Search results for: public health surveillance

Authors: Mengnan Sun

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It is unclear about the association between air pollution and Tourette Syndrome (TS), although people have suspected that air pollution might trigger TS. TS is a type of neural system disease usually found among children. The number of TS patients has significantly increased in recent decades, suggesting an importance and urgency to examine the possible triggers or conditions that are associated with TS. In this study, the correlation between air pollution and three allergic diseases---asthma, allergic conjunctivitis (AC), and allergic rhinitis (AR)---is examined. Then, a correlation between these allergic diseases and TS is proved. In this way, this study establishes a positive correlation between air pollution and TS. Measures the public can take to help TS patients are also analyzed at the end of this article. The article hopes to raise people’s awareness to reduce air pollution for the good of TS patients or people with other disorders that are associated with air pollution.

Keywords: air pollution, allergic diseases, climate change, Tourette Syndrome

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Authors: T. Yasmin, M. A. Farrelly, B. C. Rogers

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Urban water governance in developing countries faces numerous challenges arising from uncontrolled urban population expansion, water pollution, greater economic push and more recently, climate change impact while undergoing transitioning towards a sustainable system. Sustainability transition requires developing adaptive capacities of the socio-ecological and socio-technical system to be able to deal with complexity. Adaptive capacities deliver strategies to connect individuals, organizations, agencies and institutions at multiple levels for dealing with such complexity. Understanding the level of adaptive capacities for sustainability transformation thus has gained significant research attention within developed countries, much less so in developing countries. Filling this gap, this article develops a conceptual framework for analysing the level of adaptive capacities (if any) within a developing context. This framework then applied to the chronological development of urban water governance strategies in Bangladesh for almost two centuries. The chronological analysis of governance interventions has revealed that crisis (public health, food and natural hazards) became the opportunities and thus opened the windows for experimentation and learning to occur as a deviation from traditional practices. Self-organization and networks thus created the platform for development or disruptions to occur for creating change. Leadership (internal or external) is important for nurturing and upscaling theses development or disruptions towards guiding policy vision and targets as well as championing ground implementation. In the case of Bangladesh, the leadership from the international and national aid organizations and targets have always lead the development whereas more often social capital tools (trust, power relations, cultural norms) act as disruptions. Historically, this has been evident in the development pathways of urban water governance in Bangladesh. Overall this research has shown some level of adaptive capacities is growing for sustainable urban growth in big cities, nevertheless unclear regarding the growth in medium and small cities context.

Keywords: adaptive capacity, Bangladesh, sustainability transformation, water governance

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Authors: Shreyas Gambhirrao, Aditya Vichare, Aniket Tembhurne, Shahuraj Bhosale

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In today's rapidly evolving environment, stress has emerged as a significant health concern across different age groups. Stress that isn't controlled, whether it comes from job responsibilities, health issues, or the never-ending news cycle, can have a negative effect on our well-being. The problem is further aggravated by the ongoing connection to technology. In this high-tech age, identifying and controlling stress is vital. In order to solve this health issue, the study focuses on three key metrics for stress detection: body temperature, heart rate, and galvanic skin response (GSR). These parameters along with the Support Vector Machine classifier assist the system to categorize stress into three groups: 1) Stressed, 2) Not stressed, and 3) Moderate stress. Proposed training model, a NodeMCU combined with particular sensors collects data in real-time and rapidly categorizes individuals based on their stress levels. Real-time stress detection is made possible by this creative combination of hardware and software.

Keywords: real time stress detection, NodeMCU, sensors, heart-rate, body temperature, galvanic skin response (GSR), support vector machine

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Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

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Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

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Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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Authors: Hanaa M. M. El-Khayat, Hanan S. Gaber, Hoda Abdel-Hamid, Kadria M. A. Mahmoud, Hoda M. A. Abu Taleb

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This work aimed to examine Oreochromis niloticus fish from Lake Manzala in Port Said, Dakahlya and Damietta governorates, Egypt, as a bio-indicator for the lake water pollution through recording alterations in their hematological, physiological, and histopathological parameters. All fish samples showed a significant increase in levels of alkaline phosphatase (ALP), creatinine and glutathione-S-transferase (GST); only Dakahlya samples showed a significant increase (p<0.01) in aspartate aminotransferase (AST) level and most Dakahlya and Damietta samples showed reversed albumin and globulin ratio and a significant increase in γ-glutamyltransferase (GGT) level. Port-Said and Damietta samples showed a significant decrease of hemoglobin (Hb) while Dakahlya samples showed a significant decrease in white blood cell (WBC) count. Histopathological investigation for different fish organs showed that Port-Said and Dakahlya samples were more altered than Damietta. The muscle and gill followed by intestine were the most affected organs. The muscle sections showed severe edema, neoplasia, necrotic change, fat vacuoles and splitting of muscle fiber. The gill sections showed dilated blood vessels of the filaments, curling of gill lamellae, severe hyperplasia, edema and blood vessels congestion of filaments. The intestine sections revealed degeneration, atrophy, dilation in blood vessels and necrotic changes in sub-mucosa and mucosa with edema in between. The recorded significant alterations, in most of the physiological and histological parameters in O. niloticus samples from Lake Manzala, were alarming for water pollution impacts on lake fish community, which constitutes the main diet and the main source of income for the people inhabiting these areas, and were threatening their public health and economy. Also, results evaluate the use of O. niloticus fish as important bio-indicator for their habitat stressors.

