Search results for: primary health

Authors: Hatice Yildirim

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This study is an investigation into ‘The role of teaching assistants (TAs) for deaf pupils in an English primary school’, in order not only to contribute to the education of deaf pupils but also contribute to the literature, in which there has been a lack of attention paid to the role of TAs for deaf pupils. With this in mind, the research design was planned based on using a case study as a qualitative research approach in order to have a deep and first-hand understanding of the case for ‘the role of TAs for deaf pupils’ in a real-life context. 12 semi-structured classroom observations and six semi-structured interviews were carried out with four TAs and two teachers in one English mainstream primary school. The data analysis followed a thematic analysis framework. The results indicated that TAs are utilised based on a one-on-one support model and are deployed under the class teacher in the classroom. Out of the classroom activities are carried out in small groups with the agreement of the TAs and the class teacher, as per the policy of the school. Due to the one-on-one TA support model, the study pointed out the seven different roles carried out by TAs in the education of deaf pupils in an English mainstream primary school. While supporting deaf pupils academically and socially are the main roles of TAs, they also support deaf pupils by recording their progress, communicating with their parents, taking on a pastoral care role, tutoring them in additional support lessons, and raising awareness of deaf pupils’ issues.

Keywords: deaf, mainstream, teaching assistant, teaching assistant's roles

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Authors: Lakmali Anthony, Madeline Gillies

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Background: Incisional and ventral hernias are highly prevalent, with primary ventral hernias occurring in approximately 20% of adults and incisional hernias developing in up to 30% of midline abdominal incisions. Recent data from the United States have shown an increasing incidence of elective incisional and ventral hernia repair (IVHR) and emergency repair of complicated hernias. This study examines Australian population trends in IVHR over a two-decade study period. Methods: This retrospective study was performed using procedure data from the Australian Institute of Health and Welfare, and population data from the Australian Bureau of Statistics captured between 2000 and 2021 to calculate incidence rates per 100,000 population by age and sex for selected subcategories of IVHR operations. Trends over time were evaluated using simple linear regression. Results: There were 809,308 IVHR operations performed in Australia during the study period. The cumulative incidence adjusted for the population was 182 per 100,000; this increased by 9.578 per year during the study period (95% CI = 8.431- 10.726, p<.001). IVHR for primary umbilical hernias experienced the most significant increase in population-adjusted incidence, 1.177 per year. (95% CI = 0.654- 1.701, p<.001). Emergency IVHR for incarcerated, obstructed, and strangulated hernias increased by 0.576 per year (95% CI = 0.510 -0.642, p<.001). Only 20.2% of IVHR procedures were performed as day surgery. Conclusions: Australia has seen a significant increase in IVHR operations performed in the last 20 years, particularly those for primary ventral hernias. IVHR for hernias complicated by incarceration, obstruction, and strangulation also increased significantly. The proportion of IVHR operations performed as day surgery is well below the target set by the Royal Australasian College of Surgeons. With the increasing incidence of IVHR operations and an increasing proportion of these being emergent, elective IVHR should be performed as day surgery when it is safe.

Keywords: ventral, incisional, hernia, trends

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Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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Authors: Rueyhung Weng, Chia-En Huang, Jung-Chi-Liao

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The transition zone (TZ) serves as a diffusion barrier to regulate the ins and outs of the proteins recruited to the primary cilia. TCTN2 is one of the TZ proteins and its mutation causes Joubert syndrome, a serious multi-organ disease. Despite its important medical relevance, the functions of TCTN2 remain elusive. Here we created a TCTN2 gene deleted retinal pigment epithelial cells (RPE1) using CRISPR/Cas9-based genome editing technique and used this knockout line to reveal roles of TCTN2. TCTN2 knockout RPE1 cells displayed a significantly reduced ciliogenesis or a shortened primary cilium length in the cilium-remaining population. Intraflagellar transport protein IFT88 aberrantly accumulated at the tip of TCTN2 deficient cells. Guanine nucleotide exchange factor Arl13B was mostly absent from the ciliary compartment, with a small population localizing at the ciliary tip. The deficient TZ was corroborated with the mislocalization of two other TZ proteins TMEM67 and MKS1. In addition, TCTN2 deficiency induced TZ impairment led to the suppression of Sonic hedgehog signaling in response to Smoothened (Smo) agonist. Together, depletion of TCTN2 destabilizes other TZ proteins and considerably alters the localization of key transport and signaling-associated proteins, including IFT88, Arl13B, and Smo.

