Health education and promotion

Americans can take some pride in the fact that attaining what the medical profession calls "cultural competency" is a goal of most health care institutions. However, achieving this goal in today's health care environment, filled with diverse patient and provider populations, is no easy task. In addition to the complications imposed by the proliferation of managed health care, American hospitals are increasingly being staffed by and serving diverse populations. This creates the ideal breeding ground for conflict and misunderstanding, which can result in tension among the staff and inferior patient care. Hospitals can be a source of stress and frustration for patients and their families, since they are most vulnerable when they are there and are placed at the mercy of values and beliefs not their own. It is common for people from other countries to travel here for health care since the United States offers the finest in medical technology and expertise worldwide. Since our hospitals were built by European-Americans for European-Americans, their values, such as autonomy, independence and privacy, prevail in our institutions. Patients who have immigrated or are visiting from other countries often value the family over the individual or view the male head of household as the decision maker for the patient. Families may be more apt to assist the patient in "self-care" functions while the medical staff thinks the patient should value gaining independence as a critical goal of recovery. The U.S. health care system tries to provide privacy for patients by limiting visiting hours and rarely offers sleeping accommodations for visitors. Many non-Anglo patients prefer just the opposite. In this article I will address some of the problems that can result from a lack of attention to cultural differences, as well some ways they can be remedied. I have chosen examples of individuals who have not assimilated to a great degree and whose beliefs and behaviors deviate from those expressed in the American health care system. It should not be inferred that all or even most members of these groups would act in the manner described. We must also recognize that assimilation occurs in unpredictable stages and that many people work hard to rightfully maintain their cultural traditions despite prevailing American values and traditions. Anthropologists commonly make statements about groups of people; it's what we do-we look for broad patterns of similarity among groups. However, in the health care arena we cannot make the mistake of assuming that all members of a group fit the same pattern. This is particularly important when a health care provider's logic can mean the difference between life and death. By distinguishing the difference between stereotypes and generalizations as they apply in a health care environment, we can identify the point at which our health care system breaks down and suboptimal patient care results.

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Introduction: Dysmenorrhea (period pain) is common and affects around three quarters of all young women under the age of 25. The majority of young women, for a variety of reasons, think of period pain as 'normal' and something to be managed or endured. This normalisation of pain often is reinforced by family and friends and results in young women using selfcare strategies to manage their pain rather than seeking medical advice. This systematic review and meta-analysis examined observational studies reporting on the prevalence of different types of self-care, both pharmaceutical and non-pharmaceutical, self-rated effectiveness of self-care and the sources of information on menstruation in young women under 25 Methods: A search of Medline, PsychINFO, EMBASE and CINAHL in English was carried out from 1980 to December 2018. Studies that reported on menstrual self-care strategies in young women were included. Results: Nine hundred and forty-seven articles were screened. Twenty-four studies including 12,526 young women were eligible and included in the meta-analysis. Fifteen studies were from low, lower-middle or upper-middle-income countries (LMIC) and nine studies were from high income countries (HIC). Self-care was used by over half of all young women (55%, 95%CI 34.1-74.3) with both pharmaceutical (48%, 95%CI 40.0-57.0) and non-pharmaceutical (51.8%, 95%CI 31.3-71.7) options used. Paracetamol was the most common analgesic used (28.7%, 95%CI 19.6-39.9) but did not always provide sufficient pain relief in almost half of those using it. Contraceptive use was significantly higher (P<0.001) in HIC (22%) compared to LMIC (1%). Only 11% (95%CI 8.4-15.2) of young women reported seeing a medical doctor for their period pain. Conclusions: Self-care usage, both pharmaceutical and non-pharmaceutical, was common, but young women were not necessarily choosing the most effective options for pain management. High-quality information on self-care for period pain is urgently needed.

Introduction
Securing funding through grants is a critical skill for academics, researchers, healthcare professionals, and nonprofit leaders. This toolkit offers practical, step-by-step guidance to help you craft compelling, fundable proposals. Whether you're a seasoned researcher or just beginning your grant writing journey, the techniques here will support success across disciplines.

1. Understanding Grant Funding
Types of Grants
Research Grants: For scientific or scholarly research projects.

Training & Development Grants: For education, skills development, or professional training.

Project or Program Grants: For implementing specific programs in communities or institutions.

Capital Grants: For infrastructure, buildings, or large equipment purchases.

