Search results for: one health approach

Authors: Wendi Dunham, Kimberly Floyd

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The constructivist approach to learning is a theoretical orientation that posits that individuals create their own understanding and knowledge of the world through their experiences and interactions. This approach emphasizes that learning is an active process and that individuals are not passive recipients when constructing their understanding of their world. When used concurrently with trauma-informed practices, a constructivist approach can inform the development of a framework for students and teachers that supports their social, emotional, and mental health in addition to enabling academic success. This framework can be applied to teachers and students. When applied to teachers, it can be used to achieve purposeful coping mechanisms through restorative justice and dispositional mindfulness. When applied to students, the framework can implement proactive, student-based practices such as Response to Intervention (RtI) and the 4 Rs to connect resiliency and intervention to academic learning. Using a constructivist, trauma-informed framework can provide students with a greater sense of control and agency over their trauma experiences and impart confidence in achieving school success.

Keywords: trauma, trauma informed practices in education, constructivist theory framework, school responses to trauma, trauma informed supports for teachers, trauma informed strategies for students, restorative justice, mindfulness, response to intervention, the 4 R's, resiliency

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Authors: Arlan Jay Jondonero

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The study explores the potential of teleseryes in improving the reproductive health practices of its Filipino teenage viewers. This includes the identification of the elements of teleseryes and the conditions that make it suitable for teleseryes to influence the practices of its viewers, as well as the assessment of how the Sabido methodology was applied in other countries to see if it can be applied in the Philippine context. It discusses the historical context of teleseryes in the Philippines, which are now in the online digital media platform. The study recognizes the role of the social cognitive theory and dramatic theory in a viewer’s acquisition of better reproductive health practices and evaluates if these theories can be applied in the Philippine context. Using the quasi-experimental approach, the study aims to determine if there is a causal relationship between how the online teleserye “Mga Batang Poz” is perceived by the Filipino teenage audience through its characters and storylines and the development of the audience’s knowledge, perceptions, and behaviors surrounding HIV/AIDS. The study looked into the components of the teleserye that made it relatable to the Filipino youth, as well as factors that should be taken into consideration to significantly influence the reproductive health practices of the Filipino youth.

Keywords: entertainment-education, HIV, quasi-experimental, Sabido methodology, teleserye

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Authors: S. S. Bendib, L. W. Mouss, S. Kalla

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This paper proposes a self-organization-based approach for real-time systems design. The addressed issue is the mapping of an application onto an architecture of heterogeneous processors while optimizing both makespan and reliability. Since this problem is NP-hard, a heuristic algorithm is used to obtain efficiently approximate solutions. The proposed approach takes into consideration the quality as well as the diversity of solutions. Indeed, an alternate treatment of the two objectives allows to produce solutions of good quality while a self-organization approach based on the neighborhood structure is used to reorganize solutions and consequently to enhance their diversity. Produced solutions make different compromises between the makespan and the reliability giving the user the possibility to select the solution suited to his (her) needs.

Keywords: embedded real-time systems design, makespan, reliability, self-organization, compromises

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Authors: Minnie Y. Teng, Kathy Xie, Jarus Tal

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Rationale: The traditional approach to community programs for children with mental and/or developmental challenges often involves segregation from typically-developing peers. However, studies show that inclusive education improves children’s quality of life, self-concept, and long term health outcomes. Investigating factors that influence inclusion can thus have important implications in the design and facilitation of community programs such that all children - across a spectrum of needs and abilities - may benefit. Objectives: This study explores barriers and facilitators to inclusive community programming for children aged 0 to 12 with developmental/mental challenges. Methods: Using a participatory-action research methodology, semi-structured focus groups and interviews will be used to explore perspectives of sighted students, instructors, and staff. Data will be transcribed and coded thematically. Practice Implications or Results: By having a deeper understanding of the barriers and facilitators to inclusive programming in the community, researchers can work with the broader community to facilitate inclusion in children’s community programs. Conclusions: Expanding inclusive practices may improve the health and wellbeing of the pediatric populations with disabilities, which consistently reports lower levels of participation. These findings may help to identify gaps in existing practices and ways to approach them.

