Experiences of keratoconus patients attending public eye care facilities in South Africa.

BACKGROUND: Keratoconus (KC) is a progressive condition that usually affects young persons between their first and fourth decades. Myopia and irregular astigmatism are the common presentations which are proceeded by corneal steepening and thinning. Keratoconus is a progressive ectasia of the cornea that presents bilaterally, although often asymmetrical. AIM: To explore the experiences of KC patients attending public eye care facilities in Capricorn District of Limpopo province. SETTING: Capricorn District, Limpopo province, South Africa. METHODS: Descriptive qualitative phenomenology approach was used in the study to explore the lived experiences of patients diagnosed with KC, attending public eye care facilities. Purposive sampling was used to select 16 patients who were diagnosed with KC and referred for contact lens fitting. Data were collected through face-to-face, one-on-one interviews. RESULTS: Patients reported to have developed gradual vision loss which worsened when they grew older. There was lack of knowledge of KC amongst patients and this was exacerbated by limited health literacy and vocabulary barriers. Patients had difficulty performing daily activities where some had dropped out of school while others worked at a slower pace and reduced working distances. CONCLUSION: Patients with KC received inadequate information on their condition due to limited health literacy and vocabulary barriers. Programmes to promote practitioner and patient education are required to improve the perceived service level provided to KC patients.Contribution: The findings of this study will assist to improve the experiences of KC patients on perceived service quality received from public facilities.

Utilisation of and factors associated with non-COVID-19 healthcare services in public facilities amongst cross-border migrants in Thailand, 2019-2022.

BACKGROUND: It is believed that the COVID-19 pandemic might disrupt routine healthcare services. A vulnerable group such as cross-border migrants is of critical concern if the pandemic affects their service utilisation. In this study, we aim to explore the impact of COVID-19 and other related factors on non-COVID-19 service amongst cross-border migrants in Thailand. METHODS: We conducted an ecological time-series cross-sectional analysis using secondary data from 2019 to 2022, focusing on insured and non-insured migrants in a unit of a provincial monthly quarter. We obtained data on registered migrants from the Ministry of Labour and inpatient visits from the Ministry of Public Health (MOPH). Our analysis involved descriptive statistics and a random-effects negative binomial regression, considering variables such as COVID-19 cases, number of hospital beds, registered regions, and COVID-19 waves. We assessed inpatient utilisation number and rate as our primary outcomes. RESULTS: The admission numbers for insured and non-insured migrants in all regions increased 1.3-2.1 times after 2019 despite a decrease in the numbers of registered migrants. The utilisation of services for selected communicable and non-communicable diseases and obstetric conditions remained consistent throughout 2019-2022. The admission numbers and rates were not associated with an increase in COVID-19 incidence cases but significantly enlarged as time passed by compared to the pre-COVID-19 period (44.5-77.0% for insured migrants and 15.0-26.4% for non-insured migrants). Greater Bangkok saw the lowest admission rate amongst insured migrants, reflected by the incidence rate ratio of 5.7-27.5 relative to other regions. CONCLUSION: The admission numbers and rates for non-COVID-19 healthcare services remained stable regardless of COVID-19 incidence. The later pandemic waves (Delta and Omicron variants) were related to an increase in admission numbers and rates, possibly due to disruptions in outpatient care, leading to more severe cases seeking hospitalisation. Lower admission rates in Greater Bangkok may be linked to the fragmentation of the primary care network in major cities and the disintegration of service utilisation data between private facilities and the MOPH. Future research should explore migrant healthcare-seeking behaviour at an individual level, using both quantitative and qualitative methods for deeper insights.

How Much Did Urban Park Use Change under the COVID-19 Pandemic? A Comparative Study of Summertime Park Use in 2019 and 2020 in Edinburgh, Scotland.

The importance of urban parks was highlighted during the COVID-19 pandemic, when a number of restrictions on social gatherings were in place and people's movements were often restricted to their local neighbourhood. This study examined the changes in patterns of park use before and during COVID-19 to understand how the pandemic influenced such use. The methods involved behaviour observation and mapping, to offer a comparison of the use of parks in Edinburgh, Scotland, before and in the first year of the COVID-19 pandemic. The findings show an overall increase in use of urban parks during COVID-19, as expected, with significantly higher use in social areas, sports and fitness areas, and playground areas. However, while there was an overall increase in people visiting parks with others during COVID, in woodland areas there was an increase in lone visitors. This study shows the importance of parks for socialisation, exercise and children's play, but also for spending time alone in natural areas during COVID-19. The value of urban parks at a time of social disruption, such as the pandemic, is highlighted, and their role in supporting a variety of urban dwellers' needs points to priorities for future park planning, design and management.

