Spatial-Based Earthquake Disaster Risk Analysis In Parepare City, South Sulawesi

The research objectives are to create hazard maps, vulnerability maps, spatial-based risk analysis in the form of earthquake disaster risk mapsin Parepare. The earthquake disaster riskanalysis applied Geographic Information System spatial-based overlay analysismethod. Research to identify earthquake hazard risk was based on earthquake hazard factors, the vulnerability factor of population density and capacity factor. Earthquake hazard map wasgenerated from calculatingThe Peak Ground Acceleration  value, procured from the source map and hazards of earthquake in Indonesia 2017 (Team 9)the peak acceleration map in the base rock for the probability exceeded 2% in the last 50 years. Automatic terrain classification map using SRTM (250 m or mesh 1 km) was obtained from Koiwahashi and Pike (2007)and the average distribution of S-waves, shallower than 30m (AVS30),were acquired from J-SHIS for each topographical characteristic (16 classes or 24 classes). The vulnerability data were used for calculating population exposure index and loss index, and the vulnerability was obtained from Focus Group discussion. The earthquake disaster risk index calculated by useing AHP method (Analytical Hierarchy Process).The calculation results showed that the villages with a high risk of earthquake disaster were Bukit Harapan Village, Bukit Indah Village, Ujung Lare Village, WatangSoreang village, and Lapadde village, while the village having the lowest risk of earthquake was Mallusetasi vill

Interim Assessment of the PhilHealth CARES Project

The PhilHealth Customer Assistance, Relations and Empowerment Staff (CARES) project was launched in 2012 to help members and their families navigate the complex Filipino health care system. The study assesses the design and quality of implementation of the PhilHealth CARES project in selected hospitals in PhilHealth's National Capital Region (NCR). The specific objectives were: (1) understand the overall goals and objectives of the project and how these are being understood by the project managers, implementers, and staff in selected areas in NCR; (2) evaluate to what extent project objectives are being met; (3) identify the project strengths, weaknesses, opportunities, and threats as perceived by CARES managers, implementers, and staff; and (4) craft appropriate policy and programmatic responses to improve project implementation.Focus group discussions and desk review (i.e., documents and records review) were the main methods for the study. Observations and mystery client visits to four PhilHealth-accredited hospitals in NCR (private and public, Level 2 and 3) were also done. The study found there were a few critical gaps (weak technical support, discrepancies among offices in policy implementation/interpretation, problematic claiming procedures, etc.) in the execution and operation of the project which needed to be addressed so as to fully maximize the benefits of the project and ensure its sustainability not just as a project but as a program in the future

Structural equation modeling of parasympathetic and sympathetic response to traffic air pollution in a repeated measures study

Background: Traffic-related air pollution has been associated to a range of adverse health impacts, including decreased heart rate variability (HRV). The association between traffic-related pollution and HRV, however, has varied by traffic-related or HRV marker as well as by study, suggesting the need for a more comprehensive and integrative approach to examining air pollution-mediated biological impacts on these outcomes. In a Bayesian framework, we examined the effect of traffic pollution on HRV using structural equation models (SEMs) and looked at effect modification by participant characteristics. Methods: We studied measurements of 5 HRV markers [high frequency (HF), low frequency (LF), 5-min standard deviation of normal-to-normal intervals (SDNN), square root of the mean squared differences of successive normal-to-normal intervals (rMSSD), and LF/HF ratio (LF/HF)] for 700 elderly men from the Normative Aging Study. Using SEMs, we fit a latent variable for traffic pollution that is reflected by levels of carbon monoxide, nitrogen monoxide, nitrogen dioxide, and black carbon (BC) to estimate its effect on latent variable for parasympathetic tone that included HF, SDNN and rMSSD, and the sympathetic tone marker, LF/HF. Exposure periods were assessed using 4-, 24-, 48-, 72-hour moving average pre-visit. We compared our main effect findings using SEMs with those obtained using linear mixed models. Results: Traffic pollution was not associated with mean parasympathetic tone and LF/HF for all examined moving averages. In Bayesian linear mixed models, however, BC was related to increased LF/HF, an inter quartile range (IQR) increase in BC was associated with a 6.5% (95% posterior interval (PI): -0.7%, 14.2%) increase in mean LF/HF 24-hours later. The strongest association observed was for the 4-hour moving average (10.1%; 95% PI: 3.0%, 17.6%). The effect of traffic on parasympathetic tone was stronger among diabetic as compared to non-diabetic participants. Specifically, an IQR increase in traffic pollution in the 48-hr prior to the clinic visit was associated with a 44.3% (95% PI: -67.7%, -4.2%) lower mean parasympathetic tone among diabetics, and a 7.7% (95% PI: -18.0%, 41.4%) higher mean parasympathetic tone among non-diabetics. Conclusions: BC was associated with adverse changes LF/HF in the elderly. Traffic pollution may decrease parasympathetic tone among diabetic elderly

