Health Package Research Articles

Patterns of Infertility and Sociodemographic Characteristics among Patients with Infertility Attending Benjamin Mkapa Hospital in Tanzania: Analytical Cross-Sectional Study

(1) Background: Infertility is a global health problem that affects one of six couples worldwide, leading to significant negative impacts on their quality of life. Despite numerous studies on infertility patterns and sociodemographic characteristics, there remains a lack of clarity on these aspects among patients seeking care in Tanzania. (2) Methods: This hospital-based analytical cross-sectional study aimed to determine infertility patterns and sociodemographic characteristics among 385 randomly selected male and female patients attending the Benjamin Mkapa Hospital. Structured interviews using a clinical proforma collected data on the patterns of infertility and sociodemographic characteristics of the participants. The analysis included descriptive statistics and logistic regression. (3) Results: The findings indicated that the dominant pattern of infertility for both male and female participants was secondary infertility, accounting for 59.00% (228). Multivariate logistic regression analysis for both male and female patients revealed sociodemographic characteristics of infertility: age (38–43) years, AOR 5.068, 95% CI 1.573–16.33, p = 0.007), and duration of cohabiting or marriage of more than 10 years (AOR 0.406,95% CI 0.189–0.873, p = 0.021). (4) Conclusion: Integrating reproductive health education on appropriate fertility age into the reproductive health package and enhancing fertility care in public hospitals in Tanzania is recommended.

Factors influencing perceptions of processed baby foods and feeding practices among Indian mothers: a qualitative investigation

ObjectiveTo explore how professionally qualified, working Indian mothers conceptualize healthy foods in general, perceive processed infant and baby foods available commercially and what feeding practices they actually follow with their children at home.DesignFive focus groups with 8–12 participants were conducted around the participants’ conceptualization of healthy food, their perceptions about commercially available processed baby and infant foods and their actual feeding practices that they routinely follow with their children. Discussion transcripts were analyzed using an inductive coding approach.SettingIndia.ParticipantsFifty-one professionally qualified, working women with at least one child under 5 years of age.ResultsParticipants agreed that fresh food is healthiest. They also had favorable opinions about processed infant and baby foods with regards to healthfulness, hygiene and safety. Healthy foods were largely conceptualized in relation to nutrient claims, ingredients and discernible health outcomes. They use cues, such as health claims, brand, price, package design and others to determine healthfulness of the product. Perception was heavily influenced by these extrinsic cues rather than by participants’ own nutrition knowledge. Despite having the knowledge, most participants admitted to using these foods on account of factors such as their own inability to lactate, social pressure, lack of time and convenience.ConclusionsMost educated and well off people continue to use these products. While they rue the lack of stringent regulatory measures in India, they feel there is an urgent need to address this huge policy gap by way of legislation and regulation.

Oral health approach in universal health coverage

ObjectiveThis study aimed to map how oral health is addressed within the universal health coverage (UHC).MethodsThis scoping review followed the Joanna Briggs Institute methodology. Searches included the WHO Library and PubMed, Scopus, Embase, LILACS, and Cochrane databases. Quantitative and qualitative studies were included without publication date and language restrictions.ResultsA total of 486 studies were retrieved, of which 292 were excluded in the title and abstract screening phase; 121 full-texts were assessed. After the removal of duplicates and unavailable documents, 50 studies were included in the review and categorized according to the level of scientific evidence.ConclusionFew studies discussed oral health within the UHC, mostly because this coverage does not include oral health adequately. When offered, oral health packages are limited and include specific populations. Access and use of oral health services remain guided by economic factors, exposing the theoretical financial protectionism that perpetuates health inequalities.

The effectiveness of the WHO school mental health package in promoting mental health literacy among secondary school teachers in Qatar: a randomized controlled trial

