Search results for: health care economics

Authors: Danielle Slomberg, Jerome Labille, Riccardo Catalano, Jean-Claude Hubaud, Alexandra Lopes, Alice Tagliati, Teresa Fernandes

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In the assessment and management of cosmetics and personal care products, sunscreens are of emerging concern regarding both human and environmental health. Organic UV blockers in many sunscreens have been evidenced to undergo rapid photodegradation, induce dermal allergic reactions due to skin penetration, and to cause adverse effects on marine systems. While mineral UV-blockers may offer a safer alternative, their fate and impact and resulting regulation are still under consideration, largely related to the potential influence of nanotechnology-based products on both consumers and the environment. Nanometric titanium dioxide (TiO₂) UV-blockers have many advantages in terms of sun protection and asthetics (i.e., transparency). These UV-blockers typically consist of rutile nanoparticles coated with a primary mineral layer (silica or alumina) aimed at blocking the nanomaterial photoactivity and can include a secondary organic coating (e.g., stearic acid, methicone) aimed at favouring dispersion of the nanomaterial in the sunscreen formulation. The nanomaterials contained in the sunscreen can leave the skin either through a bathing of everyday usage, with subsequent release into rivers, lakes, seashores, and/or sewage treatment plants. The nanomaterial behaviour, fate and impact in these different systems is largely determined by its surface properties, (e.g. the nanomaterial coating type) and lifetime. The present work aims to develop the eco-design of sunscreens through the minimisation of risks associated with nanomaterials incorporated into the formulation. All stages of the sunscreen’s life cycle must be considered in this aspect, from its manufacture to its end-of-life, through its use by the consumer to its impact on the exposed environment. Reducing the potential release and/or toxicity of the nanomaterial from the sunscreen is a decisive criterion for its eco-design. TiO₂ UV-blockers of varied size and surface coating (e.g., stearic acid and silica) have been selected for this study. Hydrophobic TiO₂ UV-blockers (i.e., stearic acid-coated) were incorporated into a typical water-in-oil (w/o) formulation while hydrophilic, silica-coated TiO₂ UV-blockers were dispersed into an oil-in-water (o/w) formulation. The resulting sunscreens were characterised in terms of nanomaterial localisation, sun protection factor, and photo-passivation. The risk to the direct aquatic environment was assessed by evaluating the release of nanomaterials from the sunscreen through a simulated laboratory aging procedure. The size distribution, surface charge, and degradation state of the nano-composite by-products, as well as their nanomaterial concentration and colloidal behaviour were determined in a variety of aqueous environments (e.g., seawater and freshwater). Release of the hydrophobic nanocomposites into the aqueous environment was driven by oil droplet formation while hydrophilic nano-composites were readily dispersed. Ecotoxicity of the sunscreen by-products (from both w/o and o/w formulations) and their risk to marine organisms were assessed using coral symbiotes and tropical corals, evaluating both lethal and sublethal toxicities. The data dissemination and provided risk knowledge from the present work will help guide regulation related to nanomaterials in sunscreen, provide better information for consumers, and allow for easier decision-making for manufacturers.

Keywords: alteration, environmental fate, sunscreens, titanium dioxide nanoparticles

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Authors: Adila Shaukat, Hussam Al Soub, Muna Al Maslamani, Abdullatif Al Khal

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Background: The aim of this study was to assess clinical presentation and antimicrobial susceptibility of Streptococcus (S.) anginosus group infections in Hamad General Hospital, a tertiary care hospital in the state of Qatar, which is a multinational community. The S. anginosus group is a subgroup of viridans streptococci that consist of 3 different species: S. anginosus, S. constellatus, and S. intermedius. Although a part of the human bacteria flora, they have potential to cause suppurative infections. Method: We studied a total of 101 patients with S. anginosus group infections from January 2006 until March 2012 by reviewing medical records and identification of organisms by VITEK 2 and MALDI-TOF. Results: The most common sites of infection were skin and soft tissue, intra-abdominal, and bacteremia (28.7%, 24.8%, and 22.7%, respectively). Abscess formation was seen in approximately 30% of patients. Streptococcus constellatus was the most common isolated species (40%) followed by S. anginosus(30%) and S. intermedius(7%). In 23% of specimens, the species was unidentified. The most common type of specimen for organism isolation was blood followed by pus and tissue (50%, 22%, and 8%, respectively). Streptococcus constellatus was more frequently associated with abdominal and skin and soft tissue infections than the other 2 species, whereas S. anginosus was isolated more frequently from blood. All isolates were susceptible to penicillin, ceftriaxone, and vancomycin. Susceptibility to erythromycin and clindamycin was also good, reaching 91% and 95%, respectively. Forty percent of patients needed surgical drainage along with antibiotic therapy. Conclusions: Identification of S. anginosus group to species level is helpful in clinical practice because different species exhibit different pathogenic potentials.

