Search results for: community health center

Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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Authors: Annisa Siu, Ping Zou

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Background: Existent literature addressing Asian American children and adolescents reveals that this population is experiencing rates of depression comparable to those of European American and other ethnic minority youths. Within the last decade, increased attention has been given to Asian American adolescent mental health. Methods: 44 articles were extracted from Pubmed, PsycINFO, EMBASE, and Proquest CINAHL. Data were subject to thematic analyses and categorized into factors under individual, familial, and community levels. Results: Of all the individual factors, age and gender were the most supported in their relationship with depressive symptoms. Likewise, living situations, parent-child relations, peer relations, and broader environmental factors were strongly evidenced. The remaining psychosocial factors faced contrary evidence or were insubstantially addressed in the empirical literature. Discussion: The identified psychosocial factors within this study offer a starting point for future research to examine what factors should be included in formal or informal methods of screening/consultations. Clinicians should aim to understand the cultural influences specific to Asian American adolescents, particularly the central role that family relations may have on their depressive symptoms. Conclusion: Low awareness of culturally linked expressions of psychological distress can lead to misdiagnosis or under-diagnosis of depression in Asian American youth. Further evidence is needed to clarify the relationship of psychosocial factors linked to Asian American adolescent depressive symptoms.

Keywords: adolescent, Asian American, depression, psychosocial factors

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Authors: Roshani Gusain, Deep Sinha, Karan Nayal, Anmol Kumar Mishra, Manav Singh

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In this research paper, we introduce "Mind Care Assistant - Companion App", which is a Flutter and Firebase-based mental health monitor. The app wants to improve and monitor the mental health of its users, it uses noninvasive ways to check for a change in their emotional state. By responding to questions, the app will provide individualized suggestions ᅳ tasks and mindfulness exercises ᅳ for users who are depressed or anxious. The app features a chat-bot that incorporates cognitive behavioural therapy (CBT) principles and combines natural language processing with machine learning to develop personalised responses. The feature of the app that makes it easy for us to choose between iOS and Android is cross-platform, which allows users from both mobile systems to experience almost no changes in their interfaces. With Firebase integration synchronized and real-time data storage, security is easily possible. The paper covers the architecture of the app, how it was developed and some important features. The primary research result presents the promise of a "Mind Care Assistant" in mental health care using new wait-for-health technology, proposing a full stack application to be able to manage depression/anxiety and overall Mental well-being very effectively.

Keywords: mental health, mobile application, flutter, firebase, Depression, Anxiety

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Authors: Ruixia Liu

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Qinghai-Tibet Plateau has an important influence on the precipitation of its lower reaches. Data from remote sensing has itself advantage and numerical prediction model which assimilates RS data will be better than other. We got the assimilation data of MHS and terrestrial and sounding from GSI, and introduced the result into WRF, then got the result of RH and precipitation forecast. We found that assimilating MHS and terrestrial and sounding made the forecast on precipitation, area and the center of the precipitation more accurate by comparing the result of 1h,6h,12h, and 24h. Analyzing the difference of the initial field, we knew that the data assimilating about Qinghai-Tibet Plateau influence its lower reaches forecast by affecting on initial temperature and RH.

Keywords: Qinghai-Tibet Plateau, precipitation, data assimilation, GSI

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Authors: Nene Pearl Eluchie

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Globally, metal ion, particularly those generated from oil and gas effluents, form environmental pollution, particularly in developing regions like Nigeria, where water borne disease is fatal. This is clear evidence for metal ion contamination within the environment. Ecofriendly and cost effective biomaterials are the best ways of reducing metal ion contamination, thus reducing the need for chemical treatment of oil and gas effluent. Despite this, research efforts to understand the mechanism of adsorption and possible bio-adsorptive remediation interventions are limited. The study combined biomaterial and adsorption techniques: A. Indica, UV-Visible spectroscopy, SEM, FTIR in a progressive manner to provide insight. The biosorption efficiency of Azadirachta Indica silver nanoparticle AI-AgNPs was within the range of 63-95%. The study demonstrates that AI-AgNPs can be a promising agent, cheap, efficient, and biodegradable bio-sorbent for lowering oil and gas effluents. This is one of the studies to show that Azadirachta Indica is just one of the many biomaterials to synthesize silver nanoparticles through the reduction of active constituents (Nimbidin) present in them to ensure stability and surface properties, which are critical for their performance in effluent treatment. Therefore, leveraging the knowledge from this study to raise awareness through public health initiatives and community engagement will help. The prevalence of metal ions observed in the visible region in the study indicates the need for bio-adsorptive remediation interventions, not only in social settings but also in the immediate environment. There is, thus, an urgent need for targeted interventions in vulnerable communities.

