Search results for: health care

Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

Procedia PDF Downloads 129

Authors: Sokratis Koskinakis, Georgia Frakolaki, Magdalini Krokida

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Regular consumption of omega-3 fatty acid-rich lipids is said to provide a wide range of health benefits, including prevention of inflammation, cardiovascular disease, diabetes, arthritis, and ulcerative colitis. Because of their potential nutritional and health benefits, the omega-3 PUFAs are increasingly being supplemented in functional food products meant to improve human health and wellbeing. However, dietary fortification with PUFAs is difficult due to their low water solubility, tendency to oxidize quickly, and inconsistent bioavailability. These issues can be solved through application of modern encapsulation technologies, which typically entail integrating omega-3 oils into well-designed matrices made from food-grade components. Electrospinning, for example, is an effective encapsulation method for producing sub-micron or nano-scale polymer fibers. For this purpose, various combinations of hydroxypropyl-β-cyclodextrin and cellulose nanocrystals/ nanofibers were assessed for the encapsulation of omega-3 fatty acids through the innovative technology of electrospinning. The encapsulation yield was evaluated through GC-analysis, and the morphology of the final products was assessed through SEM analysis.

Keywords: electrospinning, encapsulation, omega-3 fatty acids, cellulose nanocrystals / nanofibers

Procedia PDF Downloads 79

Authors: Athena Pedro, Zandile Batweni, Laura Bradfield, Michael Dare, Ashley Nyman

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The rapid growth and development of an infant in the first 1000 days of life means that this time period provides the greatest opportunity for a positive developmental impact on a child’s life socially, emotionally, cognitively and physically. Current research is being focused on children in the first 1000 days, but there is a lack of research and understanding of mothers and their experiences during this crucial time period. Thus, it is imperative that more research is done to help better understand the experiences of mothers during the first 1000 days of their child’s life, as well as gain more insight into mothers’ knowledge regarding this time period. The first 1000 days of life, from conception to two years, is a critical period, and the child’s attachment to his or her mother or primary caregiver during this period is crucial for a multitude of future outcomes. The aim of this study was to explore mothers’ understanding and experience of the first 1000 days of their child’s life, specifically looking at attachment in the context of Bowlby and Ainsworths’ attachment theory. Using a qualitative methodological framework, data were collected through semi-structured individual interviews with 12 first-time mothers from low-income communities in Cape Town. Thematic analysis of the data revealed that mothers articulated the importance of attachment within the first 1000 days of life and shared experiences of how they bond and form attachment with their babies. Furthermore, these mothers expressed their belief in the long-term effects of early attachment of responsive positive parenting as well as the lasting effects of poor attachment and non-responsive parenting. This study has implications for new mothers and healthcare staff working with mothers of new-born babies, as well as for future contextual research. By gaining insight into the mothers’ experiences, policies and intervention efforts can be formulated in order to assist mothers during this time, which ultimately promote the healthy development of the nation’s children and future adult generation. If researchers are also able to understand the extent of mothers’ general knowledge regarding the first 1000 days and attachment, then there will be a better understanding of where there may be gaps in knowledge and thus, recommendations for effective and relevant intervention efforts may be provided. These interventions may increase knowledge and awareness of new mothers and health care workers at clinics and other service providers, creating a high impact on positive outcome. Thus, improving the developmental trajectory for many young babies allows them the opportunity to pursue optimal development by reaching their full potential.

Keywords: attachment, experience, first 1000 days, knowledge, mothers

Procedia PDF Downloads 173

Authors: Alireza Vafaei Sadr, Vida Abedi, Jiang Li, Ramin Zand

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Missing data is a common challenge in medical research and can lead to biased or incomplete results. When the data bias leaks into models, it further exacerbates health disparities; biased algorithms can lead to misclassification and reduced resource allocation and monitoring as part of prevention strategies for certain minorities and vulnerable segments of patient populations, which in turn further reduce data footprint from the same population – thus, a vicious cycle. This study compares the performance of six imputation techniques grouped into Linear and Non-Linear models on two different realworld electronic health records (EHRs) datasets, representing 17864 patient records. The mean absolute percentage error (MAPE) and root mean squared error (RMSE) are used as performance metrics, and the results show that the Linear models outperformed the Non-Linear models in terms of both metrics. These results suggest that sometimes Linear models might be an optimal choice for imputation in laboratory variables in terms of imputation efficiency and uncertainty of predicted values.

Keywords: EHR, machine learning, imputation, laboratory variables, algorithmic bias

Procedia PDF Downloads 80

Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Yuan Zhang, Xin Fu, Yixin Tan

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Gender role conflict is a key factor influencing the mental health condition of adolescents. It has a strong connection with the noticeably growing mental health crisis of high school students. This study elucidates the relationship between gender role conflict and reports of subjective well-being of teenagers through mixed-methods empirical research based on surveys conducted in two Chinese cities, namely Shenzhen and Yuxi. These two cities are from two provinces of very distinct economic and cultural backgrounds. We believe a comparison between the two cities reveals the unequally distributed social conditions in China. We found that teenagers who possess a higher degree of gender role conflict tend to exhibit more negative emotions and that this relationship is conditioned upon other important factors such as gender, only child status, and socio-economic factors. Furthermore, we discovered that the social environment that is more progressive and open to various gender roles is correlated with higher levels of subjective well-being of teenagers in Shenzhen and Yunnan.