Keywords: Lake Manzala, Oreochromis niloticus fish, water pollution, physiological, hematological and histopathological parameters

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Authors: Amit R. Bhende, G. K. Awari

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Remaining useful life (RUL) prediction is one of key technologies to realize prognostics and health management that is being widely applied in many industrial systems to ensure high system availability over their life cycles. The present work proposes a data-driven method of RUL prediction based on multiple health state assessment for rolling element bearings. Bearing degradation data at three different conditions from run to failure is used. A RUL prediction model is separately built in each condition. Feed forward back propagation neural network models are developed for prediction modeling.

Keywords: bearing degradation data, remaining useful life (RUL), back propagation, prognosis

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Authors: Leyi Wang

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The effect of religion on conflicts is usually over-focused. Religion is not the root cause of conflicts. There are always social, political or economic factors pushing the acceleration of conflicts. Meanwhile, the charisma of religion on calling for adherents is often utilized by political leaders as a tool of providing legitimacy to the initiating of violence and mobilizing the public during conflicts. What people identify from the connections between religion and conflicts is fake. There are some strategies used by politicians to upgrade the conflicts into violence. Consequently, there are some assumptions of which try to limit the religion’s effects on accelerating conflicts. This essay aims to discuss the roles of religion in international relations and argues that the religion difference is not the real source of conflicts in the globe, by reviewing the relevant literature for understanding the research background and gap of this topic. Also, this essay will suggest some implementations on dealing with the regional conflicts.

Keywords: religion, conflicts, criticism, international relations

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Authors: Raeesa Moolla, Ryan S. Johnson

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Air travel, and the use of airports, has experienced proliferative growth in the past few decades, resulting in the concomitant release of air pollutants. Air pollution needs to be monitored because of the known relationship between exposure to air pollutants and increased adverse effects on human health. This study monitored a group of volatile organic compounds (VOCs); specifically BTEX (viz. benzene, toluene, ethyl-benzene and xylenes), as many are detrimental to human health. Through the use of passive sampling methods, the spatial variability of BTEX within an international airport was investigated, in order to determine ‘hotspots’ where occupational exposure to BTEX may be intensified. The passive sampling campaign revealed BTEX_total concentrations ranged between 12.95–124.04 µg m^-3. Furthermore, BTEX concentrations were dispersed heterogeneously within the airport. Due to the slow wind speeds recorded (1.13 m.s^-1); the hotspots were located close to their main BTEX sources. The main hotspot was located over the main apron of the airport. Employees working in this area may be chronically exposed to these emissions, which could be potentially detrimental to their health.

Keywords: air pollution, air quality, hotspot monitoring, volatile organic compounds

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Authors: Fatema Akram, Mohammad G. Rasul, M. Masud K. Khan, M. Sharif I. I. Amir

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Australia is a country of some 7,700 million square kilometres with a population of about 22.6 million. At present water security is a major challenge for Australia. In some areas the use of water resources is approaching and in some parts it is exceeding the limits of sustainability. A focal point of proposed national water conservation programs is the recycling of both urban storm-water and treated wastewater. But till now it is not widely practiced in Australia, and particularly storm-water is neglected. In Australia, only 4% of storm-water and rainwater is recycled, whereas less than 1% of reclaimed wastewater is reused within urban areas. Therefore, accurately monitoring, assessing and predicting the availability, quality and use of this precious resource are required for better management. As storm-water is usually of better quality than untreated sewage or industrial discharge, it has better public acceptance for recycling and reuse, particularly for non-potable use such as irrigation, watering lawns, gardens, etc. Existing storm-water recycling practice is far behind of research and no robust technologies developed for this purpose. Therefore, there is a clear need for using modern technologies for assessing feasibility of storm-water harvesting and reuse. Numerical modelling has, in recent times, become a popular tool for doing this job. It includes complex hydrological and hydraulic processes of the study area. The hydrologic model computes storm-water quantity to design the system components, and the hydraulic model helps to route the flow through storm-water infrastructures. Nowadays water quality module is incorporated with these models. Integration of Geographic Information System (GIS) with these models provides extra advantage of managing spatial information. However for the overall management of a storm-water harvesting project, Decision Support System (DSS) plays an important role incorporating database with model and GIS for the proper management of temporal information. Additionally DSS includes evaluation tools and Graphical user interface. This research aims to critically review and discuss all the aspects of storm-water harvesting and reuse such as available guidelines of storm-water harvesting and reuse, public acceptance of water reuse, the scopes and recommendation for future studies. In addition to these, this paper identifies, understand and address the importance of modern technologies capable of proper management of storm-water harvesting and reuse.