Keywords: aquatic programs, children, disabilities, inclusion, community programs

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Authors: N. W. U. D. Chathurani, Shlomo Geva, Vinod Chandran, Proboda Rajapaksha

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Selecting an appropriate image representation is the most important factor in implementing an effective Content-Based Image Retrieval (CBIR) system. This paper presents a multi-feature fusion approach for efficient CBIR, based on the distance distribution of features and relative feature weights at the time of query processing. It is a simple yet effective approach, which is free from the effect of features' dimensions, ranges, internal feature normalization and the distance measure. This approach can easily be adopted in any feature combination to improve retrieval quality. The proposed approach is empirically evaluated using two benchmark datasets for image classification (a subset of the Corel dataset and Oliva and Torralba) and compared with existing approaches. The performance of the proposed approach is confirmed with the significantly improved performance in comparison with the independently evaluated baseline of the previously proposed feature fusion approaches.

Keywords: feature fusion, image retrieval, membership function, normalization

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Authors: Abdelhadi Adel, Kadri Ouahab

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This paper proposes a hybrid algorithm for the integration of systematic preventive maintenance policies in hybrid flow shop scheduling to minimize makespan. We have implemented a problem-solving approach for optimizing the processing time, methods based on metaheuristics. The proposed approach is inspired by the behavior of the human body. This hybridization is between a multi-agent system and inspirations of the human body, especially genetics. The effectiveness of our approach has been demonstrated repeatedly in this paper. To solve such a complex problem, we proposed an approach which we have used advanced operators such as uniform crossover set and single point mutation. The proposed approach is applied to three preventive maintenance policies. These policies are intended to maximize the availability or to maintain a minimum level of reliability during the production chain. The results show that our algorithm outperforms existing algorithms. We assumed that the machines might be unavailable periodically during the production scheduling.

Keywords: multi-agent systems, emergence, genetic algorithm, makespan, systematic maintenance, scheduling, hybrid flow shop scheduling

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Authors: Yayun Hsu, Henry Horng-Shing Lu

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In this paper, a new method is proposed to extending the method of connected component labeling from processing binary images to multi-scale modeling of images. By using the adaptive threshold of multi-scale attributes, this approach minimizes the possibility of missing those important components with weak intensities. In addition, the computational cost of this approach remains similar to that of the typical approach of component labeling. Then, this methodology is applied to grain boundary detection and Drosophila Brain-bow neuron segmentation. These demonstrate the feasibility of the proposed approach in the analysis of challenging microscopy images for scientific discovery.

Keywords: microscopic image processing, scientific data mining, multi-scale modeling, data mining

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Authors: Cledinaldo A. Dias, Isabela C. Santos, Marcus V. S. Siqueira

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In the contemporary globalization, the competitiveness generated in the search of new markets aiming at the growth of productivity and, consequently, of profits, implies the redefinition of productive processes and new forms of work organization. As a result of this structuring, unemployment, labor force turnover and the increase in outsourcing and informal work occur. Considering the different relationships and working conditions of outsourced employees, this study aims to identify the most present stressors among outsourced service providers from a Federal Institution of Higher Education in Brazil. To reach this objective, a descriptive exploratory study with a quantitative approach was carried out. The qualitative approach was chosen to provide an in-depth analysis of the occupational conditions of outsourced workers since this method seeks to focus on the social as a world of investigated meanings and the language or speech of each subject as the object of this approach. The survey was conducted in the city of Montes Claros - Minas Gerais (Brazil) and involved eighty workers from companies hired by the institution, including armed security guards, porters, cleaners, drivers, gardeners, and administrative assistants. The choice of professionals obeyed non-probabilistic criteria for convenience or accessibility. Data collection was performed by means of a structured questionnaire composed of sixty questions, in a Likert-type frequency interval scale format, in order to identify potential organizational stressors. The results obtained evidence that the stress factors pointed out by the workers are, in most cases, a determining factor due to the low productive performance at work. Amongst the factors associated with stress, the ones that stood out most were those related to organizational communication failures, the incentive to competition, lack of expectations of professional growth, insecurity and job instability. Based on the results, the need for greater concern and organizational responsibility with the well-being and mental health of the outsourced worker and the recognition of their physical and psychological limitations, and care that goes beyond the functional capacity for the work. Specifically for the preservation of mental health, physical and quality of life, it is concluded that it is necessary for the professional to be inserted in the external world that favors it internally since this set is complemented so that the individual remains in balance and obtain satisfaction in your work.