Keywords: CRISPR/Cas9, primary cilia, Sonic hedgehog signaling, transition zone

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: Folasade R. Sulaiman

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Pupils’ health and nutrition are basically important to their schooling. The preponderance of avoidable deaths among children in Africa (WHO, 2000) may not be unconnected with the nutritional and health education status of families and communities that have their children as school clients. This study adopted a descriptive survey design focusing on the assessment of the level of nutritional and health education of families and community members in the rural riverine areas of Ogun State. Two research questions were raised. The Nutritional and Health Education of Families and Communities Inventory (NHEFCI) was used to collect data from 250 rural child-bearing aged women, and 0.73 test-retest reliability coefficient was established to determine the strength of the instrument. Data collected were analysed using descriptive statistics of frequency counts, percentages and mean in accordance with research questions raised in the study. The findings revealed amongst others: that 65% of the respondents had low level of nutritional and health education among the families and community members; while 72% had low level of awareness of the possible influence of nutritional and health education on the learning outcomes of the children. Based on the findings, it was recommended among others that government should intensify efforts on sensitization, mass literacy campaign etc.; also improve upon the already existing School Feeding Programme in Nigerian primary schools to provide at least one balanced diet for children while in school; community health workers, social workers, Non-Governmental Organizations (NGO) should collaborate with international Organizations like UNICEF, UNESCO, WHO etc. to organize sensitization programmes for members of the rural riverine communities on the importance of meeting the health and nutritional needs of their children in order to attain their educational potentials.

Keywords: nutritional and health education, learning capacities, school-age children, universal basic education, rural riverine areas

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Authors: Lida Moghaddam-Banaem, Mahmood Tavoosi, Soheila Khalili

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Objective: The main objective of this study was designing a breast cancer health literacy questionnaire and assess its psychometric properties. Methods: A comprehensive literature review was performed to develop a primary questionnaire consisting of five domains. Qualitative and quantitative content validity were assessed by relevant experts, and after some modifications, the content validity index (CVI) and content validity ratio (CVR) were calculated. Qualitative and quantitative face validity were evaluated by a number of patients, and the impact score for each item was calculated. 225 women with breast cancer were asked to fill out the questionnaire and construct validity was determined by using exploratory factor analysis. The reliability was tested by Cronbach's alpha coefficient. Results: A 36-item questionnaire with five domains of reading, having access, understanding, assessing/judgment, and decision making/behavior was designed. 2 items were omitted in the qualitative content validity process. All items achieved optimum values in CVI, CVR and impact scores. Content and face validity of the questionnaire were confirmed too. According to the exploratory factor analysis, the five-factor solution accounted for 64.98 percent of the observed variance. Conclusion: Due to the obtained satisfactory validity and reliability, this tool can be used to assess health literacy in women with breast cancer. Health policy makers can use these findings for improving health-related behaviors in breast cancer patients.

Keywords: health literacy, breast cancer, questionnaire, psychometric properties

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Authors: Tuji Jemal Ahmed, Hussen Beker Yusuf

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Food safety is a major concern worldwide, with microbial contamination being one of the leading causes of foodborne illnesses. In Ethiopia, drinking water and untreated groundwater are a primary source of microbial contamination, leading to significant health risks. East Hararghe, Oromia, is one of the regions in Ethiopia that has been affected by this problem. This paper provides an overview of the impact of untreated groundwater on human health in Haramaya Rural District, East Hararghe and highlights the urgent need for sustained efforts to address the water sanitation supply problem. The use of untreated groundwater for drinking and household purposes in Haramaya Rural District, East Hararghe is prevalent, leading to high rates of waterborne illnesses such as diarrhea, typhoid fever, and cholera. The impact of these illnesses on human health is significant, resulting in significant morbidity and mortality, especially among vulnerable populations such as children and the elderly. In addition to the direct health impacts, waterborne illnesses also have indirect impacts on human health, such as reduced productivity and increased healthcare costs. Groundwater sources are susceptible to microbial contamination due to the infiltration of surface water, human and animal waste, and agricultural runoff. In Haramaya Rural District, East Hararghe, poor water management practices, inadequate sanitation facilities, and limited access to clean water sources contribute to the prevalence of untreated groundwater as a primary source of drinking water. These underlying causes of microbial contamination highlight the need for improved water sanitation infrastructure, including better access to safe drinking water sources and the implementation of effective treatment methods. The paper emphasizes the need for regular water quality monitoring, especially for untreated groundwater sources, to ensure safe drinking water for the population. The implementation of effective preventive measures, such as the use of effective disinfectants, proper waste disposal methods, and regular water quality monitoring, is crucial to reducing the risk of contamination and improving public health outcomes in the region. Community education and awareness-raising campaigns can also play a critical role in promoting safe water practices and reducing the risk of contamination. These campaigns can include educating the population on the importance of boiling water before drinking, the use of water filters, and proper sanitation practices. In conclusion, the use of untreated groundwater as a primary source of drinking water in East Hararghe, Oromia, Ethiopia, has significant impacts on human health, leading to widespread waterborne illnesses and posing a significant threat to public health. Sustained efforts are urgently needed to address the root causes of contamination, such as poor sanitation and hygiene practices, improper waste management, and the water sanitation supply problem, including the implementation of effective preventive measures and community-based education programs, ultimately improving public health outcomes in the region. A comprehensive approach that involves community-based water management systems, point-of-use water treatment methods, and awareness-raising campaigns can contribute to reducing the incidence of microbial contamination in the region.

