Search results for: basel committee (BCBS)

Authors: Patrice Conner

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Nanotechnologies have enormous potential to contribute to human flourishing in responsible and sustainable ways. They are rapidly developing field of science, technology and innovation. As enabling technologies, their full scope of applications is potentially very wide. Major implications are expected in many areas, e.g. healthcare, information and communication technologies, energy production and storage, materials science/chemical engineering, manufacturing, environmental protection, consumer products, etc. However, nanotechnologies are unlikely to realize their full potential unless their associated societal and ethical issues are adequately attended. Namely nanotechnologies and nanoparticles may expose humans and the environment to new health risks, possibly involving quite different mechanisms of interference with the physiology of human and environmental species. One of the building blocks of the ‘safe, integrated and responsible’ approach is standardization. Both the Economic and Social Committee and the European Parliament have highlighted the importance to be attached to standardization as a means to accompany the introduction on the market of nanotechnologies and nanomaterials, and a means to facilitate the implementation of regulation. ISO and CEN have respectively started in 2005 and 2006 to deal with selected topics related to this emerging and enabling technology. In the beginning of 2010, EC DG ‘Enterprise and Industry’ addressed the mandate M/461 to CEN, CENELEC and ETSI for standardization activities regarding nanotechnologies and nanomaterials. Thus CEN/TC 352 ‘Nanotechnologies’ has been asked to take the leadership for the coordination in the execution of M/461 (46 topics to be standardized) and to contact relevant European and International Technical committees and interested stakeholders as appropriate (56 structures have been identified). Prior requests from M/461 deal with characterization and exposure of nanomaterials and any matters related to Health, Safety and Environment. Answers will be given to: - What are the structures and how they work? - Where are we right now and how work is going from now onwards? - How CEN’s work and targets deal with and interact with global matters in this field?

Keywords: characterization, environmental protection, exposure, health risks, nanotechnologies, responsible and sustainable ways, safety

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Authors: Eric Dede, Marcus Tindall, John W. Cherrie, Steve Hankin, Christopher Collins

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Current exposure models used in contaminated land risk assessment are highly conservative. Use of these models may lead to over-estimation of actual exposures, possibly resulting in negative financial implications due to un-necessary remediation. Thus, we are carrying out a study seeking to improve our understanding of human exposure to selected toxic elements in soil: arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), and lead (Pb) resulting from allotment land-use. The study employs biomonitoring and physiologically-based pharmacokinetic (PBPK) modelling to quantify human exposure to these elements. We recruited 37 allotment users (adults > 18 years old) in Scotland, UK, to participate in the study. Concentrations of the elements (and their bioaccessibility) were measured in allotment samples (soil and allotment produce). Amount of produce consumed by the participants and participants’ biological samples (urine and blood) were collected for up to 12 consecutive months. Ethical approval was granted by the University of Reading Research Ethics Committee. PBPK models (coded in MATLAB) were used to estimate the distribution and accumulation of the elements in key body compartments, thus indicating the internal body burden. Simulating low element intake (based on estimated ‘doses’ from produce consumption records), predictive models suggested that detection of these elements in urine and blood was possible within a given period of time following exposure. This information was used in planning biomonitoring, and is currently being used in the interpretation of test results from biological samples. Evaluation of the models is being carried out using biomonitoring data, by comparing model predicted concentrations and measured biomarker concentrations. The PBPK models will be used to generate bioavailability values, which could be incorporated in contaminated land exposure models. Thus, the findings from this study will promote a more sustainable approach to contaminated land management.

Keywords: biomonitoring, exposure, PBPK modelling, toxic elements

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Authors: Joseph L. Mathew, Shourjendra N. Banerjee, R. K. Ratho, Sourabh Dutta, Vanita Suri

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Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months. Objective: This prospective study was designed to compare susceptibility in pre-term vs term infants, at different time points. Material and Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity > 95%). Susceptibility to measles was defined as antibody titre < 200mIU/ml. The mean antibody levels were compared between the two groups at the four time points. Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215g and 1985±175g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p > 0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3months, 6months and 9months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p > 0.05 for all inter-group comparisons). Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting the need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four-time points. A larger study is required to confirm these findings and compare sero-protection if vaccination is anticipated to be administered between 6 and 9 months.

Keywords: measles, preterm, susceptibility, term infant

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Authors: Jeroen De Ceuster

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This study is the first empirical analysis of the link between corporate governance and European Union competition law. Although competition law enforcement is often studied through the lens of competition law, we offer an alternative perspective by looking at a number of corporate governance factor at the level of the board of directors. We find that undertakings where the Chief Executive Officer is also chairman of the board are twice as likely to violate European Union competition law. No significant relationship was found between European Union competition law infringements and gender diversity of the board, the size of the board, the percentage of directors appointed after the Chief Executive Officer, the percentage of independent directors, or the presence of corporate social responsibility (CSR) committee. This contribution is based on a 1-1 matched peer study. Our sample includes all ultimate parent companies with a board that have been sanctioned by the European Commission for either anticompetitive agreements or abuse of dominance for the period from 2004 to 2018. These companies were matched to a company with headquarters in the same country, belongs to the same industry group, is active in the European Economic Area, and is the nearest neighbor to the infringing company in terms of revenue. Our final sample includes 121 pairs. As is common with matched peer studies, we use CLR to analyze the differences within these pairs. The only statistically significant independent variable after controlling for size and performance is CEO/Chair duality. The results indicate that companies whose Chief Executive Officer also functions as chairman of the board are twice as likely to infringe European Union competition law. This is in line with the monitoring theory of the board of directors, which states that its primary function is to monitor top management. Since competition law infringements are mostly organized by management and hidden from board directors, the results suggest that a Chief Executive Officer who is also chairman is more likely to be either complicit in the infringement or less critical towards his day-to-day colleagues and thus impedes proper detection by the board of competition law infringements.