Tuberculosis and Diabetes Mellitus Control and Care: A Rapid Situational Analysis for Planning a Coordinated Program Response

Tuberculosis (TB) remains one of the leading killers among bacterial diseases worldwide. In the Philippines, the prevalence of culture-positive TB is estimated to be 5 per 1000 and that for sputum smear-positive pulmonary TB is 2 per 1000 based on the 2007 National Prevalence Survey. In addition, the prevalence of metabolic syndrome among Filipinos is 5 percent or approximately 5 million people have diabetes (DM) in the Philippines. With the Philippines being endemic for TB, compounded by an upward trend of DM, there is a need to jointly address this tandem disease interaction. This study aims to mount a coordinated response to TB/DM with the following expectations: 1) improve the case detection rate for TB, 2) facilitate early management among patients, and 3) prevent a significant number of severe disease and deaths.Mixed methods are used to achieve the objectives including a systematic review and gray literature to estimate the magnitude of co-morbidity with TB and DM, records review specifically medical records on clinical charts of patients, cross-sectional survey on knowledge, attitudes, and practices of health care providers on TB/DM screening and care, focus group discussions comprising of program managers and technical advisors of the National Tuberculosis Program, and costing exercise on bidirectional screening of TB in diabetic patients and vice versa. Given the government's commitment to the nationwide control of TB, the underexplored frontier of TB among diabetic patients can be among the stretch goals toward increased case detection, management and prevention efforts. Likewise, the increasing prevalence of diabetes in the country and the associated risk of TB transmission in a TB-endemic population suggest the need for raising awareness on the need for TB screening. However, there is a body of programmatic and operational research questions to answer before an integrated approach to bidirectional screening can actually be implemented

Is the Philippines ready for HIV self-testing?

Background: The Philippines is facing a rapidly rising HIV epidemic among young men who have sex with men (MSM). Testing rates among young populations is poor. HIV self-testing (HIVST) is a promising strategy to address this testing gap. The study’s purpose was to explore the perceived acceptability, feasibility and programmatic challenges of HIVST among key informants and target users. Method: A qualitative study involving semi-structured interviews and focus group discussions (FGD). We interviewed 15 key informants involved with HIV testing programs or policies and 42 target users in six FGD in Metro Manila. We held separate discussions with high socio-economic MSM (n = 12), urban poor MSM (n = 15) and transgender women (TGW) (n = 15). Results were analysed using a thematic framework approach. Results: MSM and TGW welcomed the convenience and privacy HIVST could provide. They preferred an inexpensive accurate blood-based kit attained from reputable sites. Key informants at national and local level equally welcomed HIVST but identified a number of policy and regulatory issues. Both groups articulated the challenge of enrolling those who test reactive using HIVST to further testing and treatment in an environment characterised by acute stigma around HIV. Conclusions: HIVST was found to be highly acceptable to target users and was welcomed as an additional testing approach at national level. Strategic alliances are now needed between stakeholders to proactively deliver a patientcentred HIVST program that could provide an effective, safe means of increasing testing coverage in this escalating context. Keywords: HIV self-testing, Philippines, Men who have sex with men (MSM), Transgender women, TGW, Regulation, Polic

