Over the years, technology has revolutionized the operations of many industries, ranging from manufacturing and agriculture to financial institutions which are usually the first users of innovations. Owing to the recent technological trends in the financial sector, such as mobile money, artificial intelligence, and medical robotics, as well as the rapidly increasing human population and the emergence of new patterns of disease, it is necessary for the healthcare sector to adopt new strategies to deliver efficient and effective healthcare services. Financial technology (FinTech), a combination of financial services and technology, entails the incorporation of modern, innovative technologies by industries into their financial services. FinTech is an endless array of applications, products, and services which includes mobile banking, cryptocurrency, insurance, and investment apps among many others. Any enterprise that employs technology to enhance or automate financial services and processes is referred to as FinTech. This fast-growing industry serves the interests of both the business sector and the consuming public. There have been many applications and uses of FinTech, however, its employment in the field of health remains to be explored further and maximized, particularly in the developing world like Africa. This paper aims to explore the prospects of FinTech for healthcare in Africa.
Mining and agricultural activities are intertwined in such a way that the operation of one affects the other. This is particularly true in northern Nigeria. Over the years, mining activities are seen to negatively affect farming activities in the surrounding communities, as well as livestock grazing and fisheries. Mining is the excavation of useful and economically valuable minerals from deposits in the earth. Despite its potential to generate a large amount of revenue, the mining sector is not adequately regulated, thus, creating a ground for illegal mining activities. These activities, depending on the type of mining, have a spectrum of effects on agricultural activities such as competition for land control and use, pollution of water bodies and exposure of crops and livestock to the harmful effects of heavy metals. The cumulative effects of these activities have modified the agricultural practices, disrupted landscapes, and negatively impacted the availability of food crops in the areas where mining activities are carried out, which in turn threatens the food security of northern Nigeria. This chapter evaluates the negative impacts of mining on agricultural activities in the region, in order to provide evidence for policy makers to take action and foster sustainable solutions.
Cholera is an enteric disease caused by the ingestion of food or water contaminated by the toxins of the bacteria - Vibrio Cholerae. Its transmission is exacerbated by poor sanitary conditions and poor hygiene practices. Affected individuals may present with severe symptoms such as watery diarrhoea and vomiting that can lead to death within few hours. Cameroon is experiencing its worst cholera outbreak in decades. The outbreak is severest in the South-West and the Littoral regions. As of the time of writing, in six regions of the country, 6652 suspected cases of cholera including 134 deaths (CFR 2%) have been reported and the number is rising. Shortage of safe drinking water and contamination of rivers has exacerbated the outbreak, especially in the rural and hard to reach communities. The trans-border movement at the South-West region, defecation in the open and on rivers, and overcrowding at the Littoral region have been particularly challenging towards curbing the outbreak. Despite the challenges, Cameroon's health authorities have been working to bring the situation under control by engaging in community sensitization on good hygiene habits, disinfection of houses and vaccination campaigns. In the light of these, it is recommended that Cameroon should improve and strengthen its vaccination campaign across the country. Adequate health systems should be established at the point of entry to prevent cross-border cholera transmission and retransmission. Access to hard to reach communities should be improved so that vaccines and basic health care and sanitation services such as provision of safe drinking water can be provided.