Keywords: storm-water management, storm-water harvesting and reuse, numerical modelling, geographic information system, decision support system, database

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Authors: Bhavishya Ramchandani

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A little electronic device that is worn on the finger is called a smart ring. It incorporates mobile technology and has features that make it simple to use the device. These gadgets, which resemble conventional rings and are usually made to fit on the finger, are outfitted with features including access management, gesture control, mobile payment processing, and activity tracking. A poor sleep pattern, an irregular schedule, and bad eating habits are all part of the problems with health that a lot of people today are facing. Diets lacking fruits, vegetables, legumes, nuts, and whole grains are common. Individuals in India also experience metabolic issues. In the medical field, smart rings will help patients with problems relating to stomach illnesses and the incapacity to consume meals that are tailored to their bodies' needs. The smart ring tracks all bodily functions, including blood sugar and glucose levels, and presents the information instantly. Based on this data, the ring generates what the body will find to be perfect insights and a workable site layout. In addition, we conducted focus groups and individual interviews as part of our core approach and discussed the difficulties they're having maintaining the right diet, as well as whether or not the smart ring will be beneficial to them. However, everyone was very enthusiastic about and supportive of the concept of using smart rings in healthcare, and they believed that these rings may assist them in maintaining their health and having a well-balanced diet plan. This response came from the primary data, and also working on the Emerging Technology Canvas Analysis of smart rings in healthcare has led to a significant improvement in our understanding of the technology's application in the medical field. It is believed that there will be a growing demand for smart health care as people become more conscious of their health. The majority of individuals will finally utilize this ring after three to four years when demand for it will have increased. Their daily lives will be significantly impacted by it.

Keywords: smart ring, healthcare, electronic wearable, emerging technology

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Authors: Chunhua Ma

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Background: There is a relationship between cultural identity and psychological health. Resilience is an important factor of psychological health, and cultural identity will protect the resilience. The research showed that the cultural identity, resilience, and self-concordance of students from different cultures. It should be a theoretical basis to improve mental health of different nationalities students. And the role of resilience factors for adults’ cultural identity and self-concordance was deserve studied. Aims: The current study aimed to examine the relationship between cultural identity and self-concordance among Chinese academician from 3 minorities, postulating mediating by resilience. Methods: This study used cross-sectional and correlational design. Participants were 328 Chinese aged between 18 and 25 years. Data was collected via self-reports including both closed and opened questions. Results: Linear regression analysis controlling for age, gender, the result showed that: (a) Cultural identity was related to self-concordance, resilience was related to self-concordance and cultural identity was related to resilience, (b) Resilience mediated the link between cultural identity and self-concordance, respectively. Discussion: Our findings suggested that resilience and cultural identity are important factors in self-concordance. If minority college students realized the heterogeneous culture, it would alleviate their psychological conflict, stimulate their strength potential and improve their self-concordance.

Keywords: cultural identity, resilience, self-concordance, mediating effect

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Authors: Kholoud Abdulaziz, Kholoud Al-Najdi, Abdullah Kadri, Konstantinos E. Kakosimos

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The Middle East area is highly affected by air pollution induced by anthropogenic and natural phenomena. There is evidence that air pollution, especially particulates, greatly affects the population health. Many studies have raised a warning of the high concentration of particulates and their affect not just around industrial and construction areas but also in the immediate working and living environment. One of the methods to study air quality is continuous and periodic monitoring using active or passive samplers. Active monitoring and sampling are the default procedures per the European and US standards. However, in many cases they have been inefficient to accurately capture the spatial variability of air pollution due to the small number of installations; which eventually is attributed to the high cost of the equipment and the limited availability of users with expertise and scientific background. Another alternative has been found to account for the limitations of the active methods that is the passive sampling. It is inexpensive, requires no continuous power supply, and easy to assemble which makes it a more flexible option, though less accurate. This study aims to investigate and evaluate the use of passive sampling for particulate matter pollution monitoring in dry tropical climates, like in the Middle East. More specifically, a number of field measurements have be conducted, both indoors and outdoors, at Qatar and the results have been compared with active sampling equipment and the reference methods. The samples have been analyzed, that is to obtain particle size distribution, by applying existing laboratory techniques (optical microscopy) and by exploring new approaches like the white light interferometry to. Then the new parameters of the well-established model have been calculated in order to estimate the atmospheric concentration of particulates. Additionally, an extended literature review will investigate for new and better models. The outcome of this project is expected to have an impact on the public, as well, as it will raise awareness among people about the quality of life and about the importance of implementing research culture in the community.

Keywords: air pollution, passive samplers, interferometry, indoor, outdoor

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Authors: A.H.Y. Lai, C. Teyra

