Search results for: elderly care facilities

Authors: Majid Khan

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Introduction: In this era of microsurgery, free flap holds a remarkable spot in reconstructive surgery. A free flap is well suited for composite defects as it provides sufficient and well-vascularized tissue for coverage. We report our experience with the use of the free flaps for the reconstruction of composite defects. Methods: This is a retrospective case series (chart review) of patients who underwent reconstruction of composite defects with a free flap at Aga Khan University Hospital, Karachi (Pakistan) from January 01, 2015, to December 31, 2019. Data were collected for patient demographics, size of the defect, size of flap, recipient vessels, postoperative complications, and outcome of the free flap. Results: Over this period, 532 free flaps are included in this study. The overall success rate is 95.5%. The mean age of the patient was 44.86 years. In 532 procedures, there were 448 defects from tumor ablation of head and neck cancer. The most frequent free flap was the anterolateral thigh flap in 232 procedures. In this study, the risk factor hypertension (p=0.004) was found significant for wound dehiscence, preop radiation/chemotherapy (p=0.003), and malnutrition (p=0.005) were found significant for fistula formation. Malnutrition (p=0.02) and use of vein grafts (p=0.025) were significant factors for flap failure. Conclusion: Free tissue transfer is a reliable option for the reconstruction of large and composite defects. Hypertension, malnutrition, and preoperative radiotherapy can cause significant morbidity.

Keywords: free flap, free flap failure, risk factors for flap failure, free flap outcome

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Authors: Yosia Mulumba, Klaus Schmidt

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Financial Inclusion is considered a key pillar for development in most countries around the world. Access to affordable financial services in a country’s economy can be a driver to overcome poverty and reduce income inequalities, and thus increase economic growth. Nevertheless, the number of financially excluded populations in developing countries continues to be very high. This paper explores the role of Financial Technology (Fintech) as a key driver for achieving financial inclusion in developing countries post the COVID-19 pandemic with an emphasis on four East African countries: Kenya, Tanzania, Uganda, and Rwanda. The research paper is inspired by the positive disruption caused by the pandemic, which has compelled societies in East Africa to adapt and embrace the use of financial technology innovations, specifically Mobile Money Services (MMS), to access financial services. MMS has been further migrated and integrated with other financial technology innovations such as Mobile Banking, Micro Savings, and Loans, and Insurance, to mention but a few. These innovations have been adopted across key sectors such as commerce, health care, or agriculture. The research paper will highlight the Mobile Network Operators (MNOs) that are behind MMS, along with numerous innovative products and services being offered to the customers. It will also highlight the regulatory framework under which these innovations are being governed to ensure the safety of the customers' funds.

Keywords: financial inclusion, financial technology, regulatory framework, mobile money services

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Authors: Chuan-Ming Tung, Jin-Cheng Fu, Chia-En Feng

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In recent years, the rapid development of urban land in Taiwan has led to the constant increase of the areas of impervious surface, which has increased the risk of waterlogging during heavy rainfall. Therefore, in recent years, promoting runoff allocation responsibilities has often been used as a means of reducing regional flooding. In this study, the single catchment area covering both urban and rural land as the study area is discussed. Based on Storm Water Management Model, urban and rural land in a single catchment area was explored to develop the runoff allocation responsibilities according to their respective control regulation on land use. The impacts of runoff increment and reduction in sub-catchment area were studied to understand the impact of highly developed urban land on the reduction of flood risk of rural land at the back end. The results showed that the rainfall with 1 hour short delay of 2 years, 5 years, 10 years, and 25 years return period. If the study area was fully developed, the peak discharge at the outlet would increase by 24.46% -22.97% without runoff allocation responsibilities. The front-end urban land would increase runoff from back-end of rural land by 76.19% -46.51%. However, if runoff allocation responsibilities were carried out in the study area, the peak discharge could be reduced by 58.38-63.08%, which could make the front-end to reduce 54.05% -23.81% of the peak flow to the back-end. In addition, the researchers found that if it was seen from the perspective of runoff allocation responsibilities of per unit area, the residential area of urban land would benefit from the relevant laws and regulations of the urban system, which would have a better effect of reducing flood than the residential land in rural land. For rural land, the development scale of residential land was generally small, which made the effect of flood reduction better than that of industrial land. Agricultural land requires a large area of land, resulting in the lowest share of the flow per unit area. From the point of the planners, this study suggests that for the rural land around the city, its responsibility should be assigned to share the runoff. And setting up rain water storage facilities in the same way as urban land, can also take stock of agricultural land resources to increase the ridge of field for flood storage, in order to improve regional disaster reduction capacity and resilience.