Funding Sources
Government Agencies (e.g., NIH, UKRI, NSF, Horizon Europe)

Private Foundations (e.g., Wellcome Trust, Gates Foundation)

Universities & Research Institutions

Corporate or Industry Partnerships

Objectives: This descriptive study of 219 undergraduate medical students at Patan Academy of Health Sciences in Nepal was conducted to evaluate the relationships of their demographic variables with a health-promoting lifestyle profile. Methods: The Health Promoting Lifestyle Profile (HPLP) questionnaire was used to study students' lifestyles. We compared the HPLP scores according to gender, residence type, school background and year of study. One-way analysis of variance (ANOVA) and multiple comparison test were conducted to identify significant differences among university year (first, second, third and fourth) groups. Multiple regression analysis was used to analyze the effects of various demographics on the overall HPLP score and the six health-promoting lifestyle subscales. Results: The overall HPLP mean score of participants was 2.60 ± 0.29, with the highest mean scores being for spiritual growth (2.99 ± 0.42) and interpersonal relations (2.90 ± 0.35), and the lowest mean scores being for health responsibility (2.39 ± 0.39) and physical activity (2.25 ± 0.54), respectively. The overall HPLP score of the students was the highest for the first year students at 2.65 ± 0.26. The male students had a better overall HPLP score, although female students obtained better score in some sub-scales such as health responsibility, interpersonal relations and nutrition. The students from a public school background had significantly higher scores for health responsibility, physical activity and stress management than those who graduated school level education from a private school. Conclusions: The results of this study reveal that the status of health promoting behaviors among the students was acceptable with ample room for improvement. Implementation of health education and promotion programs with an

Health-promoting behaviors in people admitted to selected health centers in Tehran. The significance of health-promoting behaviors in maintaining people's performance and independence and promoting the quality of life increases with age. This analytical cross-sectional study was conducted to determine health-promoting behaviors in people admitted to selected health centers in Tehran in 2010. In this study, 612 people (239 men and 373 women) admitted to Tehran's selected health centers were selected purposefully. The data were collected using "Health-Promoting Lifestyle Profile II." This standard instrument consists of 6 subscales namely, nutrition, physical activity, spiritual growth, health responsibility, interpersonal relations, and stress management. To maintain weight of the items, the total scores of the instrument and subscales were calculated using mean scores. To do so, each item was assigned a score of 1-4. The independent t test and Pearson correlation coefficient were used to analyze the data. The spiritual growth and physical activity subscales comprised the maximum and minimum mean scores, respectively. The health responsibility and physical activity showed the maximum significant correlation, and the physical activity and the interpersonal relations scores showed the minimum significant correlation. The physical activity and health responsibility subscales got minimum scores. This necessitates the health care staff and authorities to pay more attention to these two subscales and take action to obviate or reduce these problems.

The article is dedicated to studying the impact of the cases causing trauma on the self – realization of students. The levels of the self – realization of students who often subject to traumas with different professions and who rarely subject to trauma are distinguished, and the impact of trauma on the level of their emotional tolerance and academic achievements is determined. It is established that there is an important relation between the self – realization of students with the events causing trauma and this relation is more evident at the levels of self – realization. The study shows that the young who are not subjected to a serious trauma have a high self – realization in comparison with others. Though their academic achievement is same, but creativity is higher in the young who are subjected to trauma less and they always think about the individual development. Procedural and content motives dominate in their activity and in reality, expresses itself as doing different work in...

Riding horses on roads can be dangerous, but little is known about accidents and near misses. To explore road safety issues amongst Australian equestrians, we conducted an online survey. More than half of all riders (52%) reported having experienced at least one accident or near miss in the 12 months prior to the survey, mostly attributed to speed. Whilst our findings confirmed factors identified overseas, we also identified issues around road rules, hand signals and road rage. This paper suggests strategies for improving the safety of horses, riders and other road users.

Riding horses on roads can be dangerous, but little is known about accidents and near misses. To explore road safety issues amongst Australian equestrians, we conducted an online survey. More than half of all riders (52%) reported having experienced at least one accident or near miss in the 12 months prior to the survey, mostly attributed to speed. Whilst our findings confirmed factors identified overseas, we also identified issues around road rules, hand signals and road rage. This paper suggests strategies for improving the safety of horses, riders and other road users.

Health-promoting behaviors in people admitted to selected health centers in Tehran. The significance of health-promoting behaviors in maintaining people's performance and independence and promoting the quality of life increases with age. This analytical cross-sectional study was conducted to determine health-promoting behaviors in people admitted to selected health centers in Tehran in 2010. In this study, 612 people (239 men and 373 women) admitted to Tehran's selected health centers were selected purposefully. The data were collected using "Health-Promoting Lifestyle Profile II." This standard instrument consists of 6 subscales namely, nutrition, physical activity, spiritual growth, health responsibility, interpersonal relations, and stress management. To maintain weight of the items, the total scores of the instrument and subscales were calculated using mean scores. To do so, each item was assigned a score of 1-4. The independent t test and Pearson correlation coefficient were used to analyze the data. The spiritual growth and physical activity subscales comprised the maximum and minimum mean scores, respectively. The health responsibility and physical activity showed the maximum significant correlation, and the physical activity and the interpersonal relations scores showed the minimum significant correlation. The physical activity and health responsibility subscales got minimum scores. This necessitates the health care staff and authorities to pay more attention to these two subscales and take action to obviate or reduce these problems.