Teachers’ mental health literacy (MHL) is fundamental for recognizing and assisting students with mental disorders. The aim of this study was to assess the effectiveness of the World Health Organization School Mental Health Program (WHO-SMHP) in promoting MHL among secondary schools’ teachers in Qatar. We conducted a two-arm randomized control trial. Teachers working in governmental secondary schools were eligible for selection. A total of 16 schools (8 intervention, 8 control) randomly selected and stratified by gender then randomly assigned (1:1). Participants and study team were aware of group assignment. Assessment of teachers’ MHL was at day 0, 3 then 3 months afterward. Bivariat analysis and Generalized Estimating Equations were used in analysis. The primary outcome was teachers MHL. Secondary outcome was the influence of sociodemographic characteristics on the level of MHL. Between October 30, 2018 and March 21, 2019, we randomly assigned 195 teachers from 16 schools to attend training workshop on WHO-SMHP (n = 95) or usual practice (n = 100). Compared with controls, teachers from intervention group demonstrated a significant improvement in the level of MHL at day three (mean difference = 19.1, 95% CI = 17.0–21.2, Cohen’s d = 2.63; p < 0.001).) and after three months (mean difference 16.61, 95% CI = 13.96–19.26, Cohen’s d = 1.86; p < 001). There were no significant differences related to influence of other variables on MHL. To our knowledge, this is the first trial to prove the effectiveness of the (WHO-SMHP) in promoting teachers MHL, which can be successfully implemented in a wider scale.

The use of community-oriented primary care (COPC) model to generate vaccine demand: The case of a remote fishing community in Cameroon

BackgroundCameroon, a country in sub-Saharan Africa, ranks among the top 15 countries worldwide with the highest number of zero-dose (unvaccinated) children. Among other reasons, pockets of hard-to-reach communities that traditionally miss essential healthcare services, including childhood immunization, largely contribute to this sub-optimal vaccination coverage. This is the case of Manoka Health District (MHD), an archipelago district with a zero-dose proportion of 91.7%. High disease burdens such as malaria and water-borne diseases have forced the population to depend on herbalists and roadside drug vendors, eroding trust in the primary healthcare system and worsening vaccine hesitancy. This study, therefore, aims to describe how a project optimized vaccine demand generation in these hard-to-reach settlements using an integrated community health worker service delivery package developed using the Community-oriented primary healthcare (COPC) model. MethodologyThis cross-sectional descriptive study was based on data collected from November 2021 to August 2022 in three project-implementing health areas (Kombo Moukoko, Kooh, and Toube) in the Manoka health district. Data was collected on the integrated health packages offered by Community Health Workers (CHWs). It comprised health education on malaria and water-borne diseases, screening for malaria using Rapid Diagnostic Test (RDT), treatment of under-5 for uncomplicated malaria and diarrhea, conduct of essential Antenatal Care (ANC) services, and vaccination counseling and referral in the three health areas. Microsoft Excel 2013 was used to analyze descriptive data and expressed results as percentages, with tables and column charts used for data visualization. All missing data were considered in the final analysis. ResultsOver 550 under-5 children and 187 pregnant women were identified to be in need of curative and preventive care services during the project period. About 81% of pregnant women received a minimum ANC package by CHWs, and 47% adhered to referrals to health facilities for continuous ANC and delivery. Half of the children under 5 with health issues were diagnosed and managed for uncomplicated malaria. Also, during home visits, 617 under-immunized and zero-dose children less than two years of age were identified, referred, and vaccinated either during an outreach program or at the nearest health post in a neighboring health area, representing about 64% (617/964) of under-2 children identified in these communities. There was a gradual increase from 0% vaccine acceptance post-referral in the first month to 47% after six months and 64% at one year of intervention. ConclusionThe use of the COPC model to co-develop integrated essential health service packages that meet the needs of communities showed value in building trust and increasing childhood immunization uptake in hard-to-reach communities.

Health technology assessment for sexual reproductive health and rights benefits package design in sub-Saharan Africa: A scoping review of evidence-informed deliberative processes