Keywords: runoff allocation responsibilities, land use, flood mitigation, SWMM

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Authors: Farid Eltom A. E., Mustafa Abdul-Halim, Abdalla Markaz, Sami Atta, Mohamed Azhari, Ahmed Rashed

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Smart environment sensors integrated with ‘Internet of Things’ (IoT) technology can provide a new concept in tracking, sensing, and monitoring objects in the environment. The aim of the study is to evaluate the farm environmental monitoring system based on (IoT) and to realize the automated management of agriculture and the implementation of precision production. Until now, irrigation monitoring operations in Sudan have been carried out using traditional methods, which is a very costly and unreliable mechanism. However, by utilizing soil moisture sensors, irrigation can be conducted only when needed without fear of plant water stress. The result showed that software application allows farmers to display current and historical data on soil moisture and nutrients in the form of line charts. Design measurements of the soil factors: moisture, electrical, humidity, conductivity, temperature, pH, phosphorus, and potassium; these factors, together with a timestamp, are sent to the data server using the Lora WAN interface. It is considered scientifically agreed upon in the modern era that artificial intelligence works to arrange the necessary procedures to take care of the terrain, predict the quality and quantity of production through deep analysis of the various operations in agricultural fields, and also support monitoring of weather conditions.

Keywords: smart environment, monitoring systems, IoT, LoRa Gateway, center pivot

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Authors: Mohamed M. Ibrahima, Abdul Aziz A.AL Sahli, Ibrahim A. Alaraidh, Ali A. Al-Homaidan, E.M. Mostafa, G.A. EL-Gaaly

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Traditionally, in Middle Eastern countries, many cultures use chewing sticks of arak for medicinal purposes especially, for oral cleanliness care. It was used by Muslims for the treatment of teeth and highly recommended to be used by muslims during the whole day. Therefore, the present work aimed to determine the total phenolic content and total flavonoids in two Miswak extracts obtained from arak roots collected from two different localities in Saudi Arabia. They were extracted with aqueous ethanol (80%) and used to estimate in vitro their antioxidative abilities. The new findings showed that the two tested extracts contained significantly different amounts of both total phenolic content and total flavonoids. According to the increase of total phenolic contents and total flavonoids obtained from the two extracts, Miswak collected from the southern region was found to contain more contents than those collected from the middle region. The results of antioxidant activities of Miswak root extract obtained by using different in vitro methods were varied depending on the technique used. According to the malondialdehyde (MDA) method, hydrogen peroxide (H2O2) scavenging ability and 1,1-diphenyl-2-picrylhydrazyl (DPPH) methods, the two Miswak extracts exhibited to have high to very high antioxidant activities. Mostly, the values of antioxidant activities of Southern region have been shown to be always the highest.

Keywords: Arak, antioxidant, medicinal plants, Saudi Arabia

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Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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Authors: Iram Malik, Mahrukh Shaukat, Abeer Malik, Hafiz Mushtaq Ahmad

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There has been a lot of research on cyberbullying but there is limited research on the topic of accidental cyberbullying on social media with a special focus on healthcare industry. This study emphasizes to uncover the factors that contribute to accidental cyberbullying on social media and how it affects individuals, professionals’ and organizations in health care sector. Nowadays social media is becoming a necessary part of our daily life; there is a need to look into how it is shaping our social life and behaviors displayed online. Instances of cyber bullying can have long-term repercussions due to over-sharing of information. The study used simple random sampling and the instrument of data collection was survey. A sample size of 250 healthcare professionals was chosen from the twin cities of Rawalpindi and Islamabad, Pakistan to examine the relationship between their attitude towards internet use, psychological distress, verbal aggression, envy, frustration, self-compassion, personality traits and accidental cyberbullying on social media. The results of the study have been encouraging. The findings show that psychological distress, aggression, envy, frustration and personality traits had direct effect on accidental cyberbullying whereas compassion, altruism lessened the effect of accidental cyberbullying behavior. It is our intent that the findings of this study could help raise awareness regarding fair use of social media, help policy makers in developing appropriate policies for avoiding cyberbullying in future.