Keywords: corporate governance, competition law, board of directors, board independence, ender diversity, corporate social responisbility

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Authors: T. Frawley, G. O'Kelly

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The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

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Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin

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Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.

Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress

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Authors: Brigita Mieziene, Arunas Emeljanovas, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background. Health-related physical fitness refers to the favorable health status, i.e. ability to perform daily activities with vigor, as well as capacities that are associated with a low risk for development of chronic diseases and premature death. However, in school-aged children it is constantly declining, while some aspects of fitness declined as much as 50 percent during the last two decades, which prognosticates increasingly earlier onset of health problems, decreasing the quality of life of the population and financial burden for the society. Therefore, the goal of the current study was to indicate nationally representative age- and gender-specific reference values of anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children from 6 to 10 years. Methods. The study included 3556 students in total, from 73 randomly selected schools. Ethics approval for research by the Kaunas Regional Ethics Committee (No. BE-2-42) was obtained. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues. Height and weight were measured and body mass index calculated. Smoothed centile charts were derived using the LMS method. Results. The numerical age- and gender-specific percentile values (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile) for anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness were provided. The equivalent smoothed LMS curves were performed. The study indicated 12.5 percent of overweight and 5 percent of obese children in accordance with international gender and age specific norms of body mass index. This data could be used in clinical and educational settings in order to identify the level of individual physical fitness within its different components.

Keywords: fitness, overweight, primary school children, reference values, smoothed percentile curves

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Authors: Ayse Inel Manav, Nuray Simsek

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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.

Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy

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Authors: Charita B. Lasala, Lakambini G. Reluya

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The human factor composing the organization is an asset that needs to be managed conscientiously and to be in tuned with the organization’s need. Thus, the human resources add value to the organization by using their talents, skills and knowledge in transforming the other resources of the organization to either produce or to deliver products and services that generate profits or other valued forms for return. Keeping these kinds of employees has always been the main goal of each Human Resources Department in every company worldwide; regardless of the work being done. They are the most important resource a company can have and treating them well will make them priceless assets that can help make a business a success. Larmen de Guia Memorial College (LGMC) and Royal Oaks International School (ROIS) is one of the many organizations that seek ways to keep the human factor and are in the process of formalization and that people management is on the top of the list thus, this study was made since there was a need for the creation of the Human Resources Department due to its absence in the organization and to help the organization in keeping these valued employees. The study was anchored on the concept that human resources consist of people who perform its activities and that all decisions that affect the workforce concern the organization’s human resources functions. In conducting this study, it made use of the mixed method using both the qualitative and quantitative approaches with focus group discussions. The design has three stages namely: problem conceptualization, case analysis, and output. The output from the survey and interviews tells the abstracted ideas on the proposed HR program for the said institution. Based on the findings of the study, it can be concluded that the personnel in the institution is not in the correct perspective, much more that the personnel has no specific job descriptions. The hiring procedure is not extensive, nor the personnel was given the chance to be exposed to training that would aid them in job development and enhancement of their skills and talents. The compensation package offered by the institution does not commensurate to their services rendered. Lastly, it is concluded that in the opinion/decision rendered by the grievance committee is not fair and that the institution failed to give good motivation/initiative for the employees to be more productive.

Keywords: employee benefits, employee relations, human resources and management, people management, recruitment, trainings

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Authors: Kevin Syam, Devendra K. Chauhan, Mandeep Singh Dhillon

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Background: The posterior horn of medial meniscus (PHMM) is a secondary stabilizer against anterior translation of tibia. Cadaveric studies have revealed increased strain on the ACL graft and greater instrumented laxity in Posterior horn deficient knees. Clinical studies have shown higher prevalence of radiological OA after ACL reconstruction combined with menisectomy. However, functional outcomes in ACL reconstructed knee in the absence of Posterior horn is less discussed, and specific role of posterior horn is ill-documented. This study evaluated functional and radiological outcomes in posterior horn preserved and posterior horn sacrificed ACL reconstructed knees. Materials: Of the 457 patients who had ACL reconstruction done over a 6 year period, 77 cases with minimum follow up of 18 months were included in the study after strict exclusion criteria (associated lateral meniscus injury, other ligamentous injuries, significant cartilage degeneration, repeat injury and contralateral knee injuries were excluded). 41 patients with intact menisci were compared with 36 patients with absent posterior horn of medial meniscus. Radiological and clinical tests for instability were conducted, and knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and the Orthopadische Arbeitsgruppe Knie score (OAK). Results: We found a trend towards significantly better overall outcome (OAK) in cases with intact PHMM at average follow-up of 43.03 months (p value 0.082). Cases with intact PHMM had significantly better objective stability (p value 0.004). No significant differences were noted in the subjective IKDC score (p value 0.526) and the functional OAK outcome (category D) (p value 0.363). More cases with absent posterior horn had evidence of radiological OA (p value 0.022) even at mid-term follow-up. Conclusion: Even though the overall OAK and subjective IKDC scores did not show significant difference between the two subsets, the poorer outcomes in terms of objective stability and radiological OA noted in the absence of PHMM, indicates the importance of preserving this important part of the meniscus.