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In Taiwan, there are 16 official indigenous groups, accounting for 2.3% of the total population. Like other indigenous populations worldwide, indigenous peoples in Taiwan have poorer mental health because of their history of oppression and colonisation. Amid the negative narratives, the ethnic identity of cultural minorities is their unique psychological and cultural asset. Moreover, positive socialisation is found to be related to strong ethnic identity. Based on Phinney’s theory on ethnic identity development and social support theory, this study adopted a strength-based approach conceptualising ethnic identity as the central organising principle that linked perceived social support and mental health among indigenous adults in Taiwan. Aims. Overall aim is to examine the effect of ethnic identity and social support on mental health. Specific aims were to examine : (1) the association between ethnic identity and mental health; (2) the association between perceived social support and mental health ; (3) the indirect effect of ethnic identity linking perceived social support and mental health. Methods. Participants were indigenous adults in Taiwan (n=200; mean age=29.51; Female=31%, Male=61%, Others=8%). A cross-sectional quantitative design was implemented using data collected in the year 2020. Respondent-driven sampling was used. Standardised measurements were: Ethnic Identity Scale(6-item); Social Support Questionnaire-SF(6 items); Patient Health Questionnaire(9-item); and Generalised Anxiety Disorder(7-item). Covariates were age, gender and economic satisfaction. A four-stage structural equation modelling (SEM) with robust maximin likelihood estimation was employed using Mplus8.0. Step 1: A measurement model was built and tested using confirmatory factor analysis (CFA). Step 2: Factor covariates were re-specified as direct effects in the SEM. Covariates were added. The direct effects of (1) ethnic identity and social support on depression and anxiety and (2) social support on ethnic identity were tested. The indirect effect of ethnic identity was examined with the bootstrapping technique. Results. The CFA model showed satisfactory fit statistics: x^2(df)=869.69(608), p<.05; Comparative ft index (CFI)/ Tucker-Lewis fit index (TLI)=0.95/0.94; root mean square error of approximation (RMSEA)=0.05; Standardized Root Mean Squared Residual (SRMR)=0.05. Ethnic identity is represented by two latent factors: ethnic identity-commitment and ethnic identity-exploration. Depression, anxiety and social support are single-factor latent variables. For the SEM, model fit statistics were: x^2(df)=779.26(527), p<.05; CFI/TLI=0.94/0.93; RMSEA=0.05; SRMR=0.05. Ethnic identity-commitment (b=-0.30) and social support (b=-0.33) had direct negative effects on depression, but ethnic identity-exploration did not. Ethnic identity-commitment (b=-0.43) and social support (b=-0.31) had direct negative effects on anxiety, while identity-exploration (b=0.24) demonstrated a positive effect. Social support had direct positive effects on ethnic identity-exploration (b=0.26) and ethnic identity-commitment (b=0.31). Mediation analysis demonstrated the indirect effect of ethnic identity-commitment linking social support and depression (b=0.22). Implications: Results underscore the role of social support in preventing depression via ethnic identity commitment among indigenous adults in Taiwan. Adopting the strength-based approach, mental health practitioners can mobilise indigenous peoples’ commitment to their group to promote their well-being.

Keywords: ethnic identity, indigenous population, mental health, perceived social support

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Authors: Tara Miller, Tariq Ganief, Jonathan Blackburn

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Millions of babies are still born to HIV-infected mothers each year despite the ramped-up HAART use. However, these infants are HIV uninfected but exposed, which is now a growing population that has weakened immune systems and poorer outcomes. Due to HIV exposure and possible ARV exposure during pregnancy and breastfeeding, these infants are believed to have altered immune responses and microbiomes when compared to their healthy counterparts. The gut microbiome roles an important role in infant development, specifically in the immune system. Research has shown these HIV-exposed, uninfected infants have weaker immune responses to their neonate vaccines, and in developing countries, this leaves them vulnerable to opportunistic disease. By gaining a deeper understanding of the gut microbiome and the products of the microbes via metaproteomic analysis, we can hopefully understand and improve the immune system and health of these infants. To investigate the metaproteome of the infants’ guts, mass spectrometry will be used, followed by data analysis using DIA-NN. The hypothesized results are that the HIV-exposed, uninfected infants have an altered microbiome compared to their healthy counterparts. Additionally, the differences found are hypothesized to be involved with inflammation which would contribute to the poor health of the infants.

Keywords: HIV, mass spectrometry, metaproteomics, microbiome

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Authors: Zylfi Shehu, Shpetim Madani, Bashkim Delia

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Context: The study focuses on the interest and engagement of high school students in Tirana, Albania, in physical activity, sports, and foreign languages. It acknowledges the numerous physiological benefits of physical activity, such as cardiovascular health and improved mood. It also recognizes the importance of physical activity in childhood and adolescence for proper skeletal development and long-term health. Research Aim: The main purpose of the study is to investigate and analyze the preferences and interests of male and female high school students in Tirana regarding their functional development, physical activity, sports participation, and choice of foreign languages. The aim is to provide insights for the students and teachers to guide future objectives and improve the quality of physical education. Methodology: The study employed a survey-based approach, targeting both male and female students in public high schools in Tirana. A total of 410 students aged 15 to 19 years old, participated in the study. The data collected from the survey were processed using Excel and presented through tables and graphs. Findings: The results revealed that team sports were more favored by the students, with football being the preferred choice among males, while basketball and volleyball were more popular among females. Additionally, English was found to be the most preferred foreign language, selected by a higher percentage of females (38.57%) compared to males (16.90%). German followed as the second preferred language. Theoretical Importance: This study contributes to the understanding of students' interests in physical activity, sports, and foreign languages in Tirana's high schools. The findings highlight the need to focus on specific sports and languages to cater to students' preferences and guide future educational objectives. It also emphasizes the importance of physical education in promoting students' overall well-being and highlights potential areas for policy and program improvement. Data Collection and Analysis Procedures: The study collected data through surveys administered to high school students in Tirana. The survey responses were processed and analyzed using Excel, and the findings were presented through tables and graphs. The data analysis allowed for the identification of preferences and trends among male and female students, providing valuable insights for future decision-making. Question Addressed: The study aimed to address the question of high school students' interest in physical activity, sports, and foreign languages. It sought to understand the preferences and choices made by students in Tirana and investigate factors such as gender, family income, and accessibility to extracurricular sports activities. Conclusion: The study revealed that high school students in Tirana show a preference for team sports, with football being the most favored among males and basketball and volleyball among females. English was found to be the most preferred foreign language. The findings provide important insights for educators and policymakers to enhance physical education programs and consider students' preferences and interests to foster a more effective learning environment. The study also emphasizes the importance of physical activity and sports in promoting students' physical and mental well-being.

