Search results for: intestinal health

Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

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Authors: Befekadu Urga Wakayo

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Introduction: Bacterial infections represent major human and animal health problems in Ethiopia. In the face of poor antibiotic regulatory mechanisms, development of antimicrobial resistance (AMR) to commonly used drugs has become a growing health and livelihood threat in the country. Monitoring and control of AMR demand close coloration between human and veterinary services as well as other relevant stakeholders. However, risk of AMR transfer from animal to human population’s remains poorly explored in Ethiopia. This systematic research literature review attempted to give an overview on AMR challenges of bovine mastitis bacteria in Ethiopia. Methodology: A web based research literature search and analysis strategy was used. Databases are considered including; PubMed, Google Scholar, Ethiopian Veterinary Association (EVA) and Ethiopian Society of Animal Production (ESAP). The key search terms and phrases were; Ethiopia, dairy, cattle, mastitis, bacteria isolation, antibiotic sensitivity and antimicrobial resistance. Ultimately, 15 research reports were used for the current analysis. Data extraction was performed using a structured Microsoft Excel format. Frequency AMR prevalence (%) was registered directly or calculated from reported values. Statistical analysis was performed on SPSS – 16. Variables were summarized by giving frequencies (n or %), Mean ± SE and demonstrative box plots. One way ANOVA and independent t test were used to evaluate variations in AMR prevalence estimates (Ln transformed). Statistical significance was determined at p < 0.050). Results: AMR in bovine mastitis bacteria was investigated in a total of 592 in vitro antibiotic sensitivity trials involving 12 different mastitis bacteria (including 1126 Gram positive and 77 Gram negative isolates) and 14 antibiotics. Bovine mastitis bacteria exhibited AMR to most of the antibiotics tested. Gentamycin had the lowest average AMR in both Gram positive (2%) and negative (1.8%) bacteria. Gram negative mastitis bacteria showed higher mean in vitro resistance levels to; Erythromycin (72.6%), Tetracycline (56.65%), Amoxicillin (49.6%), Ampicillin (47.6%), Clindamycin (47.2%) and Penicillin (40.6%). Among Gram positive mastitis bacteria higher mean in vitro resistance was observed in; Ampicillin (32.8%), Amoxicillin (32.6%), Penicillin (24.9%), Streptomycin (20.2%), Penicillinase Resistant Penicillin’s (15.4%) and Tetracycline (14.9%). More specifically, S. aurues exhibited high mean AMR against Penicillin (76.3%) and Ampicillin (70.3%) followed by Amoxicillin (45%), Streptomycin (40.6%), Tetracycline (24.5%) and Clindamycin (23.5%). E. coli showed high mean AMR to Erythromycin (78.7%), Tetracycline (51.5%), Ampicillin (49.25%), Amoxicillin (43.3%), Clindamycin (38.4%) and Penicillin (33.8%). Streptococcus spp. demonstrated higher (p =0.005) mean AMR against Kanamycin (> 20%) and full sensitivity (100%) to Clindamycin. Overall, mean Tetracycline (p = 0.013), Gentamycin (p = 0.001), Polymixin (p = 0.034), Erythromycin (p = 0.011) and Ampicillin (p = 0.009) resistance increased from the 2010’s than the 2000’s. Conclusion; the review indicated a rising AMR challenge among bovine mastitis bacteria in Ethiopia. Corresponding, public health implications demand a deeper, integrated investigation.

Keywords: antimicrobial resistance, dairy cattle, Ethiopia, Mastitis bacteria

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Authors: Felipa De Mello-Sampayo

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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.

Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time

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Authors: Shashikant Iyengar, Jasmeet Kaur, Anup Singh, Arun Kumar, Ira Sahay

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Insulin resistance (IR) is a condition that occurs when cells in the body become less responsive to insulin, leading to higher levels of both insulin and glucose in the blood. This condition is linked to metabolic syndromes, including diabetes. It is crucial to address IR promptly after diagnosis to prevent long-term complications associated with high insulin and high blood glucose. This four-month case study highlights the importance of treating the underlying condition to manage diabetes effectively. Insulin is essential for regulating blood sugar levels by facilitating the uptake of glucose into cells for energy or storage. In IR individuals, cells are less efficient at taking up glucose from the blood resulting in elevated blood glucose levels. As a result of IR, beta cells produce more insulin to make up for the body's inability to use insulin effectively. This leads to high insulin levels, a condition known as hyperinsulinemia, which further impairs glucose metabolism and can contribute to various chronic diseases. In addition to regulating blood glucose, insulin has anti-catabolic effects, preventing the breakdown of molecules in the body, such as inhibiting glycogen breakdown in the liver, inhibiting gluconeogenesis, and inhibiting lipolysis. If a person is insulin-sensitive or metabolically healthy, an optimal level of insulin prevents fat cells from releasing fat and promotes the storage of glucose and fat in the body. Thus optimal insulin levels are crucial for maintaining energy balance and plays a key role in metabolic processes. During the four-month study, researchers looked at the impact of a low-carb dietary (LCD) intervention on two male individuals (A & B) who had Type-2 diabetes. Althoughvneither of these individuals were obese, they were both slightly overweight and had abdominal fat deposits. Before the trial began, important markers such as fasting blood glucose (FBG), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, and Hba1c were measured. These markers are essential in defining metabolic health, their individual values and variability are integral in deciphering metabolic health. The ratio of TG to HDL is used as a surrogate marker for IR. This ratio has a high correlation with the prevalence of metabolic syndrome and with IR itself. It is a convenient measure because it can be calculated from a standard lipid profile and does not require more complex tests. In this four-month trial, an improvement in insulin sensitivity was observed through the ratio of TG/HDL, which, in turn, improves fasting blood glucose levels and HbA1c. For subject A, HbA1c dropped from 13 to 6.28, and for subject B, it dropped from 9.4 to 5.7. During the trial, neither of the subjects were taking any diabetic medications. The significant improvements in their health markers, such as better glucose control, along with an increase in energy levels, demonstrate that incorporating LCD interventions can effectively manage diabetes.

Keywords: metabolic disorder, insulin resistance, type-2 diabetes, low-carb nutrition

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Authors: Aditi Acharya

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Environmental pollution is threatening the environmental and human health in the most drastic way. This paper provides insight about the affects of environmental pollution in the perspective of water pollution. Sewage in drinking water, the increasing contamination of water bodies and water resources and the human beings are the major contributors, increasing the harsh activities of pollution. The research presents information about the sources of pollution, its impacts and control activities to be undertaken to make our environment free from water pollution.

