Search results for: day hospital care

Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: architectural typology, developing countries, local construction techniques, primary health care.

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Authors: Bongs Lainjo

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Educational institutions and authorities that are mandated to run education systems in various countries need to implement a curriculum that considers the possibility and existence of elementary school dropouts. This research focuses on elementary school dropout rates and the ability to replicate various predictive models carried out globally on selected Elementary Schools. The study was carried out by comparing the classical case studies in Africa, North America, South America, Asia and Europe. Some of the reasons put forward for children dropping out include the notion of being successful in life without necessarily going through the education process. Such mentality is coupled with a tough curriculum that does not take care of all students. The system has completely led to poor school attendance - truancy which continuously leads to dropouts. In this study, the focus is on developing a model that can systematically be implemented by school administrations to prevent possible dropout scenarios. At the elementary level, especially the lower grades, a child's perception of education can be easily changed so that they focus on the better future that their parents desire. To deal effectively with the elementary school dropout problem, strategies that are put in place need to be studied and predictive models are installed in every educational system with a view to helping prevent an imminent school dropout just before it happens. In a competency-based curriculum that most advanced nations are trying to implement, the education systems have wholesome ideas of learning that reduce the rate of dropout.

Keywords: elementary school, predictive models, machine learning, risk factors, data mining, classifiers, dropout rates, education system, competency-based curriculum

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Authors: Debolina Chatterjee, Suhita Chopra Chatterjee

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Imprisonment is an expansive concept, as it is regulated by laws under criminal justice system of the state. The state sets principles of punishment to control offenders and also puts limits to excess punitive control. One significant way through which it exercises control is through rules governing healthcare of imprisoned population. Prisons signify specialized settings which accommodate both medical and legal concerns. The provision of care operates within the institutional paradigm of punishment. This requires the state to negotiate adequately between goals of punishment and fulfilment of basic human rights of offenders. The present study is based on a critical analysis of prison healthcare standards in India, which include government policies and guidelines. It also demonstrates how healthcare is delivered by drawing insights from a primary study conducted in a correctional home in the state of West Bengal, India, which houses both male and female inmates. Forty women were interviewed through semi-structured interviews, followed by focus group discussions. Doctors and administrative personnel were also interviewed. Findings show how institutional practices control women through subversion of the role of doctors to prison administration. Also, poor healthcare infrastructure, unavailability of specialized services, hierarchies between personnel and inmates make prisons unlikely sites for therapeutic intervention. The paper further discusses how institutional practices foster gender-based discriminatory practices.

Keywords: imprisonment, Indian prisons, prison healthcare, punishment

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Authors: Nilima Barman, M. Atiqul Haque, Debabrata Ghosh

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Background: Zinc, one of the vital micronutrients, has an incredible role in the immune system. Hypozincemia affects host defense by reducing the number of circulating T cells and phagocytosis activity of other cells which ultimately impair cell-mediated immunity 1, 2. The immune system is detrimentally suppressed in multidrug-resistant tuberculosis (MDR-TB) 3, 4, a major threat of TB control worldwide5. As zinc deficiency causes immune suppression, we assume that it might have a role in the development of MDR-TB. Objectives: To estimate the serum zinc level in newly diagnosed multidrug resistant tuberculosis (MDR-TB) in comparison with that of newly diagnosed pulmonary TB (NdPTB) and healthy individuals. Materials and Methods: This study was carried out in the department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka in collaboration with National Institute of Diseases of the Chest Hospital (NIDCH), Bangladesh from March’ 2012 to February 2013. A total of 337 respondents, of them 107 were MDR TB patients enrolled from NIDCH, 69 were NdPTB and 161 were healthy adults. All NdPTB patients and healthy adults were randomly selected from Sirajdikhan subdistrict of Munshiganj District. It is a rural community 22 kilometer south from capital city Dhaka. Serum zinc level was estimated by atomic absorption spectrophotometry method from early morning fasting blood sample. The evaluation of serum zinc level was done according to normal range from 70 to120 µgm/dL6. Results: Males were predominant in study groups (p>0.05). Mean (sd) serum zinc levels in MDR-TB, NdPTB and healthy adult group were 65.14 (12.52), 75.22(15.89), and 87.98 (21.80) μgm/dL respectively and differences were statistically significant (F=52.08, P value<0.001). After multiple comparison test (Bonferroni test) significantly lower level of serum zinc was found in MDRTB group than NdPTB and healthy adults (p<.001). Point biserial correlation showed a negative association of having MDR TB and serum zinc level (r= -.578; p value <0.001). Conclusion: The significant low level of serum zinc in MDR-TB patients suggested impaired immune status. We recommended for further exploration of low level of serum zinc as risk factor of MDR TB.

