Search results for: bridge health monitoring

Authors: Adel A. Ghobbar, Varun Raman

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The Corrective maintenance of components and systems is a problem plaguing almost every industry in the world today. Train operators’ and the maintenance repair and overhaul subsidiary of the Dutch railway company is also facing this problem. A considerable portion of the maintenance activities carried out by the company are unscheduled. This, in turn, severely stresses and stretches the workforce and resources available. One possible solution is to have a robust preventive maintenance plan. The other possible solution is to plan maintenance based on real-time data obtained from sensor-based ‘Health and Usage Monitoring Systems.’ The former has been investigated in this paper. The preventive maintenance model developed for train operator will subsequently be extended, to tackle the unscheduled maintenance problem also affecting the aerospace industry. The extension of the model to the aerospace sector will be dealt with in the second part of the research, and it would, in turn, validate the soundness of the model developed. Thus, there are distinct areas that will be addressed in this paper, including the mathematical modelling of preventive maintenance and optimization based on cost and system availability. The results of this research will help an organization to choose the right maintenance strategy, allowing it to save considerable sums of money as opposed to overspending under the guise of maintaining high asset availability. The concept of delay time modelling was used to address the practical problem of unscheduled maintenance in this paper. The delay time modelling can be used to help with support planning for a given asset. The model was run using MATLAB, and the results are shown that the ideal inspection intervals computed using the extended from a minimal cost perspective were 29 days, and from a minimum downtime, perspective was 14 days. Risk matrix integration was constructed to represent the risk in terms of the probability of a fault leading to breakdown maintenance and its consequences in terms of maintenance cost. Thus, the choice of an optimal inspection interval of 29 days, resulted in a cost of approximately 50 Euros and the corresponding value of b(T) was 0.011. These values ensure that the risk associated with component X being maintained at an inspection interval of 29 days is more than acceptable. Thus, a switch in maintenance frequency from 90 days to 29 days would be optimal from the point of view of cost, downtime and risk.

Keywords: delay time modelling, unscheduled maintenance, reliability, maintainability, availability

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Authors: Nik Siti Hanifah Nik Ahmad

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This research discuss about teaching cupping therapy or hijama by using an online 3D Virtual Learning Environment. The experimental platform was using of flash and Second Life as 2D and 3D comparison. 81 samples have been used in three experiments with 21 in the first and 30 in each second and third. The design of the presentation was tested in five categories such as effectiveness, ease of use, efficacy, aesthetic and users’ satisfaction. The results from three experiments had shown promising outcome for usage of the technique to be implement in teaching Cupping Therapy as well as other alternative or conventional medicine knowledge especially for training.

Keywords: medical and health, cupping therapy or hijama, second life, online 3D VLE, virtual worlds

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Authors: Andres Mejia-Ortiz, Catalina Lozada, German R. Santos, Rafael Angulo-Jaramillo, Bernardo Caicedo

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The interaction between atmospheric variables and soil properties is a determining factor when evaluating the flow of water through the soil. This interaction situation directly determines the behavior of the soil and greatly influences the changes that occur in it. The atmospheric variations such as changes in the relative humidity, air temperature, wind velocity and precipitation, are the external variables that reflect a greater incidence in the changes that are generated in the subsoil, as a consequence of the water flow in descending and ascending conditions. These environmental variations have a major importance in the study of the soil because the conditions of humidity and temperature in the soil surface depend on them. In addition, these variations control the thickness of the unsaturated zone and the position of the water table with respect to the surface. However, understanding the relationship between the atmosphere and the soil is a somewhat complex aspect. This is mainly due to the difficulty involved in estimating the changes that occur in the soil from climate changes; since this is a coupled process where act processes of mass transfer and heat. In this research, an experimental field was implemented to study in-situ the interaction between the atmosphere and the soft soils of the city of Bogota, Colombia. The soil under study consists of a 60 cm layer composed of two silts of similar characteristics at the surface and a deep soft clay deposit located under the silky material. It should be noted that the vegetal layer and organic matter were removed to avoid the evapotranspiration phenomenon. Instrumentation was carried on in situ through a field disposal of many measuring devices such as soil moisture sensors, thermocouples, relative humidity sensors, wind velocity sensor, among others; which allow registering the variations of both the atmospheric variables and the properties of the soil. With the information collected through field monitoring, the water balances were made using the Hydrus-1D software to determine the flow conditions that developed in the soil during the study. Also, the moisture profile for different periods and time intervals was determined by the balance supplied by Hydrus 1D; this profile was validated by experimental measurements. As a boundary condition, the actual evaporation rate was included using the semi-empirical equations proposed by different authors. In this study, it was obtained for the rainy periods a descending flow that was governed by the infiltration capacity of the soil. On the other hand, during dry periods. An increase in the actual evaporation of the soil induces an upward flow of water, increasing suction due to the decrease in moisture content. Also, cracks were developed accelerating the evaporation process. This work concerns to the study of soil-atmosphere interaction through the experimental field and it is a very useful tool since it allows considering all the factors and parameters of the soil in its natural state and real values of the different environmental conditions.