Keywords: gender role conflict, mental health conditions, subjective well-being, social environment

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Authors: Chinlun Lai, Yu-Mei Chang

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In this paper, an augmented reality learning support system is proposed to replace the traditional teaching tool thus to help students improve their learning motivation, effectiveness, and efficiency. The system can not only reduce the exhaust of educational hardware and realistic material, but also provide an eco-friendly and self-learning practical environment in any time and anywhere with immediate practical experiences feedback. To achieve this, an interactive self-training methodology which containing step by step operation directions is designed using virtual 3D scenario and wearable device platforms. The course of nasogastric tube care of nursing skills is selected as the test example for self-learning and online test. From the experimental results, it is observed that the support system can not only increase the student’s learning interest but also improve the learning performance than the traditional teaching methods. Thus, it fulfills the strategy of learning by practice while reducing the related cost and effort significantly and is practical in various fields.

Keywords: augmented reality technology, learning support system, self-learning, simulation learning method

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Authors: Zhaoxu Lu, Yufeng Ma, Linying Gao, Li Wang, Mei Qiang

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Mercury (Hg) is a well-recognized environmental pollutant known by its toxicity of development and neurotoxicity, which may result in adverse health outcomes. However, the mechanisms underlying the teratogenic effects of Hg are not well understood. Imprinting genes are emerging regulators for fetal development subject to environmental pollutants impacts. In this study, we examined the association between paternal preconception Hg exposures and the alteration of DNA methylation of imprinting genes in human sperm DNA. A total of 618 men aged from 22 to 59 was recruited from the Reproductive Medicine Clinic of Maternal and Child Care Service Center and the Urologic Surgery Clinic of Shanxi Academy of Medical Sciences during April 2015 and March 2016. Demographic information was collected using questionnaires. Urinary Hg concentrations were measured using a fully-automatic double-channel hydride generation atomic fluorescence spectrometer. And methylation status in the DMRs of imprinting genes H19, Meg3 and Peg3 of sperm DNA were examined by bisulfite pyrosequencing in 243 participants. Spearman’s rank and multivariate regression analysis were used for correlation analysis between sperm DNA methylation status of imprinting genes and urinary Hg levels. The median concentration of Hg for participants overall was 9.09μg/l (IQR: 5.54 - 12.52μg/l; range = 0 - 71.35μg/l); no significant difference was found in median concentrations of Hg among various demographic groups (p > 0.05). The proportion of samples that a beyond intoxication criterion (10μg/l) for urinary Hg was 42.6%. Spearman’s rank correlation analysis indicates a negative correlation between urinary Hg concentrations and average DNA methylation levels in the DMRs of imprinted genes H19 (rs=﹣0.330, p = 0.000). However, there was no such a correlation found in genes of Peg3 and Meg3. Further, we analyzed of correlation between methylation level at each CpG site of H19 and Hg level, the results showed that three out of 7 CpG sites on H19 DMR, namely CpG2 (rs =﹣0.138, p = 0.031), CpG4 (rs =﹣0.369, p = 0.000) and CpG6 (rs=﹣0.228, p = 0.000), demonstrated a significant negative correlation between methylation levels and the levels of urinary Hg. After adjusting age, smoking, drinking, intake of aquatic products and education by multivariate regression analysis, the results have shown a similar correlation. In summary, mercury nonoccupational environmental exposure in reproductive-aged men associated with altered DNA methylation outcomes at DMR of imprinting gene H19 in sperm, implicating the susceptibility of the developing sperm for environmental insults.

Keywords: epigenetics, genomic imprinting gene, DNA methylation, mercury, transgenerational effects, sperm

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Authors: William Michael Short

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Semantic Web’ technologies such as the Unified Medical Language System Metathesaurus, SNOMED-CT, and MeSH have been touted as transformational for the way users access online medical and health information, enabling both the automated analysis of natural-language data and the integration of heterogeneous healthrelated resources distributed across the Internet through the use of standardized terminologies that capture concepts and relationships between concepts that are expressed differently across datasets. However, the approaches that have so far characterized ‘semantic bioinformatics’ have not yet fulfilled the promise of the Semantic Web for medical and health information retrieval applications. This paper argues within the perspective of cognitive linguistics and cognitive anthropology that four features of human meaning-making must be taken into account before the potential of semantic technologies can be realized for this domain. First, many semantic technologies operate exclusively at the level of the word. However, texts convey meanings in ways beyond lexical semantics. For example, transitivity patterns (distributions of active or passive voice) and modality patterns (configurations of modal constituents like may, might, could, would, should) convey experiential and epistemic meanings that are not captured by single words. Language users also naturally associate stretches of text with discrete meanings, so that whole sentences can be ascribed senses similar to the senses of words (so-called ‘discourse topics’). Second, natural language processing systems tend to operate according to the principle of ‘one token, one tag’. For instance, occurrences of the word sound must be disambiguated for part of speech: in context, is sound a noun or a verb or an adjective? In syntactic analysis, deterministic annotation methods may be acceptable. But because natural language utterances are typically characterized by polyvalency and ambiguities of all kinds (including intentional ambiguities), such methods leave the meanings of texts highly impoverished. Third, ontologies tend to be disconnected from everyday language use and so struggle in cases where single concepts are captured through complex lexicalizations that involve profile shifts or other embodied representations. More problematically, concept graphs tend to capture ‘expert’ technical models rather than ‘folk’ models of knowledge and so may not match users’ common-sense intuitions about the organization of concepts in prototypical structures rather than Aristotelian categories. Fourth, and finally, most ontologies do not recognize the pervasively figurative character of human language. However, since the time of Galen the widespread use of metaphor in the linguistic usage of both medical professionals and lay persons has been recognized. In particular, metaphor is a well-documented linguistic tool for communicating experiences of pain. Because semantic medical knowledge-bases are designed to help capture variations within technical vocabularies – rather than the kinds of conventionalized figurative semantics that practitioners as well as patients actually utilize in clinical description and diagnosis – they fail to capture this dimension of linguistic usage. The failure of semantic technologies in these respects degrades the efficiency and efficacy not only of medical research, where information retrieval inefficiencies can lead to direct financial costs to organizations, but also of care provision, especially in contexts of patients’ self-management of complex medical conditions.