Keywords: Bangladesh, immune status, multidrug-resistant tuberculosis, serum zinc

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Authors: Ofonime Ogba, Augustine Akpan

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Objectives and Goals: The study was aimed at determining pathogenic microbial carriage on the external body parts of Camponotus consobrinus which is also known as the banded sugar ant because of its liking for sugar and sweet food. The level of pathogenic microbial carriage of Camponotus consobrinus in association to the environment in which they have been collected is not known. Methods: The ants were purposively collected from four locations including the kitchens, bedroom of various homes, food shops, and bakeries. The sample collection took place within the hours of 6:30 pm to 11:00 pm. The ants were trapped in transparent plastic containers of which sugar, pineapple peels, sugar cane and soft drinks were used as bait. The ants were removed with a sterile spatula and put in 10mls of peptone water in sterile universal bottles. The containers were vigorously shaken to wash the external surface of the ant. It was left overnight and transported to the Microbiology Laboratory, University of Calabar Teaching Hospital for analysis. The overnight peptone broths were inoculated on Chocolate agar, Blood agar, Cystine Lactose Electrolyte-Deficient agar (CLED) and Sabouraud dextrose agar. Incubation was done aerobically and in a carbon dioxide jar for 24 to 48 hours at 37°C. Isolates were identified based on colonial characteristics, Gram staining, and biochemical tests. Results: Out of the 250 Camponotus consobrinus caught for the study, 90(36.0%) were caught in the kitchen, 75(30.0%) in the bedrooms 40(16.0%) in the bakery while 45(18.0%) were caught in the shops. A total of 82.0% prevalence of different microbial isolates was associated with the ants. The kitchen had the highest number of isolates 75(36.6%) followed by the bedroom 55(26.8%) while the bakery recorded the lowest number of isolates 35(17.1%). The profile of micro-organisms associated with Camponotus consobrinus was Escherichia coli 73(30.0%), Morganella morganii 45(18.0%), Candida species 25(10.0%), Serratia marcescens 10(4.0%) and Citrobacter freundii 10(4.0%). Conclusion: Most of the Camponotus consobrinus examined in the four locations harboured potential pathogens. The presence of ants in homes and shops can facilitate the propagation and spread of pathogenic microorganisms. Therefore, the development of basic preventive measures and the control of ants must be taken seriously.

Keywords: Camponotus consobrinus, potential pathogens, microbial isolates, spread

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Authors: Rupali, Anil Kumar Jaiswal

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Cloud computing can be defined as one of the prominent technologies that lets a user change, configure and access the services online. it can be said that this is a prototype of computing that helps in saving cost and time of a user practically the use of cloud computing can be found in various fields like education, health, banking etc.  Cloud computing is an internet dependent technology thus it is the major responsibility of Cloud Service Providers(CSPs) to care of data stored by user at data centers. Scheduling in cloud computing environment plays a vital role as to achieve maximum utilization and user satisfaction cloud providers need to schedule resources effectively.  Job scheduling for cloud computing is analyzed in the following work. To complete, recreate the task calculation, and conveyed scheduling methods CloudSim3.0.3 is utilized. This research work discusses the job scheduling for circulated processing condition also by exploring on this issue we find it works with minimum time and less cost. In this work two load balancing techniques have been employed: ‘Throttled stack adjustment policy’ and ‘Active VM load balancing policy’ with two brokerage services ‘Advanced Response Time’ and ‘Reconfigure Dynamically’ to evaluate the VM_Cost, DC_Cost, Response Time, and Data Processing Time. The proposed techniques are compared with Round Robin scheduling policy.

Keywords: physical machines, virtual machines, support for repetition, self-healing, highly scalable programming model

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Authors: S. Gharbi, S. Labidi, M. Mars, M. Chelli, F. Ladeb

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The purpose of this study is to reduce radiation dose for chest CT examination by including Tube Current Modulation (TCM) to a standard CT protocol. A scan of an anthropomorphic male Alderson phantom was performed on a 128-slice scanner. The estimation of effective dose (ED) in both scans with and without mAs modulation was done via multiplication of Dose Length Product (DLP) to a conversion factor. Results were compared to those measured with a CT-Expo software. The size specific dose estimation (SSDE) values were obtained by multiplication of the volume CT dose index (CTDIvol) with a conversion size factor related to the phantom’s effective diameter. Objective assessment of image quality was performed with Signal to Noise Ratio (SNR) measurements in phantom. SPSS software was used for data analysis. Results showed including CARE Dose 4D; ED was lowered by 48.35% and 51.51% using DLP and CT-expo, respectively. In addition, ED ranges between 7.01 mSv and 6.6 mSv in case of standard protocol, while it ranges between 3.62 mSv and 3.2 mSv with TCM. Similar results are found for SSDE; dose was higher without TCM of 16.25 mGy and was lower by 48.8% including TCM. The SNR values calculated were significantly different (p=0.03<0.05). The highest one is measured on images acquired with TCM and reconstructed with Filtered back projection (FBP). In conclusion, this study proves the potential of TCM technique in SSDE and ED reduction and in conserving image quality with high diagnostic reference level for thoracic CT examinations.