Keywords: food safety, health risks, microbial contamination, untreated groundwater

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Authors: Kyung Hwa Shin

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Primary school music education plays a crucial role in nurturing students' musical abilities and fostering a lifelong appreciation for music. As we embark on the 21st century, it becomes imperative to explore advanced approaches that can effectively engage and empower students in the realm of music. This study aims to shed light on the aspects of primary school music education in South Korea, with a specific focus on the incorporation of the Zoltán Kodály Concept. The Zoltán Kodály Concept, developed by Hungarian composer and educator Zoltán Kodály (Kodály, 1974) advocates for a holistic music education that integrates singing, movement, and music literacy. This concept has gained recognition worldwide for its effectiveness in developing musicianship and enhancing music learning experiences. This study will delve into the ways in which the Zoltán Kodály Concept has been adapted and implemented in the context of South Korean primary school music education. It will highlight the benefits of this approach in nurturing students' musical skills, fostering creativity, and promoting cultural understanding through music. Furthermore, it will enhance the delivery of the Kodály-based curriculum challenges posed by the 21st-century digital age. Drawing on this research, pedagogical practices, and case studies, this study will provide valuable insights into the practical applications of the Zoltán Kodály Concept in South Korean primary school music education. It will discuss the impact of this approach on student engagement, motivation, and achievement, as well as the role of teachers in facilitating effective implementation. Additionally, it will address the professional development opportunities available to music educators to enhance their pedagogical skills in line with the Kodály philosophy. Ultimately, it aims to inspire and empower educators, policymakers, and researchers to embrace the Zoltán Kodály Concept as a transformative and forward-thinking approach to primary school music education in the 21st century. By embracing current aspects and progressive methodologies, South Korea can continue to strengthen its music education system and cultivate a generation of musically literate and culturally enriched individuals.

Keywords: primary school music education, Zoltán Kodály concept, 21st century, South Korea, music literacy, pedagogy, curriculum

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Authors: Sonia Mahajan Dinesh, Anant Dinesh, Madhavi Tripathi, Vinod Kumar Ramteke, Rajnish Sharma, Anupam Mondal

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Background: Neo-adjuvant chemotherapy plays an important role in treatment of breast cancer by decreasing the tumour load and it offers an opportunity to evaluate response of primary tumour to chemotherapy. Standard anatomical imaging modalities are unable to accurately reflect the response to chemotherapy until several cycles of drug treatment have been completed. Metabolic imaging using tracers like 18F-fluorodeoxyglucose (FDG) as a marker of glucose metabolism or amino acid tracers like L-methyl-11C methionine (MET) have potential role for the measurement of treatment response. In this study, our objective was to compare these two PET tracers for assessment of response to neoadjuvant chemotherapy, in locally advanced breast carcinoma. Methods: In our prospective study, 20 female patients with histology proven locally advanced breast carcinoma underwent PET-CT imaging using FDG and MET before and after three cycles of neoadjuvant chemotherapy (CAF regimen). Thereafter, all patients were taken for MRM and the resected specimen was sent for histo-pathological analysis. Tumour response to the neoadjuvant chemotherapy was evaluated by PET-CT imaging using PERCIST criteria and correlated with histological results. Responses calculated were compared for statistical significance using paired t- test. Results: Mean SUVmax for primary lesion in FDG PET and MET PET was 15.88±11.12 and 5.01±2.14 respectively (p<0.001) and for axillary lymph nodes was 7.61±7.31 and 2.75±2.27 respectively (p=0.001). Statistically significant response in primary tumour and axilla was noted on both FDG and MET PET after three cycles of NAC. Complete response in primary tumour was seen in only 1 patient in FDG and 7 patients in MET PET (p=0.001) whereas there was no histological complete resolution of tumor in any patient. Response to therapy in axillary nodes noted on both PET scans were similar (p=0.45) and correlated well with histological findings. Conclusions: For the primary breast tumour, FDG PET has a higher sensitivity and accuracy than MET PET and for axilla both have comparable sensitivity and specificity. FDG PET shows higher target to background ratios so response is better predicted for primary breast tumour and axilla. Also, FDG-PET is widely available and has the advantage of a whole body evaluation in one study.