Keywords: occupational health, outsourced, organizational studies, stressors

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Authors: Sabyasachi Behera, Shiv Kumar, Pramod Gautam, Anisur Rahman, Pawan Pathak, Rahul Bhadouria

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Background: The increasing proportion of population especially urban poor and vulnerable groups or groups with specific needs, with health indicators worse than their rural counterparts in India face various issues related with availability and quality of health care. The reasons are myriad, starting from information and awareness of the community, especially, in a scenario wherein the needs and challenges of floating and migrant urban populations remain poorly understood. Weak linkages between health care facilities and slum dwellers and vulnerable populations hinder the improvement of health services for urban poor. Method: To address this issue, TCIHC program is helping health department of Indore city of Madhya Pradesh to establish a referral mechanism with a dual approach: at both community and facility level. The former is based on the premise of ‘building social capital’, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services at appropriate levels of care (Minus 2: Accredited Social Health Activist and Community Health Groups; Minus 1: Urban Health Nutrition Days; Zero: Urban Primary Health Center; Plus 1: secondary facility with BEmONC services; Plus 2: secondary facilities with CEmONC services; Plus 3: tertiary level facility) for the urban poor. The latter focuses on encouraging the provision of all services at various levels of service delivery points and stakeholders to function in a coordinated manner to ensure better health service availability and coverage in underserved slum areas. Results: This initiative has enhanced the utilization of community based, primary and secondary level services through defined referral pathways that are clearly known to a community dweller. Conclusion: An ideal referral mechanism should begin with referral at the community level wherein services of a frontline health care provider are accessed by them at their door-step, causing no delay in both understanding and decision on the health issues faced by them.

Keywords: levels of care, linkages, referral mechanism, service delivery

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Authors: Karam Ignaim, Joao M. Fernandes, Andre L. Ferreira

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Mapping the artifacts coming from a set of similar products family developed in an ad-hoc manner to make up the resulting software product line (SPL) plays a key role to maintain the consistency between requirements and code. This paper presents a feature mapping approach that focuses on tracing the artifact coming from the migration process, the current feature model (FM), to the other artifacts of the resulting SPL, the reference architecture, and code. Thus, our approach relates each feature of the current FM to its locations in the implementation code, using the reference architecture as an intermediate artifact (as a centric point) to preserve consistency among them during an SPL evolution. The approach uses a particular artifact (i.e., traceability tree) as a solution for managing the mapping process. Tool support is provided using friendlyMapper. We have evaluated the feature mapping approach and tool support by putting the approach into practice (i.e., conducting a case study) of the automotive domain for Classical Sensor Variants Family at Bosch Car Multimedia S.A. The evaluation reveals that the mapping approach presented by this paper fits the automotive domain.

Keywords: feature location, feature models, mapping, software product lines, traceability

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Authors: Dessy Arumsari, Ais Assana Athqiya, Mulyaminingrum

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Healthcare in remote areas is one of the major concerns in Indonesia. Building hospitals in a nation of 18.000 islands with a larger-than-life bureaucracy and problems with corruption, a critical shortage of qualified medical professionals and well-heeled patients resigned to traveling abroad for health care is a hard feat to accomplish. To assuring that all populations have access to appropriate and cost-effective care, a new solution to tackle this problem is with the presence of RV Car Clinic. This car has a concept such as a walking hospital that provides health facilities inside it. All of the health professionals who work in RV Car Clinic will do the rotation for a year in order to the equitable distribution of health workers. We need to advocate the policy makers to help realize RV Car Clinic in remote areas. Health services can be disseminated by the present of RV Car Clinic. Summarily, the local communities can get cost effectively because RV Car Clinic will come to their place and serve the health services.

