abstract Introduction Enzalutamide inhibits the receptor of androgen hormones. It is administered for treating metastasized prostate cancer. Enzalutamide is known to have a cardiotoxic effect. Case Report A 76 year–old man on–treatment for hypertension and overall good health underwent radical prostatectomy and bilateral ileo–obturator lymphadenectomy in 2021 for prostate cancer. In July 2023, infiltrated lymph node and lung/bone metastases were identified. Therefore, oncologist started Enzalutamide administration, i.e. Androgen Deprivation Therapy. Ecocardiography before therapy showed no alterations in cardiac morphology with normal left ventricle ejection fraction (LVEF). Three months after Enzalutamide administration, he experienced worsening dyspnea and peripheral lower extremity edema. He was admitted to the emergency Department of our hospital due to worsening dyspnea at rest, diffuse crackles and increased values in brain natriuretic peptide (BNP, 3203 pg/mL) and troponins. He was transferred to Intensive Care Unit for acute heart failure. Instrumental findings: 2D ECHOCARDIOGRAPHY: LVEF ∼20%, marked global hypocontractility at strain evaluation (GLS –9.3%); LUNG ULTRASOUND: abundant bilateral basal pleural effusion on the right extending to the middle field with atelectasis of the contiguous parenchyma; 24h Holter ECG: frequent supraventricular and ventricular ectopic arrhythmias. He begins non–invasive ventilation (NIV), high–dose diuretics, and Levosimendan. We observed amelioration in symptoms, reduction in pleural effusion, peripheral edema, and BNP levels (from 3203 pg/ml to 468.6 pg/ml). We proceed with weaning from NIV by monitoring respiratory function and performance by means of blood gas analysis. Amelioration in congestion status was evaluated by bioimpedance. After clinical stabilization, coronary angiography was performed which highlighted a bi–vessel obstructive coronary artery disease (long critical stenosis, ∼80%, on the proximal–middle section of the left anterior descending artery, ∼70% at middle section of circumflex and proximal section of first margianl). Therefore, revascularization by PCI plus DES was performed on proximal–middle LAD and on CX–MO1. Patient was discharged soon after in stable condition and underwent outpatient follow–up. Conclusions Enzalutamide might provoke important cardiotoxic effects. It might induce acute cardiac impairment and/or coronary artery diseases. Further analysis and evaluations should be performed.

A LABILE EQUILIBRIUM: THE CONTROVERSIAL ROLE OF BETA–BLOCKERS IN A CASE OF MID–VENTRICULAR TAKOTSUBO SYNDROME

Abstract Case Report Takotsubo syndrome (TTS) is a non–ischemic heart disease mimicking acute coronary syndrome. The mid–ventricular variant is almost rare (15% of TTS cases). A 62 years old woman was referred to our hospital for oppressive chest pain radiating to the jaw lasting at least 30 minutes after an attempted strangulation by a family member. She denied any conventional cardiovascular risk factor; she was taking beta–blockers (BB) to reduce symptomatic and idiopathic premature ventricular complexes (PVCs) burden. On arrival, the patient was hemodynamically stable, reporting only swallowing difficulties. Physical examination revealed neck bruising and irregular pulse. The initial ECG showed sinus rhythm with a heart rate of 62 bpm, PVCs and a biphasic T wave in lead aVL. Hs–cTnI first dosage was 145 pg/mL. Transthoracic echocardiography (TTE) found moderate left ventricular (LV) dysfunction and severe hypokinesis of mid septal and mid inferior segments. Coronary angiography revealed normal coronary arteries. Left ventriculogram showed hypokinesis of the midventricular section with a hyperdynamic base and apex suggestive of mid–ventricular variant of TTS. After a few hours, she experienced a lipothymic episode and telemetry showed marked sinus bradycardia followed by multiple sinus pauses. A TTE was immediately performed, demonstrating a worsening LV ejection fraction with new development of severe symmetrical akinesia of the LV apex. Successively, psychotherapy was started. Wall motion abnormalities and LV systolic function completely recovered over a few days. At present the patient is in good health status. Discussion domestic violence against women is prevalent, but it is often omitted as a potential stress trigger that affects their hearts. In Italy, it’s reported that 32% of women had experienced physical violence. Strangulation is very uncommon as cause of TTS and psychotherapy may prevent recurrences and recover in a shorter time. Bradycardia due to atrioventricular block and asystole has been described in the acute phase of TTS and it is often attributed to BB therapy. Although BB have been proposed to add further benefit of blunting the effect of catecholamine excess, their use should be used cautiously in the acute phase of TTS. Moreover, beta–adrenoceptor hypersensitivity may generate a parasympathetic drive when on BB infusion, provoking a worsening LV dysfunction and a transient sick sinus syndrome as we described.