Keywords: Azadirachta indica, bioadsorption, biosynthesis, effluent, nimbidin, silver nanoparticle

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Authors: Rebecca Haythorne

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Background: Agendas continuously emphasise the need to increase work based training and opportunities for individuals with learning disabilities. However research and statistics suggest that there is still significant stigma and stereotypes as to what they can contribute, or gain from being part of the working environment. Method: To tackles some of these prejudices an Occupational Therapy based intervention was developed for learning disability service users working at a social enterprise farm. The intervention aimed to increase positive public perception around individual capabilities and encourage individuals with learning disabilities to take ownership and be proud of their individual personhood and citizenship. This was achieved by using components of the Model of Human Occupation to tailor the intervention to individual values, skills and working contributions. The final project involved making creative wall art for public viewing, focusing on 'who works there and what they do'. This was accompanied by a visitor information guide, allowing individuals to tell visitors about themselves, the work they do and why it is meaningful to them. Outcomes: The intervention has helped to increased metal well-being and confidence of learning disability service users “people will know I work here now” and “I now have something to show my family about the work I do at the farm”. The intervention has also increased positive public perception and community awareness “you can really see the effort that’s gone into doing this” and “it’s a really visual experience to see people you don’t expect to see doing this type of work”. Resources left behind have further supported individuals to take ownership in creating more wall art to be sold at the farm shop. Conclusion: the intervention developed has helped to improve mental well-being of both service users and staff and improve community awareness. Due to this, the farm has decided to roll out the intervention to other areas of the social enterprise and is considering having more Occupational Therapy involvement in the future.

Keywords: citizenship, intervention, occupational therapy, personhood

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Authors: Vladimir A. Grachev

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Today, in the context of rapidly developing technosphere and hourly emerging new technologies, the industrial and environmental safety issue is ever more pressing. The article is devoted to the relationship of social, environmental, and industrial policies with industrial safety, occupational health and safety, environmental safety, and environmental protection. The author assesses the up-to-day situation through system analysis and on the basis of the existing practices. A complex system of the policies implementation without "gaps" and missing links ensures preservation of human lives, health and a favorable living environment. The author demonstrates that absence of an "environmental safety" high-priority link can lead to a significant loss of human lives and health and the global changes in the environment. The role of implementing the environmental policy of enterprises and organizations, and of economic sectors in the implementation of national environmental policy is shown. It was established that the system for implementing environmental policy should be based on a system analysis.

Keywords: environmental protection, environmental safety, industrial safety, occupational health and safety

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Authors: Homer Hermes De Dios, Dewoowoogen Baclayon

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The community assemblages of reef fishes was conducted in ten marine sanctuaries and ten non-marine sanctuary areas in Sogod Bay, Southern Leyte, Philippines from 2014-2015. A total of 223 species belonging to 39 families of reef fishes in Sogod Bay were recorded. Family Pomacentridae (e.g. damsel fishes) has the highest number of species (42), followed by Labridae or wrasses (27), Chaetodonthidae or butterfly fish (22), Scaridae or parrotfishes (17), and Acanthuridae (surgeonfishes) and Pomacanthidae (angelfishes) both with 10 species. Two of the recorded fish species were included in the IUCN Red List, wherein one is near threatened (Chlorurus bowersi) and the other is endangered species (Cheilinus undulatus). The mean total fish biomass (target + indicator + major or other fish) in MPA was significantly higher (13,468 g/500m2 or equivalent to 26.94 mt/km2) than Non-MPA with 7,408 g/500m2 or 15,216mt/km2 in Non-MPA. The mean total fish biomass in MPAs in Sogod Bay can be categorized as high (21-40 mt/km2) with minimal fishing and medium or slightly moderately fished (11-20 mt/km2) in Non-MPAs. The mean (±SE) biomass of target fishes was significantly higher in MPA than Non-MPA and differ significantly across two depths. The target fish biomass was significantly higher in Limasawa Marine Sanctuary (13,569 g/500m2) followed by Lungsodaan Marine Sanctuary in Padre Burgos (11,884 g/500m2) and the lowest was found in San Isidro (735 g/500m2). The mean total fish density (target + indicator + major or other fish) did not differ between Marine Protected area (607.912 fishes/500m2 or 1215.824 fishes/1000m2) and 525.937 fishes/500m2 in non-Marine Protected Area and can be categorized as moderate (667-2267mt/km2). The mean density of target fishes was significantly (p=0.022) higher in deeper areas (12-15m) than in shallow areas but did not differ significantly between MPAs and Non-MPA. No significant difference of the biomass and density for indicator and other fishes in MPAs and Non-MPAs.