Keywords: field monitoring, soil-atmosphere, soft soils, soil-water balance

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Authors: Radia Chemlal, Youcef Hamidi, Nabil Mameri

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This study deals with the production of biosurfactant by the Pseudomonas luteola strain on three different culture media (semi-synthetic medium M1, whey, and pharmaceutical reject) in the presence of gasoil. The monitoring of bacterial growth by measuring the optical density at 600 nm by spectrophotometer and the surface tension clearly showed the ability of Pseudomonas luteola to produce biosurfactants at various conditions of the culture medium. The biosurfactant produced in the pharmaceutical reject medium generated a decrease in the surface tension with a percentage of 19.4% greater than the percentage obtained when using whey which is 7.0%. The pharmaceutical rejection is diluted at various percentages ranging from 5% to 100% in order to study the effect of the concentration on the biosurfactant production. The best result inducing the great reduction of the surface tension value is obtained at the dilution of 30% with the pharmaceutical reject.

Keywords: biosurfactant, pseudomonas luteola, whey, antiscorpionic serum, gas oil

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Authors: Weldegerima Gebremedhin Hagos

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Background: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequels. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. Ethiopia reported the first case of SARS-CoV-2 on 13th March 2020, with community transmission ensuing by mid-May. The aim of this study was conducted to determine the prevalence of SARS-CoV-2 infection in Tigray, Ethiopia. Methods: Facility-based correctional study designs were used on a total of 380 study participants from March 2023 up to May 2023 in two general hospitals and one comprehensive specialized hospital in Tigray, Ethiopia. A pre-structured questionnaire was used to assess information regarding the socio-demographic, clinical data and other risk factors. A nasal swap was taken by trained health professionals, and the laboratory analysis was done by RT-PCR (quant studio 7-flex, applied biosystems) in Tigrai Health Research Institute and Mekelle University Medical Microbiology Research Laboratory. Result: The mean age of the study participants was 31 (SD+/-3.5) years, with 65% being male and 35% female. The overall seropositivity of sars-cov-2 among the study participants was 5.5%. The prevalence was higher in males (6.2%) than females which were (4.7%). Sars-cov-2 infection was significantly associated with a history of lack of vaccination (p-value 0.002). There was no significant association between seropositivity and demographic factors (P > 0.05). Conclusion: The seroprevalence of SARS-CoV-2 among the study participants is high. Those study participants with a previous history of vaccination have a low probability of developing COVID-19 infection. A low SARS-CoV-2 infection rate was recorded in those who frequently use masks.

Keywords: prevalence, SARS-CoV-2, infection, risk factors

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Authors: Mohammad Mahbub Alam Talukder, Shahnewaz, Hasanat-E-Rabbi, Mohammed Nazrul Islam

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Road traffic accident is a global problem which is severe in the developing countries like Bangladesh. In consequence, in developing countries road trauma has now been recognized as an increasing public health hazards and economic burning issue. And after road traffic accidents the lack of management and economic costs related with health seeking behavior have a disproportionate impact on lower income groups, thus contributing to the persistence of poverty in conjunction with disability. This cross sectional study, carried out during July 2012 to June 2013, aimed to explore health seeking decision and culture of handling the road traffic accident related victims, as taken from experiences of the poor disabled people of slum dwellers of Dhaka city. The present study has been designed based on qualitative techniques such as in-depth interview and case studies. Additionally, a survey questionnaire was used to collect the demographic characteristics of the study population (n=150) and to select participants purposely for in-depth interview (n=50) and case study (n=30). Content analysis of qualitative data was done through theme coding and matrix analysis of case study was done to use relevant verbatim. Most of the time the health seeking decision totally depended on the surrounded people of the accidental place, their knowledge, awareness and remaining facility and capacity regarding proper management of the victims. However, most of the cases the victims did not get any early treatment and it took 2-12 hours to get even the first aid because of distance, shortage of money, lack of availability of getting the aid, lack of mass awareness etc. Under the reality of discriminated and unaffordable health service provision better treatment could not turn out due to economic inability of the poor victims. To avoid the severe trauma, treatment delay must be reduced by providing first aid within very short time and to do so, mass awareness campaign is necessary for handing the victims. Moreover, necessary measures should be taken to ensure cost free health service provision to treat the chronic disabled condition of the road traffic accident related poor victims.