Keywords: ACL, functional outcome, knee, posterior of medial meniscus

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Authors: Isabela Thomas Mkude

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This research was done to assess how the community is involved in waste management activities and their willingness to pay for services. Mnadani and Madukani are among the old wards in Dodoma urban. These two areas are similar and face numerous environmental problems, poor solid waste management practices being among them. People realize problems because they live with them daily but the study advice that the only way to stay off problems is to find appropriate measures. The findings recognized some problems that led to poor community involvement solid waste management the study areas. Lack of community education on how to deal with solid wastes, poor responsibility of ward leaders in issues concerning the environment and in active participation of communities in environmental meeting are among other major problems found during the research. The research also revealed that there is low willingness to pay for waste collection among communities and financial problems that make environmental committee inactive; that leading to a poor disposal and unavailable collection facilities in urban area. Although the municipal improves disposal activities by increasing amount of waste to be disposed off by 11% in three years, the amount of waste that collected is also increasing by 41% each day. It is advised that some corrective measures need to be put in place so that the communities are well involved in managing solid wastes as the best way to attain achievement in keeping the urban free from solid waste. Environmental education dissemination to the communities is needed so that they become responsible and dedicated citizen on the environment. There should be some incentives from government to the wards local government and CBOs so that they can practically implement solid waste management programs and to attract formation of more groups and motivate the present groups. Capacity building programs to the ward leaders need to be given priority so that leaders are well organized and able to plan, coordinate and cooperate with various governmental institutions, and NGOs responsible for development and environmental management.

Keywords: solid waste, waste management, public involvement, rapid urbanized region

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Authors: A. Bajek, J. Skopinska-Wisniewska, A. Rynkiewicz, A. Jundzill, M. Bodnar, A. Marszalek, T. Drewa

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Traumatic injury and age-related degenerative diseases associated with cartilage are major health problems worldwide. The articular cartilage is comprised of a relatively small number of cells, which have a relatively slow rate of turnover. Therefore, damaged articular cartilage has a limited capacity for self-repair. New clinical methods have been designed to achieve better repair of injured cartilage. However, there is no treatment that enables full restoration of it. The aim of this study was to evaluate how collagen gel with bone marrow mesenchymal stem cells (MSCs) and collagen gel alone will influence on the hip cartilage repair after injury. Collagen type I was isolated from rats’ tails and cross-linked with N-hydroxysuccinimide in 24-hour process. MSCs were isolated from rats’ bone marrow. The experiments were conducted according to the guidelines for animal experiments of Ethics Committee. Fifteen 8-week-old Wistar rats were used in this study. All animals received hip joint surgery with a total of 30 created cartilage defects. Then, animals were randomly divided into three groups and filled, respectively, with collagen gel (group 1), collagen gel cultured with MSCs (group II) or left untreated as a control (control group). Immunohistochemy and radiological evaluation was carried out 11 weeks post implantation. It has been proved that the surface of the matrix is non-toxic, and its porosity promotes cell adhesion and growth. However, the in vivo regeneration process was poor. We observed the low integration rate of biomaterial. Immunohistochemical evaluation of cartilage after 11 weeks of treatment showed low II and high X collagen expression in two tested groups in comparison to the control one, in which we observed the high II collagen expression. What is more, after radiological analysis, we observed the best regeneration process in control group. The biomaterial construct and mesenchymal stem cells, as well as the use of the biomaterial itself was not sufficient to regenerate the hip cartilage surfaces. These results suggest that the collagen gel based biomaterials, even with MSCs, are not satisfactory in repar of hip cartilage defect. However, additional evaluation is needed to confirm these results.

Keywords: collafen gel, MSCs, cartilage repair, hip cartilage

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Authors: Betül sönmez, Fatma Azizoğlu, S. Bilge Hapçıoğlu, Aytolan Yıldırım

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Background: Social innovativeness contains the procurement of a sustainable benefit for a number of problems from working conditions to education, social development, health, and from environmental control to climate change, as well as the development of new social productions and services. Objectives: This study was conducted to determine the correlation between the social innovation tendency of nursing and medical faculty students and value types. Methods and participants: The population of this correlational study consisted of third-year students studying at a medical faculty and a nursing faculty in a public university in Istanbul. Ethics committee approval and permission from the school administrations were obtained in order to conduct the study and voluntary participation of the students in the study was ensured. 524 questionnaires were obtained with a total return rate of 57.1% (65.0% in nurse student and 52.1% in physic students). The data of the study were collected by using the Portrait Values Questionnaire and a questionnaire containing the Social Innovativeness Scale. Results: The effect of the subscale scores of Portrait Values Questionnaire on the total score of Social Innovativeness Scale was 26.6%. In the model where a significance was determined (F=37.566; p<0.01), the highest effect was observed in the subscale of universalism. The effect of subscale scores obtained from the Portrait Values Questionnaire, as well as age, gender and number of siblings was 25% on the Social Innovativeness in nursing students and 30.8% in medical faculty students. In both models where a significance was determined (p<0.01), the nursing students had the values of power, universalism and kindness, whereas the medical faculty students had the values of self-direction, stimulation, hedonism and universalism showed the highest effect in both models. Conclusions: Universalism is the value with the highest effect upon the social innovativeness in both groups, which is an expected result by the nature of professions. The effect of the values of independent thinking and self-direction, as well as openness to change involving quest for innovation (stimulation), which are observed in medical faculty students, also supports the literature of innovative behavior. These results are thought to guide educators and administrators in terms of developing socially innovative behaviors.