Pre-impaired glucose tolerance (Pre-IGT) is a stage of compensatory hyperinsulinemia to maintain normoglycemia. It is the earliest stage of glucose dysmetabolism, where beta cells can still compensate for the insulin resistance thru hyperinsulinemia. Endothelial dysfunction is a critical part in the pathogenesis of macrovascular and microvascular chronic complications in type 2 diabetes, ordinarily due to uncontrolled hyperglycemia. In pre-IGT the main problem is hyperinsulinemia on a background of normal blood sugar. C-peptide, a segment cleaved off from pro-insulin is equimolar to insulin, and has shown to cause intima media thickening. This study was undertaken to determine endothelial function of patients with pre-IGT thru flow-mediated dilatation of the brachial artery and to correlate the FMD with the insulin level, systolic blood pressure and diastolic blood pressure. This is a cross-sectional analytical study of adult patients with risk factors for developing diabetes such as, having first-degree relative with diabetes, obesity, history of gestational diabetes, and polycystic ovary syndrome (PCOS). Systolic and diastolic BP, BMI, 2-hour serum insulin, blood sugar, and lipids were determined. Patients with pre-IGT underwent brachial artery FMD. Of the 27 subjects, 21 (77.8%) had pre-IGT. The mean oral glucose tolerance test at 2-hours post-prandial was normal at 109.53 mg/dL (SD = 30.26). Results of the laboratory tests were as follows: mean Hba1c and insulin at 2 hours were 5.34% (SD = 0.44) and 112.21 uIU/mL (SD = 111.24, normal range 2.60–24.90), respectively. Comparative analyses of the demographic and clinical profiles showed similar characteristics between the normoinsulinemic and the pre-IGT subjects (p > 0.05), although there were more with positive history of type 2 DM and obesity on the latter group. Systolic and diastolic BP levels were normal. Of the 27 subjects, four (4) had abnormal FMD which had a small positive correlation with thee insulin level, systolic BP, and diastolic BP, although not statistically significant (p > 0.05). Endothelial dysfunction has shown to exist already in the pre-IGT subjects depicted in the abnormality in the arterial flow-mediated dilatation study. Systolic BP and diastolic BP levels have not shown any significant correlation with the FMD finding, and the insulin level.
The population growth rate of China has been steadily declining owing to the low birth rate of the country. The Chinese census also indicates that the population is also rapidly ageing because of increasing life expectancy in conjunction with the low birth rate. We performed a commentary to point out the challenges of the low birth rate in China. A comprehensive data search was performed in data bases such as Google Scholar and PubMed using predetermined search term. The decline in birth rate is due to societal changes including increasing standard of living. Although the Chinese government has recently allowed couples to have up to three children in a major policy shift, many couples remain unwilling to have more than one child due to the high cost. An increasing fraction of Chinese women, particularly among the highly‐educated urban dwellers, no longer regard marriage and parenthood as essential aspects of life. If not addressed urgently, the declining young population will impact China's future socio‐economic situation, as there will be a smaller workforce relative to an increasing dependent older population. The repercussions may cascade to other spheres of China's status, including socioeconomic, security and global influence, if not addressed decisively. It is imperative that the country develops policies, strategies, and approaches to tackle this issue, including human capital development and the use of technology and innovations.
The Ifugao Rice Terraces of the Philippine Cordillera is a UNESCO World Heritage Site and a proud heritage of the indigenous Ifugao people. The wooden traditional houses dot the expanse of the rice terraces and forms part of Ifugao’s tangible cultural heritage. The passage of time and modern influences have seen a decline in the number and use of these traditional houses. Moreover, little is known about wood species used in its construction. This study sought to identify different wood species from a sample of traditional houses in Kiangan, Ifugao. Thirty-two species of mostly indigenous and endemic wood species were identified. The choice of wood species and their use reflected indigenous knowledge on house construction, functionality, their physical attributes, and availability. Premium species were generally preferred but their dwindling availability has influenced a shift to the use of lesser known wood species and exotics. Better knowledge on wood used for traditional houses can help the younger generation of indigenous craftsmen. As such, the study seeks to contribute to cultural preservation by enhancing support for protection and cultivation of important wood species as well as promoting preservation of traditional houses, a tangible emblem of the Ifugao heritage and landscape.
Aims: To determine the quality of decision-making and cultural competence in terms of cultural competence behavior and cultural awareness and sensitivity of nurse leaders. Furthermore, this study explores the relationships between selected demographic profiles, cultural awareness and sensitivity, cultural competence behavior, and quality of decision-making. Background: Diversity contributes to varying beliefs and practices in the workplace. Leaders with cultural competence, awareness, and sensitivity can evaluate alternatives for the decision-making process and develop effective strategies to implement decisions. Methods: A descriptive correlational design was utilized. The respondents (n=122) completed the Cultural Competence Assessment instrument and Decision Making Quality Scale questionnaire. Results: Cultural awareness and sensitivity are significantly related to the Middle Eastern race. Furthermore, cultural competence behavior is significantly related to years of experience in Saudi Arabia and leadership positions. Quality of decision-making is significantly related to years of experience in Saudi Arabia. Cultural awareness, sensitivity, and cultural competence behavior are significantly related to the quality of decision-making. Conclusions: Culturally aware, sensitive, and competent nurse leaders are more likely to adhere to the quality decision-making criteria. Implications for nursing management: Promoting training and continuing education for nurse leaders are crucial to ensure they possess the right cultural knowledge and skills.