Keywords: ambiguity, bioinformatics, language, meaning, metaphor, ontology, semantic web, semantics

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Authors: Victor Emery David Jr., Jiang Wenchao, Daniel Mmereki, Yasinta John

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The fundamentals of public health are access to safe and clean drinking water. The presence of arsenic and other contaminants in drinking water leads to the potential risk to public health and the environment particularly in most developing countries where there’s inadequate access to safe and clean water and adequate sanitation. Liberia has taken steps to improve its drinking water status so as to achieve the Sustainable Development Goals (SDGs) target of ensuring clean water and effective sanitation but there is still a lot to be done. The Sustainable Development Goals are a United Nation initiative also known as transforming our world: The 2030 agenda for sustainable development. It contains seventeen goals with 169 targets to be met by respective countries. Liberia is situated within in the gold belt region where there exist the presence of arsenic and other contaminants in the underground water due to mining and other related activities. While there are limited or no epidemiological studies conducted in Liberia to confirm illness or death as a result of arsenic contamination in Liberia, it remains a public health concern. This paper assesses the drinking water quality, the presence of arsenic in groundwater/drinking water in Liberia, and proposes strategies for mitigating contaminants in drinking water and suggests options for improvement with regards to achieving the Sustainable Development Goals of ensuring clean water and effective sanitation in Liberia by 2030.

Keywords: arsenic, action plan, contaminants, environment, groundwater, sustainable development goals (SDGs), Monrovia, Liberia, public health, drinking water

Procedia PDF Downloads 256

Authors: Tracy Smith-Carrier

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In 1995, the World Health Organization declared that poverty was the biggest killer and the greatest cause of suffering in the world. Income is certainly a key social determinant of health, the lack of which causes innumerable health and mental health conditions. In seeking to provide relief from financial hardship for residents within their populace, states in the Global North have largely turned to the non-profit and charitable sector. The stigma and shame of accessing charity is a significant barrier for many, but what is more problematic is that the embrace of the charitable model has let governments off the hook from responding to their international human rights obligations. Although states are signatories to various human rights treaties and conventions internationally, many of these laws have not been implemented domestically. This presentation explores the limits of the charitable model in addressing poverty in countries of the Global North. Unlike in the ages passed, when poverty was thought to be an individual problem, we now know that poverty is largely systemic in nature. In this presentation, we will identify the structural determinants of poverty, outline why people are reticent to access charitable programs and services and how income security is reproduced through the charitable model, and discuss evidence-informed solutions, such as a basic income guarantee, to move beyond the charitable model in favour of a rights-based justice model. To move beyond charity, we must demand that governments recognize our fundamental human rights and address poverty and hunger using a justice model based on substantive human rights.

Keywords: basic income, charity, poverty, income security, hunger, food security, social justice, human rights

Procedia PDF Downloads 114

Authors: T. Pradhan, P. Rijal, M. C. Regmi

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Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.

Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors

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Authors: Lia Mania, Ketevan Nanobashvili