Objectives: This descriptive study of 219 undergraduate medical students at Patan Academy of Health Sciences in Nepal was conducted to evaluate the relationships of their demographic variables with a health-promoting lifestyle profile. Methods: The Health Promoting Lifestyle Profile (HPLP) questionnaire was used to study students' lifestyles. We compared the HPLP scores according to gender, residence type, school background and year of study. One-way analysis of variance (ANOVA) and multiple comparison test were conducted to identify significant differences among university year (first, second, third and fourth) groups. Multiple regression analysis was used to analyze the effects of various demographics on the overall HPLP score and the six health-promoting lifestyle subscales. Results: The overall HPLP mean score of participants was 2.60 ± 0.29, with the highest mean scores being for spiritual growth (2.99 ± 0.42) and interpersonal relations (2.90 ± 0.35), and the lowest mean scores being for health responsibility (2.39 ± 0.39) and physical activity (2.25 ± 0.54), respectively. The overall HPLP score of the students was the highest for the first year students at 2.65 ± 0.26. The male students had a better overall HPLP score, although female students obtained better score in some sub-scales such as health responsibility, interpersonal relations and nutrition. The students from a public school background had significantly higher scores for health responsibility, physical activity and stress management than those who graduated school level education from a private school. Conclusions: The results of this study reveal that the status of health promoting behaviors among the students was acceptable with ample room for improvement. Implementation of health education and promotion programs with an

Americans can take some pride in the fact that attaining what the medical profession calls "cultural competency" is a goal of most health care institutions. However, achieving this goal in today's health care environment, filled with diverse patient and provider populations, is no easy task. In addition to the complications imposed by the proliferation of managed health care, American hospitals are increasingly being staffed by and serving diverse populations. This creates the ideal breeding ground for conflict and misunderstanding, which can result in tension among the staff and inferior patient care. Hospitals can be a source of stress and frustration for patients and their families, since they are most vulnerable when they are there and are placed at the mercy of values and beliefs not their own. It is common for people from other countries to travel here for health care since the United States offers the finest in medical technology and expertise worldwide. Since our hospitals were built by European-Americans for European-Americans, their values, such as autonomy, independence and privacy, prevail in our institutions. Patients who have immigrated or are visiting from other countries often value the family over the individual or view the male head of household as the decision maker for the patient. Families may be more apt to assist the patient in "self-care" functions while the medical staff thinks the patient should value gaining independence as a critical goal of recovery. The U.S. health care system tries to provide privacy for patients by limiting visiting hours and rarely offers sleeping accommodations for visitors. Many non-Anglo patients prefer just the opposite. In this article I will address some of the problems that can result from a lack of attention to cultural differences, as well some ways they can be remedied. I have chosen examples of individuals who have not assimilated to a great degree and whose beliefs and behaviors deviate from those expressed in the American health care system. It should not be inferred that all or even most members of these groups would act in the manner described. We must also recognize that assimilation occurs in unpredictable stages and that many people work hard to rightfully maintain their cultural traditions despite prevailing American values and traditions. Anthropologists commonly make statements about groups of people; it's what we do-we look for broad patterns of similarity among groups. However, in the health care arena we cannot make the mistake of assuming that all members of a group fit the same pattern. This is particularly important when a health care provider's logic can mean the difference between life and death. By distinguishing the difference between stereotypes and generalizations as they apply in a health care environment, we can identify the point at which our health care system breaks down and suboptimal patient care results.

Objective. To determine "out-of-pocket" expenditures related to osteoarthritis (OA) and to explore whether demographic details, health status scores (Medical Outcomes Study 36-item Short Form [SF-36] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), or perception of social effect were expenditure determinants. Methods. A prospective cohort study of community-dwelling subjects with OA completed 4 consecutive 3-month cost diaries. In addition, subjects completed the SF-36 and WOMAC at baseline and at 12 months. Social impact at baseline was collected. Four groups categorized by age and sex were compared. Patients undergoing joint replacement were excluded. Results. Differences in health status were defined more by age than by sex, especially for physical function. The costs to the patients were high, particularly for women, who spent more on medications and special equipment. Women also reported receiving more assistance from family and friends. Higher disease-related expenditures were associated with greater pain levels, poorer social function and mental health, and longer duration of disease. Significant independent predictors of total patient expenditures related to OA were being female and having joint stiffness. Conclusion. Despite having heavily subsidized health care and access to the Pharmaceutical Benefits Scheme, out-ofpocket costs for patients with OA in Australia are considerable. Higher expenditures for patients with OA are related to more advanced disease, especially for women.