Keywords: accidental cyberbullying, aggression, cyberbullying, frustration, social media

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Authors: Maryam Zarra-Nezhad, Ali Moazami-Goodarzi, Joona Muotka, Nina Sajaniemi

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This study examines the extent to which the impact of a universal intervention program, i.e., POMPedaSens, on children’s early social-emotional learning (SEL) is different depending on early childhood education (ECE) teaches stress at work. The POMPedaSens program aims to promote children’s (5–6-year-olds) SEL by supporting ECE teachers’ engagement and emotional availability. The intervention effectiveness has been monitored using an 8-month randomized controlled trial design with an intervention (IG; 26 teachers and 195 children) and a waiting control group (CG; 36 teachers and 198 children) that provided the data before and after the program implementation. The ECE teachers in the IG are trained to implement the intervention program in their early childhood education and care groups. Latent change score analysis suggests that the program increases children’s prosocial behavior in the IG when teachers show a low level of stress. No significant results were found for the IG regarding a change in antisocial behavior. However, when teachers showed a high level of stress, an increase in prosocial behavior and a decrease in antisocial behavior were only found for children in the CG. The results suggest a promising application of the POMPedaSens program for promoting prosocial behavior in early childhood when teachers have low stress. The intervention will likely need a longer time to display the moderating effect of ECE teachers’ well-being on children’s antisocial behavior change.

Keywords: early childhood, social-emotional learning, universal intervention program, professional development, teachers' stress

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Authors: M. L. Yeung

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With the surge of divorce rate and male cancer onset/death rates, the phenomenon of divorced wives in the facing cancer death of their ex-husbands is not uncommon in Hong Kong. Yet, there is a dearth of study on the experiences of bereaved-divorced wives in the Hong Kong cultural context. This project fills the knowledge gap by conducting a qualitative study for having interviewed four bereaved ex-wives, who returned to ex-husbands’ end-of-life caregiving and eventually grieved for the ex-spousal’s death. From the perspectives of attachment theory and disenfranchised grief in the Hong Kong cultural context, a ‘double-loss’ experience is found in which interviewees suffer from the first loss of divorce and the second loss of ex-husbands’ death. Traumatic childhood experiences, attachment needs, role ambiguity, unresolved emotions and unrecognized grief are found significant in their lived experiences which alert the ‘double-loss’ is worthy of attention. Extending a family-centered end-of-life and bereavement care services to divorced couples is called for, in which validation on the attachment needs, ex-couple reconciliation, and acknowledgement on the disenfranchised grief are essential for social work practice on this group of clienteles specifically in Hong Kong cultural context.

Keywords: changing family, disenfranchised grief, divorce, ex-spousal death, marriage

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Authors: Rhay-Hung Weng, Ching-Yuan Huang, Wan-Ping Chen

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Recently, many hospitals have put much emphasis upon the development of nurse innovation. The present study aimed to clarify how nurse innovation is related to medical service quality and medical service experience. This study adopted questionnaire-survey method with nurses and customers of the inpatient wards from three Taiwanese hospitals as the research subjects. After pairing, there were 294 valid questionnaires. Hierarchical regression analysis was utilized to test the possible impact of nurse innovation on medical service quality and experience. In terms of the dimensions of nurse innovation, “innovation behavior” ranked the highest (3.24), followed by knowledge creation and innovation diffusion; in terms of the degree of the medical service quality, 'reliability' ranked the highest (4.35). As for the degree of the medical service experience, 'feel experience' ranked the highest (4.44). All dimensions of nurse innovation have no significant effects on medical service quality and medical service experience. Of these three dimensions of nurse innovation, the level of innovation behavior was perceived by the nurses as the highest. The study found that nurse innovation has no significant effects on medical service quality and medical service experience. Managers shall provide sufficient resources and budget for fostering innovation development and encourage their nurses to develop nursing innovation for patents. The education and training courses on “patient-centered ” shall be enhanced among hospital nurses. Health care managers shall also explore the difficulties about innovation diffusion and find the solutions for nurses.

Keywords: innovation, employee innovative behavior, service quality, service experience

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Authors: Aline Giardin

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Introduction: This review addresses the relationship between physical education and mental health and its main objective is to discuss the meanings that circulate in Psychiatric Hospitalization Units and Psychosocial Care Centers (CAPS) about the presence of physical education teachers and the practices developed by Them within these services. Material and methods: It is based on the theoretical contribution of the Psychiatric Reform and is methodologically inspired by the Bibliographic Review. Objectives: The objective of this review was to identify the main scientific evidence on the effects of physical activity on the main psychological aspects associated with mental health during the hospitalization process. Results: It was observed that physical activity has beneficial effects in the psychological, social and cognitive aspects, being thus a fundamental aspect of the lifestyle in promoting a healthy and successful treatment. In studies evaluating the effects of physical activity on mental health, the most frequently evaluated outcomes include anxiety, depression, and health-related quality of life (eg, self-esteem and self-efficacy). Evidence from epistemological studies indicates that the level of physical activity is positively associated with good mental health, when mental health is defined as good mood, general well-being and decreased symptoms. Conclusion: It is necessary to intervene and a greater interest of the professionals of physical education in the treatment with the people with mental disorders so that the negative symptoms are modified, through the aid of the physical activity, by better quality of life, physical condition, nutritional state and A healthy emotional appearance.