Keywords: environmental pollution, water pollution, nanotechnology, nanomaterials

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Authors: Hacer Sule Gonul, Vedat Uyak

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Intensive use of pesticides in agricultural activity causes mixing of these compounds into water sources with surface flow. Especially after the 1970s, a number of limitations imposed on the use of chlorinated pesticides that have a carcinogenic risk potential and regulatory limit have been established. These chlorinated pesticides discharge to water resources, transport in the water and land environment and accumulation in the human body through the food chain raises serious health concerns. Carbon nanotubes (CNTs) have attracted considerable attention from on all because of their excellent mechanical, electrical, and environmental characteristics. Due to CNT particles' high degree of hydrophobic surfaces, these nanoparticles play critical role in the removal of water contaminants of natural organic matters, pesticides and phenolic compounds in water sources. Health concerns associated with chlorinated pesticides requires the removal of such contaminants from aquatic environment. Although the use of aldrin and atrazine was restricted in our country, repatriation of illegal entry and widespread use of such chemicals in agricultural areas cause increases for the concentration of these chemicals in the water supply. In this study, the compounds of chlorinated pesticides such as aldrin and atrazine compounds would be tried to eliminate from drinking water with carbon nanotube adsorption method. Within this study, 2 different types of CNT would be used including single-wall (SWCNT) and multi-wall (MWCNT) carbon nanotubes. Adsorption isotherms within the scope of work, the parameters affecting the adsorption of chlorinated pesticides in water are considered as pH, contact time, CNT type, CNT dose and initial concentration of pesticides. As a result, under conditions of neutral pH conditions with MWCNT respectively for atrazine and aldrin obtained adsorption capacity of determined as 2.24 µg/mg ve 3.84 µg/mg. On the other hand, the determined adsorption capacity rates for SWCNT for aldrin and atrazine has identified as 3.91 µg/mg ve 3.92 µg/mg. After all, each type of pesticide that provides superior performance in relieving SWCNT particles has emerged.

Keywords: pesticide, drinking water, carbon nanotube, adsorption

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Authors: Abida Mariam, Anwaar Ahmed, Asif Ahmad, Muhammad Sheeraz Ahmad, Muhammad Akram Khan, Muhammad Mazahir

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The plant olive (Olea europaea L.) is known for its commercial significance due to nutritional and health benefits. Pakistan is ranked 4th among countries who import olive oil whereas, 70% of edible oil is imported to fulfil the needs of the country. There exists great potential for Olea europaea cultivation in Pakistan. The popularity and cultivation of olive fruit has increased in recent past due to its high socio-economic and health significance. There exist almost negligible data on the chemical composition of extra virgin olive oil extracted from cultivars grown in Pothwar, an area with arid climate conducive for growth of olive trees. Keeping in view these factors a study has been conducted to characterize the olive oil extracted from olive cultivars collected from Pothwar regions of Pakistan for their nutritional potential and value addition. Ten olive cultivars (Gemlik, Coratina, Sevillano, Manzanilla, Leccino, Koroneiki, Frantoio, Arbiquina, Earlik and Ottobratica) were collected from Barani Agriculture Research Institute, Chakwal. Extra Virgin Olive Oil (EVOO) was extracted by cold pressing and centrifuging of olive fruits. The highest amount of oil was yielded in Coratina (23.9%) followed by Frantoio (23.7%), Koroneiki (22.8%), Sevillano (22%), Ottobratica (22%), Leccino (20.5%), Arbiquina (19.2%), Manzanilla (17.2%), Earlik (14.4%) and Gemllik (13.1%). The extracted virgin olive oil was studied for various physico- chemical properties and fatty acid profile. The Physical and chemical properties i.e., characteristic odor and taste, light yellow color with no foreign matter, insoluble impurities (≤0.08), fee fatty acid (0.1 to 0.8), acidity (0.5 to 1.6 mg/g acid), peroxide value (1.5 to 5.2 meqO2/kg), Iodine value (82 to 90), saponification value (186 to 192 mg/g) and unsaponifiable matter (4 to 8g/kg), ultraviolet spectrophotometric analysis (k232 and k270), showed values in the acceptable range, established by PSQCA and IOOC set for extra virgin olive oil. Olive oil was analyzed by Near Infra-Red spectrophotometry (NIR) for fatty acids sin olive oils which were found as: palmitic, palmitoleic, stearic, oleic, linoleic and alpha-linolenic. Major fatty acid was Oleic acid in the highest percentage ranging from (55 to 66.1%), followed by linoleic (10.4 to 20.4%), palmitic (13.8 to 19.5%), stearic (3.9 to 4.4%), palmitoleic (0.3 to 1.7%) and alpha-linolenic (0.9 to 1.7%). The results were significant with differences in parameters analyzed for all ten cultivars which confirm that genetic factors are important contributors in the physico-chemical characteristics of oil. The olive oil showed superior physical and chemical properties and recommended as one of the healthiest forms of edible oil. This study will help consumers to be more aware of and make better choices of healthy oils available locally thus contributing towards their better health.

Keywords: characterization, extra virgin olive oil, oil yield, fatty acids

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Authors: Eric D. Olson

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The lesbian/gay/bisexual/transgender/queer/questioning tourist (LGBTQ+) travels more frequently, spends more money on travel, and is more likely to travel internationally compared to their straight/heterosexual counterparts. For Vietnam, this represents a huge opportunity to increase international tourism, considering social advancements and recognition of the LGBTQ+ have greatly increased in the past few years in Vietnam. For example, Vietnam’s Health Ministry confirmed in 2022 that same-sex attraction and being transgender is not a mental health condition. A robust hospitality ecosystem of LGBTQ+ tourism suppliers already exists in Vietnam catering to LGBTQ+ tourists (e.g., Gay Hanoi Tours, VietPride). Vietnam is a safe and welcoming destination with incredible nature, cosmopolitan cities, and friendly people; however, there is a dearth of academic and industry research that has examined how LGBTQ+ international tourists perceive Vietnam as an LGBTQ+ friendly destination. To rectify this gap, this research examines Vietnam as an LGBTQ+ destination in order to provide government officials, destination marketers, and industry practitioners with insight into this increasingly visible tourist market segment. A self-administered survey instrument was administered to n=375 international LGBTQ+ tourists to examine their perceptions of Vietnam. A factor analysis found three categories of LGBTQ+ factors of visitation to Vietnam: safety and security (Eigenvalue = 4.12, variance = 32.45, α = .82); LGBTQ+ attractions (Eigenvalue = 3.65 variance = 24.23, α = .75); and friendly interactions (Eigenvalue = 3.71, variance = 10.45, α = .96). Multiple regression was used to examine LGBTQ+ visitation factors and intention to visit Vietnam, F=12.20 (2, 127), p < .001, R2 = .56. Safety and security (β = 0.42, p < .001), LGBTQ+ attractions (β = 0.61, p < .001) and friendly interactions (β = 0.42, p < .001) are predictors to visit Vietnam. Results are consistent with previous research that highlight safety/security is of utmost importance to the community when traveling. Attractions, such as LGBTQ+ tours, suppliers, and festivals can also be used as a pull factor in encouraging tourism. Implications/limitations will be discussed.

