Search results for: primary health care facilities

Authors: Asrat Agalu Abejew

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Background: Antimicrobial resistance (AMR) is a silent tsunami and one of the top global threats to health care and public health. It is one of the common agendas globally and in Ethiopia. Emerging AMR will be a double burden to Ethiopia, which is facing a series of problems from infectious disease morbidity and mortality. In Ethiopia, although there are attempts to document AMR in healthcare institutions, comprehensive and all-inclusive analysis is still lacking. Thus, this study is aimed to determine trends in AMR from 2016-2021. Methods: A retrospective analysis of secondary data recorded in the Amhara Public Health Institute (APHI) from 2016 to 2021 G.C was conducted. Blood, Urine, Stool, Swabs, Discharge, body effusions, and other Microbiological specimens were collected from each study participants, and Bacteria identification and Resistance tests were done using the standard microbiologic procedure. Data was extracted from excel in August 2022, Trends in AMR were analyzed, and the results were described. In addition, the chi-square (X2) test and binary logistic regression were used, and a P. value < 0.05 was used to determine a significant association. Results: During 6 years period, there were 25143 culture and susceptibility tests. Overall, 265 (46.2%) bacteria were resistant to 2-4 antibiotics, 253 (44.2%) to 5-7 antibiotics, and 56 (9.7%) to >=8 antibiotics. The gram-negative bacteria were 166 (43.9%), 155 (41.5%), and 55 (14.6%) resistant to 2-4, 5-7, and ≥8 antibiotics, respectively, whereas 99(50.8%), 96(49.2% and 1 (0.5%) of gram-positive bacteria were resistant to 2-4, 5-7 and ≥8 antibiotics respectively. K. pneumonia 3783 (15.67%) and E. coli 3199 (13.25%) were the most commonly isolated bacteria, and the overall prevalence of AMR was 2605 (59.9%), where K. pneumonia 743 (80.24%), E. cloacae 196 (74.81%), A. baumannii 213 (66.56%) being the most common resistant bacteria for antibiotics tested. Except for a slight decline during 2020 (6469 (25.4%)), the overall trend of AMR is rising from year to year, with a peak in 2019 (8480 (33.7%)) and in 2021 (7508 (29.9%). If left un-intervened, the trend in AMR will increase by 78% of variation from the study period, as explained by the differences in years (R2=0.7799). Ampicillin, Augmentin, ciprofloxacin, cotrimoxazole, tetracycline, and Tobramycin were almost resistant to common bacteria they were tested. Conclusion: AMR is linearly increasing during the last 6 years. If left as it is without appropriate intervention after 15 years (2030 E.C), AMR will increase by 338.7%. A growing number of multi-drug resistant bacteria is an alarm to awake policymakers and those who do have the concern to intervene before it is too late. This calls for a periodic, integrated, and continuous system to determine the prevalence of AMR in commonly used antibiotics.

Keywords: AMR, trend, pattern, MDR

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Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

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Authors: Alexandra Telitsyna, Galina Semya, Elvira Garifulina

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Introduction: Starting from 2012 Russia conducts deinstitutionalization policy and now the main indicator of success is the number of children living in institutions. Active family placement process has resulted in residents of the institution now mainly consists of adolescents with behavioral and emotional problems, children with disabilities and groups of siblings. Purpose of science research: The purpose of science research is to identify factors for child’s wellbeing while temporary stay in an orphanage and the subjective assessment of children's level of well-being (psychological well-being). Methods: The data used for this project was collected by the questionnaire of 72 indicators, a tool for monitoring the behavior of children and caregivers, an additional questionnaire for children; well-being assessment questionnaire containing 10 scales for three age groups from preschool to older adolescents. In 2016-2018, the research was conducted in 1873 institution in 85 regions of Russia. In each region a team of academics, specialists from Non-profits, independent experts was created. Training was conducted for team members through a series of webinars prior to undertaking the assessment. The results: To ensure the well-being of the children, the following conditions are necessary: 1- Life of children in institution is organised according to the principles of family care (including the creation of conditions for attachment to be formed); 2- Contribution to find family-based placement for children (including reintegration into the primary family); 3- Work with parents of children, who are placed in an organization at the request of parents; 4- Children attend schools according to their needs; 5- Training of staff and volunteers; 6- Special environment and services for children with special needs and children with disabilities; 7- Cooperation with NGOs; 8 - Openness and accessibility of the organization. Conclusion: A study of the psychological well-being of children showed that the most emotionally stressful for children were questions about the presence and frequency of contact with relatives, and the level of well-being is higher in the presence of a trusted adult and respect for rights. The greatest contribution to the trouble is made by the time the child is in the orphanage, the lack of contact with parents and relatives, the uncertainty of the future.