Background Health technology assessment uses a multidisciplinary approach to support health benefits package design towards universal health coverage. The evidence-informed deliberative process framework has been used alongside Health technology assessment to enhance stakeholder participation and deliberations in health benefits package design. Applying the evidence-informed deliberative framework for Health assessment could support the morally diverse sexual reproductive health and rights (SRHR) benefits package design process. However, evidence on participation and deliberations for stakeholders in health technology assessment for SRHR benefits package design has not been curated in sub-Saharan Africa. This study synthesises literature to fill this gap. Methods This scoping review applies the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews, and deductive analysis following the evidence-informed deliberative processes framework. The search strategy uses the Guttmacher–Lancet Commission-proposed comprehensive definition of SRHR and the World Health Organisation’s universal health coverage compendium of SRHR interventions to generate search terms. Six databases and biographical hand searches were used to identify studies in Sub-Saharan Africa from 1994. Results A total of 14 studies met the inclusion criteria. Evidence for yearly public budgets and explicit SRHR health technology assessment processes was not found. In 12 of the studies reviewed, new advisory committees were set up specifically for health technology assessment for SRHR priority-setting and benefits package design. In all decision-making processes reviewed, the committee member roles, participation and deliberations processes, and stakeholder veto powers were not clearly defined. Patients, the public, and producers of health technology were often excluded in the health technology assessment for the SRHR benefits package design. Most health technology assessment processes identified at least one decision-making criterion but failed to use this in their selection and appraisal stages for SRHR benefits design. The identification, selection, and scoping stages in health technology assessment for SRHR were non-existent in most studies. In 11 of the 14 processes of the included studies, stakeholders were dissatisfied with the health policy recommendation from the appraisal process in health technology assessment. Perceived benefits for evidence-informed deliberative processes included increased stakeholder engagement and fairness in decision-making. Conclusion To support the integration of diverse social values in health technology assessment for fairer SRHR benefits package design, evidence from this review suggests the need to institutionalise health technology assessment, establish prioritisation decision criteria, involve all relevant stakeholders, and standardise the process and assessment methodological approaches.

Utilization of 12 health packages extended under Ayushman Arogya Mandir in block Marh, Jammu, Jammu and Kashmir

BackgroundThe establishment of the Ayushman Arogya Mandir marks a fundamental change in India's approach to healthcare. The present study aimed to examine the effectiveness and shortcomings of health packages extended through the Ayushman Arogya Mandir in Block Marh, Jammu, Jammu and Kashmir identifying areas for improvement, and addressing barriers to optimal utilization. MethodsThis cross-sectional study was done among 10 centres in the Marh block of Jammu, Jammu and Kashmir to achieve the desired objectives using structured and self-administered questionnaires. A convenience sampling of 105 participants, including 55 healthcare professionals and 50 community members, was adopted using time-bound enumeration. Checklists were also included to assess healthcare services, ensuring a thorough understanding of how healthcare packages are administered and implemented. Confidentiality was prioritized and ethical considerations guided the data collection process, allowing for a comprehensive examination of healthcare utilization patterns in the target region. ResultsThe results revealed that reproductive and family planning services, as well as neonatal/infant healthcare, have high utilization rates (95 % and 78 %, respectively), highlighting their significance, whereas lower rates in elderly/palliative care, psychiatric/neurological/substance use disorder care, and eye/ENT treatments indicate potential areas for improvement in healthcare awareness, access, and service provision barriers. ConclusionThe Ayushman Arogya Mandir in Block Marh, Jammu, Jammu and Kashmir are heavily leaning towards maternal and child health initiatives while other services are underutilised, highlighting the need for targeted awareness of the availability and accessibility to these services.

Development of Oral Healthcare Plan for Children with Congenital Anomalies

Background: Children having birth defects denote a high-risk group for oral diseases compared to their healthy counterpart. Untreated dental caries significantly accounts for the oral disease burden of children with birth defects. A preventive oral health and restorative dental care package with close follow up could offer much benefit for such children and this poster provides some baseline information in this regard.Objective: To describe an oral health care package offered to high caries risk children with birth defects at a multi-specialty, tertiary care, and premier public dental hospital setting in Sri Lanka.Methods: A Sample of 79 children with birth defects who visited the Preventive Oral Health Unit of the National Dental Hospital (Teaching) Sri Lanka from 1st January 2017 to 29th April 2019 were included in the present analysis, by extracting data from unit’s data base. The level of corporation of a child for oral health care was assessed by child’s compliance with mouth examination and provision of simple dental treatment in a child-friendly dental setting.Results: Children with birth defects aged (mean ± SD) [6.02 ± 3.17-years], carried a high burden of untreated dental caries. The mean number (±SD) of non-cavitated decayed teeth was 2.65± 3.62, cavitated decayed teeth was 2.97±2.97 and pulp exposed teeth was 3.59 ±3.60 respectively. Children were offered a preventive oral health care package comprised of customized behavioural management, oral hygiene instructions and dietary counselling (for parental care givers), professional fluoride applications, simple restorations of carious teeth, fissure sealant applications for permanent molar teeth, referral for pulp therapy for pulp exposed symptomatic teeth under general anaesthesia to Restorative Unit B with follow up of care. 50.6% of children deemed cooperative and 8.9% were partially cooperative to receive oral health care provided by the Preventive Oral Health Unit.Conclusion: This baseline information must be utilized for effective planning of oral healthcare for children with birth defects.