Keywords: health policy, health professional, remote areas, RV Car Clinic

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Authors: F. Slaven, M. Uys, Y. Erasmus

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The South African National Mental Health Education Programme (SANMHEP) was a National Department of Health (NDoH) initiative to strengthen mental health services in South Africa in collaboration with the Foundation for Professional Development (FPD), SANOFI and the various provincial departments of health. The programme was implemented against the backdrop of a number of challenges in the management of mental health in the country related to staff shortages and infrastructure, the intersection of mental health with the growing burden of non-communicable diseases and various forms of violence, and challenges around substance abuse and its relationship with mental health. The Mental Health Care Act (No. 17 of 2002) prescribes that mental health should be integrated into general health services including primary, secondary and tertiary levels to improve access to services and reduce stigma associated with mental illness. In order for the provisions of the Act to become a reality, and for the journey of mental health patients through the system to improve, sufficient and skilled health care providers are critical. SANMHEP specifically targeted Medical Doctors and Professional Nurses working within the facilities that are listed to conduct 72-hour assessments, as well as District Hospitals. The aim of the programme was to improve the clinical diagnosis and management of mental disorders/conditions and the understanding of and compliance with the Mental Health Care Act and related Regulations and Guidelines in the care, treatment and rehabilitation of mental health care users. The course used a blended-learning approach and trained 1 120 health care providers through 36 workshops between February and November 2019. Of those trained, 689 (61.52%) were Professional Nurses, 337 (30.09%) were Medical Doctors, and 91 (8.13%) indicated their occupation as ‘other’ (of these more than half were psychologists). The pre- and post-evaluation of the face-to-face training sessions indicated a marked improvement in knowledge and confidence level scores (both clinical and legislative) in the care, treatment and rehabilitation of mental health care users by participants in all the training sessions. There was a marked improvement in the knowledge and confidence of participants in performing certain mental health activities (on average the ratings increased by 2.72; or 27%) and in managing certain mental health conditions (on average the ratings increased by 2.55; or 25%). The course also required that participants obtain 70% or higher in their formal assessments as part of the online component. The 337 participants who completed and passed the course scored 90% on average. This illustrates that when participants attempted and completed the course, they did very well. To further assess the effect of the course on the knowledge and behaviour of the trained mental health care practitioners a mixed-method outcome evaluation is currently underway consisting of a survey with participants three months after completion, follow-up interviews with participants, and key informant interviews with department of health officials and course facilitators. This will enable a more detailed assessment of the impact of the training on participants' perceived ability to manage and treat mental health patients.

Keywords: mental health, public health facilities, South Africa, training

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Authors: Malki Nadia Fatima Zahra, Kellal Chaimaa, Brahimi Houria

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Quality is one of the most important modern management patterns that organizations seek to achieve in all areas and sectors in order to meet the needs and desires of customers and to remain continuity, as they constitute a competitive advantage for the organization, and among the most prominent organizations that must be available on the quality factor are health organizations as they relate to the most valuable component of production It is a person and his health, and that any error in it threatens his life and may lead to death, so she must provide health services of high quality to achieve the highest degree of satisfaction for the patient. This research aims to study the quality of health services and the extent of their impact on patient satisfaction, and this is through an applied study that relied on measuring the level of quality of health services in the university hospital center of Algeria and the extent of their impact on patient satisfaction according to the dimensions of the quality of health services, and we reached a conclusion that the determinants of the quality of health services. It affects patient satisfaction, which necessitates developing health services according to patients' requirements and improving their quality to obtain patient satisfaction.

Keywords: health service, health quality, quality determinants, patient satisfaction

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Authors: Vidhya Venugopal, Jeremiah Chinnadurai, Rebekah A. I. Lucas, Tord Kjellstrom, Bruno Lemke