Playing online videogames—more than just entertainment? A qualitative study of virtual social participation in persons with spinal cord injury

IntroductionSpinal cord injury (SCI) affects many aspects of life, physically, emotionally and socially. Engaging in online videogames holds the potential to facilitate increased social interactions for individuals with SCI. The aim of this study is to increase our understanding of the experiences people with SCI have with using online videogames as an arena for social participation.MethodsA focus group interview was conducted with seven participants with SCI, aged 15–35, all experienced in using online videogames as a method of socializing. The data was analyzed using thematic analysis.ResultsThe participants highlighted that playing online videogames way of maintaining social connections and expanding their social network. However, they faced challenges due to limited knowledge and negative attitudes from others regarding use of videogames as a social arena. Three main themes were developed from the findings: “Disabling social barriers”, “Attitudes towards gaming” and “Gaming—connecting people”.ConclusionHealthcare professionals should consider videogames as a leisure activity and facilitate their use, recognizing their potential for social interaction and well-being. Prioritizing activities that promote social interaction is crucial for good health.

Bridging the evidence-to-practice gap: exploring dental professionals' perspectives on managing oral health during pregnancy in Tasmania, Australia.

Poor oral health is associated with adverse health, social and economic consequences for pregnant women. While dental professionals promote good oral health within the dental practice context, more broadly, women in the antenatal period face poor oral health outcomes. Therefore, this study explored dental professionals' perceptions of their role in managing the oral health of pregnant women and identified the barriers and facilitators to improving maternal oral health. This study employed a descriptive qualitative method utilizing semi-structured interviews. Convenience and snowball sampling were used to recruit 13 dental professionals from Tasmania, Australia, comprising dentists (n = 10), oral health therapists (n = 2) and dental therapist (n = 1). Interviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis. Three major themes were constructed from the interviews: (1) dental professionals' oral health care of women during pregnancy; (2) perceived challenges to maternal oral health; and (3) proposed strategies to improve maternal oral health. Findings suggest dental professionals' competence in maternal oral health, but that several barriers, such as dental care access and maternal factors, hinder oral health outcomes. To address these barriers, oral health policies that support interprofessional collaboration, professional training and evaluation of existing community oral health programmes are needed. © 2024 Australian Dental Association.

Effect of pulsed electric field processing on the quality characteristics and enzyme activity of tender coconut water.

Tender coconut water (TCW) is a natural drink rich in natural electrolytes, minerals, salts and sugars; it has good health benefits. But, its shelf-life is very limited because of the active nature of enzymes present in it when exposed to air. Therefore, the processing of TCW is necessary to inactivate the enzymes. So, this study aims to observe the effect of various process parameters of pulsed electric field (PEF) on the quality parameters of TCW. For the treatment of TCW with PEF, a full-factorial design of experiments was followed with process parameters such as three levels of electric field intensity (8, 12, and 16 kV/cm), two levels of pulse width (PW) (50 and 70 μs), and six levels of the number of pulses (2000 to 12,000 pulses) were considered at a constant pulse OFF time of 75 ms. PEF treatment did not significantly change pH, total soluble solids, and viscosity. However, it significantly affected vitamin C, colour, and total and reducing sugars. PEF treatment significantly enhanced the total phenolic content and antioxidant activity by 23.17% and 42.49%, respectively. At the same time, significant inactivation of polyphenol oxidase (100%) and peroxidase (60.2%) was observed at PEF treatment conditions of 16 kV/cm, 70 μs PW, and 12,000 pulses. Moreover, no significant change in the sensory acceptability of PEF-treated TCW (16 kV/cm, 70 μs PW, 12,000 pulses) when compared to the untreated/fresh TCW, which is a promising sign.

Pine needle gasification-based electricity production: Understanding the effect of supply chain.

Pine needles (pine tree leaves), found abundantly across continents such as North America, Asia, Europe, South America, Africa, and parts of the Southern Hemisphere, are a significant global concern due to their high susceptibility to catching fire, especially in dry and hot climates. The same issue persists in the Uttarakhand state of India, which boasts ample pine forests, yielding a substantial 1.67 × 109kg of pine needles annually. In the present study, the annual potential emissions from forest fires in Uttarakhand were estimated to be 58.37 × 109kg of CO2 equivalent. Therefore, the present research aims to unlock pine needles' potential via gasification for green electricity and biochar production, offering an alternative to coal-based plants while reducing forest fire frequencies. Nevertheless, obstacles hindering pine needle gasification include an unsteady supply chain, limited collection windows (100days), and plant expenses, including transportation and operational costs. The primary focus of the research is to design and assess the performance of a gasification-based supply chain for pine needles in the Almora District of Uttarakhand. Ten plant capacity scenarios were considered, ranging from 25 to 250kW. The study incorporated critical factors, encompassing diverse losses within the supply chain, selecting potential plant sites, minimizing transportation distance, and evaluating the supply chain's economic and environmental performance. The economic analysis revealed that the 250-kW plant scenario exhibited a minimum discounted payback period (DPP) of 3.93years, alongside an internal rate of return (IRR) of 19% and a net present value (NPV) of 653.32 million INR without government subsidies. With subsidies included, the DPP decreased to 1.30years, improving the IRR to 69% with an NPV of 916.17 million INR. The emission analysis indicated that gasification plant capacity scenarios could potentially reduce 44.63 × 106 to 46.16 × 106kg of CO2 equivalent emissions annually compared to grid electricity while meeting nearly 5.5% of the electricity demand of Almora district. The present study aligns with SDG-7 (Affordable and Clean Energy), SDG-13 (Climate Action), SDG-9 (Industry, Innovation, and Infrastructure), SDG-11 (Sustainable Cities and Communities), SDG-3 (Good Health and Well-being), and SDG-15 (Life on Land).

