Search results for: health access

Authors: Sylvia Tumelo Nthutang, Nehemiah Mavetera

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Educational institutions are under pressure from their competitors. Regulators and community groups need educational institutions to adopt appropriate business and organizational practices. Globally, educational institutions are now using e-learning as the best teaching and learning approach. E-learning is becoming the center of attention to the learning institutions, educational systems and software inventors. North-West University (NWU) is currently using eFundi, a Learning Management System (LMS). LMS are all information systems and procedures that adds value to students learning and support the learning material in text or any multimedia files. With various e-learning tools, students would be able to access all the materials related to the course in electronic copies. The study was tasked with identifying the e-learning components at the NWU, Mafikeng campus. Quantitative research methodology was considered in data collection and descriptive statistics for data analysis. The Activity Theory (AT) was used as a theory to guide the study. AT outlines the limitations amongst e-learning at the macro-organizational level (plan, guiding principle, campus-wide solutions) and micro-organization (daily functioning practice, collaborative transformation, specific adaptation). On a technological environment, AT gives people an opportunity to change from concentrating on computers as an area of concern but also understand that technology is part of human activities. The findings have identified the university’s current IT tools and knowledge on e-learning elements. It was recommended that university should consider buying computer resources that consumes less power and practice e-learning effectively.

Keywords: e-learning, information and communication technology (ICT), teaching, virtual learning environment

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Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

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Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

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Authors: David B. Kisakye, Paul Mugabi

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Biomass briquettes have been identified as a plausible and close alternative to commonly used energy fuels such as charcoal and firewood, whose prices are escalating due to the dwindling natural resource base. However, briquettes do not seem to be as popular as would be expected. This study assessed the production, distribution, and acceptability of the briquettes in the Kampala district. A total of 60 respondents, 50 of whom were briquette users and 10 briquette producers, were sampled from five divisions of Kampala district to evaluate consumer acceptability, preference for briquette type and shape. Households and institutions were identified to be the major consumers of briquettes, while community-based organizations were the major distributors of briquettes. The Chi-square test of independence showed a significant association between briquette acceptability and briquette attributes of substitutability and low cost (p < 0,05). The Kruskal Wallis test showed that low-income class people preferred non-carbonized briquettes. Gender, marital status, and income level also cause variation in preference for spherical, stick, and honeycomb briquettes (p < 0,05). The major challenges faced by briquette users in Kampala were; production of a lot of ash, frequent crushing, and limited access to briquettes. The producers of briquettes were mainly challenged by regular machine breakdown, raw material scarcity, and poor carbonizing units. It was concluded that briquettes have a market and are generally accepted in Kampala. However, user preferences need to be taken into account by briquette produces, suitable cookstoves should be availed to users, and there is a need for standards to ensure the quality of briquettes.

Keywords: consumer acceptability, biomass residues, briquettes, briquette producers, distribution, fuel, marketability, wood fuel

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Authors: G. Santamato, M. Solazzi, A. Frisoli

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Systems for detection of damages in railway pantographs effectively reduce the cost of maintenance and improve time scheduling. In this paper, we present an approach to design a monitoring tool fitting strong customer requirements such as portability and ease of use. Pantograph has been modeled to estimate its dynamical properties, since no data are available. With the aim to focus on suspensions health, a two Degrees of Freedom (DOF) scheme has been adopted. Parameters have been calculated by means of analytical dynamics. A Finite Element Method (FEM) modal analysis verified the former model with an acceptable error. The detection strategy seeks phase-plots topology alteration, induced by defects. In order to test the suitability of the method, leakage in the dashpot was simulated on the lumped model. Results are interesting because changes in phase plots are more appreciable than frequency-shift. Further calculations as well as experimental tests will support future developments of this smart strategy.

Keywords: pantograph models, phase plots, structural health monitoring, damage detection

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Authors: Kevin Smith

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Publicly traded company in the US are legally obligated to host earnings calls that discuss their most recent financial reports. During these calls, investors are able to ask these companies questions about these financial reports and on the future direction of the company. This paper examines whether common institutional owners use these calls as a way to indirectly signal to companies in their portfolio to not take actions that could hurt the common owner's interests. This paper uses transcripts taken from the earnings calls of the six largest health insurance companies in the US from 2014 to 2019. This data is analyzed using text analysis and sentiment analysis to look for patterns in the statements made by common owners. The analysis found that common owners where more likely to recommend against direct price competition and instead redirect the insurance companies towards more passive actions, like investing in new technologies. This result indicates a mechanism that common owners use to reduce competition in the health insurance market.