Keywords: accident, injury, disabled, qualitative, slum

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Authors: Maria Luiza D. Ramiento, Maria Lissette D. Lucas

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Electricity is said to serve as the backbone of modern technology. Considering this, electricity consumption has dynamically grown due to the continuous demand. An alternative producer of energy concerning electricity must therefore be given focus. Microbial fuel cell wholly characterizes a new method of renewable energy recovery: the direct conversion of organic matter to electricity using bacteria. Electricity is produced as fuel or new food is given to the bacteria. The study concentrated in determining the feasibility of electricity production from local benthic zones. Microbial fuel cells were constructed to harvest the possible electricity and to test the presence of electricity producing microorganisms. Soil samples were gathered from Calumpang River, Palawan Mangrove Forest, Rosario River and Batangas Port. Eleven modules were constructed for the different trials of the soil samples. These modules were made of cathode and anode chambers connected by a salt bridge. For 85 days, the harvested voltage was measured daily. No parameter is added for the first 24 days. For the next 61 days, acetic acid was included in the first and second trials of the modules. Each of the trials of the soil samples gave a positive result in electricity production.There were electricity producing microbes in local benthic zones. It is observed that the higher the organic content of the soil sample, the higher the electricity harvested from it. It is recommended to identify the specific species of the electricity-producing microorganism present in the local benthic zone. Complement experiments are encouraged like determining the kind of soil particles to test its effect on the amount electricity that can be harvested. To pursue the development of microbial fuel cells by building a closed circuit in it is also suggested.

Keywords: microbial fuel cell, benthic zone, electricity, reduction-oxidation reaction, bacteria

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Authors: Burcu Kaya, Jan-Martin Kaiser, Karl-Friedrich Becker, Tanja Braun, Klaus-Dieter Lang

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Quality of the molded packages is strongly influenced by the process parameters of the transfer molding. To achieve a better package quality and a stable transfer molding process, it is necessary to understand the influence of the process parameters on the package quality. This work aims to comprehend the relationship between the process parameters, and to identify the optimum process parameters for the transfer molding process in order to achieve less voids and wire sweep. To achieve this, a DoE is executed for process optimization and a regression analysis is carried out. A systematic approach is represented to generate models which enable an estimation of the number of voids and wire sweep. Validation experiments are conducted to verify the model and the results are presented.

Keywords: dielectric analysis, electronic packages, epoxy molding compounds, transfer molding process

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Authors: Jia Guo, Qinyuan Huang, Qinyi Zhong, Yanjing Zeng, Yimeng Li, James Wiley, Kin Cheung, Jyu-Lin Chen

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Context: Mothers with abdominal obesity, particularly in China, face challenges in managing their health due to family responsibilities. Existing diabetes prevention programs do not cater specifically to this demographic. Research Aim: To assess the feasibility, acceptability, and efficacy of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in reducing weight-related variables and diabetes risk. Methodology: A randomized controlled trial was conducted in Changsha, China, where the mHealth group received personalized modules and health messages, while the control group received general health education. Data were collected at baseline, 3 months, and 6 months. Findings: The mHealth intervention significantly improved waist circumference, modifiable diabetes risk scores, daily steps, self-efficacy for physical activity, social support for physical activity, and physical health satisfaction compared to the control group. However, no differences were found in BMI and certain other variables. Theoretical Importance: The study demonstrates the feasibility and efficacy of a tailored mHealth intervention for Chinese mothers with abdominal obesity, emphasizing the potential for such programs to improve health outcomes in this population. Data Collection: Data on various variables including weight-related measures, diabetes risk scores, behavioral and psychological factors were collected at baseline, 3 months, and 6 months from participants in the mHealth and control groups. Analysis Procedures: Generalized estimating equations were used to analyze the data collected from the mHealth and control groups at different time points during the study period. Question Addressed: The study addressed the effectiveness of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in improving various health outcomes compared to traditional general health education approaches. Conclusion: The tailored mHealth intervention proved to be feasible and effective in improving weight-related variables, physical activity, and physical health satisfaction among Chinese mothers with abdominal obesity, highlighting its potential for delivering diabetes prevention programs to this population.

Keywords: type 2 diabetes, mHealth, obesity, prevention, mothers

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Authors: Bhavani Veasuvalingam

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Case-based learning (CBL) is a popular instructional method aimed to bridge theory to clinical practice. This study aims to explore CBL mixed modality curriculum in influencing students’ learning styles and strategies that support learning. An explanatory sequential mixed method study was employed with initial phase, 44-itemed Felderman’s Index of Learning Style (ILS) questionnaire employed across year one medical students (n=142) using convenience sampling to describe the preferred learning styles. The qualitative phase utilised three focus group discussions (FGD) to explore in depth on the multimodal learning style exhibited by the students. Most students preferred combination of learning stylesthat is reflective, sensing, visual and sequential i.e.: RSVISeq style (24.64%) from the ILS analysis. The frequency of learning preference from processing to understanding were well balanced, with sequential-global domain (66.2%); sensing-intuitive (59.86%), active- reflective (57%), and visual-verbal (51.41%). The qualitative data reported three major themes, namely Theme 1: CBL mixed modalities navigates learners’ learning style; Theme 2: Multimodal learners active learning strategies supports learning. Theme 3: CBL modalities facilitating theory into clinical knowledge. Both quantitative and qualitative study strongly reports the multimodal learning style of the year one medical students. Medical students utilise multimodal learning styles to attain the clinical knowledge when learning with CBL mixed modalities. Educators’ awareness of the multimodal learning style is crucial in delivering the CBL mixed modalities effectively, considering strategic pedagogical support students to engage and learn CBL in bridging the theoretical knowledge into clinical practice.

