MATERNAL AND CHILD HEALTH (MCH) SUPPORTER PROGRAMS TO EMPOWER TODDLER’S MOTHER IN SOLVING MALNUTRITION PROBLEMS IN TODDLERS

One of the focal points in the field of health is malnutrition in toddlers. Malnutrition resulting from lack of substance is impaired health necessary for nutrition growth and development. The effect of malnutrition in the child will affect their physics and intelligence and lost generation. According to WHO data (2016), about 45 % of death among children under 5 years old of was malnutrition. Malnutrition in the prevalence of the average national level reached 13,8 % and now malnutrition case is 19 % in South Kalimantan, this indicates that is above the average Kalimantan prevalence of malnutrition. Need the intervention to change the attitude of society knowledge and community empowerment that were lacking in providing healthier community. By way of MCH supporter program which apply the principle of empowerment communities through a program consisting of various efforts to improve the nutritional status of a child who carried out in Jingah Habang Ulu villages with 30 mothers as the sample. The methodology applied is quantitative research with a cross-sectional and use comparative test using statistic application. The result showed the knowledge (p-value=0,000), the differences in attitude (p-value=0,003), and the different of children weight (p-value=0,000). There were differences of knowledge, the toddler’s mother attitude, and children's weight before and after foster mother programs.

Photodynamic Therapy in the Treatment of Vulvar Lichen Sclerosus: A Systematic Review of the Literature

Vulvar lichen sclerosus (VLS) is a chronic inflammatory disease involving the genital skin and mucous membrane. Patients exhibit focal atrophy and destructive scarring, with an increased risk of malignant transformation. Due to objective symptoms as well as subjective complaints, patients with VLS experience emotional distress, lowered mood, and sexual dysfunction, which is reflected in impaired health-related quality of life. Thus, the necessity of implementing appropriate therapy at the earliest possible stage of the disease in order to avoid serious complications is highlighted. We presented the systematic review of available literature, performed with MEDLINE, Cinahl, Central, Scopus, and Web of Science databases. We identified a total of twenty relevant studies which indicate that photodynamic therapy (PDT) is a valuable therapeutic modality in the treatment of VLS.

Challenges Affecting Health Referral Systems in Low-And Middle-Income Countries: A Systematic Literature Review

Aims: Low and middle-income countries are still facing challenges of dysfunctional referral systems which have impaired health service provision. This review aimed at investigating these challenges to understand their nature, cause, and the impacts they have on health service provision. Methods: Database search was made in Google scholar, ACM Library, PubMed health, and BMC public health, and a total of 123 papers were generated. Only 14 fitted the inclusion criteria. Inclusion criteria included studies that were both quantitative and qualitative addressing challenges facing referral systems or health referral systems, studies describing the barriers to effective referral systems, and studies describing factors that affect referral systems. The review only included studies conducted in LMICs and included literature between January 2010 and February 2021. Findings: Results revealed that human resource and financial constraints, non-compliance, and communication are the key challenges affecting referral systems in LMICs. Recommendation: Countries that are facing these challenges need to overhaul the system and improve end-to-end communication between hospitals, improve capacity specifically in referral and emergency units, and sensitizing patients on the adherence to emergency protocols.

Impaired health status is independently associated with persistently elevated NT-proBNP levels despite medical therapy for heart failure with reduced ejection fraction

Background Impaired health status as measured by standardized tools such as Kansas City Cardiomyopathy Questionnaire (KCCQ), Duke Activity Status Index (DASI) and six-minute walk test (6MWT) has been shown to predict hospitalization and mortality in patients with chronic heart failure. However, prognostic implications of these measurements in response to guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF) remained to be elucidated. Purpose We hypothesized that impaired health status were predictive of persistently elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) after 6 and 12 months of therapeutic optimization in HFrEF. Methods Data on the GUIDE-IT trial that included protocolized HFrEF drug titration were analyzed. Patients who did not have NT-proBNP at 12 months were excluded. KCCQ overall and clinical summary scores, and DASI scores at baseline and 6 months were calculated. Six-minute walk test (6MWT) distance at baseline were also available. Response to medical therapy was defined as having NT-proBNP at 12 months of less than 1,000 pg/mL. Median value of each measurement was used as a cutoff. Multivariate logistic regression analysis was used to determine independent associations between different QOL scores and NT-proBNP response after adjustment for age, comorbidities, baseline EF, NYHA functional class, and NT-proBNP. Results There were 193 (43%) responders. Compared with those who responded to the medical therapy, non-responders were older, and more likely to have comorbidities including coronary artery disease, stroke, PAD, AF, hypertension, COPD, DM, CKD, and dyslipidemia, as well as lower EF, NHYA functional class and higher baseline NT-proBNP. After adjustment for baseline characteristics, lower KCCQ (either overall or summary) scores at baseline and 6 months, and lower DASI scores at 6 months (but not baseline) were independently associated with lower likelihood of response to GDMT (Table). In contrast, baseline 6MWT distance did not predict non-response to GDMT after adjustments. Conclusions Only impaired baseline KCCQ scores were predictive of persistently elevated NT-proBNP, while lower KCCQ and DASI scores at 6 month were predictive of persistently elevated NT-proBNP. FUNDunding Acknowledgement Type of funding sources: None. Health Status Score below Median and ORs