Keywords: common ownership, text analysis, sentiment analysis, machine learning

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Authors: Omar bin Mihat

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The number of sudden deaths is increasing over the past years. These deaths occur not during physical activities but upon cessation. Post-mortem confirms these deaths as cardiac arrest non-specifically. Congenital heart disease is a condition undiagnosed whereby only surface upon physical exertion leading to sudden death is unavoidable. Channelopathy, a condition that refers to any disease from the defect in iron-channel function, particularly the sodium-potassium pump, during the cessation of the exercise can be controlled. The derivation of heart rate return (HRrtn) is a procedure of a control cooling down process according to the heart rate (HR). Empirically, potassium rises linearly with intensity and falls sharply upon abrupt cessation of exertion, resulting in fatal arrhythmia due to hypokalaemia. It is vital that the flux of potassium should be maintained within the normal range during physical activities. To achieve this, the dosage of physical exertion (exercise) should be identified. Various percentages of the intensity of maximum heart rate (MHR) will precipitate different adaptations and remodeling of various organs. 70% of MHR will surface physiological adaptations, including enhancement of endurance, fitness level, and general health, and there was no significant rise of serum potassium (K+) during the entire phase of the treadmill brisk walk at a different rate of perceived exertion (RPE) from the subject of various fitness background. There was also no significant rise in blood pressure (BP) during the entire phase of the treadmill brisk walk, substantiating 70% MHR is the safe dosage across different parameters of health and fitness level.

Keywords: potassium, maximal heart rate, exercise dosage, fitness level

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Authors: Gudelj Petra, Franic Ema, Kolega Maja

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Mental health is crucial for personal, social, and socio-economic development, becoming an increasingly relevant topic, especially in the post-global pandemic era. One vulnerable demographic comprises students who, during the pandemic, faced challenges such as adapting to new educational methods, societal or residential changes, heightened stress, responsibilities, and entering the job market. These life challenges proved insurmountable for some individuals during this phase. This research aimed to examine students' attitudes towards individuals seeking psychological help. By gaining a better understanding of young people's perceptions of seeking psychological assistance, a clearer insight into how to make psychological support more accessible and acceptable can be achieved. A questionnaire was completed by 210 students from various disciplines at the University of Zagreb. At the same time, the majority of students express a positive attitude towards seeking psychological help, a very small percentage reported having sought it. One of the most common obstacles to seeking appropriate help was a lack of financial means, with the most significant motivators being the positive experiences of those who sought help and an affordable cost.

Keywords: mental health, students, psychological support, attitudes

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Authors: M. Jayandran

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Continual professional development is an important concept for safety professionals to strengthen the knowledge base and to achieve the required qualifications or international memberships in a given time. But the main problems which have observed among most of the safety aspirants are as follows: lack of focus, inferiority complex, superiority complex, lack of interest and lethargy, family and off job stress, health issues, usage of drugs and alcohol, and absenteeism. A HSE trainer should be an expert in soft skills and other stress, emotional handling techniques, so as to manage the above aspirants during training. To do this practice, a trainer has to brainstorm himself of few of the soft skills like personnel resilience, mnemonic techniques, mind healing, and subconscious suggestion techniques by integrating with an emotional intelligence quotient of the aspirants. By adopting these techniques, a trainer can successfully deliver the course and influence the different types of audience to achieve success in training.

Keywords: personnel resilience, mnemonic techniques, mind healing, sub conscious suggestion techniques

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Authors: Nadeem Yousuf Khan

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This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.

Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology

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Authors: Shima Naderi, Abbas Abbaszadeh Shahri

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Energy resources are reachable and affordable in Iran, thus surplus access to fossil fuels besides high level of economic growth leads to serious environmental critical such as pollutants and greenhouse gases in the atmosphere, increase in average degrease and lack of water sources specially in Tehran as a capital city of Iran. As building sector consumes a huge portion of energy, taking actions towards alternative sources of energy as well as conserving non-renewable energy resources and architectural energy saving methods are the fundamental basis for achieving sustainability`s goals. This study tries to explore implantation of both high technologies and traditional issues for reduction of energy demands in buildings of Tehran and introduce some factors and instructions for achieving this purpose. Green and energy efficient buildings such as ZEBs make it possible to preserve natural resources for the next generations by reducing pollution and increasing ecosystem self-recovery. However ZEB is not widely spread in Iran because of its low economic efficiency, it is not viable for a private entrepreneur without the governmental supports. Therefore executing of Architectural Energy Efficiency can be a better option. It is necessary to experience a substructure expansion with respect to traditional residential building style. Renewable energies and passive design which are the substantial part of the history of architecture in Iran can be regenerated and employed as an essential part of designing energy efficient buildings.