Keywords: tourism, LGBTQ, vietnam, regression

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Authors: Mehar Pruthi, Manjula V.

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For the longest time, Indian households have been hosts to a variety of domestic evils such as intimate partner violence, physical abuse, sexual assaults, and more commonly gender-based violence. The prevalence of such heinous acts against women is often swept under the carpet of patriarchy and leaves women scarred. Many times, these wounds are caused by more insidious and subtle acts of violence. For this study, the choice of term for these acts is Emotional Abuse. The ill effects of emotional abuse on the victim’s sense of self and psychological health have been widely established. The current study takes a qualitative approach to explore women’s experiences at the brunt of emotional abuse. To this end, six participants (N=6) were identified using purposive and snowball sampling which was followed by a pre-screening form to assess for the presence of emotional abuse. A semi-structured interview guide was employed to investigate the victim’s perception of emotional abuse, the manifestation of emotional abuse in a patriarchal society, and the reasons women remain in abusive relationships. Each interview lasted about 50-60 mins and was accompanied by extensive note-making. A preliminary analysis of the interviews was done using the Interpretative Phenomenological Approach. Initial findings reveal the emergence of themes such as feelings of loneliness, intergenerational transmission of violence, denial, justifying the partner’s behavior, staying because of children, hoping things would change, and faith in God. The study is instrumental in conceptualizing the patterns of emotional abuse keeping in mind the patriarchal context of the Indian society. It has implications for professionals in the mental health field who work with this population so they can better understand their plight. Future research could focus on rebuilding relationships for those partners who decide to sustain such relationships and focus on various coping mechanisms with special emphasis on religious beliefs.

Keywords: emotional abuse, gender-based violence, intimate partner violence, marriage, patriarchy

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Authors: Priyanka Manghani, Manthan Patel, Rahul Peddawad

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Cervical Cancer is a major public health hurdle in the area of women’s health. The most common cause of Cervical Cancer is the Human Papilloma Virus (HPV). Human papilloma virus has various genotypes, with HPV 16 and HPV 18 being the major etiological factor causing carcinoma of the Cervix. Early screening and detection by Papanicolaou Smears (PAP) is an effective method for identifying premalignant and malignant lesions. In case of existing pre- malignant lesions /cervical dysplasia’s found with HPV 16 or 18, appropriate follow up can be done to prevent it from developing into a neoplasm. Aims and Objectives: Primary Aim; To study various abnormal cervical cytology reports as detected by Pap Smear Tests, using the Bethesda System in women at a Tertiary Care Hospital. Secondary Aim; To discuss the importance of Pap smear in Cervical Cancer Screening Program. Materials and Methods: Our study is a prospective study, based on 101 women who attended the Out-patient department of Obstetrics and Gynecology at a tertiary care hospital in age group 20-40 years with chief complaints of white/foul vaginal discharge, post-coital Bleeding, low back pain, irregular menstruation, etc. 60 women, who were tested, of the total no of women, were commercial sex workers, thus being a high-risk group for HPV infection. All women underwent conventional cytology. For all the abnormal smears, further cervical biopsies were done, and the final diagnosis was done on the basis of histopathology (gold standard). Results: In all these patients, 16 patients presented with normal smears out of which 2 belonged to the category of commercial sex workers (3.33%) and 14 being from the normal/control group (34.15%). 44 women presented with inflammatory smears out of which 30 were commercial sex workers (50%) and 14 from the control Group (34.15%). A total of 11 women presented with infectious etiology with 6 being commercial sex workers (10%) and 5 (12.2%) being in the control group. A total of 8 patients presented with low-grade squamous intra epithelial lesion (LSIL) with 7 (11.7%) being commercial sex workers and 1(2.44%) patient belonging to the control group. A Total of 7 patients presented with high-grade squamous intraepithelial lesion (HSIL) with 6 (10%) being commercial sex workers and 1 (2.44%) belonging to the control group. 9 patients in total presented with atypical squamous cells of undetermined significance (ASCUS) with 6(10%) being commercial sex workers and 3 (7.32%) belonging to the control group. Squamous cell carcinoma(SCC) presence was found only in 1(1.7%) commercial sex worker. Conclusion – We conclude that HSIL, LSIL, SCC and sexually related infections are comparatively more common in vulnerable groups such as sex workers due to a variety of factors such as multiple sexual partners and poor genital hygiene. Early screening and follow up interventions are highly needed for them along with Health education for risk factors and to emphasize on the importance of Pap smear screening.

Keywords: cervical cancer, papanicolaou (pap) smear, bethesda system, neoplasm

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Authors: Jarmila Štěpánová, Martin Kudláček, Lukáš Jakubec

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The people with spinal cord injury are one of the least sport active members of our society. Their hypoactivity is determined by primary injury, i.e., the loss of motor function, the injured part of the body is connected with health complications and social handicap. Study performs one part of the standardization process of semi-structured interview PARA-SCI.CZ (Czech version of the Physical Activity Recall Assessment for People with Spinal Cord Injury), which measures the type, frequency, duration, and intensity of physical activity of people with spinal cord injury. The study focused on persons with paraplegia who use a wheelchair as their primary mode of mobility. The aim of this study was to perform a process to determine the criterion validity of PARA-SCI.CZ. The actual physical activity of wheelchair users was monitored during three days by using accelerometers Actigraph GT3X fixed on the non-dominant wrist, and semi-structured interview PARA-SCI.CZ. During the PARA-SCI.CZ interview, participants were asked to recall activities they had done over the past 3 days, starting with the previous day. PARA-SCI.CZ captured frequency, duration, and intensity (low, moderate, and heavy) of two categories of physical activity (leisure time physical activity and activities of a usual day). Accelerometer Actigraph GT3X captured duration and intensity (low and moderate + heavy) of physical activity during three days and nights. The study presented three potential recalculations of measured data. Standardization process of PARA-SCI.CZ is essential to critically approach issues of health and active lifestyle of persons with spinal cord injury in the Czech Republic. Standardized PARA-SCI.CZ can be used in practice by physiotherapists and sports pedagogues from the field of adapted physical activities.