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Consumers’ receptivity to mHealth technologies: a hybrid PLS–ANN approach

PurposeMobile health (mHealth) technologies, in particular, have been sought after and advocated as a means of dealing with the pandemic situation. Despite the obvious advantages of mHealth, which include monitoring and exchanging health information via mobile applications, mHealth adoption has yet to take off exponentially. Expanding on the unified theory of acceptance and use of technology (UTAUT) model, this study aims to better comprehend consumers’ receptivity to mHealth even after the pandemic has subsided.Design/methodology/approachThrough purposive sampling, data were collected from a sample of 345 mobile phone users and analysed using partial least squares structural equation modelling (PLS-SEM) and artificial neural networks (ANN) capture both linear and nonlinear relationships.FindingsEffort expectancy, performance expectancy, social influence, pandemic fear and trustworthiness positively influenced mHealth adoption intention, with the model demonstrating high predictive power from both the PLSpredict and ANN assessments.Research limitations/implicationsThe importance–performance map analysis (IPMA) results showed that social influence had great importance for mHealth uptake, but demonstrated low performance.Practical implicationsReferrals are an alternative that policymakers and mHealth service providers should think about to increase uptake. Overall, this study provides theoretical and practical insights that contribute to the advancement of digital healthcare, aligning with the pursuit of Sustainable Development Goal 3 (SDG 3) (good health and well-being).Originality/valueThis study has clarified both linear and nonlinear relationships among the factors influencing intentions to adopt mHealth. The findings from both PLS and ANN were juxtaposed, demonstrating consistent findings.

Where do GPs seek help for their illnesses?

Doctors generally enjoy good health, but often refrain from seeking help when they are ill. Self-treatment is widespread, and this can be an inappropriate and risky practice. This is a registry study that compares GPs' own use of the primary and specialist health services in 2018 with a control group consisting of all others in the same age group with the same sex, level of education and health as the GPs. Morbidity in both groups was surveyed with the aid of two validated morbidity indexes in the period 2015-17. Only those who scored zero on both indexes were included. While only 21.7% of the GPs had sought help from a GP and 3.3% had attended the emergency department, the corresponding figures for the control group were 61.6% and 11.8%. Of the GPs, 17.5% consulted a contract specialist, compared to 15.5% of the control group. Measured as a proportion of all specialist consultations, consultations with a psychiatrist constituted 35% for GPs and 13% for others. There were small differences in the use of somatic outpatient clinics (25.9% of GPs and 25.7% of the control group) and acute admission in somatic hospitals (3.8% of GPs and 3.3% of the control group). This study indicates that GPs receive medical assistance from other than their own GP.

Planning Policies and Public Health in Kurdistan Region of Iraq (KRI) and Its Policies to Combat COVID-19 in Duhok City

Purpose: The Kurdistan region of Iraq had been affect by the covid pandemic like the rest of the part in the world and Duhok city specifically faced several problems as the city and health policy were not ready to ace the crises. It had a negative impact on the sustainability of health sector specifically the economic side. This study tries to identify the problems to achieve tan appropriate standard of good health among Kurdistan's general population, especially in the city of Duhok, to ensure more equitable access to health services throughout the country's social and geographic expansion, take into account poverty and to strive to get better treatment, understand the condition of the city of Duhok via COVID-19, and how the government deals with the medical system in this condition, protect and encourage the right to health care for individuals and create equality in the health care system for both genders, beliefs and positions. Methodology: Through conducting the qualitative research approach by using two types for collecting data ( Data Collection Methods) which are primary data and secondary data, primary data for collecting direct information from patients and IDPs and refugees to know their health conditions and whether they are satisfied or not for public health system, physicians as well to know their treatment to patients, and secondary data to gather information from health directorate in Duhok city, camp health administration and humanitarian health organizations to understand better the situation. Findings: The findings of the study indicates that the pandemic struck at a time when public faith in the government was low, the economy was damaged by lower oil sales income, protests were common across the country, and violent extremist acts were on the rise. COVID-19 has worsened long-standing and sometimes deep-seated political, economic, social, and security issues. The COVID-19 pandemic has resulted in a dramatic loss of human life around the world, posing an unprecedented challenge to public health, food systems, and the workplace. The pandemic's economic and social impact is devastating: tens of millions of people are at risk of falling into extreme poverty, while the number of undernourished people is currently estimated to be nearly 690 million, By the end of the year, the number could have risen to 132 million. Unique Contribution to Theory, Practice and Policy: Food security, public health, and employment and labor issues, particularly worker health and safety, all intersect during the COVID-19 crisis. However, in Azadi hospital we cannot talk to people because of virus, the risk of contracting COVID-19 via an infected person's feces appears to be low. The COVID-19 virus may cause intestinal infection and be found in feces, according to some data.