Keywords: identifying factors, orphans, Russia, wellbeing

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Authors: Kyung-Sook Bang

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Background: The health status of school-age children has a great influence on their growth and life-long health. The purposes of this study were to identify physical and mental health status of late school-age children in Seoul, South Korea and to investigate the related factors for their health. Methods: After gaining the approval from Institutional Review Board (IRB), a cross-sectional study was conducted with elementary students in grade 4 or 5. Questionnaires were distributed to eight elementary schools located different regions of Seoul in November, 2016, and 302 participants were finally included. From all participants, informed consents from the parents, and assents from children were received. Children's socioeconomic status, family functioning, peer relations, physical health symptoms, and depression were measured with self-reported questionnaires. Data were analyzed with descriptive statistics, t-test, Pearson’s correlations, and multiple regression. Results: Children's physical health symptoms and depression were not significantly different, and only their peer relations were significantly different according to their socioeconomic status (t=-3.93, p<.001). Depression showed significant positive correlation with physical health symptoms (r=.720, p<.001) and negative correlations with family functioning (r=-.428, p<.001) and peer relations (r=-.775, p<.001). The multiple regression model, which explained 73.5% of variance, showed peer relations (r2 =.604), physical health symptoms (r2 change=.125), and family functioning (r2 change=.005) as significant predictors for depression. Only the peer relations was significant predictor for their physical health symptoms and explained 50.6% of it. Conclusions: The peer relations was the most important factor in their physical and mental health at this age, and it can be affected by their socioeconomic status. Nursing interventions for promoting social relations and family functioning are required to improve children’s physical and mental health, especially for vulnerable population.

Keywords: child, depression, health, peer relation

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Authors: Talha Shafiq

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The traditional electricity operation in solar thermal plants is designed to operate on a single path initiating at power plant and executes at the consumer. Due to lack of energy storage facilities during this operation, a decrease in the efficiency is often observed with the power plant performance. This paper reviews the significance of energy storage in supply design and elaborates various methods that can be adopted in this regard which are equally cost effective and environmental friendly. Moreover, various parameters in thermal storage technique are also critically analyzed to clarify the pros and cons in this facility. Discussing the different thermal storage system, their technical and economical evaluation has also been reviewed.

Keywords: thermal energy storage, sensible heat storage, latent heat storage, thermochemical heat storage

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Authors: Saeed Alshahri

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Introduction: Our study aims to estimate the characteristics & causes of TSCI at King Fahad Medical City (KFMC) in Riyadh city in order to hypothesize strategy for primary prevention of traumatic spinal cord injury. Method: Cross-sectional, retrospective study was conducted on all TSCI patients who aged 14 and above and who were admitted to rehabilitation center of King Fahad Medical City from January 2012 to December 2015. Furthermore, a descriptive analysis was conducted while considering factors including age, gender, marital status, educational level and causes of injury and characteristics of injury. Results: Total of 216 patients were admitted during this period, mean age was 28.94, majority of patients were male (86.5%), 71.7% of total patients were high school level of education or less, 68% were single, RTA was the main cause with 90.7% and the main result of TSCI was complete paraplegia 37%. Furthermore, statistically, we found that males are at a low risk of having incomplete paraplegia compared to female (p = 0.035, RRR=0.35). Conclusion: The rate of TSCI related to RTA has increased in Saudi Arabia in previous years despite the government’s efforts to decrease RTA. It’s clear that we need TSCI registry data developed on the basis of international data standards to have a clear idea about the exact etiology of TSCI in Saudi Arabia. This will assist in planning for primary prevention.

Keywords: traumatic spinal cord injury, road traffic accident, Saudi Arabia, spinal cord injury

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Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

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Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

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Authors: Leena Inamdar, David Allen, Sushma Acquilla, James Gore

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Health systems globally are facing increasingly complex challenges. Emerging health threats, changing population demographics and increasing health inequalities, globalisation, economic constraints on government spending are some of the most critical ones. These challenges demand not only innovative funding and cross-sectoral approaches, but also require a multidisciplinary public health workforce equipped with skills and expertise to meet the future challenges of the Sustainable Development Goals (SDGs). We aim to outline an approach to assessing the feasibility of establishing a competency-based public health training at a country level. Although the SDGs provide an enabling impetus for change and promote positive developments, public health training and education still lag behind. Large gaps are apparent in both the numbers of trained professionals and the options for high quality training. Public health training in most Low-Middle Income Countries is still largely characterized by a traditional and limited public health focus. There is a pressing need to review and develop core and emerging competences for a well-equipped workforce fit for the future. This includes the important role of national Health and Human Resource Ministries in determining these competences. Public health has long been recognised as a multidisciplinary field, with need for professionals from a wider range of disciplines such as management, health promotion, health economics, law. Leadership and communication skills are also critical to achieve the successes in meeting public health outcomes. Such skills and competences need to be translated into competency-based training and education, to prepare current public health professionals with the skills required in today’s competitive job market. Integration of academic and service based public-health training, flexible accredited programmes to support existing mid-career professionals, continuous professional development need to be explored. In the current global climate of austerity and increasing demands on health systems, the need for stepping up public health training and education is more important than ever. By using a case study, we demonstrate the process of assessing the in-county capacity to establish a competency based public health training programme that will help to develop a stronger, more versatile and much needed public health workforce to meet the SDGs.