Background: Providing effective, high quality, antenatal and postpartum contraceptive counseling can reduce unintended pregnancies, decrease maternal and fetal morbidity and mortality, and prevent unsafe abortions. The postpartum period is a critical time to address unmet family planning need and to reduce the risks of short interpregnancy interval. This study aimed at determining the impact of assigning a dedicated obstetrics and gynecology resident for postpartum family planning counselling on the uptake of immediate postpartum family planning. Methods: A "pre-post" observational study was conducted at Saint Paul's Hospital Millennium Medical College (SPHMMC), in Addis Ababa-Ethiopia, from May 1, 2021 to June 30, 2021. Immediate postpartum family planning uptake between the months of June (when there was a dedicated resident assigned for postpartum family planning counselling and provison on weekdays) and May (when there was no such dedicated resident for similar purpose) were compared. Data was analyzed using SPSS version 20 software packages. Simple descriptive was used to describe baseline characteristics. Chi-square test of association was done to determine the correlation between dependent and independent variables. Multivariate regression analysis was applied to determine factors associated with uptake of family planning methods in the immediate postpartum period. Odds ratio, 95% CI, and p-value < 0.05 were used to describe results significance. Results: Out of 776 mothers who delivered at SPHMMC in the month of June 2021, 158 (20.4%) of them used immediate postpartum family planning. This finding during the month of June is higher than a 15.4% immediate postpartum family planning uptake observed during the preceding month of May. Having a dedicated resident for postpartum family planning counselling was associated with an increase in immediate postpartum family planning use (AOR = 1.31, 95% CI [1.01, 1.69]). Conclusion: In this study, presence of a dedicated obstetrics and gynecology resident for postpartum family planning counselling was associated with an increase in the uptake of immediate postpartum family planning. This implies the importance of assigning a dedicated care provider for the purpose of postpartum family planning counselling within the immediate postpartum, which gives postpartum women another opportunity of adequate counselling before they are discharge from Hospitals or obstetric service centers.
Background: More information is needed about gender-affirming surgery (GAS) in the Philippines because of many self-or peer-prescribed gender-affirming procedures among transgender people. Aim: To assess the desire of transgender adults for GAS, determined the prevalence, and evaluated factors associated with the desire. Methods: We did a retrospective study of medical charts of 339 transgender men (TGM) and 186 transgender women (TGW) who attended clinical services at Victoria by LoveYourself, a transgender-led community-based clinic in Metro Manila, from March 2017 to December 2019. The medical charts were reviewed to ascertain data on gender dysphoria (GD), clinical and sociodemographic characteristics, health-seeking behaviors, and gender-affirmation-related practices, including the use of gender-affirming hormone therapy (GAHT). We also estimated the prevalence and explored factors associated with the desire for GAS using generalized linear models with a Poisson distribution, log link function, and a robust variance. Main Outcome Measures: Our primary outcome was the self-reported desire for GAS. Results: Almost half were already on GAHT, of whom 93% were self-medicating. Our study's prevalence of GD is 95% and nearly 3 in 4 desire GAS. The prevalence of desiring GAS was related to the specific surgical procedure chosen. Transgender adults opting for breast surgery and genital surgeries have 8.06 [adjusted prevalence ratio, (aPR): 8.06; 95% Confidence Interval, (CI): 5.22−12.45; P-value < .001] and 1.19 (aPR: 1.19; 95% CI: 1.11−1.28; P-value < .001) times higher prevalence of GAS desire, respectively, compared with otherwise not opting for those procedures. Moreover, the prevalence of GAS desire was higher among patients with GD (aPR 1.09; 95% CI: 1.01−1.18; P-value = .03) than individuals without GD. Clinical Translation: Providers' awareness of patients' desires, values, and health-seeking preferences could facilitate differentiated guidance on their gender affirmation. Strengths and Limitations: This quantitative study is the first to explore gender-affirming practices among transgender adults in the Philippines and provide significant insights into their healthcare needs. Our study focused only on TGM and TGW and did not reflect the other issues of transgender people outside of Metro Manila, Philippines. Furthermore, our retrospective study design may have missed essential predictors or factors not captured in the medical charts; hence, our study could never dismiss confounding factor bias due to unmeasured or residual confounding factors. Conclusions: There is a high prevalence of self-and peer-led attempts from TGM and TGW to facilitate the gender transition, with the desire for GAS being significantly associated with GD and by which specific surgical procedure is chosen. Eustaquio PC, Castelo AV, Araña YS et al. Prevalence and Factors Associated With Gender-Affirming Surgery Among Transgender Women & Transgender Men in a Community-Based
