Search results for: health economy

Authors: Rama Krishna Supramanian, Marzuki Isahak, Noran Naqiah Hairi

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Noise-induced hearing loss (NIHL) is one of the highest recorded occupational diseases, despite being preventable. Hearing Conservation Program (HCP) is designed to protect workers hearing and prevent them from developing hearing impairment due to occupational noise exposures. However, there is still a lack of evidence regarding the effectiveness of this program. The purpose of this study was to determine the effectiveness of a Hearing Conservation Program (HCP) in preventing or reducing audiometric threshold changes among vector control workers. This study adopts a cluster randomized controlled trial study design, with district health offices as the unit of randomization. Nine district health offices were randomly selected and 183 vector control workers were randomized to intervention or control group. The intervention included a safety and health policy, noise exposure assessment, noise control, distribution of appropriate hearing protection devices, training and education program and audiometric testing. The control group only underwent audiometric testing. Audiometric threshold changes observed in the intervention group showed improvement in the hearing threshold level for all frequencies except 500 Hz and 8000 Hz for the left ear. The hearing threshold changes range from 1.4 dB to 5.2 dB with largest improvement at higher frequencies mainly 4000 Hz and 6000 Hz. Meanwhile for the right ear, the mean hearing threshold level remained similar at 4000 Hz and 6000 Hz after 3 months of intervention. The Hearing Conservation Program (HCP) is effective in preserving the hearing of vector control workers involved in fogging activity as well as increasing their knowledge, attitude and practice towards noise-induced hearing loss (NIHL).

Keywords: adult, hearing conservation program, noise-induced hearing loss, vector control worker

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Authors: H. Chabalala, A. Grootboom, M. Tang

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The innovative development, production, and clinical utilisation of African natural medicines requires frameworks from systematisation, innovation, registration. Afrika faces challenges when it comes to these sectors. The opposite is the case as is is evident in ancient Asian (Traditional Chinese Medicine and Indian Ayurveda and Siddha) medical systems, which are interfaced into their respective national health and educational systems. Afrikan Natural Medicines (ANMs) are yet to develop systematisation frameworks, i.e. disease characterisation and medicines classification. This paper explores classical medical systems drawn from Afrikan and Chinese experts in natural medicines. An Afrikological research methodology was used to conduct in-depth interviews with 20 key respondents selected through purposeful sampling technique. Data was summarised into systematisation frameworks for classical disease theories, patient categorisation, medicine classification, aetiology and pathogenesis of disease, diagnosis and prognosis techniques and treatment methods. It was discovered that ancient Afrika had systematic medical cosmologies, remnants of which are evident in most Afrikan cultural health practices. Parallels could be drawn from classical medical concepts of antiquity, like Chinese Taoist and Indian tantric health systems. Data revealed that both the ancient and contemporary ANM systems were based on living medical cosmologies. The study showed that African Natural Healing Systems have etiological systems, general pathogenesis knowledge, differential diagnostic techniques, comprehensive prognosis and holistic treatment regimes. Systematisation models were developed out of these frameworks, and this could be used for evaluation of clinical research, medical application including development of curriculum for high-education. It was envisaged that frameworks will pave way towards the development, production and commercialisation of ANMs. This was piloted in inclusive innovation, technology transfer and commercialisation of South African natural medicines, cosmeceuticals, nutraceuticals and health infusions. The central model presented here in will assist in curriculum development and establishment of Afrikan Medicines Hospitals and Pharmaceutical Industries.

Keywords: African Natural Medicines, Indigenous Knowledge Systems, Medical Cosmology, Clinical Application

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Authors: Benny Sand, Yotam Lurie, Shlomo Mark

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Medical Internet of Things (MIoT), AI, and data privacy are linked forever in a gordian knot. This paper explores the conflicts of interests between the stakeholders regarding data privacy in the MIoT arena. While patients are at home during healthcare hospitalization, MIoT can play a significant role in improving the health of large parts of the population by providing medical teams with tools for collecting data, monitoring patients’ health parameters, and even enabling remote treatment. While the amount of data handled by MIoT devices grows exponentially, different stakeholders have conflicting understandings and concerns regarding this data. The findings of the research indicate that medical teams are not concerned by the violation of data privacy rights of the patients' in-home healthcare, while patients are more troubled and, in many cases, are unaware that their data is being used without their consent. MIoT technology is in its early phases, and hence a mixed qualitative and quantitative research approach will be used, which will include case studies and questionnaires in order to explore this issue and provide alternative solutions.

Keywords: MIoT, data privacy, stakeholders, home healthcare, information privacy, AI

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Authors: Tavee Cheausuwantavee