Keywords: public health training, competency-based, assessment, SDGs

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Authors: Margherita Cardellini

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To our knowledge, dark skinned children are often victims of discrimination from adults and society, but few studies specifically focus on skin color discrimination on children coming from the same children. Even today, the 'color blind children' ideology is widespread among adults, teachers, and educators and maybe also among scholars, which seem really careful about study expressions of racism in childhood. This social and cultural belief let people think that all the children, because of their age and their brief experience in the world, are disinterested in skin color. Sometimes adults think that children are even incapable of perceiving skin colors and that it could be dangerous to talk about melaninic differences with them because they finally could notice this difference, producing prejudices and racism. Psychology and neurology research projects are showing for many years that even the newborns are already capable of perceiving skin color and ethnic differences by the age of 3 months. Starting from this theoretical framework we conducted a research project to understand if and how primary school children talk about skin colors, picking up any stereotypes or prejudices. Choosing to use the focus group as a methodology to stimulate the group dimension and interaction, several stories about skin color discrimination's episodes within their classroom or school have emerged. Using the photo elicitation technique we chose to stimulate talk about the research object, which is the skin color, asking the children what was ‘the first two things that come into your mind’ when they look the photographs presented during the focus group, which represented dark and light skinned women and men. So, this paper will present some of these stories about episodes of discrimination with an escalation grade of proximity related to the discriminatory act. It will be presented a story of discrimination happened within the school, in an after-school daycare, in the classroom and even episode of discrimination that children tell during the focus groups in the presence of the discriminated child. If it is true that the Declaration of the Right of the Child state that every child should be discrimination free, it’s also true that every adult should protect children from every form of discrimination. How, as adults, can we defend children against discrimination if we cannot admit that even children are potential discrimination’s actors? Without awareness, we risk to devalue these episodes, implicitly confident that the only way to fight against discrimination is to keep her quiet. The right not to be discriminated goes through the right to talk about its own experiences of discrimination and the right to perceive the unfairness of the constant depreciation about skin color or any element of physical diversity. Intercultural education could act as spokesperson for this mission in the belief that difference and plurality could really become elements of potential enrichment for humanity, starting from children.

Keywords: colorism, experiences of discrimination, primary school children, skin color discrimination

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Authors: Jenny Clift, Rebeccah Sokol, LaTricia Mitchell, Nicholas Alexander, Karissa Rusnick

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Aims: This study sought to identify prevalent promotive factors supporting urban adolescent health and wellbeing, per adolescent and caregiver reports. Setting: The research team conducted online surveys with adolescent (n=520) and caregiver (n=73) respondents from a predominately Latinx urban high school. Methodology: A cross-sectional, qualitative study. Analysis: Inductive thematic analysis was used to analyze responses to open-ended questions. -Findings. Adolescent and caregiver respondents identified promotive factors (eight and six, respectively) that encourage adolescent health and well-being. Supportive relationships were the most frequently reported factor among adolescents (68%) and caregivers (55%). Implications: Health promotion interventions among adolescents should consider how to promote relationships to counteract negative social determinants of health (SDH) and promote optimal quality of life.

Keywords: Latinx adolescents, health and wellbeing, social determinants of health, school

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Authors: Jia Xue, Frederica G. Lamar, Siyu Lin, Jennifer G. Lamori, Samendra Sherchan

