Search results for: elderly care facilities

Authors: Mohammad Shahjahan, Md. Monoarul Haque

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In the research work information and data were collected from both types of sources, direct and indirect. Numerological, qualitative and participatory analysis methods have been followed. There were two principal sources of collecting information and data. Firstly, the data provided by the service recipients (300 nos. of women and children victims) in the Victim Support Centre and service providing policemen, executives and staffs (60 nos.). Secondly, data collected from Specialists, Criminologists and Sociologists involved in victim support services through Consultative Interview, KII, Case Study and FGD etc. The initial data collection has been completed with the help of questionnaires as per strategic variations and with the help of guidelines. It is to be noted that the main objective of this research was to determine whether services provided to the victims for their facilities, treatment/medication and rehabilitation by different government/non-government organizations was veritable at all. At the same time socio-economic background and demographic characteristics of the victims have also been revealed through this research. The results of the study show that although the number of victims has increased gradually due to socio-economic, political and cultural realities in Bangladesh, the number of victim support centers has not increased as expected. Awareness among the victims about the effectiveness of the 8 centers working in this regard is also not up to the mark. Two thirds of the victims coming to get service were not cognizant regarding the victim support services at all before getting the service. Most of those who have finally been able to come under the services of the Victim Support Center through various means, have received sheltering (15.5%), medical services (13.32%), counseling services (13.10%) and legal aid (12.66%). The opportunity to stay in security custody and psycho-physical services were also notable. Usually, women and children from relatively poor and marginalized families of the society come to victim support center for getting services. Among the women, young unmarried women are the biggest victims of crime. Again, women and children employed as domestic workers are more affected. A number of serious negative impacts fall on the lives of the victims. Being deprived of employment opportunities (26.62%), suffering from psycho-somatic disorder (20.27%), carrying sexually transmitted diseases (13.92%) are among them. It seems apparent to urgently enact distinct legislation, increase the number of Victim Support Centers, expand the area and purview of services and take initiative to increase public awareness and to create mass movement.

Keywords: crime, victim, support, Bangladesh

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Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

Procedia PDF Downloads 344

Authors: V. Morenov, E. Leusheva

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Power supplying of well drilling on oil and gas fields at ambient air low temperatures is characterized by increased requirements of electric and heat energy. Power costs for heating of production facilities, technological and living objects may several times exceed drilling equipment electric power consumption. Power supplying of prospecting and exploitation drilling objects is usually done by means of local electric power structures based on diesel power stations. In the meantime, exploitation of oil fields is accompanied by vast quantities of extracted associated petroleum gas, and while developing gas fields there are considerable amounts of natural gas and gas condensate. In this regard implementation of gas-powered self-sufficient power units functioning on produced crude products for power supplying is seen as most potential. For these purposes gas turbines (GT) or gas reciprocating engines (GRE) may be used. In addition gas-powered units are most efficiently used in cogeneration mode - combined heat and power production. Conducted research revealed that GT generate more heat than GRE while producing electricity. One of the latest GT design are microturbines (MT) - devices that may be efficiently exploited in combined heat and power mode. In conditions of ambient air low temperatures and high velocity wind sufficient heat supplying is required for both technological process, specifically for drilling mud heating, and for maintaining comfortable working conditions at the rig. One of the main heat regime parameters are the heat losses. Due to structural peculiarities of the rig most of the heat losses occur at cold air infiltration through the technological apertures and hatchways and heat transition of isolation constructions. Also significant amount of heat is required for working temperature sustaining of the drilling mud. Violation of circulation thermal regime may lead to ice build-up on well surfaces and ice blockages in armature elements. That is why it is important to ensure heating of the drilling mud chamber according to ambient air temperature. Needed heat power will be defined by heat losses of the chamber. Noting heat power required for drilling structure functioning, it is possible to create combined heat and power complex based on MT for satisfying consumer power needs and at the same time lowering power generation costs. As a result, combined power supplying scheme for multiple well drilling utilizing heat of MT flue gases was developed.

Keywords: combined heat, combined power, drilling, electric supply, gas-powered units, heat supply

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Authors: Murray Matarab Konzang

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Lae Port Development Project, Four Lane Highway and other development in the extraction industry which have direct road link to Lae City are predicted to have significant impact on its road network system. This paper evaluates Lae roads improvement program with forecast on planning, economic and the installation of bypasses to ease congestion, effective and convenient transport service for bulk goods and reduce travel time. Land-use transportation study and plans for local area traffic management scheme will be considered. City roads are faced with increased number of traffic and some inadequate road pavement width, poor transport plans, and facilities to meet this transportation demand. Lae also has drainage system which might not hold a 100 year flood. Proper evaluation, plan, design and intersection analysis is needed to evaluate road network system thus recommend improvement and estimate future growth. Repetitive and cyclic loading by heavy commercial vehicles with different axle configurations apply on the flexible pavement which weakens and tear the pavement surface thus small cracks occur. Rain water seeps through and overtime it creates potholes. Effective planning starts from experimental research and appropriate design standards to enable firm embankment, proper drains and quality pavement material. This paper will address traffic problems as well as road pavement, capacities of intersections, and pedestrian flow during peak hours. The outcome of this research will be to identify heavily trafficked road sections and recommend treatments to reduce traffic congestions, road classification, and proposal for bypass routes and improvement. First part of this study will describe transport or traffic related problems within the city. Second part would be to identify challenges imposed by traffic and road related problems and thirdly to recommend solutions after the analyzing traffic data that will indicate current capacities of road intersections and finally recommended treatment for improvement and future growth.