The WHO Surgical Safety Checklist was launched in 2009, and appropriate use reduces mortality, surgical site infections and complications after surgery by up to 50%. Implementation across low-income and middle-income countries has been slow; published evidence is restricted to reports from a few single institutions, and significant challenges to successful implementation have been identified and presented. The Mercy Ships Medical Capacity Building team developed a multidisciplinary 3-day Surgical Safety Checklist training programme designed for rapid wide-scale implementation in all regional referral hospitals in Madagascar. Particular attention was given to addressing previously reported challenges to implementation. We taught 427 participants in 21 hospitals; at 3-4 months postcourse, we collected surveys from 183 participants in 20 hospitals and conducted one focus group per hospital. We used a concurrent embedded approach in this mixed-methods design to evaluate participants&#39...

Objective-Subjective well-being has well-established positive health consequences. During emerging adulthood, from ages 18 to 25 years, people's global evaluations of their well-being (i.e., satisfaction with life [SWL]) appear to worsen more than any other time in the adult lifespan, indicating that this population would benefit from strategies to enhance SWL. In these studies, we investigated top-down (i.e., time-invariant, trait-like) and bottom-up (i.e., time-varying, state-like) influences of physical activity (PA) on daily SWL. Methods-Two daily diary studies lasting 8 days (N = 190) and 14 days (N = 63) were conducted with samples of emerging adults enrolled in college to evaluate relations between daily PA and SWL while controlling for established and plausible top-down and bottom-up influences on SWL. Results-In both studies, multilevel models indicated that people reported greater SWL on days when they were more active (a within-person, bottom-up effect). Top-down effects of PA were not significant in either study. These findings were robust when we controlled for competing topdown influences (e.g., sex, personality traits, self-esteem, body mass index, mental health Correspondence concerning this article should be addressed to 17 Recreation Building,

Objective-Subjective well-being has well-established positive health consequences. During emerging adulthood, from ages 18 to 25 years, people's global evaluations of their well-being (i.e., satisfaction with life [SWL]) appear to worsen more than any other time in the adult lifespan, indicating that this population would benefit from strategies to enhance SWL. In these studies, we investigated top-down (i.e., time-invariant, trait-like) and bottom-up (i.e., time-varying, state-like) influences of physical activity (PA) on daily SWL. Methods-Two daily diary studies lasting 8 days (N = 190) and 14 days (N = 63) were conducted with samples of emerging adults enrolled in college to evaluate relations between daily PA and SWL while controlling for established and plausible top-down and bottom-up influences on SWL. Results-In both studies, multilevel models indicated that people reported greater SWL on days when they were more active (a within-person, bottom-up effect). Top-down effects of PA were not significant in either study. These findings were robust when we controlled for competing topdown influences (e.g., sex, personality traits, self-esteem, body mass index, mental health Correspondence concerning this article should be addressed to 17 Recreation Building,

The COVID-19 pandemic brought the world to a standstill, forcing businesses to close or adjust operations to online platforms. Nursing Educational Institutions (NEIs) were similarly affected by the implementation of public health measures to reduce the transmission of COVID-19, leading to abrupt lockdowns and campus closures, reduced or no face-to-face time in labs, and a sudden loss of clinical placement sites for students. To combat this problem, NEIs had to adjust their conventional practices and find alternative, novel approaches to fulfill the required hands-on lab teaching and clinical practice hours for their students. Many NEIs turned to simulation to close this gap for nursing students. Therefore, this integrative review seeks to explore what innovative simulation strategies were used during the pandemic era and the lessons that can be learned from these innovations. Key Terms: COVID-19, simulation, innovative strategies, undergraduate nursing

This is the second issue this year with papers dealing with various issues from the region. Mohamed, N did an integrative review aims to identify the factors that promote back-care practices among nurses working in longterm care settings. This integrative review was guided by Whittemore and Knafl's (2005) framework. Three databases were searched for peer-reviewed studies published between 2011 and 2021 based on set inclusion and exclusion criteria. A hand search was also conducted among the reference lists of the included peer-reviewed articles. The identified articles were critically appraised using the Mixed Methods Appraisal Tool. Data was then extracted, and the various barriers and facilitators of back-care practices were noted based on the three levels of the Socio-Ecological Model: individual, organizational, and environmental. Three main factors that influence back-care practices include lack of knowledge among nurses about the programs, lack of organizational support, and lack of maneuvering space.