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Introduction: The effects of climate change (CC) are largely discussed across the globe in terms of impacts on the environment and the general population, but the impacts on workers remain largely unexplored. The predicted rise in temperatures and heat events in the CC scenario have health implications on millions of workers in physically exerting jobs. The current health and productivity risks associated with heat exposures are characterized, future risk estimates as temperature rises and recommendations towards developing protective and preventive occupational health and safety guidelines for India are discussed. Methodology: Cross-sectional studies were conducted in several occupational sectors with workers engaged in moderate to heavy labor (n=1580). Quantitative data on heat exposures (WBGT°C), physiological heat strain indicators viz., Core temperature (CBT), Urine specific gravity (USG), Sweat rate (SwR) and qualitative data on heat-related health symptoms and productivity losses were collected. Data were analyzed for associations between heat exposures, health and productivity outcomes related to heat stress. Findings: Heat conditions exceeded the Threshold Limit Value (TLV) for safe manual work in 66% of the workers across several sectors (Avg.WBGT of 28.7°C±3.1°C). Widespread concerns about heat-related health outcomes (86%) were prevalent among workers exposed to high TLVs, with excessive sweating, fatigue and tiredness being commonly reported by workers. The heat stress indicators, core temperature (14%), Sweat rate (8%) and USG (9%), were above normal levels in the study population. A significant association was found between rise in Core Temperatures and WBGT exposures (p=0.000179) Elevated USG and SwR in the worker population indicate moderate dehydration, with potential risks of developing heat-related illnesses. In a steel industry with high heat exposures, an alarming 9% prevalence of kidney/urogenital anomalies was observed in a young workforce. Heat exposures above TLVs were associated with significantly increased odds of various adverse health outcomes (OR=2.43, 95% CI 1.88 to 3.13, p-value = <0.0001) and productivity losses (OR=1.79, 95% CI 1.32 to 2.4, p-value = 0.0002). Rough estimates for the number of workers who would be subjected to higher than TLV levels in the various RCP scenarios are RCP2.6 =79%, RCP4.5 & RCP6 = 81% and at RCP 8.5 = 85%. Rising temperatures due to CC has the capacity to further reduce already compromised health and productivity by subjecting the workers to increased heat exposures in the RCP scenarios are of concern for the country’s occupational health and economy. Conclusion: The findings of this study clearly identify that health protection from hot weather will become increasingly necessary in the Indian subcontinent and understanding the various adaptation techniques needs urgent attention. Further research with a multi-targeted approach to develop strategies for implementing interventions to protect the millions of workers is imperative. Approaches to include health aspects of climate change within sectoral and climate change specific policies should be encouraged, via a number of mechanisms, such as the “Health in All Policies” approach to avert adverse health and productivity consequences as climate change proceeds.

Keywords: heat stress, occupational health, productivity loss, heat strain, adverse health outcomes

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Authors: Uche Joyce Ogbonda, Yingchun Ji, Paul Coates

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The proximity of schools to gas flaring sites and the use of simple ventilation systems in school buildings with currently no regulation or laid down blueprint during design and construction in an environment prone to adverse environmental hazards caused by the continuous exploration of oil in the Niger Delta is worrisome. Although a wide health implication has been associated with inhalation of poor air, its effect on the performance of schoolchildren and staffs is poorly understood. Thus, the aim of this research is to explore from professionals around the region the issues surrounding the provision of clean air indoors even though, most developed and developing world are advancing in newer systems and technologies for clean indoor air. This study adopts both qualitative and quantitative approach using both open-ended and semi- structured interview techniques. This paper finds that indoor air quality is not considered during design, selection, and construction of schools. Analysis showed that rather than consider the health effect associated with the inhalation of ambient air by schoolchildren who spend 80% of their active time in schools due to the use of simple open windows and doors as source of breathable air. Advanced ventilation systems were therefore recommended to ensure supplying clean air for school buildings.

Keywords: air quality, gas flare, health implication, schools, ventilation system

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Authors: Nadeesha Sewwandi, Dilini Shashikala, Rajarathnam Kanapathy, Shivakumaran Viyasan, Saman Kumara, Duminda Guruge