Exploring Nutrient Profiles, Phytochemical Composition, and the Antiproliferative Activity of Ganoderma lucidum and Ganoderma leucocontextum: A Comprehensive Comparative Study.

Ganoderma, often hailed as a holistic "health package", comprises an array of nutritional components and active compounds, contributing to its esteemed status in the realm of healthy foods. In this study, a comprehensive analysis was performed to elucidate the diverse nutritional profiles, bioactive components, and antiproliferative activities between two Ganoderma species: G. lucidum (GLU) and G. leucocontextum (GLE). The results showed that GLE possessed a higher level of nutritional constituents, except for dietary fiber. Fatty acid analysis revealed comparable profiles rich in unsaturated fatty acids for both species. The ethanol extract of GLU and GLE exhibited potent antioxidant capabilities and remarkable inhibition of tumor cell proliferation via apoptosis induction, with greater potency in GLE. The heightened triterpene levels in GLE potentially contribute to its augmented antitumoral effects. The exploration emphasized the significance of comprehending the varied chemical compositions of Ganoderma species, providing insights into their potential health benefits applications in the food and pharmaceutical industries.

"How Do I Test the Waters? How Do I Go Forward?": Codesigning a Supportive Pathway after Critical Illness.

Rationale: Long-term recovery after critical illness can be affected by post-intensive care syndrome (PICS), a significant burden, which can impact return to activities and work. There is a need for streamlined support for intensive care unit (ICU) patients in their recovery while enduring PICS symptoms. Objectives: To explore critical illness recovery from the experiences, perspectives, and beliefs of former ICU patients, their caregivers, and multidisciplinary clinicians to design a future rehabilitation intervention prototype to support ICU patients. Methods: This was an experience-based codesign (EBCD) study underpinned by the Behavior Change Wheel framework involving ICU patients (<5 years after illness), caregivers, and multidisciplinary clinicians with current clinical experience with ICU recovery at any point along the care continuum (ICU, acute, subacute, or community settings) from two metropolitan hospitals in Melbourne, Australia. Two rounds of experience-based codesign workshops were held between August 2021 and February 2022. Workshop content was analyzed via a reflective thematic approach to determine themes and develop an intervention. The intervention was mapped according to the template for intervention description and replication framework. Results: Forty people participated in the codesign process: 15 ICU patients, 2 caregivers, and 23 clinicians. Fifteen major themes were identified in the experience of ICU recovery. Returning home was a key time point for change, acceptance, and adjustment, with the burden of physical limitations and mental health problems becoming apparent. Most participants expressed that PICS was poorly understood in the community, and there was a lack of support to aid recovery. Based on these results, an intervention prototype was developed with a primary goal of improving care after hospital discharge. This was further refined in the second round of workshops. A resource toolkit was deemed most acceptable to end-users, including a hospital-directed support program involving psychology and physical therapy and an accompanying digital health package. Conclusions: A critical time point for more support in the recovery journey was the transition from hospital to home. To address this, a rehabilitation prototype including a physical and psychological support intervention and supporting digital health toolkit was codesigned. The intervention package will be developed and trialed with future ICU patients and their families. Clinical trial registered with www.clinicaltrials.gov (NCT05044221).

Health packages and affective infrastructures: promises of (Im)mobility in pandemic times

ABSTRACT In spring 2020, during the peak of the first wave of the coronavirus outbreak across Europe, special COVID-19 health packages started to reach tens of thousands of overseas Chinese students. Ordered and distributed by Chinese Consulates and affiliated student and scholar associations, these health packages were delivered with a special message attached – “the homeland is always by your side”. Meanwhile, Chinese students found themselves stranded in various pandemic hotspots due to prolonged national lockdowns mandated by China’s stringent zero-Covid policies and persistent international travel restrictions. How did Chinese students continue to celebrate a sense of being cared for by the state when millions were forcibly stopped by heightened infrastructural barriers and denied the possibility of returning home? Focusing on Covid health packages, this paper explores the many layers of infrastructural processes at play – logistical, socio-cultural, technological, and emotional. Affective attachments are activated as patchwork remedies for halted physical infrastructures, serving to align and redirect individual hope while normalising rejections, failures, and neglect. Covid health packages offer insight into how nationalist affect is made infrastructural to stabilize and uphold a tightly controlled (im)mobility regime during troubled times. Overseas students are drawn towards specific Chinese attachments infused with state promises of provision and care, with which many find special meanings in their own immobility and prolonged isolation.

