Search results for: advance care planning

Authors: Mara Balestrieri

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Climate change has long been the focus of attention for the growing impact of extreme weather events and global warming in many areas of the planet and the evidence of economic, social, and environmental damage caused by global warming. Nowadays, climate change is recognized as a critical global problem. Several initiatives have been undertaken over time to enhance the long theoretical debate and field experience in order to reduce Co2 emissions and contain climate alteration. However, the awareness that climate change is already taking place has led to a growing demand for adaptation. It is certainly a matter of anticipating the negative effects of climate change but, at the same time, implementing appropriate actions to prevent climate change-related damage, minimize the problems that may result, and also seize any opportunities that may arise. Consequently, adaptation has become a core element of climate policy and research. However, the attention to this issue has not developed in a uniform manner across countries. Some countries are further ahead than others. This paper examines the literature on climate change adaptation developed until 2018 in Italy, considering the urban dimension, to provide a framework for it, and to identify main topics and features. The papers were selected from Scopus and were analyzed through a matrix that we propose. Results demonstrate that adaptation to climate change studies attracted increasing attention from Italian scientific communities in the last years, although Italian scientific production is still quantitatively lower than in other countries and describes strengths and weaknesses in line with international panorama with respect to objectives, sectors, and problems.

Keywords: adaptation, bibliometric literature, climate change, urban studies

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Authors: Mir Mohammad Reza Hosseini

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In new years immune checkpoint inhibitors have gathered care as being one of the greatest talented kinds of immunotherapy on the prospect. There has been a specific emphasis on the immune checkpoint molecules, cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1). In 2011, ipilimumab, the primary antibody obstructive an immune checkpoint (CTLA4) was authorized. It is now documented that recognized tumors have many devices of overpowering the antitumor immune response, counting manufacture of repressive cytokines, staffing of immunosuppressive immune cells, and upregulation of coinhibitory receptors recognized as immune checkpoints. This was fast followed by the growth of monoclonal antibodies directing PD1 (pembrolizumab and nivolumab) and PDL1 (atezolizumab and durvalumab). Anti-PD1/PDL1 antibodies have developed some of the greatest extensively set anticancer therapies. We also compare and difference their present place in cancer therapy and designs of immune-related toxicities and deliberate the role of dual immune checkpoint inhibition and plans for the organization of immune-related opposing proceedings. In this review, the employed code and present growth of numerous immune checkpoint inhibitors are abridged, while the communicating device and new development of Immune checkpoint inhibitors in cancer therapy-based synergistic therapies with additional immunotherapy, chemotherapy, phototherapy, and radiotherapy in important and clinical educations in the historical 5 years are portrayed and tinted. Lastly, we disapprovingly measure these methods and effort to find their fortes and faintness based on pre-clinical and clinical information.

Keywords: checkpoint, cancer therapy, PD-1, PDL-1, CTLA4, immunosuppressive

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Authors: Ashok Kumar, Parveen Parveen

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India is bestowed with an extremely high population of plant species with medicinal value and even has two biodiversity hotspots. Indian systems of medicine including Ayurveda, Siddha and Unani have historically been serving humankind across the world since time immemorial. About 1500 plant species have well been documented in Ayurvedic Nighantus as official medicinal plants. Additionally, several hundred species of plants are being routinely used as medicines by local people especially tribes living in and around forests. The natural resources for medicinal plants have unscientifically been over-exploited forcing rapid depletion in their genetic diversity. Moreover, renewed global interest in herbal medicines may even lead to additional depletion of medicinal plant wealth of the country, as about 95% collection of medicinal plants for pharmaceutical preparation is being carried out from natural forests. On the other hand, huge export market of medicinal and aromatic plants needs to be seriously tapped for enhancing inflow of foreign currency. Asparagus racemosus Willd., a member of family Liliaceae, is one of thirty-two plant species that have been identified as priority species for cultivation and conservation by the National Medicinal Plant Board (NMPB), Government of India. Though attention is being focused on standardization of agro-techniques and extraction methods, little has been designed on genetic improvement and selection of desired types with higher root production and saponin content, a basic ingredient of medicinal value. The saponin not only improves defense mechanisms and controls diabetes but the roots of this species promote secretion of breast milk, improved lost body weight and considered as an aphrodisiac. There is ample scope for genetic improvement of this species for enhancing productivity substantially, qualitatively and quantitatively. It is emphasized to select desired genotypes with sufficient genetic diversity for important economic traits. Hybridization between two genetically divergent genotypes could result in the synthesis of new F1 hybrids consisting of useful traits of both the parents. The evaluation of twenty seed sources of Asparagus racemosus assembled different geographical locations of India revelled high degree of variability for traits of economic importance. The maximum genotypic and phenotypic variance was observed for shoot height among shoot related traits and for root length among root related traits. The shoot height, genotypic variance, phenotypic variance, genotypic coefficient of variance, the phenotypic coefficient of variance was recorded to be 231.80, 3924.80, 61.26 and 1037.32, respectively, where those of the root length were 9.55, 16.80, 23.46 and 41.27, respectively. The maximum genetic advance and genetic gain were obtained for shoot height among shoot-related traits and root length among root-related traits. Index values were developed for all seed sources based on the four most important traits, and Panthnagar (Uttrakhand), Jodhpur (Rajasthan), Dehradun (Uttarakhand), Chandigarh (Punjab), Jammu (Jammu & Kashmir) and Solan (Himachal Pradesh) were found to be promising seed sources.