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: COVID-19 pandemic significantly has impacted everyone’s life. Persons with disabilities (PWDs) in Thailand have been also effected by COVID-19 situation in many aspects of their lives, while there have been no more appropriate services of the government and providers. Research projects had been only focused on health precaution and protection. Rapid need assessments on populations and vulnerable groups were limited and conducted via social media and an online survey. However, little is known about the real problems and needs of Thai PWDs during the COVID-19 pandemic for an effective plan and integral services for those PWDs. Therefore, this study aims to explore the diverse problems and needs of Thai PWDs in the COVID -19 pandemic. Results from the study can be used by the government and other stakeholders for further effective services. Methods: This study was used a mixed-method design that consisted of both quantitative and qualitative measures. In terms of the quantitative approach, there were 744 PWDs and caregivers of all types of PWDs selected by proportional multistage stratified random sampling according to their disability classification and geographic location. Questionnaires with 59 items regarding participant characteristics, problems, and needs in health, education, employment, and other social inclusion, were distributed to all participants and some caregivers completed questionnaires when PWDs were not able to due to limited communication and/or literacy skills. Completed questionnaires were analyzed by descriptive statistics. For qualitative design, 62 key informants who were PWDs or caregivers were selected by purposive sampling. Ten focus groups, each consisting of 5-6 participants and 7 in-depth interviews from all the groups identified above, were conducted by researchers across five regions. Focus group and in-depth interview guidelines with 6 items regarding problems and needs in health, education, employment, other social inclusion, and their coping during COVID -19 pandemic. Data were analyzed using a modification of thematic content analysis. Results: Both quantitative and qualitative studies showed that PWDs and their caregivers had significant problems and needs all aspects of their life, including income and employment opportunity, daily living and social inclusion, health, and education, respectively. These problems and needs were related to each other, forming a vicious cycle. Participants also learned from negative pandemic to more positive life aspects, including their health protection, financial plan, family cohesion, and virtual technology literacy and innovation. Conclusion and implications: There have been challenges facing all life aspects of PWDs in Thailand during the COVID -19 pandemic, particularly incomes and daily living. All challenges have been the vicious cycle and complicated. There have been also a positive lesson learned of participants from the pandemic. Recommendations for government and stakeholders in the COVID-19 pandemic for PWDs are the following. First, the health protection strategy and policy of PWDs should be promoted together with other quality of life development including income generation, education and social inclusion. Second, virtual technology and alternative innovation should be enhanced for proactive service providers. Third, accessible information during the pandemic for all PWDs must be concerned. Forth, lesson learned from the pandemic should be shared and disseminated for crisis preparation and a positive mindset in the disruptive world.

Keywords: challenge, COVID-19, disability, Thailand

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Authors: Hayani Anastasia, Junus Widjaja, Anis Nur Widayati

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In Indonesia, schistosomiasis is caused by Schistosoma japonicum with Oncomelania hupensis lindoensis as the intermediate host. Schistosomiasis can infect humans and all species of mammals. In order to achieve schistosomiasis elimination by 2020, schistosomiasis control, including environmental management, has been carried out by multi-sector. A cross-sectional study was conducted in 2018 to evaluate the multi-sectoral schistosomiasis control program. Data were collected by depth interviews of stakeholders, stool surveys, snail surveys, observation, and document reviews. About 53.6% of control programs in the schistosomiasis control roadmap were not achieved. The number of foci area found in 2018 are not significantly different compared to before the control programs. Moreover, the prevalence of schistosomiasis in the human was 0-5.1% and in mammals was the range from 0 to 10%. In order to overcome the problems, a policy about schistosomiasis as a priority program in ministries and agencies other than the Ministry of Health is needed. Innovative health promotion with interactive media also needs to be applied. Also, the schistosomiasis work team needs to be more active with the Agency of Regional Development as the leading sector.

Keywords: evaluation, Indonesia, multi-sector, schistosomiasis

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Authors: Olufunke Ayilara Aje-Famuyide

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The centrality of the Petroleum Industry in the world energy is undoubted. The world economy almost runs and depends on petroleum. Petroleum industry is a multi-trillion industry; it turns otherwise poor and underdeveloped countries into wealthy nations and thrusts them at the center of international diplomacy. Although these developing nations lack the necessary technology to explore and exploit petroleum resources they are not without help as developed nations, represented by their multinational corporations are ready and willing to provide both the technical and managerial expertise necessary for the development of this natural resource. However, the exploration of these petroleum resources comes with, sometimes, grave, concomitant consequences. These consequences are especially pronounced with respect to the environment. From the British Petroleum Oil rig explosion and the resultant oil spillage and pollution in New Mexico, United States to the Mobil Oil spillage along Nigerian coast, the story and consequence is virtually the same. Nigeria’s Niger Delta Region produces Nigeria’s petroleum which accounts for more than ninety-five percent of Nigeria’s foreign exchange earnings. Between 1999 and 2007, Nigeria earned more than $400 billion from petroleum exports. Nevertheless, petroleum exploration and exploitation has devastated the Niger Delta environment. From oil spillage which pollutes the rivers, farms and wetlands to gas flaring by the multi-national corporations; the consequences is similar-a region that has been devastated by petroleum exploitation. This paper thus seeks to examine the consequences and impact of petroleum pollution in the Niger Delta of Nigeria with particular reference on the right of the people of Niger Delta to a healthy environment. The paper further seeks to examine the relevant international, regional instrument and Nigeria’s municipal laws that are meant to protect the result of the people of the Niger Delta and their enforcement by the Nigerian State. It is quite worrisome that the Niger Delta Region and its people have suffered and are still suffering grave violations of their right to a healthy environment as a result of petroleum exploitation in their region. The Nigerian effort at best is half-hearted in its protection of the people’s right.

Keywords: environment, exploration, petroleum, pollution

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Authors: A. Ramkumar, Anvesh Sagar, Preetham P. Karkera

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Globalization in the modern era is dependent on the International logistics, the economic and reliable means is provided by the ocean going merchant vessel. The propulsion system which drives this massive vessels has gone through leaps and bounds of evolution. Most reliable system of propulsion adopted by the majority of vessels is by marine diesel engine. Since the first oil crisis of 1973, there is demand in increment of efficiency of main engine. Due to increase in the oil prices ship-operators explores for reduction in the operational cost of ship. And newly adopted IMO’s EEDI & SEEMP rules calls for the effective measures taken in this regard. The main engine of a ship suffers a lot of thermal losses, they mainly occur due to exhaust gas waste heat, radiation and cooling. So to increase the overall efficiency of system, we have to look into the solution to harnessing this waste energy of main engine to increase the fuel economy. During the course of research, engine manufacturers have developed many waste heat recovery systems. In our paper we see about additional options to harness this waste heat. The exhaust gas of engine coming out from the turbocharger still holds enough heat to go to the exhaust gas economiser to produce steam. This heat of exhaust gas can be used to heat a liquid of less boiling point after coming out from the turbocharger. The vapour of this secondary liquid can be superheated by a bypass exhaust or exhaust of turbocharger. This vapour can be utilized to rotate the turbine which is coupled to a generator. And the electric power for ship service can be produced with proper configuration of system. This can be included in PMS of ship. In this paper we seek to concentrate on power generation with use of exhaust gas. Thereby taking out the load on the main generator and increasing the efficiency of the system. This will help us to comply with the new rules of IMO. Our method helps to develop clean energy.