Research on the site selection of emergency medical facilities from the perspective of country parks.

Post-epidemic era, human society entered the stage of epidemic prevention and control normalized, emergency medical facilities are an important means of epidemic prevention and control, attention-needed can provide construction sites for emergency medical facilities. Disaster prevention and green space can provide construction sites for emergency medical facilities. In comparison, it was found that the site selection conditions of country parks and emergency medical facilities were more compatible. Based on the requirement of the latter's location, using the Delphi method and analytic hierarchy process, through to the country park type, effective safety area, space fragmentation, distance away from the water, in the wind, away from the city center distance, hydrogeology, eight factors such as traffic is quantitative, construct the evaluation system of emergency medical facility location. Taking Nanjing as an example, the Nanjing city region within the scope of the 43 country parks comprehensive comparison. Results show that green hill forest park, the highest scores in addition to the traffic time factor, the remaining seven factor score the highest, the most balanced distribution, security, scalability, rehabilitation, convenience, pollution prevention, and evacuation. It can be preferred as the site selection and construction target of emergency medical facilities. Besides, the Youzishan Forest Park and Dongkeng Country Park comprehensive scores and each factor score is higher, can be used as emergency preplan alternative goals. The score results indicate that the evaluation method for severity exhibits higher levels of differentiation, significant validity, and highly consistent assignment of impact factor weights. In view of the different regional land, impact factor weights assignment can be adjusted adjust measures to local conditions, to effectively make use of the existing conditions, avoid adverse factors.

Change of urban park usage as a response to the COVID-19 global pandemic.

Urban parks became critical for maintaining the well-being of urban residents during the COVID-19 global pandemic. To examine the impact of COVID-19 on urban park usage, we selected New York City (NYC) and used SafeGraph mobility data, which was collected from a large sample of mobile phone users, to assess the change in park visits and travel distance to a park based on 1) park type, 2) the income level of the visitor census block group (visitor CBG) and 3) that of the park census block group (park CBG). All analyses were adjusted for the impact of temperature on park visitation, and we focused primarily on visits made by NYC residents. Overall, for the eight most popular park types in NYC, visits dropped by 49.2% from 2019 to 2020. The peak reduction in visits occurred in April 2020. Visits to all park types, excluding Nature Areas, decreased from March to December 2020 as compared to 2019. Parks located in higher-income CBGs tended to have lower reductions in visits, with this pattern being primarily driven by large parks, including Flagship Parks, Community Parks and Nature Areas. All types of parks saw significant decreases in distance traveled to visit them, with the exception of the Jointly Operated Playground, Playground, and Nature Area park types. Visitors originating from lower-income CBGs traveled shorter distances to parks and had less reduction in travel distances compared to those from higher-income CBGs. Furthermore, both before and during the pandemic, people tended to travel a greater distance to parks located in high-income CBGs compared to those in low-income CBGs. Finally, multiple types of parks proved crucial destinations for NYC residents during the pandemic. This included Nature Areas to which the visits remained stable, along with Recreation Field/Courts which had relatively small decreases in visits, especially for lower-income communities. Results from this study can support future park planning by shedding light on the different uses of certain park types before and during a global crisis, when access to these facilities can help alleviate the human well-being consequences of "lockdown" policies.

The difference in the elderly's visual impact assessment of pocket park landscape.

As an important part of urban public open space, pocket parks have become an important activity place for the elderly in the context of the aging society in China. With the pocket parks in Nanjing, Jiangsu province, China as research object, this paper set six landscape features to be studied, namely, Height of trees, Green color richness, Stratification of green landscapes, Green space ratio, Leisure facilities, and Water landscape. The elderly respondents with different demographic characteristics, such as age, gender, education level and residential type, were subjected to the picture stimulation experiment whose results were then statistically analyzed. The results indicate that gender and residential type exert certain influence on the elderly's visual impact assessment of pocket park landscape. To be specific, the male elderly prefer the pocket park landscape with 3-6 m high trees, medium green space ratio, and more leisure facilities; the female elderly are in greater favor of pocket park landscapes with 0-3 m high trees, five or more colors, three or more layers; the elderly who live with their families prefer pocket park landscapes with medium green space ratio and more leisure facilities; to the elderly who live alone, pocket park landscapes with trees which are 0-3 m high, five or more colors, and medium leisure facilities are more attractive. This study can provide valuable reference for pocket park design in China.