Maintaining the health of people with and without COVID-19 during isolation: a case study.

This case study evaluated the effects of a health package (HP) of a light intensity individualised exercise program and advice on anxiety management and nutrition, on the physical and mental health of people with or without COVID-19, who were quarantined in hotels used as Special Health Accommodation and admitted to the Royal Prince Alfred Virtual Hospital, Sydney during the COVID-19 pandemic. After initial screening and consenting, participants completed three surveys: Depression, Anxiety, Stress Scale; Brief Fatigue Inventory; and the European Quality of Life 5-Dimensions 5-Levels, and were provided with the HP for the duration of their quarantine. The three surveys and a participant reported experience measure were completed prior to discharge. The HP for people in quarantine demonstrated stability of health outcomes and reduction in fatigue. Most participants reported that the HP helped them cope with isolation. Provision of a HP during quarantine could be useful to support physical and mental health.

SciKit digital health package for accelerometry-measured physical activity: comparisons to existing solutions and investigations of age effects in healthy adults

IntroductionAccelerometry has become increasingly prevalent to monitor physical activity due to its low participant burden, quantitative metrics, and ease of deployment. Physical activity metrics are ideal for extracting intuitive, continuous measures of participants’ health from multiple days or weeks of high frequency data due to their fairly straightforward computation. Previously, we released an open-source digital health python processing package, SciKit Digital Health (SKDH), with the goal of providing a unifying device-agnostic framework for multiple digital health algorithms, such as activity, gait, and sleep.MethodsIn this paper, we present the open-source SKDH implementation for the derivation of activity endpoints from accelerometer data. In this implementation, we include some non-typical features that have shown promise in providing additional context to activity patterns, and provide comparisons to existing algorithms, namely GGIR and the GENEActiv macros. Following this reference comparison, we investigate the association between age and derived physical activity metrics in a healthy adult cohort collected in the Pfizer Innovation Research Lab, comprising 7–14 days of at-home data collected from younger (18–40 years) and older (65–85 years) healthy volunteers.ResultsResults showed that activity metrics derived with SKDH had moderate to excellent ICC values (0.550 to 1.0 compared to GGIR, 0.469 to 0.697 compared to the GENEActiv macros), with high correlations for almost all compared metrics (&amp;gt;0.733 except vs GGIR sedentary time, 0.547). Several features show age-group differences, with Cohen’s d effect sizes &amp;gt;1.0 and p-values &amp;lt; 0.001. These features included non-threshold methods such as intensity gradient, and activity fragmentation features such as between-states transition probabilities.DiscussionThese results demonstrate the validity of the implemented SKDH physical activity algorithm, and the potential of the implemented PA metrics in assessing activity changes in free-living conditions.

Impact of integrated preventive and curative health package on nutritional status of children under 2 years of age in the health area of Tama, Tahoua region (Niger).

Niger, relevant in light of current political coup, is one of the countries with the worst human development indicators, characterized by high fertility rates and extremely high infant mortality rates. Food insecurity in the region is alarming, leading to high malnutrition rates in children. This study aimed to evaluate an integral preventive-curative health program targeting children aged under 2 years in the health area of Tama, district of Bouza, Tahoua. Anthropometric follow-up data of 6,962 children aged under 2 years were included in this study. These children received complete vaccination and malaria chemoprevention, and those older than 6 months received nutritional supplementation with a small quantity of lipid-based nutrient supplements. Fundamental growth indicators (height-for-age, weight-for-height, weight-for-age, and middle-upper arm circumference) and the Composite Index of Anthropometric Failure were calculated at the beginning and end of the program (mean time spent in the program: 14.5 ± 6.6 months) The evolution of these indicators was compared with those of a sample from a vertical vaccination program conducted in the neighboring region of Madarounfa on similar dates. The proportion of children without anthropometric failure decreased from 59.5 to 40.2% (p < 0.001), with the categories that included stunting increasing the most. When analyzing the anthropometric indicators according to the months of compliance with the program, there was a slight improvement in the indicators of acute malnutrition, whereas those of chronic malnutrition worsened significantly. However, when compared with the Madarounfa sample, the children in the present study registered a significantly lower worsening in all three indicators: height-age (-0.46 vs. -2.44; p < 0.001), weight-height (+0.31 vs. -0.55; p < 0.001) and weight-age (-0.03 vs. -1.63; p < 0.001) difference. The comprehensive preventive-curative health program slightly slows the worsening of cumulative malnutrition in the early years of life in complex contexts, such as southern Niger.