Keywords: anthropomorphic phantom, computed tomography, CT-expo, radiation dose

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Authors: Ya-Chuan Tseng, Hsin-Yi Liu, Meei-Fang Lou, Guey-Shiun Huang

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Purpose: Sensory impairments are common in older adults. Hearing and visual impairments affect their physical and mental health and quality of life (QOL) adversely. However, systematic reviews of the relationship between hearing impairment, visual impairment, dual sensory impairment and quality of life are scarce. The purpose of this systematic review was to determine the relationship between hearing impairment, visual impairment, dual sensory impairment and quality of life. Methods: Searches of EMBASE, PubMed, CINAHL, MEDLINE, Cochrane Library and Airiti Library were conducted between January 2006 and December 2017 using the keywords ‘quality of life,’ ‘life satisfaction,’ ‘well-being,’ ‘hearing impairment’ and ‘visual impairment’ Two authors independently assessed methodologic quality using a modified Downs and Black tool. Data were extracted by the first author and then cross-checked by the second author. Results: Twenty-three studies consisting mostly of community-dwelling older adults were included in our review. Sensory impairment was found to be in significant association with quality of life, with an increase in hearing impairment or visual impairment severity resulting in a lower quality of life. Quality of life for dual sensory impairment was worse than for hearing impairment or visual impairment individually. Conclusions: A significant association was confirmed between hearing impairment, visual impairment, dual sensory impairment and quality of life. Our review can be used to enhance health care personnel’s understanding of sensory impairment in older adults and enable healthcare personnel to actively assess older adults’ sensory functions so that they can help alleviate the negative impact of sensory impairments on QOL in older adults.

Keywords: nursing, older adults, quality of life, systematic review, hearing impairment, visual impairment

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Authors: Rian de Villiers

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Human mobility is one of the most significant development, foreign policy and domestic issues in the world today. Teacher loss due to migration is a global phenomenon that is impacting both developed and developing nations the world over. The purpose of this study was to find out how many newly qualified South African teachers were planning to teach in a foreign country; what were the prospective migrant teachers’ motives for migration; what destination countries were the most popular and why; and what were the prospective migrant teachers’ information needs before leaving South Africa. A group of final-year Bachelor of Education student teachers from a single university responded to a questionnaire on intra-and intercontinental migration. The responses were analysed quantitatively and/or qualitatively. The findings showed that 79% of the students indicated that they would be teaching in South Africa, 9% were planning to teach in another country, while 8% were undecided. More than a third of the students (38%) said that they would like to teach in another country in five years time. Just more than a quarter of the students (27%) preferred Australia as a destination, followed by the United Kingdom (16%), Korea (16%) and the USA (14%). The student teachers’ most important motive to teach in a foreign country was the opportunity to travel (27%), followed by earning a higher salary (26%) and professional development (23%). The student teachers indicated that their most important migration needs before leaving South Africa were information about health care, accommodation and banking assistance. Huge loss of teachers to host countries has a serious, negative impact upon the education system of most developing and/or source countries, including South Africa. Several steps and strategies to resolve teacher loss in South Africa are discussed.

Keywords: migration, academic mobility, teachers, teacher students, South Africa

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Authors: Shahid Iqbal

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It is observed that international migration is increased over a time period in all over the world counties and Pakistan is not escaped. It played a pivotal role in household economy and affecting the gender roles both positive and negative in the developing countries. A vast majority of males from Pakistan migrate to other countries in search of employment and income generating activities and their families left behind, particularly nuclear families are subjected to different social problems. In this scenario, most of the responsibilities lie on the female partners as they have to play the role of male as well as female for their children and household chores. Wives of some males feel loneliness, isolation and a sense of insecurity. Keeping in mind, these realities, this study aims to explore the social impact of husbands’ absentee ship on the lives of families left behind. Particularly, wives’ own experiences will be analyzed. This study will be carried out in the District Gujrat of Punjab Pakistan. Since this study will focus on observing the social impact of male’s migration on families, so, all the households that had at least one member abroad will be the potential respondents of the study. Purposes sampling technique will be used as method to locate the respondents. A focus group discussion will be conducted as a tool for the collection of data. Those women will be approached who are taking care of their families in the absence of their husbands for last three years. For the sake of analysis Interpretative Phenomenological Analysis (IPA) will be applied and researcher will explore how participants make sense of their personal experience and social world.

Keywords: social consequences, male migration, left behind, absentee ship, Pakistan

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Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

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INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.

Keywords: neuropathic pain, chronic pain, treatment, gabapentin

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Authors: Matheesha Herath, Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore

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Background: Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. It is unknown whether the acute surgical unit (ASU) model affects the management and disclosure of these findings. Methods: An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings and communication of the findings to the patient and to their general practitioner (GP). Results: 1,214 patients underwent emergency appendicectomy; 465 in the traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the traditional and ASU group with regards to communication of the findings to the patient (p=0.44) and their GP (p=0.27), and there was no difference in the rates of appropriate management (p=0.21). Conclusions: The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during an appendectomy.

Keywords: acute care surgery, appendicitis, appendicectomy, incidental

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Authors: Ana Fouto

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Background: Continuing Personal Development (CPD) enables professionals to keep up to date with the professional requirements, broadening their knowledge and expertise. However, much of the research explores the registered professionals’ experiences and the factors that influence their choice of engaging, despite the unregistered staff providing the majority of the direct patient care. Aim: To explore the Nursing/Midwifery Assistants’ (NAs) perception of the concept of CPD, as well as explore the factors that influence the NAs to engage (or not) with CPD experiences. Methodology: This pilot study used a qualitative approach through a case study, where a semi-structured interview was applied to three NAs to explore the factors that influence the decision-making of process of CPD engagement. Thematic analysis was used to analyse their answers and interpret patterns and associations. Findings: All the participants agreed that CPD is important and relevant to their practice and personal lives. Five main categories were identified: NAs’ scope of practice, the impact of CPD; decision-making process; challenges; changes required. Although similar findings to the registered nurses were identified, the lack of CPD regulation for NAs and the rapid evolution of their role make the CPD engagement more problematic. Conclusion: Engagement with CPD is influenced by a wide range of professional (organisational and national) and personal factors. NAs perceive lack of management support at different stages of the CPD activities as a main influence. Organisations should be more flexible in the recruitment, offer of CPD choices, content, delivery, and contractual arrangements of NAs, which may increase engagement.