Keywords: architectural energy efficiency, passive design, renewable energies, zero energy buildings

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Authors: Katalin Szöllősi, László Szabó

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Introduction and purpose: Even though female sexual dysfunctions are common among women in the postpartum period, the profile of these disturbances has not been well investigated in Hungary yet. The aim of the study was to evaluate the postpartum female sexual functions in Hungary. This research sought to investigate the possible predictor factors which can influence postpartum female sexual functions. Method and sample: This was a cross-sectional study, including patients from two maternity clinics in Budapest. 113 women were recruited into our study 3 months after their childbirth. 53 had vaginal birth, 60 had a caesarian section. Data were collected from medical reports in addition by using self-developed questions and validated questionnaires in order to measure important predictors which may be responsible for postpartum sexual dysfunctions such as mode of delivery, parity, urinary incontinence and body image. Sexual functions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). The Hungarian version of Body Image Questionnaire-Short Form14 (BSQ-SF14) was applied for assessing body image. Results: 82,3% of the participants began to have sexual intercourse within three months postpartum. 53,98% of the participants reported sexual dysfunctions (cut-off FSFI score 26,55). According to our results mode of delivery, parity, hemorrhoids, time of intercourse, resumption was not associated with female sexual dysfunctions. We found correlation at a tendential level between urinary incontinence and sexual dysfunctions (p=0,003, R=0,26). We found a negative correlation at a tendential level between the total score of BSQ-SF14 and FSFI (p=0,03, R=-0,269). Only 32,74% of women reported discussing sexual life with health care professionals. However, 67,25% of them would have had the need to be asked about their postpartum health issues. Conclusions and recommendations: The prevalence of female sexual dysfunctions were relatively high after childbirth. We found that incontinence and body image was associated with sexual dysfunctions; other risk factors remained unknown. Despite regular contact with health care professionals, women rarely get any information about postpartum sexual health issues. The high prevalence of dysfunctions indicates the need for further investigation to address other risk factors and proper counselling of women after childbirth.

Keywords: body image, postpartum, sexual dysfunction, urinary incontinence

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Authors: Masoumeh Pirhadi

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Air pollution is becoming a major health problem affecting millions. In support of this observation, the world health organization estimates that many people feel unhealthy due to pollution. This is a coupled fact that one of the main global sources of air pollution in cities is greenhouse gas emissions due heavy traffic. Green walls are developed as a sustainable strategy to reduce pollution by increasing vegetation in developed areas without occupying space in the city. This concept an offer advantageous environmental benefits and they can also be proposed for aesthetic purposes, and today they are used to preserve the urban environment. Green walls can also create environments that can promote a healthy lifestyle. Findings of multiple studies also indicate that Green infrastructure in cities is a strategy for improving air quality and increasing the sustainability of cities. Since these green solutions (green walls) act as porous materials that affect the diffusion of air pollution they can also act as a removing air vents that clean the air. Therefore, implementation of this strategy can be considered as a prominent factor in achieving a cleaner environment.

Keywords: green vegetation, air pollution, green wall, urban area

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Authors: Shreekumari Patel, Prabhjot Kaur, Paras Solanki

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Moon Mineralogy Mapper (M3), Miniature Radio Frequency (Mini-RF), Kaguya Terrain Camera images, Lunar Orbiter Laser Altimeter (LOLA) digital elevation model (DEM) and Lunar Reconnaissance Orbiter Camera (LROC)- Narrow angle camera (NAC) and Wide angle camera (WAC) images were used to study mineralogy, surface physical properties, and age of the 42 km diameter Kopff crater. M3 indicates the low albedo crater floor to be high-Ca pyroxene dominated associated with floor fracture suggesting the igneous activity of the gabbroic material. Signature of anorthositic material is sampled on the eastern edge as target material is excavated from ~3 km diameter impact crater providing access to the crustal composition. Several occurrences of spinel were detected in northwestern rugged terrain. Our observation can be explained by exposure of spinel by this crater that impacted onto the inner rings of Orientale basin. Spinel was part of the pre-impact target, an intrinsic unit of basin ring. Crater floor was dated by crater counts performed on Kaguya TC images. Nature of surface was studied in detail with LROC NAC and Mini-RF. Freshly exposed surface and boulder or debris seen in LROC NAC images have enhanced radar signal in comparison to mature terrain of Kopff crater. This multidisciplinary analysis of remote sensing data helps to assess lunar surface in detail.

Keywords: crater, mineralogy, moon, radar observations

Procedia PDF Downloads 151

Authors: Akiode Ayobami, Akiode Akinsewa, Odeku Mojisola, Salako Busola, Odutolu Omobola, Nuhu Khadija