Keywords: physical activity, lifestyle, paraplegia, semi-structure interview, accelerometer

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Authors: Jamal Almatawah, Hamad Matar, Abdulsalam Altemeemi

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The World Health Organization (WHO) has recognized environmental noise as harmful pollution that causes adverse psychosocial and physiologic effects on human health. The motor vehicle is considered to be one of the main source of noise pollution. It is a universal phenomenon, and it has grown to the point that it has become a major concern for both the public and policymakers. The aim of this paper, therefore, is to investigate the Traffic noise levels and the contributing factors that affect its level, such as traffic volume, heavy-vehicle Speed and other metrological factors in Ishbiliyah as a sample of a residential area in Kuwait. Three types of roads were selected in Ishbiliyah expressway, major arterial and collector street. The other source of noise that interferes the traffic noise has also been considered in this study. Traffic noise level is measured and analyzed using the Bruel & Kjaer outdoor sound level meter 2250-L (2250 Light). The Count-Cam2 Video Camera has been used to collect the peak and off-peak traffic count. Ambient Weather WM-5 Handheld Weather Station is used for metrological factors such as temperature, humidity and wind speed. Also, the spot speed was obtained using the radar speed: Decatur Genesis model GHD-KPH. All the measurement has been detected at the same time (simultaneously). The results showed that the traffic noise level is over the allowable limit on all types of roads. The average equivalent noise level (LAeq) for the Expressway, Major arterial and Collector Street was 74.3 dB(A), 70.47 dB(A) and 60.84 dB(A), respectively. In addition, a Positive Correlation coefficient between the traffic noise versus traffic volume and between traffic noise versus 85th percentile speed was obtained. However, there was no significant relation and Metrological factors. Abnormal vehicle noise due to poor maintenance or user-enhanced exhaust noise was found to be one of the highest factors that affected the overall traffic noise reading.

Keywords: traffic noise, residential area, pollution, vehicle noise

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Authors: Liana C. Salanță, Maria Tofană, Carmen R. Pop, Vlad Mureșan

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The landscape of functional food is expanding very fast, due to the consumer interest for healthy natural products. Consumers nowadays demand healthy products that impart phytonutrients to encourage good health and well-being, prevent diseases, without sacrificing taste and texture. Candies are foodstuffs appreciated by all category of consumers. They are available in a range variety of forms (jellies, marshmallows, caramels, lollipops, etc.). Jelly is characterized by a gummy and chewy texture typically conferred by a hydrocolloid (gelatin, pectin). The purpose of this research was to obtain hypocaloric jelly (no added sugar) enriched with protein powder from acai, chia seeds and hemp, which are considered superfood. Peach and raspberry juice were used for obtaining functional jelly, due to the specific flavour, natural carbohydrate, natural pigments and vitamins (C, B1, PP, etc). Instead of classic hydrocolloids used in Romania for the industry of jelly, agar-agar was used in this study, due to its properties. Agar-agar is able to form gels in the aqueous medium, stronger than other gel-forming agents. High sugar concentrations or an acid environment (as is necessary with pectins) are not needed. In addition to its gelation properties, Agar-agar is considered to have important nutritional benefits, high content of fibre and has low calories. Six prototypes of jellies were obtained and evaluated by physicochemical, microbiological and sensorial analysis. For the textural profile analysis, the Brookfield CT3 Texture Analyzer, equipped with a 10kg load cell, was used. The results revealed that hypocaloric jelly can serve as a good source of bioactive compounds in the diet. The jelly is a convenient way of delivering potential health benefits of protein powder and agar-agar to a wide range of consumers.

Keywords: agar-agar, functional food, hypocaloric jelly, superfoods

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Authors: Ghulam Rasool Madni

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Global economies are prioritizing the attainment of Sustainable Development Goals (SDGs) for well-being of their people. An emphasis lies on the concept of metagovernance when contemplating the role of government in SDGs, especially in the context of its influence and guidance. Existing literature acknowledges the pivotal role of metagovernance in achieving the SDGs, but aspects of metagovernance unclear that are important for 17 SDGs. Using data from 41 countries, a comparative analysis is conducted for the year 2022. Utilizing a multiple regression analysis, the impact of different dimensions of metagovernance to achieve SDGs is explored, with a particular focus on sustainable policies, strategic capacity, policy coherence, democratic institutions, reflexivity, and adaptation. It is found that sustainable policies have a positive and significant relationship with different SDGs, including no poverty, zero hunger, health, sanitation and clean water, affordable and clean energy, decent work and economic growth, industry, innovation and infrastructure, reduced inequalities while democratic institutions also have a positive relationship with no poverty, good health and well-being, quality education, gender equality, clean water and sanitation, clean and affordable energy, and peace, justice, and strong institutions in these countries. Policymakers are suggested to ensure that sustainable policies are backed by legislation to provide them with a strong legal foundation. It is suggested to develop a long-term vision for sustainability that goes beyond short-term political cycles. Economies are encouraged to invest in building the capacity of government agencies, civil society organizations, and other stakeholders to effectively implement sustainable policies. Moreover, democratic institutions may be established through a constitution providing a solid foundation for democratic governance, including protection of human rights, separation of powers, and mechanisms for accountability and transparency.

Keywords: metagovernance, sustainable development goals, sustainable policies, democratic institutions

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Authors: J. Hash, J. Converse, L. Gibson

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Plant medicines are of growing interest for addressing mental health concerns. Ayahuasca, a traditional plant-based medicine, has established itself as a powerful way of processing trauma and precipitating healing and mood stabilization. Eye Movement Desensitization and Reprocessing (EMDR) is another treatment modality that aids in the rapid processing and resolution of trauma. We investigated group EMDR therapy, G-TEP, as a preparatory practice before Ayahuasca ceremonies to determine if the combination of these modalities supports participants in their journeys of letting go of past experiences negatively impacting mental health, thereby accentuating the healing of the plant medicine. We surveyed 96 participants (51 experimental G-TEP, 45 control grounding prior to their ceremony; age M=38.6, SD=9.1; F=57, M=34; white=39, Hispanic/Latinx=23, multiracial=11, Asian/Pacific Islander=10, other=7) in a pre-post, mixed methods design. Participants were surveyed for demographic characteristics, symptoms of PTSD and cPTSD (International Trauma Questionnaire (ITQ), depression (Beck Depression Inventory, BDI), and stress (Perceived Stress Scale, PSS) before the ceremony and at the end of the ceremony weekend. Open-ended questions also inquired about their expectations of the ceremony and results at the end. No baseline differences existed between the control and experimental participants. Overall, participants reported a decrease in meeting the threshold for PTSD symptoms (p<0.01); surprisingly, the control group reported significantly fewer thresholds met for symptoms of affective dysregulation, 2(1)=6.776, p<.01, negative self-concept, 2 (1)=7.122, p<.01, and disturbance in relationships, 2 (1)=9.804, p<.01, on subscales of the ITQ as compared to the experimental group. All participants also experienced a significant decrease in scores on the BDI, t(94)=8.995, p<.001, and PSS, t(91)=6.892, p<.001. Similar to patterns of PTSD symptoms, the control group reported significantly lower scores on the BDI, t(65.115)=-2.587, p<.01, and a trend toward lower PSS, t(90)=-1.775, p=.079 (this was significant with a one-sided test at p<.05), compared to the experimental group following the ceremony. Qualitative interviews among participants revealed a potential explanation for these relatively higher levels of depression and stress in the experimental group following the ceremony. Many participants reported needing more time to process their experience to gain an understanding of the effects of the Ayahuasca medicine. Others reported a sense of hopefulness and understanding of the sources of their trauma and the necessary steps to heal moving forward. This suggests increased introspection and openness to processing trauma, therefore making them more receptive to their emotions. The integration process of an Ayahuasca ceremony is a week- to months-long process that was not accessible in this stage of research, yet it is an integral process to understanding the full effects of the Ayahuasca medicine following the closure of a ceremony. Our future research aims to assess participants weeks into their integration process to determine the effectiveness of EMDR, and if the higher levels of depression and stress indicate the initial reaction to greater awareness of trauma and receptivity to healing.