Keywords: asparagus, genetic, genotypes, variance

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Authors: Bahareh Ansari

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Background: The Open Government Data (OGD) movement in the last decade has encouraged many government organizations around the world to make their data publicly available to advance democratic processes. But current open data platforms have not yet reached to their full potential in supporting all interested parties. To make the data useful and understandable for everyone, scholars suggested that opening the data should be supplemented by visualization. However, different visualizations of the same information can dramatically change an individual’s cognitive and emotional experience in working with the data. This study reviews the data visualization literature to create a list of the methods empirically tested to enhance users’ performance and experience in working with a visualization tool. This list can be used in evaluating the OGD visualization practices and informing the future open data initiatives. Methods: Previous reviews of visualization literature categorized the visualization outcomes into four categories including recall/memorability, insight/comprehension, engagement, and enjoyment. To identify the papers, a search for these outcomes was conducted in the abstract of the publications of top-tier visualization venues including IEEE Transactions for Visualization and Computer Graphics, Computer Graphics, and proceedings of the CHI Conference on Human Factors in Computing Systems. The search results are complemented with a search in the references of the identified articles, and a search for 'open data visualization,' and 'visualization evaluation' keywords in the IEEE explore and ACM digital libraries. Articles are included if they provide empirical evidence through conducting controlled user experiments, or provide a review of these empirical studies. The qualitative synthesis of the studies focuses on identification and classifying the methods, and the conditions under which they are examined to positively affect the visualization outcomes. Findings: The keyword search yields 760 studies, of which 30 are included after the title/abstract review. The classification of the included articles shows five distinct methods: interactive design, aesthetic (artistic) style, storytelling, decorative elements that do not provide extra information including text, image, and embellishment on the graphs), and animation. Studies on decorative elements show consistency on the positive effects of these elements on user engagement and recall but are less consistent in their examination of the user performance. This inconsistency could be attributable to the particular data type or specific design method used in each study. The interactive design studies are consistent in their findings of the positive effect on the outcomes. Storytelling studies show some inconsistencies regarding the design effect on user engagement, enjoyment, recall, and performance, which could be indicative of the specific conditions required for the use of this method. Last two methods, aesthetics and animation, have been less frequent in the included articles, and provide consistent positive results on some of the outcomes. Implications for e-government: Review of the visualization best-practice methods show that each of these methods is beneficial under specific conditions. By using these methods in a potentially beneficial condition, OGD practices can promote a wide range of individuals to involve and work with the government data and ultimately engage in government policy-making procedures.

Keywords: best practices, data visualization, literature review, open government data

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Authors: Asma Ammar, Nabiha Bouafia , Asma BenCheikh, Mohamed Mahjoub, Olfa Ezzi, Wadiaa Bannour, Radhia Helali, Mansour Njah