Keywords: abscess, bacterial infection, bacteremia, Streptococcus anginosus

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Authors: Meifang Chen

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Background: As China increased its engagement in global health affairs and research, global Health (GH) emerged as a new discipline in China after 2010. Duke Kunshan University (DKU), as a member of the Chinese Consortium of Universities for Global Health, is the first university that experiments “Western-style” liberal arts and sciences (LAS) education pedagogy in GH undergraduate and postgraduate programs in China since 2014. The COVID-19 pandemic has brought significant disruption to education across the world. At the peak of the pandemic, 45 countries in the Europe and Central Asia regions closed their schools, affecting 185 million students. DKU, as many other universities and schools, was unprepared for this sudden abruptness and were forced to build emergency remote learning systems almost immediately. This qualitative study aims to gain a deeper understanding of 1) how Chinese students and parents embrace GH training in the liberal arts and sciences education context, and 2) how the COVID pandemic influences the students’ learning experience as well as affects students and parents’ perceptions of GH-related study and career development in China. Methods: students and parents at DKU were invited and recruited for open-ended, semi-structured interviews during Sept 2021-Mar 2022. Open coding procedures and thematic content analysis were conducted using Nvivo 12 software. Results: A total of 18 students and 36 parents were interviewed. Both students and parents were fond of delivering GH education using the liberal arts and sciences pedagogy. Strengths of LAS included focusing on whole person development, allowing personal enrichment, tailoring curriculum to individual’s interest, providing well-rounded knowledge through interdisciplinary learning, and increasing self-study capacity and adaptability. Limitations of LAS included less time to dive deep into disciplines. There was a significant improvement in independence, creativity, problem solving, and team coordinating capabilities among the students. The impact of the COVID pandemic on GH learning experience included less domestic and abroad fieldwork opportunities, less in-person interactions (especially with foreign students and faculty), less timely support, less lab experience, and coordination challenges due to time-zone difference. The COVID pandemic increased the public’s awareness of the importance of GH and acceptance of GH as a career path. More job and postgraduate program opportunities were expected in near future. However, some parents expressed concerns about GH-related employment opportunities in China. Conclusion: The application of the liberal arts and science education pedagogy in GH training were well-received by the Chinese students and parents. Although global pandemic like COVID disrupted GH learning in many ways, most Chinese students and parents held optimistic attitudes toward GH study and career development.

Keywords: COVID, global health, liberal arts and sciences pedagogy, China

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Authors: Sameh El Mahdy

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Recording and documenting archaeological collections, especially photographic documentation, is considered one of the very important matters that museums care about and give great priority, as photographic documentation is of great importance. We monitor some of them for example, Photographs of collectibles are considered evidence and an archival record that proves the condition of the collectibles at various stages. A photo of the possessions is placed on the paper record of the possessions registration. These photos are used in inventorying archaeological collections. These pictures are viewed by researchers and scholars interested in studying these collections. These images are used in advertising campaigns for museum displays of archaeological collections. The Grand Egyptian Museum is considered one of the museums that is a unique model in terms of establishing a specific system that is used when photographing archaeological collections. The Grand Egyptian Museum sets standards for the photos that are taken inside the Grand Egyptian Museum. We mention some of them for example, Pictures must be of high quality. It is necessary to set a color scale for the drawing in order to clarify the dimensions of the collectibles in the picture and also in order to clarify the natural colors of the collectibles without any additions. Putting the numbers of the collectibles in the pictures, especially the number of the Grand Egyptian Museum. To take a good photo of the artifacts in the Grand Egyptian Museum, there are many steps: (1) Create a good location, (2) How to handle the Artifacts. (3) Choose the best position for the artifact, (4) Make the light to create a good photo without shadows to make the photo represent all the artifact details. (5) Be sure of the camera settings, and their quality. All of these steps and other ones are the best criteria for taking the best photo, which helps us in the database to represent the details of the artifact in our interface.

Keywords: grand egyptian museum, photographing, museum collections, registration and documentation

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Authors: Abimbola Motunrayo Enitan, Ibironke Titilayo Enitan, John Odiyo

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The study assessed quality of surface water across Ndawuse River Phase 1, District of the Federal Capital Territory (FCT), Abuja, Nigeria based on physico-chemical variables that are linked to agrochemical and eutrophication, as well as heavy metals concentrations. In total, sixteen surface water samples were obtained from five locations along the river. The results were compared with the standard limits set by both World Health Organization and Federal Environmental Protection Agency for drinking water. The results obtained indicated that BOD5, turbidity, 0.014-3.511 mg Fe/L and 0.078-0.14 mg Cr/L were all above the standard limits. The results further showed that the quality of surface water is being significantly affected by human activities around the Ndawuse River which could pose an adverse health risk to several communities that rely on these receiving water bodies primarily as their source of water. Therefore, there is a need for strict enforcement of environmental laws considering the physico-chemical analysis.

Keywords: Abuja, heavy metals, human exposure risk, Ndawuse River, Nigeria, surface water