Keywords: ayahuasca, EMDR, PTSD, mental health

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Authors: Tahra ElObeid, Omnya Ahmed, Reem Al-Sharshani, Doaa Dalloul, Jannat Alnattei

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Background: Camelus dormedarius camels are also called ‘the Arabian camels’ and are present in the desert area of North Africa and the Middle East. Recently, camel’s milk has a great attention globally because of their proteins and peptides that have been reported to be beneficial for the health and in the management of many diseases. Objectives: This study was designed to investigate the antioxidant, antimicrobial activity and to evaluate the total phenolic content of camel’s milk proteins in Qatar. Methods: Fresh two camel’s milk samples from Omani breed and called Muhajer (camel’s milk A and B) were collected on the 1st of the December. Both samples were from the same location Al- Shahaniyah, Doha, Qatar, but from different local private farms and feeding system. Camel’s milk A and B were defatted by centrifugation and their proteins were extracted by acid and thermal precipitation. The antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. Total phenolic compound (TPC) was evaluated by Folin-Ciocalteu reagent (FCR). On the other hand, the antimicrobial activity against eight different type of pathogenic bacteria was evaluated by disc diffusion method and the zone of inhibition was measured. Results: The of the total phenolic content of whole milk in both camel’s milk A and B were significantly the highest among the protein extracts. The % of the DPPH radical inhibition of casein protein in both camel’s milk A and B were significantly the highest among the protein extracts. In this study, there were marked changes in the antibacterial activity in the different camel milk protein extracts. All extracts showed bacterial overgrowth. Conclusion: The antioxidant activity of the camel milk protein extracts correlated to their unique phenolic compounds and bioactive protein peptides. The antimicrobial activity was not detected perhaps due to the technique, the quality, or the extraction method. Overall, camel's milk exhibits a high antioxidant activity, which is responsible for many health benefits besides the nutritional values.

Keywords: camels milk, antioxidant content, antimicrobial activity, proteins, Qatar

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Authors: Abdelsalam Elawwad, Mostafa Ragab, Hisham Abdel-Halim

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Leakage in sewerage system can cause groundwater and soil contamination in urban areas, especially in area with a high groundwater table. This is a serious problem in small villages in developing countries that rely on ground water as a source for irrigation and drinking purposes. In the developed countries, the recent trend in areas with low population densities is vacuum sewerage system, which is environmentally safer than conventional gravity system, protecting public health, preventing exfiltration to the ground water, very easily applied in a relatively short time and can cope with a faster expansion of the urbanized areas. The aim of this work is to assess the feasibility of using vacuum sewerage in developing country, such as Egypt. Knowledge of local conditions can determine the most suitable sewer system for a specific region. Technical, environmental and financial comparisons between conventional sewerage system and vacuum sewerage system were held using statistical analysis. Different conditions, such as population densities, geometry of area, and ground water depths were evaluated. Sample comprising of 30 Egyptian villages was selected, where a complete design for conventional sewerage system and vacuum sewerage system was done. Based on this study, it is recommended from the environmental point of view to construct the vacuum sewerage system in such villages with low population densities; however, it is not economic for all cases. From financial point of view, vacuum sewerage system was a good competitor to conventional systems in flat areas and areas with high groundwater table. The local market supplying of the construction equipment especially collection chambers will greatly affect the investment cost. Capacity building and social mobilization will also play a great role in sustainability of this system. At the end, it is noteworthy that environmental sustainability and public health are more important than the financial aspects.

Keywords: ground water, conventional system, vacuum system, statistics, cost, density, terrain

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Authors: Peter Ekene Egwu

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Waste management is of critical importance in Africa for reasons related to public health, human dignity, climate resilience and environmental preservation. However, delivering waste management services requires adequate funding, which has generally been lacking in a context where the generation of waste is outpacing the development of waste management infrastructure in most cities. The sector represents a growing percentage of cities’ greenhouse gas (GHG) emissions, and some of the African cities profiled in this study are now designing waste management strategies with emission reduction in mind.

Keywords: management waste material, Africa, uses of new technology to manage waste, waste management

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Authors: Elsa Marta Soares, Ana Rita Valente, Cristiana Rodrigues, Filipa Gonçalves

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Background: The assessment of feelings and attitudes of preschool children in relation to stuttering is crucial. Negative experiences can lead to anxiety, worry or frustration. To avoid the worsening of attitudes and feelings related to stuttering, it is important the early detection in order to intervene as soon as possible through an individualized intervention plan. Then it is important to have Portuguese instruments that allow this assessment. Aims: The aim of the present study is to realize the translation and adaptation of the Communication Attitude Test for Children in Preschool Age and Kindergarten (KiddyCat) for EP. Methodology: For the translation and adaptation process, a methodological study was carried out with the following steps: translation, back translation, assessment by a committee of experts and pre-test. This abstract describes the results of the first two phases of this process. The translation was accomplished by two bilingual individuals without experience in health and any knowledge about the instrument. One of them was an English teacher and the other one a Translator. The back-translation was conducted by two Senior Class Teachers that live in United Kingdom without any knowledge in health and about the instrument. Results and Discussion: In translation there were differences in semantic equivalences of various expressions and concepts. A discussion between the two translators, mediated by the researchers, allowed to achieve the consensus version of the translated instrument. Taking into account the original version of KiddyCAT the results demonstrated that back-translation versions were similar to the original version of this assessment instrument. Although the back-translators used different words, they were synonymous, maintaining semantic and idiomatic equivalences of the instrument’s items. Conclusion: This project contributes with an important resource that can be used in the assessment of feelings and attitudes of preschool children who stutter. This was the first phase of the research; expert panel and pretest are being developed. Therefore, it is expected that this instrument contributes to an holistic therapeutic intervention, taking into account the individual characteristics of each child.