Keywords: health mental, physical activity, benefits, treatment

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Authors: Ruangdech Sirikit

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The purposes of this research were to study the variables affecting the quality assessment of mathematics subject in Thailand by using value-added analysis on TIMSS 2011. The data used in this research is the secondary data from the 2011 Trends in International Mathematics and Science Study (TIMSS), collected from 6,124 students in 172 schools from Thailand, studying only mathematics subjects. The data were based on 14 assessment tests of knowledge in mathematics. There were 3 steps of data analysis: 1) To analyze descriptive statistics 2) To estimate competency of students from the assessment of their mathematics proficiency by using MULTILOG program; 3) analyze value added in the model of quality assessment using Value-Added Model with Hierarchical Linear Modeling (HLM) and 2 levels of analysis. The research results were as follows: 1. Student level variables that had significant effects on the competency of students at .01 levels were Parental care, Resources at home, Enjoyment of learning mathematics and Extrinsic motivation in learning mathematics. Variable that had significant effects on the competency of students at .05 levels were Education of parents and self-confident in learning mathematics. 2. School level variable that had significant effects on competency of students at .01 levels was Extra large school. Variable that had significant effects on competency of students at .05 levels was medium school.

Keywords: quality assessment, value-added model, TIMSS, mathematics, Thailand

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Authors: Gokul Gaudel, Zhang Wen Hui, Dang Quang Hung, Le Thi Hien, Liang Xiao

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The community forests of Nepal serve as a major source of medicinal plants for majority of local people who are dependent on traditional health care system. This study aims to explore the ethnobotanical information of the medicinal plants used by five different community forest user groups of Parbat district of Nepal. The research was conducted during different periods of the year 2015, using semi-structured, open-ended questionnaires, formal and informal interviews, and group discussions. In total 145 different plant species within 77 families were documented, the majority of them being herb were found to be used to treat 84 different ailments. In terms of plant parts use: whole plants, barks, fruits, leaves were found to be in top priorities. Oral administration was the dominant route (57%), followed by both oral and dermal route (29%) and dermal only (14%). Females were found to have 24% more ethnobotanical knowledge than male. The knowledge of ethnobotanical medicinal plants was found excellent on age group 65-75. This study showed that community forests of Parbat district are rich in medicinal plants but the new generation was found less interested in using them. Easy access to modern medicines, lack of documentation and knowledge transfer to young generations are the major causes of diminishing utility of traditional medicinal practices.

Keywords: ailments, community forest, ethnobotany, medicinal plants, Parbat

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Authors: Hamida Hamed Said Al Harthi

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Background: Illegal drug use is a rising problem that affects Omani youth. This research aimed to study a group of young Omani men who were imprisoned more than once for illegal drug use, focusing on exploring their lifestyle experiences inside and outside the prison and whether these contributed to their early relapse and re-imprisonment. This is the first study of its kind from Oman conducted in a prison setting. Methods: 19 Omani males aged 18–35 years imprisoned in Oman Central Prison were recruited using purposive sampling. Focused ethnography was conducted over 8 months to explore the drug-related experiences outside the prison and during imprisonment. Face-to-face semi-structured interviews with the participants yielded detailed transcripts and field notes. These were thematically analyzed, and the results were compared with the existing literature. Results: The participants’ voices yielded new insights into the lives of young Omani men imprisoned for illegal drug use, including their sufferings and challenges in prison. These included: entry shock, timing and boredom, drug trafficking in prison, as well as physical and psychological health issues. Overall, imprisonment was reported to have negatively impacted the participants’ health, personality, self-concept, emotions, attitudes, behavior and life expectations. The participants reported how their efforts to reintegrate into the Omani community after release from prison were rebuffed due to stigmatization and rejection from society and family. They also experienced frequent unemployment, police surveillance, accommodation problems and a lack of rehabilitation facilities. The immensity of the accumulated psychophysiological trauma contributed to their early relapse and re-imprisonment. Conclusion: This thesis concludes that imprisonment is largely ineffective in controlling drug use in Oman. Urgent action is required across multiple sectors to improve the lives and prospects of users of illegal drugs within and outside the prison to minimize factors contributing to early relapse. Key Words: illegal drugs, drug users, Oman, addiction, Omani culture, prisoners, relapse, re-imprisonment, qualitative research, ethnography.

