Abstracts | Health and Medical Engineering
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 663

World Academy of Science, Engineering and Technology

[Health and Medical Engineering]

Online ISSN : 1307-6892

633 A Study on the Causes of Running Injuries and Its Extent of Rehabilitation Mechanism Practices in First Division Athletics Club Athletes

Authors: Abdeta Bayissa Mekessa

Abstract:

This study is conducted with the ultimate objective of identifying parts of the body frequently exposed to running injury, causes of running injury, and the proper mechanism of rehabilitation in the Ethiopian first division athletics club. In this study, the research aims are to study parts of the body of the athletes who are frequently exposed to injury and the prevalence and major causes of running injuries that happen during training and competition in Ethiopian first-division athletics clubs. What are the proper mechanisms of rehabilitation used during injury times to achieve athletes’ proper recovery? To what extent are running injuries associated with the demography of the athletes in the first-division Ethiopian athletics clubs? How do rehabilitation mechanisms related to recovery time in running injuries of running events in short-distance, middle-distance, and long-distance running? The research question was answered through cross- a cross-sectional research design with a quantitative method that targets the Ethiopian first-division athletics club. The target population for the study comprised athletes in the Ethiopian first-division athletics club. Two-stage samplings were used to obtain the sample size; first, simple random sampling, then a Systematic sampling technique was used to obtain the sample size. Based on this, 180 athletes were selected for a sample, and a deep investigation was done. A pilot survey was conducted before extending the main investigation to pre-test the clarity, understanding, and reliability of the questionnaires. The data that were collected from subjects were statistically analyzed using SPSS 20; ANOVA was used for intra-group comparison when statistically a significant mean difference was observed between groups. Descriptive statistics, correlation, and regression analysis were used. The analysis method used was mean, standard deviation, percentage, frequency, one-way ANOVA test the assess the group among the demographic characters t-test, and Pearson's Correlation coefficient was used. The study results revealed that the parts of the body frequently exposed for running injury are Ankle, foot toe, Achilles tendon, and knee was the most exposed for running injury. As a result, the researcher has recommended creating awareness for athletes to know the body parts frequently exposed to running injury and education on benefits. Using a proper way scientific training method for running and free injury running, follow the right principles of training, like warming up before running and including plenty of slow and sustained stretches, then stretching the muscles of the thighs and calves, and finally cooling down after running. Athletes should have to use the right running shoes and educate the athletes to get enough rest and sleep, proper nutrition, and rehydration.

Keywords: athletes, rehabilitation, injury, cause of injury, running

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632 Data-Driven Performance Evaluation of Surgical Doctors Based on Fuzzy Analytic Hierarchy Processes

Authors: Yuguang Gao, Qiang Yang, Yanpeng Zhang, Mingtao Deng

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To enhance the safety, quality and efficiency of healthcare services provided by surgical doctors, we propose a comprehensive approach to the performance evaluation of individual doctors by incorporating insights from performance data as well as views of different stakeholders in the hospital. Exploratory factor analysis was first performed on collective multidimensional performance data of surgical doctors, where key factors were extracted that encompass assessment of professional experience and service performance. A two-level indicator system was then constructed, for which we developed a weighted interval-valued spherical fuzzy analytic hierarchy process to analyze the relative importance of the indicators while handling subjectivity and disparity in the decision-making of multiple parties involved. Our analytical results reveal that, for the key factors identified as instrumental for evaluating surgical doctors’ performance, the overall importance of clinical workload and complexity of service are valued more than capacity of service and professional experience, while the efficiency of resource consumption ranks comparatively the lowest in importance. We also provide a retrospective case study to illustrate the effectiveness and robustness of our quantitative evaluation model by assigning meaningful performance ratings to individual doctors based on the weights developed through our approach.

Keywords: analytic hierarchy processes, factor analysis, fuzzy logic, performance evaluation

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631 Perception of Health Care Providers on the Use of Modern Contraception by Adolescents in Rwanda

Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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630 Advancing Healthcare Excellence in China: Crafting a Strategic Operational Evaluation Index System for Chinese Hospital Departments amid Payment Reform Initiatives

Authors: Jing Jiang, Yuguang Gao, Yang Yu

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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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629 Uncommon Presentation of Iscahemic Heart Disease with Sheehan’s Syndrome at Mid-Level Private Hospital of Bangladesh and Its Management- A Case Report

Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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628 Effectiveness of Technology Enhanced Learning in Orthodontic Teaching

Authors: Mohammed Shaath

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Aims Technological advancements in teaching and learning have made significant improvements over the past decade and have been incorporated in institutions to aid the learner’s experience. This review aims to assess whether Technology Enhanced Learning (TEL) pedagogy is more effective at improving students’ attitude and knowledge retention in orthodontic training than traditional methods. Methodology The searches comprised Systematic Reviews (SRs) related to the comparison of TEL and traditional teaching methods from the following databases: PubMed, SCOPUS, Medline, and Embase. One researcher performed the screening, data extraction, and analysis and assessed the risk of bias and quality using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2). Kirkpatrick’s 4-level evaluation model was used to evaluate the educational values. Results A sum of 34 SRs was identified after the removal of duplications and irrelevant SRs; 4 fit the inclusion criteria. On Level 1, students showed positivity to TEL methods, although acknowledging that the harder the platforms to use, the less favourable. Nonetheless, the students still showed high levels of acceptability. Level 2 showed there is no significant overall advantage of increased knowledge when it comes to TEL methods. One SR showed that certain aspects of study within orthodontics deliver a statistical improvement with TEL. Level 3 was the least reported on. Results showed that if left without time restrictions, TEL methods may be advantageous. Level 4 shows that both methods are equally as effective, but TEL has the potential to overtake traditional methods in the future as a form of active, student-centered approach. Conclusion TEL has a high level of acceptability and potential to improve learning in orthodontics. Current reviews have potential to be improved, but the biggest aspect that needs to be addressed is the primary study, which shows a lower level of evidence and heterogeneity in their results. As it stands, the replacement of traditional methods with TEL cannot be fully supported in an evidence-based manner. The potential of TEL methods has been recognized and is already starting to show some evidence of the ability to be more effective in some aspects of learning to cater for a more technology savvy generation.