Keywords: social innovativeness, portrait values questionnaire, nursing students, medical faculty students

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Authors: Haifeng Shi, Kun Song, Yili Zhao

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In China, with the extensive promotion of the ‘aging in place’ pension policy as the background, most of the elders will choose to remain in their current homes and communities, finding out of preference or necessity that they will need to remodel their homes to fit their changing needs. This generation elder born in the 1960s to 1970s almost live in the same form of housing-condominium built from 1982 to 2012. Based on the survey of existing multi-family housing, especially in Tianjin, it is found that the current ‘double two-thirds principles’ is becoming the threshold for modification to existing house, particularly in the project of elevators addition to existing condominium (built from 1982 to 2016 without elevators below 6 floors according to the previous building code). Firstly, this article concludes the local policies of elevator addition nationwide, most of which has determined the importance and necessity of the community-based self-organization principle in the operation of the elevator addition. Secondly, by comparing the three existing community management systems (owners' congress, property management system and community committee) in instances, find that the community-based ‘two-thirds’ principle is not conducive to implement for multi-owned property renovation in the community or common accessibility modification in the building. However, analysis the property and other community management related laws, pointing out the shortcomings of the existing community-based ‘two-thirds’ decision-making norms. The analyzation showed that the unit-based and ‘100% principle’ method is more capable of common accessibility in the condominium in China. Differing from existing laws, the unit-based principle will be effective for the process of decision-making and ‘100% principle’ will protect closely profit-related householders for condominium modification in the multi-owned area. These three aspects of the analysis suggest that the establishment of the unit-based self-organization mechanism is a preferred and inevitable method to solve the problem of elevators addition to the existing condominium in China.

Keywords: aging in place, condominium, modification, multi own

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Authors: Muhammad Zafar Khan, Babar Khan, Muhammad Saeed Awan, Farida Begum

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Livestock depredation has greater significance in pastoral societies like Himalaya-Karakoram-Hindu Kush mountain ranges. The dynamics of depredation by large predators (snow leopard and wolf) and its implications for conservation and livelihoods of local people was investigated by household surveys in Hushey valley of Central Karakoram National Park, Pakistan. We found that, during five years (2008-12) 90% of the households in the valley had lost their livestock to snow leopard and wolf, accounting for 4.3% of the total livestock holding per year. On average each household had to bear a loss of 0.8 livestock head per year, equivalent to Pak Rupees 9,853 (US$ 101), or 10% of the average annual cash income. Majority of the predation incidences occurred during late summer in alpine pastures, mostly at night when animals were not penned properly. The prey animals in most of the cases were females or young ones. Of the total predation incidences, 60% were attributed to snow leopard, 37% to wolf, while in 3% the predator was unknown. The fear of snow leopard is greater than that of wolf. As immediate response on predation, majority of the local people (64%, n=99) preferred to report the case to their village conservation committee, 32% had no response while only 1% tended to kill the predator. The perceived causes of predation were: poor guarding practices (77%); reduction in wild prey (13%) and livestock being the favourite food of predators (10%). The most preferred strategies for predator management, according to the respondents were improved and enhanced guarding of livestock (72%), followed by increasing wild prey (18%) and lethal control (10%). To strike a balance between predator populations and pastoral livelihoods, better animal husbandry practices should be promoted including: improved guarding through collective hiring of skilled shepherds; corral improvement and use of guard dogs.

Keywords: Panthera unica, Canis lupus, Karakoram, human-carnivore conflict, predation

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolic syndrome (MetS) is a disease associated with obesity. It is a complicated clinical problem possibly affecting body composition as well as macrominerals. These parameters gain further attention, particularly in the pediatric population. The aim of this study is to investigate the amount of discrete body composition fractions in groups that differ in the severity of obesity. Also, the possible associations with calcium (Ca), phosphorus (P), magnesium (Mg) will be examined. The study population was divided into four groups. Twenty-eight, 29, 34, and 34 children were involved in Group 1 (healthy), 2 (obese), 3 (morbid obese), and 4 (MetS), respectively. Institutional Ethical Committee approved the study protocol. Informed consent forms were obtained from the participants. The classification of obese groups was performed based upon the recommendations of the World Health Organization. Metabolic syndrome components were defined. Serum Ca, P, Mg concentrations were measured. Within the scope of body composition, fat mass, fat-free mass, protein mass, mineral mass were determined by a body composition monitor using bioelectrical impedance analysis technology. Weight, height, waist circumference, hip circumference, head circumference, and neck circumference values were recorded. Body mass index, diagnostic obesity notation model assessment index, fat mass index, and fat-free mass index values were calculated. Data were statistically evaluated and interpreted. There was no statistically significant difference among the groups in terms of Ca and P concentrations. Magnesium concentrations differed between Group 1 and Group 4. Strong negative correlations were detected between P as well as Mg and fat mass index as well as diagnostic obesity notation model assessment index in Group 4, the group, which comprised morbid obese children with MetS. This study emphasized unique associations of P and Mg minerals with diagnostic obesity notation model assessment index and fat mass index during the evaluation of morbid obese children with MetS. It was also concluded that diagnostic obesity notation model assessment index and fat mass index were more proper indices in comparison with body mass index and fat-free mass index for the purpose of defining body composition in children.

Keywords: children, fat mass, fat-free mass, macrominerals, obesity

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Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

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Authors: Nami Matsumoto

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This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.