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Background: The coronavirus disease COVID-19 has become the cause of a global health crisis during the current pandemic. This study aims to fill the paucity of epidemiological studies on the impact of COVID-19 on the oral health of pediatric populations. Methods: It was conducted an observational, cross-sectional study in Georgia, in Tbilisi (capital of Georgia), among 7 to 12-year-old PCR or rapid test-confirmed post-Covid populations in all districts of Tbilisi (10 districts in total). 332 beneficiaries who were infected with Covid within one year were included in the study. The population was selected in schools of Tbilisi according to the principle of cluster selection. A simple random selection took place in the selected clusters. According to this principle, an equal number of beneficiaries were selected in all districts of Tbilisi. By July 1, 2022, according to National Center for Disease Control and Public Health data (NCDC.Ge), the number of test-confirmed cases in the population aged 0-18 in Tbilisi was 115137 children (17.7% of all confirmed cases). The number of patients to be examined was determined by the sample size. Oral screening, microbiological examination of saliva, and administration of oral health questionnaires to guardians were performed. Statistical processing of data was done with SPSS-23. Risk factors were estimated by odds ratio and logistic regression with 95% confidence interval. Results: Statistically reliable differences between the averages of oral health indicators in asymptomatic and symptomatic covid-infected groups are: for caries intensity (DMF+def) t=4.468 and p=0.000, for modified gingival index (MGI) t=3.048, p=0.002, for simplified oral hygiene index (S-OHI) t=4.853; p=0.000. Symptomatic covid-infection has a reliable effect on the oral microbiome (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis); (n=332; 77.3% vs n=332; 58.0%; OR=2.46, 95%CI: 1.318-4.617). According to the logistic regression, it was found that the severity of the covid infection has a significant effect on the frequency of pathogenic and conditionally pathogenic bacteria in the oral cavity B=0.903 AOR=2.467 (CL 1.318-4.617). Symptomatic covid-infection affects oral health indicators, regardless of the presence of other risk factors, such as parental employment status, tooth brushing behaviors, carbohydrate meal, fruit consumption. (p<0.05). Conclusion: Risk factors (parental employment status, tooth brushing behaviors, carbohydrate consumption) were associated with poorer oral health status in a post-Covid population of 7- to 12-year-old children. However, such a risk factor as symptomatic ongoing covid-infection affected the oral microbiome in terms of the abundant growth of pathogenic and conditionally pathogenic bacteria (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis) and further worsened oral health indicators. Thus, a close association was established between symptomatic covid-infection and microbiome changes in the post-covid period; also - between the variables of oral health indicators and the symptomatic course of covid-infection.

Keywords: oral microbiome, COVID-19, population based research, oral health indicators

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Authors: Catherine Begin, Jeanne Berthod, Manon Truchon

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In Quebec, there are more than 8,000 community organizations throughout the province, representing more than 72,000 jobs. Working in a community setting involves several particularities (e.g., contact with the suffering of users, feelings of powerlessness, institutional pressure, unstable funding, etc.), which can put workers at risk of fatigue, burnout, and psychological distress. A 2007 study shows that 52% of community workers surveyed have a high psychological distress index. The Ricochet project, founded in 2019, is an initiative aimed at providing various care and services to community workers in the Quebec City region, with a global health approach. Within this program, mindful self-compassion training (MSC) is offered at a low cost. MSC is one of the effective strategies proposed in the literature to help prevent and reduce burnout. Self-compassion is the recognition that suffering, failure, and inadequacies are inherent in the human experience and that everyone, including oneself, deserves compassion. MSC training targets several behavioral, cognitive, and emotional learnings (e.g., motivating oneself with caring, better managing difficult emotions, promoting resilience, etc.). A mixed-method evaluation was conducted with the participants in order to explore the effects of the training on community workers in the Quebec City region. The participants were community workers (management or caregiver). 15 participants completed satisfaction and perceived impact surveys, and 30 participated in structured interviews. Quantitative results showed that participants were generally completely satisfied or satisfied with the training (94%) and perceived that the training allowed them to develop new strategies for dealing with stress (87%). Participants perceived effects on their mood (93%), their contact with others (80%), and their stress level (67%). Some of the barriers raised were scheduling constraints, length of training, and guilt about taking time for oneself. The qualitative results show that individuals experienced long-term benefits, as they were able to apply the tools they received during the training in their daily lives. Some barriers were noted, such as difficulty in getting away from work or problems with the employer, which prevented enrollment. Overall, the results of this evaluation support the use of MSC (mindful self-compassion) training among community workers. Future research could support this evaluation by using a rigorous design and developing innovative ways to overcome the barriers raised.

Keywords: mindful self-compassion, community workers, work stres, burnout, wellbeing at work

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Authors: Ahlyum Mun, Ji-Young Moon, Moon-Seok Yoon, Dong-Jin Baek, Doo-Seok Seo, Oun-Kyong Moon

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There is a growing public concern over the standards of farm animal welfare, with higher standards of food safety. In addition, the recent low incidence of Avian Influenza in laying hens among certificated farms is receiving attention. In this study, we introduce animal welfare systems covering the rearing, transport and slaughter of farm animals in South Korea. The concepts of animal welfare farm certification are based on ensuring the five freedoms of animal. The animal welfare is also achieved by observing the condition of environment including shelter and resting area, feeding and water and the care for the animal health. The certification of farm animal welfare is handled by the Animal Protection & Welfare Division of Animal and Plant Quarantine Agency (APQA). Following the full amendment of Animal Protection Law in 2011, animal welfare farm certification program has been implemented since 2012. The certification system has expanded to cover laying hen, swine, broiler, beef cattle and dairy cow, goat and duck farms. Livestock farmers who want to be certified must apply for certification at the APQA. Upon receipt of the application, the APQA notifies the applicant of the detailed schedule of the on-site examination after reviewing the document and conducts the on-site inspection according to the evaluation criteria of the welfare standard. If the on-site audit results meet the certification criteria, APQA issues a certificate. The production process of certified farms is inspected at least once a year for follow-up management. As of 2017, a total of 145 farms have been certified (95 laying hen farms, 12 swine farms, 30 broiler farms and 8 dairy cow farms). In addition, animal welfare transportation vehicles and slaughterhouses have been designated since 2013 and currently 6 slaughterhouses have been certified. Animal Protection Law has been amended so that animal welfare certification marks can be affixed only to livestock products produced by animal welfare farms, transported through animal welfare vehicles and slaughtered at animal welfare slaughterhouses. The whole process including rearing–transportation- slaughtering completes the farm animal welfare system. APQA established its second 5-year animal welfare plan (2014-2019) that includes setting a minimum standard of animal welfare applicable to all livestock farms, transportation vehicles and slaughterhouses. In accordance with this plan, we will promote the farm animal welfare policy in order to truly advance the Korean livestock industry.