Equity assessment of maternal and child healthcare benefits utilization and distribution in public healthcare facilities in Bangladesh: a benefit incidence analysis.

BACKGROUND: The distribution of healthcare services should be based on the needs of the population, regardless of their ability to pay. Achieving universal health coverage implies first ensuring that people of all income levels have access to quality healthcare, and then allocating resources reasonably considering individual need. Hence, this study aims to understand how public benefits in Bangladesh are currently distributed among wealth quintiles considering different layers of healthcare facilities and to assess the distributional impact of public benefits. METHODS: To conduct this study, data were extracted from the recent Bangladesh Demographic and Health Survey 2017-18. We performed benefit incidence analysis to determine the distribution of maternal and child healthcare utilization in relation to wealth quintiles. Disaggregated and national-level public benefit incidence analysis was conducted by the types of healthcare services, levels of healthcare facilities, and overall utilization. Concentration curves and concentration indices were estimated to measure the equity in benefits distribution. RESULTS: An unequal utilization of public benefits observed among the wealth quintiles for maternal and child healthcare services across the different levels of healthcare facilities in Bangladesh. Overall, upper two quintiles (richest 19.8% and richer 21.7%) utilized more benefits from public facilities compared to the lower two quintiles (poorest 18.9% and poorer 20.1%). Benefits utilization from secondary level of health facilities was highly pro-rich, while benefit utilization found pro-poor at primary levels. The public benefits in Bangladesh were also not distributed according to the needs of the population; nevertheless, poorest 20% household cannot access 20% share of public benefits in most of the maternal and child healthcare services even if we ignore their needs. CONCLUSIONS: Benefit incidence analysis in public health spending demonstrates the efficacy with which the government allocates constrained health resources to satisfy the needs of the poor. Public health spending in Bangladesh on maternal and child healthcare services were not equally distributed among wealth quintiles. Overall health benefits were more utilized by the rich relative to the poor. Hence, policymakers should prioritize redistribution of resources by targeting the socioeconomically vulnerable segments of the population to increase their access to health services to meet their health needs.

Predictors of long-term care use - informal home care recipients versus private and public facilities residents in Poland.

BACKGROUND: The population aging, together with the shrinking caring potential of families, is a major challenge for social policy in the coming years. The aim of the study is to identify the factors that determine not only the use of long-term care (LTC) but also the selection of individual types of such care in Poland. METHODS: Using unique data collected from inpatient LTC facilities in Poland and the Survey on Health, Ageing and Retirement in Europe (SHARE) database, we estimate logistic regressions explaining the choice of LTC solution. RESULTS: Our results suggest that social inequalities play a role in choosing the type of LTC. Better educated people choose private institutions, while people without support network use more often social residential homes. The impact of multimorbidity on choosing different types of inpatient facilities is limited, thus the number of ADL limitations remains a better indicator of long term care utilization. CONCLUSIONS: The study confirms that social inequalities influence decisions about the choice of LTC. However, multi-morbidity is a predictor of using LTC to a limited extent. The differences in LTC selection determinants between women and men are noticeable.

The optimal spatial delineation method for the service level of urban park green space from the perspective of opportunity equity.