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Brackish water samples from Lake Pontchartrain in Louisiana were assessed for the presence of pathogenic amoeba Naegleria fowleri, which causes primary amoebic meningoencephalitis (PAM). In our study, quantitative polymerase chain reaction (qPCR) methods were used to determine N. fowleri, E. coli, and Enterococcus in water collected from Lake Pontchartrain. A total of 158 water samples were analyzed over the 10-month sampling period. Statistically significant positive correlation between water temperature and N. fowleri concentration was observed. N. fowleri target sequence was detected at 35.4% (56/158) of the water samples from ten sites around the Lake ranged from 11.6 GC/100 ml water to 457.8 GC/100 ml water. A single factor (ANOVA) analysis shows the average concentration of N. fowleri in summer (119.8 GC/100 ml) was significantly higher than in winter (58.6 GC/100 ml) (p < 0.01). Statistically significant positive correlations were found between N. fowleri and qPCR E. coli results and N. fowleri and colilert E. coli (culture method), respectively. A weak positive correlation between E. coli and Enterococcus was observed from both qPCR (r = 0.27, p < 0.05) and culture based method (r = 0.52, p < 0.05). Meanwhile, significant positive correlation between qPCR and culture based methods for E. coli (r = 0.30, p < 0.05) and Enterococcus concentration was observed (r = 0.26, p < 0.05), respectively. Future research is needed to determine whether sediment is a source of N. fowleri found in the water column.

Keywords: brackish water, Escherichia coli, Enterococcus, Naegleria fowleri, primary amoebic meningoencephalitis (PAM), qPCR

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Authors: Nassim Salmi

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This study aimed to identify the administrative, social, cultural, economic and psychological challenges facing the nursing s ector in the Tebessa Algeria. It also seeks to identify whether there are differences between the opinions of managers in public and private hospitals about these challenges. To achieve the objectives of the study, the descriptive analytical method was adopted. The study also used the questionnaire as a tool for collecting the necessary data and information, which was applied to a sample of directors of public and private hospitals in the Tebessa, which amounted to (114) individuals. The study reached a set of results, including: that there are no statistically significant differences between the opinions of managers in public and private hospitals about the administrative, social, cultural, economic and psychological challenges facing the nursing sector in the Tebessa . The results also showed agreement between the views of managers in private public hospitals that the most important administrative challenges are the lack of training programs that affect the efficiency and performance of nursing work, and that the most important social and cultural challenges are the hospital’s failure to provide suitable nurseries for Saudi female nurses, and that the most important economic challenges are the lack of Availability of medical equipment and devices, and the most important psychological challenge is the tense relationship between the administration and the hospital's nursing staff. The study recommended focusing on the importance of rehabilitation and training together, activating the role of training in the ministry and making it compulsory and a condition of renewal for practicing and continuing the nursing profession, and providing the social and economic needs of the nursing staff.

Keywords: postoperative care, gynecology, nursing documentation, database

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Nora Kuiper, Candace Rowell, Hugues Preud'Homme, Basem Shomar

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As the global dependence on seawater desalination as a primary drinking water resource increases, a unique class of secondary pollutants is emerging. The presence of bromide salts in seawater may result in increased levels of bromine and brominated byproducts in drinking water. The State of Qatar offers a unique setting to study these pollutants and their impacts on consumers as the country is 100% dependent on seawater desalination to supply municipal tap water and locally produced bottled water. Tap water (n=115) and bottled water (n=62) samples were collected throughout the State of Qatar and analyzed for a suite of inorganic and organic compounds, including 54 volatile organic compounds (VOCs), with an emphasis on brominated byproducts. All VOC identification and quantification was completed using a Bruker Scion GCMSMS with static headspace technologies. A risk survey tool was used to collect information regarding local consumption habits, health outcomes and perception of water sources for adults and children. This study is the first of its kind in the country. Dibromomethane, bromoform, and bromobenzene were detected in 61%, 88% and 2%, of the drinking water samples analyzed. The levels of dibromomethane ranged from approximately 100-500 ng/L and the concentrations of bromoform ranged from approximately 5-50 µg/L. Additionally, bromobenzene concentrations were 60 ng/L. The presence of brominated compounds in drinking water is a public health concern specific to populations using seawater as a feed water source and may pose unique risks that have not been previously studied. Risk assessments are ongoing to quantify the risks associated with prolonged consumption of disinfection byproducts; specifically the risks of brominated trihalomethanes as the levels of bromoform found in Qatar’s drinking water reach more than 60% of the US EPA’s Maximum Contaminant Level of all THMs.

Keywords: brominated byproducts, desalination, trihalomethanes, risk assessment

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Authors: Yi Yin Chen, Changsoo Hur

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This study explores the role of totems and decorative texts on an indigenous primary school campus in Taiwan, as well as how they affect the building of the cultural identity of indigenous students. By employing Roland Barthes' semiotic theory, this research aims to uncover the cultural meanings and social functions contained in these visual symbols, as well as their significance for building a cultural identity among indigenous students. The study uses a qualitative method, combining observations, interviews, and document analysis to explore how these symbols perform as carriers of hidden meaning and contribute to educational and cultural settings. The findings show that totems on the indigenous school campus reflect the ethnic group's cultural background knowledge, allowing students to study their cultural heritage and providing a sense of belonging. However, certain textual decorations also reflect the historical influence of the hegemonic government attempting to establish moral norms in the ethnic group. This coexistence of traditional ethnic totems and hegemonic textual admonitions in the school environment creates a complex identity landscape for students, leading to a multiplicity of cultural identities. It underlines the importance of culturally relevant symbols in enhancing students' cultural heritage and identity and presents the challenges posed by conflicting cultural messages within the educational context.