Keywords: animal welfare, farm animal, certification system, South Korea

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Authors: Shreyas Gambhirrao, Aditya Vichare, Aniket Tembhurne, Shahuraj Bhosale

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In today's rapidly evolving environment, stress has emerged as a significant health concern across different age groups. Stress that isn't controlled, whether it comes from job responsibilities, health issues, or the never-ending news cycle, can have a negative effect on our well-being. The problem is further aggravated by the ongoing connection to technology. In this high-tech age, identifying and controlling stress is vital. In order to solve this health issue, the study focuses on three key metrics for stress detection: body temperature, heart rate, and galvanic skin response (GSR). These parameters along with the Support Vector Machine classifier assist the system to categorize stress into three groups: 1) Stressed, 2) Not stressed, and 3) Moderate stress. Proposed training model, a NodeMCU combined with particular sensors collects data in real-time and rapidly categorizes individuals based on their stress levels. Real-time stress detection is made possible by this creative combination of hardware and software.

Keywords: real time stress detection, NodeMCU, sensors, heart-rate, body temperature, galvanic skin response (GSR), support vector machine

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Authors: Raafat A. Mandour

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Background; Water may be regarded as polluted if it contains substances that render it unsafe for public use. The surface, subsoil waters and the shallow water-bearing geologic formation are more subjected to pollution due to its closeness to the human daily work. Aim of the work; determine the distribution of iron level in drinking water and its relation to iron level in blood patients suffering from liver diseases. Materials and Methods; For the present study, a total number of (71) drinking water samples (surface, wells and tap) have been collected and Blood samples were carried out on (71) selected inhabitants who attended in different hospitals, from different localities and suffering from liver diseases. Serum iron level in these patients was estimated by using IRON-B kit, Biocon company (Germany) and the 1, 10-phenanthroline method. Results; The water samples analyzed for iron are found suitable for drinking except two samples at Mit-Ghamr district showing values higher than the permissible limit of Egyptian Ministry of Health (EMH) and World Health Organization (WHO).The comparison between iron concentrations in drinking water and human blood samples shows a positive relationship. Conclusion; groundwater samples from the polluted areas should have special attention for treatment.

Keywords: water samples, blood samples, EMH, WHO

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Authors: Martyn Queen, Diane Crone, Andrew Parker, Saul Bloxham

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Rationale: There is a growing body of evidence that supports the use of physical activity during and after cancer treatment. However, activity levels for patients remain low. As more cancer patients are treated successfully, and treatment costs continue to escalate, physical activity may be a promising adjunct to a person-centred healthcare approach to recovery. Aim: The aim was to further understand how physical activity may enhance the recovery process for a group of mixed-site cancer patients. Objectives: The research investigated longitudinal changes in physical activity and perceived the quality of life between two and six month’s post-exercise interventions. It also investigated support systems that enabled patients to sustain these perceived changes. Method: The respondent cohort comprised 14 mixed-site cancer patients aged 43-70 (11 women, 3 men), who participated in a two-phase physical activity intervention that took place at a university in the South West of England. Phase 1 consisted of an eight-week structured physical activity programme; Phase 2 consisted of four months of non-supervised physical activity. Semi-structured interviews took place three times over six months with each participant. Grounded theory informed the data collection and analysis which, in turn, facilitated theoretical development. Findings: Our findings propose three theories on the impact of physical activity for recovering cancer patients: 1) Knowledge gained through a structured exercise programme can enable recovering cancer patients to independently sustain physical activity to four-month follow-up. 2) Sustaining physical activity for six months promotes positive changes in the quality of life indicators of chronic fatigue, self-efficacy, the ability to self-manage and energy levels. 3) Peer support from patients facilitates adherence to a structured exercise programme and support from a spouse, or life partner facilitates independently sustained physical activity to four-month follow-up. Conclusions: This study demonstrates that qualitative research can provide an evidence base that could be used to support future care plans for cancer patients. Findings also demonstrate that a physical activity intervention can be effective at helping cancer patients recover from the side effects of their treatment, and recommends that physical activity should become an adjunct therapy alongside traditional cancer treatments.

Keywords: physical activity, health, cancer recovery, quality of life, support systems, qualitative, grounded theory, person-centred healthcare

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Authors: Amit R. Bhende, G. K. Awari

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Remaining useful life (RUL) prediction is one of key technologies to realize prognostics and health management that is being widely applied in many industrial systems to ensure high system availability over their life cycles. The present work proposes a data-driven method of RUL prediction based on multiple health state assessment for rolling element bearings. Bearing degradation data at three different conditions from run to failure is used. A RUL prediction model is separately built in each condition. Feed forward back propagation neural network models are developed for prediction modeling.