Keywords: assessment, feelings and attitudes, preschool children, stuttering

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Authors: Moetazza M. Alshafei, Ahmed M. Mabrouk, Emtenan M. Hanafi, Manal M. Ramadan, Reda M. S. Korany, Seham S. Kassem, Dina Mostafa Mohammed

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Metabolic syndrome (MeS) is a major health problem with a high incidence of obese individuals worldwide. Increased related morbidity of diabetes, hypertension and fatty liver disease, and complicated cardiovascular disease are inevitable. Boswellia serrata gum (Bos) is a promising traditional medicinal plant; it has several pharmacological properties, including anti-inflammatory, antioxidant, and antilipase activities. Probiotics (Bac) supplements have good benefits on health and MeS, whether it is supplemented in combination with prebiotics or alone. Microencapsulation helps to mask unpalatable taste and odor and deliver active ingredients to targeted organs. Methodology MeS rat model was produced by feeding rats with a high fat, high CHO diet (HFD). Bos was extracted, and both Bos and the probiotic were microencapsulated with a spray drier. Female rats were divided into 5 groups (N8). HFD control, control normal receiving basic diet, HFD treated, from the start of the experiment, either with encapsulated Bos, Bac and Bos or Bac only, all treatments were received for eight weeks (after approval from NRC animal ethical committee). Serum was collected to analyze lipid profile, blood sugar, liver and kidney functions, antioxidants, leptin, and progesterone. Rat's organs and body fat were weighed and collected for histopathology. Statistical analysis was done by use of one way Anova test in the SPSS program. Results showed control of elevated body weight, lipid profile, and glucose levels as well as decrease of body fat index and improvement of histopathology of liver and heart, especially in combination. Conclusion: We concluded that both microencapsulated Bos and probiotics have a controlling effect on MeS parameters.

Keywords: metabolic syndrome, Boswellia serata, probiotic, micro-encapsulation, histopathology, liver steatosis

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Authors: Halimatus Sakdiah Minhat, Hamizah Sulaiman

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Introduction: Old age is commonly link with menopause among women. The main purpose of this study is to explore the views of middle-aged women and its association with menopause. Methods: Qualitative interviews in the form of focus group discussions (FGD) were conducted among women aged between 35 and 59 years old living in urban localities in two different states in Malaysia. Selection of respondents were conducted using the maximum variation sampling, focussing on five age categories which are between 35 to 39, 40 to 44, 45 to 49, 50 to 54 and 55 to 59 years old. Each FGD involved 5 to 7 respondents and lasted for 1 to 2 hours each. The content of the interviews were recorded, transcribed verbatim after each interview before the next focus group discussion is conducted. Field notes of reflexive observations were recorded by the rapporteur. Individual transcripts were analysed using standard methods of qualitative thematic analysis. The material was read through twice and later coded. The codes were further collapsed into several key themes related to perceptions towards menopause among the respondents. Results: A total number of 36 middle-aged women were consented for the interviews. The contents of the interviews revealed that younger women tend to associate menopause with being old, which were dominated by the younger aged categories of less than 50 years old. Majority of the respondents linked menopause with end of woman’s reproductive capacity or inability to give birth, lethargic or endless feeling of tiredness and insomnia, emotional instability or having more sensitive feelings and also the beginning of many health problems such as osteoarthritis which they perceived very synonyms with being old. Conclusion: The findings of this study indirectly reflect the negative views towards menopause among the middle-aged women in Malaysia. Being residents in the urban areas equipped with advanced technology and health information, do not exclude them from having negative views about menopause. However, this is a qualitative study which only focussing on age ranges, regardless of their socioeconomic and demographic background, which make further studies on related issues are necessaries. The fact that it was a qualitative interview, the findings could not be generalised and only specific to the targeted population.

Keywords: Menopause, Middle-aged women, old, Malaysia

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Authors: Daniel F. Bohorquez, Luis M. Agudelo, Henry H. León

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Heart rate variability (HRV) is defined as the temporary variation between heartbeats or RR intervals (distance between R waves in an electrocardiographic signal). This distance is currently a recognized biomarker. With the analysis of the distance, it is possible to assess the sympathetic and parasympathetic nervous systems. These systems are responsible for the regulation of the cardiac muscle. The analysis allows health specialists and researchers to diagnose various pathologies based on this variation. For the acquisition and analysis of HRV taken from a cardiac electrical signal, electronic equipment and analysis software that work independently are currently used. This complicates and delays the process of interpretation and diagnosis. With this delay, the health condition of patients can be put at greater risk. This can lead to an untimely treatment. This document presents a single portable device capable of acquiring electrocardiographic signals and calculating a total of 19 HRV metrics. This reduces the time required, resulting in a timelier intervention. The device has an electrocardiographic signal acquisition card attached to a microcontroller capable of transmitting the cardiac signal wirelessly to a mobile device. In addition, a mobile application was designed to analyze the cardiac waveform. The device calculates the RR and different metrics. The application allows a user to visualize in real-time the cardiac signal and the 19 metrics. The information is exported to a cloud database for remote analysis. The study was performed under controlled conditions in the simulated hospital of the Universidad de la Sabana, Colombia. A total of 60 signals were acquired and analyzed. The device was compared against two reference systems. The results show a strong level of correlation (r > 0.95, p < 0.05) between the 19 metrics compared. Therefore, the use of the portable system evaluated in clinical scenarios controlled by medical specialists and researchers is recommended for the evaluation of the condition of the cardiac system.

Keywords: biological signal análisis, heart rate variability (HRV), HRV metrics, mobile app, portable device.