Traffic-Related Air Pollution and QT Interval: Modification by Diabetes, Obesity, and Oxidative Stress Gene Polymorphisms in the Normative Aging Study

BACKGROUND. Acute exposure to ambient air pollution has been associated with acute changes in cardiac outcomes, often within hours of exposure. OBJECTIVES. We examined the effects of air pollutants on heart-rate-corrected QT interval (QTc), an electrocardiographic marker of ventricular repolarization, and whether these associations were modified by participant characteristics and genetic polymorphisms related to oxidative stress. METHODS. We studied repeated measurements of QTc on 580 men from the Veterans Affairs Normative Aging Study (NAS) using mixed-effects models with random intercepts. We fitted a quadratic constrained distributed lag model to estimate the cumulative effect on QTc of ambient air pollutants including fine particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5), ozone (O3), black carbon (BC), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide (SO2) concentrations during the 10 hr before the visit. We genotyped polymorphisms related to oxidative stress and analyzed pollution-susceptibility score interactions using the genetic susceptibility score (GSS) method. RESULTS. Ambient traffic pollutant concentrations were related to longer QTc. An interquartile range (IQR) change in BC cumulative during the 10 hr before the visit was associated with increased QTc [1.89 msec change; 95% confidence interval (CI), -0.16 to 3.93]. We found a similar association with QTc for an IQR change in 1-hr BC that occurred 4 hr before the visit (2.54 msec change; 95% CI, 0.28-4.80). We found increased QTc for IQR changes in NO2 and CO, but the change was statistically insignificant. In contrast, we found no association between QTc and PM2.5, SO2, and O3. The association between QTc and BC was stronger among participants who were obese, who had diabetes, who were nonsmokers, or who had higher GSSs. CONCLUSIONS. Traffic-related pollutants may increase QTc among persons with diabetes, persons who are obese, and nonsmoking elderly individuals; the number of genetic variants related to oxidative stress increases this effect.National Institute of Environmental Health Sciences (ES014663-01A2, P01 ES09825); United States Environmental Protection Agency (R827353, R83241601

Development of a Mobile Game to Influence Behavior Determinants of HIV Service Uptake Among Key Populations in the Philippines: User-Centered Design Process

Opportunities in digital distribution place mobile games as a promising platform for games for health. However, designing a game that can compete in the saturated mobile games market and deliver persuasive health messages can feel like an insurmountable challenge. Although user-centered design is widely advocated, factors such as the user's subject domain expertise, budget constraints, and poor data collection methods can restrict the benefits of user involvement. OBJECTIVE: This study aimed to develop a playable and acceptable game for health, targeted at young key populations in the Philippines. METHODS: Authors identified a range of user-centered design methods to be used in tandem from published literature. The resulting design process involved a phased approach, with 40 primary and secondary users engaged during the initial ideation and prototype testing stages. Selected methods included participatory design workshops, playtests, playability heuristics, and focus group discussions. Subject domain experts were allocated roles in the development team. Data were analyzed using a framework approach. Conceptual frameworks in health intervention acceptability and game design guided the analysis. In-game events were captured through the Unity Analytics service to monitor uptake and game use over a 12-month period. RESULTS: Early user involvement revealed a strong desire for online multiplayer gameplay, yet most reported that access to this type of game was restricted because of technical and economic constraints. A role-playing game (RPG) with combat elements was identified as a very appealing gameplay style. Findings guided us to a game that could be played offline and that blended RPG elements, such as narrative and turn-based combat, with match-3 puzzles. Although the game received a positive response during playtests, gameplay was at times perceived as repetitive and predicted to only appeal to casual gamers. Knowledge transfer was predominantly achieved through interpretation of the game's narrative, highlighting this as an important design element. Uptake of the game was positive; between December 1, 2017, and December 1, 2018, 3325 unique device installs were reported globally. Game metrics provided evidence of adoption by young key populations in the Philippines. Game uptake and use were substantially higher in regions where direct engagement with target users took place. CONCLUSIONS: User-centered design activities supported the identification of important contextual requirements. Multiple data collection methods enabled triangulation of findings to mediate the inherent biases of the different techniques. Game acceptance is dependent on the ability of the development team to implement design solutions that address the needs and desires of target users. If target users are expected to develop design solutions, they must have adequate expertise and a significant role within the development team. Facilitating meaningful partnerships between health professionals, the games industry, and end users will support the games for health industry as it matures