Keywords: case-based learning, learnign style, medical students, learning

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Authors: Dr.Vasundhra Misra, Prof. Praveen Vashist

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Purpose: Vitamin A deficiency prevention programmes are at varying stages of development and implementation in all countries. Vitamin A deficiency has been recognized as a public health issue in developing countries like India. Despite achieving a lot of success a load of blindness due to Vitamin A deficiencies is still high. In this regard, a study was conducted to assess the awareness and health-seeking practices about Vitamin A deficiency diseases among the urban slum population of Delhi, India. Methods: A descriptive cross-sectional study was conducted in the 5 slum clusters from the urban population of South Delhi. A specially designed pre-tested questionnaire schedule was administered. The study sample was comprised of 1552 inhabitants. Results: The mean age of the respondents was 34 ± 12.1 years. A total of 1003 (64.6%) participants out of 1552, had heard of night blindness. Awareness of night blindness was more in the elderly age group and also found significant (p < 0.001). Only 31 (3.1%) knew that night blindness is caused due to deficiency of vitamin A. The awareness of vitamin A prophylaxis programme was significantly higher among elder age (p < 0.05) and females (p < 0.05). Conclusion: The findings highlighted that even though many of the respondents have heard of night blindness but the awareness about causes and treatment was found low in the community. There is a need for efforts directed to enhance community-level counseling and educational programmes.

Keywords: awareness, health-seeking practices, night blindness, vitamin-A deficiency diseases

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Authors: Ren-Jy Ben, Jo-Chi Jao, Chiu-Ya Liao, Ya-Ru Tsai, Lain-Chyr Hwang, Po-Chou Chen

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Cancer is still one of the serious diseases threatening the lives of human beings. How to have an early diagnosis and effective treatment for tumors is a very important issue. The animal carcinoma model can provide a simulation tool for the study of pathogenesis, biological characteristics and therapeutic effects. Recently, drug delivery systems have been rapidly developed to effectively improve the therapeutic effects. Liposome plays an increasingly important role in clinical diagnosis and therapy for delivering a pharmaceutic or contrast agent to the targeted sites. Liposome can be absorbed and excreted by the human body, and is well known that no harm to the human body. This study aimed to compare the therapeutic effects between encapsulated (doxorubicin liposomal, LipoDox) and un-encapsulated (doxorubicin, Dox) anti-tumor drugs using Magnetic Resonance Imaging (MRI). Twenty-four New Zealand rabbits implanted with VX2 carcinoma at left thigh were classified into three groups: control group (untreated), Dox-treated group and LipoDox-treated group, 8 rabbits for each group. MRI scans were performed three days after tumor implantation. A 1.5T GE Signa HDxt whole body MRI scanner with a high resolution knee coil was used in this study. After a 3-plane localizer scan was performed, Three-Dimensional (3D) Fast Spin Echo (FSE) T2-Weighted Images (T2WI) was used for tumor volumetric quantification. And Two-Dimensional (2D) spoiled gradient recalled echo (SPGR) dynamic Contrast-enhanced (DCE) MRI was used for tumor perfusion evaluation. DCE-MRI was designed to acquire four baseline images, followed by contrast agent Gd-DOTA injection through the ear vein of rabbits. Afterwards, a series of 32 images were acquired to observe the signals change over time in the tumor and muscle. The MRI scanning was scheduled on a weekly basis for a period of four weeks to observe the tumor progression longitudinally. The Dox and LipoDox treatments were prescribed 3 times in the first week immediately after VX2 tumor implantation. ImageJ was used to quantitate tumor volume and time course signal enhancement on DCE images. The changes of tumor size showed that the growth of VX2 tumors was effectively inhibited for both LipoDox-treated and Dox-treated groups. Furthermore, the tumor volume of LipoDox-treated group was significantly lower than that of Dox-treated group, which implies that LipoDox has better therapeutic effect than Dox. The signal intensity of LipoDox-treated group is significantly lower than that of the other two groups, which implies that targeted therapeutic drug remained in the tumor tissue. This study provides a radiation-free and non-invasive MRI method for therapeutic monitoring of targeted liposome on an animal tumor model.

Keywords: doxorubicin, dynamic contrast-enhanced MRI, lipodox, magnetic resonance imaging, VX2 tumor model

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

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

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

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Authors: Amir Mohammad Fathollahi Fard, Mostafa Hajiaghaei-Keshteli, Mohammad Mahdi Paydar

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With increasing life expectancy in developed countries, the role of home care services is highlighted by both academia and industrial contributors in Home Health Care Supply Chain (HHCSC) companies. The main decisions in such supply chain systems are the location of pharmacies, the allocation of patients to these pharmacies and also the routing and scheduling decisions of nurses to visit their patients. In this study, for the first time, an integrated model is proposed to consist of all preliminary and necessary decisions in these companies, namely, location-allocation-routing model. This model is a type of NP-hard one. Therefore, an Imperialist Competitive Algorithm (ICA) is utilized to solve the model, especially in large sizes. Results confirm the efficiency of the developed model for HHCSC companies as well as the performance of employed ICA.