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Authors: Alvaro Valera Sosa

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Background: In recent years, childhood overweight and obesity have become an increasing and challenging phenomenon in Berlin and Germany in general. The highest shares of childhood overweight in Berlin are district localities within the inner city ring with lowest socio-economic levels and the highest number of migration background populations. Most factors explaining overweight and obesity are linked to individual dispositions and nutrition balances. Among various strategies, to target drinking behaviors of children and adolescents has been proven to be effective. On the one hand, encouraging the intake of water – which does not contain energy and thus may support a healthy weight status – on the other hand, reducing the consumption of sugar-containing beverages – which are linked to weight gain and obesity. Anyhow, these preventive approaches have mostly developed into individual or educational interventions widely neglecting environmental modifications. Therefore, little is known on how urban physical environment patterns and features can act as influence factors for childhood overweight. Aiming the development of a physical environment intervention tackling children overweight, this study evaluated urban situations surrounding public playgrounds in Berlin where the issue is evident. It verified the presence and state of physical environmental conditions that can be conducive for children to engage physical activity and water intake. Methods: The study included public playgrounds for children from 0-12 y/o within district localities with the highest prevalence of childhood overweight, highest population density, and highest mixed uses. A systematic observation was realized to describe physical environment patterns and features that may affect children health behavior leading to overweight. Neighborhood walkability for all age groups was assessed using the Walkability for Health framework (TU-Berlin). Playground physical environment conditions were evaluated using Active Living Research assessment sheets. Finally, the food environment in the playground’s pedestrian catchment areas was reviewed focusing on: proximity to suppliers offering sugar-containing beverages, and physical access for 5 y/o children and up to drinking water following the Drinking Fountains and Public Health guidelines of the Pacific Institute. Findings: Out of 114 locations, only 7 had a child population over 3.000. Three with the lowest socio-economic index and highest percentage of migration background were selected. All three urban situations presented similar walkability: large trafficked avenues without buffer bordering at least one side of the playground, and important block to block disconnections for active travel. All three playgrounds rated equipment conditions from good to very good. None had water fountains at the reach of a 5 y/o. and all presented convenience stores and/or fast food outlets selling sugar-containing beverages nearby the perimeter. Conclusion: The three playground situations selected are representative of Berlin locations where most factors that influence children overweight are found. The results delivered urban and architectural design directives for an environmental intervention, used to study children health-related behavior. A post-intervention evaluation could prove associations between designed spaces and children overweight rate reduction creating a precedent in public health interventions and providing novel strategies for the health sector.

Keywords: children overweight, evaluation research, public playgrounds, urban design, urban health

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Authors: Anela Lupuwana

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The main objective of this paper is to develop an ethnobotanical survey that documents medicinal plants used to treat diarrhea among infants in the Eastern Cape province of South Africa. In South Africa’s pluralistic healthcare system, medicinal plants are an integral part of healing and treating an array of diseases. This is also the case in rural areas of South Africa, where healthcare facilities are hard to access. There is a lack of literature on the use of medicinal plants to cure ailments common to children, and this paper fills this gap. A total of 18 participants were interviewed using semi-structured interviews. A purposive approach was used to sample the study cohorts. A total of 28 medicinal plants representing 19 different families were recorded, with the family Asteraceae (11%) having the most medicinal plants. The remaining plants (82%) were distributed equally among the following families: Rubiaceae, Canellaceae, Aloaceae, Rutaceae, Thymeleaceae, Myrinaceae, Olinaceae, Iradeceae, Zingiberaceae, Capparaceae, Aizoaceae, Fabaceae, Geraniaceae, Cornaceae, Monimiaceae, Talinaceae, Chrysobalanaceae, and Icacinaceae. Oral administration was the most common mode of administration, with 82% of plants taken orally. Healing was proven to be holistic; it was more than just treating physical ailments as such; infants were protected from evil spirits that made them vulnerable to illnesses. There was also evidence of the assimilation of Dutch medicine and animal products into traditional healing methods. In order to mitigate the prevalence of disease and illness in South Africa, I recommend that diversity in healing practices should be acknowledged and appreciated.

Keywords: infants, traditional healers, primary care givers, traditional medicine

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Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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Authors: Giorgio Visentin, Alexei A. Buchachenko

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Recent proposals to use Yb dimer as an optical clock and as a sensor for non-Newtonian gravity imply the knowledge of its interaction potential. Here, the ground-state Born-Oppenheimer Yb₂ potential energy curve is represented by a semi-analytical function, consisting of short- and long-range contributions. For the former, the systematic ab initio all-electron exact 2-component scalar-relativistic CCSD(T) calculations are carried out. Special care is taken to saturate diffuse basis set component with the atom- and bond-centered primitives and reach the complete basis set limit through n = D, T, Q sequence of the correlation-consistent polarized n-zeta basis sets. Similar approaches are used to the long-range dipole and quadrupole dispersion terms by implementing the CCSD(3) polarization propagator method for dynamic polarizabilities. Dispersion coefficients are then computed through Casimir-Polder integration. The semiclassical constraint on the number of the bound vibrational levels known for the ¹⁷⁴Yb isotope is used to scale the potential function. The scaling, based on the most accurate ab initio results, bounds the interaction energy of two Yb atoms within the narrow 734 ± 4 cm⁻¹ range, in reasonable agreement with the previous ab initio-based estimations. The resulting potentials can be used as the reference for more sophisticated models that go beyond the Born-Oppenheimer approximation and provide the means of their uncertainty estimations. The work is supported by Russian Science Foundation grant # 17-13-01466.

Keywords: ab initio coupled cluster methods, interaction potential, semi-analytical function, ytterbium dimer

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Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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Authors: Ahmed Noor Al-Qayyim

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During the past decades, the bridge structures are considered very important portions of transportation networks, due to the fast urban sprawling. With the failure of bridges that under operating conditions lead to focus on updating the default bridge inspection methodology. The structures health monitoring (SHM) using the vibration response appeared as a promising method to evaluate the condition of structures. The rapid development in the sensors technology and the condition assessment techniques based on the vibration-based damage detection made the SHM an efficient and economical ways to assess the bridges. SHM is set to assess state and expects probable failures of designated bridges. In this paper, a presentation for Frequency Response function method that uses the captured vibration test information of structures to evaluate the structure condition. Furthermore, the main steps of the assessment of bridge using the vibration information are presented. The Frequency Response function method is applied to the experimental data of a full-scale bridge.