Urban park green spaces (UPGS) constitute a vital component of urban ecosystems, and the unequal distribution of UPGS can significantly impact the well-being of residents. Therefore, investigating the spatial delineation methods of UPGS service levels from the perspective of opportunity equity contributes to enhancing people's quality of life and promoting social harmony. Taking the Yingze District of Taiyuan City as an example, this study uses a modified accessibility measurement method of UPGS with the smallest clustered unit (building) as the service demand point and the UPGS entrance/exit as the service provision point, to establish a micro-scale evaluation framework for spatial equity considering the service radius and service quality of UPGS. The findings are as follows: after setting different service radius for UPGS at different levels, additional areas not covered by UPGS service were identified compared to setting the same service radius uniformly, which could prevent these areas from being overlooked in urban plans. After considering the quality of UPGS services, additional areas with low and high UPGS service levels were identified. Accurate spatial delineation of UPGS service level can avoid wasting public resources by including areas with high service levels in the scope of new UPGS requirements, while areas with low service levels lose opportunities for consideration in future urban infrastructure planning. This study emphasizes the residents' demand for both the quantity and quality of UPGS, facilitating an accurate assessment of whether urban residents can enjoy UPGS, the number of UPGS options available to them, and evaluate the quality of UPGS services experienced. Overall, this research provides new insights for evaluating the spatial equity of urban public facilities.

Research on urban country parks based on emergency medical facilities for public health emergencies-a case study of Guangzhou, China.

As COVID-19 has swept across the world, the escalating number of confirmed and suspected cases overwhelmed the admission capacity of the designated hospitals. Faced with such a grim situation, governments made a quick decision to build emergency medical facilities to address the outbreak. However, the emergency medical facilities faced a huge risk of epidemic spread and improper site could lead to serious secondary transmission. Using the disaster prevention and risk avoidance function of urban green space can solve the problem of selecting the location of emergency medical facilities to a certain extent, with country parks having a high degree of compatibility with the latter. Based on the location requirements of emergency medical facilities, using Analytic Hierarchy Process and Delphi method, through analyzing the type of country parks, effective risk avoidance area, spatial fragmentation, distance from water sources, wind direction, and distance from the city, quantification of 8 impact factors such as hydrogeology and traffic duration was conducted to comprehensively compare 30 country parks in Guangzhou. The results showed that the overall quality of country parks approximated a normal distribution, with Lianma Forest Country Park having the highest comprehensive score and the most balanced distribution of scores for various impact factors. Considering safety, expandability, rehabilitation, convenience, pollution prevention, and fecal isolation, it is a preferred destination for emergency medical facility construction.

[The use of sports facilities for physical activity: a public health and equity perspective]. / El uso de instalaciones deportivas para promover la actividad física: una perspectiva de salud pública y equidad.

Introduction: Background: despite multimillion-dollar investments in sports facilities, there is little information on their contribution to energy expenditure of the population. In this study, participation in 71 physical activities (PAs) and 31 different types of spaces was examined. Objectives: to evaluate which types of spaces are more effective from a public health perspective. Methods: a cross-sectional sample was designed, stratified and proportional to the adult population of Gran Canaria (n = 3,000, ≥ 18 years). PA was evaluated using a validated questionnaire. The spaces used were grouped into two categories: public open spaces and sport facilities. Descriptive statistics and multiple logistic regression were used to analyze the data. Results: the open public spaces accumulated a volume of hours for PA between 1.6 and 28.4 times higher than the sport facilities depending on the socio-demographic group analyzed. The indoor sport facilities were the ones that expressed the greatest associative strength with the achievement of PA recommendations (OR = 5.45, 95 % CI: 4.01; 7.40). Conclusion: a dilemma was posed from a public health perspective because the urban open public spaces reached more population and supported most of the population's energy expenditure, particularly in the groups with the highest health risk, but the indoor sport facilities were the ones that best contributed to achieving a healthy level of physical activity. This study suggests changes in the polices of construction and management of sport facilities and open public spaces to increase PA in groups at higher health risk.

Introducción: Introducción: pese a las inversiones multimillonarias en instalaciones para la actividad física-deportiva, hay poca información acerca de su contribución en el gasto energético poblacional. En este estudio examinamos la participación en 71 actividades físicas (AF) y 31 tipos de espacios diferentes. Objetivo: valorar qué tipos de espacios son más eficaces desde una perspectiva de salud pública y equidad. Método: muestra transversal aleatoria, estratificada y proporcional en género y edad a la población de adultos de Gran Canaria (n = 3.000, ≥ 18 años). La AF fue evaluada mediante cuestionario validado. Los espacios de AF fueron agrupados en dos categorías: espacios públicos abiertos (EPA) e instalaciones deportivas. Para analizar los datos se emplearon estadística descriptiva y regresión logística múltiple. Resultados: los EPA acumularon un volumen de horas de AF entre 1,6 y 28,4 veces mayor que las instalaciones deportivas dependiendo del grupo sociodemográfico analizado. Las instalaciones deportivas cubiertas fueron las que expresaron la mayor fuerza asociativa con el logro de las recomendaciones de AF (OR = 5,45, IC 95 %: 4,01; 7,40). Conclusiones: se planteó un dilema desde una perspectiva de salud porque los EPA urbanos llegaron a más población y dieron soporte a la mayor parte del gasto energético poblacional, particularmente, en los grupos de mayor riesgo de salud, pero las instalaciones deportivas cubiertas fueron las que mejor contribuyeron a lograr un nivel saludable de actividad física. Este estudio sugiere cambios en las políticas de construcción y gestión de instalaciones deportivas y EPA para aumentar la AF en los grupos de mayor riesgo de salud.