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Background: The objective of the present study was to identify factors associated with vaccination against Hepatitis B virus (HBV) among healthcare workers (HWs) in the University Hospital Center (UHC) Farhat Hached Sousse, Tunisia. Methods: We conducted a descriptive cross-sectional study all licensed physicians (n= 206) and a representative sample of paramedical staff (n= 372) exercising at UHC Hached Sousse (Tunisia) during two months (January and February 2014). Data were collected using a self-administered and pre-tested questionnaire, which composed by 21 questions. In order to determinate factors associated with vaccination against hepatitis B among HWs, this questionnaire was based on the Health Belief Model, one of the most classical behavior theories. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify the determinants of the use of vaccination against HBV. Results: The response rates were 79.8%. Fifty two percent believe that HBV is frequent in our healthcare units and 60.6% consider it a severe infection. The prevalence of HWs vaccination was 39%, 95% CI [34.49%; 43.5%]. In multivariate analysis, determinants of the use of vaccination against HBV among HWs were young age (p=10-4), male gender (p = 0. 006), high or very high importance accorded to health (p = 0.035), perception membership in a risk group for HBV infection (p = 0.038) and very favorable or favorable opinion about vaccination against HVB (p=10-4). Conclusion: The results of our study should be considered in any strategy for preventing VHB infection in HWs. In the mean time, coverage with standard vaccines should be improved also by supplying complete information on the risks of VHB infection and on the safety and efficacy of vaccination.

Keywords: Hepatitis B virus, healthcare workers, prevalence, vaccination

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Authors: Mohammed Muzafar, Darshan Ruikar

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BIM, an acronym for Building Information Modelling relates to the practice of creating a computer generated model which is capable of displaying the planning, design, construction and operation of a structure. The resulting simulation is a data-rich, object-oriented, intelligent and parametric digital representation of the facility, from which views and data, appropriate to various users needs can be extracted and analysed to generate information that can be used to make decisions and to improve the process of delivering the facility. BIM also refers to a shift in culture that will influence the way the built environment and infrastructure operates and how it is delivered. One of the main issues of concern in the construction industry at present in the UK is its record on Health & Safety (H&S). It is, therefore, important that new technologies such as BIM are developed to help improve the quality of health and safety. Historically the H&S record of the construction industry in the UK is relatively poor as compared to the manufacturing industries. BIM and the digital environment it operates within now allow us to use design and construction data in a more intelligent way. It allows data generated by the design process to be re-purposed and contribute to improving efficiencies in other areas of a project. This evolutionary step in design is not only creating exciting opportunities for the designers themselves but it is also creating opportunity for every stakeholder in any given project. From designers, engineers, contractors through to H&S managers, BIM is accelerating a cultural change. The paper introduces the concept behind a research project that mitigates the H&S risks associated with the construction, operation and maintenance of assets through the adoption of BIM.

Keywords: building information modeling, BIM levels, health, safety, integration

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Authors: Getachew Adugna

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Background: Chronic energy malnutrition and human immune deficiency virus among pregnant women are highly prevalent in Sub-Saharan Africa, and they are interrelated in a vicious cycle. However, the prevalence of chronic energy malnutrition and its determinant factors among human immune deficiency virus-positive pregnant women is not well studied in Ethiopia and Addis Ababa in particular. Objective: To determine the prevalence & associated factors of chronic energy malnutrition among human immune deficiency virus-positive pregnant women in health centres of Addis Ababa Ethiopia. Methods: An institution-based cross-sectional study was conducted and a systematic random sampling technique was used to select study subjects. A total of 253 study subjects were enrolled in the study—a structured and pre-tested questionnaire collected sociodemographic, maternal health-related, and nutritional-related variables. MUAC measurements were taken and medical charts were reviewed. Bi-variable and multi-variable logistic regression analyses were used to assess the effect of different factors on chronic energy malnutrition. Result: The overall prevalence of chronic energy malnutrition was 32.0%. It was significantly associated with dietary counselling (AOR: 0.062; 95%CI: 0.007, 0.549), CD4 level (AOR: 0.219; 95%CI: 0.025, 1.908), and clinical stage (AOR: 0.127; 95%CI: 0.053, 0.305). Conclusions: The prevalence of chronic energy malnutrition among Human Immune deficiency virus-infected pregnant women in Addis Ababa was high and Nutritional Intervention should be an integral part of the HIV care program.