Keywords: nursing assistants, engagement, factors, pilot, continuing professional development (CPD)

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Authors: Dusanee Suwankhong, Pranee Liamputtong

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Breast surgery leaves undesirable scars to all women who experienced mastectomy, despite the fact that this could be a principle approach to save one life. This paper explores how Thai women living with breast cancer perceived and experienced a scarred body after breast surgery. In-depth interviews and drawing methods were employed among 20 women diagnosed with breast cancer. The interviewed data were analysed using thematic analysis method. The results showed that all women with breast cancer who underwent breast surgery perceived and experienced scar as a persisting and visible side-effect. This disfigurement appearance presented a negative image of feminine identity and led to emotional burdens among women. They responded to being scarred in different ways relating to their perceptions of body and changes. The older group had less embarrassed feelings towards being scarred comparing to the younger one. All women tried to seek means to cope with such physical impairment and keep balance life related to their condition. For example, they relied on Buddhism practice and tried to heal the keloid using natural products. Scars appeared to be an unpleasant effect for women who underwent breast mastectomy. Nurses and health care professionals in the local health service sectors need to pay close attention to how the women see the scarred body and their experiences of living with the distorted feminine appearance, and to provide sensitive support that meets the needs of these vulnerable women. The suitable supports can reduce the sense of embarrassment and increase their sense of self-confidence about their social femininity.

Keywords: breast surgery, emotional response, qualitative study, scars, Thai women

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Authors: Hilal Keskin, Gülzade Uysal

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This study was conducted to determine the effect of bedside music mobile use on physiological parameters and pain level during intestinal stomaterapy in infants. The study was carried out with 66 babies (music mobile group: 33, Control group: 33) who were followed in the pediatric surgery and urology unit of Kanuni Sultan Süleyman Training and Research Hospital between December 2018- October 2019. Data were collected using the “Data Collection Form” and “FLACC Pain Scale.” They were evaluated using the appropriate statistical methods in the SPSS 22.0 program. The difference between the descriptive features of music mobile and control group was not significant (p> 0.05) groups are distributed homogeneously. When the in-group results were examined; There was no significant change in the mean values of Hearth Peak Beat (HPB), SpO2 and blood pressure of the infants in the music mobile group during stomaterapy (p>0.05). Body temperature and Face, Leg, Activity, Cry, Consolability (FLACC) Pain Scale scores were found to increase immediately after stomaterapy (p<0.05). It was found that the mean scores of KTA, body temperature and FLACC pain of the babies in the control group increased significantly after the stomaterapy and SpO2 value decreased (p <0,05). After 15 minutes from stomatherapy, KTA, blood pressure, body temperature and FLACC pain scores averaged; although SpO2 value increased, it was determined that it could not reach pre-stomaterapy value. Results between groups; KTA, SpO2, systolic/diastolic blood pressure, body temperature, and FLACC pain score mean values between groups were homogeneous before stomaterapy (p> 0.05). In the control group, a significant increase was found in the mean scores of KTA, body temperature and FLACC pain after stomaterapy compared to the bedside music mobile group, and a significant decrease in SpO2 values (p <0.05). In the control group, the mean body temperature and FLACC pain scores of the infants 15 minutes after stomaterapy were significantly increased and the SpO2 values were significantly lower than the bedside music group (p <0.05). According to the results of the research; The use of bedside music mobile during intestinal stomaterapy was found to be effective in decreasing the physiological parameters and pain level. It can be recommended for use in infants during painful interventions.

Keywords: intestinal stomatherapy, infant, musical mobile, pain, physiological parameters

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Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

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Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

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Authors: Christos Lampropoulos, Maria Konsta, Ifigenia Apostolou, Vicky Dradaki, Tamta Sirbilatze, Irini Dri, Christina Kordali, Vaggelis Lambas, Kostas Argyros, Georgios Mavras

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Objectives: Mediterranean diet has been associated with lower incidence of cardiovascular disease and cancer. The purpose of our study was to examine the hypothesis that Mediterranean diet may protect against mortality and reduce admission duration in elderly, hospitalized patients. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). The following data were taken into account in analysis: anthropometric and laboratory data, dietary habits (MedDiet score), patients’ nutritional status [Mini Nutritional Assessment (MNA) score], physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and admission duration difference respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 30% per each unit increase of MedDiet score (OR=0.7, 95% CI:0.6-0.8, p < 0.0001). Patients with cancer-related admission were 37.7 times more likely to die, compared to those with infection (OR=37.7, 95% CI:4.4-325, p=0.001). According to multivariate linear regression analysis, admission duration was inversely related to Mediterranean diet, since it is decreased 0.18 days on average for each unit increase of MedDiet score (b:-0.18, 95% CI:-0.33 - -0.035, p=0.02). Additionally, the duration of current admission increased on average 0.83 days for each previous hospital admission (b:0.83, 95% CI:0.5-1.16, p<0.0001). The admission duration of patients with cancer was on average 4.5 days higher than the patients who admitted due to infection (b:4.5, 95% CI:0.9-8, p=0.015). Conclusion: Mediterranean diet adequately protects elderly, hospitalized patients against mortality and reduces the duration of hospitalization.