Keywords: Roland Barthes, semiotic, Indigenous, Bunun

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Authors: Rose A. Yemson, Ping Jiang, Oyedeji L. Inumoh

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The deployment of wireless sensor network has rapidly increased, however with the increased capacity and diversity of sensors, and applications ranging from biological, environmental, military etc. generates tremendous volume of data’s where more attention is placed on the distributed sensing and little on how to manage, analyze, retrieve and understand the data generated. This makes it more quite difficult to process live sensor data, run concurrent control and update because sensor data are either heavyweight, complex, and slow. This work will focus on developing a web service platform for automatic detection of sensors, acquisition of sensor data, storage of sensor data into a database, processing of sensor data using reconfigurable software components. This work will also create a web service based sensor data management system to monitor physical movement of an individual wearing wireless network sensor technology (SunSPOT). The sensor will detect movement of that individual by sensing the acceleration in the direction of X, Y and Z axes accordingly and then send the sensed reading to a database that will be interfaced with an internet platform. The collected sensed data will determine the posture of the person such as standing, sitting and lying down. The system is designed using the Unified Modeling Language (UML) and implemented using Java, JavaScript, html and MySQL. This system allows real time monitoring an individual closely and obtain their physical activity details without been physically presence for in-situ measurement which enables you to work remotely instead of the time consuming check of an individual. These details can help in evaluating an individual’s physical activity and generate feedback on medication. It can also help in keeping track of any mandatory physical activities required to be done by the individuals. These evaluations and feedback can help in maintaining a better health status of the individual and providing improved health care.

Keywords: HTML, java, javascript, MySQL, sunspot, UML, web-based, wireless network sensor

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Authors: Zhang Kehan, Du Luona

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Wireless power transfer (WPT) systems have been widely investigated for advantages of convenience and safety compared to traditional plug-in charging systems. The research contents include impedance matching, circuit topology, transfer distance et al. for improving the efficiency of WPT system, which is a decisive factor in the practical application. What is more, coil structures such as spiral circular coil and helical coil with variable distance between two turns also have indispensable effects on the efficiency of WPT systems. This paper compares the efficiency of WPT systems utilizing spiral or helical coil with variable distance between two turns, and experimental results show that efficiency of spiral circular coil with an optimum distance between two turns is the highest. According to efficiency formula of resonant WPT system with series-series topology, we introduce M²/R₋₁ to measure the efficiency of spiral circular coil and helical coil WPT system. If the distance between two turns s is too close, proximity effect theory shows that the induced current in the conductor, caused by a variable flux created by the current flows in the skin of vicinity conductor, is the opposite direction of source current and has assignable impart on coil resistance. Thus in two coil structures, s affects coil resistance. At the same time, when the distance between primary and secondary coils is not variable, s can also make the influence on M to some degrees. The aforementioned study proves that s plays an indispensable role in changing M²/R₋₁ and then can be adjusted to find the optimum value with which WPT system achieves the highest efficiency. In actual application situations of WPT systems especially in underwater vehicles, miniaturization is one vital issue in designing WPT system structures. Limited by system size, the largest external radius of spiral circular coil is 100 mm, and the largest height of helical coil is 40 mm. In other words, the turn of coil N changes with s. In spiral circular and helical structures, the distance between each two turns in secondary coil is set as a constant value 1 mm to guarantee that the R2 is not variable. Based on the analysis above, we set up spiral circular coil and helical coil model using COMSOL to analyze the value of M²/R₋₁ when the distance between each two turns in primary coil sp varies from 0 mm to 10 mm. In the two structure models, the distance between primary and secondary coils is 50 mm and wire diameter is chosen as 1.5 mm. The turn of coil in secondary coil are 27 in helical coil model and 20 in spiral circular coil model. The best value of s in helical coil structure and spiral circular coil structure are 1 mm and 2 mm respectively, in which the value of M²/R₋₁ is the largest. It is obviously to select spiral circular coil as the first choice to design the WPT system for that the value of M²/R₋₁ in spiral circular coil is larger than that in helical coil under the same condition.