Categorization and Analysis of Primary Care mHealth Apps Related to Breast Health and Breast Cancer: Systematic Search in App Stores and Content Analysis.

Breast cancer is the most common cause of cancer mortality among women globally. The use of mobile health tools such as apps and games is increasing rapidly, even in low- and middle-income countries, to promote early diagnosis and to manage care and support of survivors and patients. The primary objective of this review was to categorize selected mobile health apps related to breast health and prevention of breast cancer, based on features such as breast self-examination (BSE) training and reminders, and to analyze their current dissemination. An ancillary objective was to highlight the limitations of existing tools and suggest ways to improve them. We defined strict inclusion and exclusion criteria, which required apps to have titles or descriptions that suggest that they were designed for the general public, and not for patients with breast cancer or health workers. Apps that focused on awareness and primary care via self-check were included, while those that focused on topics such as alternative treatments and medical news were excluded. Apps that were not specifically related to breast cancer were also excluded. Apps (in any language) that appeared in the search with keywords were included. The database consisted of apps from AppAgg and Google Play Store. Only 85 apps met the inclusion criteria. Selected apps were categorized on the basis of their alleged interactive features. Descriptive statistics were obtained, and available language options, the number of downloads, and the cost of the apps were the main parameters reviewed. The selected apps were categorized on the basis of the following features: education, BSE training, reminders, and recording. Of the 85 selected apps, 72 (84.7%) focused on disseminating breast cancer information. BSE training was provided by only 47% (n=40) of the apps, and very few had reminder (n=26, 30.5%) and recording (n=11, 12.9%) features. The median number of downloads was the highest for apps with recording features (>1000 downloads) than those with education, BSE training, reminder, and recording features (>5000 downloads). Most of these apps (n=74, 83.5%) were monolingual, and around 80.3% (n=49) of these apps were in English. Almost all the apps on Google Play Store were free of charge. Although there exist several apps on Google Play Store to promote awareness about breast health and cancer, the usefulness of most of them appears debatable. To provide a complete breast health package to the users, such apps must have all of the following features: reminders or notifications and symptom recording and tracking. There is still an urgent need to scientifically evaluate existing apps in the target populations in order to make them more functional and user-friendly.

From adversity to advancement: leveraging war-tested approaches for the post-conflict reformation of the Ukrainian healthcare landscape.

The Russo-Ukrainian Conflict has had significant repercussions on Ukraine's healthcare system, resulting in civilian casualties and damage to healthcare institutions. The disruption of personnel, medical supplies, and patient transportation has created considerable challenges for healthcare services. However, there are successful approaches from comparable contexts that can serve as a catalyst for post-conflict healthcare reformation in Ukraine. Key strategies include improving healthcare accessibility for marginalized populations through standardized essential health and surgical care packages, rehabilitating damaged facilities, strengthening primary care provisions, and supporting war survivors with disabilities. By adopting these proven practices, Ukraine can strengthen its healthcare system and facilitate a sustainable recovery, contributing to the country's resilience and ensuring essential healthcare services for its population.

Delaware MH bills signed into law

Delaware Gov. John Carney signed three pieces of legislation from House Speaker Valerie Longhurst aimed at improving mental health resources for Delawareans, Cape Gazette reported Aug. 22. The new laws, House Bill 3, House Bill 4 and House Substitute 2 for House Bill 160, will increase mental health resources for students and help more Delawareans access behavioral health care in their time of need. HB3 will help students prioritize their mental health by providing them with excused absences for mental or behavioral health reasons. HB4 will ensure that students have access to behavioral health support in their schools in the aftermath of a school‐connected traumatic event, defined as the death of any student, educator, administrator or other building employee of a public school or other traumatic event that affects a significant portion of the students of the school. The state Department of Education will also be responsible for covering the costs of grief counseling offered to students at the school for up to 45 days after a school‐connected event, with an option to renew for an additional 45 days. HB3 and HB4 are part of a larger package of bills known as the 2023 Delaware Behavioral Health Package. Collectively, the measures encompass a holistic approach to improving the way mental health care is delivered and addressed for children in Delaware. House Bill 160 will create a dedicated funding source for the state's new 988 Suicide &amp; Crisis Lifeline.