Keywords: Lae, road network, highway, vehicle traffic, planning

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Authors: Paul Lawrence Filomeno, John Robert Medina, Anna Lisa Ong-Lim, Leonila Dans

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Introduction: In most hospitals, pediatric residents are part of the frontline team who interacts with medically underserved patients. Despite of these daily encounters, little is known regarding their attitudes and behaviors towards caring for these underserved patients. Objectives: This study measured the pediatric resident physicians’ attitudes and behaviors towards underserved patients and determine its association. Methodology: The study utilized a cross-sectional mixed methodology, combining the use of a self-administered questionnaire survey using the Learner’s Needs Assessment tool, measuring both attitudes and behaviors towards the underserved. This is followed by a focus group discussion (FGD) involving a sample of residents at the Philippine General Hospital. Results: The response rate was 100% among 62 residents. Overall, 78% of pediatric residents acknowledged the issues of medically underserved to be very important. Volunteerism (behaviors) was only 27% during residency, and was projected to be 90% in future practice. No significant association was noted between their attitudes and behaviors. The FGD revealed that factors (i.e. burnout) causes strains in residents towards the underserved. Frustration from genuine concern for the underserved children was apparent. Conclusion: Among PGH pediatric residents, their attitudes and behaviors are noted to be positive towards the underserved. There was no significant correlation noted between having positive attitudes and volunteerism (behaviors) of the residents towards the underserved. Despite this, residents pointed out certain factors (i.e. burnout) that affect their attitudes and behaviors. The study results may serve as the basis for curriculum enhancements tailored to promote resident well-being, molding them to become the ‘5-star pediatricians’ who will genuinely be ready to serve the underserved.

Keywords: pediatric residents, attitudes, behaviors, underserved children

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Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia

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An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.

Keywords: quality-of-life, long-term services and supports, person-centered, community

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Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath

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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.

Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics

Procedia PDF Downloads 349

Authors: Arfan Riasat, M. Iqbal Zafar, Gulfam Riasat

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Pakistani women actively participate in livestock management activities, along with their normal domestic chores. The study was designed to measure the position and contribution of rural women, their constraints in livestock management activities and mainly how the rural women contribute for development in the district Faisalabad. It was envisioned that women participation in livestock activities have rarely been investigated. A multistage random sampling technique was used to collect the data from Tehsil Summandry of the district selected at random. Two union councils were taken by using simple random sampling technique. Four Chak (village) from each union council were selected at random and fifteen woman were further selected randomly from each selected chak. The results show that a vast majority of women were illiterate, having annual family income of one to two lac. They are living in joint family system. Their main occupation is agriculture and they spend long hours in whole livestock related activities to support their families. A large proportion of the respondents reported that they had to face problems and constraints in livestock activities in the context of decision making, medication, awareness, training along with social and economic issues. Analysis indicated that education level of women, income of household, age were significantly associated with level of participation. Women participation in livestock activities increased production and they were involved in income generating activities for better economic conditions of their families.

Keywords: women, participation, livestock, management, rural development

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Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier

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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.

Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas

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Authors: Laila Habiballah, Ahmad Tubaishat

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Background: with the development of information and communication technology, using the internet as a source to obtain health information is increasing. Nursing students as future health care providers should have the skills of locating, evaluating and using online health information. This will enable them to help their patients and families to make informed decisions. Aim: this study has a two-fold aim. The first is to assess the eHealth literacy among nursing students in Jordan. The second aim is to explore the factors that have an effect on the eHealth literacy. Methods: this is a descriptive cross-sectional survey that conducted in two universities in Jordan; public and private one. A number of 541 students from both universities were completed the eHEALS scale, which is an instrument designed to measure the eHealth literacy. Some additional personal and demographical variable were collected to explore its effect on eHealth literacy. Results: Students have a high perceived level of e-Health literacy (M=3.62, SD=0.58). They are aware of the available online health resources, know how to search, locate, and use these resources. But, they do not have the skills to evaluate these resources and cannot differentiate between the high and low-quality resources. The results showed as well that type of university, type of students' admission, academic level, students' skills of using the internet, and the perception of usefulness and importance of internet have an effect on the eHealth literacy. While the age, gender, GPA, and the frequency of using the internet was no significant factors. Conclusion: This study represents a baseline reference for the eHealth literacy in Jordan. Students have some skills of eHealth literacy and other skills need to be improved. Nursing educators and administrators should integrate and incorporate the skills of eHealth literacy in the curriculum.