Keywords: illigal drugs, Prison, Omani culture lifestyle, post prison life

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Authors: Mona Awad Wanis Gad

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The method of factory making plans has changed loads, in particular, whilst it's miles approximately making plans the factory building itself. Factory making plans have the venture of designing merchandise, plants, tactics, organization, regions, and the construction of a factory. Ordinary restructuring is turning into greater essential for you to preserve the competitiveness of a manufacturing unit. Regulations in new regions, shorter lifestyle cycles of product and manufacturing era, in addition to a VUCA global (Volatility, Uncertainty, Complexity and Ambiguity) cause extra common restructuring measures inside a factory. A digital factory model is the planning foundation for rebuilding measures and turns into a critical device. Furthermore, digital building fashions are increasingly being utilized in factories to help facility management and manufacturing processes. First, exclusive styles of digital manufacturing unit fashions are investigated, and their residences and usabilities to be used instances are analyzed. Within the scope of research are point cloud fashions, building statistics fashions, photogrammetry fashions, and those enriched with sensor information are tested. It investigated which digital fashions permit a simple integration of sensor facts and in which the variations are. In the end, viable application areas of virtual manufacturing unit models are determined by a survey, and the respective digital manufacturing facility fashions are assigned to the application areas. Ultimately, an application case from upkeep is selected and implemented with the assistance of the best virtual factory version. It is shown how a completely digitalized preservation process can be supported by a digital manufacturing facility version by offering facts. Among different functions, the virtual manufacturing facility version is used for indoor navigation, facts provision, and display of sensor statistics. In summary, the paper suggests a structuring of virtual factory fashions that concentrates on the geometric representation of a manufacturing facility building and its technical facilities. A practical application case is proven and implemented. For that reason, the systematic selection of virtual manufacturing facility models with the corresponding utility cases is evaluated.

Keywords: augmented reality, digital factory model, factory planning, restructuring digital factory model, photogrammetry, factory planning, restructuring building information modeling, digital factory model, factory planning, maintenance

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Authors: Ilona Bala

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The subject of this abstract is related to the notion of 'popular music', a notion that should be treated with extreme care, particularly when applied to Frederic Chopin, one of the greatest composers of Romanticism. By ‘popular music’, we mean a category of everyday music, set against the more intellectual kind, referred to as ‘classical’. We only need to look back to the culture of the nineteenth century to realize that this ‘popular music’ refers to the ‘music of the low’. It can be studied from a sociological viewpoint, or as sociological aesthetics. However, we cannot ignore the fact that, very quickly, this music spread to the wealthiest strata of the European society of the nineteenth century, while likewise the lowest classes often listen to the intellectual classical music, so pleasant to listen to. Further, we can observe that a sort of ‘sacralisation of kitsch’ occurs at the intersection between the classical and popular music. This process is the topic of this contribution. We will start by investigating the notion of kitsch through the study of Chopin’s popular compositions. However, before considering the popularisation of this music in today’s culture, we will have to focus on the use of the word kitsch in Chopin’s times, through his own musical aesthetics. Finally, the objective here will be to negate the theory that art is simply the intellectual definition of aesthetics. A kitsch can, obviously, only work on the emotivity of the masses, as it represents one of the features of culture-language (the words which the masses identify with). All art is transformed, becoming something outdated or even outmoded. Here, we are truly within a process of mythologization of art, through the study of the aesthetic reception of the musical work.

Keywords: F. Chopin, kitsch, musical work, mythologization of art, popular music, romantic music

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Authors: K. P. Farsana

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Belief in supernatural causation of mental illnesses and resort to religious and faith healing as the method of intervention still continue in many parts of the world. The proposed study intended to find out the belief and causation on health and illness and utilization of religious and faith healing, its implications, and associated socio-cultural and religious factors among Mappila Muslims of Malabar, Kerala, a southern state of India.Thangals are the endogamous community in Kerala, of Yemeni heritage who claim direct descent from the Prophet Mohammed’s family. Because of their sacrosanct status, many Thangal works as religious healers in Malabar, Northern Kerala. Using the case of one Thangal healer as an illustration of the many religious healers in Kerala who engage in the healing practices, it is intended, in this paper to illustrate the religious and ritual healing practices among Mappila Muslims of Malabar. It was found that the majority of the Mappila Muslims believed in supernatural causation on illness, and majority of them consulted religious and faith healers for various health problems before seeking professional help, and a considerable proportion continued to believe in the healing efficiency of the religious and faith healing. A significant proportion of the population found religious and faith healing practices are supportive and more acceptable within the community. Religion and belief system play an important role in the heath seeking behavior of a person.