Keywords: abundance, density, species richness, target fish, coral reef management

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Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Holistic and patient-centred palliative care and support require an integrated system of care that includes health and social service providers working together to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the benefits and challenges of mobilizing multidisciplinary care teams for health care professionals and social service providers. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed, and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers posed by multidisciplinary care teams. Three main findings emerged: First, the data highlighted the benefits of multidisciplinary care teams for both patient outcomes and quality of life and provider mental health; second, the data showed that the lack of a system-wide integrated communication system reduces the quality of patient care and increases provider stress while working in multidisciplinary care teams; finally, the data demonstrated the existence of implicit hierarchies between disciplines, this coupled with different disciplinary perspectives of palliative care provision can lead to friction and challenges within care teams. These findings will have important implications for the future of palliative care as they will help to facilitate and build stronger person-centred/relationship-centred palliative care practices by naming the challenges faced by multidisciplinary palliative care teams and providing examples of best practices.

Keywords: public health palliative care, palliative care nursing, care networks, integrated health care, palliative care approach, public health, multidisciplinary work, care teams

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Authors: Han Ding, Wang Xiaoliang, Duan Dengping

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During the process of airship design, the layout and the geometric shape of the hull and fins are crucial to the motion characteristics of the airship. In this paper, we obtained the quantification motion sensitivity of the airship to geometric parameters through turning circles and horizontal/vertical zigzag maneuvers by the parameterization of airship shape and building the dynamic model using Lagrangian approach and MATLAB Simulink program. In the dynamics simulation program, the affection of geometric parameters to the mass, center of gravity, moments of inertia, product of inertia, added mass and the aerodynamic forces and moments have been considered.

Keywords: airship, Lagrangian approach, turning circles, horizontal/vertical zigzag maneuvers

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Authors: Tak Mau Simon Chan, Ying Chuen Lance Chan

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Homelessness has been a popular and controversial debate in Hong Kong, a city which is densely populated and well-known for very expensive housing. The constitution of the homeless as threats to the community and environmental hygiene is ambiguous and debatable in the Hong Kong context. The lack of an intervention model is the critical research gap thus far, aside from the tangible services delivered. The life story approach (LSA), with its unique humanistic orientation, has been well applied in recent decades to depict the needs of various target groups, but not the homeless. It is argued that the life story approach (LSA), which has been employed by health professionals in the landscape of dementia, and health and social care settings, can be used as a reference in the local Chinese context through indigenization. This study, therefore, captures the viewpoints of service providers and users by constructing an indigenous intervention model that refers to the LSA in serving the chronically homeless. By informing 13 social workers and 27 homeless individuals in 8 focus groups whilst 12 homeless individuals have participated in individual in-depth interviews, a framework of LSA in homeless people is proposed. Through thematic analysis, three main themes of their life stories was generated, namely, the family, negative experiences and identity transformation. The three domains solidified framework that not only can be applied to the homeless, but also other disadvantaged groups in the Chinese context. Based on the three domains of family, negative experiences and identity transformation, the model is applied in the daily practices of social workers who help the homeless. The domain of family encompasses familial relationships from the past to the present to the speculated future with ten sub-themes. The domain of negative experiences includes seven sub-themes, with reference to the deviant behavior committed. The last domain, identity transformation, incorporates the awareness and redefining of one’s identity and there are a total of seven sub-themes. The first two domains are important components of personal histories while the third is more of an unknown, exploratory and yet to-be-redefined territory which has a more positive and constructive orientation towards developing one’s identity and life meaning. The longitudinal temporal dimension of moving from the past – present - future enriches the meaning making process, facilitates the integration of life experiences and maintains a more hopeful dialogue. The model is tested and its effectiveness is measured by using qualitative and quantitative methods to affirm the extent that it is relevant to the local context. First, it contributes to providing a clear guideline for social workers who can use the approach as a reference source. Secondly, the framework acts as a new intervention means to address problem saturated stories and the intangible needs of the homeless. Thirdly, the model extends the application to beyond health related issues. Last but not least, the model is highly relevant to the local indigenous context.

Keywords: homeless, indigenous intervention, life story approach, social work practice

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Authors: Dhiraj Neupane

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Decentralized policy and practices have largely concentrated on the transformation of decision-making authorities from central to local institutions (or people) in the developing world. Such policy and practices always aimed for the equitable and efficient management of resources in the line of poverty reduction. The transformation of forest decision-making autonomy has also glorified as the best forest management alternatives to maximize the forest benefits and improve the livelihood of local people living nearby the forests. However, social heterogeneity and poor decision-making capacity of local institutions (or people) pose a nexus while managing the resources and sharing the forest benefits among the user households despite the policy objectives. The situation is severe in the lowland of Nepal, where forest resources have higher economic potential and user households have heterogeneous socio-economic conditions. The study discovered that utilizing the power of decision-making autonomy, user households were putting low values of timber considering the equitable access of timber to all user households as it is the most valuable product of community forest. Being the society is heterogeneous by socio-economic conditions, households of better economic conditions were always taking higher amount of forest benefits. The low valuation of timber has negative consequences on equitable benefit sharing and poor support to livelihood improvement of user households. Moreover, low valuation has possibility to increase the local demands of timber and increase the human pressure on forests.