Keywords: Mediterranean diet, malnutrition, nutritional status, prognostic factors for mortality

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Authors: Mehmet Budak, Mehmet Fatih Ustundag

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Objectives: In this research, we studied the extent of exposure to physical violence and committing violence in patients diagnosed with schizophrenia in comparison to a control group consisting of patients with psychiatric diseases other than psychotic and mood disorders. Method: Between August 2019 and October 2019, a total of 100 hospitalized patients diagnosed with schizophrenia (clinically in remission, Brief Psychiatric Rate Scale < 30) were sequentially studied while undergoing inpatient treatment at Erenkoy Mental Health Training and Research Hospital. From the outpatient clinic, 50 patients with psychiatric disorders other than psychotic disorders or mood disorders were consecutively included as a control group. All participants were evaluated by the sociodemographic data that also questions the history of violence, physical examination, bilateral comparative hand, and forearm anterior-posterior and lateral radiography. Results: While 59% of patients with schizophrenia and 28% of the control group stated that they were exposed to physical violence at least once in a lifetime (p < 0,001); a defensive wound or fracture was detected in 29% of patients with schizophrenia and 2% of the control group (p < 0.001). On the other hand, 61% of patients diagnosed with schizophrenia, and 32% of the control group expressed that they committed physical violence at least once in a lifetime (p: 0.001). A self-destructive wound or fracture was detected in 53% of the patients with schizophrenia and 24% of the control group (p: 0,001). In the schizophrenia group, the rate of committing physical violence is higher in those with substance use compared to those without substance use (p:0.049). Also, wounds and bone fractures (boxer’s fracture) resulting from self-injury are more common in schizophrenia patients with substance use (p:0,002). In the schizophrenia group, defensive wounds and parry fractures (which are located in the hand, forearm, and arm usually occur as a result of a trial to shield the face against an aggressive attack and are known to be the indicators of interpersonal violence) are higher in those with substance use compared to those who do not (p:0,007). Conclusion: This study shows that exposure to physical violence and the rate of violence is higher in patients with schizophrenia compared to the control group. It is observed that schizophrenia patients who are stigmatized as being aggressive are more exposed to violence. Substance use in schizophrenia patients increases both exposure to physical violence and the use of physical violence. Physical examination and anamnesis that question violence are important tools to reveal the exposure to violence in patients. Furthermore, some specific bone fractures and wounds could be used to detect victimization even after plenty of time passes.

Keywords: fracture, physical violence, schizophrenia, substance use

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Authors: Francisco M. Silva

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Technology is evolving, creating an impact on our everyday lives and the telehealth industry. Telehealth encapsulates the provision of healthcare services and information via a technological approach. There are several benefits of using web-based methods to provide healthcare help. Nonetheless, few health and psychological help approaches combine this method with wearable sensors. This paper aims to create an online platform for users to receive self-care help and information using wearable sensors. In addition, researchers developing a similar project obtain a solid foundation as a reference. This study provides descriptions and analyses of the software and hardware architecture. Exhibits and explains a heart rate dynamic and efficient algorithm that continuously calculates the desired sensors' values. Presents diagrams that illustrate the website deployment process and the webserver means of handling the sensors' data. The goal is to create a working project using Arduino compatible hardware. Heart rate sensors send their data values to an online platform. A microcontroller board uses an algorithm to calculate the sensor heart rate values and outputs it to a web server. The platform visualizes the sensor's data, summarizes it in a report, and creates alerts for the user. Results showed a solid project structure and communication from the hardware and software. The web server displays the conveyed heart rate sensor's data on the online platform, presenting observations and evaluations.

Keywords: Arduino, heart rate BPM, microcontroller board, telehealth, wearable sensors, web-based healthcare

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Authors: Tamar Trop, Ido Izhaki

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Small natural freshwater bodies (SNFWBs), which are vital for many waterbird species, are considered endangered habitats due to their progressive loss and extensive degradation. While SNFWBs are becoming extinct, studies have indicated that many waterbird species may greatly benefit from various types of small artificial waterbodies (SAWBs), such as floodwater and treated water reservoirs. If designed and managed with care, SAWBs hold significant potential to serve as alternative or complementary habitats for birds, and thus mitigate the adverse effects of SNFWBs loss. Currently, most reservoirs are built as infrastructural facilities and designed according to engineering best practices and site-specific considerations, which do not include catering for waterbirds' needs. Furthermore, as things stand, there is still a lack of clear and comprehensive knowledge regarding the additional factors that should be considered in tackling the challenge of attracting waterbirds' to reservoirs, without compromising on the reservoirs' original functions. This study attempts to narrow this knowledge gap by performing a systematic review of the various factors (e.g., bird attributes; physical, structural, spatial, climatic, chemical, and biological characteristics of the waterbody; and anthropogenic activities) affecting the occurrence, abundance, richness, and diversity of waterbirds in SNFWBs. The methodical review provides a concise and relatively unbiased synthesis of the knowledge in the field, which can inform decision-making and practice regarding the planning, design, and management of reservoirs with birds in mind. Such knowledge is especially beneficial for arid and semiarid areas, where natural water sources are deteriorating and becoming extinct even faster due to climate change.