To evaluate a case management (CM) model for people with mild dementia, whereby resources within the family and in the community were mobilized and optimally used. Method: Community dwelling psychiatric and geriatrics outpatients with mild dementia were randomized to receive CM by a trained occupational therapist for 4 months (CM group, N ¼ 59) or usual care only (control group, N ¼ 43). Primary outcome indicators included the Zarit Burden Scale (ZBI), General Health Questionnaire (GHQ), and Personal Well-Being Index for Adult (PWI-A) of the family caregivers. Secondary outcome indicators included the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Personal Well-Being Index for Intellectually Disabled (PWI-ID) of the demented subjects as measured at fourth and twelfth months. Result: CSDDis reduced in the CM group at fourth month, but not at twelfth month. The changes in outcome variables of persons with dementia did not differ between the groups (Mann-Whitney U-test, p > 0.05). At follow-up, CM group used more day care and domestic helpers than control group (x 2 , p > 0.05). Conclusion: Case management for Chinese persons with mild dementia outpatients did not show significant effects in reducing caregiver burden, but encouraged family caregivers to seek external support.

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men’s involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher stages. Women’s education and ages, spontaneous recall of modern contraceptive method, cons for IUD, and self-efficacy for contraception and for convincing wives to get IUD inserted (or continue use) were significant predictors of men’s readiness to accept IUD. Interventions are targeted to reduce cons and increase self-efficacy for I...

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men’s involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher stages. Women’s education and ages, spontaneous recall of modern contraceptive method, cons for IUD, and self-efficacy for contraception and for convincing wives to get IUD inserted (or continue use) were significant predictors of men’s readiness to accept IUD. Interventions are targeted to reduce cons and increase self-efficacy for I...

Objective: The objective of the study was to explore the impact of implementation of the Public Health Amendment (Vaccination of Children Attending Child Care Facilities) Act 2013 on childcare centres in the Northern Rivers region of New South Wales (NSW), from the perspective of childcare centre directors. Importance of study: Immunisation is an effective public health intervention, but more than 75 000 Australian children are not fully vaccinated. A recent amendment to the NSW Public Health Act 2010 asks childcare facilities to collect evidence of complete vaccination or approved exemption before allowing enrolment. Methods: Ten childcare centre directors participated in a semiscripted interview. Interviews were recorded, transcribed and analysed. Results: Common themes included misinterpretation of the amendment before implementation, the importance of adequate notice for implementation, lack of understanding of assessment of compliance, increased administrative requirements, the importance of other public health efforts, and limited change in vaccination rates. Childcare centres differed in their experience of the resources provided by the government, interactions with Medicare, and ease of integration with existing record-keeping methods. Conclusions: Participants felt that the amendment was successfully implemented. The amendment was felt to have fulfilled its aim of prompting parents who had forgotten to vaccinate, but failed to significantly affect conscientious objectors. Overall, the amendment was perceived to be a positive step in improving vaccination rates, but its impact was largely complementary to other components of the multifaceted vaccination policy.

Background: National policies seek to involve older Australian's in decisions regarding their care; however, research has found varying levels of decision self-efficacy and health literacy skills. An increasing number of older Australians use complementary medicine (CM). We examined the effectiveness of a CM educational intervention delivered using a web or DVD plus booklet format to increase older adults' decision self-efficacy and health literacy. Methods: A randomised controlled trial was conducted. We recruited individuals aged over 65 years living in retirement villages or participating in community groups, in Sydney Australia. Participants were randomly allocated to receive a CM education intervention delivered using a website or DVD plus booklet versus booklet only. The primary outcome was decision self-efficacy. A secondary outcome included the Preparation for Decision-Making scale and health literacy. Outcomes were collected at 3 weeks, and 2 months from baseline, and analysed using an adjusted ANOVA, or repeated measures ANOVA. Result: We randomised 153 participants. Follow up at 3 weeks and 2 months was completed by 131 participants. There was a 14% (n = 22) attrition rate. At the end of the intervention, we found no significant differences between groups for decision self-efficacy (mean difference (MD) 3.8, 95% confidence interval (CI)-2.0 to 9.6 p = 0.20), there were no differences between groups on nine health literacy domains, and the Preparation for Decision-Making scale. Over 80% of participants in both groups rated the content as excellent or good. Conclusion: Decision self-efficacy improved for participants, but did not differ between groups. Decision self-efficacy and health literacy outcomes were not influenced by the delivery of education using a website, DVD or booklet. Participants found the resources useful, and rated the content as good or excellent. CM Web or DVD and booklet resources have the potential for wider application. Trial registration: The trial was registered with the Australian New Zealand Clinical Trials Registry: ACTRN (ACTRN12616000135415). The trial was registered on 5 February 2016.