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Introduction: Nutrition is fundamental for good health and development during the early years of life. This study describes how rural community does interventions for improving the nutrition and health of children less than 5 year ages using health promotion approach and this study was conducted with children society and mothers groups in a rural village called Welankulama in Sri Lanka. Methodology: The details got from Public Health Midwife in this village showed there were malnourished children under 5 years age. So, we discussed this problem with the children society, mothers groups and identified the determinants with them. Then they wanted to address some of the determinants that they prioritized from their discussions. ‘Evening school’ was a new place to this village to do collective feeding for small children. ‘Mobile library’ was another new concept in this village and nutrition books, evidence collection were there to read for villagers. Mothers marked the foods given to their kids in a book called ‘Nutrition book’. And also mothers tend to mark the level of eating foods to motivate their children in a ‘Hapana calendar’. Results: In terms of results, malnourished children under 5 years age got reduced and the number of children having illnesses got reduced. Marking nutrition book and ‘Hapana calendar’ were become as trend among mothers. Apart from the above, there was good improvement of physical, social and emotional wellbeing of children. Children who received early stimulation with nutrition supplements had better outcomes than children who only received nutrition supplements, thereby amplifying the impact of nutrition. Conclusion: Health promotion interventions are helped to change nutritional behaviors of early childhood in rural community and it makes children healthier and better able to learn.

Keywords: early childhood, nutrition, determinants, health promotion process

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Authors: Muhammad Wahb

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Physical activity is increasingly recognized as a significant factor in maintaining optimal health and preventing chronic diseases. This research scrutinizes the long-term health benefits of sustained physical activity, employing a systematic review of epidemiological studies and randomized control trials conducted over the past decade. The study illuminates the protective effects of regular physical activity against cardiovascular disease, obesity, diabetes, and mental health disorders, with a special focus on the mechanisms involved. Furthermore, the paper provides insights into how public health initiatives can effectively promote physical activity among diverse populations, contributing to improved community health outcomes.

Keywords: physical activity, long-term health benefits, chronic disease prevention, public health

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Authors: Siyanda S. Biyela, Willie A. Cronje

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This paper presents a desktop study of comparing two different wave energy to electricity technologies (WECs) using a techno-economic approach. This techno-economic approach forms basis of a framework for rapid comparison of current and future technologies. The approach also seeks to assist in investment and strategic decision making expediting future deployment of wave energy harvesting in South Africa.

Keywords: cost of energy (COE) tool, sea state, wave energy converter (WEC), WEC-Sim

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Authors: Brian W. Mandikiana

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Homestead food production has the potential to alleviate hunger, improve health and nutrition for children and adults. This article examines the relationship between self-reported hunger and homestead food production using the ordered probit model. A sample of households participating in homestead food production was drawn from the first wave of the South African National Income Dynamics Survey, a nationally representative cross-section. The sample selection problem was corrected using an ordered probit model with sample selection approach. The findings show that homestead food production exerts a positive and significant impact on children and adults’ ability to cope with hunger and malnutrition. Yet, on the contrary, potential gains of homestead food production are threatened by shocks such as crop failure.

Keywords: agriculture, hunger, nutrition, sample selection

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Authors: Muhammad Mukhtar Aliyu

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This study investigated tutors’ experiences and perceptions of a problem-based learning approach (PBL) in a writing classroom. The study involved two Nigerian lecturers who facilitated an intact class of second-year students in an English composition course for the period of 12 weeks. Semi-structured interviews were employed to collect data of the study. The lecturers were interviewed before and after the implementation of the PBL process. The overall findings of the study show that the lecturers had positive perceptions of the use of PBL in a writing classroom. Specifically, the findings reveal the lecturers’ positive experiences and perception of the group activities. Finally, the paper gives some pedagogical implications which would give insight for better implementation of the PBL approach.

Keywords: experiences and perception, Nigeria, problem-based learning approach, writing classroom

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Authors: Silvia Maria Moya

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After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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Authors: Edward B. Ssekulima, Amir Etemadi

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This paper presents a Systems Thinking and System of Systems (SoS) viewpoint for managing requirements complexity in the grid integration of Variable Renewable Energy (VRE). To achieve a SoS approach, it is often necessary to inculcate a Systems Thinking (ST) perspective in the planning and design of the attendant system. We show how this approach can support the enhanced integration of VRE (wind, solar small hydro) for which intermittency is a key inhibiting factor to their sustainable grid integration. The results indicate that a ST and SoS approach are a critical tool for decision makers in the planning, design and deployment of VRE Sources for their sustainable grid-integration in accordance with relevant techno-economic, social and environmental requirements.