Keywords: artificial waterbodies, reservoirs, small waterbodies, waterbirds

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Authors: Maznieda Mahjom, Rohaida Ismail, Masita Arip, Mohd Shaiful Azlan, Nor’Ashikin Othman, Hafizah Abdullah, nor Zahrin Hasran, Joshita Jothimanickam, Syaqilah Shawaluddin, Nadia Mohamad, Raheel Nazakat, Tuan Mohd Amin, Mizanurfakhri Ghazali, Rosmanajihah Mat Lazim

Abstract:

COVID-19 outbreak is particularly detrimental to the mental health of everyone as well as leaving a long devastating crisis in the healthcare sector. Daily increment of COVID-19 cases and close contact, necessitating the testing of a large number of samples, thus increasing the workload and burden to laboratory personnel. This study aims to determine the prevalence of personal-, work- and client-related burnout as well as to measure the concentration of salivary cortisol among laboratory personnel in the main laboratories in Klang Valley, Malaysia. This cross-sectional study was conducted in late 2021 and recruited a total of 404 respondents from three laboratories in Klang Valley, Malaysia. The level of burnout was assessed using Copenhagen Burnout Inventory (CBI) comprising three sub-dimensions of personal-, work- and client-related burnout. The cut-off score of 50% and above indicated possible burnout. Meanwhile, salivary cortisol was measured using a competitive enzyme immunoassay kit (Salimetrics, State College, PA, USA). Normal levels of salivary cortisol concentration in adults are within 0.094 to 1.551 μg/dl (morning) and can be none detected to 0.359 μg/dl (evening). The prevalence of personal-, work- and client-related burnout among laboratory personnel were 36.1%, 17.8% and 7.2% respectively. Meanwhile, the abnormal morning and evening cortisol concentration recorded were 29.5% and 21.8% excluding 6.9%-7.4% missing data. While the IgA level is normal for most of the respondents, which recorded at 95.53%. Laboratory personnel were at risk of suffering burnout during the COVID-19 pandemic. Thus, mental health programs need to be addressed at the department and hospital level by regularly screening healthcare workers and designing an intervention program. It is also vital to improve the coping skills of laboratory personnel by increasing the awareness of good coping skill techniques. The training must be in an innovative way to ensure that the lab personnel can internalise the technique and practise it in real life.

Keywords: burnout, COVID-19, laborotary personnel, salivary cortisol

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Authors: Dibakar Chakrabarty, Mebada Suiting

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Rapid urbanization coupled with changes in land use pattern results in increasing peak discharge and shortening of catchment time of concentration. The consequence is floods, which often inundate roads and inhabited areas of cities and towns. Management of storm water resulting from rainfall has, therefore, become an important issue for the municipal bodies. Proper management of storm water obviously includes adequate design of storm water drainage networks. The design of storm water network is a costly exercise. Least cost design of storm water networks assumes significance, particularly when the fund available is limited. Optimal design of a storm water system is a difficult task as it involves the design of various components, like, open or closed conduits, storage units, pumps etc. In this paper, a methodology for least cost design of storm water drainage systems is proposed. The methodology proposed in this study consists of coupling a storm water simulator with an optimization method. The simulator used in this study is EPA’s storm water management model (SWMM), which is linked with Genetic Algorithm (GA) optimization method. The model proposed here is a mixed integer nonlinear optimization formulation, which takes care of minimizing the sectional areas of the open conduits of storm water networks, while satisfactorily conveying the runoff resulting from rainfall to the network outlet. Performance evaluations of the developed model show that the proposed method can be used for cost effective design of open conduit based storm water networks.

Keywords: genetic algorithm (GA), optimal design, simulation-optimization, storm water network, SWMM

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Authors: B. Sathyanarayana

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As per the report of World Health Organization, more than 80% of world population uses medicines made from herbal and natural materials. They have stood the test of time for their safety, efficacy, cultural acceptability and lesser side effects. Quality assurance and control measures, such as national quality specification and standards for herbal materials, good manufacturing practices (GMP) for herbal medicines, labelling, and licensing schemes for manufacturing, imports and marketing, should be in place in every country where herbal medicines are regulated. These measures are vital for ensuring the safety and efficacy of herbal medicines. In the case of herbal products challenge begins at the stage of designing itself except the classical products. Selection of herbal ingredients, officinal parts to be used, proportions are vital. Once the formulation is designed one should take utmost care to produce the standardized product of assured quality and safety. Quality control measures should cover the validation of quality and identity of raw materials, in process control (as per SOP and GMP norms) and at the level of final product. Quality testing, safety and efficacy studies of the final product are required to ensure the safe and effective use of the herbal products in human beings. Medicinal plants being the materials of natural resource are subjected to great variation making it really difficult to fix quality standards especially in the case of polyherbal preparations. Manufacturing also needs modification according to the type of ingredients present. Hence, it becomes essential to develop Standard operative Procedure for a specific herbal product. Present paper throws a light on the challenges that are encountered during the design and development of herbal products.