Keywords: distance between two turns, helical coil, spiral circular coil, wireless power transfer

Procedia PDF Downloads 336

Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

Procedia PDF Downloads 289

Authors: Cebrail Çiflikli, Emre Öner Tartan

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Parallel to the fast worldwide increase of elderly population and spreading unhealthy life habits, there is a significant rise in the number of patients and health problems. The supervision of people who have health problems and oversight in detection of people who have potential risks, bring a considerable cost to health system and increase workload of physician. To provide an efficient solution to this problem, in the recent years mobile applications have shown their potential for wide usage in health monitoring. In this paper we present an Android mobile application that records and evaluates ECG signal using Pan-Tompkins algorithm for QRS detection. The application model includes an alarm mechanism that is proposed to be used for sending message including abnormality information and location information to health supervisor.

Keywords: Android mobile application, ECG monitoring, QRS detection, Pan-Tompkins Algorithm

Procedia PDF Downloads 225

Authors: Sarwat Jahan, Asker Rajin Rahman

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Management of offtake of any fluvial river is very sensitive in terms of long-term sustainability where the variation of water flow and sediment transport range are wide enough throughout a hydrological year. The Gorai River is a major distributary of the Ganges River in Bangladesh and is termed as a primary source of fresh water for the South-West part of the country. Every year, significant siltation of the Gorai offtake disconnects it from the Ganges during the dry season. As a result, the socio-economic and environmental condition of the downstream areas has been deteriorating for a few decades. To improve the overall situation of the Gorai offtake and its dependent areas, a study has been conducted by the Institute of Water Modelling, Bangladesh, in 2022. Using the mathematical morphological modeling tool MIKE 21C of DHI Water & Environment, Denmark, simulated results revealed the need for dredging/river training structures for offtake management at the Gorai offtake to ensure significant dry season flow towards the downstream. The dry season flow is found to increase significantly with the proposed river interventions, which also improves the environmental conditions in terms of salinity of the South-West zone of the country. This paper summarizes the primary findings of the analyzed results of the developed mathematical model for improving the existing condition of the Gorai River.

Keywords: Gorai river, mathematical modelling, offtake, siltation, salinity

Procedia PDF Downloads 88

Authors: Jessica Hemberg, Amanda Sundqvist, Yulia Korzhina, Lillemor Östman, Sofia Gylfe, Frida Gädda, Lisbet Nyström, Henrik Groundstroem, Pia Nyman-Kurkiala

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Purpose: There are large gaps in the literature on COVID-19 pandemic-related mental health outcomes and after-effects specific to adolescents and young adults. The study's aim was to explore adolescents’ and young adults’ experiences of well-being, health, and loneliness during the COVID-19 pandemic. Method: A qualitative exploratory design with qualitative content analysis was used. Twenty-three participants (aged 19-27; four men and 19 women) were interviewed. Results: Four themes emerged: Changed social networks – fewer and closer contacts, changed mental and physical health, increased physical and social loneliness, well-being, internal growth, and need for support. Conclusion: Adolescents’ and young adults’ experiences of well-being, health, and loneliness are subtle and complex. Participants experienced changed social networks, mental and physical health, and well-being. Also, internal growth, need for support, and increased loneliness were seen. Clear information on how to seek help and support from professionals should be made available.

Keywords: adolescents, COVID-19 pandemic, health, interviews, loneliness, qualitative, well-being, young adults

Procedia PDF Downloads 86

Authors: Amy Gooden

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Various modes of consent have been utilized in health research, but open consent has not been explored in South Africa’s AI research context. Open consent entails the sharing of data without assurances of privacy and may be seen as an attempt to marry open science with informed consent. Because all potential uses of data are unknown, it has been questioned whether consent can be informed. Instead of trying to adapt existing modes of consent, why not adopt a new perspective? This is what open consent proposes and what this research will explore in AI health research in South Africa.

Keywords: artificial intelligence, consent, health, law, research, South Africa

Procedia PDF Downloads 147

Authors: Ali Shirazi, Robert A. Taylor, Stephen D. White, Graham L. Morrison

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In this paper, a detailed simulation model of a solar-powered triple-effect LiBr–H₂O absorption chiller is developed to supply both cooling and heating demand of a large-scale building, aiming to reduce the fossil fuel consumption and greenhouse gas emissions in building sector. TRNSYS 17 is used to simulate the performance of the system over a typical year. A combined energetic-economic-environmental analysis is conducted to determine the system annual primary energy consumption and the total cost, which are considered as two conflicting objectives. A multi-objective optimization of the system is performed using a genetic algorithm to minimize these objectives simultaneously. The optimization results show that the final optimal design of the proposed plant has a solar fraction of 72% and leads to an annual primary energy saving of 0.69 GWh and annual CO₂ emissions reduction of ~166 tonnes, as compared to a conventional HVAC system. The economics of this design, however, is not appealing without public funding, which is often the case for many renewable energy systems. The results show that a good funding policy is required in order for these technologies to achieve satisfactory payback periods within the lifetime of the plant.