Keywords: chronic energy malnutrition, HIV, MUAC, Addis Ababa

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Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

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Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Sinead Impey, Damon Berry, Selma Furtado, Miriam Galvin, Loretto Grogan, Orla Hardiman, Lucy Hederman, Mark Heverin, Vincent Wade, Linda Douris, Declan O'Sullivan, Gaye Stephens

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Healthcare is a knowledge-rich environment. This knowledge, while valuable, is not always accessible outside the borders of individual clinics. This research aims to address part of this problem (at a study site) by constructing a maximal data set (knowledge artefact) for motor neurone disease (MND). This data set is proposed as an initial knowledge base for a concurrent project to develop an MND patient data platform. It represents the domain knowledge at the study site for the duration of the research (12 months). A knowledge elicitation method was also developed from the lessons learned during this process - the WICKED method. WICKED is an anagram of the words: eliciting and confirming data, information, knowledge, wisdom. But it is also a reference to the concept of wicked problems, which are complex and challenging, as is eliciting expert knowledge. The method was evaluated at a second site, and benefits and limitations were noted. Benefits include that the method provided a systematic way to manage data, information, knowledge and wisdom (DIKW) from various sources, including healthcare specialists and existing data sets. Limitations surrounded the time required and how the data set produced only represents DIKW known during the research period. Future work is underway to address these limitations.

Keywords: healthcare, knowledge acquisition, maximal data sets, action design science

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Authors: A. Myrzabekova, D. Nurmukhamed, K. Nurumov, A. Zhulbarissova

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It is widely believed that stress can affect teachers’ intention to change the workplace. While existing research primarily focuses on the intrinsic sources of stress stemming from the school climate, the current attempt analyzes educational policies as one of the determinants of teacher’s intention to leave schools. In this respect, Kazakhstan presents a unique case since the country endorsed several educational policies which directly impacted teaching and administrative practices within schools. Using Teaching and Learning International Survey 2018 (TALIS) data with the country specific questionnaire, we construct a statistical measure of stress caused by the implementation of educational policies and test its impact on teacher’s intention to leave through the logistic regression. In addition, we control for sociodemographic, professional, and students related covariates while considering the intrinsic dimension of stress stemming from the school climate. Overall, our results suggest that stress caused by the educational policies has a statistically significant positive effect on teachers’ intentions to transfer between schools. Both policy makers and educational scholars could find these results beneficial. For the former careful planning and addressing the negative effects of the educational policies is critical for the sustainability of the educational process. For the latter, accounting for exogenous sources of stress can lead to a more complete understanding of why teachers decide to change their schools.

Keywords: educational policies, Kazakhstani teachers, logistic regression factor analysis, sustainability education TALIS, teacher turnover intention, work stress

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Authors: Oluwagbemiga Paul Agboola, Cornelius Olatunji Omojola, Dayo Martins Oyeshomo

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The role of a recreational park in human and environmental development has attracted much interest in the recent time. Recreation parks' development could act as an effective planning strategy to enhance environmental sustainability, social cohesiveness, and users' quality of life. Similarly, parks enhance neighbourhood's aesthetics, refresh the air and enhance humans' contact with nature. In this connection, recreation parks create natural surroundings of rural areas for leisure, relaxation, recreation, psychological and physical comfort of the people. The purpose of this paper is to investigate the effectiveness of the two recreational parks' development as a strategy for neighbourhood's environmental improvement, sustainability and the recreationists' cohesiveness. A total number of 158 survey questionnaires were distributed to the tourists at Ikogosi cold and warm spring in Ekiti state as well as Olumirin waterfalls, Erin-Ijesa, Osun State, in South-West, Nigeria. The quantitative results of the analyzed data with Relative Importance Index (RII) revealed that recreation parks provide optimum opportunities for users' social cohesiveness and well-being while parks' sustainable environment could be enhanced base on the provision of essential facilities, services, and future developmental plans. It is recommended that for recreation parks to realize their full potential in environmental sustainability, adequate maintenance and provision of essential facilities becomes imperative.

Keywords: environmental sustainability, neighbourhood development, recreational park, Nigeria

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Authors: Yi-Fung Lin, Yuan-Mei Liao