Introduction We compared depression of people who smoke and those who do not, depending on whether they have an underlying disease making them at risk for COVID-19. Moreover, we analyzed the factors associated with their depression. Methods We recruited 948 Lebanese residents, ages 18 and above. Our survey included the Patient Health Questionnaire-9 (PHQ-9) to assess depression. We divided participants, based on smoking and having a disease making one at risk for a COVID19 infection into four groups: non-smokers not at risk (NSNR), non-smokers at risk (NSR), smokers not at risk (SNR), and smokers at risk (SR). Results SR had PHQ-9 scores higher than other groups. The diet was not changed during the pandemic, whereas weight increased in all groups but SR. Those not at risk slept longer, while sports were decreased in NSR and SNR. Hobbies were decreased in all groups except SNR. Depending on the group, factors such as age, sex, residency, diet, exercise, sleep duration, and hobbies were associated with PHQ-9 scores. Limitations we cannot draw causal relationships. Participation required internet access, and participants might not represent the actual population due to the snowball effect. Also, recall bias might skew results. We did not inquire about sexual activity, which could be an essential coping mechanism. Conclusion Factors associated with depression for one group did not necessarily do so for another. Controlling the underlying risk or smoking cessation could move a patient to a group with more options associated with depression, thereby additional methods to decrease depression.
We examine and assess the service contracting (SC) program implemented for the first time in Metro Manila, Philippines as a response to the impact of the pandemic on road-based public transport sector. We develop an evaluation framework, consisting of three indicators: social amelioration, increase in transport supply and performance improvement. These indicators are the purported objectives of SC. Using a mix of qualitative and quantitative methods, our evaluation suggests that although SC has brought positive impact in terms of the first two indicators, there is no robust evidence so far that may suggest that SC has improved the performance of public transport service delivery. We also find that while the primary objective of providing social amelioration to affected operators is appropriate during the time of the pandemic, this has also brought challenges in financially sustaining the program and in effecting improvements to public transport services. Our work aims to contribute as an empirical case study on the upsides and downsides of service contracting implemented as a business model for public transport provision during the pandemic.
Background: Anthracnose caused by Colletotrichum gloeosporioides is considered as a major postharvest disease affecting many fruits. This plant disease is traditionally managed with synthetic fungicides, which are generally toxic and are linked to pathogen resistance. Recently, microencapsulated bioactives are being developed as potential alternative strategies to these methods, while utilizing natural fungicides and other phytochemicals. Wild oregano [Plectranthus amboinicus (Lour.) Spreng] contains potent antimicrobial phenolics, but these compounds are volatile and relatively unstable, which limits their efficacy during application. Herein, a Baker's yeast microencapsulation system was applied to improve the stability of wild oregano phenolic extract (WOPE) and enhance its antifungal activity against anthracnose. Results: Encapsulation of WOPE in plasmolyzed yeast cells afforded a high encapsulation efficiency (93%) and yielded WOPE-loaded yeast microcapsules (WLYM) with an average diameter of 2.65 μm. Storage stability studies showed WLYM are stable for at least four months. A 24-h in vitro release experiment showed that WLYM had an initial burst release upon re-dispersion in water, followed by a controlled release to about 80% of the loaded WOPE. Upon application as a spray-type postharvest treatment for papaya, WLYM exhibited a significantly improved mycelial inhibitory action against C. gloeosporioides and greatly reduced the anthracnose symptoms in papaya fruits. Conclusion: This study presented a yeast microencapsulation system that can effectively stabilize WOPE and enhance its antifungal activity, making this microparticle formulation a promising environmentally safe postharvest treatment option to combat anthracnose symptoms in papaya fruits. This article is protected by copyright. All rights reserved.