Keywords: TEL, orthodontic, teaching, traditional

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627 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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626 Stroke Prevention in Patients with Atrial Fibrillation and Co-Morbid Physical and Mental Health Problems

Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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625 Dose Measurement in Veterinary Radiology Using Thermoluminescent Dosimeter

Authors: Ava Zarif Sanayei, Sedigheh Sina

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Radiological protection for plants and animals is an area of regulatory importance. Acute doses of 0.1 Gy/d (10 rad/d) or below are highly unlikely to produce permanent, measurable negative effects on populations or communities of plants or animals. The advancement of radio diagnostics for domestic animals, particularly dogs and cats, has gained popularity in veterinary medicine. As pets are considered to be members of the family worldwide, they are entitled to the same care and protection. It is important to have a system of radiological protection for nonhuman organisms that complies with the focus on human health as outlined in ICRP publication 19. The present study attempts to assess surface-skin entrance doses in small pets undergoing abdominal radio diagnostic procedures utilizing a direct measurements technique with a thermoluminescent dosimeter. These measurements allow the determination of the entrance skin dose (ESD) by calculating the amount of radiation absorbed by the skin during exposure. A group of Thirty TLD-100 dosimeters produced by Harshaw Company, each with a repeatability greater than 95% and calibration using ¹³⁷Cs gamma source, were utilized to measure doses to ten small pets, including cats and dogs in the radiological department in a veterinary clinic in Shiraz, Iran. Radiological procedures were performed using a portable imaging unit (Philips Super M100, Philips Medical System, Germany) to acquire images of the abdomen; ten exams of abdomen images of different pets were monitored, measuring the thicknesses of the two projections (lateral and ventrodorsal) and the distance of the X-ray source from the surface of each pet during the exams. A group of two dosimeters was used for each pet which has been stacked on their skin on the abdomen region. The outcome of this study involved medical procedures with the same kVp, mAs, and nearly identical positions for different diagnostic X-ray procedures executed over a period of two months. The result showed the mean ESD value was 260.34±50.06 µGy due to the approximate size of pets. Based on the results, the ESD value is associated with animal size, and larger animals have higher values. If a procedure doesn't require repetition, the dose can be optimized. For smaller animals, the main challenge in veterinary radiology is the dose increase caused by repetitions, which is most noticeable in the ventro-dorsal position due to the difficulty in immobilizing the animal.

Keywords: direct dose measuring, dosimetry, radiation protection, veterinary medicine

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624 Dosimetry in Interventional Radiology Examinations for Occupational Exposure Monitoring

Authors: Ava Zarif Sanayei, Sedigheh Sina

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Interventional radiology (IR) uses imaging guidance, including X-rays and CT scans, to deliver therapy precisely. Most IR procedures are performed under local anesthesia and start with a small needle being inserted through the skin, which may be called pinhole surgery or image-guided surgery. There is increasing concern about radiation exposure during interventional radiology procedures due to procedure complexity. The basic aim of optimizing radiation protection as outlined in ICRP 139, is to strike a balance between image quality and radiation dose while maximizing benefits, ensuring that diagnostic interpretation is satisfactory. This study aims to estimate the equivalent doses to the main trunk of the body for the Interventional radiologist and Superintendent using LiF: Mg, Ti (TLD-100) chips at the IR department of a hospital in Shiraz, Iran. In the initial stage, the dosimeters were calibrated with the use of various phantoms. Afterward, a group of dosimeters was prepared, following which they were used for three months. To measure the personal equivalent dose to the body, three TLD chips were put in a tissue-equivalent batch and used under a protective lead apron. After the completion of the duration, TLDs were read out by a TLD reader. The results revealed that these individuals received equivalent doses of 387.39 and 145.11 µSv, respectively. The findings of this investigation revealed that the total radiation exposure to the staff was less than the annual limit of occupational exposure. However, it's imperative to implement appropriate radiation protection measures. Although the dose received by the interventional radiologist is a bit noticeable, it may be due to the reason for using conventional equipment with over-couch x-ray tubes for interventional procedures. It is therefore important to use dedicated equipment and protective means such as glasses and screens whenever compatible with the intervention when they are available or have them fitted to equipment if they are not present. Based on the results, the placement of staff in an appropriate location led to increasing the dose to the radiologist. Manufacturing and installation of moveable lead curtains with a thickness of 0.25 millimeters can effectively minimize the radiation dose to the body. Providing adequate training on radiation safety principles, particularly for technologists, can be an optimal approach to further decreasing exposure.

Keywords: interventional radiology, personal monitoring, radiation protection, thermoluminescence dosimetry

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623 X-Ray Shielding Properties of Bismuth-Borate Glass Doped with Rare-Earth Ions

Authors: Vincent Kheswa

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X-rays are ionizing electromagnetic radiation that is used in various industries such as computed tomography scans, dental X-rays, and screening freight trains. However, they pose health risks to humans if they are not shielded properly. In recent years, many researchers around the globe have been searching for nontoxic best possible glass materials for shielding X-rays. In this work, the x-ray shielding properties of 45Na₂O + 10 Bi₂O₃ + (5 - x)TiO₂+ (x) Nb₂O₅ + 40 P₂O₅, were x = 0, 1, 3, 5 mol%, glass materials were studied. The results revealed that the glass sample with the highest TiO2 content has the highest mass and linear attenuation coefficients and lowest half-value thickness, tenth-value thickness and mean-free path in the 20 to 80 keV energy region. The sample with 3 mol% of Nb₂O₅ has the highest mass and linear attenuation coefficients and the lowest half-value thickness, tenth-value thickness, and mean-free path at 15 keV and photon energies between 80 to 300 keV. It was, therefore, concluded that 45Na₂O + 10 Bi₂O₃ + 5 TiO₂ + 40 P₂O₅ glass is best for shielding x-rays of energies between 20 and 80 keV, while 45Na₂O + 10 Bi₂O₃ + 2 TiO₂ + 3 Nb₂O₅ + 40 P₂O₅ is best for shielding 15 keV x-rays and x-rays of energies between 80 keV and 300 keV.