Keywords: home health care supply chain, location-allocation-routing problem, imperialist competitive algorithm, optimization

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Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

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Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

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Authors: Lucie Cote, Sonia McFadden

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Mental health problems in the workplace are currently one of the main causes of absences. Research work has highlighted the importance of a collaborative process involving the stakeholders in the return-to-work process and has established the best management practices to ensure a successful return-to-work. However, very few studies have specifically explored the combination of various management models and determined whether they could satisfy the needs of the stakeholders. The objective of this study is to analyze two models for managing the return to work: the ‘medical-administrative’ and the ‘support of the worker’ in order to understand the actions and actors involved in these models. The study also aims to explore whether these models meet the needs of the actors involved in the management of the return to work. A qualitative case study was conducted in a Canadian federal organization. An abundant internal documentation and semi-directed interviews with six managers, six workers and four human resources professionals involved in the management of records of employees returning to work after a mental health problem resulted in a complete picture of the return to work management practices used in this organization. The triangulation of this data facilitated the examination of the benefits and limitations of each approach. The results suggest that the actions of management for employee return to work from both models of management ‘support of the worker’ and ‘medical-administrative’ are compatible and can meet the needs of the actors involved in the return to work. More research is needed to develop a structured model integrating best practices of the two approaches to ensure the success of the return to work.

Keywords: return to work, mental health, management models, organizations

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Authors: Tahsin A. H. Nishat, Raquib Ahsan

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Sensitivity analysis of design parameters of the optimization procedure can become a significant factor while designing any structural system. The objectives of the study are to analyze the sensitivity of deck slab thickness parameter obtained from both the conventional and optimum design methodology of pre-stressed post-tensioned I-girder and deck system and to compare the relative significance of slab thickness. For analysis on conventional method, the values of 14 design parameters obtained by the conventional iterative method of design of a real-life I-girder bridge project have been considered. On the other side for analysis on optimization method, cost optimization of this system has been done using global optimization methodology 'Evolutionary Operation (EVOP)'. The problem, by which optimum values of 14 design parameters have been obtained, contains 14 explicit constraints and 46 implicit constraints. For both types of design parameters, sensitivity analysis has been conducted on deck slab thickness parameter which can become too sensitive for the obtained optimum solution. Deviations of slab thickness on both the upper and lower side of its optimum value have been considered reflecting its realistic possible ranges of variations during construction. In this procedure, the remaining parameters have been kept unchanged. For small deviations from the optimum value, compliance with the explicit and implicit constraints has been examined. Variations in the cost have also been estimated. It is obtained that without violating any constraint deck slab thickness obtained by the conventional method can be increased up to 25 mm whereas slab thickness obtained by cost optimization can be increased only up to 0.3 mm. The obtained result suggests that slab thickness becomes less sensitive in case of conventional method of design. Therefore, for realistic design purpose sensitivity should be conducted for any of the design procedure of girder and deck system.

Keywords: sensitivity analysis, optimum design, evolutionary operations, PC I-girder, deck system

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Authors: Michael B. C. Khoo, J. L. Khoo, W. C. Yeong, W. L. Teoh

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The Shewhart Xbar control chart is a useful process monitoring tool in manufacturing industries to detect the presence of assignable causes. However, it is insensitive in detecting small process shifts. To circumvent this problem, adaptive control charts are suggested. An adaptive chart enables at least one of the chart’s parameters to be adjusted to increase the chart’s sensitivity. Two common adaptive charts that exist in the literature are the double sampling (DS) Xbar and variable sampling interval (VSI) Xbar charts. This paper compares the performances of the DS and VSI Xbar charts, based on the average time to signal (ATS) criterion. The ATS profiles of the DS Xbar and VSI Xbar charts are obtained using the Mathematica and Statistical Analysis System (SAS) programs, respectively. The results show that the VSI Xbar chart is generally superior to the DS Xbar chart.

Keywords: adaptive charts, average time to signal, double sampling, charts, variable sampling interval

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Authors: Heribert R. Kaijage, Samuel N. A. Codjoe, Simon H. D. Mamuya, Mangi J. Ezekiel