Keywords: sustainable grid-integration, system of systems, systems thinking, variable energy resources

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Authors: Felix Lankester, Alicia Davis, Safari Kinung'hi, Catherine Bunga, Shayo Alkara, Imam Mzimbiri, Jonathan Yoder, Sarah Cleaveland, Guy H. Palmer

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Achieving the London Declaration goal of a 90% reduction in neglected tropical diseases (NTDs) by 2030 requires cost-effective strategies that attain high and comprehensive coverage. The first objective of this trial was to assess the impact on cost and coverage of employing a novel integrative One Health approach linking two NTD control programs: mass drug administration (MDA) for soil-transmitted helminths in humans (STH) and mass dog rabies vaccination (MDRV). The second objective was to compare the coverage achieved by the MDA, a community-wide deworming intervention, with that of the existing national primary school-based deworming program (NSDP), with particular focus on the proportion of primary school-age children reached and their school enrolment status. Our approach was unconventional because, in line with the One Health approach to disease control, it coupled the responsibilities and resources of the Ministries responsible for human and animal health into one program with the shared aim of preventing multiple NTDs. The trial was carried out in hard-to-reach pastoral communities comprising 24 villages of the Ngorongoro District, Tanzania, randomly allocated to either Arm A (MDA and MDRV), Arm B (MDA only) or Arm C (MDRV only). Objective one: The percentage of people in each target village that received treatment through MDA in Arms A and B was 63% and 65%, respectively (χ2 = 1, p = 0.32). The percentage of dogs vaccinated in Arm A and C was 70% and 81%, respectively (χ2 =9, p = 0.003). It took 33% less time for a single person and a dog to attend the integrated delivery than two separate events. Cost per dose (including delivery) was lower under the integrated strategy, with delivery of deworming and rabies vaccination reduced by $0.13 (54%) and $0.85 (19%) per dose, respectively. Despite a slight reduction in the proportion of village dogs vaccinated in the integrated event, both the integrated and non-integrated strategies achieved the target threshold of 70% required to eliminate rabies. Objective two: The percentages of primary school age children enrolled in school that was reached by this trial (73%) and the existing NSDP (80%) were not significantly different (F = 0.9, p = 0.36). However, of the primary school age children treated in this trial, 46% were not enrolled in school. Furthermore, 86% of the people treated would have been outside the reach of the NSDP because they were not primary school age or were primary school age children not enrolled in school. The comparable reach, the substantial reductions in cost per dose delivered and the decrease in participants’ time support this integrated One Health approach to control multiple NTDs. Further, the recorded level of non-enrolment at primary school suggests that, in remote areas, school-based delivery strategies could miss a large fraction of school-age children and that programs that focus delivery solely at the level of the primary school will miss a substantial proportion of both primary school age children as well as other individuals from the community. We have shown that these populations can be effectively reached through extramural programs.

Keywords: canine mediated human rabies, integrated health interventions, mass drug administration, neglected tropical disease, One Health, soil-transmitted helminths

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Authors: Benazzouz Djamel, Termeche Adel, Touati Youcef, Alem Said, Ouziala Mahdi

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This paper presents an approach which detect and isolate efficiently a fault in a system. This approach avoids false alarms, non-detections and delays in detecting faults. A study case have been proposed to show the importance of taking into consideration the uncertainties in the decision-making procedure and their effect on the degradation diagnostic performance and advantage of using Bond Graph (BG) for such degradation. The use of BG in the Linear Fractional Transformation (LFT) form allows generating robust Analytical Redundancy Relations (ARR’s), where the uncertain part of ARR’s is used to generate the residuals adaptive thresholds. The study case concerns an electromechanical system composed of a motor, a reducer and an external load. The aim of this application is to show the effectiveness of the BG-LFT approach to robust fault detection.