Keywords: bearing degradation data, remaining useful life (RUL), back propagation, prognosis

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Authors: Raeesa Moolla, Ryan S. Johnson

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Air travel, and the use of airports, has experienced proliferative growth in the past few decades, resulting in the concomitant release of air pollutants. Air pollution needs to be monitored because of the known relationship between exposure to air pollutants and increased adverse effects on human health. This study monitored a group of volatile organic compounds (VOCs); specifically BTEX (viz. benzene, toluene, ethyl-benzene and xylenes), as many are detrimental to human health. Through the use of passive sampling methods, the spatial variability of BTEX within an international airport was investigated, in order to determine ‘hotspots’ where occupational exposure to BTEX may be intensified. The passive sampling campaign revealed BTEX_total concentrations ranged between 12.95–124.04 µg m^-3. Furthermore, BTEX concentrations were dispersed heterogeneously within the airport. Due to the slow wind speeds recorded (1.13 m.s^-1); the hotspots were located close to their main BTEX sources. The main hotspot was located over the main apron of the airport. Employees working in this area may be chronically exposed to these emissions, which could be potentially detrimental to their health.

Keywords: air pollution, air quality, hotspot monitoring, volatile organic compounds

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Authors: Ngoc Dao

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State Paid Leave Programs (PFL) complement the Federal Family and Medical Leave Act (FMLA) by offering workers time off to take care of their newborns or sick family members with supplemental income, and further job protection. Up to date, four states (California, New Jersey, Rhode Island, and New York) implemented paid leave policies. This study adds further understanding of how state PFL policies help working families with elder parents improve their work balance by examining the paid leave policies on labor outcomes. Early findings suggest State Paid Leave Policies reduced the likelihood to exit the labor market by 1.6 percentage points, with larger effects among paid leave policies with job protection feature. In addition, the results imply job protection in paid leave policies matters in helping employed caregivers attach to the labor market.

Keywords: family paid leave, working caregivers, employment, social welfare

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Authors: Chunhua Ma

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Background: There is a relationship between cultural identity and psychological health. Resilience is an important factor of psychological health, and cultural identity will protect the resilience. The research showed that the cultural identity, resilience, and self-concordance of students from different cultures. It should be a theoretical basis to improve mental health of different nationalities students. And the role of resilience factors for adults’ cultural identity and self-concordance was deserve studied. Aims: The current study aimed to examine the relationship between cultural identity and self-concordance among Chinese academician from 3 minorities, postulating mediating by resilience. Methods: This study used cross-sectional and correlational design. Participants were 328 Chinese aged between 18 and 25 years. Data was collected via self-reports including both closed and opened questions. Results: Linear regression analysis controlling for age, gender, the result showed that: (a) Cultural identity was related to self-concordance, resilience was related to self-concordance and cultural identity was related to resilience, (b) Resilience mediated the link between cultural identity and self-concordance, respectively. Discussion: Our findings suggested that resilience and cultural identity are important factors in self-concordance. If minority college students realized the heterogeneous culture, it would alleviate their psychological conflict, stimulate their strength potential and improve their self-concordance.

Keywords: cultural identity, resilience, self-concordance, mediating effect

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Authors: A.H.Y. Lai, C. Teyra

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In Taiwan, there are 16 official indigenous groups, accounting for 2.3% of the total population. Like other indigenous populations worldwide, indigenous peoples in Taiwan have poorer mental health because of their history of oppression and colonisation. Amid the negative narratives, the ethnic identity of cultural minorities is their unique psychological and cultural asset. Moreover, positive socialisation is found to be related to strong ethnic identity. Based on Phinney’s theory on ethnic identity development and social support theory, this study adopted a strength-based approach conceptualising ethnic identity as the central organising principle that linked perceived social support and mental health among indigenous adults in Taiwan. Aims. Overall aim is to examine the effect of ethnic identity and social support on mental health. Specific aims were to examine : (1) the association between ethnic identity and mental health; (2) the association between perceived social support and mental health ; (3) the indirect effect of ethnic identity linking perceived social support and mental health. Methods. Participants were indigenous adults in Taiwan (n=200; mean age=29.51; Female=31%, Male=61%, Others=8%). A cross-sectional quantitative design was implemented using data collected in the year 2020. Respondent-driven sampling was used. Standardised measurements were: Ethnic Identity Scale(6-item); Social Support Questionnaire-SF(6 items); Patient Health Questionnaire(9-item); and Generalised Anxiety Disorder(7-item). Covariates were age, gender and economic satisfaction. A four-stage structural equation modelling (SEM) with robust maximin likelihood estimation was employed using Mplus8.0. Step 1: A measurement model was built and tested using confirmatory factor analysis (CFA). Step 2: Factor covariates were re-specified as direct effects in the SEM. Covariates were added. The direct effects of (1) ethnic identity and social support on depression and anxiety and (2) social support on ethnic identity were tested. The indirect effect of ethnic identity was examined with the bootstrapping technique. Results. The CFA model showed satisfactory fit statistics: x^2(df)=869.69(608), p<.05; Comparative ft index (CFI)/ Tucker-Lewis fit index (TLI)=0.95/0.94; root mean square error of approximation (RMSEA)=0.05; Standardized Root Mean Squared Residual (SRMR)=0.05. Ethnic identity is represented by two latent factors: ethnic identity-commitment and ethnic identity-exploration. Depression, anxiety and social support are single-factor latent variables. For the SEM, model fit statistics were: x^2(df)=779.26(527), p<.05; CFI/TLI=0.94/0.93; RMSEA=0.05; SRMR=0.05. Ethnic identity-commitment (b=-0.30) and social support (b=-0.33) had direct negative effects on depression, but ethnic identity-exploration did not. Ethnic identity-commitment (b=-0.43) and social support (b=-0.31) had direct negative effects on anxiety, while identity-exploration (b=0.24) demonstrated a positive effect. Social support had direct positive effects on ethnic identity-exploration (b=0.26) and ethnic identity-commitment (b=0.31). Mediation analysis demonstrated the indirect effect of ethnic identity-commitment linking social support and depression (b=0.22). Implications: Results underscore the role of social support in preventing depression via ethnic identity commitment among indigenous adults in Taiwan. Adopting the strength-based approach, mental health practitioners can mobilise indigenous peoples’ commitment to their group to promote their well-being.