Keywords: decentralized forest policy, Nepal, poverty, social heterogeneity, Terai

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Authors: Wei Zhang, Chye Kiang Heng, John Chye Fung

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Background: The world’s demographics is currently undergoing the largest wave of both rapid ageing and dramatic urbanisation in human history. As one of the most rapidly ageing countries, Singapore will see about one in four residents aged 65 years and above by 2030 in its high-rise and high-density urban environment. Research questions: To support urban seniors ageing in place and interdependence among senior residents and their informal caregivers, this study argues a community-based care model with bottom-up mutual help networks and asks how neighbourhood built-environment influences the formulation and facilitation of bottom-up mutual help networks in Singapore. Methods: Two public housing communities with different physical environment and rich age-friendly neighbourhood initiatives were chosen as the case studies. The categories, participants and places of bottom-up mutual help activities will be obtained via field observation, non-structural interviews of participants, service providers and managers of care facilities, and documents. Mapping and content analysis will be used to explore the influences of neighbourhood built-environment on the formulation and facilitation of bottom-up mutual help networks. Results and conclusions: The results showed that neighbourhood design, place programming, and place governance have a confluence on the bottom-up mutual help networks for senior residents. Significance: The outcomes of this study will provide fresh evidence for paradigm shifts of community-based care for the elderly and neighbourhood planning. In addition, the research findings will shed light on meaningful implications of urban planners and policy makers as they tackle with the issues arising from the ageing society.

Keywords: Built environment, Mutual help, Neighbourhood, Senior residents, Singapore

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Authors: Deepak Nathiya1, Ramesh Roop Rai, Pratima Singh1, Preeti Raj1, Supriya Suman, Balvir Singh Tomar

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Background: Sarcopenia is a catabolic state in liver cirrhosis (LC), accelerated with a breakdown of skeletal muscle to release amino acids which adversely affects survival, health-related quality of life, and response to any underlying disease. The primary objective of the study was to investigate the long-term effect of branched-chain amino acids (BCAA) supplementations on parameters associated with improved prognosis in sarcopenic patients with LC, as well as to evaluate its impact on cirrhotic-related events. Methods: We carried out a 24 week, single-center, randomized, open-label, controlled, two cohort parallel-group intervention trial comparing the efficacy of BCAA against lactoalbumin (L-ALB) on 106 sarcopenic liver cirrhotics. The BCAA (intervention) group was treated with 7.2 g BCAA per whereas, the lactoalbumin group was also given 6.3 g of L-Albumin. The primary outcome was to assess the impact of BCAA on parameters of sarcopenia: muscle mass, muscle strength, and physical performance. The secondary outcomes were to study combined survival and maintenance of liver function changes in laboratory and clinical markers in the duration of six months. Results: Treatment with BCAA leads to significant improvement in sarcopenic parameters: muscle strength, muscle function, and muscle mass. The total cirrhotic-related complications and cumulative event-free survival occurred fewer in the BCAA group than in the L-ALB group. Prognostic markers also improved significantly in the study. Conclusion: The current clinical trial demonstrated that long-term BCAAs supplementation improved sarcopenia and prognostic markers in patients with advanced liver cirrhosis.

Keywords: sarcopenia, liver cirrhosis, BCAA, quality of life

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Authors: Betül Gelengül Eki̇mci̇, Semra Günay Aktaş