Keywords: 11C-methionine, 18F-FDG, breast carcinoma, neoadjuvant chemotherapy

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Authors: K. Matušínská, H. Starzyczná, M. Stoklasa

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The paper deals with finding and describing of the effective marketing communication forms relating to the segment 50+ in the financial market in the Czech Republic. The segment 50+ can be seen as a great marketing potential in the future but unfortunately the Czech financial institutions haven´t still reacted enough to this fact and they haven´t prepared appropriate marketing programs for this customers´ segment. Demographic aging is a fundamental characteristic of the current European population evolution but the perspective of further population aging is more noticeable in the Czech Republic. This paper is based on data from one part of primary marketing research. Paper determinates the basic problem areas as well as definition of marketing communication in the financial market, defining the primary research problem, hypothesis and primary research methodology. Finally suitable marketing communication approach to selected sub-segment at age of 50-60 years is proposed according to marketing research findings.

Keywords: population aging in the Czech Republic, segment 50+, financial services, marketing communication, marketing research, marketing communication approach

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Authors: Moon Moon Devi, Ran Budnik

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The current large area cosmic ray detector surface arrays typically measure only the net flux and arrival-time of the charged particles produced in an extensive air shower (EAS). Measurement of the individual charged particles at a surface array will provide additional distinguishing parameters to identify the primary and to map the very high energy interactions in the upper layers of the atmosphere. In turn, these may probe anomalies in QCD interactions at energies beyond the reach of current accelerators. The recent attempts of studying the individual muon tracks are limited in their expandability to larger arrays and can only probe primary particles with energy up to about 10^15.5 eV. New developments in detector technology allow for a realistic cost of large area detectors, however with limitations on energy resolutions, directional information, and dynamic range. In this study, we perform a simulation study using CORSIKA to combine the energy spectrum and lateral spread of the muons with the longitudinal depth (Xmax) of an EAS initiated by a primary at ultra high energies (10¹⁶ – 10¹⁹) eV. Using proton and iron as the shower primaries, we show that the muon observables and Xmax together can be used to distinguish the primary. This study can be used to design a future detector for the surface array, which will be able to enhance our knowledge of primaries and QCD interactions.

Keywords: ultra high energy extensive air shower, muon tracking, air shower primaries, QCD interactions

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Authors: Tsebe Wilfred Molotja, Mahlapahlapane Themane, Kgetja Maruma

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It is globally accepted that reading in the primary schools serves as a foundational basis for good reading skills. This is evident in the students’ academic success throughout their studying life. However, the PIRLS (2016) report on Literacy performance found that primary school learners are not able to read as fluently as expected. The results from ANA (2012) also indicated that South African learners achieved the lowest as compared to other global ones. The purpose of this study is to investigate the approaches employed by educators in developing learners’ reading and writing skills and to workshop them on the best reading and writing approaches to be implemented. The study adopted an explorative qualitative design where 27 educators from primary schools around the University of Limpopo were purposefully sampled to participate in this study. Data was collected through interviews and classroom observation during class visits facilitated by research assistants. The study found that teachers are aware of different approaches to developing learners’ reading and writing skills even thou these are not aligned with the curriculum. However, the problem is with implementation, as the conditions in the classrooms are not conducive for such. The study recommends that more workshops on capacitating teachers with the pedagogical approaches to teaching reading be held. The appeal is also made to the Department of Basic Education that it makes the classrooms to be conducive for teaching and learning to take place.

Keywords: academic success, reading and writing, community based, approaches

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Authors: Khorief Ouissem, Sassi Boudmagh Souad, Mahimoud Aissa

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The health and safety problem in the construction companies has been a major subject of research in Algeria for many years. The latest statistics of the Algerian National Social Security Fund (CNAS) shows that a third of accidents recorded at the national level are originated from construction activities. It is becoming increasingly essential and urgent to investigate and address its causes in order to find measures to overcome the deficiencies in this area. Thus, this paper takes in investigating this problem through a study conducted in the city of Skikda, Algeria. The study was carried out through questionnaire where twenty construction companies were taking into consideration. First, the study identifies the regulations and the laws related to the health and safety in the construction sector in Algeria. Then it goes on to assess and evaluate the implementation of the identified regulations in the companies selected. The result of the assessment indicates that the majority of the construction companies considered do not meet the health and safety standards and regulations. To extract the main causes of the failure of the system to control this industry, the observations and the evaluation were analyzed using the 5M or Ichikawa diagram method. This method is based on identifying the causes of the problem in terms of purpose, the list of potential causes for families. These families often correspond to 5M (Labor, Material, Methods, Middle, and Management). Finally, having identified the primary motives, the present authors propose a list of actions to move towards a more controlled and effective health and safety system for the construction industry.