Keywords: eHealth, literacy, nursing, students, Jordan

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Authors: Xiaohong Xu, Tianchu Zhang, Yangfan Chen, Rongtai Tan

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In Canada, Air Quality Health Index (AQHI) is a scale designed to help residences understand the impact of air quality on human health. In Ontario, Canada, AQHI was implemented in June 2015. This study investigated temporal variability of daily AQHI and impact of regional transport on AQHI in Windsor, Ontario, Canada from 2016 to 2019. During 2016–2019, 1428 daily AQHIs were recorded in Windsor Downtown Station. Among those, the AQHIs were at the low health risk level (AQHI = 1, 2 or 3) in 82% of days, only a few days at high risk level (AQHI = 7), the rest were at moderate health risk level (AQHI = 4, 5, 6), indicating air quality in Windsor was fairly good with relatively low health risk. The annual mean AQHI value decreased from 2.95 in 2016 to 2.81 in 2019, demonstrating the improvement of air quality. Half of the days, AQHI were 3 regardless of season. AQHI was higher in the warm season (3.1) than in the cold season (2.6) due to more frequent moderate risk days (27%, AQHI = 4) in warm season and more frequent low risk days (42%, AQHI = 2) in the cold season. Among the three pollutants considered in AQHI calculation, O3 was the most frequently reported dominant contributor to daily AQHI (88% of days), followed by NO2 (12%), especially in the cold season, with small contribution from PM2.5 (<1%). In the past two decades, NO2 concentrations had decreased significantly and O3 concentrations had increased, resulting in daily AQHI being less reliance on NO2 (from 51% of days being the primary contributor during 2003–2010 to 12% during 2016–2019) and more on O3 concentrations (49% to 88%). Trajectory analysis found that AQHI ≤ 3 days were closely associated with air masses from the north and northwest, whereas AQHI > 3 days were closely associated with air masses from the west and southwest. This is because northerly flows brought in clear air mass owing to less industrial facilities, while polluted air masses were transported from the south of Windsor, where several industrial states of the US were located. Overall, O3 concentrations dictate the daily AQHI values, the seasonal variability of AQHI, and the impact of regional transport on AQHI in Windsor. This makes further reductions of AQHI challenging because O3 concentrations are likely to continue increasing due to weakened consumption of O3 by NO owing to decreasing NO emissions and more hot days because of climate change. The predominant and increasing contribution of O3 to AQHI calls for more effective control measures to mitigate O3 pollution and its impact on human health and the environment.

Keywords: air quality, Air Quality Health Index (AQHI), hysplit, regional transport, windsor

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Authors: M. Roberts Masillamani

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There is a phenomenal difference, as regard to the teaching methodology adopted at the urban and the rural area colleges. However, bright and talented student may be from rural back ground even. But there is huge dearth of the digitization in the rural areas and lesser developed countries. Today’s students need new skills to compete and successful in the future. Education should be combination of practical, intellectual, and social skills. What does this mean for rural classrooms and how can it be achieved. Rural colleges are not able to hire the best resources, since the best teacher’s aim is to move towards the city. If city is provided everywhere, then there will be no rural area. This is possible by forming university clusters (UC). The University cluster is a group of renowned and accredited universities coming together to bridge this dearth. The UC will deliver the live lectures and allow the students’ from remote areas to actively participate in the classroom. This paper tries to present a plan of action of providing a better live classroom teaching and learning system from the city to the rural and the lesser developed countries. This paper titled “University Clusters using ICT for teaching and learning” provides a true concept of opening live digital classroom windows for rural colleges, where resources are not available, thus reducing the digital divide. This is different from pod casting a lecture or distance learning and eLearning. The live lecture can be streamed through digital equipment to another classroom. The rural students can collaborate with their peers and critiques, be assessed, collect information, acquire different techniques in assessment and learning process. This system will benefit rural students and teachers and develop socio economic status. This will also will increase the degree of confidence of the Rural students and teachers. Thus bringing about the concept of ‘Train the Trainee’ in reality. An educational university cloud for each cluster will be built remote infrastructure facilities (RIF) for the above program. The users may be informed, about the available lecture schedules, through the RIF service. RIF with an educational cloud can be set by the universities under one cluster. This paper talks a little more about University clusters and the methodology to be adopted as well as some extended features like, tutorial classes, library grids, remote laboratory login, research and development.

Keywords: lesser developed countries, digital divide, digital learning, education, e-learning, ICT, library grids, live classroom windows, RIF, rural, university clusters and urban