Keywords: female, male, foreign languages, sports, physical education, high school students

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Authors: M. R. Bhuiyan, S. M. M. Hossain, M. Z. Islam

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Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p<0.001). Again, families with higher monthly family income incurred higher treatment cost (r=0.526, p<0.05). Difference between mean direct and indirect cost was found significant (t=4.190, df=61, p<0.001). According to the analysis of variance, mean difference of father’s educational status among direct cost (F=10.337, p<0.001) and total treatment cost (F=7.841, p<0.001), which were statistically significant. The study revealed that maximum children with ASD were under five years, three-fourth were male. According to monthly family income, maximum family were in middle class. The study recommends cost effective interventions and financial safety-net measures to reduce the financial burden of families for the children with ASD.

Keywords: autism spectrum disorder, financial burden, direct cost, indirect cost, special education

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Authors: Jaeyoung Kim, Heeju Lee, Huijin Jung, Heesoo Pyo, Seungki Kim, Joonseok Lee

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Avian influenza viruses (AIV) are the primary cause of highly contagious respiratory diseases caused by type A influenza viruses of the Orthomyxoviridae family. AIV are categorized on the basis of types of surface glycoproteins such as hemagglutinin and neuraminidase. Certain H5 and H7 subtypes of AIV have evolved to the high pathogenic avian influenza (HPAI) virus, which has caused considerable economic loss to the poultry industry and led to severe public health crisis. Several commercial kits have been developed for on-site detection of AIV. However, the sensitivity of these methods is too low to detect low virus concentrations in clinical samples and opaque stool samples. Here, we introduced a background-free near-infrared (NIR)-to-NIR upconversion nanoparticle-based lateral flow immunoassay (NNLFA) platform to yield a sensor that detects AIV within 20 minutes. Ca²⁺ ion in the shell was used to enhance the NIR-to-NIR upconversion photoluminescence (PL) emission as a heterogeneous dopant without inducing significant changes in the morphology and size of the UCNPs. In a mixture of opaque stool samples and gold nanoparticles (GNPs), which are components of commercial AIV LFA, the background signal of the stool samples mask the absorption peak of GNPs. However, UCNPs dispersed in the stool samples still show strong emission centered at 800 nm when excited at 980 nm, which enables the NNLFA platform to detect 10-times lower viral load than a commercial GNP-based AIV LFA. The detection limit of NNLFA for low pathogenic avian influenza (LPAI) H5N2 and HPAI H5N6 viruses was 10² EID₅₀/mL and 10³.⁵ EID₅₀/mL, respectively. Moreover, when opaque brown-colored samples were used as the target analytes, strong NIR emission signal from the test line in NNLFA confirmed the presence of AIV, whereas commercial AIV LFA detected AIV with difficulty. Therefore, we propose that this rapid and background-free NNLFA platform has the potential of detecting AIV in the field, which could effectively prevent the spread of these viruses at an early stage.

Keywords: avian influenza viruses, lateral flow immunoassay on-site detection, upconversion nanoparticles

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Authors: Zena F. Mushtaq, Iqbal M. Abbas

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Background: Diabetes mellitus during pregnancy is one of the major medical and social problems with increasing prevalence in last decades and may lead to more vulnerable to dental problems and increased risk for periodontal diseases. Objectives: To assess oral hygiene behaviors among pregnant women with diabetes who attended primary health care centers and find out the relationship between oral hygiene behaviors and studied variables. Methodology: A cross sectional design was conducted from 7 July to 30 September 2014 on non probability (convenient sample) of 150 pregnant women with diabetes was selected from twelve Primary Health Care Centers at Baghdad city. Questionnaire format is tool for data collection which had designed and consisted of three main parts including: socio demographic, reproductive characteristics and items of oral hygiene behaviors among pregnant women with diabetes. Reliability of the questionnaire was determined through internal consistency of correlation coefficient (R= 0.940) and validity of content was determined through reviewing it by (12) experts in different specialties and was determined through pilot study. Descriptive and inferential statistics were used to analyze collected data. Result: Result of study revealed that (35.3%) of study sample was (35-39) years old with mean and SD is (X & SD = 33.57 ± 5.54) years, and (34.7%) of the study sample was graduated from primary school and less, half of the study sample was government employment and self employed, (42.7%) of the study sample had moderate socioeconomic status, the highest percentage (70.0%) of the study sample was nonsmokers, The result indicates that oral hygiene behaviors have moderate mean score in all items. There are no statistical significant association between oral hygiene domain and studied variables. Conclusions: All items related to health behavior concerning oral hygiene is in moderate mean of score, which may expose pregnant women with diabetes to high risk of periodontal diseases. Recommendations: Dental care provider should perform a dental examination at least every three months for each pregnant woman with diabetes, explanation of the effect of DM on periodontal health, oral hygiene instruction, oral prophylaxis, professional cleaning and treatment of periodontal diseases(scaling and root planing) when needed.