Keywords: ethnic identity, indigenous population, mental health, perceived social support

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Authors: Nicola Harrison

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Familial childhood sexual abuse (FCSA) prevalence rates in Aotearoa, New Zealand, are amongst the highest globally, particularly in indigenous communities. However, such statistics seem incongruent with indigenous paradigms of unity, care, and connection. The inability of policymakers and mainstream service providers to acknowledge the direct links between the social contexts created by colonisation for indigenous families in Aotearoa and intergenerational FCSA has meant there has been little meaningful success in combatting this significant social problem. This research traces the conditions of intergenerational FCSA to the systemic inequalities created by colonization. Kaupapa Māori methodologies were applied to this qualitative piece of empirical research wherein 17 indigenous contributors shared their stories of FCSA. From these stories and existing literature, we can identify how the machinations of colonisation are mirrored by techniques used to perpetrate abuse. Once identified, we are then able to recommend actions for halting FCSA for future generations.

Keywords: indigenity, family violence, childhood sexual abuse, colonization

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Authors: Tara Miller, Tariq Ganief, Jonathan Blackburn

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Millions of babies are still born to HIV-infected mothers each year despite the ramped-up HAART use. However, these infants are HIV uninfected but exposed, which is now a growing population that has weakened immune systems and poorer outcomes. Due to HIV exposure and possible ARV exposure during pregnancy and breastfeeding, these infants are believed to have altered immune responses and microbiomes when compared to their healthy counterparts. The gut microbiome roles an important role in infant development, specifically in the immune system. Research has shown these HIV-exposed, uninfected infants have weaker immune responses to their neonate vaccines, and in developing countries, this leaves them vulnerable to opportunistic disease. By gaining a deeper understanding of the gut microbiome and the products of the microbes via metaproteomic analysis, we can hopefully understand and improve the immune system and health of these infants. To investigate the metaproteome of the infants’ guts, mass spectrometry will be used, followed by data analysis using DIA-NN. The hypothesized results are that the HIV-exposed, uninfected infants have an altered microbiome compared to their healthy counterparts. Additionally, the differences found are hypothesized to be involved with inflammation which would contribute to the poor health of the infants.

Keywords: HIV, mass spectrometry, metaproteomics, microbiome

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Authors: Isaiah Chacha, Samuel Arimi, Andrew Thaiya

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Background: This study was conducted to assess knowledge, attitudes and practices regarding anthrax in Maragua, Kenya to provide baseline information to design interventions. Methods: A cross sectional survey was conducted among head of households, health and veterinary workers in Maragua Sub-county in August and September 2014. Administered questionnaires were used to collect data from household members and a key informant interview held with health and veterinary workers. Multi stage sampling was used to obtain participants’ knowledge, attitudes and practices. Questions were scored and descriptively analyzed using Excel spreadsheet then exported to GenStat Discovery Edition 4. Results: A total of 293 community members were recruited in this study. The overall level of knowledge was 77.9% of all community members regarding cause, transmission, symptoms and prevention of the disease in both humans and animals. Majority of the participants (96.3%) had heard about anthrax. A total of 99 (33.8%) correspondents had seen a person with anthrax and 75.1% think that anthrax is a very serious disease in the area. Of the interviewed correspondents, 14.3% of them have had their animals (mostly cattle) suffer from anthrax while 15.7% had either suffered from anthrax or have had their family member who suffered from anthrax. Conclusion: The study findings indicate above average knowledge on cause, symptoms, transmission and prevention of anthrax among community members in humans and animals. Practices in this study were still risk among community members. Veterinary and Medical health planners should design anthrax awareness interventions as a team targeting to reach these communities and the public through barazas, radio, CHW and other communication channel on a regular basis.