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There is strong evidence that climate has changed significantly affecting various sectors including public health. The recommended feasible solution is adopting development trajectories which combine both mitigation and adaptation measures for improving resilience pathways. This approach demands a consideration for complex interactions between climate and social-ecological systems. While other sectors such as agriculture and water have developed climate resilience indices, the public health sector in Tanzania is still lagging behind. The aim of this study was to find out how can we use Demographic and Health Surveys (DHS) linked with Remote Sensing (RS) technology and metrological information as tools to inform climate change resilient development and evaluation for the health sector. Methodological review was conducted whereby a number of studies were content analyzed to find appropriate indicators and indices for climate resilience household and their integration approach. These indicators were critically reviewed, listed, filtered and their sources determined. Preliminary identification and ranking of indicators were conducted using participatory approach of pairwise weighting by selected national stakeholders from meeting/conferences on human health and climate change sciences in Tanzania. DHS datasets were retrieved from Measure Evaluation project, processed and critically analyzed for possible climate change indicators. Other sources for indicators of climate change exposure were also identified. For the purpose of preliminary reporting, operationalization of selected indicators was discussed to produce methodological approach to be used in resilience comparative analysis study. It was found that household climate resilient index depends on the combination of three indices namely Household Adaptive and Mitigation Capacity (HC), Household Health Sensitivity (HHS) and Household Exposure Status (HES). It was also found that, DHS alone cannot complement resilient evaluation unless integrated with other data sources notably flooding data as a measure of vulnerability, remote sensing image of Normalized Vegetation Index (NDVI) and Metrological data (deviation from rainfall pattern). It can be concluded that if these indices retrieved from DHS data sets are computed and scientifically integrated can produce single climate resilience index and resilience maps could be generated at different spatial and time scales to enhance targeted interventions for climate resilient development and evaluations. However, further studies are need to test for the sensitivity of index in resilience comparative analysis among selected regions.

Keywords: climate change, resilience, remote sensing, demographic and health surveys

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Authors: Dhananjay W. Bansod, Santosh Phad

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Non-Communicable Diseases (NCD) are major contributing factors to the disease burden in the world as well as in India. With a growing proportion of older persons in India gives rise to several challenges. With the advancement of age, elderly is exposed to various kinds of health problems more specifically NCDs. Therefore, an effort has been made to examine the prevalence of NCDs among older persons and its treatment-seeking behaviour, also it is tried to explore the association between the NCDs and its effect on the overall wellbeing of older persons. Data used from “Building Knowledge Base of Population Ageing Survey” conducted in 2011 in seven states of India. Six chronic diseases used (non-communicable diseases) namely Arthritis, Hypertension, Cataract, Diabetes, Asthma and Heart diseases to understand the issues related to NCDs. Also seen the effect of NCDs on the wellbeing of the elderly, the subjective well-being consists of nine questions from which SUBI score generated for mental health status, which ranges from 9 to 27. This Index indicates that lower the score better is the mental health status. Further, this index modified and generated three categories of Better (9-15), Average (16-20) and Worse (21-27). The reliability analysis is carried out with the coefficient (Cronbach’s alpha) of the scale was 0.8884. The result shows that Orthopedic / musculoskeletal ailments involving arthritis, rheumatism and osteoarthritis are the most common type of ailment followed by hypertension. Two-thirds of the elderly reported suffering from at least one chronic ailment. Most chronic illness conditions received some form of treatment and mainly depend on public health facilities. Financial insecurity is the primary obstruction in seeking treatment for most of the chronic ailments which typically require a longer duration of medication and repeated medical consultations, both having significant economic implications. According to SUBI index, only 15 per cent of the elderly are in Better mental health status, and one-third of the elderly are with the worse score. Elderly with the ailments like Cataract, Asthma and Arthritis have worse mental health. It depicts that the burden of disease is more among the elderly and it is directly affecting the overall wellbeing of older persons.

Keywords: NCD, well-being, older person, India

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Authors: Carlos V. Gonzalez

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Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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Authors: Razia Hossaini, Maryam Hosseini

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Background and Objective: The impact of smoking on the shift in oral microbial composition has been questioned. This study aims to compare the oral microbiome between Turkish patients with dental caries and healthy individuals. Materials and Methods: An observational case-control study was conducted from January to June 2024, involving 270 young adults (180 with dental caries and 90 healthy controls). Participants were matched by age, gender, education, sugar consumption, and tooth brushing habits. Oral samples were collected using sterilized swabs and preserved in a PBS-glycerol solution. The cultured bacterial samples were characterized based on their morphological characteristics, Gram staining properties, hemolysis patterns, and biochemical tests including methyl red, sugar fermentation, Simmons citrate utilization, coagulase production, and catalase activity. These tests were conducted to accurately identify the bacterial species present. Subsequently, the relationship between smoking and oral health was evaluated, with a particular focus on assessing the smoking-induced changes in the composition of the oral microbiota using statistical analyses. Results: The study’s results demonstrate a clear association between smoking and an increased risk of dental caries, as well as significant shifts in the oral microbiota of smokers (p=0.04). These findings emphasize the critical need for public health initiatives that target smoking cessation as a means of improving oral health outcomes. Since smokers are 1.28 times more likely to develop dental caries than non-smokers, public health campaigns should incorporate messages that highlight the direct impact of smoking on oral health, alongside the well-established risks such as lung disease and cardiovascular conditions.The observed alterations in the oral microbiota—specifically the higher prevalence of pathogens like Escherichia coli, Pseudomonas aeruginosa, Streptococcus mutans, and Lactobacillus acidophilus in patients with dental caries—suggest that smoking not only predisposes individuals to dental decay but also creates an environment conducive to the growth of harmful bacteria. Public health interventions could therefore focus on the dual benefit of smoking cessation: reducing the incidence of dental caries and restoring a healthier oral microbiome. Additionally, the reduced presence of beneficial or less pathogenic species such as Neisseria and Micrococcus luteus in smokers implies that smoking alters the protective balance of the oral microbiome. This further underscores the importance of preventive oral health strategies tailored to smokers. Conclusion: Smoking significantly impacts oral health by promoting dysbiosis, increasing cariogenic bacteria, and reducing beneficial bacteria, which contributes to the development of dental caries. These findings highlight the need for integrated public health efforts that address both smoking cessation and oral health promotion. By raising awareness of the specific oral health risks associated with smoking, public health initiatives could help reduce the burden of dental caries and other smoking-related oral diseases, ultimately improving quality of life for individuals and reducing healthcare costs.