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Background: Pain is common among patients with cancer and is also one of the most disturbing symptoms. As this suffering is subjective, if patients proactively participate in their pain self-management, pain could be alleviated effectively. However, not everyone can carry out self-management very well because human behavior is a product of the cognition process. In this process, we can see that "self-efficacy" plays an essential role in affecting human behaviors. Methods: We used the eight steps of concept analysis proposed by Walker and Avant to clarify the concept of “self-efficacy for cancer pain management.” A comprehensive literature review was conducted for relevant publications that were published during the period of 1977 to 2021. We used several keywords, including self-efficacy, self-management, concept analysis, conceptual framework, and cancer pain, to search the following databases: PubMed, CINAHL, Web of Science, and Embase. Results: We identified three defining attributes for the concept of self-efficacy for cancer pain management, including pain management abilities, confidence, and continuous pain monitoring, and recognized six skills related to pain management abilities: problem-solving, decision-making, resource utilization, forming partnerships between medical professionals and patients, planning actions, and self-regulation. Five antecedents for the concept of self-efficacy for cancer pain management were identified: pain experience, existing cancer pain, pain-related knowledge, a belief in pain management, and physical/mental state. Consequences related to self-efficacy for cancer pain management were achievement of pain self-management, well pain control, satisfying quality of life, and containing motivation. Conclusions: This analysis provides researchers with a clearer understanding of the concept of “self-efficacy for cancer pain management.” The findings presented here provide a foundation for future research and nursing interventions to enhance self-efficacy for cancer pain management.

Keywords: cancer pain, concept analysis, self-efficacy, self-management

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Authors: S Eli, DGB Kalio, BOA Altraide, P Kua, DA MacPepple, FE Okonofua

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Background: Anaemia in pregnancy is worrisome morbidity encountered by obstetricians and gynaecologist in the developing countries of the world. It is an indirect cause of maternal mortality and also a cause of perinatal mortality. Aim: The study aimed to ascertain the prevalence of anaemia amongst antenatal clinic (ANC) attendees at booking at The Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Rivers State, Nigeria. Method: The method was a cross-sectional study of ANC attendees at booking at RSUTH. The cut-off for anaemia by the WHO used for this study was packed cell volume (PCV) less than 33%. Simple randomized sampling method was used. Information was analyzed using SPSS version 25. Result: A total of 500 questionnaires were distributed, and 488 questionnaires retrieved. The mean age was of the ANC attendees was 31.44 years, and the modal parity was 0. Three hundred and fifty-seven (73.2%) of the respondents had a tertiary level of education, 126(25.8%) had a secondary level of education while 5 (1%) of the respondents had a primary level of education. Five (1%) of the respondents did not volunteer their educational status. The modal packed cell volume was 32%. Three hundred and eighty-two (78.3%) of the ANC attendees had PCV level less than 33% compared to 106 (21.7%) who had PCV equal or greater than 33%. Conclusion: The study revealed that the prevalence of anaemia in pregnancy amongst ANC attendees at the RSUTH was high, representing 73.3% of the subjects. Anaemia was common amongst multiparas (38.5%). Malaria prophylaxis, as well as encouraging pregnant women to be compliant with their routine antenatal drugs as well as counseling on the right diet, cannot be overemphasized during pregnancy. In addition, women should use family planning for child spacing for them to recover from previous pregnancies.

Keywords: anaemia, ANC attendees, Nigeria, prevalence

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Authors: Liu Szu Yin

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The center of urban development lies in commercial transactions and folk religious activities. In Taipei City, temples serve as crucial urban spaces and centers for civic activities and religious beliefs. The appearance of local temples can be influenced by the prosperity of the surrounding communities. Apart from being centers of religious worship, Taipei's temples also host festival celebrations, allowing people to gather in front of the temples and form collective urban memories. The spatial attributes for hosting festival activities include streets, squares, parks, and buildings. In Taipei, many traditional festivals take place on the streets, either as round-trip routes or linear routes with a single starting and ending point. Given the processions and parades involving palanquins and other ceremonial objects during traditional festival activities, street spaces are frequently utilized. Therefore, this study analyzes the historical context and street spaces of three traditional festivals in Taipei City, including Qingshan Temple in Monga, Xiahai City God Temple in Dadaocheng, and Baoan Temple in Dalongdong, through on-site research. Most urban festival planners need to understand the characteristics of the city's streets in order to effectively utilize street spaces for festival planning. Taipei's traditional festivals not only preserve Chinese traditional culture but also incorporate modern elements, ensuring the transmission of culture and faith and allowing the city to become characterized by sustainable culture and unique urban memories.