Attitudes toward and knowledge of collaboration of dental and medical practice among medical students in Southern India: a cross-sectional questionnaire survey

Background: Enhancing oral health care services provided through inter-professional collaboration between medical and dental practitioner is important, and even essential. The purpose of this study is to assess the attitude toward and knowledge of medical-dental collaborative practice among medical students attending colleges in Southern India. Methods: A cross sectional questionnaire survey was conducted by inviting 900 medical students and interns of medical colleges in coastal South India with prior information and permission. The questionnaire consisted of 11 questions to assess attitude toward and knowledge of medical-dental collaborative practice and was distributed in pen &amp; paper format to participants who agreed to take part in the study. Chi square test was employed for data analysis. The responses obtained were correlated with age, gender and year of study of participants using Pearson’s correlation test Results: Most of the students agreed that oral health was an integral part of systemic health, however participants disagreed on attending compulsory rotation in dentistry at a statistically significant level (p&lt;0.05), moreover participants did not agree with physicians having an active role in motivating their patients for regular dental check-up. 82% of the medical students believe that dental check-up should be included in health packages under health insurance. A statistically significant (p&lt;0.05) difference was observed among 3 rd year &amp; 4 th year students and interns and also it was found that female students provided more positive responses towards medical-dental collaboration. Conclusions: Even though medical students showed fairly positive attitudes and knowledge towards dentistry, the analysis within the study groups showed that knowledge and attitudes regarding the collaborative practice worsened over the academic years among the medical students.

Attitudes toward and knowledge of collaboration of dental and medical practice among medical students in Southern India: a cross-sectional questionnaire survey.

Enhancing oral health care services provided through inter-professional collaboration between medical and dental practitioner is important, and even essential. The purpose of this study is to assess the attitude toward and knowledge of medical-dental collaborative practice among medical students attending colleges in Southern India. A cross sectional questionnaire survey was conducted among medical students and interns of medical colleges in coastal South India with prior information and permission. The questionnaire consisted of 11 questions to assess attitude toward and knowledge of medical-dental collaborative practice. The demographic backgrounds of participants were also recorded. Chi square test was employed for data analysis. The responses obtained were correlated with age, gender and year of study of participants using Pearson's correlation test Results: A total 250 questionnaires were distributed and 234 responses were appropriately completed. Most of the students agreed that oral health was an integral part of systemic health, however participants disagreed on attending compulsory rotation in dentistry at a statistically significant level (p<0.05), moreover participants did not agree with physicians having an active role in motivating their patients for regular dental check-up. 82% of the medical students believe that dental check-up should be included in health packages under health insurance. A statistically significant (p<0.05) difference was observed among 3 rd year & 4 thyear students and interns and also it was found that female students provided more positive responses towards medical-dental collaboration. Even though medical students showed fairly positive attitudes and knowledge towards dentistry, the analysis within the study groups showed that knowledge and attitudes regarding the collaborative practice worsened over the academic years among the medical students. In order to destigmatize and foster interdisciplinary collaboration which would contribute to higher resource efficiency and the standard of care, continuing education in both the disciplines would be highly beneficial.

Knowledge, Attitudes and Practices of Mothers regarding the Nutrition of Children from 6 to 59 Months in the Urban Commune of Koniakary (MALI)

Introduction: Nutrition is a health package, which is defined as the body's processing and use of food. The primary pathological situation resulting from the quality of nutrition is malnutrition. Objective: To describe the knowledge, attitudes and practices (KAP) related to the practices of mothers on the nutrition of children aged 6-59 months and to bring about a change in behaviour among the target group in the urban commune of Koniakary. The Methodology: This was a prospective and descriptive action research study in the urban commune of Koniakary, involving 99 mothers or babysitters and their children aged 6 to 59 months. The action research is carried out in three phases: survey, action and evaluation. Our work focused on the evaluation after the actions. Results: In our study, the age range of 15-20 years was predominant among the mothers and childminders (28%), 57.6% were married and monogamous and 92% were housewives. The children were predominantly male (52%). The 6-10 month age group was the most represented, 29.3%. The vast majority of children were vaccinated 94%. In relation to the knowledge and attitudes of mothers and guardians: The importance of supplementary feeding for children increased from 59.2% to 92.9%. Concerning practices: exclusive breastfeeding up to 6 months increased from 50% to 80.8%, hand washing with soap increased from 62.6% to 96%, the use of the health centre in case of illness as a first intention was 65.7%, this rate increased to 91.9%.