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Festive, habitual activities celebrated on the specified date by a local community, are conducive to recognition of the region. The main function of festive events is to help gathering people via an annual celebration to create an atmosphere of understanding and the opportunity to participate in the joy of life. At the same time, festive events may serve as special occasions on which immigrants return home to celebrate with their family and community, reaffirming their identity and link to the community’s traditions. Festivals also support the local economy by bringing in different visitors to the region. The tradition of “Beet Brewing-Molasses Production,” which is held in İdrisyayla Village is an intangible cultural heritage with customs, traditions, and rituals carrying impacts of cuisine culture of Rumelian immigrants in the Ottoman. After the harvest of the beet plant in the autumn season of the year, Beet Brewing Molasses syrup is made by traditional production methods with co-op of the local community. Festive occurring brewing paste made process provided transmission of knowledge and experience to the young generations. Making molasses, which is a laborious process, is accompanied by folk games such as "sayacı," which is vital element of the festive performed in İdrisyayla. Performance provides enjoyable time and supporting motivation. Like other forms of intangible cultural heritage, “Beet Brewing-Molasses Festive in İdrasyayla is threatened by rapid urbanisation, young generation migration, industrialisation and environmental change. The festive events are threatened with gradual disappearance due to changes communities undergo in modern societies because it depends on the broad participation of practitioners. Ensuring the continuity of festive events often requires the mobilization of large numbers of individuals and the social, political and legal institutions and mechanisms of society. In 2015, Intangible cultural heritage research project with the title of "İdrisyayla Molasses Process" managed by the Eskişehir Governorship, City Directorate of Culture and Tourism and Anadolu University, project members took part in the festival organization to promote sustainability, making it visible, to encourage the broadest public participation possible, to ensure public awareness on the cultural importance. To preserve the originality of and encourage participation in the festive İdrisyayla, local associations, researchers and institutions created foundation and supports festive events, such as "sayacı" folk game, which is vital element of the festive performed in İdrisyayla. Practitioners find new opportunity to market İdrisyayla Molasses production. Publicity program through the press and exhibition made it possible to stress the cultural importance of the festive in İdrisyayla Village. The research reported here used a survey analysis to evaluate an affect of the festive after the spirit of the 2015 Festive in İdrisyayla Village. Particular attention was paid to the importance of the cultural aspects of the festival. Based on a survey of more than a hundred festival attendees, several recommendations are made to festival planners. Results indicate that the variety of festive activities and products offered for sale very important to attendees. The local participants care product sales rather than cultural heritage.

Keywords: agritourism, cultural tourism, festival, sustainable cultural heritage

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Authors: Sukhwinder Singh, Julian Park, Dinesh Kumar Benbi

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Although soil health, which is recognized as one of the key determinants of sustainable agricultural development, can be measured by a range of physical, chemical and biological parameters, the widely used parameters include pH, electrical conductivity (EC), organic carbon (OC), plant available phosphorus (P) and potassium (K). Soil health is largely affected by the occurrence of natural events or human activities and can be improved by various land management practices. A database of 120 soil samples collected from farmers’ fields spread across three major agro-climatic zones of Punjab suggested that the average pH, EC, OC, P and K was 8.2 (SD = 0.75, Min = 5.5, Max = 9.1), 0.27 dS/m (SD = 0.17, Min = 0.072 dS/m, Max = 1.22 dS/m), 0.49% (SD = 0.20, Min = 0.06%, Max = 1.2%), 19 mg/kg soil (SD = 22.07, Min = 3 mg/kg soil, Max = 207 mg/kg soil) and 171 mg/kg soil (SD = 47.57, Min = 54 mg/kg soil, Max = 288 mg/kg soil), respectively. Region-wise, pH, EC and K were the highest in south-western district of Ferozpur whereas farmers in north-eastern district of Gurdaspur had the best soils in terms of OC and P. The soils in the central district of Barnala had lower OC, P and K than the respective overall averages while its soils were normal but skewed towards alkalinity. Besides agro-climatic conditions, the size of landholding and farmer education showed a significant association with Soil Fertility Index (SFI), a composite index calculated using the aforementioned parameters’ normalized weightage. All the four stakeholder groups cited the current cropping patterns, burning of rice crop residue, and imbalanced use of chemical fertilizers for change in soil health. However, the current state of soil health in Punjab is unclear, which needs further investigation based on temporal data collected from the same field to see the short and long-term impacts of various crop combinations and varied cropping intensity levels on soil health.

Keywords: soil health, punjab agriculture, sustainability, soil fertility index

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Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: S. Pesina, T. Solonchak

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Lexical invariants, being a sort of stereotypes within the frames of ordinary consciousness, are created by the members of a language community as a result of uniform division of reality. The invariant meaning is formed in person’s mind gradually in the course of different actualizations of secondary meanings in various contexts. We understand lexical the invariant as abstract language essence containing a set of semantic components. In one of its configurations it is the basis or all or a number of the meanings making up the semantic structure of the word.