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Authors: John Michael Weber

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The following research results spanned six months and 175 people addicted to some form of substance, from alcohol to heroin. One question was asked, and the answers were amazing and consistent. The following work is the detailed results of this writer’s answer to his own question and the 175 that followed. A constant pattern took shape throughout the bio-psycho-social assessments, these addicts had “first memories,” the memories were vivid and took place between the ages of three to six years old, to a person those first memories were traumatic. This writer’s personal search into his childhood was not to find an excuse for the way he became, but to explain the reason for becoming an addict. To treat addiction, these memories that have caused Post Traumatic Stress Disorder (PTSD), must be recognized as the catalyst that sparked a predisposition. Cognitive Behavioral Therapy (CBT), integrated with treatment specifically focused on PTSD, gives the addict a better chance at recovery sans relapse. This paper seeks to give the findings of first memories of the addicts assessed and provide the best treatment plan for such an addict, considering, the childhood trauma in congruence with treatment of the Substance Use Disorder (SUD). The question posed was concerning what their first life memory wa It is the hope of this author to take the knowledge that trauma is one of the main catalysts for addiction, will allow therapists to provide better treatment and reduce relapse from abstinence from drugs and alcohol. This research led this author to believe that if treatment of childhood trauma is not a priority, the twelve steps of Alcoholics Anonymous, specifically steps 4 and 5, will not be thoroughly addressed and odds for relapse increase. With this knowledge, parents can be educated on childhood trauma and the effect it has on their children. Parents could be mindful of the fact that the things they perceive as traumatic, do not match what a child, in the developmental years, absorbs as traumatic. It is this author’s belief that what has become the status quo in treatment facilities has not been working for a long time. It is for that reason this author believes things need to change. Relapse has been woven into the fabric of standard operating procedure and that, in this authors view, is not necessary. Childhood Trauma is not being addressed early in recovery and that creates an environment of inevitable relapse. This paper will explore how to break away from the status -quo and rethink the current “evidencebased treatments.” To begin breaking away from status-quo, this ends the Abstract, with hopes an interest has been peaked to read on.

Keywords: childood, trauma, treatment, addiction, change

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Authors: Gaurav Vaidya, N. R. Mandal

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UN Summit, 2000 had resolved to provide access to sanitation to whole humanity as part of ‘Millennium Development Goals -2015’. However, more than one third of world’s population still did not have the access to basic sanitation facilities by 2015. Therefore, it will be a gigantic challenge to achieve goal-6 of ‘UN Sustainable Development Goal’ to ensure availability and sustainable management of sanitation for all by the year 2030. Countries attempt to find out own ways of meeting this challenge of providing access to safe sanitation and as part of monitoring the actions have prepared varied types of ‘performance assessment frameworks (PAF)’. India introduced Service Level Benchmarking (SLB) in 2010 to set targets and achieve the goals of NUSP. Further, a method of reviewing performance was introduced as ‘Swachh Sarvekshan’ (Cleanliness Surveys) in 2016 and in 2017 guidelines for the same was revised. This study, as a first step, reviews the documents in use in India with a conclusion that the frameworks adopted are based on target setting, financial allocation and performance in achieving the targets set. However, it does not focus upon sanitation needs holistically i.e., areas and aspects not targeted through projects are not covered in the performance assessment. In this context, as a second step, this study reviews literature available on performance assessment frameworks for urban sanitation in selected other countries and compares the same with that in India. The outcome of the comparative review resulted in identification of unaddressed aspects as well as inadequacy of parameters in Indian context. Thirdly, in an attempt to restructure the performance assessment process and develop an index in urban sanitation, researches done in other urban services such as health and education were studied focusing on methods of measuring under-performance. As a fourth step, a tentative modified framework is suggested with the help of understanding drawn from above for urban sanitation using stages of Urban Sanitation Service Chain Management (SSCM) and modified set of parameters drawn from the literature review in the first and second steps. This paper reviews existing literature on SSCM procedures, Performance Index in sanitation and other urban services and identifies a tentative list of parameters and a framework for measuring under-performance in sanitation services. This may aid in preparation of a Service Delivery Under-performance Index (SDUI) in future.

Keywords: assessment, performance, sanitation, services

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Authors: Adel A. Ghobbar, Ahmad Bakkar

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Although special care is given to maintenance, aircraft systems fail, and these failures cause delays and cancellations. The occurrence of Delays and Cancellations affects operators and manufacturers negatively. To reduce technical delays and cancellations, one should be able to determine the important systems causing them. The goal of this research is to find a method to define the most expensive delays and cancellations systems for Airline operators. A predictive model was introduced to forecast the failure and their impact after carrying out research that identifies relevant information to tackle the problems faced while answering the questions of this paper. Data were obtained from the manufacturers’ services reliability team database. Subsequently, delays and cancellations evaluation methods were identified. No cost estimation methods were used due to their complexity. The model was developed, and it takes into account the frequency of delays and cancellations and uses weighting factors to give an indication of the severity of their duration. The weighting factors are based on customer experience. The data Analysis approach has shown that delays and cancellations events are not seasonal and do not follow any specific trends. The use of weighting factor does have an influence on the shortlist over short periods (Monthly) but not the analyzed period of three years. Landing gear and the navigation system are among the top 3 factors causing delays and cancellations for all three aircraft types. The results did confirm that the cooperation between certain operators and manufacture reduce the impact of delays and cancellations.