Effect of daily social media exposure on anxiety and depression disorders among cargo seafarers: a cross-sectional study

Background: Several studies have linked social media use to increased risks for anxiety and depression. Cargo seafaring is one occupation prone to constant mental health instability due to workload, social isolation, and harsh working conditions. We examined the effect of daily social media exposure, occupational experience, and socioeconomic factors on anxiety and depression disorders among cargo seafarers. Materials and methods: We assessed the anxiety and depression disorders of 153 cargo seafarers using Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9 scales. We fitted generalised linear models to estimate associations between depression and anxiety disorders and daily social media exposure, occupational experience, and socioeconomic factors. Results: Approximately 30% and 37% of the seafarers had mild, moderate, or severe anxiety and depression disorders. The prevalence of anxiety was 2.68 times higher (adjusted prevalence ratio [aPR] 2.68, 95% confidence interval [95% CI] 1.30–5.50) and 2.27 times higher (aPR 2.27; 95% CI 1.12–4.62) among seafarers who spend > 2 to 4 hours and > 4 hours each day, respectively, on social media compared to seafarers who spend only up to 2 hours. In addition, seafarers who were on social media daily for > 2 to 4 hours (aPR 1.49; 95% CI 0.86–2.60) and > 4 hours (aPR 1.34; 95% CI 0.75–2.40) had a higher prevalence of depression compared to seafarers who were on social media daily for only up to 2 hours. Non-Catholics or seafarers with ≤ 10 years of occupational experience had a higher prevalence for anxiety and depression disorders than Catholics or seafarers with > 10 years of occupational experience. Conclusions: Daily social media exposure for > 2 hours, working for ≤ 10 years, or being a non-Catholic may contribute to the increase in the seafarers’ susceptibility to depression and anxiety disorders. The establishment of support groups for cargo seafarers is warranted to promote mental health awareness and well-being

Evaluating Knowledge to Support Climate Action: A Framework for Sustained Assessment. Report of an Independent Advisory Committee on Applied Climate Assessment

As states, cities, tribes, and private interests cope with climate damages and seek to increase preparedness and resilience, they will need to navigate myriad choices and options available to them. Making these choices in ways that identify pathways for climate action that support their development objectives will require constructive public dialogue, community participation, and flexible and ongoing access to science- and experience-based knowledge. In 2016, a Federal Advisory Committee (FAC) was convened to recommend how to conduct a sustained National Climate Assessment (NCA) to increase the relevance and usability of assessments for informing action. The FAC was disbanded in 2017, but members and additional experts reconvened to complete the report that is presented here. A key recommendation is establishing a new nonfederal "climate assessment consortium" to increase the role of state/local/tribal government and civil society in assessments. The expanded process would 1) focus on applied problems faced by practitioners, 2) organize sustained partnerships for collaborative learning across similar projects and case studies to identify effective tested practices, and 3) assess and improve knowledge-based methods for project implementation. Specific recommendations include evaluating climate models and data using user-defined metrics; improving benefit-cost assessment and supporting decision-making under uncertainty; and accelerating application of tools and methods such as citizen science, artificial intelligence, indicators, and geospatial analysis. The recommendations are the result of broad consultation and present an ambitious agenda for federal agencies, state/local/tribal jurisdictions, universities and the research sector, professional associations, nongovernmental and community-based organizations, and private-sector firms.New York State Energy Research and Development Authority [123416]; Columbia University's Earth Institute; American Meteorological Society; Kresge Foundation6 month embargo; published online: 21 May 2019This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]