Keywords: lexical invariant, invariant theories, polysemantic word, cognitive linguistics

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Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

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Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

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Authors: Vincent Jones

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The North African country of Libya is in crisis and is currently a humanitarian disaster. The current American ‘hands off’ foreign policy appear to have contributed to this crisis. The research upon which this paper is based focused on a qualitative analysis of migration to Libya and its history with slavery, current conditions that have contributed to the re-emergence of slavery, an analysis of available resources in the effected region, and an analysis of legal remedies pursuant to international law. In addition, a qualitative analysis of American foreign policy from the Reagan Administration through the current Trump administration has been a focus of analysis. The major findings of this research are: (1) Since the removal of Muammar Gadhafi, a move that the United States played a major role in achieving, the nation of Libya has been in free fall and the rule of law has all but disappeared. As a major port stop for refugees and migrants fleeing atrocities in sub-Saharan African states, Libya has become the gate way to European ports of asylum. The problem is these migrant refugees are unwanted, caught between rival and often ineffective governments, profiteers, and inaction from the international community. (2) The outlook for these refugees is bleak: the ineffective government of Libya is ill-equipped to handle the large influx, European refugee destination states like Italy and Greece are already overburdened by the Syrian refugee crisis and are reluctant to accept more refugees, leaving the powerful and armed Libyan militia in control of a situation that is ripe for exploitation. (3) The combined intervention of the international community, led by a newly committed and engaged American foreign policy. In conclusion, a new American foreign policy approach along with the active engagement of the United Nations, EU, and the African Union can effectively resolve this humanitarian crisis.

Keywords: slavery, Libya, migrants, slave auction

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Authors: Mubarak Jan Beebee Zeba Mahetaab, Sumera Bibi Keenoo

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Background: Covid-19 was first reported in Wuhan. On 13th March 2020, WHO declared Covid-19 as a pandemic disease with 140,936 cases globally. The outbreak of covid-19 occurred in over 184 countries, and it created a lot of medical and mental burdens. Aside from the physical problems, the mental health of the medical staff has been of critical concern. Aims and Objectives: To determine the prevalence of burnout among HCW dealing with COVID-19, identify the risk factors and find measures to support their mental health while dealing with the current and future pandemic. Methodology: A cross-sectional study was conducted among the HCW who fought against COVID-19 in SSRN Hospital in Mauritius. The HCWs were recruited using the snowballing sampling technique. Age, gender, job category, income, duration of vacation, working environment and importance of mental health were measured. Results: The prevalence of burnout was highest among HCA. Age had no significant association with pandemic-related burnout. In Mauritius, burnout during the pandemic is linked with lower income and having less vacation days. Conclusion: Burnout is prevalent among healthcare workers working during the Covid-19 Pandemic. Interventions such as psychological counselling, yoga and financial increments need to be implemented to help the healthcare workers.

Keywords: burnout, Covid-19, health care professionals, pandemic

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Authors: Anneke Van Biljon

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Background: Exercise is a primary form of preventing and improving cardiometabolic disease risk factors; however specific exercise variables and their associated health benefits in children are inconclusive. A preliminary study revealed that different exercise variables may improve particular cardiometabolic health benefits. Objectives: This study further investigated the specific cardiometabolic health benefits associated with three isocaloric exercise interventions set at different intensities. Methods: Hundred-and-twenty (n = 120) participants between the ages of 10 – 14 years old were assigned to four different study groups 1. High intensity interval training (HIIT) at > 80% MHR 2. Moderate intensity continuous training (MICT) at 65% – 70% MHR 3. Alternative intensities (ALT) of HIIT and MICT 4. Control group. Exercise interventions were designed to generate isocaloric workloads of ~154.77 kcal per session, three times per week for five weeks. The one-way ANOVA test established comparisons between group means. Post hoc tests were calculated to determine specific group differences. Results: Although, all exercise groups improved cardiometabolic health, the MICT group showed greater improvements in fasting glucose (-9.30%), whereas cardiorespiratory fitness increased most by 31.33% (p = 0.000) within the HIIT group. Finally, ALT group recorded overall superior and additional cardiometabolic health benefits compared with both MICT and HIIT groups. Conclusion: The findings of this study indicate that superior benefits may be elicited when combining and alternating MICT and HIIT. These results provide specific exercise recommendations for achieving optimal and substantial cardiometabolic health benefits in children which will contribute towards achieving the health-related Sustainable Development Goals for 2030.

Keywords: cardiometabolic disease risk factors, exercise, pediatrics, interventions

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Authors: Anastasia P. Samaras, Allison Ward-Parsons, Beth Dalbec, Paula Cristina Azevedo, Anya Evmenova, Arvinder Johri, Lynne Scott Constantine, Lesley Smith

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Two cycles of qualitative data were collected. Cycle One sources included participant survey results, participant postings on Blackboard forums, facilitator memos, and meeting notes as well as reflections and notes from whole-group meetings.