Keywords: festival space, urban festival, taipei, urban memory

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Authors: Yuan Zhao, Phimsupha Kokchang

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As a responsible nation, China has outlined its Nationally Determined Contributions (NDCs) of reaching peak carbon by 2030 and carbon neutrality by 2060. Peak and carbon neutrality are tough goals to achieve, and China must undertake a shift to green energy. In contrast, China's existing energy consumption structure is unsustainable and heavily dependent on coal supplies. China must revise its energy mix planning in order to strengthen energy security and satisfy the requirement for low-carbon energy generation to mitigate climate change. Shanxi Province is one of China's most important coal-producing regions, and Linfen is one of the province's key economic towns. However, Shanxi Province's economic development is severely hampered by the region's high levels of pollution and energy consumption. The purpose of this study is to investigate Linfen citizens' perceptions and attitudes toward China's NDC's energy restructuring plan through questionnaires. The majority of respondents were aware of China's NDCs, as indicated by 402 valid responses to an online questionnaire. Furthermore, respondents' perceptions and attitudes toward renewable energy initiatives are growing. To ensure that the results were dependable and consistent, reliability and validity were examined. According to the findings, the majority of Linfen's citizens believe that renewable energy projects such as solar and wind, which are consistent with China's NDCs, may improve their quality of life, public health, and the nation's economy.

Keywords: China’s NDC, perceptions, attitudes, Linfen, energy restructuring

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Authors: S. M. Amin Hosseini, Oriol Pons, Albert de la Fuente

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After natural disasters, displaced people (DP) require important numbers of housing units, which have to be erected quickly due to emergency pressures. These tight timeframes can cause the multiplication of the environmental construction impacts. These negative impacts worsen the already high energy consumption and pollution caused by the building sector. Indeed, post-disaster housing, which is often carried out without pre-planning, usually causes high negative environmental impacts, besides other economic and social impacts. Therefore, it is necessary to establish a suitable strategy to deal with this problem which also takes into account the instability of its causes, like changing ratio between rural and urban population. To this end, this study aims to present a model that assists decision-makers to choose the most suitable building technology for post-disaster housing units. This model focuses on the alternatives sustainability and fulfillment of the stakeholders’ satisfactions. Four building technologies have been analyzed to determine the most sustainability technology and to validate the presented model. In 2003, Bam earthquake DP had their temporary housing units (THUs) built using these four technologies: autoclaved aerated concrete blocks (AAC), concrete masonry unit (CMU), pressed reeds panel (PR), and 3D sandwich panel (3D). The results of this analysis confirm that PR and CMU obtain the highest sustainability indexes. However, the second life scenario of THUs could have considerable impacts on the results.

Keywords: sustainability, post-disaster temporary housing, integrated value model for sustainability assessment, life cycle assessment

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Authors: N. Mathew, A. Qureshi, D. C. Khakha, R. Sagar

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Adolescents in India, account for one-fifth of the total population and are a significant human resource. Present study was conducted to find out various life stressors of adolescents, coping strategies adopted by them and the impact of stress on adolescent mental health. A descriptive, cross sectional study conducted on schools in the south zone of Delhi, capital city of the country. Data was collected on 360 adolescents between the age group of 13-17 years on socio-demographic profile, Adolescent life event stress scale, brief cope and youth self report for ages 11-18. Adolescents had significantly higher stress on uncontrollable events such as family events, relocation events, accident events and ambiguous events as compared to controllable events such as sexual events, deviance events and autonomy events (p<0.01).Adolescent stress was significantly correlated with various demographic variables in the study. The most frequently used coping strategies by the adolescents were positive reframing, planning, active coping, and instrumental support. It has also been found that the stress has a significant impact on adolescent mental health in the form of either internalizing problems such as anxious, withdrawn and somatic problems or externalizing problems such as rule breaking and aggressive behaviors. Out of the total sample of 360 adolescents 150 were identified as having psycho-social morbidity, including 59 borderline cases and 91 high-risk cases Study pointed out the need for mental health screening among the adolescents and also indicated the need for mental health inputs in educational institutions.

Keywords: adolecents, stress, coping, mental health

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Authors: Tsung Chieh Ma, I-Ling Chen