Keywords: health and safety, construction industry, performance measurement, Algeria

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Authors: Hafiz A. Sakandar, M. Afzaal, U. Khan, M. N. Akhtar

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Food is the primary concern of living organisms, provision of diet for maintenance of good physical and mental health is a basic right of an individual and the outcome of factors related to diet on health has been matter of apprehension since ancient times. Healthy and fresh food always demanded by the consumers. Modern research has find out many alternatives of traditional packaging. Now the consumer knows that good packaging system is that which protects the food from the contaminants and increases shelf life of food product. While in Pakistan about 40% of fruits and vegetables lost due to spoilage caused by poor handling, transportation, and poor packaging interaction with other environmental conditions. So it is crucial for developing countries like Pakistan to pay attention to these exacerbating situations for economy losses by considering food packaging an ultimate solution to the problem.

Keywords: packaging, food safety, antimicrobial, food losses

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Authors: Mohammad Ansari, Satinder Mann, Ahmed Ismail

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Primary care patients in Emergency Departments (ED) have been the topic of discussion since 1998 in the United Kingdom. Numerous studies have analysed attendances in EDs retrospectively and suggest that at least one third to fifty percent patients attending ED with problems which could be managed appropriately in General Practice or minor injuries units. The pattern of ED Usage seems to be International. In Australia and many departments in the United States include walk in facilities staffed by physicians on family practice residency programme. It clearly appears in the United Kingdom that EDs have to accept that such patients with primary care problems will attend the ED and facilities will have to be provided to see and treat such patients. Urgent care centres were introduced in the United Kingdom nearly a decade ago to reduce the pressure on EDs. Most of these were situated near pre-existing EDs. Unfortunately these centres failed to have the desired effect of reducing the number of patients visiting EDs, it has been noticed that when more patients were seen in Urgent Care centres there were increased attendances in ED as well. A new model of Urgent Care centre was started in the ED of George Eliot Hospital, Nuneaton, UK. We looked at the working of the centre by looking at the number of patients seen daily against the number of total attendances in the ED. We studied the number and type of patients seen by the Urgent Care Doctor. All the medical records of the patients were seen and the time patients spent in the Urgent Care centre was recorded. The total number of patients seen during this study were 1532. 219 (14.3% ) were seen within our Urgent Care centre. None of the patients waited over four hours to be seen. It has been recognised that primary care patients in the ED are a major part of attendances of the department and unless these patients are seen in Urgent Care centres, overcrowding and long waits cannot been avoided. It has been shown that employing primary care Physicians in Urgent Care centres reduces overall cost because they do not carry out as many investigations as Junior Doctors. In our study over 14% patients were seen by Urgent Care Physicians and none of the patients waited for more than four hours and we feel that care provided to the patients by Urgent Care centre was highly effective and satisfying for the patient.

Keywords: urgent care centres, primary care physicians, overcrowding, cost

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Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

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Authors: Md Fazlul Kader, Soo Young Shin

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In this paper, we consider a cognitive relay network (CRN) in which the primary receiver (PR) is protected by peak transmit power $\bar{P}_{ST}$ and/or peak interference power Q constraints. In addition, the interference effect from the primary transmitter (PT) is considered to show its impact on the performance of the CRN. We investigate the outage probability (OP) and outage capacity (OC) of the CRN by deriving closed-form expressions over Rayleigh fading channel. Results show that both the OP and OC improve by increasing the cooperative relay nodes as well as when the PT is far away from the SR.

Keywords: cognitive relay, outage, interference limited, decode-and-forward (DF)

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Authors: Moleseng Claude Moshobane

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Alien species cause considerable negative impacts on biodiversity, economy and public health. Impacts of alien species on public health have received a degree of attention worldwide, largely in developed countries, but scarce in developing countries. Here, we provide a review of human exposures and poisonings cases from native and alien plant species reported to poison information centers. A retrospective review of the Tygerberg Poison Information Centre (TPIC) and Poisons Information Centre (PIC) at Red Cross War Memorial Children's Hospital (RCWMCH) was conducted over approximately 2-year period (1 June 2015 through to 06 March 2017). Combined, TPIC and PIC handled 626 cases during the 2-year period. Toxicity cases were more abundant in Gauteng (47.1%), followed by Western Cape (29.4%). The primary mechanism of injury was ingestion (96.7%), and all cases were predominantly accidental. Most reported cases involved infants (20.6%), with few fully-grown adults related cases (5.8%). Adults presented minor to moderate toxicity, while infants none to minor toxicity. We conclude that reported toxicity cases on human health are biased towards few alien species and that several cases relate to unknown species of mushrooms. Public awareness is essential to reducing the poisoning incidences.