Keywords: anthrax, attitudes, Kenya, knowledge, Maragua, practices

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Authors: Ayesha Asif, Muhammad Zeeshan

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The sensitivity of hospital-microenvironments for all types of pollutants, due to the presence of patients with immune deficiencies, makes them complex indoor spaces. Keeping in view, this study investigated indoor air quality (IAQ) of two most sensitive places, i.e., operation theater (OT) and intensive care unit (ICU), of a publically managed hospital. Taking CO₂ concentration as air quality indicator and temperature (T) and relative humidity (RH) as thermal comfort parameters, continuous monitoring of the three variables was carried out. Measurements were recorded at an interval of 1 min for weekdays and weekends, including occupational and non-occupational hours. Outdoor T and RH measurements were also used in the analysis. Results show significant variation (p < 0.05) in CO₂, T and RH values over the day during weekdays while no significant variation (p > 0.05) have been observed during weekends of both the monitored sites. Maximum observed values of CO₂ in OT and ICU were found to be 2430 and 624 ppm, T as 24.7ºC and 28.9ºC and RH as 29.6% and 32.2% respectively.

Keywords: indoor air quality, CO₂ concentration, hospital building, comfort assessment

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Authors: Anne Allmrodt

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Regions of South-East Europe are characterised by high out-migration for decades. The reasons for leaving range from the hope of a better work situation to a better health care system and beyond. In Serbia, this high out-migration hits the rural areas in particular so that the population number is in the red repeatedly. It might not be hard to guess that this negative population growth has the potential to create different challenges for those who stay in rural areas. So how are they coping with the – statistically proven – high out-migration? Having this in mind, the study is investigating the people‘s individual awareness of the social phenomenon high out-migration and their daily life strategies in rural areas. Furthermore, the study seeks to find out the people’s resilient skills in that context. Is the condition of high out-migration conducive for resilience? The methodology combines a quantitative and a qualitative approach (mixed methods). For the quantitative part, a standardised questionnaire has been developed, including a multiple choice section and a choice experiment. The questionnaire was handed out to people living in rural areas of Serbia only (n = 100). The sheet included questions about people’s awareness of high out-migration, their own daily life strategies or challenges and their social network situation (data about the social network was necessary here since it is supposed to be an influencing variable for resilience). Furthermore, test persons were asked to make different choices of coping with high out-migration in a self-designed choice experiment. Additionally, the study included qualitative interviews asking citizens from rural areas of Serbia. The topics asked during the interview focused on their awareness of high out-migration, their daily life strategies, and challenges as well as their social network situation. Results have shown the following major findings. The awareness of high out-migration is not the same with all test persons. Some declare it as something positive for their own life, others as negative or not effecting at all. The way of coping generally depended – maybe not surprising – on the people’s social network. However – and this might be the most important finding - not everybody with a certain number of contacts had better coping strategies and was, therefore, more resilient. Here the results show that especially people with high affiliation and proximity inside their network were able to cope better and shew higher resilience skills. The study took one step forward in terms of knowledge about societal resilience as well as coping strategies of societies in rural areas. It has shown part of the other side of nowadays migration‘s coin and gives a hint for a more sustainable rural development and community empowerment.

Keywords: coping, out-migration, resilience, rural development, social networks, south-east Europe

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Authors: Zeynep Selin Acar

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In international system, there has always been a cycle of violence, war and peace. As there travels the time, after Christianity and later Just War theorists, international relations theorists have been tried to limit violence and war. As pieces of international law, Peace of Augsburg, Kellog-Briand Pact, League of Nations Covenant and UN Charter were and are still not effective to prevent war. Moreover, in order to find a way around these rules, it is believed that a new excuse started to be used instead of violence or war, humanitarian intervention. However, it has neither a legal nor a universally accepted framework. As a result, it is open to be manipulated by states. In order to prevent this, Responsibility to Protect (RtoP) which gives a state the responsibility to protect its citizens against violence, is created. Additionally, RtoP transfers this responsibility to regional or international group of states at the time when a state is the origin of violence. In the lights of these, this paper analyzes RtoP as an ethical approach to war and peace studies because it provides other states as guardians and care-takers of people who do not belong to them or do not share any togetherness.

Keywords: ethics, humanitarian intervention, responsibility to protect, UN charter

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Authors: Vicent Lwanga

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Background: Despite sensitization workshops that have been going on in rural areas in Kapchorwa District in Uganda to prevent stigmatization of People Living With HIV/AIDS (PLWHA), interview with PLWHA sows that they are still being stigmatized. This behavior of some people within the community possesses a serious danger to the successful prevention and control of HIV in our society. Evidence exists that some people still believe that eating, living together, and even discussing with PLWHA might make them infected, too, despite all persuasions against such attitude. Description: A face to face interview with some selected PLWHA in Kapchorwa, testified that stigmatization against those who have disclosed their status still lingers on. The interviews with the PLWHA reveals that people still believe that they are being bewitched and cursed by God for their sins, and as such, people keep away from them to avoid the wrath of God. Findings: The more the stigmatization against the PLWHA persists, the more difficult it will be to successfully prevent, control, and eradicate HIV in the society. This is because many PLWHA would prefer not to be identified if they are not shown love and care. Conclusion: A more continuous campaign to stop the stigmatization of PLWHA needs to be on-going. This could be done more effectively by Community-Based Organisations (CBOs) with workshops, print media, and seminars.

Keywords: aids, community, HIV, stigma

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