Keywords: bridge assessment, health monitoring, damage detection, frequency response function (FRF), signal processing, structure identification

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Authors: Abanoub Rady Shaker Saleb

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Nowadays, design and architecture are being affected and underwent change with the rapid advancements in technology, economics, politics, society and culture. Architecture has been transforming with the latest developments after the inclusion of computers into design. Integration of design into the computational environment has revolutionized the architecture and new perspectives in architecture have been gained. The history of architecture shows the various technological developments and changes in which the architecture has transformed with time. Therefore, the analysis of integration between technology and the history of the architectural process makes it possible to build a consensus on the idea of how architecture is to proceed. In this study, each period that occurs with the integration of technology into architecture is addressed within historical process. At the same time, changes in architecture via technology are identified as important milestones and predictions with regards to the future of architecture have been determined. Developments and changes in technology and the use of technology in architecture within years are analyzed in charts and graphs comparatively. The historical process of architecture and its transformation via technology are supported with detailed literature review and they are consolidated with the examination of focal points of 20th-century architecture under the titles; parametric design, genetic architecture, simulation, and biomimicry. It is concluded that with the historical research between past and present; the developments in architecture cannot keep up with the advancements in technology and recent developments in technology overshadow the architecture, even the technology decides the direction of architecture. As a result, a scenario is presented with regards to the reach of technology in the future of architecture and the role of the architect.

Keywords: design and development the information technology architecture, enterprise architecture, enterprise architecture design result, TOGAF architecture development method (ADM)

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Authors: Alexi Colleen F. Lim, Inna Felicia I. Agoncillo, Quenniejoy T. Dizon, Jennifer Joyce T. Eti, Carlota Aileen H. Monares, Neil Roy B. Rosales, Joshua F. Santillan, Alyssa Francesca D. S. Tanchuling, Josefina A. Tuazon, Mary Joan Therese C. Valera-Kourdache

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Majority of leading causes of mortality in the Philippines are NCDs, which are preventable through control of known risk factors such as smoking, obesity, physical inactivity, and alcohol. Sugar-sweetened beverages such as soda and energy drinks also contribute to NCD risk and are of concern particularly for youth. This study provides baseline data on beverage consumption of university students in Manila with the focus on alcohol and soda. It further aims to identify factors affecting consumption. Specific objectives include: (1) to describe beverage consumption practices of university students in Manila; and (2) to determine factors promoting excessive consumption of alcohol and soda including demographic characteristics, attitude, interpersonal and environmental variables. Methods: The study employed correlational design with randomly selected students from two universities in Manila. Students 18 years or older who agreed to participate were included after obtaining ethical clearance. The study had two instruments: (1) World Health Organization’s Alcohol Use Disorders Identification Test (AUDIT) was used with permission, to determine excessive alcohol consumption; and (2) a questionnaire to obtain information regarding soda and energy drink consumption. Results: Out of 400 students surveyed, 70% were female and 78.75% were 18-20 years old (mean=19.79; SD=3.76). Among them, 51.50% consumed alcohol, with 30.10% excessive drinkers. Soda consumption is 91.50% with 37.70% excessive consumers. For energy drinks, 36.75% consume this and only 4.76% drink excessively. Using logistic regression, students who were more likely to be excessive alcohol drinkers belonged to non-health courses (OR=2.21) and purchased alcohol from bars (OR=7.84). Less likely to drink excessively are students who do not drink due to stress (OR=0.05) and drink when it is accessible (OR=0.02). Excessive soda consumption was less likely for female students (OR=0.28), those who drink when it is accessible (OR=0.14), do not drink soda during stressful situations (OR=0.19), and do not use soda as hangover treatment (OR=0.15). Conclusion: Excessive alcohol consumption was greater among students in Manila (30.10%) than in US (20%). Drinking alcohol with friends was not related to excessive consumption but availability in bars was. It is expected that health sciences students are less likely to engage in excessive alcohol as they are more aware of its ill effects. Prevalence of soda consumption in Manila (91.50%) is markedly higher compared to 24.5% in the US. These findings can inform schools in developing appropriate health education interventions and policies. For greater understanding of these behaviors and factors, further studies are recommended to explore knowledge and other factors that may promote excessive consumption.

Keywords: alcohol consumption, beverage consumption, energy drinks consumption, soda consumption, university students

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Authors: Joana Margarida Bôto, Belmira Neto, Vera Miguéis, Manuela Meireles, Ada Rocha