Keywords: reliability, availability, delays & cancellations, aircraft maintenance

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Authors: Bhawna Shivan

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Indian monuments have been spoken of as for variety, extent, completeness and beauty unsurpassed perhaps unequaled in world. India’s monumental heritage is a part and parcel of India today. The underlying issue with the monumental heritage in contemporary times is that these monuments suffered many times with various degrees of threats/ pressures which hampered their beauty. In the current situation, the urbanization policies for sustainable development and tourism management pay no attention to the basic point of conservation and protection of these cultural heritages rather they focus more on profit earned from these sites. Many times rich heritage is found balancing between conflicting pressures of conservation of heritage elements with sustainability and local economic development. There is a need of a new attitude to India’s independent and democratic ideology. The paper will enquire about the historical perspective by analyzing and understanding the importance of Mughal Architecture while focusing on Humayun Tomb while assessing the value and sentiment people attach to these monuments. It will also put the focus on the future of these monuments in the era of globalization and urbanization. The role of public and private authorities for conservation and sustainable development of these monuments. As well as assessing other facilities like toilets, parking, eatery joint, Museum with Display of structural representation and display of books, and a mobile shop. The research will be helpful in assessing the importance of heritage buildings whether they are a tool of enhancing ‘Tourism Industry’ for Central and State Government or really there is still some future of these monuments. Can we still consider these heritage sites as the integral part of our society in this urbanized world? The study will also analyze the attitude of the central and state government towards a building when it declared as a ‘World Heritage Site’. The study will also examine how the Youth and other aged generations append their sentimental values towards them, say (what is their purpose of coming to a heritage site, what makes them coming here, how they view this particular monument) Apart from this, probing the factors such as rapid growth of cities and its population, increasing value of urban land and effect of globalization on urban growth pattern that are capable of producing a variety of threats and pressures on any monument for instance Humayun Tomb.

Keywords: globalization, monuments, tourism, urban heritage

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Authors: Rodziana M. Razali, Tamara J. Duraisingham

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Malaysia is not a signatory to the 1951 Refugee Convention and its 1967 Protocol despite receiving the largest share of refugee inflows in Southeast Asia aside from Thailand. In Peninsular Malaysia, the majority of refugees and asylum seekers are from Myanmar, with Rohingya refugees recording the highest number compared to all other ethnicities. In the eastern state of Sabah, the presence of refugees who have long established themselves in the state is connected to those who escaped military persecution in southern Philippines in the 1970’s and 1980’s. A combination of legal and non-legal factors has created and sustained an adverse atmosphere of deprivation of legal identity for children of migrants including refugees born in Malaysia. This paper aims to qualitatively analyse the barriers to birth registration as the cornerstone of every person’s legal identity for children of refugees born in this country, together with the associated human rights implications. Data obtained through semi-structured interviews with refugees in Kota Kinabalu, Sabah and Rohingya refugees in Peninsular Malaysia shall be studied alongside secondary sources. Results show that births out of medical facilities, suspension of birth records, illiteracy, lack of awareness on the importance and procedures of birth registration, inability to meet documentary requirements, as well as fear of immigration enforcement, are the key factors hindering birth registration. These challenges exist against the backdrop of restrictive integration policy to avoid destabilising demographic and racial balance, political sentiment stirring xenophobic prejudices, as well as other economic and national security considerations. With no proof of their legal identity, the affected children grow up in a legal limbo, facing multiple human rights violations across generations. This research concludes that the country’s framework and practice concerning birth registration is in need of serious reform and improvement to reflect equality and universality of access to its birth registration system. Such would contribute significantly towards meeting its commitments to the post-2015 sustainable development agenda that pledges to 'Leave no one behind', as well as its recently announced National Human Rights Action Plan.

Keywords: birth registration, children, Malaysia, refugees

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Authors: Arvin Baes

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This study was conducted to assess the holistic needs of cancer patients in terms of physiological, psychological, social, and spiritual needs and to determine how they respond through coping. It was conducted from January-April 2018 from various hospitals in Laguna, with 20 respondents. It utilized a survey descriptive type of research, a checklist type of questionnaire, and purposive sampling in selecting the respondents. It was found out that in terms of physiological needs, fatigue is the most common symptoms they experienced. In terms of psychological, social, and spiritual needs, most of the patients experienced a significant concern. Meanwhile, in coping, religion dominates among the 14 strategies followed by Use of Emotional Support and Positive Reframing, and Substance Use obtained the lowest response. Most of the respondents were female, and its significant relationship in terms of Positive Reframing agrees significantly. In coping and civil status, Positive Reframing and Humor are significant among married respondents. In coping and stage of cancer, 'Positive Reframing' and 'Humor' are significant with the stage of cancer. In coping and treatment modalities, Active Coping, Use of Emotional Support, and Religion are significantly related to patients’ treatment modalities. There is also a significant relationship between Active Coping and Physiological Needs, Religion and Psychological Needs, and Self-blaming and Psychological, Social, and Spiritual Needs. Thus, it is concluded that holistic needs and coping are essential to each other to meet the wholeness of cancer patients. A formulated care intervention program would be beneficial among this group of patients.