Keywords: health care, Japanese-English medical encounters, language barriers, trust

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Authors: J. E. Cobbinah

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One of the most challenging issues confronting schools is good leadership succession planning. Experts argue that, although the idea of leadership succession planning is one of the strategies or practices that can help sustain improvement and promote continuity of good leadership, seem to have been neglected in many schools over the years. Appointment of head teachers in senior high schools is based on long service or one’s ability to demonstrate his/her competence in a leadership selection interview. There is no clear and well-structured leadership succession plan, before leadership position is filled, while school leadership succession planning seem to be an issue that nobody talks about. In faith-based schools the issue is even worse, because religious groups impose whoever they consider strong in the faith on schools as leaders, irrespective of the individual competence, ability to take up challenges associated with individuals’ preparedness to take up leadership position. Therefore, the present study examined the nature (including type) of leadership succession plans in faith-based senior high schools and its associated challenges. Convergent mixed method design was employed to effectively achieve the objectives of the study. The data collection strategies involved the use of interviews, questionnaires, and reviews of secondary data. The data was gathered from students, school leaders (head teachers, deputy heads, and head of departments), selected parents teachers associated members, school management committee members and members from school governors. The results show that governors of faith-based schools are making efforts to enhance education quality, by making school leadership accountable, the absence and the neglect of clear, and well-structured leadership succession plan has some negative outcomes. Unsustainable students’ academic performance, lack of support from existing staffs and senior leaders and lack of support in the implementation of school improvement plan. It would be concluded that, faith-based schools should focus on leadership competence and abilities in the selection process of potential school leaders to achieve a good succession plan rather than appointing leaders who are affiliates of one’s faith.

Keywords: school leadership, succession planning, faith-based schools, school governors

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Authors: Salman Naseer, Usman Zafar, Iqra Zafar

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This study explores the implication of Vehicular Adhoc Network (VANET) - in the rural and urban scenarios that is one domain of Mobile Adhoc Network (MANET). VANET provides wireless communication between vehicle to vehicle and also roadside units. The Federal Commission Committee of United States of American has been allocated 75 MHz of the spectrum band in the 5.9 GHz frequency range for dedicated short-range communications (DSRC) that are specifically designed to enhance any road safety applications and entertainment/information applications. There are several vehicular related projects viz; California path, car 2 car communication consortium, the ETSI, and IEEE 1609 working group that have already been conducted to improve the overall road safety or traffic management. After the critical literature review, the selection of routing protocols is determined, and its performance was well thought-out in the urban and rural scenarios. Numerous routing protocols for VANET are applied to carry out current research. Its evaluation was conceded with the help of selected protocols through simulation via performance metric i.e. throughput and packet drop. Excel and Google graph API tools are used for plotting the graphs after the simulation results in order to compare the selected routing protocols which result with each other. In addition, the sum of the output from each scenario was computed to undoubtedly present the divergence in results. The findings of the current study present that DSR gives enhanced performance for low packet drop and high throughput as compared to AODV and DSDV in an urban congested area and in rural environments. On the other hand, in low-density area, VANET AODV gives better results as compared to DSR. The worth of the current study may be judged as the information exchanged between vehicles is useful for comfort, safety, and entertainment. Furthermore, the communication system performance depends on the way routing is done in the network and moreover, the routing of the data based on protocols implement in the network. The above-presented results lead to policy implication and develop our understanding of the broader spectrum of VANET.

Keywords: AODV, DSDV, DSR, Adhoc network

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Authors: Jakkireddy Sravani

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Introduction: The maintenance of hemodynamic stability is of pivotal importance in supratentorial surgeries. Anesthesia for supratentorial tumors requires an understanding of localized or generalized rising ICP, regulation, and maintenance of intracerebral perfusion, and avoidance of secondary systemic ischemic insults. We aimed to compare the effects of the combination of ketamine and propofol with propofol alone when used as an induction and maintenance anesthetic agent during supratentorial tumors. Methodology: This prospective, randomized, double-blinded controlled study was conducted at AIIMS Raipur after obtaining the institute Ethics Committee approval (1212/IEC-AIIMSRPR/2022 dated 15/10/2022), CTRI/2023/01/049298 registration and written informed consent. Fifty-two supratentorial tumor patients posted for craniotomy and excision were included in the study. The patients were randomized into two groups. One group received a combination of ketamine and propofol, and the other group received propofol for induction and maintenance of anesthesia. Intraoperative hemodynamic stability and quality of brain relaxation were studied in both groups. Statistical analysis and technique: An MS Excel spreadsheet program was used to code and record the data. Data analysis was done using IBM Corp SPSS v23. The independent sample "t" test was applied for continuously dispersed data when two groups were compared, the chi-square test for categorical data, and the Wilcoxon test for not normally distributed data. Results: The patients were comparable in terms of demographic profile, duration of the surgery, and intraoperative input-output status. The trends in BIS over time were similar between the two groups (p-value = 1.00). Intraoperative hemodynamics (SBP, DBP, MAP) were better maintained in the ketamine and propofol combination group during induction and maintenance (p-value < 0.01). The quality of brain relaxation was comparable between the two groups (p-value = 0.364). Conclusion: Ketamine and propofol combination for the induction and maintenance of anesthesia was associated with superior hemodynamic stability, required fewer vasopressors during excision of supratentorial tumors, provided adequate brain relaxation, and some degree of neuroprotection compared to propofol alone.