Keywords: bismuth-titanium-phosphate glass, x-ray shielding, LAC, MAC, radiation shielding

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622 Policy Evaluation of Republic Act 9502 “Universally Accessible Cheaper and Quality Medicines Act of 2008”

Authors: Trina Isabel D. Santiago, Juan Raphael M. Perez, Maria Angelica O. Soriano, Teresita B. Suing, Jumee F. Tayaban

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To achieve universal healthcare for everyone, the World Health Organization has emphasized the importance of National Medicines Policies for increased accessibility and utilization of high-quality and affordable medications. In the Philippines, significant challenges have been identified surrounding the sustainability of essential medicines, resulting in limited access such as high cost and dominance and market dominance and monopoly of multinational companies (MNCs) in the Philippine pharmaceutical industry. These identified challenges have been addressed by several initiatives, such as the Philippine National Drug Policy and Generics Act of 1988 (Republic Act 6675), to attempt to reduce drug prices. Despite these efforts, the concerns with drug accessibility and affordability continue to persist; hence, Republic Act 9502 was enacted. This paper attempts to review RA 9502 in the pursuit of making medicines more affordable for Filipinos, analyze and critique the problems and challenges associated with the law, and provide recommendations to address identified problems and challenges. A literature search and review, as well as an analysis of the law, has been done to evaluate the policy. RA 9502 recognizes the importance of market competition in drug price reduction and quality medicine accessibility. Contentious issues prior to enactment of the law include 1) parallel importation, pointing out that the drug price will depend on the global market price, 2) contrasting approaches in the drafting of the law as the House version focused on medicine price control while the Senate version prioritized market competition, and 3) MNCs opposing the amendments with concerns on discrimination, constitutional violations, and noncompliance with international treaty obligations. There are also criticisms and challenges with the implementation of the law in terms of content or modeling, interpretation and implementation, and other external factors or hindrances. The law has been criticized for its narrow scope as it only covers specific essential medicines with no cooperation with the national health insurance program. Moreover, the law has sections taking advantage of the TRIPS flexibilities, which disallow smaller countries to reap the benefits of flexibilities. The sanctions and penalties have an insignificant role in implementation as they only ask for a small portion of the income of MNCs. Proposed recommendations for policy improvement include aligning existing legislation through strengthened price regulation and expanded law coverage, strengthening penalties to promote law adherence, and promoting research and development to encourage and support local initiatives. Through these comprehensive recommendations, the issues surrounding the policy can be addressed, and the goal of enhancing the affordability and accessibility of medicines in the country can be achieved.

Keywords: drug accessibility, drug affordability, price regulation, Republic Act 9502

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621 The Impact of Gold Mining on Disability: Experiences from the Obuasi Municipal Area

Authors: Mavis Yaa Konadu Agyemang

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Despite provisions to uphold and safeguard the rights of persons with disability in Ghana, there is evidence that they still encounter several challenges which limit their full and effective involvement in mainstream society, including the gold mining sector. The study sought to explore how persons with physical disability (PWPDs) experience gold mining in the Obuasi Municipal Area. A qualitative research design was used to discover and understand the experiences of PWPDs regarding mining. The purposive sampling technique was used to select five key informants for the study with the age range of (24-52 years) while snowball sampling aided the selection of 16 persons with various forms of physical disability with the age range of (24-60 years). In-depth interviews were used to gather data. The interviews lasted from forty-five minutes to an hour. In relation to the setting, the interviews of thirteen (13) of the participants with disability were done in their houses, two (2) were done on the phone, and one (1) was done in the office. Whereas the interviews of the five (5) key informants were all done in their offices. Data were analyzed using Creswell’s (2009) concept of thematic analysis. The findings suggest that even though land degradation affected everyone in the area, persons with mobility and visual impairment experienced many difficulties trekking the undulating land for long distances in search of arable land. Also, although mining activities are mostly labour-intensive, PWPDs were not employed even in areas where they could work. Further, the cost of items, in general, was high, affecting PWPDs more due to their economic immobility and paying for other sources of water due to land degradation and water pollution. The study also discovered that the peculiar conditions of PWPDs were not factored into compensation payments, and neither were females with physical disability engaged in compensation negotiations. Also, although some of the infrastructure provided by the gold mining companies in the area was physically accessible to some extent, it was not accessible in terms of information delivery. There is a need to educate the public on the effects of mining on PWPDs, their needs as well as disability issues in general. The Minerals and Mining Act (703) should be amended to include provisions that would consider the peculiar needs of PWPDs in compensation payment.