Keywords: herbal product, challenges, quality, safety, efficacy

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Authors: Makkia Ahmad Ali Al-Falahi, Abdullah Abdelaziz Muharram

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Background: Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. Objective: To assess the prevalence of occupational health hazards among healthcare workers and associated risk factors in public hospitals in Sana'a City, Yemen. Method: Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. Results: More the half (60.6%) of HCWs aged between 20-30 years, (50.8%) were males, (56.3%) were married, and (45.5%) had a diploma qualification, while (65.2%) of HCWs had less than 6 years of experience. The result showed that the highest prevalence of occupational hazards was (99%), (ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p >0.05). Conclusion and recommendations: The study showed the highest prevalence of occupational hazards; regarding the prevalence of biological hazards exposure to sharp-related injury, the most prevalent physical hazards were slip/trip/and fall. Ergonomic hazards had back or neck pain during work. Chemical hazards were allergic to medical gloves powder. On psychosocial hazards was suffered from verbal and physical harassment. The study concluded by raising awareness among HCWs by conducting training courses to prevent occupational hazards.

Keywords: health workers, occupational hazards, risk factors, the prevalence

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Authors: Alice Khachian, Shoaleh Bigdeli, Azita Shoghie, Leili Borimnejad

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Background and aim: The hidden curriculum is crucial in nursing education and can determine professionalism and professional competence. It has a significant effect on their moral performance in relation to patients. The present study was conducted with the aim of identifying the hidden curriculum components in the nursing and midwifery faculty. Methodology: The ethnographic study was conducted over two years using the Spradley method in one of the nursing schools located in Tehran. In this focused ethnographic research, the approach of Lincoln and Goba, i.e., transferability, confirmability, and dependability, was used. To increase the validity of the data, they were collected from different sources, such as participatory observation, formal and informal interviews, and document review. Two hundred days of participatory observation, fifty informal interviews, and fifteen formal interviews from the maximum opportunities and conditions available to obtain multiple and multilateral information added to the validity of the data. Due to the situation of COVID, some interviews were conducted virtually, and the activity of professors and students in the virtual space was also monitored. Findings: The components of the hidden curriculum of the faculty are: the atmosphere (physical environment, organizational structure, rules and regulations, hospital environment), the interaction between activists, and teaching-learning activities, which ultimately lead to “A disconnection between goals, speech, behavior, and result” had revealed. Conclusion: The mutual effects of the atmosphere and various actors and activities on the process of student development, since the students have the most contact with their peers first, which leads to the most learning, and secondly with the teachers. Clinicians who have close and person-to-person contact with students can have very important effects on students. Students who meet capable and satisfied professors on their way become interested in their field and hope for their future by following the mentor of these professors. On the other hand, weak and dissatisfied professors lead students to feel abandoned, and by forming a colony of peers with different backgrounds, they distort the personality of a group of students and move away from family values, which necessitates a change in some cultural practices at the faculty level.

Keywords: hidden curriculum, nursing education, ethnography, nursing

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Authors: Adrian Kong, William Chang, Rolando Valdes, Alec Rodriguez, Roberto Miki

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The Pneumask consists of a custom snorkel-specific adapter that attaches a snorkel-port of the mask to a 3D-printed filter. This full-face snorkel mask was designed for use as personal protective equipment (PPE) during the COVID-19 pandemic when there was a widespread shortage of PPE for medical personnel. Various clinical validation tests have been conducted, including the sealing capability of the mask, filter performance, CO2 buildup, and clinical usability. However, data regarding the filter efficiencies of Pneumask and multiple filter types have not been determined. Using an experimental system, we evaluated the filtration efficiency across various masks and filters during inhalation. Eighteen combinations of respirator models (5 P100 FFRs, 4 Dolfino Masks) and filters (2091, 7093, 7093CN, BB50T) were evaluated for their exposure to airborne particles sized 0.3 - 10.0 microns using an electronic airborne particle counter. All respirator model combinations provided similar performance levels for 1.0-micron, 3.0-micron, 5.0-micron, 10.0-microns, with the greatest differences in the 0.3-micron and 0.5-micron range. All models provided expected performances against all particle sizes, with Class P100 respirators providing the highest performance levels across all particle size ranges. In conclusion, the modified snorkel mask has the potential to protect providers who care for patients with COVID-19 from increased airborne particle exposure.