Background: General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. Methods: A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Results: Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar's generic communication and consultation skills, only 72% referred to culture or to the patient's Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. Conclusions: The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise health supports designed to decrease the disadvantage faced by vulnerable populations.

Objectives: To find the effect of fine motor skill training on decoding skills in school going children between the ages of 4 to 9 years and to compare its effect between both the genders. Study design: An Experimental study on 30school going children between the ages of 5-9 years, was conducted in Pune,India.The Abecedarian Reading Assessment for decoding skills. The children underwent fine motor skill training for a period of 2 weeks, three times per week for 45 minutes, which included, weight bearing exercises, Theraputty exercises, Theraband exercises, activities using different texturesand ADL activities. Paired T test was used for statistical analysis. Results: A total of 30 children with a mean age of 7 years were included. Paired T test showed statistically significant improvement in post training decoding skills (t=16.9, p=&lt;0.0001) in male children (28.55; 39.55)of age 6 years (23.60;34.80). Conclusion: Fine motor skill training was found to be effective in improving dec...

Taking into an account dynamically changing nutrition practices in Papua New Guinea (PNG), this study aimed to document and elucidate ethnocultural food practices related to pregnancy. With convenient sampling, 176 pregnant women were interviewed using a semistructured questionnaire. The participants originated from three different ethnic rural communities in Madang Province and one from Simbu Province. Strength of beliefs in traditional food customs and taboos among pregnant women varied significantly between regions, with those believing in taboos ranging from 66 to 13%. The majority of the foods enlisted as taboos for pregnant women were rich in protein. A common belief supporting various taboos was that breaking them may cause deformities in the newborn. The participants demonstrated a low knowledge level on nutrition, which in conjunction with restrictive food taboos led to their suboptimal dietary practices. Our results suggested that communication on nutrition is inadequate i...

The aim of our study was to determine the importance and assessment of a health-promoting lifestyle and its possible association with well-being of medical students. Study Design: Cross Sectional Study. Setting: Aziz Fatima Medical and Dental College Faisalabad. Period: June to July 2020. Material & Methods: The English version of Health-Promoting Lifestyle Profile, and WHO-5 Well-Being Index were used in our study. Results: The research was conducted with 205 medical students. From which 102(49.8%) belongs from 4-year class and 103(50.2%) from 5-year class. Based on the table, the mean age of the total participants was 22.45(±1.03) years. Among the participants, the mean score of a health-promoting lifestyle was 133.36 ±18.90, which is interpreted as moderate. Lifestyle mean score is greater in 5th-year class as compare to 4th-year class but no significant difference was found because p value is greater than 0.05 there was a significant relationship between wellbeing and health-promoting lifestyle. Age and gender, were associated with students lifestyles. Independent t test is used to compare the mean difference in gender and MBBS class. Chi square test is used to find the significant association between well-being categories with gender and MBBS class. Pearson correlation coefficient method is used to measure the correlation between well being and healthy lifestyles. Conclusion: A health-promoting lifestyle of students in this study was moderate and they did not have an acceptable level of physical activity. The medical students' curriculums need to be improved to enhance health promoting lifestyles.

This inquiry engaged graduate students in the Homeland Security and Emergency Management programcoursedesignatedasAcademicCommunityEngagement(ACE)atanInstitutionofHigher Education(IHE)inruralTexas.ThepurposewastoevaluateanAmericanRedCross(ARC)risk-reductionHomeFireCampaigninitiativeandtoimplementnewstrategiesdesignedbystudentsand groundedinafteractionreports(AARs)andprinciplesofemergencymanagement(EM).Vygotsky's modelofsociallearningandCulturalHistoricalActivityTheory(CHAT)framedthestudy.Students partnered with the ARC, emergency responders, and civil society organizations to (a) assess the effectivenessoftheARC-ledcampaign;(b)applyEMprinciplesindesigningthestudent-ledcampaign; (c)implementEMprinciplestonewcapability-buildingstrategies;and(d)offerrecommendations. Comparativeanalysesofseparatecampaigneventsinthecommunityrevealedreciprocalbenefits; solutionsdevisedbystudentsenhancedprogrameffectivenessandexpandedsocialcapital;students reporteddeepcontextualizedlearning.