Keywords: religious and faith healing, mental illness, Mappila Muslims, Malabar

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Authors: Renee Monchalin

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Métis peoples, while comprising over a third of the total Indigenous population in Canada, experience major gaps in health services that accommodate their cultural identities. This is problematic given Métis peoples experience severe disparities in health determinants and outcomes compared to the non-Indigenous Canadian population. At the same time, Métis are unlikely to engage in health services that do not value their cultural identities, often utilizing mainstream options. Given these contexts, this research aims to fill the culturally-safe health care gap for Métis peoples in Canada. It does this by engaging 56 urban Métis women who participated in a longitudinal cohort study, Our Health Counts (OHC) Toronto. Traditionally, Métis women were central to the health and well-being of their communities. However, due to decades of colonial legislation and forced land displacement, female narratives have been silenced, and Métis identities have been fractured. This has resulted in having direct implications on Métis people’s current health and access to health services. Solutions to filling the Métis health service gap may lie in the all too often unacknowledged or missing voices of Métis women. Through a conversational method, this research will explore urban Métis women’s perspectives on identity and their experiences with health services in Toronto. The goal of this research is to learn from urban Métis women on steps towards filling the health service gap. This research is currently in the data collection stage. Preliminary findings from the conversations will be disseminated. Policy recommendations for health service providers will be provided to better accommodate Métis people.

Keywords: indigenous health, Metis health, urban, health service access, identity

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Authors: Md. Shafiullah

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This study delves into the evolving landscape of urban childcare in Bangladesh, focusing on the experiences and challenges faced by parents in Dhaka city. This paper argues that the traditional childcare arrangement of city families is inadequate to meet the development needs of children. The study aims to explore the childcare challenges faced by urban parents as they transition from traditional family-based childcare networks to alternative caregiving arrangements amidst urbanization, economic shifts, and social transformations. Utilizing a mixed-method research approach, combining quantitative surveys (n = 200) and four qualitative interviews, the research examines the parental viewpoints on childcare practices and the role of societal norms and values. The study finds childcare crises in both the family and daycare settings. In family care, caregiving suffers from the less availability of grandparents, a lack of skills of caregivers, and a lack of child interaction. As for the daycare, it is affected by the absence of appropriate policies, a lack of quality, health and safety concerns, affordability issues, and cultural concerns. Additionally, the study highlights inadequacies in childcare policies and regulatory frameworks, calling for comprehensive reforms to address the childcare vacuum in urban areas. By shifting the focus from developed to developing countries, this study contributes to the literature and suggests policy implications for Bangladesh and beyond.

Keywords: childcare, child development, childcare policy, daycare, Bangladesh

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Authors: Luljeta Gashi, Naser Ramadani, Zana Deva, Dafina Gexha-Bunjaku

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The official HIV/AIDS data in Kosovo are based on HIV case reporting from health-care services, the blood transfusion system and Voluntary Counselling and Testing centres. Between 1986 and 2014, are reported 95 HIV and AIDS cases, of which 49 were AIDS, 46 HIV and 40 deaths. The majority (69%) of cases were men, age group 25 to 34 (37%) and route of transmission is: heterosexual (90%), MSM (7%), vertical transmission (2%) and IDU (1%). Based on existing data and the UNAIDS classification system, Kosovo is currently still categorised as having a low-level HIV epidemic. Even though with a low HIV prevalence, Kosovo faces a number of threatening factors, including increased number of drug users, a stigmatized and discriminated MSM community, high percentage of youth among general population (57% of the population under the age of 25), with changing social norms and especially the sexual ones. Methods: Data collection was done using self administered structured questionnaires amongst 249 high school students. Data were analysed using the Statistical Package for Social Sciences (SPSS). Results: The findings revealed that 68% of students know that HIV transmission can be reduced by having sex with only one uninfected partner who has no other partners, 94% know that the risk of getting HIV can be reduced by using a condom every time they have sex, 68% know that a person cannot get HIV from mosquito bites, 81% know that they cannot get HIV by sharing food with someone who is infected and 46% know that a healthy looking person can have HIV. Conclusions: Seventy one percent of high school students correctly identify ways of preventing the sexual transmission of HIV and who reject the major misconceptions about HIV transmission. The findings of the study indicate a need for more health education and promotion.