Keywords: COVID-19, PPE, mask, filtration, efficiency

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Authors: Chiao-Wen Lan, David Gere

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Background and Significance: Performance has a rich history of imparting information and encouraging reflection, yet there is a paucity of literature on applying performance as a method of analysis and not as a medium for health education. This study aimed to apply ethnodrama strategies to the issue of HIV-related stigma in rural China and to use a critical performance as a vehicle for communication of health research. Methods: The program, titled 'STOP STIGMA,' included dance, narratives and original quotes from people living with HIV/AIDS in China, and spectacle such as photographs, set, and props corresponding to the history of HIV in rural China. Results: The performance represented a step away from a completely textual interpretation of data towards a theatrical style that begins to privilege what arts-based research scholars Rossiter and colleagues have termed 'an embodied, theatrical representation of data.' It offered an opportunity to deliver individual and collective stories that represent how HIV-positive people experience living with HIV/AIDS in China, which could play an integral part in the formulation of actions to effect change. Discussion: This method of communicating health research has implications for fostering dialogue among researchers, community members, and medical practitioners. Although arts-based approaches are not new to the scientific community, the integration of dance, video, ethnodrama, and sciences provides opportunities to innovate in non-traditional research dissemination and communication.

Keywords: health communication, HIV/AIDS, stigma, vulnerable populations

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Authors: Amina Akhtar, Rory O'Connor

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Introduction: There remains significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter. Methods: Data was retrieved for patients between 10-25 years old from the National Trauma Audit and Research Network (TARN) database who had been involved as pedestrians in motor vehicle accidents between 2015-2020. The incidence of injuries, their severity (using the Injury Severity Score [ISS]), hospital transfer time, and mortality were analysed according to the hours of daylight, darkness, and season. Results: The study identified a seasonal pattern, showing that autumn was the predominant season and led to 34.9% of injuries, with a further 25.4% in winter in comparison to spring and summer, with 21.4% and 18.3% of injuries, respectively. However, visibility alone was not a sufficient factor as 49.5% of injuries occurred during the time of darkness, while 50.5% occurred during daylight. Importantly, the greatest injury rate (number of injuries/hour) occurred between 1500-1630, correlating to school pick-up times. A further significant relationship between injury severity score (ISS) and daylight was demonstrated (p-value= 0.0124), with moderate injuries (ISS 9-14) occurring most commonly during the day (72.7%) and more severe injuries (ISS>15) occurred during the night (55.8%). Conclusion: We have identified a relationship between time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest injury rate, suggesting that reduced visibility coupled with school pick-up times may play a significant role. This could be addressed through a targeted public health approach to implementing change. We recommend targeted public health measures to improve road safety that focus on these times and that increase the visibility of children combined with education for drivers.

Keywords: major trauma, paediatric trauma, road traffic accidents, diurnal pattern

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Authors: Mohd Bahroddin Badri, Ridzuan Masri

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Despite the existence of large volume of waqf assets, it is argued that the potential of these assets not fully unleashed. There are many waqf assets especially in the form of land waqf that are idle and undeveloped mainly because of the insufficient fund and lack of investment expertise. This paper attempts to explore few cases on the innovation of waqf development in Malaysia and some countries that demonstrate synergistic collaboration between stakeholders, e.g., the government, nazir, Islamic religious councils, corporate entities and Islamic financial institutions for waqf development. This paper shows that cash waqf, corporate waqf, Build-Operate-Transfer (BOT) and Sukuk are found to be contemporary mechanisms within Islamic finance ecosystem that drive and rejuvenate the development of waqf to the next level. It further highlights few samples of waqf Sukuk that were successfully issued in selected countries. This paper also demonstrates that the benefit of waqf is beyond religious matters, which may also include education, healthcare, social care, infrastructure and corporate social responsibility (CSR) activities. This research is qualitative in nature, whereby the researcher employs descriptive method on the collected data. The researcher applies case study and library research method to collect and analyse data from journal articles, research papers, conference paper and annual reports. In a nutshell, the potential of contemporary models as demonstrated in this paper is very promising, in which the practical application of those instruments should be expanded for the rejuvenation of waqf asset.

Keywords: cash waqf, corporate waqf, Sukuk waqf, build-operate-transfer

Procedia PDF Downloads 178

Authors: Helen Johnson-Egemba

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This paper will discuss the current effectiveness of music therapy for a range of conditions, such as depression and anxiety. Indeed, traditional forms of therapy have often been effective in treating various mental and physical health conditions. However, they are not with their limitations. Music therapy, on the other hand, is a non-invasive and cost-effective alternative that can produce similar or even better results. Music therapy can produce longer-lasting results. The research also highlights the underlying mechanisms of traditional music therapy, such as its complementary treatment. A systematic review of existing literature was conducted to gather relevant studies and establish a comprehensive understanding of the topic. Various research methods, including experimental studies, qualitative research, surveys, were utilized to explore the therapeutic potential of traditional music interventions. The findings reveal that traditional music therapy shows promise in managing anxiety and depression symptoms, with positive outcomes impacting brain activity, emotions, and stress regulation. The outcomes of this study contribute to evidence-based practice, providing insights for clinicians and therapists to incorporate traditional music therapy into their treatment approaches. Furthermore, the research promotes awareness and acceptance of traditional music as a legitimate and effective therapeutic intervention for anxiety and depression, potentially enhancing access to alternative and complementary treatment options. Overall, this study demonstrates the potential benefits of traditional music therapy in addressing anxiety and depression, offering valuable implications for mental health care and improving the well-being of individuals struggling with these conditions.

Keywords: anxiety, effectiveness, depression, traditional music, therapy, treatment

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