Keywords: EEDI–energy efficiency design index, IMO–international maritime organization PMS-power management system, SEEMP–ship energy efficiency management plan

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Authors: Leyli Khavari, Javad Yousefian

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The aim of this study was to investigate the effect of physical biorhythm cycle on health-related fitness factors. For this purpose, 120 athlete and non-athlete male and female students were selected randomly and based on the level of physical activity divided into athletic and non-athletic groups. The exact date of birth and also when the subjects were in the positive, negative and critical physical biorhythm cycle was determined by calculation software biorhythm. The physical fitness factors tests, including Queens College Step Test, AAHPERD sit-ups; Wells stretch test and hand dynamometer. Students in three stages in positive, negative and critical physical cycle were tested. Data processing using SPSS software and statistical tests ANOVA with repeated measures and student t test was used for dependent. The results of this study showed that changes in physical fitness and physical biorhythm were not affected by changes in the 23-day physical cycle.

Keywords: AAHPERD test, biorhythm, physical cycle, Queens College Step Test

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Authors: Amit Kaushik

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Equus kiang kiang is an indigenous large-bodied herbivore species, and in India, it is restricted to limited geographies of Ladakh. One of such areas is the Tsokar Basin. With the rise in global pashmina demand, the livestock numbers have grown significantly. Previous studies have reported conflict between a nomadic pastoral community, the Changpas, and kiang. Absentee pastoralism (in lieu of pure pastoralism) and tourism are two major economic activities among the local people. However, the social, economic, political, and ecological changes are inevitable in such a contemporary system. The study examines several factors influencing the local pastoral economy and focuses on the presence of two non-human cohabitants, kiang, and the wolf. This study used semi-structured interviews and vehicle count method in four different seasons. The results show that people perceived kiang as a threat but also reveal a level of tolerance towards them. The locals predicted high kiang numbers ranging from 200-3000 in the basin and contrastingly ranked them behind wolves, which are very few in numbers. Due to a lack of scientific pieces of evidence, the kiang population status remains obscure, and local peoples’ concerns remain unaddressed. But how this competitive dysfunctionality does take place? On one side, the rural development or the animal husbandry department aims at developing the area by providing stall-feed and tourism, whereas, on another side, the wildlife department emphasizes wildlife conservation. Therefore, the managers and planners may need to be cautious about the local socio-ecological complexities and may require inter-departmental communications. The study concludes that an interdisciplinary inquiry may be an important tool in understanding such a precarious situation and may be used in the policy-making processes.

Keywords: coexistence, human-livestock-wildlife interactions, interdisciplinary approach, kiang, policymaking, tsokar.

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Authors: S. Farzad, M. Ali Mandegari, J. F. Görgens

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The South African Sugar Industry, which has a significant impact on the national economy, is currently facing problems due to increasing energy price and low global sugar price. The available bagasse is already combusted in low-efficiency boilers of the sugar mills while bagasse is generally recognized as a promising feedstock for second generation bioethanol production. Establishment of biorefinery annexed to the existing sugar mills, as an alternative for the revitalization of sugar industry producing biofuel and electricity has been proposed and considered in this study. Since the scale is an important issue in the feasibility of the technology, this study has taken into account a typical sugar mill with 300 ton/hr sugar cane capacity. The biorefinery simulation is carried out using Aspen PlusTM V8.6, in which the sugar mill’s power and steam demand has been considered. Hence, sugar mills in South Africa can be categorized as highly efficient, efficient, and not efficient with steam consumption of 33, 40, and 60 tons of steam per ton of cane and electric power demand of 10 MW; three different scenarios are studied. The sugar cane bagasse and tops/trash are supplied to the biorefinery process and the wastes/residues (mostly lignin) from the process are burnt in the CHP plant in order to produce steam and electricity for the biorefinery and sugar mill as well. Considering the efficient sugar mill, the CHP plant has generated 5 MW surplus electric powers, but the obtained energy is not enough for self-sufficiency of the plant (Biorefinery and Sugar mill) due to lack of 34 MW heat. One of the advantages of second generation biorefinery is its low impact on the environment and carbon footprint, thus the plant should be self-sufficient in energy without using fossil fuels. For this reason, a portion of fresh bagasse should be sent to the CHP plant to meet the energy requirements. An optimization procedure was carried out to find out the appropriate portion to be burnt in the combustor. As a result, 20% of the bagasse is re-routed to the combustor which leads to 5 tons of LP Steam and 8.6 MW electric power surpluses.