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The Mediterranean diet has been recognized as a sustainable model of living with benefits for the environment and human health. However, a complete assessment of its sustainability, encompassing all dimensions and aspects, to our best knowledge, has not yet been realized. This systematic literature review aimed to fill this gap by identifying and describing the indicators used to assess the sustainability of the Mediterranean diet, looking at several dimensions, and presenting the results from their application. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines methodology was used, and searches were conducted in PubMed, Scopus, Web of Science, and GreenFile. There were identified thirty-two articles evaluating the sustainability of the Mediterranean diet. The environmental impact was quantified in twenty-five of these studies, the nutritional quality was evaluated in seven studies, and the daily cost of the diet was assessed in twelve studies. A total of thirty-three indicators were identified and separated by four dimensions of sustainability, specifically, the environmental dimension (ten indicators, namely carbon, water, and ecological footprint), the nutritional dimension (eight indicators, namely Health score and Nutrient Rich Food Index), the economic dimension (one indicator, the dietary cost), the sociocultural dimension (six indicators – with no results). Only eight of the studies used combined indicators. The Mediterranean diet was considered in all articles as a sustainable dietary pattern with a lower impact than Western diets. The carbon footprint ranged between 0.9 and 6.88 kg CO₂/d per capita, the water footprint between 600 and 5280 m³/d per capita, and the ecological footprint between 2.8 and 53.42 m²/d per capita. The nutritional quality was high, obtaining 122 points using the Health score and 12.95 to 90.6 points using the Nutrient Rich Food Index. The cost of the Mediterranean diet did not significantly differ from other diets and varied between 3.33 and 14.42€/d per capita. A diverse approach to evaluating the sustainability of the Mediterranean diet was found.

Keywords: Mediterranean diet, sustainability, environmental indicators, nutritional indicators

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Authors: John Chau, Tzvi Aviv

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Cardiometabolic conditions (hypertension, diabetes, and hyperlipidemia) are major public health concerns. Analysis of all prescription records from about 10 million patients at the largest network of pharmacies in Canada reveals small year-over-year increases in the treatment prevalence of cardiometabolic diseases prior to the COVID-19 pandemic. Cardiometabolic treatment rates increase with age and are higher in males than females. Hypertension treatment rates were 24% in males and 19% in females in 2021. Diabetes treatment rates were 10% in males and 7% in females in 2021. Geospatial analysis using patient addresses reveals interesting differences among provinces and neighborhoods in Canada. Using digital surveys distributed among 8,504 Canadian adults, an increase in hypertension awareness with age and female gender was observed. However, 7% of seniors and 6% of middle-aged Canadians reported uncontrolled blood pressure (>140/90 mmHg). In addition, elevated blood pressure (130-139/80-89 mmHg) was reported by 20% of seniors and 14% of middle-aged Canadians.

Keywords: cardiometabolic conditions, diabetes, hypertension, precision public health

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Authors: Pangkaj Kumar Mahanta, Md. Rafizul Islam

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The rapid growth of the population causes a substantial amount of increase in household waste all over the world. Waste management is becoming one of the most challenging phenomena in the present day. The most environmentally friendly final disposal process of waste is sanitary landfilling, which is practiced in most developing countries. However, in Southeast Asia, most of the final disposal point is an open dump site. Due to the ignominy of proper management of waste and monitoring, the surrounding environment gets polluted more by the open dump site in comparison with a sanitary landfill. Khulna is 3rd largest metropolitan city in Bangladesh, having a population of around 1.5 million and producing approximately 450 tons per day of Municipal Solid Waste. The Municipal solid waste of Khulna city is disposed of in Rajbandh open dump site. The surrounding air is being polluted by the gas produced in the open dump site. Also, the open dump site produces leachate, which contains various heavy metals like Cadmium (Cd), Chromium (Cr), Lead (Pb), Manganese (Mn), Mercury (Hg), Strontium (Sr), etc. Leachate pollutes the soil as well as the groundwater of the open dump site and also the surrounding area through seepage. Moreover, during the rainy season, the surface water is polluted by leachate runoff. Also, the plastic waste flowing out from the open dump site through various drivers pollutes the nearby environment. The health risk assessment associated with heavy metals was carried out by computing the chronic daily intake (CDI), hazard quotient (HQ), and hazard index (HI) via different exposure pathways following the USEPA guidelines. For ecological risk, potential contamination index (Cp), Contamination factor (CF), contamination load index (PLI), numerical integrated contamination factor (NICF), enrichment factor (EF), ecological risk index (ER), and potential ecological risk index (PERI) were computed. The health risk and ecological risk assessment results reveal that some heavy metals possess strong health and ecological risk. In addition, the child faces higher harmful health risks from several heavy metals than the adult for all the exposure pathways and media. The conversion of an open dump site into a sanitary landfill and a proper management system can reduce the problems associated with an open dump site. In the sanitary landfill, the produced gas will be managed properly to save the surrounding atmosphere from being polluted. The seepage of leachate can be minimized by installing a compacted clay layer (CCL) as a baseline and leachate collection in a sanitary landfill to save the underlying soil layer and surrounding water bodies from leachate. Another important component of a sanitary landfill is the conversion of plastic waste to energy will minimize the plastic pollution in the landfill area and also the surrounding soil and water bodies. Also, in the sanitary landfill, the bio-waste can be used to make compost to reduce the volume of bio-waste and proper utilization of the landfill area.

Keywords: ecological risk, health risk, open dump site, sanitary landfill

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Authors: Kgantsi B. T., Ochwelwang A. R., Mathuthu M., Jegede O. A.

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Anthropogenic activities near water bodies contribute to poor water quality, which degrades the condition of the biota and elevates the risk to human health. The Vaal River is essential in supplying Gauteng and neighboring regions of South Africa with portable water for a variety of consumers and industries. Consequently, it is necessary to monitor and assess the radioactive risk in relation to the river's water quality. This study used an inductive coupled plasma mass spectrometer (ICPMS) to analyze the radionuclide activity concentration in the Vaal River, South Africa. Along with thorium and potassium, the total uranium concentration was calculated using the isotopic content of uranium. The elemental concentration of ²³⁸U, ²³⁵U, ²³⁴U, ²³²Th, and 40K were translated into activity concentrations. To assess the water safety for all users and consumers, all values were compared to world average activity concentrations 35, 30, and 400 Bqkg⁻¹ for ²³⁸U, ²³⁴Th, and ⁴⁰K, respectively, according to the UNSCEAR report. The results will serve as a database for further monitoring and evaluation of the radionuclide from the river, taking cognisance of potential health hazards.