Keywords: adjunct faculty, professional development, self-study methodology, teaching

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Authors: P. J. Kagosi, M. Mndolwa, E. Japhate

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The study was conducted to communities adjacent MNR, Lushoto district, Tanzania. The MNR is one of the nine nature reserves in the Eastern Arc Mountains of Tanzania with an area of 8,700ha with high biological diversity. However, biodiversity in MNR have been threatened by increasing human activities for livelihood in 1970s. The AF systems in the study area was practised since 1980s however, no study was conducted on AF impacts. This paper presents the influence of AF on livelihood of communities adjacent MNR and biodiversity conservation. Qualitative and quantitative data were collected using socio-economic survey and botanical surveys. Data were analysed using Statistical Packages for Social Sciences and content analysis. The study found that in 1970s free livestock grazing caused considerable surface runoff, soil erosion and reduction of crop production. Since 1980s, the study area received various interventions based on the land conservations and improved livelihood through practising AF systems. It was further found that the AF farming improved crop productivity, reduced soil erosion, increased firewood (80.2%) and other forest products availability and AF encouraged community members practicing indoor livestock keeping.The dominant agroforestry tree found in the study area is grevillea reported by 74.1% of respondents planting an average of 40 trees. The study found that the AF reduced pressure to MNR as forest products and fodders were obtained from community's farms in turn, currently water flow from MNR has been increased. Thus AF products support livelihood needs and conserve biodiversity. The study recommends continuity education on new AF technology packages.

Keywords: impact of agroforestry, biodiversity management, communities’ livelihoods, Magamba nature reserve

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Authors: Veronica Ramirez

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For over 40 years now, the Philippines has been supplying Household Service Workers (HSWs) globally. As a requirement of the Philippine Overseas Employment Agency (POEA), all Filipinos applying for overseas work undergo medical examination and a certificate of good health is submitted to the foreign employer before hiring. However, there are workplace-related health problems that develop during employment such as musculoskeletal strain or injury, back pain, hypertension and other illnesses. Some workers are in good working conditions but are on call more than 12 hours per day. There are also those who experience heavy physical work with short rest periods or time off. They can also be easily exposed to disease outbreaks and epidemics. It was the objective of this study to determine the common health problems of Filipino Overseas Service Workers and analyze their implications to wellness in the workplace. Specifically, it sought to describe the work conditions of HSWs and determine the work-related factors affecting their health. It also identified the medical care they avail of and how they perceive their health and wellness as determinants of well-being. Finally, it proposes ways to promote wellness among HSWs. This study focused on physical illnesses and does not include mental problems experienced by HSWs. Using a questionnaire, primary data were gathered online and through survey of HSW rehires who were retaking Pre-Departure Orientation Seminar at recruitment agencies. The 2010 Health Benefit Availment data from the Overseas Workers Welfare Administration (OWWA) was also utilized. Descriptive analysis was employed on the data gathered. Key stakeholders in the migration industry were also interviewed. Previous research studies, reports and literature on migration and wellness were used as secondary data. The study found that Filipino overseas HSWs are vulnerable to physical injury and experience body pains such as back, hip and shoulder pain. Long hours of work, work hazards and lack of rest due to poor accommodations can aggravate their physical condition. Although health insurance and health care are available, HSWs are not aware how to avail them. On the basis of the findings, a Wellness Program can be designed that include health awareness, health care availment, occupational ergonomics, safety and health, work and leisure balance, developing emotional intelligence, anger management and spirituality.

Keywords: health, household service worker, overseas, wellness

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Authors: Alessandra Marino

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This paper thoroughly investigates the design characteristics necessary for intergenerational living and evaluates their applicability within the Italian social panorama in order to identify a model that can serve as a reference for subsequent regulatory adjustments of a new building typology. The applied methodology involves the collaboration of people with various background and architects, all representing the three main ages of life - childhood or youth, adulthood, seniority - through questionnaires aimed at researching the peculiar characteristics that contemporary intergenerational housing should include; the questionnaires are then compared with each other in order to identify any recurring patterns by age group and/or influenced by the specialist knowledge on the subject of the architects compared to the rest of the user sample. The results indicate that among specialist users in the field of architecture, young students identify home automation as the key to the inclusion of the weakest groups within the building, adult architects believe that the identification of intergenerational/community services within the building is the cornerstone, and senior architects focus on widespread spatial accessibility. At the same time, the results among non-specialist users do not identify a significantly diversified model by age group but are generally in agreement in the importance of separation between private environments and collective spaces. The interpretation of the results obtained leads to a compositional study of a new building typology with the future objective of channeling the subsequent outcomes within the regulatory adjustments of the sector.