Keywords: biorefinery, sugarcane bagasse, sugar mill, energy analysis, bioethanol

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Authors: Mohammed Jemal Ahmed

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Some anti-Islam attributes, such as alcoholism and voyeurism, have become de facto manifestations of the tourism sector. This eventually causes a paradoxical relationship between tourism and Islam. Hence, on the one hand, Islam inherently encourages Muslims to engage in tourism, the interest of Muslims to engage in tourism is steadily increasing. On the other hand, haram activities and products that are not allowed to Muslims as per the Islamic law and doctrine have surrounded tourism. Therefore, halal tourism has emerged as the best mediator to reconcile the conflicts between secular interests and religious values. Recent studies have confirmed that halal tourism is an emerging cultural phenomenon and secular rather than religious. The central aim of halal tourism is to have delighted customers irrespective of their religious and cultural backgrounds while promoting environmental conservation and social coexistence. This study appraises halal tourism development in Ethiopia from commercial, socio-cultural and diplomatic perspectives. Employing qualitative methodologies, the study, firstly, tried to clarify the existing terminological ambiguities between halal tourism and Islamic tourism and redefine both concepts. Then, it assessed perceptions of local communities and stakeholders towards halal tourism and identified halal tourism resources of Ethiopia. Accordingly, five clusters of halal visitor attractions and five potential halal tourism routes were identified and proposed. Furthermore, the comparative advantages of Ethiopia in terms of halal tourism development and potential barriers to halal tourism development in the country were rigorously appraised. The findings of this study reveal that halal tourism could inject hard currency into the national economy and create job opportunities for the locals. It could also support the mainstream tourism industry through product diversification and curving seasonality. Moreover, socially, halal tourism reinforces interreligious cohesion, relationship and coextensive in multi-religious, multicultural and multiethnic Ethiopia. Politically, it strengthens Ethiopia's foreign diplomatic relationship with the Islamic world and its near and distant neighbor Muslim Countries.

Keywords: halal-conscious travelers, halal tourism, Islamic tourism, tourism resources

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Authors: Bassem Nassar, Wessam Hussein, Medhat Mokhtar

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The crucial concern of satellite operations is to ensure the health and safety of satellites. The worst case in this perspective is probably the loss of a mission but the more common interruption of satellite functionality can result in compromised mission objectives. All the data acquiring from the spacecraft are known as Telemetry (TM), which contains the wealth information related to the health of all its subsystems. Each single item of information is contained in a telemetry parameter, which represents a time-variant property (i.e. a status or a measurement) to be checked. As a consequence, there is a continuous improvement of TM monitoring systems in order to reduce the time required to respond to changes in a satellite's state of health. A fast conception of the current state of the satellite is thus very important in order to respond to occurring failures. Statistical multivariate latent techniques are one of the vital learning tools that are used to tackle the aforementioned problem coherently. Information extraction from such rich data sources using advanced statistical methodologies is a challenging task due to the massive volume of data. To solve this problem, in this paper, we present a proposed unsupervised learning algorithm based on Principle Component Analysis (PCA) technique. The algorithm is particularly applied on an actual remote sensing spacecraft. Data from the Attitude Determination and Control System (ADCS) was acquired under two operation conditions: normal and faulty states. The models were built and tested under these conditions and the results shows that the algorithm could successfully differentiate between these operations conditions. Furthermore, the algorithm provides competent information in prediction as well as adding more insight and physical interpretation to the ADCS operation.

Keywords: space telemetry monitoring, multivariate analysis, PCA algorithm, space operations

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Authors: Ogbuagu Josephat Okechukwu, Okeke Abuchi Princewill, Arinze Rosemary Uche, Tabugbo Ifeyinwa Blessing, Ogbuagu Adaora Stellamaris

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Phthalates or Phthalate esters (PAEs), categorized as an endocrine disruptor and persistent organic pollutants, are known for their environmental contamination and toxicological effects. In this study, the concentration of selected phthalates was determined across the sampling site to investigate their occurrence and the ecological and health risk assessment they pose to the environment. Water and sediment samples were collected following standard procedures. Solid phase and ultrasonic methods were used to extract seven different PAEs, which were analyzed by Gas Chromatography with Mass Detector (GCMS). The analytical average recovery was found to be within the range of 83.4% ± 2.3%. The results showed that PAEs were detected in six out of seven samples with a high percentage of detection rate in water. Di-n-butyl phthalate (DPB) and disobutyl phthalates (DiBP) showed a greater detection rate compared to other PAE monomers. The concentration of PEs was found to be higher in sediment samples compared to water samples due to the fact that sediments serve as a sink for most persistent organic pollutants. The concentrations of PAEs in water samples and sediments ranged from 0.00 to 0.23 mg/kg and 0.00 to 0.028 mg/l, respectively. Ecological risk assessment using the risk quotient method (RQ) reveals that the estimated environmental risk caused by phthalates lies within the moderate level as RQ ranges from 0.1 to 1.0, whereas the health risk assessment caused by phthalates on estimating the average daily dose reveals that the ingestion of phthalates was found to be approaching permissible limit which can cause serious carcinogenic occurrence in the human system with time due to excess accumulation.

Keywords: phthalates, endocrine disruptor, risk assessment, ecological risk, health risk

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Authors: Ali A. Alshatwi, Vaiyapuri S. Periasamy, Jegan Athinarayanan

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Engineered nanoparticles’ usage rapidly increased in various applications in the last decade due to their unusual properties. However, there is an ever increasing concern to understand their toxicological effect in human health. Particularly, metal and metal oxide nanoparticles have been used in various sectors including biomedical, food and agriculture. But their impact on human health is yet to be fully understood. In this present investigation, we assessed the toxic effect of engineered nanoparticles (ENPs) including Ag, MgO and Co3O4 nanoparticles (NPs) on human mesenchymal stem cells (hMSC) adopting cell viability and cellular morphological changes as tools The results suggested that silver NPs are more toxic than MgO and Co3O4NPs. The ENPs induced cytotoxicity and nuclear morphological changes in hMSC depending on dose. The cell viability decreases with increase in concentration of ENPs. The cellular morphology studies revealed that ENPs damaged the cells. These preliminary findings have implications for the use of these nanoparticles in food industry with systematic regulations.