Keywords: mining, resettlement, compensation, environmental, social, disability

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620 HRCT of the Chest and the Role of Artificial Intelligence in the Evaluation of Patients with COVID-19

Authors: Parisa Mansour

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Introduction: Early diagnosis of coronavirus disease (COVID-19) is extremely important to isolate and treat patients in time, thus preventing the spread of the disease, improving prognosis and reducing mortality. High-resolution computed tomography (HRCT) chest imaging and artificial intelligence (AI)-based analysis of HRCT chest images can play a central role in the treatment of patients with COVID-19. Objective: To investigate different chest HRCT findings in different stages of COVID-19 pneumonia and to evaluate the potential role of artificial intelligence in the quantitative assessment of lung parenchymal involvement in COVID-19 pneumonia. Materials and Methods: This retrospective observational study was conducted between May 1, 2020 and August 13, 2020. The study included 2169 patients with COVID-19 who underwent chest HRCT. HRCT images showed the presence and distribution of lesions such as: ground glass opacity (GGO), compaction, and any special patterns such as septal thickening, inverted halo, mark, etc. HRCT findings of the breast at different stages of the disease (early: andlt) 5 days, intermediate: 6-10 days and late stage: >10 days). A CT severity score (CTSS) was calculated based on the extent of lung involvement on HRCT, which was then correlated with clinical disease severity. Use of artificial intelligence; Analysis of CT pneumonia and quot; An algorithm was used to quantify the extent of pulmonary involvement by calculating the percentage of pulmonary opacity (PO) and gross opacity (PHO). Depending on the type of variables, statistically significant tests such as chi-square, analysis of variance (ANOVA) and post hoc tests were applied when appropriate. Results: Radiological findings were observed in HRCT chest in 1438 patients. A typical pattern of COVID-19 pneumonia, i.e., bilateral peripheral GGO with or without consolidation, was observed in 846 patients. About 294 asymptomatic patients were radiologically positive. Chest HRCT in the early stages of the disease mostly showed GGO. The late stage was indicated by such features as retinal enlargement, thickening and the presence of fibrous bands. Approximately 91.3% of cases with a CTSS = 7 were asymptomatic or clinically mild, while 81.2% of cases with a score = 15 were clinically severe. Mean PO and PHO (30.1 ± 28.0 and 8.4 ± 10.4, respectively) were significantly higher in the clinically severe categories. Conclusion: Because COVID-19 pneumonia progresses rapidly, radiologists and physicians should become familiar with typical TC chest findings to treat patients early, ultimately improving prognosis and reducing mortality. Artificial intelligence can be a valuable tool in treating patients with COVID-19.

Keywords: chest, HRCT, covid-19, artificial intelligence, chest HRCT

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619 The Convergence of IoT and Machine Learning: A Survey of Real-time Stress Detection System

Authors: Shreyas Gambhirrao, Aditya Vichare, Aniket Tembhurne, Shahuraj Bhosale

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In today's rapidly evolving environment, stress has emerged as a significant health concern across different age groups. Stress that isn't controlled, whether it comes from job responsibilities, health issues, or the never-ending news cycle, can have a negative effect on our well-being. The problem is further aggravated by the ongoing connection to technology. In this high-tech age, identifying and controlling stress is vital. In order to solve this health issue, the study focuses on three key metrics for stress detection: body temperature, heart rate, and galvanic skin response (GSR). These parameters along with the Support Vector Machine classifier assist the system to categorize stress into three groups: 1) Stressed, 2) Not stressed, and 3) Moderate stress. Proposed training model, a NodeMCU combined with particular sensors collects data in real-time and rapidly categorizes individuals based on their stress levels. Real-time stress detection is made possible by this creative combination of hardware and software.

Keywords: real time stress detection, NodeMCU, sensors, heart-rate, body temperature, galvanic skin response (GSR), support vector machine

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618 Implementing a Comprehensive Emergency Care and Life Support Course in a Low- and Middle-Income Country Setting: A Survey of Learners in India

Authors: Vijayabhaskar Reddy Kandula, Peter Provost Taillac, Balasubramanya M. A., Ram Krishnan Nair, Gokul Toshnival, Vibhu Dhawan, Vijaya Karanam, Buffy Cramer

Abstract:

Introduction: The lack of Emergency Care Services (ECS) is a cause of extensive and serious public health problems in low- and middle-income countries (LMIC), Many LMIC countries have ambulance services that allow timely transfer of ill patients but due to poor care during the ‘Golden Hour’ many deaths occur which are otherwise preventable. Lack of adequate training as evidenced by a study in India is a major reason for poor care during the ‘Golden Hour’. Adapting developed country models which includes staffing specialty-trained doctors in emergency care, is neither feasible nor guarantees cost-effective ECS. Methods: Based on our assessment and felt needs by first-line doctors providing emergency care in 2014, Rajiv Gandhi Health Sciences University’s JeevaRaksha Trust in partnership with the University of Utah, USA, designed, piloted and successfully implemented a 4-day Comprehensive-Emergency Care and Life Support course (C-ECLS) for allopathic doctors. 1730 doctors completed the 4-day course between June 2014 and December- 2020. Subsequently, we conducted a survey to investigate the utilization rates and usefulness of the training. 1662 were contacted but only 309 completed the survey. The respondents had the following designations: Senior faculty (33%), junior faculty (25), Resident (16%), Private-Practitioners (8%), Medical-Officer (16%) and not-working (11%). 51% were generalists (51%) and the rest were specialists (>30 specialties). Results: 97% (271/280) felt they are better doctors because of C-ECLS. 79% (244/309) reported that training helped to save life- specialists more likely than generalists (91% v/s 68%. P<0.05). 64% agreed that they were confident of managing COVID-19 symptomatic patients better because of C-ECLS. 27% (77) were neutral; 9% (24) disagreed. 66% agreed that training helps to be confident in managing COVID-19 critically ill patients. 26% (72) were neutral; 8% (23) disagreed. Frequency of use of C-ECLS skills: Hemorrhage-control (70%), Airway (67%), circulation skills (62%), Safe-transport and communication (60%), managing critically ill patients (58%), cardiac arrest (51%), Trauma (49%), poisoning/animal bites/stings (44%), neonatal-resuscitation (39%), breathing (36%), post-partum-hemorrhage and eclampsia (35%). Among those who used the skills, the majority (ranging from (88%-94%) reported that they were able to apply the skill more effectively because of ECLS training. Conclusion: JeevaRaksha’s C-ECLS is the world’s first comprehensive training. It improves the confidence of front-line doctors and enables them to provide quality care during the ‘Golden Hour’ of emergency. It also prepares doctors to manage unknown emergencies (e.g., COVID-19). C-ECLS was piloted in Morocco, and Uzbekistan and implemented countrywide in Bhutan. C-ECLS is relevant to most settings and offers a replicable model across LMIC.