Keywords: economic, environmental, multi-objective optimization, solar air-conditioning, triple-effect absorption chiller

Procedia PDF Downloads 232

Authors: Ivy Jeralyn T. Andres, Eva B. Macugay

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Using a descriptive research design utilizing the Research and Development (R&D) methodology, this study focused on the development of Reproductive Health Education (RHE) Toolkit for Science Teachers that provides a guide in teaching reproductive health. Based on the findings, the teacher-respondents identified nine topics that can be included in the development of the RHE toolkit. The topics included are The Male Reproductive System, The Female Reproductive System, The Roles of Hormones in Male and Female Reproductive System, Menstrual Cycle, Fertilization, Pregnancy and Childbirth, Breastfeeding, Human Reproductive and Developmental Concerns and Reproductive Health Management and Diseases. The developed RHE Toolkit is remarked as very highly valid and very highly acceptable learning material. The validators and evaluators acknowledged the developed RHE toolkit as clear, creative, and academically useful supplemental material for educating reproductive health. Moreover, it follows the principles of SMART objectives, factual, timely, and relevant content for both learners and the community as a whole. Science teachers should employ the RHE Toolkit in teaching reproductive health education into their respective classes. It is also suggested that the developed RHE toolkit can be implemented to elementary pupils and the community, particularly in rural areas.

Keywords: reproductive health education, toolkit, science teachers, supplemental material

Procedia PDF Downloads 75

Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

Procedia PDF Downloads 75

Authors: Anja Gräff, Stefan Holzer, Manfred Höld, Jörn Stumpenhausen, Heinz Bernhardt

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In view of the increasing quantity of 'green energy' from renewable raw materials and photovoltaic facilities, it is quite conceivable that power supply variations may occur, so that constantly working machines like automatic milking systems (AMS) may break down temporarily. The usage of farm-made energy is steadily increasing in order to keep energy costs as low as possible. As a result, power cuts are likely to happen more frequently. Current work in the framework of the project 'stable 4.0' focuses on possible stress reactions by simulating power cuts up to four hours in dairy farms. Based on heart activity it should be found out whether stress on dairy cows increases under these circumstances. In order to simulate a power cut, 12 random cows out of 2 herds were not admitted to the AMS for at least two hours on three consecutive days. The heart rates of the cows were measured and the collected data evaluated with HRV Program Kubios Version 2.1 on the basis of eight parameters (HR, RMSSD, pNN50, SD1, SD2, LF, HF and LF/HF). Furthermore, stress reactions were examined closely via video analysis, milk yield, ruminant activity, pedometer and measurements of cortisol metabolites. Concluding it turned out, that during the test only some animals were suffering from minor stress symptoms, when they tried to get into the AMS at their regular milking time, but couldn´t be milked because the system was manipulated. However, the stress level during a regular “time-dependent milking rejection” was just as high. So the study comes to the conclusion, that the low psychological stress level in the case of a 2-4 hours failure of an AMS does not have any impact on animal welfare and health.