Keywords: cobalt oxide, human mesenchymal stem cells, MgO, silver

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Habtamu Fufa, Yemane Berhane

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Child under nutrition has long-term consequences for intellectual ability, economic productivity, reproductive performance and susceptibility to metabolic and cardiovascular disease. The unacceptably high prevalence of malnutrition in young children of the region has not changed much over the last decades, which could make the achievement of the corresponding Millennium Development Goals very unlikely. Despite the well-documented problems of child malnutrition in Sub-Saharan Africa, there is few systematic review of evidences on determinants of child malnutrition in the region. The current available evidence on determinants of child under nutrition in Sub-Saharan Africa is systematically reviewed. The method used in searching relevant literature was using bio medical databases PUBMED, Google scholar and the website of the World Health Organization on nutrition using the following key words: "Determinants “, "Child Malnutrition", and "Sub- Saharan Africa". The search was limited to articles published in and after 1995 up to date. In all the reviewed articles, the data were analyzed using multivariate regression analysis and or odds ratios for significance of determinants in child malnutrition. Synthesis of 40 published articles from various countries of the region is done and noted that household economic status, maternal education, disease, breastfeeding practices, age and sex of a child, birth interval and residential areas were found to be determinants of child under nutrition. Poverty remains the main factor of malnutrition in Sub-Saharan Africa and poor education of parents aggravates the malnutrition through perpetuation of poor nutrition practices. Male children under five years are the most affected ones. Understanding of these determinants of poor nutritional attainment would provide insights in designing interventions for reducing the high levels of child malnutrition in this region. Large-scale multi-sectoral community-based interventions are urgently needed for a sustainable improvement of child nutritional & health status in Sub-Saharan Africa.

Keywords: child malnutrition, determinants, Sub-Saharan Africa, health status

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Authors: Dieudonne Uwizeye, Reuben Muhayiteto

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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

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Authors: Vasoontara Yiengprugsawan, Sam-ang Seubsman

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As Thais live longer, caregivers will become even more important to social and healthcare systems. Commonly reported in many low and middle‐income countries in Asia, formal social welfare services to support caregivers are lacking and informal family support will be required for all levels of care. In 2005, 87,151 open‐university adults were recruited to the Thai Cohort Study, with the majority aged between 25 and 39 years, and residing nationwide. At the 4‐year follow up in 2009 (n=60569) and the 8‐year follow‐up in 2013 (n=42785), prospective cohort participants were asked if they provide care for chronically ill, disabled, or frail family members. Among Thai cohort members reporting between 2009 and 2013, approximately 56% were not caregivers in either year, 24.5% reported providing care in 2009 only, 8.6% in 2013 only, and 10.6% reported providing care at both time points. Caregivers in the cohort reported providing financial support, help with shopping, emotional support, and assist with daily activities. Kessler 6 psychological distress scale, measured in both 2009 and 2013, was used as the primary outcome of a relationship between caregiving status and mental health. Using multivariate logistic regression, our 4‐year longitudinal findings revealed that cohort members who reported providing care at both time points were 1.4 to 1.6 times more likely to report high psychological distress than non‐caregivers, after accounting for potential covariates. With increasing needs for informal care provided by family members, the future health and social welfare system will need to provide adequate support to caregivers (e.g., respite care, clinical support and information for the family, and awareness of mental health among caregivers).

Keywords: family caregivers, psychological distress, prospective cohort, longitudinal study, Thailand

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Authors: Hajar Hajmohammadi, Paul Pfeffer, Anna De Simoni, Jim Cole, Chris Griffiths, Sally Hull, Benjamin Heydecker

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Background: There is strong interest in the relationship between short-term air pollution exposure and human health. Most studies in this field focus on serious health effects such as death or hospital admission, but air pollution exposure affects many people with less severe impacts, such as exacerbations of respiratory conditions. A lack of quantitative analysis and inconsistent findings suggest improved methodology is needed to understand these effectsmore fully. Method: We developed a time series regression model to quantify the relationship between daily NOₓ concentration and Asthma exacerbations requiring oral steroids from primary care settings. Explanatory variables include daily NOₓ concentration measurements extracted from 8 available background and roadside monitoring stations in east London and daily ambient temperature extracted for London City Airport, located in east London. Lags of NOx concentrations up to 21 days (3 weeks) were used in the model. The dependent variable was the daily number of oral steroid courses prescribed for GP registered patients with asthma in east London. A mixed distribution model was then fitted to the significant lags of the regression model. Result: Results of the time series modelling showed a significant relationship between NOₓconcentrations on each day and the number of oral steroid courses prescribed in the following three weeks. In addition, the model using only roadside stations performs better than the model with a mixture of roadside and background stations.

Keywords: air pollution, time series modeling, public health, road transport

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Authors: Dhananjoy Dutta

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Field studies in lower Gangetic plains of India reveal that over-abstraction of groundwater for irrigation to paddy leads to a substantial depletion of groundwater over the decades, resulting in negative effects on lowering of the water table, drying up of surface water sources and aquifer pollution with leached-out arsenic. The aggravating arsenic toxicity in drinking water is manifested in health problems and ‘arsenicosis’ of people. A social conflict arises between farmers, who intend to grow paddy for livelihoods, and the groundwater authority, which enacts the ‘Regulation Laws’ by putting a check on the excessive installation of private tube-wells for irrigation. Hence, considering the challenges of resource sustainability, health issues, and food security, the study calls for a paradigm shift in policy from further groundwater development to sustainable water resources management and evaluates some strategies integrating supply and demand side management for mitigating the problems.