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Purpose: Evidence exists that family planning use can contribute to reduction in infant and maternal mortality in any country. Despite these benefits, contraceptive use in Nigeria still remains very low, only 10% among married women. Understanding factors that predict contraceptive use is very important in order to improve the situation. In this paper, we analysed data from the 2013 Nigerian Demographic and Health Survey (NDHS) to better understand predictors of contraceptive use in Nigeria. The use of logistics regression and other traditional models in this type of situation is not appropriate as they do not account for social structure influence brought about by the hierarchical nature of the data on response variable. We therefore used multilevel modelling to explore the determinants of contraceptive use in order to account for the significant variation in modern contraceptive use by socio-demographic, and other proximate variables across the different Nigerian states. Method: This data has a two-level hierarchical structure. We considered the data of 26, 403 married women of reproductive age at level 1 and nested them within the 36 states and the Federal Capital Territory, Abuja at level 2. We modelled use of modern contraceptive against demographic variables, being told about FP at health facility, heard of FP on TV, Magazine or radio, husband desire for more children nested within the state. Results: Our results showed that the independent variables in the model were significant predictors of modern contraceptive use. The estimated variance component for the null model, random intercept, and random slope models were significant (p=0.00), indicating that the variation in contraceptive use across the Nigerian states is significant, and needs to be accounted for in order to accurately determine the predictors of contraceptive use, hence the data is best fitted by the multilevel model. Only being told about family planning at the health facility and religion have a significant random effect, implying that their predictability of contraceptive use varies across the states. Conclusion and Recommendation: Results showed that providing FP information at the health facility and religion needs to be considered when programming to improve contraceptive use at the state levels.

Keywords: multilevel modelling, family planning, predictors, Nigeria

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Authors: Dukali Abujnah, Mokhtar Blgacem Halbuda

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Water is one of the world's natural resources. It is an essential source for the maintenance of human, animal, and plant life. It has a significant impact on the country's economy and all human activities. Over the past twenty years, pressure on water resources has increased due to population and industrial growth and increasing demand for agricultural and household products, which has become a major concern of the international community. The aim of this study is the physical and bacteriological analysis of drinking water in the city of Value. The study covered different locations in the city. Thirty-six groundwater samples were taken from wells and various tanks owned by the State and private wells, and the Ain Thalia spring and other samples were taken from underground water tanks. It fills up with rainwater during the rainy season. These samples were analyzed for their physical, chemical, and biological status and the results were compared to Libyan and World Health Organization drinking water specifications to assess the quality of drinking water in the city of Value. Physical and chemical analysis of water samples showed acceptable values for acidity and electrical conductivity, and turbidity was found in water samples collected from underground reservoirs compared to Libyan and World Health Organization standards. The highest levels of electrical conductivity and alkalinity, TDS, and water hardness in the samples collected were below the maximum acceptable levels for drinking water as recommended by Libyan and World Health Organization specifications. The biological test results also showed that the water samples were free of intestinal bacteria.

Keywords: quality, agriculture, region, reservoir, evaluation

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Authors: Alina Hamid Bari

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Intellectual Property (IP) policies of a country have a huge impact on the pharmaceutical industry as this industry is all about patents. Developed countries have used IP protection to boost their economy; developing countries are concerned about access to medicine for poor people. U.S. company, Pfizer had a monopoly for 14 years for Lipitor and it all came to end when Pfizer decided to operate in India. This research will focus at the effects of Indian IP policies on USA by comparing Pfizer & Ranbaxy with regards to Trade Related Aspects of Intellectual Property Rights. For this research inductive approach has been used. Main source of material is Annual reports, theory based on academic books and articles along with rulings of court, policy statements and decisions, websites and newspaper articles. SWOT analysis is done for both Pfizer & Ranbaxy. The main comparison was done by doing ratio analysis and analyses of annual reports for the year 2011-2012 for Pfizer and Ranbaxy to see the impact on their profitability. This research concludes that Indian intellectual laws do affect the profitability of the U.S. pharmaceutical industry which can in turn have an impact on the US economy. These days India is only granting patents on products which it feels are deserving of it. So the U.S. companies operating in India have to defend their invention to get a patent. Thus, to operate in India and maintain monopoly in market, US firms have to come up with different strategies.

Keywords: atorvastatin, India, intellectual property, lipitor, Pfizer, pharmaceutical industry, Ranbaxy, TRIPs, U.S.

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Authors: Kudu Dangana, Pai H. Halilu, Osesienemo R. Asiribo-Sallau, Garba Inuwa Kuta

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The study examined the determinants of household water accessibility in Southern part of Niger State, Nigeria. Data for the study was obtained from primary and secondary sources using questionnaire, interview, personal observation and documents. 1,192 questionnaires were administered; sampling techniques adopted are combination of purposive, stratified and simple random. Purposive sampling technique was used to determine sample frame; sample unit was determined using stratified sampling method and simple random technique was used in administering questionnaires. The result was analyzed within the scope of “WHO” water accessibility indicators using descriptive statistics. Major sources of water in the area are well; hand and electric pump borehole and streams. These sources account for over 90% of household’s water. Average per capita water consumption in the area is 22 liters per day, while location efficiency of facilities revealed an average of 80 people per borehole. Household water accessibility is affected mainly by the factors of distances, time spent to obtain water, low income status of the majority of respondents to access modern water infrastructure, and to a lesser extent household size. Recommendations includes, all tiers of government to intensify efforts in providing water infrastructures and existing ones through budgetary provisions, and communities should organize fund raising bazaar, so as to raise fund to improve water infrastructures in the area.