Keywords: smoking, dysbiosis, bacteria, oral health, dental decay

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Authors: Mukesh Ravi Raushan

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Despite consideration of obesity as a deadly public health issue contributing 2.6 million deaths worldwide every year developing country like India is facing malnutrition and it is more common than in Sub-Saharan Africa. About one in every three malnourished children in the world lives in India. The paper assess the nutritional health among children using data from total number of 43737 infant and young children aged 0-59 months (µ = 29.54; SD = 17.21) of the selected households by National Family Health Survey, 2005-06. The wasting was measured by a Z-score of standardized weight-for-height according to the WHO child growth standards. The impact of education with place of residence was found to be significantly associated with the complementary food diversity score (CFDS) in India. The education of mother was positively associated with the CFDS but the degree of performance was lower in rural India than their counterpart from urban. The result of binary logistic regression on wasting with WHO seven types of recommended food for children in India suggest that child who consumed the milk product food (OR: 0.87, p<0.0001) were less likely to be malnourished than their counterparts who did not consume, whereas, in case of other food items as the child who consumed food product of seed (OR: 0.75, p<0.0001) were less likely to be malnourished than those who did not. The nutritional status among children were negatively associated with the protein containing complementary food given the child as those child who received pulse in last 24 hour were less likely to be wasted (OR: 0.87, p<0.00001) as compared to the reference categories. The frequency to feed the indexed child increases by 10 per cent the expected change in child health outcome in terms of wasting decreases by 2 per cent in India when place of residence, education, religion, and birth order were controlled. The index gets improved as the risk for malnutrition among children in India decreases.

Keywords: CFDS, food diversity index, India, logistic regression

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Authors: Murat Iskender Aktaş, Sadi Ergin, Rasime Acar Aktaş

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In the light of fast-paced changes and developments in the health sector, the Ministry of Health started a new structuring with decree law numbered 663 within the scope of the Project of Transformation in Health. Accordingly, hospitals should ensure patient satisfaction through more efficient, more effective use of resources and sustainable finance by placing patients in the centre and should operate to increase efficiency to its maximum level while doing these. Within this study, in order to find out how efficient the hospitals were in terms of medical waste management between the years 2011-2014, the data from six hospitals of Amasya Public Hospitals Union were evaluated separately through Data Envelopment Analysis (DEA) method. First of all, input variables were determined. Input variables were the number of patients admitted to polyclinics, the number of inpatients in clinics, the number of patients who were operated and the number of patients who applied to the laboratory. Output variable was the cost of medical wastes in Turkish liras. Each hospital’s total medical waste level before and after public hospitals union; the amounts of average medical waste per patient admitted to polyclinics, per inpatient in clinics, per patient admitted to laboratory and per operated patient were compared within each group. In addition, average medical waste levels and costs were compared for Turkey in general and Europe in general. Paired samples t-test was used to find out whether the changes (increase-decrease) after public hospitals union were statistically significant. The health facilities that were unsuccessful in terms of medical waste management before and after public hospital union and the factors that caused this failure were determined. Based on the results, for each health facility that was ineffective in terms of medical waste management, the level of improvement required for each input was determined. The results of the study showed that there was an improvement in medical waste management applications after the health facilities became a member of public hospitals union; their medical waste levels were lower than the average of Turkey and Europe while the averages of cost of disposal were the highest.

Keywords: medical waste management, cost of medical waste, public hospitals, data envelopment analysis

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Authors: Ayyoub Jamali, Jennie Edlund, Alena Kozlová

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This paper evaluates the monitoring, prevention, and enforcing mechanisms of the core values of international organisations (IOs) in a comparative human rights perspective. The IOs in focus are the European Union, the Council of Europe, the African Union, and the Organization of American States. The paper will take the founding treaties of these IOs and their relevant protocols as a starting point to identify the values and the mechanisms used for their implementation. It will explore the scope of violations, the procedures in place and evaluate what type of response to those breaches seems to work best in terms of achieving its declared objectives. The study will identify and compare the weaknesses and strengths of each mechanism used by the IOs and recognize common challenges and means, thereby drawing inter-organizational comparisons. Consequently, the findings of this paper can be used among the IOs to improve their system and thus enhance their effectiveness.