Keywords: alien species, poisoning, invasive species, public health

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Authors: Jingwen Shan

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In order to explore the key factors affecting the robot program learning intention of school students, this study takes the technology acceptance model as the theoretical basis and invites 167 students from Jiading District of Shanghai as the research subjects. In the robot course, the model of school students on their learning behavior is constructed. By verifying the causal path relationship between variables, it is concluded that teachers can enhance students’ perceptual usefulness to robotics courses by enhancing subjective norms, entertainment perception, and reducing technical anxiety, such as focusing on the gradual progress of programming and analyzing learner characteristics. Students can improve perceived ease of use by enhancing self-efficacy. At the same time, robot hardware designers can optimize in terms of entertainment and interactivity, which will directly or indirectly increase the learning intention of the robot course. By changing these factors, the learning behavior of primary and secondary school students can be more sustainable.

Keywords: TAM, learning behavior intentions, robot courses, primary and secondary school students

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Authors: Huda Aljabi

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The existence of heavy metals similar to cadmium, arsenic, lead and mercury in the drinking water be able to be a threat to public health. The amount of the substances of these heavy metals in drinking water has expected importance. The National Primary Drinking Water Regulations have set limits for the concentrations of these elements in drinking water because of their toxicity. Furthermore, bromate shaped during the disinfection of drinking water by Ozonation can also be a health hazard. The Paper proposed here will concentrate on the compilation of all available data and information on the presence of trace metals and bromate in the drinking water at residential houses distributed over different areas in Kuwait. New data will also be collected through a sampling of drinking water at some of the residential houses present in different areas of Kuwait and their analysis for the contents of trace metals and bromate. The collected data will be presented on maps showing the distribution of these metals and bromate in the drinking water of Kuwait. Correlation among different chemical parameters will also be investigated using the GRAPHER software. This will help both the Ministry of Electricity and Water (MEW) and the Ministry of Health (MOH) in taking corrective measures and also in planning the infrastructure activities for the future.

Keywords: bromate, ozonation, GIS, heavy metals

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Authors: Rapuane Eric Jan Pule

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Sport participation plays a significant role in learners’ well-being and lifestyle. Learners spend most of their time in the school environment, where they are monitored, guided and advised by teachers. Teachers have a good relationship with the learners, therefore they can play a major role in promoting and influencing learners to participate in physical activities, both competitive and recreational purposes. Their influence and involvement could assist in increasing the number learners' involvement in physical activities, sport and recreation at Township schools. The national sport and recreation plan in South Africa, recommends that promotion of sport and physical activities at primary and secondary schools should play an important role in helping learners commit to a live-long participation in sport, recreational and physical activities. Schoolteachers could play an influential role in ensuring that learners spent their leisure time productively through physical and recreational activities. However, the role and the influence of teachers in promoting physical and recreational activities have been previously overlooked in the literature. Part of this study focuses on the in-depth challenges encountered by primary and secondary school teachers at Township schools in promoting and influencing learners’ involvement in sport, recreation and physical activities. 109 primary and secondary teachers at Township schools agreed to participate in the study through the provision of informed consent. The participants consisted of 49 primary school teachers and 60 secondary school teachers. Quantitative approach was followed using validated structured questionnaire comprising 12 close-ended items were used. Findings indicated that teachers' can play a significant role in influencing and encouraging learners to participate in sport, recreation or physical activities. Teachers view physical activity as an important developmental component for learners. Primary school teachers believe that they have a significant role to play in encouraging and promoting physical activities, sport and recreation, as compared to the secondary school teachers. Both group of teachers at primary and secondary schools, believe that infrastructure development, financial support, and extra incentives could motivate them to promote physical, recreational and sporting activities at schools. Teachers also acknowledge that schools are facing challenges in implementing and coordinating physical activities and recreational programmes as required by the Department of sport and recreation South Africa. It is recommended that the Department of Basic Education and Sport and Recreation South Africa revise their policies regarding the role of teachers in promoting and administering physical and recreational activities at schools.