Keywords: comprehensive emergency care and life support, training, capacity building, low- and middle-income countries, developing countries

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617 Efficacy of Pooled Sera in Comparison with Commercially Acquired Quality Control Sample for Internal Quality Control at the Nkwen District Hospital Laboratory

Authors: Diom Loreen Ndum, Omarine Njimanted

Abstract:

With increasing automation in clinical laboratories, the requirements for quality control materials have greatly increased in order to monitor daily performance. The constant use of commercial control material is not economically feasible for many developing countries because of non-availability or the high-cost of the materials. Therefore, preparation and use of in-house quality control serum will be a very cost-effective measure with respect to laboratory needs.The objective of this study was to determine the efficacy of in-house prepared pooled sera with respect to commercially acquired control sample for routine internal quality control at the Nkwen District Hospital Laboratory. This was an analytical study, serum was taken from leftover serum samples of 5 healthy adult blood donors at the blood bank of Nkwen District Hospital, which had been screened negative for human immunodeficiency virus (HIV), hepatitis C virus (HCV) and Hepatitis B antigens (HBsAg), and were pooled together in a sterile container. From the pooled sera, sixty aliquots of 150µL each were prepared. Forty aliquots of 150µL each of commercially acquired samples were prepared after reconstitution and stored in a deep freezer at − 20°C until it was required for analysis. This study started from the 9th June to 12th August 2022. Every day, alongside with commercial control sample, one aliquot of pooled sera was removed from the deep freezer and allowed to thaw before analyzed for the following parameters: blood urea, serum creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), potassium and sodium. After getting the first 20 values for each parameter of pooled sera, the mean, standard deviation and coefficient of variation were calculated, and a Levey-Jennings (L-J) chart established. The mean and standard deviation for commercially acquired control sample was provided by the manufacturer. The following results were observed; pooled sera had lesser standard deviation for creatinine, urea and AST than commercially acquired control samples. There was statistically significant difference (p<0.05) between the mean values of creatinine, urea and AST for in-house quality control when compared with commercial control. The coefficient of variation for the parameters for both commercial control and in-house control samples were less than 30%, which is an acceptable difference. The L-J charts revealed shifts and trends (warning signs), so troubleshooting and corrective measures were taken. In conclusion, in-house quality control sample prepared from pooled serum can be a good control sample for routine internal quality control.

Keywords: internal quality control, levey-jennings chart, pooled sera, shifts, trends, westgard rules

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616 Determining the Effectiveness of Positive Psychology Education on Social Welfare of High School Girls with Premenstrual Syndrome (PMS)

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Mina Gholampour, Majid Saffarinia, Tayebeh Mohtashami, Amin Asadi Hieh

Abstract:

The study aimed to assess the impact of positive psychology education on the social well-being of high school girls experiencing premenstrual syndrome (PMS). The statistical population comprised high school girls with PMS, with 30 randomly selected participants divided into two groups: 15 in the experimental group and 15 in the control group. The research employed a pre-test and post-test design using a standard questionnaire to evaluate premenstrual syndrome symptoms over a 7-day period before menstruation to a maximum of 2 days after menstruation, along with the Social Keys welfare questionnaire. During the study, the experimental group underwent an 8-session positive psychology group program. Data analysis was conducted using analysis of covariance. The results indicated a significant positive effect of positive psychology training on enhancing the social well-being of girls (p < 0.05). In conclusion, the findings suggest that positive psychology interventions can effectively increase social well-being among high school girls experiencing premenstrual syndrome.

Keywords: positive psychology, premenstrual syndrome, social welfare, girls

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615 Pattern of Structural Relationships of Quality of Life Based on Anxiety and Rumination Mediated by Personality Types in Psoriasis Patients

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Afsaneh Bayat, Amin Asadi Hieh

Abstract:

The purpose of this research was to investigate the pattern of structural relationships of quality of life based on anxiety and rumination with the mediation of personality types in psoriasis patients. Methods: The community of this research is made up of the members of Psoriasis Society of Iran - Sadafak. In the sample size of 2266 people, according to Morgan's table, 327 people will be considered as a statistical sample. To assess the quality of life, the 26-item questionnaire of the World Health Organization, anxiety with software SPSS and appropriate to the conditions were used to test the hypotheses, correlation matrix tests and factor analysis. Results: There is a relationship between quality of life with anxiety and rumination in psoriasis patients. The mediating role of personality types showed Psychotic annoyance has a significant relationship with anxiety (physical and emotional symptoms). Extraversion, agreeing and being conscientious play a mediating role in a significant relationship between quality of life in psoriasis patients. Also, irritability plays a mediating role in a meaningful relationship between rumination in psoriasis patients. Conclusion: According to the obtained results, it can be said that psoriasis patients with physical and emotional symptoms of anxiety and rumination have a low quality of life. Also, negative personality types (perfectionism and neuroticism) can cause or aggravate skin disorders in these patients. In other words, psychological factors are considered predisposing, accelerating and perpetuating factors in psoriasis skin disorders, so it is suggested to pay attention to these variables in the success of treating patients with psoriasis.