Recently, representatives of politics, health officials and academia in Germany have advocated a greater role for Germany in matters concerning global health. However, health professionals in Germany are rarely taught about global health topics and accordingly real expertise in this field is lacking. To advance knowledge and competencies at German universities and adequately equip health professionals to achieve Germany's political goals, global health curricula must be developed at medical schools and other institutions. Such ambitions raise questions about the required content and dimensions of global health curricula as the field is currently highly heterogeneous and ill defined. To systematically identify strengths and shortcomings of current curricula, we scrutinised the global health curriculum at our institution, Charité-Universitätsmedizin Berlin, using an analytical framework that integrates the various approaches of global health. Our analysis identified that four (technical, social justice, security and humanitarian) of five approaches are present in our core global health curriculum. Local and global aspects of the field are equally represented. We propose that the use of such a structured analytical framework can support the development of GH curricula for all health professionals-in Germany and elsewhere. But it can also help to evaluate existing curricula like ours at Charité. This framework has the potential to support the design of comprehensive GH trainings, serving German aspirations in politics and academia to promote health worldwide.

Recently, representatives of politics, health officials and academia in Germany have advocated a greater role for Germany in matters concerning global health. However, health professionals in Germany are rarely taught about global health topics and accordingly real expertise in this field is lacking. To advance knowledge and competencies at German universities and adequately equip health professionals to achieve Germany’s political goals, global health curricula must be developed at medical schools and other institutions. Such ambitions raise questions about the required content and dimensions of global health curricula as the field is currently highly heterogeneous and ill defined. To systematically identify strengths and shortcomings of current curricula, we scrutinised the global health curriculum at our institution, Charité—Universitätsmedizin Berlin, using an analytical framework that integrates the various approaches of global health. Our analysis identified that four (technic...

Telehealth and e-health are providing a means to transform systems of care for children throughout the world by providing greater access to clinical service and consultation, as well as sharing knowledge, education, and training. Leap-frogging over prior barriers, these information and communication technologies (ICT) also have the potential to offer greater access to these services in developing countries.1 The use of telehealth must be put in the context of the critical health needs in each country, cultural perspectives, current and future communication infrastructure, other supportive resources, and likelihood for sustainability. Furthermore, these telehealth efforts should be aimed at improving the local capacity in providing ongoing health services in each country and blending into that country’s current and future healthcare system. Fundamental steps in addressing global health issues include reducing poverty, improving education and health promotion strategies, ensuring acce...

Objectives: The aim of our study was to determine the importance and assessment of a health-promoting lifestyle and its possible association with well-being of medical students. Study Design: Cross Sectional Study. Setting: Aziz Fatima Medical and Dental College Faisalabad. Period: June to July 2020. Material & Methods: The English version of Health-Promoting Lifestyle Profile, and WHO-5 Well-Being Index were used in our study. Results: The research was conducted with 205 medical students. From which 102(49.8%) belongs from 4-year class and 103(50.2%) from 5-year class. Based on the table, the mean age of the total participants was 22.45(±1.03) years. Among the participants, the mean score of a health-promoting lifestyle was 133.36 ±18.90, which is interpreted as moderate. Lifestyle mean score is greater in 5th-year class as compare to 4th-year class but no significant difference was found because p value is greater than 0.05 there was a significant relationship between well-being a...

Heavy metals contamination of groundwater has been of public health concern in recent years because of their implication in human health and environment. This study therefore assesses heavy metals contamination in groundwater from selected communities in Sagamu, Ogun State, Nigeria. Fifty groundwater samples were purposively collected for Physicochemical and heavy metals determination, and also spatial distribution maps of selected heavy metals were produced using Arc GIS software. Data were analyzed using descriptive statistics. Physicochemical results of groundwater revealed that the water was acidic with low conductivity and total dissolved solids (TDS). The levels of arsenic and chromium were found to be within the Maximum Contaminant Levels (MCL) while that of Pb and Cd were above MCL. The spatial distribution showed that there was predominantly high concentration of lead across the study area and cadmium was predominantly high especially in area close to industries.

Heavy metals' presence in groundwater has garnered a lot of attention recently due to their impact on ecosystem and human health. Thus, this chapter was designed to assess the effects of heavy metals contamination in groundwater and its implication for public health education in selected communities located in an industrial area in Ogun state, southwestern Nigeria. Fifty groundwater sources were identified using a handheld global positioning system and analyzed for physicochemical and heavy metals properties. Four-hundred participants were selected and interviewed using pre-tested semi-structured questionnaire. The results indicated that there were high quantities of heavy metals in the groundwater that were above the allowable limit set by national and international regulations. A larger percentage of the respondents' drinks water from groundwater supply. The majority of those surveyed were poorly informed on the effects of heavy metal contamination. The following ailments were experienced by the respondents in the last 6 months: frequent watery stool, difficulty in breathing, and skin infection. Few of the respondents reported the following occurrences in their household in the last 1 year: still birth, stunted growth in child, and death due to cancer. Therefore, there is a requirement for immediate public health education and health promotion activities among the local populace.