Keywords: township, physical activities, sport and recreation participation, learners, teachers, primary and secondary schools, physical education

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Authors: Justina Jor, Mahmud Pinga

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Climate change has become a significant worldwide environmental challenge with extensive implications, compelling both governments and non-governmental organizations to remain vigilant, as it seemingly impacts various sectors of the global economy, including education. The study investigates the implementation of smart climate change measures for effective primary school management in Benue State, Nigeria. Theorized by the diffusion of innovations, the study was guided by two research questions, and two null hypotheses were formulated and tested. The study used a descriptive survey design. The population comprised 12,364 teachers from 2,721 primary schools, with a sample of 618 teachers from 136 schools selected through a multistage sampling procedure. Smart climate change measures questionnaire (SCCMQ) and key informant interview (KII) were used for data collection. The data collected were analyzed using mean and standard deviation to answer the research questions, while the Chi-square (χ2) test of goodness-of-fit was used to test the hypotheses at a 0.05 level of significance, with qualitative data analyzed using simple percentages, tables, and bar charts. The findings highlight the significant positive impact of green building practices on the efficient administration of primary schools in Benue State, Nigeria. The crucial integration of environmentally sustainable construction methods is emphasized for enhancing overall management in these educational institutions. In addition, the research demonstrates a favorable impact on the adoption of renewable energy solutions and effective school management. The utilization of renewable energy not only aligns with eco-friendly practices but also contributes to the overall operational efficiency and sustainability of primary schools in the region. The study recommends that educational authorities and policymakers prioritize integrating green building practices and renewable energy solutions, pointing towards the prospect of improved governance and functionality for primary education facilities not only in Benue but throughout Nigeria.

Keywords: smart, climate change, effective management, green building, renewable energy

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Authors: Emma Mathias

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The aim of this study was to explore the role of food insecurity as a mediator of mental health in sub-Saharan Africa, taking Ghana as a case study. Although a quantitative correlation has recently been established between food insecurity and mental illness in Ghana, the nature and validity of this correlation remains unclear. A qualitative exploration was employed to investigate this correlation further. During the data collection period, twelve semi-structured interviews and five focus groups were conducted with a total of 124 individuals who were diagnosed with mental illnesses and their primary carers throughout rural and urban areas in Ghana. Interviews and focus groups were transcribed, translated, and analysed using thematic analysis. Preliminary results suggest that food insecurity may plays a role in mental illness in rural areas of Ghana where communities are reliant on agriculture for their livelihoods, but may play a lesser role in urban areas where communities are more reliant on petty trade as a source of livelihood. These results support psychosocial theories which suggest that the social and cultural factors involved in food production and consumption may be the key mediators between food insecurity and mental health.

Keywords: Food insecurity, Ghana, Mental health, Phenomenology

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Authors: Yazan M. Alatrash, Han-ok Kang, Hyun-gi Yoon, Shen Zhang, Juhyeon Yoon

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Flow coastdown phenomena are very important to secure nuclear fuel integrity during loss of off-site power accidents. In this study, primary coolant flow coastdown phenomena are investigated for the Jordan Research and Training Reactor (JRTR) using a simulation software package, Modular Modelling System (MMS). Two MMS models are built. The first one is a simple model to investigate the characteristics of the primary coolant pump only. The second one is a model for a simulation of the Primary Coolant System (PCS) loop, in which all the detailed design data of the JRTR PCS system are modelled, including the geometrical arrangement data. The same design data for a PCS pump are used for both models. Coastdown curves obtained from the two models are compared to study the PCS loop coolant inertia effect on a flow coastdown. Results showed that the loop coolant inertia effect is found to be small in the JRTR PCS loop, i.e., about one second increases in a coastdown half time required to halve the coolant flow rate. The effects of different flywheel inertia on the flow coastdown are also investigated. It is demonstrated that the coastdown half time increases with the flywheel inertia linearly. The designed coastdown half time is proved to be well above the design requirement for the fuel integrity.

Keywords: flow coastdown, loop inertia, modelling, research reactor

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Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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Authors: Binh Thanh Ta, Elizabeth Sturgiss