Keywords: quality of life, anxiety, rumination, personality types, psoriasis.

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614 Examining the Structural Model of Mindfulness and Headache Intensity With the Mediation of Resilience and Perfectionism in Migraine Patients

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Nazila Esmaeili, Ahmad Alipour, Amin Asadi Hieh

Abstract:

Headache disorders are one of the most common disorders of the nervous system and are associated with suffering, disability, and financial costs for patients. Mindfulness as a lifestyle, in line with human nature, has the ability to affect the emotional system, i.e. thoughts, body sensations, raw emotions and action impulses of people. The aim of this study was to test the fit of structural model of mindfulness and severity of headache mediated by resilience and perfectionism in patients with migraine. Methods: The statistical population of this study included all patients with migraine referred to neurologists in Tehran in the spring and summer of 1401. The inclusion criteria were diagnosis of migraine by a neurologist, not having mental disorders or other physical diseases, and having at least a diploma. According to the number of research variables, 180 people were selected by convenience sampling method, which online answered the Ahvaz perfectionism questionnaire (AMQ), Connor and Davidson resilience questionnaire (CD-RISC), Ahvaz migraine headache questionnaire (APS) and 5-factor mindfulness questionnaire ((MAAS). Data were analyzed using structural equation modeling and Amos software. Results: The results showed that the direct pathways of mindfulness were not significant for severe headache (P <0.05), but other direct pathways - mindfulness to resilience, mindfulness to perfectionism, resilience to severe headache and perfectionism to severe headache), Was significant (P <0.01). After modifying and removing the non-significant paths, the final model fitted. Mediating variables Resilience and perfectionism mediated all paths of predictor variables to the criterion. Conclusion: According to the findings of the present study, mindfulness in migraine patients reduces the severity of headache by promoting resilience and reducing perfectionism.

Keywords: migraine, headache severity, mindfulness, resilience, perfectionism

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613 The Effectiveness of Sexual Cognitive Behavioral Therapy on Strategic Thinking and Communication Patterns of Couples in Colostomy Patients

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Seyedeh Somayeh Amiri, Mozhgan Shakhseniaei, Amin Asadi Hieh

Abstract:

The purpose of this research was to determine the effectiveness of sexual cognitive behavioral therapy on strategic thinking and communication patterns of couples in colostomy patients. In this study, experimental research was conducted with a pre-test and post-test design with a control group and a follow-up period. The statistical population studied were married female colostomy patients referring to the Iranian Ostomy Association. 30 qualified people were selected by voluntary sampling and randomly divided into two experimental and control groups (15 people in each group). Both groups responded to Goleman's strategic thinking (2007) and the communication patterns of Christensen and Sulawai questionnaires (1984). The results of covariance analysis showed that sexual cognitive behavioral therapy has an effect on improving strategic thinking. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving the strategic thinking of colostomy patients until the follow-up stage. Also, sexual cognitive behavioral therapy has an effect on improving the communication patterns of couples in colostomy patients. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving communication patterns of couples in patients with colostomy until the follow-up stage. Based on the results of this research, sexual cognitive behavioral therapy can be used to improve strategic thinking and communication patterns of couples of colostomy patients.

Keywords: sexual cognitive behavioral therapy, strategic thinking, communication patterns of couples, colostomy

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612 Predicting Daily Patient Hospital Visits Using Machine Learning

Authors: Shreya Goyal

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The study aims to build user-friendly software to understand patient arrival patterns and compute the number of potential patients who will visit a particular health facility for a given period by using a machine learning algorithm. The underlying machine learning algorithm used in this study is the Support Vector Machine (SVM). Accurate prediction of patient arrival allows hospitals to operate more effectively, providing timely and efficient care while optimizing resources and improving patient experience. It allows for better allocation of staff, equipment, and other resources. If there's a projected surge in patients, additional staff or resources can be allocated to handle the influx, preventing bottlenecks or delays in care. Understanding patient arrival patterns can also help streamline processes to minimize waiting times for patients and ensure timely access to care for patients in need. Another big advantage of using this software is adhering to strict data protection regulations such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States as the hospital will not have to share the data with any third party or upload it to the cloud because the software can read data locally from the machine. The data needs to be arranged in. a particular format and the software will be able to read the data and provide meaningful output. Using software that operates locally can facilitate compliance with these regulations by minimizing data exposure. Keeping patient data within the hospital's local systems reduces the risk of unauthorized access or breaches associated with transmitting data over networks or storing it in external servers. This can help maintain the confidentiality and integrity of sensitive patient information. Historical patient data is used in this study. The input variables used to train the model include patient age, time of day, day of the week, seasonal variations, and local events. The algorithm uses a Supervised learning method to optimize the objective function and find the global minima. The algorithm stores the values of the local minima after each iteration and at the end compares all the local minima to find the global minima. The strength of this study is the transfer function used to calculate the number of patients. The model has an output accuracy of >95%. The method proposed in this study could be used for better management planning of personnel and medical resources.