Keywords: international organizations, core values, human rights, enforcement mechanism, compliance

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Authors: Longtao He, Han Wu

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Summary: As the need for elder care increases in China due to a growing aging population and, in particular, rising cancer rates, it becomes increasingly important to also support family caregivers, who are often the main source of care. We used a qualitative meta-synthesis to systematically evaluate and integrate the caregiving experiences of family caregivers of elderly cancer patients as revealed by articles published in Chinese journals. Findings: Nine studies are included in the final analysis. The caregiver experiences they describe are synthesized into three primary themes: care needs, care burden, and care gains, with numerous secondary themes. Besides the findings that seem to align with other findings across cultures, we have highlighted three main discoveries from the synthesis that may be quite specific to the Chinese context: 1. more sub-themes related to specific caregiving skills caregivers of cancer patients; 2. a call for health professionals to improve their communication skills with family caregivers; 3. the important role of filial piety. Applications: Our findings can be used to help health social workers and relevant policymakers in China support family caregivers by identifying the education and training required for caregivers, ways to make the most of potential care gains, and ways to ease care burdens.

Keywords: cancer, Chinese family caregivers, caregiving skills, care burden, care gains, health social work

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Authors: Olgun Akbulut

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Turkey has entered in the European human rights monitoring in the early 1990s. Since then many improvements have been observed in domestic law. However, one area stays the least developed one: gender discrimination. Although the country is proud of the fact that electoral rights for women were recognized in Turkey even before many developed countries in the west, interestingly the first Turkish case where the European Court of Human Rights (ECrtHR) found discrimination concerned gender discrimination. With the proposed paper, the author is willing to determine and analyze the findings of the ECrtHR in cases decided against Turkey concerning gender discrimination, identify whether Turkish public institutions display coordination in engagement or disengagement in implementing the judgments where the ECrtHR found discrimination on the basis of gender and evaluate the effectiveness of the Court's jurisprudence on Turkish gender policy.

Keywords: equality, gender discrimination, human rights, Turkey

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Authors: Semayat Fanta, P.M. Mohite, C.S. Upadhyay

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Damage meso-model for laminates is one of the most widely applicable approaches for the analysis of damage induced in laminated fiber-reinforced polymeric composites. Damage meso-model for laminates has been developed over the last three decades by many researchers in experimental, theoretical, and analytical methods that have been carried out in micromechanics as well as meso-mechanics analysis approaches. It has been fundamentally developed based on the micromechanical description that aims to predict the damage initiation and evolution until the failure of structure in various loading conditions. The current damage meso-model for laminates aimed to act as a bridge between micromechanics and macro-mechanics of the laminated composite structure. This model considers two meso-constituents for the analysis of damage in ply and interface that imparted from low-velocity impact. The damages considered in this study include fiber breakage, matrix cracking, and diffused damage of the lamina, and delamination of the interface. The damage initiation and evolution in laminae can be modeled in terms of damaged strain energy density using damage parameters and the thermodynamic irreversible forces. Interface damage can be modeled with a new concept of spherical micro-void in the resin-rich zone of interface material. The damage evolution is controlled by the damage parameter (d) and the radius of micro-void (r) from the point of damage nucleation to its saturation. The constitutive martial model for meso-constituents is defined in a user material subroutine VUMAT and implemented in ABAQUS/Explicit finite element modeling tool. The model predicts the damages in the meso-constituents level very accurately and is considered the most effective technique of modeling low-velocity impact simulation for laminated composite structures.

Keywords: mesomodel, laminate, low-energy impact, micromechanics

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Authors: Sultan Alanazi, Adwan Alanazi

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Social applications consist of powerful tools that allow people to connect and interact with each other. However, its negative use cannot be ignored. Cyberbullying is a new and serious Internet problem. Cyberbullying is one of the most common risks for teenagers to go online. More than half of young people report that they do not tell their parents when this will occur, which can have significant physiological consequences. Cyberbullying involves the deliberate use of digital media on the Internet to convey false or embarrassing information about others. Therefore, this article provides a way to detect cyber-bullying in social media applications for parents. The purpose of our work is to develop an architectural model for identifying and measuring the state of Cyberbullying faced by children on social media applications. For parents, this will be a good tool for monitoring their children without invading their privacy. Finally, some interesting open-ended questions were raised, suggesting promising ideas for starting new research in this new field.

Keywords: cyberbullying, cyber bullying, internet crimes, social media security, E-crimes

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Authors: Arjmand Khaliq, Pemra Sohaib

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In this paper smart grid technologies which converts conventional grid into smart grid has been discussed. Integration of advanced technologies including two way communication, advanced control system, sensors, smart metering system and other provide opportunity to make conventional grid a intelligent and automatic system which is named as smart grid. This paper gives the concept of smart grid and functional characteristics of smart grid technology, summed up the research progress in Pakistan and abroad and the significance of developing smart grid. Based on the analysis of the smart grid, smart grid technologies will result a reliable and energy efficient power system in the future. On the other hand smart grid technologies have been reviewed in this paper highlighting the key technologies of smart grid, and points out the problems and challenges in the realization of smart grid.

Keywords: energy, power system reliability, power system monitoring and control, sensor, smart grid, two-way communication

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