Keywords: Val Rivers, ICPMS, uranium, risks

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Authors: Pedro Gomes, Lia Ferreira, Sofia Garcia, Jaime Babulal, Luís Costa, Luís Castelo, José Muras, Isabel Gonçalves, Rui Carvalho

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Introduction: Foot ulcers and their complications are an important cause of morbidity and mortality in diabetes. Objectives: The present study aims to evaluate the outcomes in terms of need for hospitalization, amputation, healing time and mortality in patients with new-onset diabetic foot ulcers in subgroups stratified by etiology. Methods: A retrospective study based on clinical assessment of patients presenting with new ulcers to a multidisciplinary diabetic foot consult during 2012. Outcomes were determined until September 2014, from hospital registers. Baseline clinical examination was done to classify ulcers as neuropathic, ischemic or neuroischemic. Results: 487 patients with new diabetic foot ulcers were observed; 36%, 15% and 49% of patients had neuropathic, ischemic and neuroischemic ulcers, respectively. For analysis, patients were classified as having predominantly neuropathic (36%) or ischemic foot (64%). The mean age was significantly higher in the group with ischemic foot (70±12 vs 63±12 years; p <0.001), as well as the duration of diabetes (18±10 vs 16 ± 10years, p <0.05). A history of previous amputation was also significantly higher in this group (24.7% vs 15.6%, p <0.05). The evolution of ischemic ulcers was significantly worse, with a greater need for hospitalization (27.2% vs 18%, p <0.05), amputation (11.5% vs 3.6% p <0.05) mainly major amputation (3% vs. 0%; p <0.001) and higher mean healing time (151 days vs 89 days, p <0.05). The mortality rate at 18 months, was also significantly higher in the ischemic foot group (7.3% vs 1.8%, p <0.05). Conclusions: All types of diabetic foot ulcers are associated with high morbidity and mortality, however, the presence of arterial disease confers a poor prognosis. Diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care.

Keywords: diabetes, foot ulcers, etiology, outcome

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Authors: Andrew T. Hendrickson, Liven De Marez, Marijn Martens, Gytha Muller, Tudor Paisa, Koen Ponnet, Catherine Schweizer, Megan Van Meer, Mariek Vanden Abeele

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Quantifying and understanding the myriad ways people use their phones and how that impacts their relationships, cognitive abilities, mental health, and well-being is increasingly important in our phone-centric society. However, most studies on the patterns of phone use have focused on theory-driven tests of specific usage hypotheses using self-report questionnaires or analyses of smaller datasets. In this work we present a series of analyses from a large corpus of over 3000 users that combine data-driven and theory-driven analyses to identify reliable smartphone usage patterns and clusters of similar users. Furthermore, we compare the stability of user clusters across user- and system-initiated sessions, as well as during the hypothesized ritualized behavior times directly before and after sleeping. Our results indicate support for some hypothesized usage patterns but present a more complete and nuanced view of how people use smartphones.

Keywords: data mining, experience sampling, smartphone usage, health and well being

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Authors: Nana Segu Acquaah-Harrison, James Osei Mensah, Richard Aidoo, David Amponsah, Amy Buah, Gilbert Aboagye

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The study aimed at assessing the feasibility of commercial meat rabbit production in the Kumasi Metropolis of Ghana. Structured and unstructured questionnaires were utilized in obtaining information from two hundred meat consumers and 15 meat rabbit farmers. Data were analyzed using Net Present Value (NPV), Internal Rate of Return (IRR), Benefit Cost Ratio (BCR)/Profitability Index (PI) technique, percentages and chi-square contingency test. The study found that the current demand for rabbit meat is low (36%). The desirable nutritional attributes of rabbit meat and other socio economic factors of meat consumers make the potential demand for rabbit meat high (69%). It was estimated that GH¢5,292 (approximately $ 2672) was needed as a start-up capital for a 40-doe unit meat rabbit farm in Kumasi Metropolis. The cost of breeding animals, housing and equipment formed 12.47%, 53.97% and 24.87% respectively of the initial estimated capital. A Net Present Value of GH¢ 5,910.75 (approximately $ 2984) was obtained at the end of the fifth year, with an internal rate return and profitability index of 70% and 1.12 respectively. The major constraints identified in meat rabbit production were low price of rabbit meat, shortage of fodder, pest and diseases, high cost of capital, high cost of operating materials and veterinary care. Based on the analysis, it was concluded that meat rabbit production is feasible in the Kumasi Metropolis of Ghana. The study recommends embarking on mass advertisement; farmer association and adapting to new technologies in the production process will help to enhance productivity.