Keywords: accessibility, determined, stratified, scope

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Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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Authors: Munish Garg, Vinni Ahuja

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In the past few years, the high consumption of soft drinks has attracted negative attention world-wide due to its possible adverse effects, leading the health conscious people to find alternative nutraceutical or herbal health drinks. In the present study, a nutraceutical soft drink was developed utilizing some easily available and well known traditional herbs having nutritional potential. The key ingredients were selected as bael, amla, lemon juice, ashwagandha and poppy seeds based on their household routine use in the summer with proven refreshing, cooling and energetic feeling since ages. After several trials made, the final composition of nutraceutical summer soft drink was selected as most suitable combination based on the taste, physicochemical, microbial and organoleptic point of view. The physicochemical analysis of the prepared drink found to contain optimum level of titratable acidity, total soluble solids and pH which were in accordance of the commercial recommendations. There were no bacterial colonies found in the product therefore found within limits. During the nine point’s hedonic scale sensory evaluation, the drink was strongly liked for colour, taste, flavour and texture. The formulation was found to contain flavonoids (80mg/100ml), phenolics (103mg/100ml), vitamin C (250mg/100ml) and has antioxidant potential (75.52%) apart from providing several other essential vitamins, minerals and healthy components. The developed nutraceutical drink provides an economical and feasible option for the consumers with very good taste combined with potential health benefits. The present drink is potentially capable to replace the synthetic soft drinks available in the market.

Keywords: herbal drink, summer drink, nutraceuticals, soft drink

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Authors: C. A Osunla, A. I. Okoh

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Treated wastewater effluent has been found to encompass high levels of pollutants, including disease-causing bacteria such as Vibrio pathogens. The current study was designed to evaluate the physicochemical qualities and prevalence of Vibrio pathogens in treated effluents of two wastewater treatment plants (WWTP) in Eastern Cape Province, South Africa over the period of six months. Parameters measured include pH, temperature, electrical conductivity, salinity, turbidity, total dissolved solid (TDS), dissolved oxygen (DO), and free chlorine; and these parameters were simultaneously monitored in the treated final effluents of the two wastewater treatment plants using standard methods. The ranges of values for the physicochemical are: pH (7.0–8.6), total dissolved solids (286.3–916.5 mg/L), electrical conductivity (572.57–1704.5 mS/m), temperature (10.3–28.6 °C), turbidity (4.02–43.20 NTU), free chlorine (0.00–0.19 mg/L), dissolve oxygen (2.06–6.32 mg/L) and biochemical oxygen demand (0.1–9.0 mg/L). The microbiological assessment for both WWTPs revealed the presence of Vibrio counts ranging between 0 and 8.76×104 CFU/100 mL. The obtained values of the measured parameters and Vibrio loads of the treated wastewater effluents were found outside the compliance levels of the South African guidelines and World Health Organization tolerance limits for effluents intended to be discharged into receiving waterbodies. Hence, we conclude that these WWTPs are important point sources of pollution in surface water with potential public health and ecological risks.

Keywords: effluents, public health, South Africa, Vibrio, wastewater

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Authors: Edward Nartey

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Although the boundaries of sustainable performance and growth in the field of service supply chains (SCs) have been broadened by scholars in recent years, research on the impact and promises of Industry 4.0 Destructive Technologies (IDTs) on sustainability performance under disruptive events is still scarce. To mitigate disruptions in the SC and improve efficiency by identifying areas for cost savings, organizations have resorted to investments in digitalization, automation, and control mechanisms in recent years. However, little is known about the sustainability implications for IDT adoption and controls in service SCs, especially during disruptive events. To investigate this paradox, survey data were sought from 223 public health managers across Ghana and analyzed via covariance-based structural equations modelling. The results showed that both formal and informal control have a positive and significant relationship with IDT adoption. In addition, formal control has a significant and positive relationship with environmental and economic sustainability but an insignificant relationship with social sustainability. Furthermore, informal control positively impacts economic performance but has an insignificant relationship with social and environmental sustainability. While the findings highlight the prevalence of the IDTs being initiated by Ghanaian public health institutions (PHIs), this study concludes that the installed control systems in these organizations are inadequate for promoting sustainable SC behaviors under destructive events. Thus, in crisis situations, PHIs need to redesign their control systems to facilitate IDT integration towards sustainability issues in SCs.