Keywords: diabetes, health behavior, pregnant women, oral hygiene

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Authors: Mayantoinette F. Watson

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During such an unprecedented time of the largest public health crisis, the COVID-19 pandemic, nursing students are of the utmost concern regarding their psychological and physical well-being. Questions are emerging and circulating about what will happen to the nursing students and the long-term effects of the pandemic, especially now that hospitals are being overwhelmed with a significant need for nursing staff. Expectations, demands, change, and the fear of the unknown during this unprecedented time can only contribute to the many stressors that accompany nursing students through laborious clinical and didactic courses in nursing programs. The risk of psychological distress is at a maximum, and its effects can negatively impact not only nursing students but also nursing education and academia. The high exposures to interpersonal, economic, and academic demands contribute to the major health concerns, which include a potential risk for psychological distress. Achievement of educational success among nursing students is directly affected by the high exposure to anxiety and depression from experiences within the program. Working relationships and achieving academic success is imperative to positive student outcomes within the nursing program. The purpose of this study is to identify and establish influences and associations within multilevel factors, including the effects of the COVID-19 pandemic on psychological distress in nursing students. Neuman’s Systems Model Theory was used to determine nursing students’ responses to internal and external stressors. The research in this study utilized a mixed-methods, convergent study design. The study population included undergraduate nursing students from Southeastern U.S. The research surveyed a convenience sample of undergraduate nursing students. The quantitative survey was completed by 202 participants, and 11 participants participated in the qualitative follow-up interview surveys. Participants completed the Kessler Psychological Distress Scale (K6), the Perceived Stress Scale (PSS4), and the Dundee Readiness Educational Environment Scale (DREEM12) to measure psychological distress, perceived stress, and perceived educational environment. Participants also answered open-ended questions regarding their experience during the COVID-19 pandemic. Statistical tests, including bivariate analyses, multiple linear regression analyses, and binary logistics regression analyses were performed in effort to identify and highlight the effects of independent variables on the dependent variable, psychological distress. Coding and qualitative content analysis were performed to identify overarching themes within participants’ interviews. Quantitative data were sufficient in identifying correlations between psychological distress and multilevel factors of coping, marital status, COVID-19 stress, perceived stress, educational environment, and social support in nursing students. Qualitative data were sufficient in identifying common themes of students’ perceptions during COVID-19 and included online learning, workload, finances, experience, breaks, time, unknown, support, encouragement, unchanged, communication, and transmission. The findings are significant, specifically regarding contributing factors to nursing students’ psychological distress, which will help to improve learning in the academic environment.

Keywords: nursing education, nursing students, pandemic, psychological distress

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Authors: Ignacio W. Loor

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In the context of informal settlements in Quito, this paper provides evidence that slopes and deep ravines typical of Andean cities, around which marginalized urban communities sit, constitute a platform for green infrastructure that supports mobility for pedestrians in an incremental fashion. This is informally shaped green infrastructure that provides connectivity to other mobility infrastructures such as roads and public transport, which permits relegated dwellers reach their daily destinations and reclaim their rights to the city. This is relevant in that walking has been increasingly neglected as a viable mean of transport in Latin American cities, in favor of rather motorized means, for which the mobility benefits of green infrastructure have remained invisible to policymakers, contributing to the progressive isolation of informal settlements. This research leverages greatly on an ecological rejuvenation programme led by the municipality of Quito and the Andean Corporation for Development (CAN) intended for rehabilitating the ecological functionalities of ravines. Accordingly, four ravines in different stages of rejuvenation were chosen, in order to through ethnographic methods, capture the practices they support to dwellers of informal settlements across different stages, particularly in terms of issues of mobility. Then, by presenting fragments of interviews, description of observed phenomena, photographs and narratives published in institutional reports and media, the production process of mobility infrastructure over unoccupied slopes and ravines, and the roles that this infrastructure plays in the mobility of dwellers and their quotidian practices are explained. For informal settlements, which normally feature scant urban infrastructure, mobility embodies an unfavourable driver for the possibilities of dwellers to actively participate in the social, economic and political dimensions of the city, for which their rights to the city are widely neglected. Nevertheless, informal green infrastructure for mobility provides some alleviation. This infrastructure is incremental, since its features and usability gradually evolves as users put into it knowledge, labour, devices, and connectivity to other infrastructures in different dimensions which increment its dependability. This is evidenced in the diffusion of knowledge of trails and routes of footpaths among users, the implementation of linking stairs and bridges, the improved access by producing public spaces adjacent to the ravines, the illuminating of surrounding roads, and ultimately, the restoring of ecological functions of ravines. However, the perpetuity of this type of infrastructure is also fragile and vulnerable to the course of urbanisation, densification, and expansion of gated privatised spaces.

Keywords: green infrastructure, informal settlements, urban mobility, walkability

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has in relation to this study enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying program theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving program theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: ovarian cancer, exercise intervention, implementation, Co-design

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Authors: Fernando Nobre Cavalcante

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In Brazil, and more recently in the city of Fortaleza, there is a new form of entrepreneurship that is focused on the information and communication technology service sector and that draws the attention of young people, investors, governments, authors and media companies: it is known as the start-up movement. Today, it is considered to be a driving force behind the creative economy. Rooted on progressive discourse, the words enterprise and innovation seduce new economic agents motivated by success stories from Silicon Valley in America along with increasing commercial activity for digital goods and services. This article assesses, from a sociological point of view, the new productive wave problematized by the light of Manuel Castells’ informational capitalism. Considering the skeptical as well as the optimistic opinions about the impact of this new entrepreneurial rearrangement, the following question is asked: How Brazilian entrepreneurs evaluate public policy incentives for startups Brazilian Federal Government? The raised hypotheses are based on employability factors as well as cultural, economical, and political matters related to innovation and technology. This study has produced a nationwide quantitative assessment with a special focus on the reality of these Ceará firms; as well as comparative qualitative interviews on Brazilian experiences lived by identified agents. This article outlines the public incentive policy of the federal government, the Start-up Brasil Program, from the perspective of these companies and provides details as to the discipline methods of the new enterprising way born in the United States. The startups are very young companies that are headed towards the economic sustainment of the productive sector services. These companies are dropping the seeds that will produce the re-enchantment of young people and bring them back to participation in political debate; they provide relief and reheats the job market; and they produce a democratization of the entrepreneurial ‘Do-It-Yourself’ culture. They capitalize the pivot of the wall street wolves and of agents being charged for new masks. There are developmental logic’s prophylaxis in the face of dreadful innovation stagnation. The lack of continuity in Brazilian governmental politics and cultural nuances related to entrepreneurship are barring the desired regional success of this ecosystem.