Methodology and organisation of health-improving work with students with impaired health

The article analyses the features of the methodology for organising physical culture and health-improving work with students with impaired health in Russian universities. The work experience in this direction of physical culture teachers of the Institute of Pedagogy and Psychology of Kostroma State University is presented. The methodology of organising physical culture and health-improving work with students with impaired health in terms of distance education via e-mail is considered; the WhatsApp system popular among young people; Zoom platform; YouTube video hosting. Within the framework of this problem, a digital self-observation diary of students with impaired health has been developed and tested. The tables provide information about students with weakened health of the Institute of Pedagogy and Psychology of KSU, those who started and did not start physical excercises in a distance format and the main reasons for their refusal to practice in a distance format. The author's model of the organisation of distance physical culture and health-improving work with students with health problems is described, including: purpose, objectives, principles, means of physical culture and health-improving work with students with impaired health, as well as features of distance interaction between students and teachers; factors ensuring the implementation of this type of activity and elements of a comprehensive assessment. In the conclusion of the article, conclusions are drawn about the results of the study.

The value of physical culture and health-improving activity in the physical training of students with weakened health

The article examines the key features of the organisation of physical culture and health-improving activities in the framework of physical training of students with impaired health. The considered research problem lies in the contradiction between the need to improve physical culture and health-improving activity in higher training and the lack in the modern training system of effective practices for organising physical training of students with impaired health. The study examines the main changes in recent years in the practice of organising physical culture and health-improving activities for students with impaired health, we reveal the mechanism for the formation of special medical groups, as well as their differentiation depending on the type of students' diseases. The importance of increasing the effectiveness of physical culture and health-improving activity in universities is noted, in view of the continuing growth in the number of students with impaired health. Based on the analysis of the current state of the system of physical training of university students, the main problems inherent in this area are highlighted, namely – the diversity of competences in the field of physical culture, the lack of balance between the acquisition of theoretical knowledge and the physical activity of students with impaired health, the lack of a motivational aspect in the system of physical training. The need for a qualitative modernisation of the practice of applying the competency approach to physical training of students and the introduction of a motivational component in the curriculum for physical culture is emphasised. For the further development of this direction, it is necessary to find and maintain a balance between theoretical work and obtaining practical skills in the process of physical culture and health-improving activities, as well as the ability to apply them in subsequent life.

The Effects of Conflicts and Self-Reported Insecurity on Maternal Healthcare Utilisation and Children Health Outcomes in the Democratic Republic of Congo (DRC)

Background The Democratic Republic of Congo (DRC) has experienced political unrest, civil insecurity, and military disputes, resulting in extreme poverty and a severely impaired health care system. To reduce the morbidity and mortality in women and children by strengthening healthcare, this study aimed at exploring the relationship between self-reported insecurity of mothers and maternal health-seeking behaviours and diseases in children in the DRC. Method Data collected from 8144 mothers and 14,403 children from the Multiple Indicators Cluster Survey (MICS) conducted by the National Institute of Statistics in 2017–2018, in collaboration with the United Nations Children’s Fund (UNICEF), was used. The severity of the conflict in different provinces was measured using the Uppsala Conflict Data Program (UCDP) reports. Multivariate logistic regression and stratified analysis were utilized to explore the association between conflicts with maternal health-seeking behaviours and diseases among children. Results High self-reported insecurity was positively associated with skilled antenatal care (OR1.93, 95%CI 1.50–2.49), skilled attendants at delivery (OR1.42, 95%CI 1.08–1.87), and early initiation of breastfeeding (OR1.32, 95%CI 1.04–1.68). These associations were more significant in regions with more armed conflict. It was also found that children of mothers with high self-reported insecurity were more likely to suffer from diarrhoea (OR1.47, 95%CI: 1.14–1.88), fever (OR1.23, 95%CI 1.01–1.50), cough (OR1.45, 95%CI 1.19–1.77), and dyspnea (OR2.04, 95%CI 1.52–2.73), than children of mothers with low self-reported insecurity. Conclusions Conflicts increases mothers’ insecurities and negatively affects children’s development. However, high conflict regions have to increase governmental and international assistance to promote the availability and access to maternal and child health services.