Keywords: machine learning, SVM, HIPAA, data

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611 Contribution Of Community-based House To House (H2h) Active Tuberculosis (Tb) Case Finding (Acf) To Increase In Tb Notification In Nigeria: Kano State Experience 2012 To 2022

Authors: Ibrahim Umar, S Chindo, A Rajab

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Background: TB remains a disease of public health concern in Nigeria with an estimated incidence rate of 219/100,000. Kano has the second highest TB burden in Nigeria and is the leading state with the highest consistent yearly TB notification. House-to-house (H2H) active case search in the community was found to have major contribution to the total TB notification in the state. Aims and Objective: To showcase the impact of H2H community active TB case search (ACF) to yearly TB notification in Kano State, Northern Nigeria from 2012 to 2022. Methodology: This is a retrospective descriptive study based on the analysis of data collected during the routine quarterly and yearly TB data collected in the state. Data was analyzed using the Power BI with statistical alpha level of significance <0.05. Results: Between 2012 and 2013 there was no House-to-house active TB case search in Nigeria and Kano had zero contribution to TB notification from the community in those years. However, in 2014 with the introduction of H2H Active TB Case Search Kano notified 6,014 TB cases out of which 113 came from the community ACF that translated to 2% contribution to total TB notification. From 2014 to 2022 there was progressive increase in community contribution to TB case notification from 113 out of 6,014 total TB patients notified (2012) to 11,799 out of 26,371 TB patients notified (2022) in Kano State. This translated to 45% increase in community contribution to total TB case notification. Discussion: Remarkable increase in community contribution to total TB case notification in Kano State was achieved in 2022 with 11,799 TB cases notified from the community Active TB case search to the total of 26,731 TB cases notified in Kano State, Nigeria. Conclusion: in research has shown that Community-based H2H Active TB Case Search through Community TB Workers (CTWs) is an excellent strategy in finding the missing TB cases towards Ending TB in the world.

Keywords: tuberculosis(TB), active case search (ACF), house-to-house (H2H), community TB workers (CTWs)

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610 Systematic Review of Digital Interventions to Reduce the Carbon Footprint of Primary Care

Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

Abstract:

Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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609 Spiritual Symbols of African Fruits as Responsive Catalysts for Naturopathy

Authors: Orogun Daniel Oghenekevhwe

Abstract:

Africa being an agrarian continent has an abundance of fruits that are both nutritional and medicinal. Regardless of the abundance of these healing elements, Africa leads the statistics of poor healthcare globally. Among others, there are two noticeable challenges in the healthcare system which are ‘Poor access and high cost of medical healthcare’. The effects of both the access and economic implications are (1) Low responsiveness and (2) High mortality rate. While the United Nations and the global health community continue to work towards reduced mortality rates and poor responsiveness to healthcare and wellness, this paper investigates how some Africans use the spiritual symbols of African fruits as responsive catalysts to embrace naturopathy thereby reducing the effects and impacts of poor healthcare challenges in Africa. The main argument is whether there are links between spiritual symbols and fruits that influence Africans' response to naturopathy and low-cost healthcare. Following that is the question of how medical healthcare responds to such development. Bitter Kola (Garcinia) is the case study fruit, and Sunnyside in Pretoria, South Africa, has been spotted as one of the high-traffic selling points of herbal fruits. A mixed research method is applicable with an expected 20 Quantitative data respondents among sellers and nutritionists and 50 Qualitative Data respondents among consumers. Based on the results, it should be clear how spirituality contributes to alternative healthcare and how it can be further encouraged to bridge the gap between the high demand and low supply of healthcare in Africa and beyond.

Keywords: spiritual symbols, naturopathy, African fruits, spirituality, healthcare

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608 Sexual Cognitive Behavioral Therapy: Psychological Performance and Openness to Experience

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Amin Asadi Hieh, Majid Kazemnezhad

Abstract:

This research was conducted with the aim of determining the effectiveness of sexual cognitive behavioral therapy on psychological performance and openness to experience in women. The type of research was experimental in the form of pre-test-post-test. The statistical population of this research was made up of all working and married women with membership in the researcher's Instagram social network who had problems in marital-sexual relationships (N=900). From the statistical community, which includes working and married women who are members of the researcher's Instagram social network who have problems in marital-sexual relationships, there are 30 people including two groups (15 people in the experimental group and 15 people in the control group) as available sampling and selected randomly. They were placed in two experimental and control groups. The anxiety, stress, and depression scale (DASS) and the Costa and McCree personality questionnaire were used to collect data, and the cognitive behavioral therapy protocol of Dr. Mehrnaz Ali Akbari was used for the treatment sessions. To analyze the data, the covariance test was used in the SPSS22 software environment. The results showed that sexual cognitive behavioral therapy has a positive and significant effect on psychological performance and openness to experience in women. Conclusion: It can be concluded that interventions such as cognitive-behavioral sex can be used to treat marital problems.

Keywords: sexual cognitive behavioral therapy, psychological function, openness to experience, women

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607 Gambling Addiction in Canadian - Vietnamese Community

Authors: Hung Ton

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The Vietnamese community in Toronto, Ontario, Canada, is a minority group with an estimated less than 1% of the population. They have been in Canada since the 1970s, therefore, many funding sources are considering them as a long-time residential group. However, their limitation of resources cannot give them equal opportunities to successfully gain support from many levels of government in Canada, compared to other long-time settled and large groups. In 2020 and 2021, they have zero financial support for addressing problem gambling in the Vietnamese community. In contrast, casinos never forget this community. The gambling industry has been targeting the Vietnamese community as one of their major clientele groups. There are always in-equal battles between low-budget educational workshops by this underserved community group and expensive variety music shows by casinos. In the very same target group, five single lines of free ads by a community project cannot get more attention than a full-page colorful poster by casinos. An outreach worker is running back and forth to talk to a group of 10 or 15 persons in an ESL or Tai Chi class held in a basement of an old community center while fifty thousand dollars variety music shows can attract five thousand audience in their luxury facilities. Five-dollar vouchers for those who attend the problem gambling awareness session are incomparable to two hundred dollar free tickets for people to attend the show in casinos and then exit the gambling area after the show ends. There is only one problem gambling counselor who speaks the Vietnamese language in the Ontario province and in Canada at large. However, there are 70 casinos in Ontario and more than 200 licensed gambling facilities in Canada. He has been lonely in all in-equal "battles" for the last almost 25 years. He exists, fighting over there with or without funding support for the program, he fights still.