Keywords: creative economy, entrepreneurship, informationalism, innovation, startups, start-up brasil program

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Authors: Jeanne Grace, Jacqueline Naiker

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Background: Longevity is increasing, accompanied by a rise in disability and chronic diseases with physical activity (PA) delaying disability, ensuring successful aging (SA) and independent living in older adults. Aim: This study aimed to determine objectively measured PA levels, health-related quality of life (HRQoL), life-space mobility, and successful aging (SA) of older adults in KwaZulu-Natal province, South Africa, as well as their mutual associations. Methods: A total of 210 older adults aged 65–92 years were purposively sampled and completed the Medical Outcomes Study 36-Item Short-Form Health Survey, the Life-Space Mobility, and Successful Aging questionnaires. PA levels were measured using an Omron Pedometer, which the participants wore for seven consecutive days. Results: The average number of steps taken per day for the seven days was 2025, with 98.6% of the entire study population classified as sedentary. The Vitality domain (one of 8 categorized) reflected the best health status (M = 59.9, SD ± 18.8), with a significant 93% of the participants indicating that they had not visited places outside their immediate neighborhood (P < 0.0005). A significant, negative association between the average number of steps taken in 7 days and all three SA variables – namely, the physical (r = –0.152, P = 0.027), sociological (r = –0.148, P = 0.032) and psychological (r = –0.176, P = 0.010), and a significant, positive association with life-space mobility (r = 0.224, P = 0.001) was noted. Conclusion: The majority of the elderly were sedentary, affecting their HRQoL, life-space mobility, and SA negatively.

Keywords: active life expectancy, geriatrics, nursing homes, well-being

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Authors: Rajesh Kumar

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The largest issue in the current situation is managing solid waste since it pollutes the ecosystem. When considering how to manage waste, even the disposal of mixed waste is a challenge. The Saksham Yuva Project, which is managed by the Haryana government, highlights the consequences and drivers of managing the solid waste of urban areas in the municipal committee pundri in the present study. The overall goal of the Saksham Yuva project is to mobilise the public and educate them about the dangers associated with garbage management. There has been a 20% reduction in waste, according to the study's impacts, and the cost of waste management has also gone down. Further, the study also reported the alternative use of wastes in revenue generation by generating Khaad for agricultural purposes.

Keywords: solid waste management, people awareness, dry and wet waste disposal, material recover facility

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Authors: Usama Bin Zubair, Muhammad Azeem

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Introduction: Depression has been one of the most commonly diagnosed mental health disorders in Pakistan. A Census conducted by the government of Pakistan in 2017 showed that more than 10000 trans-genders live in Pakistan. HIV, illicit substance use and mental health issues, including depression, have been the main health problems faced by them. Trans-gender population has been suffering from depressive illness more than normal population all over the world. Aim: To assess the prevalence of depression among the transgender population and analyze the relationship of socio-demographic factors with depression. Subjects and Methods: The sample population comprised of one hundred and forty-two transgender people of Rawalpindi and Islamabad. Beck depressive inventory II (BDI-II) was used to record the presence and severity of the depressive symptoms. Depressive symptoms were categorized as mild, moderate and severe. Relationship of the age, smoking, family income, illicit substance use and education were studied with the presence of depressive symptoms among these transgender people of twin cities of Pakistan. Results: A total of 142 transgender people were included in the final analysis. The mean age of the study participants was 39.55 ± 6.18. Out of these, 45.1% had no depressive symptoms while 31.7% had mild, 12.7% had moderate and 10.6% had severe depressive symptomatology. After applying the binary logistic regression, we found that the presence of depressive symptoms had a significant association with illicit substance use among the target population. Conclusion: This study showed a high prevalence of depressive symptoms among the transgender population in the twin cities of Pakistan. Use of illicit substances like tobacco, cannabis, opiates, and alcohol should be discouraged to prevent mental health problems.

Keywords: depression, transgender, prevalence, sociodemographic factors

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Authors: Armin Samarghandi, Amirreza Jafari, Mohamad Ghiasi

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Numerous assertions and some empirical evidence imply that 'green' buildings ought to be more productive and healthier (mentally and physiologically) than conventional structures. Since then, empirical data has been equivocal, indicating either that the studies are inaccurate or that the research has just scratched the surface of green buildings in offices, accommodation, and hospital settings and not taken the aforementioned holistically. This study compared four green-certified buildings -one residential green building, one green hospital, and one green school- with conventional structures in Tehran, Iran, by means of a questionnaire spread among those utilizing these buildings, and assessing their productivity and health rate as opposed to the time they resided, worked in conventional buildings. The results demonstrated higher scores pertaining to productivity and physical and mental wellness as a consequence of better indoor environmental quality (IEQ), natural lighting, design, and sustainability of these buildings against non-green buildings. In addition, ancillary matters -environmental, financial, intellectual, emotional, social, and spiritual dimensions of participants- were indirectly evaluated, and the same results were produced.