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Authors: Anum Rafiq

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Adolescence is a vulnerable period for youth across the world. It is a period of new learning with opportunities to understand and develop perspectives on health and well-being. With youth beginning to engage in intimate relationships at an earlier age in the 21st century, concentrating on the learning opportunity they have in school is paramount. The nature of what has been deemed important to teach in schools has changed throughout history, and the focus has shifted from home/family skills to teaching youth how to be competitive in the job market. Amidst this emphasis, opportunities for them exist to learn about building healthy intimate relationships, one of the foundational elements of most people’s lives. Using an Institutional Ethnography (IE), the lived experiences of youth in how they understand intimate relationships and how their learning experience is organized through the high school Health and Physical Education (H&PE) course is explored. An empirical inquiry into how the actual work of teachers and youth are socially organized by a biomedical, employment-related, and efficiency-based discourse is provided. Through thirty-two qualitative interviews with teachers and youth, a control of ruling relations such as institutional accountability circuits, performance reports, and timetabling over the experience of teachers and youth is found. One of the facets of the institutional accountability circuit is through the social organization of teaching and learning about healthy intimate relationships being framed through a biomedical discourse. In addition, the role of a hyper-focus on performance and evaluation is found as paramount in situating healthy intimacy discussions as inferior to neoliberally charged productivity measures such as employment skills. Lastly, due to the nature of institutional policies such as regulatory guidelines, teachers are largely influenced to avoid diving into discussions deemed risky or taboo by society, such as healthy intimacy in adolescence. The findings show how texts such as the H&PE curriculum, the Ontario College of Teachers (OCT) guidelines, Ministry of Education Performance Reports, and the timetable organize the day-to-day activities of teachers and students and reproduce different disjunctures for youth. This disjuncture includes some of their experiences being subordinated, difficulty relating to curriculum, and an experience of healthy living discussions being skimmed over across sites. The findings detail that the experience of youth in learning about healthy intimate relationships is not akin to the espoused vision outlined in policy documents such as the H&PE (2015) curriculum policy. These findings have implications for policymakers, activists, and school administration alike, which call for an investigation into who is in power when it comes to youth’s learning needs, as a pivotal period where youth can be equipped with life-changing knowledge is largely underutilized. A restructuring of existing institutional practices that allow for the social and institutional flexibility required to broach the topic of healthy intimacy in a comprehensive manner is required.

Keywords: health policy, intimate relationships, youth, education, ruling relations, sexual education, violence prevention

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Authors: Niraimathi Kesavan, Sangeeta Sharma, Deepa Jagan, Sridhar Sukumar, Mohan Ramachandran, Vidhubala Elangovan

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Background: Childhood is a dynamic period for growth and development. Optimum nutrition during this period forms a strong foundation for growth, development, resistance to infections, long-term good health, cognition, educational achievements, and work productivity in a later phase of life. Underprivileged children living in a resource constraint settings like shelter homes are at high risk of malnutrition due to poor quality diet and nutritional inadequacy. In low-income countries, underprivileged children are vulnerable to being deprived of nutritious food, which stands as a major challenge in the health sector. The present aims to assess the dietary intake, nutritional status, and nutritional inadequacy and their association with malnutrition among children residing in shelter homes in rural Tamil Nadu. Methods: The study was a descriptive survey conducted among all the children aged between 8-18 years residing in two selected shelter homes (Anbu illam, a home for female children, and Amaidhi illam, a home for male children), rural Tirunelveli, Tamil Nadu, India. A total of 57 children were recruited, including 18 boys and 39 girls, for the study. Dietary intake was measured using seven days 24 hours recall. The average nutrient intake was considered for further analysis. Results: Of the 57 children, about 60% (n=35) were undernutrition. The mean daily energy intake was 1298 (SD 180) kcal for boys and 952 (SD155) kcal for girls. The total calorie intake was 55-60% below the estimated average requirement (EAR) for adolescent boys and girls in the age group 13-15 years and 16-18 years. Carbohydrates were the major source of energy (boys 53% and girls 51%), followed by fat (boys 31.5% and girls 34.5%) and protein (boys 14% and girls 12.9%). Dairy intake (<200ml/day) was less than the recommendation (500ml/day). Micro-nutrient-rich foods such as fruits, vegetables, and green leafy vegetables in the diet were <200g/day, which was far less than the recommended dietary guidelines of 400g- 600g/day for the age group of 7-18 years. Nearly 26% of girls reported experiencing menstrual problems. The majority (76.9%) of the children exhibited nutrient deficiency-related signs and symptoms. Conclusion: The total energy, minerals, and micro-nutrient intake were inadequate and below the Recommended Dietary Allowance for children and adolescents. The diet predominantly consists of refined cereals, rice, semolina, and vermicelli. Consumption of whole grains, milk, fruits, vegetables, and leafy vegetables was far below the recommended dietary guidelines. Dietary inadequacies among these children pose a serious concern for their overall health status and its consequences in the later phase of life.

Keywords: adolescents, children, dietary intake, malnutrition, nutritional inadequacy, shelter home

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Authors: Hardik Goswami, Gayatri Swarnakar

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-Mastitis disease has been known as one of the most costly diseases of dairy cattle and observed as an inflammatory disease of cow and buffalo udder. Mastitis badly affected animal health, quality of milk and economics of milk production along with cause’s great economic loss. Bacteria have been representing the most common etiological agents of mastitis. The antibiotic sensitivity test was important to attain accurate treatment of mastitis. The aim of present research work was to explore prevalence and antibiotic susceptibility pattern of bacterial isolates recovered from cow and buffalo clinical mastitis milk sample. During the period of April 2010 to April 2014, total 1487 clinical mastitis milk samples of cow and buffalo were tested to check the prevalence of mastitis causing bacterial isolates. Milk samples were collected aseptically from the udder at the time of morning milking. The most prevalent bacterial isolates were Staphylococcus aureus (24.34%) followed by coliform bacteria (15.87%), coagulase negative Staphylococcus aureus (13.85%), non-coliform bacteria (13.05%), mixed infection (12.51%), Streptococcus spp. (10.96%). Out of 1487, 140 (9.42%) mastitis milk samples showed no growth on culture media. Identification of bacteria made on the basis of Standard Microbial features and procedures. Antibiotic susceptibility of bacterial isolates was investigated by Kirby-Bauer disk diffusion method. In vitro Antibiotic susceptibility test of bacterial isolates revealed higher sensitivity to Gentamicin (74.6%), Ciprofloxacin (62.1%) and Amikacin (59.4%). The lower susceptibility was shown to Amoxicillin (21.6%), Erythromycin (26.4%) and Ceftizoxime (29.9%). Antibiotic sensitivity pattern revealed Gentamicin are the possible effective antibiotic against the major prevalent mastitis pathogens. Present research work would be helpful in increase production, quality and quantity of milk, increase annual income of dairy owners and improve health of cow and buffaloes.