Keywords: coping strategies, cancer, cancer patients, holistic needs

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Authors: Jansirani Natarajan, Mickael Antoinne Joseph

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The COVID-19 pandemic has interrupted face-to-face education and forced universities into an emergency remote teaching curriculum over a short duration. This abrupt transition in the Spring 2020 semester left both faculty and students without proper preparation for continuing higher education in an online environment. Online learning took place in different formats, including fully synchronous, fully asynchronous, and blended in our university through the e-learning platform MOODLE. Studies have shown that students’ engagement, is a critical factor for optimal online teaching. Very few studies have assessed online engagement with ERT during the COVID-19 pandemic. Purpose: Therefore, this study, sought to understand how the sudden transition to emergency remote teaching impacted nursing students’ engagement with online courses in a Middle Eastern public university. Method: A cross-sectional descriptive research design was adopted in this study. Data were collected through a self-reported online survey using Dixon’s online students’ engagement questionnaire from a sample of 177 nursing students after the ERT learning semester. Results The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement, and performance engagement were 30, 25, 30, and 10 respectively. Dixson (2010) noted that a mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The majority of the participants were females (71.8%) and 84.2% were regular BSN students. Most of them (32.2%) were second-year students and 52% had a CGPA between 2 and 3. Most participants (56.5%) had low engagement scores with ERT learning during the COVID lockdown. Among the four engagement domains, 78% had low engagement scores for the participation domain. There was no significant association found between the engagement and the demographic characteristics of the participants. Conclusion The findings supported the importance of engaging students in all four categories skill, emotional, performance, and participation. Based on the results, training sessions were organized for faculty on various strategies for engaging nursing students in all domains by using the facilities available in the MOODLE (online e-learning platform). It added value as a dashboard of information regarding ERT for the administrators and nurse educators to introduce numerous active learning strategies to improve the quality of teaching and learning of nursing students in the University.

Keywords: engagement, perception, emergency remote learning, COVID-19

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Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev

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Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.

Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP

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Authors: Alexander Rincón Ruiz

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This article is based on an exhaustive review and interdisciplinary effort spanning three years. It involved interviews, dialogues, discussion panels, and collective work on various visions of bio-economy in Colombia. The dialogue included government institutions, universities, local communities, activist groups, research institutes, the productive sector, and politicians, integrating perspectives such as Latin American environmental thought, complexity theory, modern visions, local worldviews (Afro-Colombian, indigenous, peasant), decoloniality, political ecology, ecological economics, and environmental economies. This work highlighted the need to redefine the traditional bio-economy concept, typically focused on markets and biotechnology, and to revisit the original idea of a bio-economy as an ‘economy for life’. In a country as diverse as Colombia—both biophysically and in its varied relationships with the territory—this redefinition is crucial. It emphasizes alternative logics of well-being related to resilience, care, and cooperation, reflecting Indigenous, Afro-Colombian, and peasant worldviews. This article is significant for proposing, for the first time, a viable approach to diverse and alternative economies for life tailored to the Colombian context. It represents not only academic work but also a political commitment to inclusion and plurality, aligning with the Colombian context and potentially extendable to other regions.

Keywords: ecological economics, decoloniality, complexity, Biodiversity

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Authors: Georgitta Joseph Valiyamattam

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Autism spectrum disorders (ASD) are a growing phenomenon in India with over 10 million cases being recorded. Children with various levels and forms of ASD can be a major challenge both within the context of regular or special schooling. According to statistics by the Centers for Disease Control and Prevention (CDC), one in every 88 children today is born with autism spectrum disorder (ASD) against a ratio of one in 110 few years back. The growing number of children with autism spectrum disorders places greater demands on health services and necessitates the roping in of non-traditional modes of treatment to complement or even substitute traditional health care methods when possible. Research evidence, particularly from Western countries, as also some parts of Asia, suggests that animal-assisted therapy, or zootherapy, may be used as an effective individual or complementary therapeutic tool for increasing overall wellbeing and quality of life among children with Autism spectrum disorders. The paper through a case-study format seeks to evaluate the efficacy (initial stage) of animal assisted therapy (canine-therapy with visiting dog: breed-Golden retriever), as a non-conventional treatment modality for improving cognitive functioning and managing the behavioral and psychological symptoms of Autism Spectrum Disorders. As a pilot study forming the basis for subsequent larger application of AAT, it analyses areas of efficacy as also the challenges faced, both with regard to the mode of therapy, as also particular to the Indian setting.

Keywords: animal assisted therapy, autism, canine therapy, analyzing initial efficacy

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Authors: Melik Kara, Gulsah Tulger Kara