Keywords: groundwater, irrigation, paddy farming, water table depletion, arsenic pollution, gangetic plains

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Authors: Moyera Sanganeria

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In the highly competitive landscape of contemporary sports, sportspersons worldwide encounter formidable challenges, often practicing for extensive hours while contending with limited social and physical resources. A growing number of sportspersons globally are sharing their struggles with depression, anxiety, and stress arising from the complex journey and identity associated with being a sportsperson. This qualitative study aims to investigate the challenges faced by sportspersons in individual versus team sports and explore potential gender-based variations in coping strategies. It attempts to do so by recognizing the imperative to comprehend the root causes and coping mechanisms for these stressors. By employing purposive sampling, MMA and Kabaddi players from training academies across Mumbai were selected for the study. Twelve participants were interviewed through semi-structured interviews guided by an interview guide. Reflective thematic analysis was employed to discern diverse stressors and coping strategies. Key stressors encountered by young Indian sportspersons encompass injuries, socio-economic challenges, financial constraints, escalating competition, and performance anxiety. Notably, individuals engaged in team sports tended to adopt emotion-focused coping mechanisms, while those in individual sports leaned more towards problem-focused coping strategies in response to these stressors. There were no prominent gender differences found in coping strategies employed by sportspersons. This study underscores the critical issue of declining mental health among sportspersons in India, emphasizing the necessity for a structured and customized mental health intervention strategy tailored to the unique needs of this population.

Keywords: stressors, coping strategies, sports psychology, sportspersons, mental health

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Authors: Harriet Bothwell, Lowri Evans, Kevin Jones

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Background: The University of Bristol provides all medical students the opportunity to undertake student selected components (SSCs) at multiple stages of the undergraduate programme. SSCs enable students to explore areas of interest that are not necessarily covered by the curriculum. Students are required to produce a written report and most use SSCs as an opportunity to undertake an audit or small research project. In 2013 Swindon Academy, based at the Great Western Hospital, offered eight students the opportunity of a global health SSC which included a two week trip to rural hospital in Uganda. This SSC has since expanded and in 2017 a total of 20 students had the opportunity to undertake small research projects at two hospitals in rural Uganda. 'Tomorrows Doctors' highlights the importance of understanding healthcare from a 'global perspective' and student feedback from previous SSCs suggests that self-assessed knowledge of global health increases as a result of this SSC. Through the most recent version of this SSC students had the opportunity to undertake projects in a wide range of specialties including paediatrics, palliative care, surgery and medical education. Methods: An anonymous online questionnaire was made available to students following the SSC. There was a response rate of 80% representing 16 out of the 20 students. This questionnaire surveyed students’ satisfaction and experience of the SSC including the level of academic, project and spiritual support provided as well as perceived challenges in completing the project and barriers to healthcare delivery in the low resource setting. This survey had multiple open questions allowing the collection of qualitative data. Further qualitative data was collected from the students’ project report. The suggested format included a reflection and all students completed these. All qualitative data underwent thematic analysis. Results: All respondents rated the overall experience of the SSC as 'good' or 'excellent'. Preliminary data suggest that students’ confidence in their knowledge of global health, diagnosis of tropical diseases and management of tropical diseases improved after completing this SSC. Thematic analysis of students' reflection is ongoing but suggests that students gain far more than improved knowledge of tropical diseases. Students reflect positively on having the opportunity to research in a low resource setting and feel that by completing these projects they will be 'useful' to the hospital. Several students reflect the stark contrast to healthcare delivery in the UK and recognise the 'privilege' of having a healthcare system that is free at the point of access. Some students noted the different approaches that clinicians in Uganda had to train in 'taking ownership' of their own learning. Conclusions: Students completing this SSC report increased knowledge of global health and tropical medicine. However, their reflections reveal much broader learning outcomes and demonstrate considerable insight in multiple topics including conducting research in the low resource setting, training and healthcare inequality.

Keywords: global health, medical education, student feedback, undergraduate

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Authors: Marilou P. Angeles

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Seniors are a growing number of population all over the world, and they are getting sick with illnesses like diabetes, high blood, and high cholesterol. It is necessary to see the relationship of their physical illness and its effect on their quality of life. Having chronic illnesses also can affect the mood of the elderly; becoming cranky, lonely, not eating, etc. Therefore, there is a need to study the relationship of the quality of life of the elderly and the level of depression. Depression for elderly is known as late onset depression or vascular depression since it is tied to the vascular illnesses they are experiencing, although this is not homogeneous. There is heterogeneity in seniors. The purpose of the study is to determine how keep the satisfaction in life i.e., quality of life of seniors, as long as possible. This study was made in 4 barangays in Longos, Potrero, Tonsuya and Catmon, in Malabon, Metro Manila, Philippines. These Filipino seniors are availing of free medicines for their diabetes, high blood, and high cholesterol ailments in the barangay health centers, given freely by the Department of Health. Two instruments were used; quality of life (CASP-19) and patient health questionnaire(PHQ-19). The quality of life questionnaire was based on the theory of Abraham Maslow, human: beings are motivated to action by needs, starting from the lowest, physiological to the highest self-transcendence. Severity of depression is determined by PHQ-9, and according to the unified model of depression by Aaron Beck and Kurt B. Bredemeier, depression happens when a person cannot cope with life has not able to satisfy his needs as a person. The Pearson R correlation was used to determine the significance of the relationship between quality of life and depression. Finding is there is negative relationship between quality of life and depression. It means that a high value of quality of life lowers or minimizes depression. CASP-19 found that the Filipino elderly were in control, independent, enjoying their lives even if they are poor, and this is shown by the significant results. Self-transcendence, a need to give back to others, is important for Filipino elderly. Although the seniors have difficulty with money and they were affected by their illnesses, they are full of optimism, they are ignoring their physical pain because they are focusing on helping their loved ones (i.e., self-transcendence), their children and grandchildrenothers, and if problems come, they are resilient accepting of the challenges, because they have strong faith in God. They are also having pleasures interacting with their friends and neighbors who, like them, have the same health problems. And these two coping strategies for the elderlies allow them to live a meaningful life, a life high in quality. Thus, where there is high quality of life, there is none or minimal depression. Recommendation for future study is finding the relationship of spirituality to quality of life of seniors.