A comic based interactive digital intervention to enhance facilitation skills of nurse mentors in public facilities - results of a pilot intervention in Bihar, India.

BACKGROUND: Various trainings are designed to educate nurses to become simulation educators. However, there are no good strategies to sustain their learnings and keep them engaged. We developed a series of 10 interactive digital storytelling comic episodes 'The Adventures of Super Divya (SD)' to strengthen simulation educator's facilitation knowledge, skills, confidence, and engagement. This endline evaluation presents results on the change in knowledge after watching the episodes and retention of that knowledge over 10 months. OBJECTIVES: The objectives of this pilot study are to: 1) assess the change in knowledge between the baseline and post-episode surveys; and 2) understand the retention of knowledge between the post-episode and the endline survey. METHODS: A human-centred design was used to create the episodes grounded in the lived experience of nurse simulation educators. The heroine of the comic is Divya, a 'Super Facilitator' and her nemesis is Professor Agni who wants to derail simulation as an educational strategy inside obstetric facilities. Professor Agni's schemes represent real-life challenges; and SD uses effective facilitation and communication to overcome them. The episodes were shared with a group of nurse mentors (NM) and nurse mentor supervisors (NMS) who were trained to be champion simulation educators in their own facilities. To assess change in knowledge, we conducted a baseline, nine post-episode surveys and an endline survey between May 2021 and February 2022. RESULTS: A total 110 NM and 50 NMS watched all 10 episodes and completed all of the surveys. On average, knowledge scores increased by 7-9 percentage points after watching the episodes. Comparison of survey responses obtained between 1 and 10 months suggest that the gain in knowledge was largely retained over time. CONCLUSIONS: Findings suggest that this interactive comic series was successful in a resource limited setting at engaging simulation educators and helped to maintain their facilitation knowledge over time.

Settings for the development of health literacy: A conceptual review.

Advances in conceptualizing settings in health promotion include understanding settings as complex and interlinked systems with a core commitment to health and related outcomes such as health literacy. Traditional settings for the development of health literacy include health care environments and schools. There is a need to identify and conceptualize non-traditional and emerging settings of twenty-first-century everyday life. The aim of this conceptual review is to inform a conceptual model of a "non-traditional" setting for the development of health literacy. The model uses the example of the public library to propose four equity-focused antecedents required in a setting for the development of health literacy: the setting acknowledges the wider determinants of health, is open access, involves local communities in how it is run, and facilitates informed action for health. The review concludes that a settings approach to the development of health literacy can be conceptualized as part of a coordinated "supersetting approach," where multiple settings work in synergy with each other.

How can public open spaces contribute to physical activity promotion? / Como os espaços públicos abertos podem contribuir para a promoção da atividade física?

Public open spaces (POSs) are means to ensure one's right to recreation and health. The objective of this essay is to present reflections and evidence on how these spaces contribute to promoting physi-cal activity (PA). Understanding how to access (proximity/distance), quantity and diversity, and the surrounding and internal conditions of places (quality, structure, aesthetics, safety) can affect the use of POSs is imperative for public management actions. Thinking of POS use beyond PA by recog-nizing its social, economic, and cultural benefits can be fundamental to reduce inequalities regarding access to these places. POS-related actions and demands are intersectoral, multiprofessional, and interdisciplinary, thus requiring political, academic, and community involvement and commitment for PA promotion