Background: National policies seek to involve older Australian's in decisions regarding their care; however, research has found varying levels of decision self-efficacy and health literacy skills. An increasing number of older Australians use complementary medicine (CM). We examined the effectiveness of a CM educational intervention delivered using a web or DVD plus booklet format to increase older adults' decision self-efficacy and health literacy. Methods: A randomised controlled trial was conducted. We recruited individuals aged over 65 years living in retirement villages or participating in community groups, in Sydney Australia. Participants were randomly allocated to receive a CM education intervention delivered using a website or DVD plus booklet versus booklet only. The primary outcome was decision self-efficacy. A secondary outcome included the Preparation for Decision-Making scale and health literacy. Outcomes were collected at 3 weeks, and 2 months from baseline, and analysed using an adjusted ANOVA, or repeated measures ANOVA. Result: We randomised 153 participants. Follow up at 3 weeks and 2 months was completed by 131 participants. There was a 14% (n = 22) attrition rate. At the end of the intervention, we found no significant differences between groups for decision self-efficacy (mean difference (MD) 3.8, 95% confidence interval (CI)-2.0 to 9.6 p = 0.20), there were no differences between groups on nine health literacy domains, and the Preparation for Decision-Making scale. Over 80% of participants in both groups rated the content as excellent or good. Conclusion: Decision self-efficacy improved for participants, but did not differ between groups. Decision self-efficacy and health literacy outcomes were not influenced by the delivery of education using a website, DVD or booklet. Participants found the resources useful, and rated the content as good or excellent. CM Web or DVD and booklet resources have the potential for wider application. Trial registration: The trial was registered with the Australian New Zealand Clinical Trials Registry: ACTRN (ACTRN12616000135415). The trial was registered on 5 February 2016.

Inappropriate prescribing of medicines may lead to a significant risk of an adverse drug-related event. In particular, prescribing may be regarded as inappropriate when alternative therapy that is either more effective or associated with a lower risk exists to treat the same condition. This review aims to identify interventions and strategies that can significantly reduce inappropriate prescribing in the elderly. The review is based on a search of electronic databases using synonyms of keywords such as 'elderly', 'interventions', 'optimized prescribing' and 'inappropriate prescribing' to identify reported interventions intended to improve inappropriate prescribing in the elderly. A total of 711 articles published in English were retrieved and considered. Of these, 24 original studies, involving 56 to 124 802 participants, met the inclusion

Evidence for the superiority of particular characteristics in PBL tutors in medical curricula is generally inconclusive. Most studies have investigated the effectiveness of content experts compared with that of non-experts as measured either by student satisfaction or academic achievement. A few have compared academic staff tutors with student tutors. The purpose of this study was to investigate the relationship between students&#39; perception of overall tutor effectiveness, particular tutor behaviours, clinical qualifications and academic appointment. A questionnaire designed to evaluate particular aspects of PBL tutoring technique, related either to subject-matter knowledge or to process-facilitation skill, as well as overall effectiveness, was distributed to students in first year of a PBL medical program at the end of each of three tutor terms. A total of 76 tutor terms were included in the study. Data analysis compared clinical with non-clinical tutors, and staff with non-staf...

Background: Patan Academy of Health Sciences (PAHS) aims to produce physicians who would be able and willing to serve in the rural areas. Recognizing the critical importance of student selection strategy, among others, in achieving the program goals, it has adopted an innovative scheme for selecting medical students. This paper describes PAHS medical student selection scheme that favors enrollment of deserving applicants from rural and disadvantaged groups so as to help improve distribution of physicians in rural Nepal. Methods: A student admission committee comprising a group of medical educators finalized a three-step student selection scheme linked with scholarships after reviewing relevant literatures and consultative meetings with experts within and outside Nepal. The committee did local validation of Personal Quality Assessment (PQA) that tested cognitive ability and personality traits, Admission OSPE (Objective Structured Performance Examination) that assessed non-cognitive attributes of applicants. It also provided preferential credits to applicants' socioeconomic characteristics to favor the enrollment of deserving applicants from rural and disadvantaged groups through Social Inclusion Matrix (SIM). Three different categories of scholarship schemes namely Partial, Collaborative and Full were devised with Partial providing 50% and other two categories each providing 100% coverage of tuition fee. Results: PAHS student selection scheme succeeded in enrolling more than half of its students from rural areas of Nepal, including about 10% of the students from that of the most backward region of the country. About one third of students were female and about the same were from public and community school. Sixty percent of students receive different categories of scholarships. Conclusions: Limited findings indicate the success of the selection scheme in enrolling high proportion of applicants from rural and disadvantageous groups and enable them to pursue study by providing scholarships.