Keywords: CASP-19, depression, quality of life, PHQ-9, senior citizen

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Authors: Kelsey Kimball

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Generalized anxiety disorder (GAD) is a common mental health illness affecting approximately 10% of the perinatal population. Research examining cognitive behavioral therapy in this population has only recently become more prevalent though exploring this subject is long overdue. This research examines the impact of cognitive behavioral therapy (CBT) on GAD during the perinatal period. The aim of this project was to identify the most effective way to manage GAD during the perinatal period to provide clinicians with evidence-based methods of caring for this population’s mental health. The research was conducted using several databases to identify ten primary research articles involving anxiety management. A critique and a systematic review of the literature was done. The results of the systematic literature review suggested that CBT had a significant positive impact on perinatal anxiety. Three main themes were derived from the literature: CBT for managing GAD in the general population, CBT for managing GAD in the perinatal population, and CBT’s effect on worry and problematic behaviors in both populations. Nurse practitioners are central in improving access to and treatment of perinatal anxiety disorders.

Keywords: anxiety, cognitive behavioral therapy, nurse practitioner, perinatal

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Authors: Paul Narh Doku

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The relationship between parental HIV/AIDS status or death and child mental health is well known, although the role of child maltreatment as a confounder or mediator in this relationship remains uncertain. This study examined the potential path mechanism through child maltreatment mediating the link between HIV/AIDS family dysfunction trajectories and psychosocial problems. A cross-sectional survey was conducted in the Lower Manya Municipal Assembly of Ghana. A questionnaire which consisted of the Strengths and Difficulties Questionnaire (SDQ), Social and Health Assessment (SAHA), Rosenberg Self-Esteem Scale (RSES), and the Conflict Tactics Scale (CTS) was completed by 291 adolescents. Controlling for relevant sociodemographic confounders, mediation analyses using linear regression were fitted to examine whether the association between family dysfunction and psychosocial problems is mediated by child maltreatment. The results indicate that, among adolescents, child maltreatment fully mediated the association between being orphaned by AIDS and self-esteem, delinquency and risky behaviours, and peer problems. Similarly, child maltreatment fully mediated the association between living with an HIV/AIDS-infected parent and self-esteem, delinquency and risky behaviours, depression/emotional problems, and peer problems. Partial mediation was found for hyperactivity. Child maltreatment mediates the association between the family dysfunction trajectories of parental HIV/AIDS or death and psychosocial problems among adolescents. This implies that efforts to address child maltreatment among families affected by HIV/AIDS may be helpful in the prevention of psychosocial problems among these children, thus enhancing their well-being. The findings, therefore, underscore the need for comprehensive psychosocial interventions that address both the unique negative exposures of HIV/AIDS and maltreatment for children affected by HIV.

Keywords: child maltreatment, child abuse, mental health, psychosocial problems, domestic violence, HIV/AIDS, adolescents

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Authors: Chao-Ton Su, Li-Fei Chen

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The parameter design is crucial to improving the uniformity of a product or process. In the product design stage, parameter design aims to determine the optimal settings for the parameters of each element in the system, thereby minimizing the functional deviations of the product. In the process design stage, parameter design aims to determine the operating settings of the manufacturing processes so that non-uniformity in manufacturing processes can be minimized. The parameter design, trying to minimize the influence of noise on the manufacturing system, plays an important role in the high-tech companies. Taiwan has many well-known high-tech companies, which show key roles in the global economy. Quality remains the most important factor that enables these companies to sustain their competitive advantage. In Taiwan however, many high-tech companies face various quality problems. A common challenge is related to root causes and defect patterns. In the R&D stage, root causes are often unknown, and defect patterns are difficult to classify. Additionally, data collection is not easy. Even when high-volume data can be collected, data interpretation is difficult. To overcome these challenges, high-tech companies in Taiwan use more advanced quality improvement tools. In addition to traditional statistical methods and quality tools, the new trend is the application of powerful tools, such as neural network, fuzzy theory, data mining, industrial engineering, operations research, and innovation skills. In this study, several examples of optimizing the parameter settings for the manufacturing process in Taiwan’s tech companies will be presented to illustrate proposed approach’s effectiveness. Finally, a discussion of using traditional experimental design versus the proposed approach for process optimization will be made.

Keywords: quality engineering, parameter design, neural network, genetic algorithm, experimental design

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Authors: M. Lu

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The paper presents part of the results of EU-funded projects: SoCool@EU (Sustainable Organisation between Clusters Of Optimized Logistics @ Europe), DG-RTD (Research and Innovation), Regions of Knowledge Programme (FP7-REGIONS-2011-1). It will provide an in-depth review of emerging technologies for further improving urban mobility and freight transport systems, such as (information and physical) infrastructure, ICT-based Intelligent Transport Systems (ITS), vehicles, advanced logistics, and services. Furthermore, the paper will provide an analysis of the barriers and will review business models for the market uptake of innovations. From a perspective of science and technology, the challenges of urbanization could be mainly handled through adequate (human-oriented) solutions for urban planning, sustainable energy, the water system, building design and construction, the urban transport system (both physical and information aspects), and advanced logistics and services. Implementation of solutions for these domains should be follow a highly integrated and balanced approach, a silo approach should be avoided. To develop a sustainable urban transport system (for people and goods), including inter-hubs and intra-hubs, a holistic view is needed. To achieve a sustainable transport system for people and goods (in terms of cost-effectiveness, efficiency, environment-friendliness and fulfillment of the mobility, transport and logistics needs of the society), a proper network and information infrastructure, advanced transport systems and operations, as well as ad hoc and seamless services are required. In addition, a road map for an enhanced urban transport system until 2050 will be presented. This road map aims to address the challenges of urban transport, and to provide best practices in inter-city and intra-city environments from various perspectives, including policy, traveler behaviour, economy, liability, business models, and technology.