Espaços públicos abertos (EPA) são equipamentos que promovem o direito à recreação e à saúde. O objetivo deste ensaio é apresentar reflexões e evidências sobre como esses espaços contribuem para a promoção da atividade física (AF). Compreender como o acesso (proximidade/distância), a quantidade e diversidade, as condições do entorno e internas dos locais (qualidade, estrutura, estética, segurança), podem afetar o uso dos EPA é fundamental para ações da gestão pública. Pensar o uso do EPA para além da prática de AF, reconhecendo seus benefícios sociais, econômicos e culturais pode ser fundamental para diminuir as iniquidades de acesso a esses locais. Ações e demandas relacionadas aos EPA são intersetoriais, multiprofissionais e interdisciplinares, necessitando com isso envolvimento e comprometimento político, acadêmico e comunitário, a fim de promover AF

If You Build It Will They Come? Park Upgrades, Park Use and Park-Based Physical Activity in Urban Cape Town, South Africa-The SUN Study.

The development and upgrade of recreational public spaces are key government strategies to increase opportunities for physical activity (PA) and enhance social interaction and community cohesion. This study aimed to evaluate differences in park use and park-based PA in recently upgraded/developed parks (intervention, n = 4) against established parks (control, n = 4) and in regional parks in high- and low-income settings (n = 2). Additionally, associations between target area features, park use and PA were identified. Direct observation of park use and attributes was conducted using the System for Observing Play and Recreation in Communities (SOPARC) over four months. Despite more park users in intervention parks (2519 vs. 1432), control park visitors were 48% more likely to be engaged in PA (p < 0.001). Similarly, while high-income park users attracted more visitors (2135 vs. 1111), they were 79% less likely to be engaged in any PA compared with low-income park visitors. The likelihood of both use of and PA by gender and age differed by features. Active recreation features in intervention parks attracted more users than the same features in control parks. In this study, upgraded or newly developed parks attracted more visitors but not necessarily overall greater levels of physical activity.

How Do Ecological and Recreational Features of Waterfront Space Affect Its Vitality? Developing Coupling Coordination and Enhancing Waterfront Vitality.

People are increasingly concerned with natural environment quality (NEQ) as well as recreation services (RS) as the popularity of natural experiences grows. Specifically, public spaces in ecologically sensitive areas must achieve coordinated eco-recreational development. Waterfront spaces fall into this category, providing a high-quality natural environment and facilitating various recreational activities. This paper uses two waterfront spaces, Foshan New City Riverfront Park and Nanhai Qiandeng Lake Park, as sample sites, divides 22 waterfront space samples into specific research objects, introduces dual variables for RS function and NEQ, and uses mathematical and statistical methods, such as Pearson correlation analysis, coupling coordination degree calculation, and redundancy analysis, to investigate the influence of different waterfront spaces on RS function and NEQ. Finally, we propose an optimization strategy for coupling and coordinating the development of the RS function and the NEQ of waterfront space. This paper found the following: (1) RS (number of public facilities) and natural environment quality (shoreline curvature) are the dominant factors in the vitality of waterfront space; (2) optimization of RS function will restrict the development of NEQ to a certain extent; and (3) the coupling and coordination of NEQ and RS function are positively related to the vitality of waterfront space. This study can be valuable for government officials and waterfront space planners as they develop social-ecological synergy models.

Dual contraception method utilization and associated factors among women on anti-retroviral therapy in public facilities of Bishoftu town, Oromia, Ethiopia.