Keywords: industry 4.0 destructive technologies, formal control, informal control, sustainable supply chain performance, public health organizations

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Authors: Dararat Tongdee, Surapong Chirarattananon, Somchai Maneewan, Chantana Punlek

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Recently, the Internet of Things (IoT) is the important technology that connects devices to the network and people can access real-time communication. This technology is used to report, collect, and analyze the big data for achieving a purpose. For a smart building, there are many IoT technologies that enable management and building operators to improve occupant thermal comfort, indoor air quality, and building energy efficiency. In this research, we propose monitoring and controlling performance of a smart dedicated outdoor air system (SDOAS) based on IoT platform. The SDOAS was specifically designed with the desiccant unit and thermoelectric module. The designed system was intended to monitor, notify, and control indoor environmental factors such as temperature, humidity, and carbon dioxide (CO₂) level. The SDOAS was tested under the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE 62.2) and indoor air quality standard. The system will notify the user by Blynk notification when the status of the building is uncomfortable or tolerable limits are reached according to the conditions that were set. The user can then control the system via a Blynk application on a smartphone. The experimental result indicates that the temperature and humidity of indoor fresh air in the comfort zone are approximately 26 degree Celsius and 58% respectively. Furthermore, the CO₂ level was controlled lower than 1000 ppm by indoor air quality standard condition. Therefore, the proposed system can efficiently work and be easy to use for buildings.

Keywords: internet of things, indoor air quality, smart dedicated outdoor air system, thermal comfort

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Authors: Ashish Sinha, Pushpend Agrawal

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Background: Patients with undiagnosed pulmonary TB predominantly act as reservoirs for its transmission through 10-15 secondary infections in the next 1-5 Yrs. Delays in the diagnosis and treatment may worsen the disease with increase the risk of death. Factors responsible for such delays by tracking patient pathways to treatment may help in planning better interventions. The provision of ‘free diagnosis and treatment’ forms the cornerstone of the National Tuberculosis Elimination Programme (NTEP). OOPE is defined as the money spent by the patient during TB care other than public health facilities. Free TB care at all health facilities could reduce out-of-pocket expenses to the minimum possible levels. Material and Methods: This cross-sectional study was conducted among randomly selected 252 TB patients from Nov – Oct 2022 by taking in-depth interviews following informed verbal consent. We documented their journey from initial symptoms until they reached the public health facility, along with their ‘out-of-pocket expenditure’ (OOPE) pertaining to TB care. Results: Total treatment delay was 91±72 days on average (median: 77days, IQR: 45-104 days), while the isolated patient delay was 31±45 days (median: 15 days, IQR: 0 days to 43 days); diagnostic delay; 57±60 days (median: 42days, IQR 14-78 days), treatment delay 19 ± 18 days (median: 15days, IQR: 11-19 days). A patient delay (> 30 days) was significantly associated with ignorance about classic symptoms of pulmonary TB, adoption of self-medication, illiteracy, and middle and lower social class. Diagnostic delay was significantly higher among those who contacted private health facilities, were unaware of signs and symptoms, had >2 consultations, and not getting an appropriate referral for TB care. Most (97%) of the study participants interviewed claimed to have incurred some expenditure.Median total expenses were 6155(IQR: 2625-15175) rupees. More than half 141 (56%) of the study participants had expenses >5000 rupees. Median transport expenses were 525(IQR: 200-1012) rupees; Median consultation expenses were 700(IQR: 200-1600) rupees; Median investigation expenses were 1000(IQR: 0-3025) rupees and the Median medicine expenses were 3350(IQR: 1300-7525).OOPE for consultation, investigation, and medicine was observed to be significantly higher among patients who ignored classical signs& symptoms of TB, repeated visits to private health facilities, and due to self-medication practices. Transport expenses and delays in seeking care at facilities were observed to have an upward trend with OOP Expenses (r =1). Conclusion: Delay in TB care due to low awareness about signs and symptoms of TB and poor seeking care, lack of proper consultation, and appropriate referrals reported by the study subjects indicate the areas which need proper attention by the program managers. Despite a centrally sponsored programme, the financial burden on TB patients is still in the unacceptable range. OOPE could be reduced as low as possible by addressing the responsible factors linked to it.

Keywords: patient pathway, delay, pulmonary tuberculosis, out of pocket expenses

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Authors: Elisa Silva, Rui Lança, Fátima Farinha, Miguel José Oliveira, Manuel Duarte Pinheiro, Cátia Miguel

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Tourism is one of the global engines of development. With good planning and management, it can be a positive force, bringing benefits to touristic destinations around the world. However, without constrains, boundaries well established and constant survey, tourism can be very harmful and induce destination’s degradation. In the interest of the tourism sector and the community it is important to develop the destination maintaining its sustainability. The OBSERVE project is an instrument for monitoring and evaluating the sustainability of the region of Algarve. Its main priority is to provide environmental, economic, social-cultural and institutional indicators to support the decision-making process towards a sustainable growth. In the pursuit of the objectives, it is being developed a digital platform where the significant indicators will be continuously updated. It is known that the successful development of a touristic region depends from the careful planning with the commitment of central and regional government, industry, services and community stakeholders. Understand the different perspectives of stakeholders is essential to engage them in the development planning. However, actual stakeholders’ engagement process is complex and not easy to accomplish. To create a consistent system of indicators designed to monitor and evaluate the sustainability performance of a touristic region it is necessary to access the local data and the consideration of the full range of values and uncertainties. This paper presents the OBSERVE project and describes the stakeholders´ engagement process highlighting the contributions, ambitions and constraints.