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The soil is a crucial component of the ecosystem, and in industrial and urban areas it receives large amounts of trace elements from several sources. Therefore, accumulated pollutants in surface soils can be transported to different environmental components, such as deep soil, water, plants, and dust particles. While elemental contamination of soils is caused mainly by atmospheric deposition, soil also affects the air quality since enriched trace elemental contents in atmospheric particulate matter originate from resuspension of polluted soils. The objectives of this study were to determine the total and leachate concentrations of trace elements in soils of city area in Izmir and characterize their spatial distribution and to identify the possible sources of trace elements in surface soils. The surface soil samples were collected from 20 sites. They were analyzed for total element concentrations and leachate concentrations. Analyses of trace elements (Ag, Al, As, B, Ba, Be, Bi, Ca, Cd, Ce, Co, Cr, Cs, Cu, Dy, Er, Eu, Fe, Ga, Gd, Hf, Ho, K, La, Li, Lu, Mg, Mn, Mo, Na, Nd, Ni, P, Pb, Pr, Rb, Sb, Sc, Se, Si, Sm, Sn, Sr, Tb, Th, Ti, Tl, Tm, U, V, W, Y, Yb, Zn and Zr) were carried out using ICP-MS (Inductively Coupled Plasma-Mass Spectrometer). The elemental concentrations were calculated along with overall median, kurtosis, and skewness statistics. Elemental composition indicated that the soil samples were dominated by crustal elements such as Si, Al, Fe, Ca, K, Mg and the sea salt element, Na which is typical for Aegean region. These elements were followed by Ti, P, Mn, Ba and Sr. On the other hand, Zn, Cr, V, Pb, Cu, and Ni (which are anthropogenic based elements) were measured as 61.6, 39.4, 37.9, 26.9, 22.4, and 19.4 mg/kg dw, respectively. The leachate element concentrations were showed similar sorting although their concentrations were much lower than total concentrations. In the study area, the spatial distribution patterns of elemental concentrations varied among sampling sites. The highest concentrations were measured in the vicinity of industrial areas and main roads. To determine the relationships among elements and to identify the possible sources, PCA (Principal Component Analysis) was applied to the data. The analysis resulted in six factors. The first factor exhibited high loadings of Co, K, Mn, Rb, V, Al, Fe, Ni, Ga, Se, and Cr. This factor could be interpreted as residential heating because of Co, K, Rb, and Se. The second factor associated positively with V, Al, Fe, Na, Ba, Ga, Sr, Ti, Se, and Si. Therefore, this factor presents mixed city dust. The third factor showed high loadings with Fe, Ni, Sb, As, Cr. This factor could be associated with industrial facilities. The fourth factor associated with Cu, Mo, Zn, Sn which are the marker elements of traffic. The fifth factor presents crustal dust, due to its high correlation with Si, Ca, and Mg. The last factor is loaded with Pb and Cd emitted from industrial activities.

Keywords: trace elements, surface soil, source apportionment, Izmir

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Authors: Emilia K. H. Danielsson-Waters, Malaz Elsaddig, Kevin Jones

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Unfortunately, it is well known that neonatal deaths are a common and potentially preventable occurrence across the world. Neonatal resuscitation is a simple and inexpensive intervention that can effectively reduce this rate, and can be taught and implemented globally. This project is a follow-on from one in 2012, which found that neonatal resuscitation simulation was valuable for education, but would be better improved by being delivered by local staff. Methods: This study involved auditing the neonatal admission and death records within a rural Ugandan hospital, alongside implementing a Train-The-Trainer teaching scheme to teach Neonatal Resuscitation. One local doctor was trained for simulating neonatal resuscitation, whom subsequently taught an additional 14 staff members in one-afternoon session. Participants were asked to complete questionnaires to assess their knowledge and confidence pre- and post-simulation, and a survey to identify barriers and drivers to simulation. Results: The results found that the neonatal mortality rate in this hospital was 25% between July 2016- July 2017, with birth asphyxia, prematurity and sepsis being the most common causes. Barriers to simulation that were identified predominantly included a lack of time, facilities and opportunity, yet all members stated simulation was beneficial for improving skills and confidence. The simulation session received incredibly positive qualitative feedback, and also a 0.58-point increase in knowledge (p=0.197) and 0.73-point increase in confidence (0.079). Conclusion: This research shows that it is possible to create a teaching scheme in a rural hospital, however, many barriers are in place for its sustainability, and a larger sample size with a more sensitive scale is required to achieve statistical significance. This is undeniably important, because teaching neonatal resuscitation can have a direct impact on neonatal mortality. Subsequently, recommendations include that efforts should be put in place to create a sustainable training scheme, for example, by employing a resuscitation officer. Moreover, neonatal resuscitation teaching should be conducted more frequently in hospitals, and conducted in a wider geographical context, including within the community, in order to achieve its full effect.

Keywords: neonatal resuscitation, sustainable medical education, train-the-trainer, Uganda

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Authors: Manaphol Kulpraneet, Anirut Limtrakul, Surangrat Srisurapanon, Piyatida Tangteerawatana

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Tuberculosis (TB) remains a global health care disease world-wide. Control of the global TB epidemic has been impaired by the lack of an effective vaccine, by the emergence of drug resistant forms of Mycobacterium tuberculosis and by lack of sensitive and rapid diagnostics. Cytokines play a major role in defense against M. tuberculosis infection. Polymorphisms in the genes encoding various cytokines have been associated with tuberculosis susceptibility. Polymorphisms of the regulatory cytokine gene, the interleukin (IL)-10 is associated with the risk of tuberculosis (TB) in different populations. However, IL-10 gene polymorphism and susceptibility to TB in Thai is still unknown. The purpose of this study was to evaluate whether the common IL-10 promoter gene polymorphisms are associated with TB in Thai population. Forty eight patients with newly diagnosed pulmonary tuberculosis were studied. DNA samples were extracted from leukocytes and used to investigate -1087A/G, -819C/T, -252C/A (rs1800896, rs1800871, rs1800872) in IL-10 gene using restriction fragment length polymorphism (PCR-RFLP) methods. In this study, the genotype and allele frequencies of IL-10-1087A/G, -819C/T, -252C/A polymorphism did not significantly different between TB patients and healthy controls ((genotype: p=0.38, p=0.92, p=1; allele: p=0.57, p=0.77, p=0.89, respectively). The lack of association between common IL-10 promoter polymorphisms and TB susceptibility in this study may provide clue for better understanding of IL-10-1087A/G, -819C/T, -252C/A polymorphism and TB susceptibility in Thai population, which might facilitate the rationale design of vaccines. However, further studies in large scales population are required for confirmation.