Keywords: supratentorial tumors, hemodynamic stability, brain relaxation, ketamine, propofol

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Authors: Ravan Samadov

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Mentally disabled people are the most discriminated against among other disabled people and face much stronger negative attitudes across many cultures. The most complex and severe form of exclusion of these people is deprivation of liberty on the grounds of their disability. This problem was for many years overlooked to a great extent by the core human rights instruments. However, the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006, is considered a potential tool to successfully fill the gap. It is especially vital for the developing countries with the vast majority of disabled people of the world and the CRPD is presumed to be able to trigger drastic positive changes. Article 14 of the mentioned human rights treaty has brought into the international forum a new notion, as prohibits deprivation of liberty on the grounds of disability. It is to be understood as an absolute prohibition of deprivation of liberty on the grounds of disability, including mental disability, which manifests in the form of non-consensual psychiatric hospitalisation. The interpretation by the CRPD Committee indicates that this prohibition well embraces all types of non-consensual psychiatric hospitalisation – whether it is based on illness, impairment or disability. This prohibition also extends to such justifications as ‘dangerousness’, ‘need for treatment’ and ‘diminished capacity’. Moreover, providing due substantive and/or procedural safeguards does not render any legitimacy to application of deprivation of liberty on the grounds of mental disability. Logically, this new prohibition form was to be duly considered by different UN human rights bodies, and was subsequently to bring changes to their practices. However, the analyses of post-CRPD work of those bodies allows for asserting the contrary, as they have continued displaying the position which recognises deprivation of liberty on the grounds of disability to be legitimate. While such a position could be justified in the pre-CRPD time as stemming from the silence of human rights documents about it, the continuation of this course after the CRPD entered into force may call the integrity and coherence of the UN human rights treaty system into question. The non-coherent approaches of different UN bodies to this novelty give grounds for misinterpretation thereof, and hinder its due implementation by the States Parties. The paper will discuss the nature of the mentioned new prohibition and the controversial approaches to that notion by different UN human rights bodies.

Keywords: CRPD, deprivation of liberty, mental disability, non-consensual psychiatric hospitalisation, UN bodies

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Authors: P. Dhesi, R. Burns

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Background: The UK has one of the largest immigration detention estates in Europe and is under increasing scrutiny, particularly regarding the lack of transparency over the use of detention and the conditions. Therefore, this research seeks to explore the professional perceptions of the ability of immigration detention in the UK to promote health and dignity. Methods: A phenomenological approach to qualitative methods were used, with social constructivist theorisations of health and dignity. Seven semi-structured interviews were conducted using Microsoft Teams. Participants included a range of immigration detention stakeholders who have visited closed immigration detention centres in the UK in a professional capacity. Recorded interviews were transcribed verbatim, and analysis was data-driven through inductive reflexive thematic analysis of the entire data set to account for the small sample size. This study received ethical approval from University College London Research Ethics Committee. Results: Two global themes were created through analysis: apathetic place and hostile space. Apathetic place discusses the lack of concern for detainees' daily living and healthcare needs within immigration detention in the UK. This is explored through participants' perceptions of the lack of ability of monitoring and evaluation processes to ensure detainees are able to live with dignity and understand the unfulfilled duty of care that exists in detention. Hostile space discusses immigration detention in the UK as a wider system of hostility. This is explored through the disempowering impact on detainees, the perception of a failing system as a result of inadequate safeguarding procedures, and a belief that the intention of immigration detention is misaligned with its described purpose. Conclusion: This research explains why the current immigration detention system in the UK is unable to promote health and dignity, offering a social justice and action-orientated approach to research in this sphere. The findings strengthen the discourse against the use of detention as an immigration control tool in the UK. Implications for further research include a stronger emphasis on investigating alternatives to detention and culturally considerate opportunities for patient-centred healthcare.

Keywords: access to healthcare, dignity, health, immigration detention, migrant, refugee, UK

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Authors: Arunas Emeljanovas, Brigita Mieziene, Tomas Venckunas

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Background statement: Level of aerobic capacity in school age children provides important information about the current and future cardiovascular, skeletal and mental health. It is widely recognised that risk factors for modern chronic diseases of the adults have their origins in childhood and adolescence. The aim of the study was to analyse the trends of aerobic capacity across decades within groups of gender and age. Methods. The research included data of participants from the three nationally representative cohort studies performed in Lithuania in the years 1992, 2002 and 2012 among 11 to 18-years-old school children. Total of 18,294 school children were recruited for testing. Only those who had their body weight and height measured and completed 20 m shuttle endurance test were included in the analysis. The total number of students included in the analyses was 15,213 (7608 boys and 7605 girls). The permission to conduct the study was obtained from the Lithuanian Bioethics Committee (permission number BE-2-45). Major findings: Results are performed across gender and age groups. The comparison of shuttle endurance test, controlling for body mass index, indicated that in general there is a constant decrease of aerobic capacity across decades in both genders and age groups. The deterioration in aerobic capacity in boys accounted for 17 to 43 percent across age groups within decades. The biggest decrease was in 14 years-old boys. The deterioration in girls accounted for 19 to 37 percent across age groups with the highest decrease in 11 years-old girls. Though, girls had lower levels of aerobic capacity through all age groups and across three decades. Body mass index, as a covariate, accounted for up to six percent in deterioration of aerobic capacity. Final statement: The detected relationships may reflect the level and pattern of engagement in physical activity and sports where increased activity associates with superior performance in the tests because of the upregulated physiological function and instigated competitive/motivational level. The significance of the decade indirectly supports the importance of the recently changed activity among schoolchildren for this relationship.