Keywords: bond graph, LFT, uncertainties, detection and faults isolation, ARR

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Authors: Aena Iqbal

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The lack of access to maternal and reproductive health in Pakistan poses a great threat to global public health. Obstetric issues, including vesicovaginal fistulas (VVF), are the most common in South Asian countries, leaving women in a more vulnerable state. Koohi Goth Women’s Hospital offers free VVF operations, which draws in women from all over Pakistan. Although reproductive health is being handled, mental health is often neglected in these scenarios. Using a series of questions inspired by the Warwick Edinburgh Model, this paper builds on the results from interviewing women who have received vesicovaginal fistula repair surgery on their mental health, a taboo topic in Pakistan.

Keywords: obstetrics, VVF, Pakistan, reproductive health

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Authors: Yang L. Frances

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Women's health and wellness has been becoming an increasingly important issue in mass media in the age of globalization. In this context, the current research focuses on comparing the construction of healthy bodies in women's health magazines of China and U.S. Trends Health in China and Women's Health in U.S are chosen. Textual analysis and in depth interviews are combined to examine how the healthy bodies are constructed in two magazines through discursive strategies. The interviews with the Deputy Editorial Director, Creative Director and Senior Visual Design of two magazines are undertaken to make the further comparisons. In both Trends Health and Women's Health, women's subjectivity is realized in the construction of ideal healthy body; nevertheless in the process of constructing healthy body, the disciplinary practices imposed on women's bodies are different in two magazines. This paper argues that women's health magazines in both China and America provide an alternative discourse to speak their voices on the one hand, but on the other hand, Women's Health and Trends Health construct the healthy body through disparate disciplinary practices because of the different socio-cultural contexts in two societies.

Keywords: healthy body, women's health magazines, Foucault, textual analysis

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Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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Authors: Elvira Mustikawati P.H., Iis Dewi Ratih, Dita Amelia

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Bojonegoro has proclaimed a policy of zero malnutrition. Therefore, as an effort to solve the cases of malnutrition children in Bojonegoro, this study used the approach geographically Mixed Weighted Regression (MGWR) to determine the factors that influence the percentage of malnourished children under five in which factors can be divided into locally influential factor in each district and global factors that influence throughout the district. Based on the test of goodness of fit models, R2 and AIC values in GWR models are better than MGWR models. R2 and AIC values in MGWR models are 84.37% and 14.28, while the GWR models respectively are 91.04% and -62.04. Based on the analysis with GWR models, District Sekar, Bubulan, Gondang, and Dander is a district with three predictor variables (percentage of vitamin A, the percentage of births assisted health personnel, and the percentage of clean water) that significantly influence the percentage of malnourished children under five.

Keywords: GWR, MGWR, R2, AIC

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Authors: Thuvanan Borvornvitchotikarn, Werasak Kurutach

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Mutual information (MI) is widely used in medical image registration. In the different medical images analysis, it is difficult to choose an optimal bins size number for calculating the probability distributions in MI. As the result, this paper presents a new adaptive bins number selection approach that named a hybrid EMPCA-Scott approach. This work combines an expectation maximization principal component analysis (EMPCA) and the modified Scott’s rule. The proposed approach solves the binning problem from the various intensity values in medical images. Experimental results of this work show the lower registration errors compared to other adaptive binning approaches.

Keywords: mutual information, EMPCA, Scott, probability distributions

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Authors: Meredith Rossi, Lesley Lee, Mary Wear, Mary Van Baalen, Bradley Rhodes

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The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. A better understanding of the individual, population, and mission impacts of astronaut occupational exposures is critical to providing clinical care, targeting occupational surveillance efforts, and planning for future space exploration. The ability to characterize the risk of latent health conditions is a significant component of this understanding. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA-Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential long-term health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging populations are necessary to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography); and expanded monitoring will increase NASA’s ability to better characterize conditions resulting from astronaut occupational exposures. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of expanding the medical monitoring of former NASA astronauts under the Astronaut Occupational Health program. Increasing the breadth of monitoring services will ultimately enrich the existing evidence base of occupational health risks to astronauts. Such an expansion would therefore improve the understanding of the health of the astronaut population as a whole, and the ability to identify, mitigate, and manage such risks in preparation for deep space exploration missions.

Keywords: astronaut, long-term health, NASA, occupational health, surveillance

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