Transport workers, seafarers and fishers have biannual mandatory fit-for duty medical examinations. Urine dipstick is used for early diagnosis of Type 2 diabetes mellitus. Due to low sensitivity with more than 80% false negatives the method should be replaced by highly sensitive blood tests, Hb1Ac or similar for diagnosis of Type 2 diabetes mellitus to pursue the UN Global Sustainable Goals, especially Goal 3: Good health and well-being for all workers and Goal 8: Decent Work and Economic Growth.
Transport workers like seafarers, truck-, bus-, train- and taxi drivers and fishers have a known great inequity in health at work including high risk of developing type 2 diabetes. Their routine mandatory medical examinations use urine glucose for diabetes check with more than 50% false negatives, which should be replaced by high sensitive tests for diabetes-2, like A1C, Fasting Glucose (FPG) or Oral Glucose Tolerance Test (OGTT).
The COVID-19 pandemic is having an unprecedented and consequential impact on global economies, businesses, and workforces. Foreign nationals account for the majority of the population in the Middle East. Throughout this article, the authors address the negative ramifications the COVID-19 pandemic has had on the migrant workforce in the Middle East. This pandemic has intensified various socio-economic and public health crises such as unemployment, income cuts, depletion of savings, repatriation difficulties, inadequate living conditions, and associated burden on healthcare facilities by the COVID-19 infection.
The number of COVID-19 cases is continuously increasing in different countries including the Philippines. It is estimated that the basic reproduction number of COVID-19 is around 1.5–4 (as of May 2020). The basic reproduction number characterizes the average number of persons that a primary case can directly infect in a population full of susceptible individuals. However, there can be superspreaders that can infect more than this estimated basic reproduction number. In this study, we formulate a conceptual mathematical model on the transmission dynamics of COVID-19 between the frontliners and the general public. We assume that the general public has a reproduction number between 1.5 and 4, and frontliners (e.g. healthcare workers, customer service and retail personnel, food service crews, and transport or delivery workers) have a higher reproduction number. Our simulations show that both the frontliners and the general public should be protected against the disease. Protecting only the frontliners will not result in flattening the epidemic curve. Protecting only the general public may flatten the epidemic curve but the infection risk faced by the frontliners is still high, which may eventually affect their work. The insights from our model remind us of the importance of community effort in controlling the transmission of the disease.
Objective: To determine the prevalence of second-trimester safe abortion care and to examine its association with emotional factors. Methods: We conducted a cross-sectional study on second-trimester safe abortion care clients from June 1, 2020 to December 31, 2020 at St. Paul's Hospital Millennium Medical College. Data were collected using an interviewer-administered questionnaire on Open Data Kit and analyzed using STATA release 15. Variables with P value <0.2 on bivariate analysis were entered for multivariable regression analysis. Odds ratio with 95%CI and P value below 0.05 were used to present the significance of study findings. Results: The prevalence of induced second-trimester abortion among safe abortion clients was 64%. Women who had no emotional factors, who had no interpersonal problems, who were married, and who had middle or high incomes were less likely to make a late request for safe abortion care (aOR 0.31, 95% CI 0.15-0.67; aOR 0.55, 95% CI 0.32-0.97; aOR 0.37, 95% CI 0.17-0.77; and aOR 0.51, 95% CI 0.27-0.96, respectively). Conclusion: Sixty-four percent of safe abortion-care clients made a late request (second trimester presentation) for safe abortion care. Women who had no emotional factors had a low risk of making such a late request. Likewise, married women who had no interpersonal factors and had middle or high income were at low risk of seeking safe abortion care in the second trimester.
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