Keywords: sustainable tourism, stakeholders' engagement, OBSERVE project, Algarve region

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Authors: Jerickson Abbie Flores, Jana Fragante, Jan Paolo Dipasupil, Jan Jorge Francisco

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Malnutrition is one of the rapidly growing health problems affecting the world at present. Children affected are not only at risk for significant health problems, but are also faced with psychological and social consequences, including low self-esteem. School-age children are specifically vulnerable to develop poor self-esteem especially when their peers find them physically unattractive. Thus, malnutrition, whether obesity or undernourishment, contributes a significant role to a developing child’s health and behavior. This research aims to determine if there is a significant difference on the level of self-esteem among Filipino children ages 9-12 years old with abnormal body mass index (BMI) and those children with desirable BMI. Using a cross-sectional study design, the correlation between body mass index (BMI) and self-esteem was observed among children ages 9-12 years old. Participants took the Hare self esteem questionnaire, which is specifically designed to measure self-esteem in school age children. The lowest possible score is 15 and the highest possible score is 45. A total of 1140 students with ages 9-12 years old from Cembo Elementary School (public school) participated in the study. Among the participants, 239 out of the 1140 have desirable body mass index, 878 are underweight, and 23 are overweight. Using the test questionnaire, the computed mean scores were 36.599, 36.045 and 36.583 for normal, underweight and overweight categories respectively. Using Pearson’s Correlation Test and Spearman’s Correlation Coefficient Test, the study showed positive correlation (p value of 0.047 and 0.004 respectively) between BMI and Self-esteem scores which indicates that the higher the BMI, the higher the self-esteem of the participants.

Keywords: body mass index, malnutrition, school-age children, self-esteem

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Authors: Surekha Rathod

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Sickle cell disease is a vascular disorder characterized by chronic, ongoing organ damage that is punctuated by episodes of acutely painful vascular complications.1 It is the most common genetic blood disorder in the United States, with about 2000 infants being identified through routine blood screenings annually, and an estimated 104,000-138,000 affected individuals living in the United States. Approximately 0.3%-1.3% of African American are affected by Sickle Cell Diseases (SCD).3 The aim of this paper is to present oral health status of patients with SCD. A total of 200 subjects of both sexes in the age group 18- 40 years were included in this study. The subjects were examined and the following indices were recorded • Oral hygiene index – Simplified (OHI-S). • Probing depths (PD). • Clinical Attachment Levels (CAL). • Gingival Index - Loe and Sillness. • Turesky Gillmore Glickman Modification of the Quigley Hein Plaque Index. (1970) • DMFT index. • Sickle Cell Disease Severity Index. A total of 1478 patients were screened of which 200 subjects were found to be diagnosed with SCD by electrophoresis. The study thus, included 200 subjects (111 females & 89 males) diagnosed with Sickle Cell Disease in the age group of 18-40 years. The probing pocket depths (PPD) were measured in millimeters. 36% had PPD in the range of 2-4mm, 48% had PPD in the range of 4-6mm while 16% had PPD of more than 6mm. Similar results were obtained for the Clinical Attachment Levels (CAL). 29.5 % subjects had CAL 2-4mm, 44.5% had 4-6mm & 26% had CAL 6mm & above. We can thus conclude that although oral health is not a priority for patients with SCD, it is supported by increased plaque accumulation. Because of the chronic anemic state of the patients with SCD, they should be encouraged to pay strict attention to oral hygiene instructions and practice.

Keywords: chronic, genetic, oral, sickle cell disease, vascular

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Authors: Yilin Liao, Hewen Li, Paula McConvey

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Concussion for speed skaters often occurs when skaters fall on the ice and impact the crash mats during practices and competition races. Gaining insight into the impact of interactions is of essential interest as it is directly related to skaters’ potential health risks and injuries. Precise concussion measurements are challenging and very difficult, making computer simulation the only reliable way to analyze accidents. This research aims to create the crash mat and skater’s multi-body model using Solidworks, develop a computer simulation model for skater-mat impact using ANSYS software, and predict the skater’s concussion degree by evaluating the “head injury criteria” (HIC) through the resulting accelerations. The developed method and results help understand the relationship between impact parameters and concussion risk for speed skaters and inform the design of crash mats and skating rink layouts more specifically by considering athletes’ health risks.