Keywords: intergenerational living, social sustainability, health, lifestyle, well-being

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Authors: Sung-Jun Yoo, Kazuhide Ito

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In this study, a comprehensive computer simulated person (CSP) that integrates computational human model (virtual manikin) and respiratory tract model (virtual airway), was applied for estimation of indoor environmental quality. Moreover, an inclusive prediction method was established by integrating computational fluid dynamics (CFD) analysis with advanced CSP which is combined with physiologically-based pharmacokinetic (PBPK) model, unsteady thermoregulation model for analysis targeting micro-climate around human body and respiratory area with high accuracy. This comprehensive method can estimate not only the contaminant inhalation but also constant interaction in the contaminant transfer between indoor spaces, i.e., a target area for indoor air quality (IAQ) assessment, and respiratory zone for health risk assessment. This study focused on the usage of the CSP as an air/thermal quality sensor in indoors, which means the application of comprehensive model for assessment of IAQ and thermal environmental quality. Demonstrative analysis was performed in order to examine the applicability of the comprehensive model to the heating, ventilation, air conditioning (HVAC) control scheme. CSP was located at the center of the simple model room which has dimension of 3m×3m×3m. Formaldehyde which is generated from floor material was assumed as a target contaminant, and flow field, sensible/latent heat and contaminant transfer analysis in indoor space were conducted by using CFD simulation coupled with CSP. In this analysis, thermal comfort was evaluated by thermoregulatory analysis, and respiratory exposure risks represented by adsorption flux/concentration at airway wall surface were estimated by PBPK-CFD hybrid analysis. These Analysis results concerning IAQ and thermal comfort will be fed back to the HVAC control and could be used to find a suitable ventilation rate and energy requirement for air conditioning system.

Keywords: CFD simulation, computer simulated person, HVAC control, indoor environmental quality

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Authors: Shi-Bo Feng, Sheng-Jie Zhang, Jin Zhou

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The relationship between microbial diversity and algal bloom has received considerable attention for decades. Microbes undoubtedly affect annual bloom events and impact the physiology of both partners, as well as shape ecosystem diversity. However, knowledge about interactions and network correlations among broader-spectrum microbes that lead to the dynamics in a complete bloom cycle are limited. In this study, pyrosequencing and network approaches simultaneously assessed the associate patterns among bacteria, archaea, and microeukaryotes in surface water and sediments in response to a natural dinoflagellate (Alexandrium sp.) bloom. In surface water, among the bacterial community, Gamma-Proteobacteria and Bacteroidetes dominated in the initial bloom stage, while Alpha-Proteobacteria, Cyanobacteria, and Actinobacteria become the most abundant taxa during the post-stage. In the archaea biosphere, it clustered predominantly with Methanogenic members in the early pre-bloom period while the majority of species identified in the later-bloom stage were ammonia-oxidizing archaea and Halobacteriales. In eukaryotes, dinoflagellate (Alexandrium sp.) was dominated in the onset stage, whereas multiply species (such as microzooplankton, diatom, green algae, and rotifera) coexistence in bloom collapse stag. In sediments, the microbial species biomass and richness are much higher than the water body. Only Flavobacteriales and Rhodobacterales showed a slight response to bloom stages. Unlike the bacteria, there are small fluctuations of archaeal and eukaryotic structure in the sediment. The network analyses among the inter-specific associations show that bacteria (Alteromonadaceae, Oceanospirillaceae, Cryomorphaceae, and Piscirickettsiaceae) and some zooplankton (Mediophyceae, Mamiellophyceae, Dictyochophyceae and Trebouxiophyceae) have a stronger impact on the structuring of phytoplankton communities than archaeal effects. The changes in population were also significantly shaped by water temperature and substrate availability (N & P resources). The results suggest that clades are specialized at different time-periods and that the pre-bloom succession was mainly a bottom-up controlled, and late-bloom period was controlled by top-down patterns. Additionally, phytoplankton and prokaryotic communities correlated better with each other, which indicate interactions among microorganisms are critical in controlling plankton dynamics and fates. Our results supplied a wider view (temporal and spatial scales) to understand the microbial ecological responses and their network association during algal blooming. It gives us a potential multidisciplinary explanation for algal-microbe interaction and helps us beyond the traditional view linked to patterns of algal bloom initiation, development, decline, and biogeochemistry.

Keywords: microbial community, harmful algal bloom, ecological process, network

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Authors: Muhammad Haseeb

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It is crucial to have a balanced approach to food's energy and nutritional content in a world with limited resources. The preservation of the environment is vital, and both the agrifood-making and food service sectors will be requested to use fewer resources to produce a wider range of existing foods and develop imaginative foods that are physiologically appropriate for a better sense of good health, have long shelf lives and are conveniently transportable. Delivering healthy diets that satisfy consumer expectations from robust and sustainable agrifood systems is necessary in a world that is changing and where natural resources are running out. Across the whole food supply chain, an integrated multi-sectoral approach is needed to alleviate global food and nutrition insecurity.

Keywords: health, food, nutrition, supply chain

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