Keywords: antibiotic, buffalo, cow, mastitis, prevalence

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Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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Authors: Sophia Cyril Vincent

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Background: As per the Indian Census 2011, there is nearly 104 million elderly population aged above 60 years (53 million females and 51 males), and the count is expected to be 173 million by the end of 2026. Nearly 5.5% of women and 1.5% of men are living alone.1 In India, even though it is the moral duty of the children to take care of aged parents, many elders are landing in old age homes due to the social transformation factors like mushrooming of nuclear families, migration of children, cultural echoes, differences in mindset and values. Nearly 728 old age homes are seen across the country, out of which 78 old age homes with approximately 3000 inmates are seen only in Bangalore2. The existing literature shows that elderly women residing in old age homes experience the challenges like- loneliness, health issues, rejection from children, grief, death anxiety, etc, which leads to mental and physical wellbeing in numerous and tangible ways3. Hence the best and cost-effective way to improve the meaning and quality of life among elderly females is logotherapy, a type of psychotherapeutic analysis and treatment, motivating and driving force4 within the human experience to lead a decent life. Aim: The current research is aimed at studying the effectiveness of a logotherapy intervention on meaning and quality of life among elderly women of old age homes. Samples:200 women aged < 60 years and staying in the old age home for more than 1 year were randomly allocated to the control group and experimental group. Methodology: Using the Meaning in life questionnaire (MLQ)and the World health organization quality of life (WHOQOL) questionnaire, meaning and quality of life were assessed among both groups' women. Intensive Logotherapy and meaning in life program for five days were provided for the experimental group and the control group, with no treatment. Result: Under analysis. Conclusion: It is the right of the elderly woman to lead a happy and peaceful life till her death irrespective of the residing place. Hence, continuous monitoring and effective management are necessary for elderly women.

Keywords: quality of life, meaning of life, logo therapy, old age home

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Authors: Daniela Prado, Lexi Frankel, Amalia Ardeljan, Lokesh Manjani, Matthew Cardeiro, Omar Rashid

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Background: Clostridium difficile (C. diff) is a gram-positive bacterium that is known to cause life-threatening diarrhea and severe inflammation of the colon. It originates as an alteration of the gut microbiome and can be transmitted through spores. Recent studies have shown a high association between the development of C. diff in cancer patients due to extensive hospitalization. However, research is lacking regarding C. diff’s association in the causation or prevention of cancer. The objective of this study was to therefore assess the correlation between Clostridium difficile infection (CDI) and the incidence of bone cancer. Methods: This retrospective analysis used data provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate the patients infected versus patients not infected with C. diff using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale, for the purpose of academic research. Standard statistical methods were used. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 78863 patients in both the infected and control group, respectively. The two groups were matched by age range and CCI score. The incidence of bone cancer was 659 patients (0.835%) in the C. diff group compared to 1941 patients (2.461%) in the control group. The difference was statistically significant by a P-value < 2.2x10^-16 with an odds ratio (OR)= 0.33 (0.31-0.37) with a 95% confidence interval (CI). Treatment for CDI was analyzed for both C. diff infected and noninfected populations. 91 out of 16,676 (0.55%) patients with a prior C. diff infection and treated with antibiotics were compared to the control group were 275 out of 16,676 (1.65%) patients with no history of CDI and received antibiotic treatment. Results remained statistically significant by P-value <2.2x10-16 with an OR= 0.42 (0.37, 0.48). and a 95% CI. Conclusion: The study shows a statistically significant correlation between C. diff and a reduced incidence of bone cancer. Further evaluation is recommended to assess the potential of C. difficile in reducing bone cancer incidence.

Keywords: bone cancer, colitis, clostridium difficile, microbiome

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Authors: Andrea Vega-Tinoco, Ana I. Gil-Lacruz, Marta Gil-Lacruz

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The main objective of this research is to acknowledge whether civic participation affects the well-being of the elderly, thus being a key activity of active aging. It is also of interest to recognize any differences among genders, generational cohorts or country of residence. If a positive relationship is found between civic participation and well-being, the actions that promote this participation will benefit the quality of life of senior citizens. Otherwise, independent action must be taken in the improvement of social and human capital. The sample consists of approximately 50.000 individuals from the European Social Survey (2002-2016). Only individuals born before 1965 in 15 European countries were considered. The sample was distributed according to gender, year of birth, country, level of studies and ESS wave to form pseudo-panel data cohorts, leaving a total of 1.318 observations. The data were analyzed through a Cross-Lagged Model using Fixed-Effects. A bidirectional association is observed between the civic participation and well-being variables. However, participating in the past seems to have a higher impact on today’s health, happiness and life satisfaction than the other way around. Furthermore, 26% of the respondents expressed to be satisfied with their life, 27% to be happy and 57% to have good health. On the other hand, 49% have participated civically in the last year, being the most common activities: signing petitions, boycotting products and volunteer work in non-political organizations. A slight trend of BabyBoomers and men towards greater participation can be observed, as well as a higher impact of this participation on their well-being. In addition, international differences exhibit a stronger relation for Nordic, East European and Mediterranean countries. The given results support the hypothesis that civic participation is a promoter of well-being for the elderly. This paper positively highlights the activity of involving in political and non-political organizations, as well as wearing badges. At any rate, almost all forms of civic participation show a positive relationship with well-being and should therefore be promoted, although differences between countries must be taken into consideration.

Keywords: active aging, civic participation, Europe, well-being

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Authors: Nikhil A. Gavhane, Sachin Shah, Ishant S. Mahajan, Pawan D. Bahekar

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Introduction: Millions of people are affected with dengue fever every year, which drives up healthcare expenses in many low-income countries. Organ failure and other serious symptoms may result. Another worldwide public health problem is sickle cell anaemia, which is most prevalent in Africa, the Caribbean, and Europe. Dengue epidemics have reportedly occurred in locations with a high frequency of sickle cell disease, compounding the health problems in these areas. Aims and Objectives: This study examines dengue infection in sickle cell disease-afflicted pre-schoolers. Method:This Retrospective cohort study examined paediatric patients. Young people with sickle cell disease (SCD), dengue infection, and a control group without SCD or dengue were studied. Data on demographics, SCD consequences, medical treatments, and laboratory findings were gathered to analyse the influence of SCD on dengue severity and clinical outcomes, classified as severe or non-severe by the 2009 WHO classification. Using fever or admission symptoms, the research estimated acute illness duration. Result: Table 1 compares haemoglobin genotype-based dengue episode features in SS, SC, and controls. Table 2 shows that severe dengue cases are older, have longer admission delays, and have particular symptoms. Table 3's multivariate analysis indicates SS genotype's high connection with severe dengue, multiorgan failure, and acute pulmonary problems. Table 4 relates severe dengue to greater white blood cell counts, anaemia, liver enzymes, and reduced lactate dehydrogenase. Conclusion: This study is valuable but confined to hospitalised dengue patients with sickle cell illness. Small cohorts limit comparisons. Further study is needed since findings contradict predictions.

Keywords: dengue, chills, headache, severe myalgia, vomiting, nausea, prostration

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