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Central to patient-centered care is the idea of treating a patient as a person and understanding their perspectives regarding their health conditions and care preferences. Surprisingly, little is known about how GPs can understand their patients’ perspectives. This paper addresses the challenge of understanding patient perspectives in behavior change consultations by adopting Conversation Analysis (CA), which is an empirical research approach that allows both researchers and the audience to examine patients’ perspectives as displayed in GP-patient interaction. To understand people’s perspectives, CA researchers do not rely on what they say but instead on how they demonstrate their endogenous orientations to social norms when they interact with each other. Underlying CA is the notion that social interaction is orderly by all means. (It is important to note that social orders should not be treated as exogenous sets of rules that predetermine human behaviors. Rather social orders are constructed and oriented by social members through their interactional practices. Also, note that these interactional practices are the resources shared by all social members). As CA offers tools to uncover the orderliness of interactional practices, it not only allows us to understand the perspective of a particular patient in a particular medical encounter but, more importantly, enables us to recognise the shared interactional practice for signifying a particular perspective. Drawing on the 10 video-recorded consultations on behavior change in primary care, we have discovered the orderliness of patient laughter when reporting health behaviors, which signifies their orientation to the problematic nature of the reported behaviors. Among 24 cases where patients reported their health behaviors, we found 19 cases in which they laughed while speaking. In the five cases where patients did not laugh, we found that they explicitly framed their behavior as unproblematic. This finding echoes the CA body research on laughter, which suggests that laughter produced by first speakers (as opposed to laughing in response to what has been said earlier) normally indicates some sort of problems oriented to the self (e.g. self-tease, self-depreciation, etc.). This finding points to the significance of understanding when and why patients laugh; such understanding would assist GPs to recognise whether patients treat their behavior as problematic or not, thereby producing responses sensitive to patient perspectives.

Keywords: patient centered care, laughter, conversation analysis, primary care, behaviour change consultations

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Authors: Ozge Yalciner

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Intercultural communication is crucial in the education of multilingual learners in primary grades, significantly influencing their academic and social development. This study explores how intercultural communication intersects with multilingual education, highlighting the importance of culturally responsive teaching practices. It addresses the challenges and opportunities presented by diverse linguistic backgrounds and proposes strategies for creating inclusive and supportive learning environments. The research emphasizes the need for teacher training programs that equip educators with the skills to recognize and address cultural differences, thereby enhancing student engagement and participation. This study was completed in an elementary school in a city in the Midwest, USA. The data was collected through observations and interviews with students and teachers. It discusses the integration of multicultural perspectives in curricula and the promotion of language diversity as an asset. Peer interactions and collaborative learning are highlighted as crucial for developing intercultural competence among young learners. The findings suggest that meaningful intercultural communication fosters a sense of belonging and mutual respect, leading to improved educational outcomes for multilingual students. Prioritizing intercultural communication in primary education is essential for supporting the linguistic and cultural identities of multilingual learners. By adopting inclusive pedagogical approaches and fostering an environment of cultural appreciation, educators can better support their students' academic success and personal growth.

Keywords: diversity, intercultural communication, multilingual learners, primary grades

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Authors: María José López Rey, Mar Chaves Carrillo, Manuela Caballero Guisado

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The data presented here are part of a broader investigation on active population aging. The work was carried out in November 2020 in Extremadura, a region of southern Spain. This R + D + I project, called "Active aging scenarios in Extremadura: intervention proposals," was carried out by a team of professors, researchers from the University of Extremadura. The project has been financed by the European Regional Development Funds and the Government of Extremadura. Here, we focus on aspects that have to do with the experience of health, especially during the COVID-19 pandemic, and how this has affected the population related to the main sociodemographic variables. In an exercise of methodological triangulation, thus providing robustness to the analysis, primary data, obtained from the survey designed ad hoc, are combined with other secondary data from various sources and studies carried out in Spain (Sociological Research Centre, and National Institute of Statistics). The survey was carried out on a representative sample of the population over 55 years old, coming from Extremadura. Among the findings, we must highlight the practical invariability of perceptions based on the main sociodemographic variables, as well as some differences indicated by the variables sex and age.

Keywords: aging, health, COVID-19, perceptions

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Authors: Badino Manuel, Farias Maria Alejandra

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Telemedicine (TM) has the potential to develop efficient and cost-effective means for delivering quality health care services and outcomes, showing equal or, in some cases, better results than in-person treatment. To analyze patient satisfaction with the use of TM becomes relevant because this can affect the results of treatment and the adherence to it. The aim is to assess patient satisfaction with telemedicine for treating substance-related disorders in a mental health service in Córdoba, Argentina. A descriptive cross-sectional study was conducted among patients with substance-related disorders (N=115). A patient satisfaction survey was conducted from December 2021 to March 2022. For a total of 115 participants, 59,1% were male, 38,3% were female and 2,6% non-binary. In relation to educational status, 40% finished university, 39,1% high school, and 20,9 % only primary school. Regarding age, 4,3 % were young, 92,2% were adults, and 3,5% were elderly. Regarding TM treatment, 95,7% reported being satisfied. Furthermore, 85,2% of users declared that they would continueTM treatment, and 14,8% said that they would not resume TM treatment. To conclude, high levels of patient satisfaction contributes to the continuity of TM modality.

Keywords: telemedicine, mental health, substance-related disorders, patient satisfaction

Procedia PDF Downloads 92