Keywords: computer simulation modeling, concussion, impact, speed skater

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Authors: Bencharif Meriem, Sersar Ibrahim, Djaafri Zineb

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Introduction and purpose of the study: Education plays a fundamental role in the lives of young people, but what about their physical well-being as they spend long hours sitting at school? School inactivity is a problem that deserves particular attention because it can have significant repercussions on the health and development of students. The aim of this study was to describe and evaluate the physical activity of students in different practices in class, at recess and in the canteen. Material and methods: A physical activity diary and an anthropometric measurement sheet (weight, height) were provided to 123 school-aged adolescents. The measurements were carried out according to international recommendations. The statistical tests were carried out with the R software. 3.2.4. The significance threshold retained was 0.05. Results and Statistical Analysis: One hundred and twenty-three students agreed to participate in the study. Their average age was 16.5±1.60 years. Overweight was present in 8.13% and obesity in 4.06%. For the practice of physical activity, during physical education and sports classes, all students played sports with an average of 1.94±1.00 hours/week, of which 74.00% sweated or were out of breath during these hours of physical activity. It was also noted that boys practiced sports more than girls (p<0.0001). Each day, on average, students spent 39.78±37.85 min walking or running during recess. On the other hand, they spent, on average 4.25±2.65 hours sitting per day in class, at recess, in the canteen, etc., without counting the time spent in front of a screen. The increasing use of screens has become a major concern for parents and educators. On average, students spent approximately 42.90±38.41 min per day using screens in class, at recess, in the canteen and at home. (computer, tablet, telephone, video games, etc.) and therefore to a prolonged sedentary lifestyle. On average, students sat for more than 1.5 hours without moving for at least 2 minutes in a row approximately 1.72±0.71 times per day. Conclusion: These students spent many hours sitting at school. This prolonged inactivity can have negative consequences on their health, including problems with posture and cardiovascular health. It is crucial that schools, educators and parents collaborate to promote more active learning environments where students can move more and thus contribute to their overall well-being. It's time to rethink how we approach education and student health to give them a healthier, more active future.

Keywords: physical acivity, sedentarity, adolescents, school

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Authors: Md Shohidul Islam, Jongmyon Kim, Ui-pil Chong

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Medical image is an integral part of e-health care and e-diagnosis system. Medical image watermarking is widely used to protect patients’ information from malicious alteration and manipulation. The watermarked medical images are transmitted over the internet among patients, primary and referred physicians. The images are highly prone to corruption in the wireless transmission medium due to various noises, deflection, and refractions. Distortion in the received images leads to faulty watermark detection and inappropriate disease diagnosis. To address the issue, this paper utilizes error correction code (ECC) with (8, 4) Hamming code in an existing watermarking system. In addition, we implement the high complex ECC on a graphics processing units (GPU) to accelerate and support real-time requirement. Experimental results show that GPU achieves considerable speedup over the sequential CPU implementation, while maintaining 100% ECC efficiency.

Keywords: medical image watermarking, e-health system, error correction, Hamming code, GPU

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Authors: Tonya P. Bowers

Abstract:

Background: The community/patient-focused quality improvement (QI) project has resolved a clinical problem using a quantitative design evaluating behavior change practices in a convenience sample from a multi-cultural congregation in a faith-based setting. AD is a legal document that speaks for the patient when they are unable to speak for themselves. The AD provides detailed information regarding critical medical decisions on behalf of the patient if they’re unable to make decisions themselves. The goal of an AD is to improve EOL care renderings that align with the patient’s desires. The AD diminishes anxiety and stress associated with making difficult EOL care decisions for patients and their families. Method: The project has two intervention strategies: pre-intervention and post-intervention formative surveys and a final summative survey. Most of the data collection takes place during implementation. The Let’s Talk About It Program utilized an online meeting platform for presentation. Participants were asked to complete informed consent and surveys via an online portal. Education included slide presentation, Advance Directive demonstration, video clips, discussions and 1:1 assistance with AD completion with a project manager. Results: Considering the overwhelming likelihood responses where 87.5% identified they “definitely would” hold an End-Of-Life conversation with their healthcare provider or family, and 81.25% indicated their likelihood that they “definitely would” complete an advance directive. In addition, the final summative post-intervention survey (n-14) also demonstrated an overwhelming 93% positive response. Which undoubtedly demonstrates favorable outcomes for the project. Conclusion: the Let’s Talk About It Program demonstrated effectiveness in improving participants' attitudes and acceptance towards Advance Directives and expanding End-of-Life care discussions. Emphasis on program sustainment within the church is imperative in fostering continued awareness and improved health outcomes for the local community with low health literacy.

Keywords: advance directive, end of life, advance care planning, palliative care, low health literacy, faith-based

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