Keywords: green building, LEED, productivity, physical and mental health, indoor environmental quality

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Authors: B. T. Naveen Kumar, Anuj Tyagi, Niraj Kumar Singh, Visanu Boonyawiwat, A. H. Shanthanagouda, Orawan Boodde, K. M. Shankar, Prakash Patil, Shubhkaramjeet Kaur

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Early mortality syndrome (EMS)/Acute Hepatopancreatic Necrosis Disease (AHPND) has emerged as a major obstacle for the shrimp farming around the world. It is caused by a strain of Vibrio parahaemolyticus. The possible preventive and control measure is, early and rapid detection of the pathogen in the broodstock, post-larvae and monitoring the shrimp during the culture period. Polymerase chain reaction (PCR) based early detection methods are good, but they are costly, time taking and requires a sophisticated laboratory. The present study was conducted to develop a simple, sensitive and rapid diagnostic farmer level kit for the reliable detection of AHPND in shrimp. A panel of monoclonal antibodies (MAbs) were raised against the recombinant Pir B protein (rPirB). First, an immunodot was developed by using MAbs G3B8 and Mab G3H2 which showed specific reactivity to purified r-PirB protein with no cross-reactivity to other shrimp bacterial pathogens (AHPND free Vibrio parahaemolyticus (Indian strains), V. anguillarum, WSSV, Aeromonas hydrophila, and Aphanomyces invadans). Immunodot developed using Mab G3B8 is more sensitive than that with the Mab G3H2. However, immunodot takes almost 2.5 hours to complete with several hands-on steps. Therefore, the flow-through assay (FTA) was developed by using a plastic cassette containing the nitrocellulose membrane with absorbing pads below. The sample was dotted in the test zone on the nitrocellulose membrane followed by continuos addition of five solutions in the order of i) blocking buffer (BSA) ii) primary antibody (MAb) iii) washing Solution iv) secondary antibody and v) chromogen substrate (TMB) clear purple dots against a white background were considered as positive reactions. The FTA developed using MAbG3B8 is more sensitive than that with MAb G3H2. In FTA the two MAbs showed specific reactivity to purified r-PirB protein and not to other shrimp bacterial pathogens. The FTA is simple to farmer/field level, sensitive and rapid requiring only 8-10 min for completion. Tests can be developed to kits, which will be ideal for use in biosecurity, for the first line of screening (at the port or pond site) and during monitoring and surveillance programmes overall for the good management practices to reduce the risk of the disease.

Keywords: acute hepatopancreatic necrosis disease, AHPND, flow-through assay, FTA, farmer level, immunodot, pond site, shrimp

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Authors: Ali A Alshraifeen, Josie Evans, Kathleen Stoddart

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End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influence of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving hemodialysis (HD) treatment in Scotland. This study was conducted to explore spirituality in the daily lives of among these patients and how it may influence their QOL and general well-being. The study employed a qualitative method. Data were collected using semi-structured interviews with a sample of 21 patients. A thematic approach using Framework Analysis informed the qualitative data analysis. Participants were recruited from 11 dialysis units across four Health Boards in Scotland. The participants were regular patients attending the dialysis units three times per week. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings suggest that patients’ QOL might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability and being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humor was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study provide a significant contribution to a very limited body of work. The study contributes to our understanding of spirituality and how people receiving dialysis treatment use it to manage their daily lives. Spirituality is of particular interest due to its connection with health outcomes in patients with chronic illnesses. The link between spirituality and many chronic illnesses has gained some recognition, yet the identification of its influence on the health outcomes and well-being in patients with ESRD is still evolving. There is a need to understand patients’ experiences and examine the factors that influence their QOL and well-being to ensure that the services available are adequately tailored to them. Hence, further research is required to obtain a better understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD.

Keywords: end-stage renal disease, general well-being, quality of life, spirituality

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Authors: Hassan Shahmiri Barzoki

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Background: Posttraumatic stress disorder (PTSD) is an abnormal physiologic and psychological reaction in person with severe traumatic history. In recent studies, the relationship between PTSD and some other disease apparently unrelated to psychological situations, such as cardiovascular diseases, diabetes, and metabolic syndrome, has been revealed. Thus, the aim of this study was to survey the prevalence of metabolic syndrome and mental health in PTSD patients. Methods: The research design was retrospective cohort study. Subjects were consisted of 142 Iran-Iraq war veterans with PTSD (age: 40-60 years), and the control group was consisted of 153 veterans without PTSD. Data was collected using questionnaires, physical exams and laboratory tests. Results: Prevalence of metabolic syndrome was 45.1%in PTSD group and 17% in control group. In addition, blood pressure, triglyceride and fasting blood sugar in PTSD group were significantly higher than control group (p<0.05). Also, PTSD patients had significant high rates of psychiatric disorders. Conclusion: PTSD patients are more prone to metabolic syndrome and psychiatric disorders than control group.

Keywords: mental health, metabolic syndrome, post traumatic stress disorder, patient

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