Keywords: Canadian Vietnamese, gambling addiction, gambling treatment, community awareness

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606 Data Mining in Healthcare for Predictive Analytics

Authors: Ruzanna Muradyan

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Medical data mining is a crucial field in contemporary healthcare that offers cutting-edge tactics with enormous potential to transform patient care. This abstract examines how sophisticated data mining techniques could transform the healthcare industry, with a special focus on how they might improve patient outcomes. Healthcare data repositories have dynamically evolved, producing a rich tapestry of different, multi-dimensional information that includes genetic profiles, lifestyle markers, electronic health records, and more. By utilizing data mining techniques inside this vast library, a variety of prospects for precision medicine, predictive analytics, and insight production become visible. Predictive modeling for illness prediction, risk stratification, and therapy efficacy evaluations are important points of focus. Healthcare providers may use this abundance of data to tailor treatment plans, identify high-risk patient populations, and forecast disease trajectories by applying machine learning algorithms and predictive analytics. Better patient outcomes, more efficient use of resources, and early treatments are made possible by this proactive strategy. Furthermore, data mining techniques act as catalysts to reveal complex relationships between apparently unrelated data pieces, providing enhanced insights into the cause of disease, genetic susceptibilities, and environmental factors. Healthcare practitioners can get practical insights that guide disease prevention, customized patient counseling, and focused therapies by analyzing these associations. The abstract explores the problems and ethical issues that come with using data mining techniques in the healthcare industry. In order to properly use these approaches, it is essential to find a balance between data privacy, security issues, and the interpretability of complex models. Finally, this abstract demonstrates the revolutionary power of modern data mining methodologies in transforming the healthcare sector. Healthcare practitioners and researchers can uncover unique insights, enhance clinical decision-making, and ultimately elevate patient care to unprecedented levels of precision and efficacy by employing cutting-edge methodologies.

Keywords: data mining, healthcare, patient care, predictive analytics, precision medicine, electronic health records, machine learning, predictive modeling, disease prognosis, risk stratification, treatment efficacy, genetic profiles, precision health

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605 Need for Cognition: An Important, Neglected Personality Variable in the Development of Spirituality Within the Context of Twelve Step Recovery from Addictive Disorders

Authors: Paul E. Priester

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The Twelve Step approach to recovery from substance use and addictive disorders is considered an evidence-based model that assists many who recover from a chronic, progressive, fatal disease. Two key processes that contribute to the success of obtaining recovery from substance use disorders (SUD) are meeting engagement and the development of spiritual beliefs. Beyond establishing that there is a positive relationship between the development of spiritual beliefs in recovery from SUD’s, there has been a paucity of research exploring individual differences among individuals in this development of spiritual beliefs. One such personality variable that deserves exploration is that of the need for cognition. The need for cognition is a personality variable that explains the cognitive style of individuals. Individuals with a high need for cognition enjoy examining the complexities of a situation before coming to a conclusion. While individuals with a low need for cognition do not value or spend time cognitively dissecting a situation or decision. It is important to point out that a high need for cognition does not necessarily imply a high level of cognitive ability. Indeed, one could make the argument that a low need for cognition individual is not “wasting” cognitive energy in perseverating the multitude of aspects of a particular decision. This paper will present two case studies demonstrating the development of spiritual beliefs that enabled long-term recovery from SUD. The first case study presents an agnostic individual with a low need for cognition cognitive style in his development of spirituality in support of his recovery from alcoholism within the context of Alcoholics Anonymous. The second case study represents an adamant atheist with a high need for cognition cognitive style. This second individual is an intravenous cocaine addict and alcoholic who recovers through the development of spirituality within the contexts of Alcoholics Anonymous and Narcotics Anonymous. The two case studies will be contrasted with each other, noting how the individuals’ cognitive style mediated the development of spirituality that supported their long-term recovery from alcoholism and addiction.

Keywords: spirituality, twelve step recovery, need for cognition, individual differences in recovery from addictions

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604 The Role of Artificial Intelligence in Creating Personalized Health Content for Elderly People: A Systematic Review Study

Authors: Mahnaz Khalafehnilsaz, Rozina Rahnama

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Introduction: The elderly population is growing rapidly, and with this growth comes an increased demand for healthcare services. Artificial intelligence (AI) has the potential to revolutionize the delivery of healthcare services to the elderly population. In this study, the various ways in which AI is used to create health content for elderly people and its transformative impact on the healthcare industry will be explored. Method: A systematic review of the literature was conducted to identify studies that have investigated the role of AI in creating health content specifically for elderly people. Several databases, including PubMed, Scopus, and Web of Science, were searched for relevant articles published between 2000 and 2022. The search strategy employed a combination of keywords related to AI, personalized health content, and the elderly. Studies that utilized AI to create health content for elderly individuals were included, while those that did not meet the inclusion criteria were excluded. A total of 20 articles that met the inclusion criteria were identified. Finding: The findings of this review highlight the diverse applications of AI in creating health content for elderly people. One significant application is the use of natural language processing (NLP), which involves the creation of chatbots and virtual assistants capable of providing personalized health information and advice to elderly patients. AI is also utilized in the field of medical imaging, where algorithms analyze medical images such as X-rays, CT scans, and MRIs to detect diseases and abnormalities. Additionally, AI enables the development of personalized health content for elderly patients by analyzing large amounts of patient data to identify patterns and trends that can inform healthcare providers in developing tailored treatment plans. Conclusion: AI is transforming the healthcare industry by providing a wide range of applications that can improve patient outcomes and reduce healthcare costs. From creating chatbots and virtual assistants to analyzing medical images and developing personalized treatment plans, AI is revolutionizing the way healthcare is delivered to elderly patients. Continued investment in this field is essential to ensure that elderly patients receive the best possible care.

Keywords: artificial intelligence, health content, older adult, healthcare

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