Keywords: aerobic capacity, cardiovascular health, endurance, school age children

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric obesity indices such as waist circumference (WC), indices derived from anthropometric measurements such as waist-to-hip ratio (WHR), and indices created from body fat mass composition such as trunk-to-leg fat ratio (TLFR) are commonly used for the evaluation of mild or severe forms of obesity. Their clinical utilities are being compared using body mass index (BMI) percentiles to classify obesity groups. The best of them is still being investigated to make a clear-cut discrimination between healthy normal individuals (N-BMI) and overweight or obese (OB) or morbid obese patients. The aim of this study is to derive a new index, which best suits the purpose for the discrimination of children with N-BMI from OB children. A total of eighty-three children participated in the study. Two groups were constituted. The first group comprised 42 children with N-BMI, and the second group was composed of 41 OB children, whose age- and sex- adjusted BMI percentile values vary between 95 and 99. The corresponding values for the first group were between 15 and 85. This classification was based upon the tables created by World Health Organization. The institutional ethics committee approved the study protocol. Informed consent forms were filled by the parents of the participants. Anthropometric measurements were taken and recorded following a detailed physical examination. Within this context, weight, height (Ht), WC, hip C (HC), neck C (NC) values were taken. Body mass index, WHR, (WC+HC)/2, WC/Ht, (WC/HC)/Ht, WC*NC were calculated. Bioelectrical impedance analysis was performed to obtain body’s fat compartments in terms of total fat, trunk fat, leg fat, arm fat masses. Trunk-to-leg fat ratio, trunk-to-appendicular fat ratio (TAFR), (trunk fat+leg fat)/2 ((TF+LF)/2) were calculated. Fat mass index (FMI) and diagnostic obesity notation model assessment-II (D2I) index values were calculated. Statistical analysis of the data was performed. Significantly increased values of (WC+HC)/2, (TF+LF)/2, D2I, and FMI were observed in OB group in comparison with those of N-BMI group. Significant correlations were calculated between BMI and WC, (WC+HC)/2, (TF+LF)/2, TLFR, TAFR, D2I as well as FMI both in N-BMI and OB groups. The same correlations were obtained for WC. (WC+HC)/2 was correlated with TLFR, TAFR, (TF+LF)/2, D2I, and FMI in N-BMI group. In OB group, the correlations were the same except those with TLFR and TAFR. These correlations were not present with WHR. Correlations were observed between TLFR and BMI, WC, (WC+HC)/2, (TF+LF)/2, D2I as well as FMI in N-BMI group. Same correlations were observed also with TAFR. In OB group, correlations between TLFR or TAFR and BMI, WC as well as (WC+HC)/2 were missing. None was noted with WHR. From these findings, it was concluded that (WC+HC)/2, but not WHR, was much more suitable as an anthropometric obesity index. The only correlation valid in both groups was that exists between (WC+HC)/2 and (TF+LF)/2. This index was suggested as a link between anthropometric and fat-based indices.

Keywords: children, hip circumference, obesity, waist circumference

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Authors: Jennifer Walinga, Samantha Heron

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The goal of the study was to inform the design of effective leadership and mentorship development programming for sport science leaders within the network of Canadian sport institutes and centers. The LEAD (Learn, Engage, Accelerate, Develop) program was implemented to equip sport science leaders with the leadership knowledge, skills, and practice to foster a high - performance culture, enhance the daily training environment, and contribute to optimal performance in sport. After two years of delivery, this analysis of LEAD’s effect on individual and organizational health and performance factors informs the quality of future deliveries and identifies best practice for leadership development across the Canadian sport system and beyond. A larger goal for this project was to inform the public sector more broadly and position sport as a source of best practice for human and social health, development, and performance. The objectives of this study were to review and refine the LEAD program in collaboration with Canadian Sport Institute and Centre leaders, 40-50 participants from three cohorts, and the LEAD program advisory committee, and to trace the effects of the LEAD leadership development program on key leadership mentorship and organizational health indicators across the Canadian sport institutes and centers so as to capture best practice. The study followed a participatory action research framework (PAR) using semi structured interviews with sport scientist participants, program and institute leaders inquiring into impact on specific individual and organizational health and performance factors. Findings included a strong increase in self-reported leadership knowledge, skill, language and confidence, enhancement of human and organizational health factors, and the opportunity to explore more deeply issues of diversity and inclusion, psychological safety, team dynamics, and performance management. The study was significant in building sport leadership and mentorship development strategies for managing change efforts, addressing inequalities, and building personal and operational resilience amidst challenges of uncertainty, pressure, and constraint in real time.

Keywords: sport leadership, sport science leader, leadership development, professional development, sport education, mentorship

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Authors: Azziz Assoumani, Francois Lestremau, Celine Ferret, Benedicte Lepot, Morgane Salomon, Helene Budzinski, Marie-Helene Devier, Pierre Labadie, Karyn Le Menach, Patrick Pardon, Laure Wiest, Emmanuelle Vulliet, Pierre-Francois Staub