Keywords: feasibility, commercial meat rabbit, production, Kumasi, Ghana

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Authors: Anil Khanal, Ali Osareh, Gary Lebby

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Wind energy offers a significant advantage such as no fuel costs and no emissions from generation. However, wind energy sources are variable and non-dispatchable. The utility grid is able to accommodate the variability of wind in smaller proportion along with the daily load. However, at high penetration levels, the variability can severely impact the utility reserve requirements and the cost associated with it. In this paper, the impact of wind energy is evaluated in detail in formulating the total utility cost. The objective is to minimize the overall cost of generation while ensuring the proper management of the load. Overall cost includes the curtailment cost, reserve cost and the reliability cost as well as any other penalty imposed by the regulatory authority. Different levels of wind penetrations are explored and the cost impacts are evaluated. As the penetration level increases significantly, the reliability becomes a critical question to be answered. Here, we increase the penetration from the wind yet keep the reliability factor within the acceptable limit provided by NERC. This paper uses an economic dispatch (ED) model to incorporate wind generation into the power grid. Power system costs are analyzed at various wind penetration levels using Linear Programming. The goal of this study shows how the increases in wind generation will affect power system economics.

Keywords: wind power generation, wind power penetration, cost analysis, economic dispatch (ED) model

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Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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Authors: Mahmoud Nabilu

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The present study explored the effect of using Mobile listening applications on developing listening skills by Iranian intermediate EFL learners. Fifty male intermediate English learners whose age range was between 15 and 20, participated in the study. The participants were placed in two groups on the basis of their scores on a placement test. Therefore, the participants of the study were homogenized in terms of general proficiency, and groups were assigned as one experimental group and one control group. The experimental group was instructed by the treatment which was using mobile applications to develop their listening skills while the control group received traditional methods. The research data were obtained from the 40-item multiple-choice tests as a pre-test and a post-test. The results of the t-test clearly revealed that the learners in the experimental group performed better in the post-test than the pre-test. This implies that using a mobile application for developing listening skills as a treatment was effective in helping the language learners perform better on post-test. However, a statistically significant difference was found between the post-tests scores of the two groups. The mean of the experimental group was greater compared to the control group. The participants were Iranian and from an Iranian Language Institute, so care should be taken while generalizing the results to the learners of other nationalities. However, in the researcher's view, the findings of this study have valuable implications for teachers and learners, methodologists and syllabus designers, linguists and MALL/CALL (mobile/computer-assisted language learning) experts. Using the result of the present paper is an aim of raising the consciousness of a better technique of developing listening skills in order to make language learning more efficient for the learners.

Keywords: Mobile listening applications, intermediate EFL learners, MALL, CALL

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Authors: Yuki Hara

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Healthy assets are recognized as important for all people in the world through experiencing COVID-19. Each part of life and work is important to be changed against the preceding wide-spreading of COVID-19. Furthermore, it is necessary to innovate the whole structure of a city upon the sum of the parts. This study aims at creating a comprehensive strategy from a small practice of making healthier lives with collaborating local actors for a city. This paper employs action research as the research framework. The core practice is the 'Ken’iku Festival' at Ken’iku Festival Committee. The field locates the urban-rural fringe in the northwest part of Fujisawa city, Kanagawa prefecture, Japan. The data is collected through the author's practices for three years from the observations and interviews at meetings and discussions among stakeholders, texts in municipal reports, books, and movies, 3 questionnaires for customers and stakeholders at the Ken’iku Festival. These data are analysed by qualitative methods. The results show that couples in their 40s with children and couples or friends over the 70s are at the heart of promoting healthy lifestyles. In contrast, 40% of the visitors at the festival are the people who have no idea or no interest in healthier actions, which the committee has to suggest healthy activities through more pleasing services. The committee could organize staff and local actors as the core parties involved through gradually expanding its tasks relating to the local practices. This private sectoral activity from health promotion is covering a part of the whole-city planning of Fujisawa municipality by including many people over organisations into one community. This paper concludes from local practice networking through the festival that a comprehensive strategy for a healthy city is both a practical approach easily applied to each partner and one of the holistic services.

Keywords: communal practice network, healthy cities, health & development, health promotion, with and after COVID-19

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Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

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This paper adopted a retrospective review of China’s assistance to Latin America from the1950s to 2020. Findings suggested that China’s assistance to Latin America can be roughly divided into five stages: The 1950s to 1960s was the initial stage of China’s assistance to Latin America, mainly focusing on the establishment of diplomatic relations with Cuba and other Latin American countries. The strategy has a strong ideological basis. The 1980s was the stage of development of China's aid to Latin America, which was characterized by consolidating and expanding diplomatic space, emphasizing the spirit of cooperation of equality, mutual benefit, and common development. 90-20 marked the further development of diplomatic relations with Latin American countries, plus domestic market-oriented reforms, emphasizing the importance of economic considerations and less ideological orientation, and this period also witnessed more Chinese state-owned enterprises going out to invest in Latin America. 2010-2019 marked the further development of Latin American relations. This paper contributes to the literature of diplomacy and health assistance to Latin America and highlights the importance of foreign aid and health assistance in sealing bilateral diplomatic relations.