Keywords: dairy cow, heart activity, power cut, stable 4.0

Procedia PDF Downloads 307

Authors: Omer Zvi Shaked, Amir Tirosh

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Type 1 Diabetes (T1DM) is an incurable chronic illness with no known preventive measures. Excess to insulin therapy can lead to hypoglycemia with neuro-glycogenic symptoms such as shakiness, nausea, sweating, irritability, fatigue, excessive thirst or hunger, weakness, seizure, and coma. Severe Hypoglycemia (SH) is also considered a most aversive event since it may put patients at risk for injury and death, which matches the criteria of a traumatic event. SH has a ranging prevalence of 20%, which makes it a primary medical Issue. One of the results of SH is an intense emotional fear reaction resembling the form of post-traumatic stress symptoms (PTS), causing many patients to avoid insulin therapy and social activities in order to avoid the possibility of hypoglycemia. As a result, they are at risk for irreversible health deterioration and medical complications. Fear of Hypoglycemia (FOH) is, therefore, a major disturbance for T1DM patients. FOH differs from prevalent post-traumatic stress reactions to other forms of traumatic events since the threat to life continuously exists in the patient's body. That is, it is highly probable that orthodox interventions may not be sufficient for helping patients after SH to regain healthy social function and proper medical treatment. Accordingly, the current presentation will demonstrate the results of a study conducted among T1DM patients after SH. The study was designed in two stages. First, a preliminary qualitative phenomenological study among ten patients after SH was conducted. Analysis revealed that after SH, patients confuse between stress symptoms and Hypoglycemia symptoms, divide life before and after the event, report a constant sense of fear, a loss of freedom, a significant decrease in social functioning, a catastrophic thinking pattern, a dichotomous split between the self and the body, and internalization of illness identity, a loss of internal locus of control, a damaged self-representation, and severe loneliness for never being understood by others. The second stage was a two steps study of intervention among five patients after SH. The first part of the intervention included three months of therapeutic 3rd wave CBT therapy. The contents of the therapeutic process were: acceptance of fear and tolerance to stress; cognitive de-fusion combined with emotional self-regulation; the adoption of an active position relying on personal values; and self-compassion. Then, the intervention included a one-week practical real-time 24/7 support by trained medical personnel, alongside a gradual exposure to increased insulin therapy in a protected environment. The results of the intervention are a decrease in stress symptoms, increased social functioning, increased well-being, and decreased avoidance of medical treatment. The presentation will discuss the unique emotional state of T1DM patients after SH. Then, the presentation will discuss the effectiveness of the intervention for patients with chronic conditions after a traumatic event. The presentation will make evident the unique situation of illness-related PTSD. The presentation will also demonstrate the requirement for multi-professional collaboration between social work and medical care for populations with chronic medical conditions. Limitations of the study and recommendations for further research will be discussed.

Keywords: type 1 diabetes, chronic illness, post-traumatic stress, illness-related PTSD

Procedia PDF Downloads 170

Authors: Satoko Yamasaki, Hiromi Kawasaki, Kotomi Yamashita, Susumu Fukita, Kei Sounai

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People are susceptible to rumors when the cause of their health problems is unknown or invisible. In order for individuals to be unaffected by rumors, they need basic knowledge and correct information. Community health nursing classes use cases where basic knowledge of radiation can be utilized on a regular basis, thereby teaching that basic knowledge is important in preventing anxiety caused by rumors. Nursing students need to learn that preventive activities are essential for public health nursing care. This is the same methodology used to reduce COVID-19 anxiety among individuals. This study verifies the learning effect concerning the basic knowledge of radiation necessary for case consultation by emergency distance learning. Sixty third-year nursing college students agreed to participate in this research. The knowledge tests conducted before and after classes were compared, with the chi-square test used for testing. There were five knowledge questions regarding distance lessons. This was considered to be 5% significant. The students’ reports which describe the results of responding to health consultations, were analyzed qualitatively and descriptively. In this case study, a person living in an area not affected by radiation was anxious about drinking water and, thus, consulted with a student. The contents of the lecture were selected the minimum amount of knowledge used for the answers of the consultant; specifically hot spots, internal exposure risk, food safety, characteristics of cesium-137, and precautions for counselors. Before taking the class, the most correctly answered question by students concerned daily behavior at risk of internal exposure (52.2%). The question with the fewest correct answers was the selection of places that are likely to be hot spots (3.4%). All responses increased significantly after taking the class (p < 0.001). The answers to the counselors, as written by the students, were 'Cesium is strongly bound to the soil, so it is difficult to transfer to water' and 'Water quality test results of tap water are posted on the city's website.' These were concrete answers obtained by using specialized knowledge. Even in emergency distance learning, the students gained basic knowledge regarding radiation and created a document to utilize said knowledge while assuming the situation concretely. It was thought that the flipped classroom method, even if conducted remotely, could maintain students' learning. It was thought that setting specific knowledge and scenes to be used would enhance the learning effect. By changing the case to concern that of the anxiety caused by infectious diseases, students may be able to effectively gain the basic knowledge to decrease the anxiety of residents due to infectious diseases.

Keywords: effect of class, emergency distance learning, nursing student, radiation

Procedia PDF Downloads 109

Authors: Alex Vakaloudis, Juan Manuel Escano-Gonzalez

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Setting up a system to broadcast live lectures on the web is a procedure which on the surface does not require any serious technical skills mainly due to the facilities provided by popular learning management systems and their plugins. Nevertheless, producing a system of outstanding quality is a multidisciplinary and by no means a straightforward task. This complicatedness may be responsible for the delivery of an overall poor experience to the learners, and it calls for a formal rating framework that takes into account the diverse aspects of an architecture for synchronous video e-learning systems. We discuss the specifications of such a framework which at its final stage employs fuzzy logic technique to transform from qualitative to quantitative results.

Keywords: synchronous video, fuzzy logic, rating framework, e-learning

Procedia PDF Downloads 550