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Seven French wastewater treatment plants (WWTP) were monitored for 53 contaminants of emerging concern within a nation-wide monitoring campaign in surface waters, which took place in 2018. The overall objective of the 2018 campaign was to provide the exercise of prioritization of emerging substances, which is being carried out in 2021, with monitoring data. This exercise should make it possible to update the list of relevant substances to be monitored (SPAS) as part of future water framework directive monitoring programmes, which will be implemented in the next water body management cycle (2022). One sampling campaign was performed in October 2018 in the seven WWTP, where affluent and sludge samples were collected. Surface water samples were collected in September 2018 at three to five sites upstream and downstream the point of effluent discharge of each WWTP. The contaminants (36 biocides and 17 surfactants, selected by the Prioritization Experts Committee) were determined in the seven WWTP effluent and sludge samples and in surface water samples by liquid or gas chromatography coupled with tandem mass spectrometry, depending on the contaminant. Nine surfactants and three biocides were quantified at least in one WWTP effluent sample. Linear alkylbenzene sulfonic acids (LAS) and fipronil were quantified in all samples; the LAS were quantified at the highest median concentrations. Twelve surfactants and 13 biocides were quantified in at least one sludge sample. The LAS and didecyldimethylammonium were quantified in all samples and at the highest median concentrations. Higher concentration levels of the substances quantified in WWTP effluent samples were observed in the surface water samples collected downstream the effluents discharge points, compared with the samples collected upstream, suggesting a contribution of the WWTP effluents in the contamination of surface waters.

Keywords: contaminants of emerging concern, effluent, monitoring, river water, sludge

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Authors: Binaya Tamang, Buddhhi Raj Pokhrel, Narayan Gautam

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Background: There may be a connection between thyroid function and vitamin D status since both bind to similar nuclear hormone receptors and have similar response regions on gene promoters. The purpose of the current study was to investigate the relationship between thyroid hormones and vitamin D levels in females who were attending a tertiary care center in western Nepal and were either hypothyroid or euthyroid. Methods: This hospital-based cross-sectional study was carried out between March 2020 and March 2021 by the Biochemistry department of the Universal College of Medical Sciences (UCMS), Bhairahawa, Province No. 5, Nepal, in cooperation with Internal medicine. Prior to the study, institutional review committee approval (UCMS/IRC/008/20) was acquired from UCMS. Women who visited the Internal Medicine OPD of UCMS and were advised to get a thyroid function test (TFT) were included in the study population. Only those who were willing to participate in the study were enrolled after the goals and advantages of the study had been explained to them. Participants who had recently used vitamin D supplements and medications that affected thyroid hormones were excluded. The participants gave their consent verbally and in writing. After getting the consent, a convenient sample technique was applied. Serum was isolated after drawing 3 ml of blood in a plain vial. Chemiluminescence assay was used to analyze vitamin D and thyroid hormones (MAGLUMI 2000). SPSS version 16.0 for Windows was used to conduct the statistical analysis. Statistical significance was defined as a P-value < 0.05. Results: Majority of the study population (n=214, 71%) had insufficient serum vitamin D levels. Among the thyroid groups, the median Vitamin D levels were significantly lower in hypothyroid (16.88 ng/ml) as compared to the euthyroid groups (25.01 ng/ml) (P<0.001). Similarly, serum Vitamin D levels were considerably lower in the obese population (16.86 ng/ml) as compared to the normal BMI group (24.90 ng/ml) (P<0.001) as well as in the vegetarian (15.43 ng.ml) than mixed diet consumer (24.89 ng/ml) (P<0.01). Even after the adjustment for these variables, the Vitamin D levels were significantly lower in the hypothyroid population than in the euthyroid group (P<0.001). Conclusion: Comparing the hypothyroid population to the euthyroid, the median serum vitamin D levels were considerably lower. We were alarmed to see that the majority of euthyroid participants also had low levels of vitamin D. Therefore if left untreated, low vitamin D levels in hypothyroid patients could worsen their health further.

Keywords: vitamin D, thyroid hormones, euthyroid, hypothyroid, Nepal

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Authors: Karina Peron, Ricardo Ghelman, Monica Taminato, Katia R. Oliveira, Debora C. A. Rodrigues, Juliana R. C. Mumme, Olga K. M. Sunakozaua, Georg Seifert, Vicente O. Filho

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The nurse is the most available health professional for the interventions of support in the integrative approach in hospital environment, therefore a professional group key to changes in the model of care. The central components in the performance of anthroposophic nursing procedures are direct physical contact, promotion of proper rhythm, thermal regulation and the construction of a calm and empathic atmosphere, safe for patients and their caregivers. The procedures of anthroposophic external therapies (AET), basically composed of the application of compresses and the use of natural products, provide an opportunity to intensify the therapeutic results through an innovative, complementary and integrative model in the university hospital. The objective of this work is to report the implementation of a program of nursing techniques (AET) through a partnership between the Pediatric Oncology Sector of the Department of Pediatrics of the Faculty of Medicine of the University of Sao Paulo and Charite University of Berlin, with lecturers from Berlin's Integrative Hospital Havelhöhe and Witten-Herdecke Integrative Hospital, both in Germany. Intensive training activities of the Hospital's nursing staff and a survey on AET needs were developed based on the most prevalent complaints in pediatric oncology patients in the three environments of the Hospital of Pediatric Oncology: Bone Marrow Transplantation Unit, Intensive Care Unit and Division of Internal Patients. We obtained the approval of the clinical protocol of external anthroposophic therapies for nursing care by the Ethics Committee and the Academic Council of the Hospital. With this project, we highlight the key AET needs that will be part of the standard program of pediatric oncology care with appropriate scientific support. The results of the prevalent symptoms were: vomiting, nausea, pain, difficulty in starting sleep, constipation, cold extremities, mood disorder and psychomotor agitation. This project was the pioneer within the Integrative Pediatrics Program, as an innovative concept of Medicine and Integrative Health presented at scientific meetings.

Keywords: integrative health care, integrative nursing, pediatric nursing, pediatric oncology

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Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya

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The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.

Keywords: public health, emergency management, covid-19, pandemic

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