Keywords: Kosovo, KPAR, HIV, high school

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Authors: Liliane Clark

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Immigrating to a different country may imply having to handle many difficult exertions. There is a particular issue that has to be endured by some immigrants: the children they had to leave behind. It is a phenomenon that occurs with certain frequency. Surprisingly, despite the fact that immigration in the United States is such a large proceeding, there is not much research about the topic in America exploring the trauma of the abandonment caused by this separation and its consequences on the mental health of those children. The term “left behind children” is usually applied to children who were left behind by their parents in their original nation under the care of a noteworthy relative, frequently the grandparents, when they moved to another country. This preliminary research, which is a partial study projected for a doctoral thesis, investigated whether the trauma of abandonment experienced by ten left behind children had affected their emotional development. The Strengths and Difficulties Questionnaire (SDQ) and a brief interview were utilized to assess the information. The SDQ explored scales such as emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behavior. In this pilot study, the results indicated that all these issues had some sort of significant correlation between them. During the interviews, the participants or their parents identified a range of symptoms: anxiety disorder, eating disorders, panic attacks, psychotic-like experiences, drug use and depression. Hence, it seems that there is a connection between the trauma of abandonment suffered due to the separation and the children’s consequent symptomatic behavior. Further studies are indeed necessary to validate the initial results of this investigation.

Keywords: abandonment, parent migration, psychological problems, trauma

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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: 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: Maria Magdy Danial Riad

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Background: In the United Kingdom (UK), pharmacists' roles have expanded considerably in recent decades to encompass clinical practice through more direct patient care. However, dispensing and compounding remain core activities for pharmacists. A lack of marketed preparations for species-specific animal use results in veterinary pharmacy practice compounding, retaining its prominence. Current participation by pharmacists to support this sphere of practice would appear to be minimal. Objectives: This study was undertaken to determine the opinions and views toward the practice of veterinary pharmacy by a cross-sectional group of pharmacists. Methods: Research data were collected via a self-administered survey questionnaire distributed at the 2012 annual conference of the Royal Pharmaceutical Society. Sampling was purposive, with a random distribution of the questionnaire to pharmacists during the conference sessions. Key findings: Interaction by pharmacists with veterinary pharmacies is currently minimal, primarily due to a lack of knowledge of veterinary medicines. Respondents revealed a lack of veterinary pharmacy courses during their undergraduate studies. This has led to situations where some veterinary prescriptions are dispensed without adequate checks being performed by the pharmacist. Pharmacists, on occasion, do not dispense veterinary prescriptions presented to them due to insufficient knowledge of veterinary medicines and/or a lack of consultable reference sources. The effect on practice is that pharmacists do not always participate as fully as would seem logical. Conclusions: Pharmacists' participation in veterinary pharmacy is limited by a lack of knowledge of veterinary medicines, mostly resulting from inadequate tuition on veterinary pharmacy during their initial education.

Keywords: veterinary pharmacy, veterinary medicines, pharmacy education, pharmacists continuing professional development

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Authors: Irfan Khan, Chiemeka David Ekene Arize, Hilly Swami, Suprabha Jha

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Background: The rise of myocardial infarction (MI) among young adults, especially those with psychiatric conditions on antipsychotic medications, highlights the need to explore non-traditional cardiovascular risk factors. Case Presentation: We discuss a 24-year-old male with acute MI, diagnosed with an acute anxiety disorder, treated with risperidone and quetiapine, and with a history of occasional smoking. Despite no significant medical history, his presentation underscores the complex interactions between psychiatric conditions, antipsychotic medication, and lifestyle choices in the etiology of MI. Discussion: This case sheds light on the intricate relationship between minimal smoking habits, the use of atypical antipsychotics, and psychiatric illness as contributory factors to cardiovascular risk in young patients. It suggests a synergistic effect, amplifying the risk of MI, which is not adequately captured by traditional risk models. Conclusion: The case emphasizes the importance of an integrated care appro ach for young MI patients with psychiatric conditions and highlights the urgent need for further research to understand the compounded cardiovascular risk posed by psychiatric medications and lifestyle factors. It advocates for comprehensive risk assessments that consider these non-traditional factors to improve outcomes for this vulnerable patient population.

Keywords: myocardial infarction, young adults, psychiatric illness, antipsychotic medications, smoking

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Authors: Narendra Kumar

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This study uses data from the ‘National Family Health Survey (NFHS-3) 2005-06’ to investigate the predictors of infant and child mortality among low economic households in East and Northeast region. The cross tabulation, life table survival estimates and Cox proportional hazard model techniques have been used to estimate the predictors of infant and child mortality. The life table survival estimates for infant and child mortality shows that infant mortality in female child is lower in comparison to male child but with child mortality, the rates are higher for female in comparison to male child and the Cox proportional hazard model also give highly significant in female in comparison to male child. The infant and child mortality rates among poor households highest in the Central region followed by North and Northeast region and the lowest in South region in comparison to all regions of India. Education of respondent has been found a significant characteristics in both analyzes, further birth interval, respondent occupation, caste/tribe and place of delivery has substantial impact on infant and child mortality among low economic households in East and Northeast region. Finally these findings specified that an increase in parents’ education, improve health care services and improve socioeconomic conditions of low economic households which should in turn raise infant and child survival and should decrease child mortality among low economic households in India.