Keywords: IL-10, cytokines, single nucleotide polymorphism (SNP), tuberculosis

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Authors: Maher El-Masri, Jamie Crawley, Judy Bornais, Abeer Omar

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Background: Misuse of Emergency Department (ED) for non-urgent healthcare results in unnecessary crowdedness that can result in long ED waits and delays in treatment, diversion of ambulances to other hospitals, poor health outcomes for patients, and increased risk of death Objectives: The main purpose of this study was to explore the independent predictors of non-urgent ED visits in Erie St. Clair LHIN. Secondary purposes of the study include comparison of the rates of non-urgent ED visits between urban and rural hospitals Design: A secondary analysis of archived population-based data on 597,373 ED visits in southwestern Ontario Results The results suggest that older (OR = .992; 95% CI .992 – .993) and female patients (OR = .940; 95% CI .929 - .950) were less likely to visit ED for non-urgent causes. Non-urgent ED visits during the winter, spring, and fall were 13%, 5.8%, and 7.5%, respectively, lesser than they were during the summer time. The data further suggest that non-urgent visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts compared to the day shift. Non-urgent visits were 2.76 times more likely to present to small community hospitals than large community hospitals. Health care providers were 1.92 times more likely to refer patients with non-urgent health problem to the ED than the decision taken by patients, family member or caretakers. Conclusion: In conclusion, our study highlights a number of important factors that are associated with inappropriate use of ED visits for non-urgent health problems. Knowledge of these factors could be used to address the issue of unnecessary ED crowdedness.

Keywords: emergency department, non-urgent visits, predictors, logistic regression

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Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

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NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studies are shortcoming on individual patient experience. The aim of this study was to assess the patient’s satisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. For all patients managed with woodcast in our unit, we undertook a structured questionnaire that included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score and the pain numerical score at the time of injury and six weeks after. 30 patients were initially managed with woodcast. 80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Paris casting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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Authors: Mónica Catarina Soares

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Neoliberal rationality is currently changing the ways concepts like freedom or equality are framed. As an omnipresent and context-sensitive paradigm, homo oeconomicus is continuously taking place in realms of life previously insulated from economic and market-driven principles. This presentation is based on the argument that, more than ever, this paradigm is nowadays framing institutional and everyday discourses in regard to social problems. Although neoliberal rationality is based on the putative ideological basis that everyone is equal, equality seems to be reshaped by specific meanings apprehended by this rationality. In this sense, an illusion of equality seems to be relevant to legitimize different social inequalities (e.g., access to health care or to habitation). Political psychology has studied how ideology is relevant to legitimize market and unequal systems, but still the specific relation between markets, (in)equality and neoliberal languages is not widely addressed. The goal is to discuss the smithereens of the neoliberal rationality when it comes to legitimizing social inequalities by contesting the arguments of meritocracy, progressive freedom and minimal guarantees obeying to market-rules and principles. This analysis can be helpful to grasp for instance the continuously dismantlement of the welfare-state in different countries of the global north and how it is turning the regulation/emancipation tension inside out. The ultimate goal is to contribute to the breaking up of a paradigm that is still too big to capture, too depoliticized and chameleonic to fully acknowledge the biopolitics of power that is helping to create it.

Keywords: discourses, legitimacy, neoliberal rationality, social inequality

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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Authors: Jyoti Pandey, Rajiv Kumar Bhatt

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In the absence of proper sanitation, people suffered from high levels of infectious diseases leading to high incidences of morbidity and mortality. This directly affected the ability of a country to maintain an efficient economy and implied great personal suffering among infected individuals and their families. This paper aims to estimate the catastrophic expenditure of households in terms of direct and indirect losses which a person has to face due to the illness of WASH diseases; the severity of the scenario is answered by finding out the impoverishment effect. We used the primary data survey for the objective outlined. Descriptive and analytical research types are used. The survey is done with the questionnaire formulated precisely, taking care of the inclusion of all the variables and probable outcomes. A total of 300 households is covered under this study. In order to pursue the objectives outlined, multistage random sampling of households is used. In this study, the cost of illness approach is followed for accessing economic impact. The study brought out the attention that a significant portion of the total consumption expenditure is going lost for the treatment of water and sanitation related diseases. The infectious and water vector-borne disease can be checked by providing sufficient required sanitation facility, and that 2.02% loss in income can be gained if the mechanisms of the pathogen is checked.

Keywords: water, sanitation, impoverishment, catastrophic expenditure

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