Keywords: synchromodality, multimodal transport, logistics, Intelligent Transport Systems (ITS)

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Authors: Gianvito Colucci, Valeria Di Cosmo, Matteo Nicoli, Orsola Maria Robasto, Laura Savoldi

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The hydrogen value chain deployment is likely to be boosted in the near term by the energy security measures planned by European countries to face the recent energy crisis. In this context, some countries are recognized to have a crucial role in the geopolitics of hydrogen as importers, consumers and exporters. According to the European Hydrogen Backbone Initiative, Italy would be part of one of the 5 corridors that will shape the European hydrogen market. However, the set targets are very ambitious and require large investments to rapidly develop effective hydrogen policies: in this regard, scenario analysis is becoming increasingly important to support energy planning, and energy system optimization models appear to be suitable tools to quantitively carry on that kind of analysis. The work aims to assess the competitiveness of hydrogen in contributing to the Italian energy security in the coming years, under different price and import conditions, using the energy system model TEMOA-Italy. A wide spectrum of hydrogen technologies is included in the analysis, covering the production, storage, delivery, and end-uses stages. National production from fossil fuels with and without CCS, as well as electrolysis and import of low-carbon hydrogen from North Africa, are the supply solutions that would compete with other ones, such as natural gas, biomethane and electricity value chains, to satisfy sectoral energy needs (transport, industry, buildings, agriculture). Scenario analysis is then used to study the competition under different price and import conditions. The use of TEMOA-Italy allows the work to catch the interaction between the economy and technological detail, which is much needed in the energy policies assessment, while the transparency of the analysis and of the results is ensured by the full accessibility of the TEMOA open-source modeling framework.

Keywords: energy security, energy system optimization models, hydrogen, natural gas, open-source modeling, scenario analysis, TEMOA

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Authors: James Beauchemin

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Research indicates that college students are experiencing mental health challenges of greater severity, and an increased number of students are seeking help. Contributing to the compromised wellness of the college student population are the prevalence of unhealthy lifestyle habits and behaviors such as alcohol consumption, tobacco use, dietary concerns, risky sexual behaviors, and lack of physical activity. Alternative approaches are needed for this population that emphasize prevention and holistic lifestyle change that mitigate mental health and wellness challenges and alleviate strain on campus resources. This presentation will introduce a Solution-Focused Wellness (SFW) intervention model and examine wellness domains solution-focused strategies to promote personal well-being, and provide supporting research from multiple studies that illustrate intervention effectiveness with a collegiate population. Given the subjective and personal nature of wellness, a therapeutic approach that provides the opportunity for individuals to conceptualize and operationalize wellness themselves is critical to facilitating lasting wellness-based change. Solution-Focused Brief Therapy (SFBT) is a strength-based modality defined by its emphasis on constructing solutions rather than focusing on problems and the assumption that clients have the resources and capacity to change. SFBT has demonstrated effectiveness as a brief therapeutic intervention with the college population in groups and related to health and wellness. By integrating SFBT strategies with personal wellness, a brief intervention was developed to support college students in establishing lifestyles trends consistent with their conceptualizations of wellness. Research supports the effectiveness of a SFW model in improving college student wellness in both face-to-face and web-based formats. Outcomes of controlled and longitudinal studies will be presented, demonstrating significant improvements in perceptions of stress, life satisfaction, happiness, mental health, well-being, and resilience. Overall, there is compelling evidence that utilization of a Solution-Focused Brief Therapy approach with college students can help to improve personal wellness and establish healthy lifestyle trends, providing an effective prevention-focused strategy for college counseling centers and wellness centers to employ. Primary research objectives include: 1)establish an evidence-based approach to facilitating wellness pro motion among the college student population, 2) examine the effectiveness of a Solution-Focused Wellness (SFW) intervention model in decreasing stress, improving personal wellness, mental health, life satisfaction, and resiliency,3) investigate intervention impacts over time (e.g. 6-week post-intervention), and 4) demonstrate SFW intervention utility in wellness promotion and associated outcomes when compared with no-treatment control, and alternative intervention approaches.

Keywords: wellness, college students, solution-focused, prevention

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Authors: Felix Aberu

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The high rate of greenhouse gas (CO₂) emission and increased concentration of Carbon Dioxide in the atmosphere are not unconnected to both human and natural activities. This has caused climate change and global warming in the world. The adverse effect of these climatic changes has no doubt threatened human existence. Hence, this study examined the effects of environmental and climate influence on mortality and morbidity rates, with particular reference to the world’s leading CO₂ emission countries, using both the pre-estimation, estimation, and post-estimation techniques for more dependable outcomes. Hence, the System Generalized Method of Moments (SGMM) was adopted as the main estimation technique for the data analysis from 1996 to 2023. The coefficient of carbon emissions confirmed a positive and significant relationship among CO₂ emission, mortality, and morbidity rates in the world’s leading CO₂ emissions countries, which implies that carbon emission has contributed to mortality and morbidity rates in the world. Therefore, significant action should be taken to facilitate the expansion of environmental protection and sustainability initiatives in any CO₂ emissions nations of the world.

Keywords: environmental, mortality, morbidity, health outcomes, carbon emissions

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