Keywords: infant, child, mortality, socio-economic, India

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Authors: Elif Ates, Naile Bilgili

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Background: One of the most important medical complications that individuals with spinal cord injury (SCI) face are the neurogenic bladder. Objectives: To review methods used for management of neurogenic bladder and their effects. Methods: The study was conducted by searching CINAHL, Ebscohost, MEDLINE, Science Direct, Ovid, ProQuest, Web of Science, and ULAKBİM National Databases for studies published between 2005 and 2015. Key words used during the search included ‘spinal cord injury’, ‘bladder injury’, ‘nursing care’, ‘catheterization’ and ‘intermittent urinary catheter’. After examination of 551 studies, 21 studies which met inclusion criteria were included in the review. Results: Mean age of individuals in all study samples was 42 years. The most commonly used bladder management method was clean intermittent catheterization (CIC). Compliance with CIC was found to be significantly related to spasticity, maximum cystometric capacity, and the person performing catheterization (p < .05). The main reason for changing the existing bladder management method was urinary tract infections (UTI). Individuals who performed CIC by themselves and who voided spontaneously had better life quality. Patient age, occupation status and whether they performed CIC by themselves or not were found to be significantly associated with depression level (p ≤ .05). Conclusion: As the most commonly used method for bladder management, CIC is a reliable and effective method, and reduces the risk of UTI development. Individuals with neurogenic bladder have a higher prevalence of depression symptoms than the normal population.

Keywords: bladder management, catheterization, nursing, spinal cord injury

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Authors: Karthikeyan Srinivasan, Ranjana Singh, Yatin Talwar, Karthikeyan Srinivasan

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Healthcare services play a vital role in the life of human being. The Setup of Hospital varies in wide spectrum of cost, technology, and access. Hospital’s of Public sector satisfies need of a common man to poorer, which can differ at private owned hospitals on cost and treatment. Patient assessing hospital frequently assumes spending time at the hospital is miserable and not aware of what is happening around them. Mostly they are queued up round the clock waiting to be admitted on hospital beds. The idea here is to highlight the role in admitting patient population of Outdoor as well as Emergency entering the Post Graduate Institute of Medical Education and Research, Chandigarh with available hospital beds. This study emphasizes the trend forecasting and acquiring beds needed. The conception “if patient population increases’ likewise increasing hospital beds advertently perceived. If tend to increase the hospital beds, thereby exploring budget, Manpower, space, and infrastructure make compulsion. This survey ideally draws out planning and forecasting beds to cater patient population in and around neighboring state of Chandigarh for admission at territory healthcare and research institute on available hospital beds. Executing healthcare services for growing population needs to know Roemer’s law indicating "in an insured population, a hospital bed built is a filled bed".

Keywords: admissions, average length of stay, bed days, hospital beds, occupancy rates

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Authors: Niu Shu Fen

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Sleep disturbance is highly prevalent among shift-working nurses. We aimed to evaluate whether aerobic exercise (i.e., walking combined with jogging) improves objective Sleepparameters among female nurses at the end of an 8-week exercise program and 4 weeks after study completion. This single-blinded, parallel design, randomized controlled trial was conducted in the floor classroom of a would-be medical center in northern Taiwan. Sixtyeligible female nurses were randomly assigned to either aerobic exercise (n = 30) or usual care (n = 30) group. The moderate-intensity aerobic exercise program was performed over 5days (60 min per day) a week for 8 weeks after work hours. Objective sleep outcomes including total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE), were retrieved using an Actigraph device. A generalized estimated equation model was used for data analyses. The aerobic exercise group had significant improvements in TST and SE at 4 weeks and 8 weeks compared with baseline evaluation(TST: B = 70.49 and 55.96, both p < 0.001; SE: B = 5.21 and 3.98, p < 0.001 and 0.002).Significant between-group differences were observed in SOL and WASO at 4 weeks but not8 weeks compared with the baseline evaluation (SOL: B = −7.18, p = 0.03; WASO: B =−11.38, p = 0.008). The positive lasting effects for TST were observed only until the 4-week follow-up. To improve sleep quality and quantity, we encourage female nurses to regularly perform moderate-intensity aerobic exercise.

Keywords: sleep quality, aerobic exercise, nurses, shift work

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