INTRODUCTION: Dual contraception is a method used to prevent sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) and unintended pregnancies. Prevention of unintended pregnancy in people living with HIV (PLHIV) and ART given to pregnant women to suppress viral load prevent transmission of HIV to children. Counseling and provision of dual contraceptive methods is a very cost-effective method to tackle this double burden among women living with HIV. However, little has been known about utilization of dual methods among HIV positive women in Bishoftu town and its surroundings. OBJECTIVE: The aim of this study was to assess dual contraception method utilization and associated factors among reproductive age women who were on antiretroviral therapy in public health facilities of Bishoftu town. METHODS: A facility based cross- sectional study was conducted from November 01 to December 30, 2020. The study participants were selected by using simple random sampling technique. Data were collected using a pretested and structured questionnaire through a face to face interview. Data were processed and analyzed using SPSS version 20. Frequencies and percentages were used to describe characteristics of participants. Bivariable and multivariable logistic regression analyses were used to identify variables which had an independent association with the dependent variable. The degree of association between dependent and independent variables were measured using odds ratio with 95% confidence interval. Level of significance was set at a p-value less than 0.05. RESULTS: The Magnitude of dual contraceptive utilization of women living with HIV in Bishoftu town was 56.9% (95% Cl (51.6, 62.1). Being married (AOR = 4.33; 95% Cl (1.67, 11.27), not getting pregnant since the start of chronic care follow up (AOR = 2.19; 95% Cl (2.90, 3.70), having a partner positive for HIV (AOR = 2.67; 95% Cl (1.34, 5.32) and having a partner negative for HIV (AOR = 2.38; 95% Cl (1.09, 5.20) were factors independently associated with dual method contraceptive use. CONCLUSION: The study showed that use of dual contraceptive methods was low; factors like marital status, partner HIV status, and pregnancy after chronic HIV care follow up were found to be significantly associated with dual contraceptive method use. In addition to ART, use of dual contraceptive methods utilization may play a role in prevention of HIV infection in children and is important in the prevention of unintended pregnancy.

Waste management practices among dental surgery staff of major hospitals in Accra: a descriptive cross-sectional study

Introduction: the practice of dentistry in contemporary times produces considerable waste that could be harmful to individuals and the environment at large. In Ghana and many other jurisdictions, there are guidelines that outline how these wastes should be managed. This study was conducted to explore practices concerning dental waste management among dental surgery staff in some public facilities in Accra, Ghana. Methods: a descriptive cross-sectional study involving dental surgery staff of four major facilities in Accra was done. Overall, 124 staff from the selected facilities participated in the study, and 51 different dental surgeries were assessed. Data were collected using a structured questionnaire and an observation checklist. The questionnaire included questions on socio-demographics, as well as knowledge and practices regarding dental waste management. Results: there was unsatisfactory knowledge of waste disposal, while practices did not generally meet international recommendations and the Ministry of Health´s (MOH) guidelines. Though all respondents stored their sharp waste in puncture-proof containers, 98.4% did not label their clinical waste, while 62.9% would dispose of used X-ray fixers by pouring them down the drain. None of the 51 surgeries observed had more than one colour code available. Conclusion: there is a palpable need for education, monitoring, and empowerment concerning waste management in Ghana´s oral healthcare system.

Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities: Results of the IMAgiNE EURO study in 16 countries.

OBJECTIVE: To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean. METHODS: Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities. RESULTS: Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52-1.90), elective cesarean (17.3% vs 7.8%; aOR 1.90; 95% CI 1.65-2.19), and emergency cesarean before labor (7.4% vs 3.9%; aOR 1.39; 95% CI 1.14-1.70) (P < 0.001 for all comparisons), with analyses by country confirming these results. QMNC index results were heterogeneous across countries and regions in the same country and were largely affected by geographical distribution of regions rather than by type of facility alone. CONCLUSION: The study confirms that births in private facilities have higher odds of cesarean. It also suggests that QMNC should be closely monitored in all facilities to achieve high-quality care, independent of facility type or geographical distribution. GOV IDENTIFIER: NCT04847336.

Assessing Park Quality with a Wearable Video Device and an Unmanned Aerial System.

Parks are ideal places for promoting physical activity, which is vital for achieving and sustaining good health. Thus, it is important to develop and provide the best methods for assessing aspects of parks that could influence physical activity. This study examined the use of high-tech video capture for describing park quality. Videos were obtained with a wearable video device (WVD) and an unmanned aerial system (UAS) at 28 and 17 parks, respectively. In-person audits of park attributes were performed using the Physical Activity Readiness Assessment (PARA) instrument while video was simultaneously captured. The PARA provides quality ratings of park attributes that range from poor to good. Kappa statistics were calculated to compare in-person PARA outcomes with PARA outcomes obtained by reviewing the WVD and UAS videos. Substantial and almost-perfect agreements were found between WVD and in-person PARAs on the quality of features and amenities and the severity of incivilities. Agreements between UAS and in-person PARAs on feature and amenity quality and incivility severity were unacceptable (mostly fair and moderate). In conclusion, being able to reliably assess park quality using video provides advantages over in-person assessments (e.g., retrospective analysis). In addition, it sets up the possibility of utilizing computer vision to automate the video analysis process.