Keywords: aid, china, latin america, bilateral relations

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Authors: Birendra Kumar Jha, Mingma L. Sherpa, Binod Kumar Dahal

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Background: The metabolic syndrome is emerging as a major public health concern in the world. Urbanization, surplus energy uptake, compounded by decreased physical activities, and increasing obesity are the major factors contributing to the epidemic of metabolic syndrome worldwide. However, prevalence of metabolic syndrome and its risk factors are little studied in Terai region of Nepal. The objectives of this research were to estimate the prevalence and to identify the risk factors of metabolic syndrome among adults in Terai region of Nepal. Method: We used a community based cross sectional study design. A total of 225 adults (age: 18 to 80 years) were selected from three district of Terai region of Nepal using cluster sampling by camp approach. IDF criteria (central obesity with any two of following four factors: triglycerides ≥ 150 mg/dl or specific treatment for lipid abnormality, reduced HDL, raised blood pressure and raised fasting plasma glucose or previously diagnosed type 2 diabetes) were used to assess metabolic syndrome. Interview, physical and clinical examination, measurement of fasting blood glucose and lipid profile were conducted for all participants. Chi-square test and multivariable logistic regression were employed to explore the risk factors of metabolic syndrome. Result: The overall prevalence of metabolic syndrome was 70.7%. Hypertension, increased fasting blood sugar, increased triglycerides and decreased HDL were observed in 50.7%, 32.4%, 41.8% and 79.1% of the subjects respectively. Socio-economic and behavioral risk factors significantly associated with metabolic syndrome were gender male (OR=2.56, 955 CI: 1.42-4.63; p=0.002), in service or retired from service (OR=3.72, 95% CI: 1.72-8.03; p=0.001) and smoking (OR= 4.10, 95% CI: 1.19-14.07; p=0.016). Conclusion: Higher prevalence of Metabolic syndrome along with presence of behavioral risk factors in Terai region of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate the need to promote public health programs in this region to maintain quality of life.

Keywords: metabolic syndrome, Nepal, prevalence, risk factors, Terai

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Authors: Ndukwe, Chinedu O.

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Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

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Authors: Abigail Bentley, Audrey Prost, Nayreen Daruwalla, Apoorwa Gupta, David Osrin

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BACKGROUND: Intimate partner violence (IPV) can impact a woman’s physical, reproductive and mental health, including common mental disorders such as anxiety and depression. However, people other than an intimate partner may also perpetrate violence against women in the family, particularly in India. This study aims to investigate the relationship between experiences of violence perpetrated by the husband and other members of the wider household and symptoms of common mental disorders in women residing in informal settlement (slum) areas of Mumbai. METHODS: Experiences of violence were assessed through a detailed cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points in the woman’s life and the main perpetrator of each act. Symptoms of common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scores were divided into four groups and the relationship between experiences of each type of violence in the last 12 months and GHQ-12 score group was analyzed using ordinal logistic regression, adjusted for the woman’s age and clustering. RESULTS: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 7 years of education and had been married 9 years. 88% were Muslim and 47% lived in joint and 53% in nuclear families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 23% physical, 12% sexual). 7% had a high GHQ-12 score (6 or above). For violence experiences in the last 12 months, the odds of being in the highest GHQ-12 score group versus the lower groups combined were 13.1 for emotional violence, 6.5 for economic, 5.7 for physical and 6.3 for sexual (p<0.001 for all outcomes). DISCUSSION: The high level of violence reported across the lifetime could be due to the detailed assessment of violent acts at multiple time points and the inclusion of perpetrators within the family other than the husband. Each type of violence was associated with greater odds of a higher GHQ-12 score and therefore more symptoms of common mental disorders. Emotional violence was far more strongly associated with symptoms of common mental disorders than physical or sexual violence. However, it is not possible to attribute causal directionality to the association. Further work to investigate the relationship between differing severity of violence experiences and women’s mental health and the components of emotional violence that make it so strongly associated with symptoms of common mental disorders would be beneficial.

Keywords: common mental disorders, family violence, India, informal settlements, mental health, violence against women

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Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

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Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

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Authors: Gulay Aras, Isil Kutluturk Karagoz, Z. Candan Algun

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Background: Hypermetropia in school-age is a pathology that responds to treatment. In the literature, there has been no study of exercise practice in hypermetropia treatment. Objective: The purpose of this study was to investigate the effects of eye exercises and convergence exercise on visual acuity in school-age children with hypermetropia. Methods: Forty volunteer school-age children with hypermetropia (30 girls, 30 boys, between 7-17 years of age) were included in the study. Sociodemographic information and clinical characteristics were evaluated. 40 participants were randomly divided into two groups: eye exercises and convergence exercises. Home exercise protocols were given to all groups for six weeks, and regular phone calls were made once a week. Individuals performed eye exercises 10 times, convergence exercises 5 min. for two sessions per day for six weeks. The right and left eyes of all the subjects participating in the study were assessed separately by the eye doctor with a Snellen chart. The participants' quality of life was assessed using Pediatric Quality of Life Inventory Version 4.0. Physical health total score (PHTS) and scale total score (STS), which were obtained by evaluating Psychosocial health total score (PSHTS) school, emotional and social functioning, were calculated separately in the scores. At the end of the exercise program, the assessment tests applied at the beginning of the study were reapplied to all individuals. Results: There was no statistically significant difference between the pre- and post-Snellen chart measurements and quality of life in the eye exercises group (p > 0,05). There was a statistically significant difference in visual acuity of right and left eyes (p=0,004, p=0,014) and quality of life in PHTS, PSHTS and STS in the convergence exercise group (p=0,001, p=0,017, p=0,001). Conclusions: In school-age children, convergence exercises were found to be effective on visual acuity and health-related quality of life. Convergence exercises are recommended for the treatment of school-aged children with hypermetropia.

Keywords: convergence exercise, eye exercises, hypermetropia, school-age children

Procedia PDF Downloads 238