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Disclosing family origins to adoptees is an important topic in the adoption process. Adoption agencies usually educate adoptive parents on how to disclose to adoptees, but many adoptive parents worry that the disclosure will affect the parent–child relationship. Thus, how adoptees would like to receive the disclosure and whether they subjectively feel that the parent–child relationship is affected are both topics worthy of further discussion. This research takes a qualitative approach and connects with adoption agencies to interview six adoptees who are now adults. The purpose of the interviews is to learn about their experience receiving disclosures and their subjective feelings after learning of their family origins. The aim is to reveal the changes disclosure brought to the parent–child relationship and whether common concerns are raised due to the adoptive status. We also want to know about factors that affect their identification with their adopted status so that we can consequently give advice to other adoptive families. in this study finds that adoptees see disclosure as a process rather than an isolated event. The majority want to be told their family origin as early and proactively as possible and expect to learn the reasons they were given up for adoption and taken in as adoptees. The disclosure does not necessarily influence the parent–child relationship, and adoptees care more about the positive experiences they had with adoptive parents in their childhood. Moreover, adopted children seek contact with their original family mostly to understand why they were given up for adoption. The effects of disclosure depend on how the adoptive parents or other significant people in the lives of adoptees interpret the identity of the adoptees. That is, their response and attitude toward the identity have a lasting impact on the adoptees. The study suggests that early disclosure gives adoptees a chance to internalize the experience in the process and find self-identification.

Keywords: adoption, adoptees, disclosure of family origins, parent–child relationship, self-identity

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Authors: Imtiaz Ali, Imam Mansoor

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Investigations as a part of the academic study were undertaken to identify and evaluate the significant risks associated with the construction of K-span buildings in the region of UAE. Primary field data was collected through questionnaires obtaining specific open and close-ended questions from carefully selected construction firms, civil engineers and, construction manager regarding risks associated to K-span building construction. Historical data available for other regions of the same construction technique was available which was compared for identifying various non-critical and critical risk parameters by comparative evaluation techniques to come up with important risks and potential sources for their control and minimization in K-Span buildings that is increasing in the region. The associated risks have been determined with their Relative Importance Index (RII) values of which Risk involved in Change of Design required by Owners carries the highest value (RII=0.79) whereas, Delayed Payment by Owner to Contractor is one of the least (RII=0.42) value. The overall findings suggest that most relative risks as quantified originate or associated with the contractors. It may be concluded that project proponents undertaking K-span projects in planning and budgeting the cost and delays should take into account of risks on high account if changes in design are also required any delays in the material by the supplier would then be a major risk in K-span project delay. Since projects are, less costly, so owners have limited budgets, then they hire small contractors, which are not highly competent contractors. So study suggests that owner should be aware of these types of risks associated with the construction of K-span buildings in order to make it cost effective.

Keywords: k-span buildings, k-span construction, risk management, relative improvement index (RII)

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Authors: Yusuf Jundi Sado

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Changes in land use are mostly credited to human actions that result in negative impacts on biodiversity and ecosystem functions. This study aims to analyze the dynamics of land use and land cover changes for sustainable natural resources planning and management. Chilalo-Galama Mountain Range, Ethiopia. This study used Thematic Mapper 05 (TM) for 1986, 2001 and Landsat 8 (OLI) data 2017. Additionally, data from the Central Statistics Agency on human population growth were analyzed. Semi-Automatic classification plugin (SCP) in QGIS 3.2.3 software was used for image classification. Global positioning system, field observations and focus group discussions were used for ground verification. Land Use Land Cover (LU/LC) change analysis was using maximum likelihood supervised classification and changes were calculated for the 1986–2001 and the 2001–2017 and 1986-2017 periods. The results show that agricultural land increased from 27.85% (1986) to 44.43% and 51.32% in 2001 and 2017, respectively with the overall accuracies of 92% (1986), 90.36% (2001), and 88% (2017). On the other hand, forests decreased from 8.51% (1986) to 7.64 (2001) and 4.46% (2017), and grassland decreased from 37.47% (1986) to 15.22%, and 15.01% in 2001 and 2017, respectively. It indicates for the years 1986–2017 the largest area cover gain of agricultural land was obtained from grassland. The matrix also shows that shrubland gained land from agricultural land, afro-alpine, and forest land. Population dynamics is found to be one of the major driving forces for the LU/LU changes in the study area.

Keywords: Landsat, LU/LC change, Semi-Automatic classification plugin, population dynamics, Ethiopia

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Authors: Abeer Ahmed Abdelhamed

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Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.

Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange

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Authors: Mostafa Gabr, Rania Abdul Galil, Nihal Salim

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Various interventions are applied in cities with the aim to improve living and acoustic environmental conditions. Noise is one of the most influential and critical factors in the environment that has an effect on the QOL (quality of life) and urban environment. It ranks second among environmental pollution issues according to EEAA. Traffic noise is a major source of noise. Noise barriers are one of the physical techniques in landscape design used to reduce the impact of noise pollution in urban areas. Roadways noise pollution can be best controlled by a noise barrier. The aim of this paper is to consider all facets of sustainability when designing a comfortable acoustic environment in roadways, through different strategies related to planning and the design process. The study focuses on the relation between the design of noise barriers as a landscape noise mitigation installation and their materiality in so far as it influences the sustainability of the open space and the acceptability of users. According to previous studies, design of noise barrier mainly depends on cost as a decisive factor. This study asserts that environmental and socioeconomic costs associated are equally important. Hence, the paper presents a strategy for sustainable soundscape design. It builds a framework focusing on materiality considering the environmental and socioeconomic impact of noise barriers shaping urban open space around the road ways, and the different academic and market positions on noise barrier types and materials. Finally, it concludes with a matrix of the relation between the noise barrier design consideration and the three pillars of sustainability (social, economic and environmental).

Keywords: traffic noise level, acoustic sustainability, noise barrier, noise reduction, noise control, acoustical level

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Authors: Alireza Ansariyar, Safieh Laaly

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Over the last decades, the vehicle industry has shown increased interest in integrating autonomous, connected, and electrical technologies in vehicle design with the primary hope of improving mobility and road safety while reducing transportation’s environmental impact. Using the State of Maryland (M.D.) in the United States as a pilot study, this research investigates CAVs’ fuel consumption and air pollutants (C.O., PM, and NOx) and utilizes meaningful linear regression models to predict CAV’s environmental effects. Maryland transportation network was simulated in VISUM software, and data on a set of variables were collected through a comprehensive survey. The number of pollutants and fuel consumption were obtained for the time interval 2010 to 2021 from the macro simulation. Eventually, four linear regression models were proposed to predict the amount of C.O., NOx, PM pollutants, and fuel consumption in the future. The results highlighted that CAVs’ pollutants and fuel consumption have a significant correlation with the income, age, and race of the CAV customers. Furthermore, the reliability of four statistical models was compared with the reliability of macro simulation model outputs in the year 2030. The error of three pollutants and fuel consumption was obtained at less than 9% by statistical models in SPSS. This study is expected to assist researchers and policymakers with planning decisions to reduce CAV environmental impacts in M.D.

Keywords: connected and autonomous vehicles, statistical model, environmental effects, pollutants and fuel consumption, VISUM, linear regression models

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Authors: Abu Zafor Sadek

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Pharmaceuticals were one of the least impacted business sectors during the corona pandemic as they are the center point of Covid-19 fight. Emergency use authorization, unproven indication of some commonly used drugs, self-medication, research and production capacity of an individual country, capacity of producing vaccine by many countries, Active Pharmaceutical Ingredients (APIs) related uncertainty, information gap among manufacturer, practitioners and user, export restriction, duration of lock-down, lack of harmony in transportation, disruption in the regulatory approval process, sudden increased demand of hospital items and protective equipment, panic buying, difficulties in in-person product promotion, e-prescription, geo-politics and associated issues added a new dimension to this industry. Although the industry maintains a reasonable growth throughout Covid-19 days; however, it has been characterized by both long- and short-term effects. Short-term effects have already been visible to so many countries, especially those who are import-dependent and have limited research capacity. On the other hand, it will take a few more time to see the long-term effects. Nevertheless, supply chain disruption, changes in strategic planning, new communication model, squeezing of job opportunity, rapid digitalization are the major short-term effects, whereas long-term effects include a shift towards self-sufficiency, growth pattern changes of certain products, special attention towards clinical studies, automation in operations, the increased arena of ethical issues etc. Therefore, this qualitative and exploratory study identifies the post-covid-19 landscape of the global pharmaceutical industry.

Keywords: covid-19, pharmaceutical, businees, landscape

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Authors: Dalia Almaghaslah, A. Alsayari, R. Asiri, N. Albugami

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The aim of this study was to evaluate the pharmacy workforce in Saudi Arabia in terms of supply, geographical distribution, nationality and gender distribution, as well as to assess the employment rate. A retrospective cross-sectional approach was used to address these objectives. Relevant data was identified and retrieved from the latest version of the Health Statistical Yearbook— Kingdom of Saudi Arabia, 2016; Saudi Commission for Health Specialties publications, 2018; and national pharmacy organisation websites. In general, the exponential increase in the number of pharmacy schools has helped to produce more pharmacists in the rural areas of the country, but inequitable distribution of the workforce still exists. The reliance on non-indigenous pharmacists, especially in the private sector, is substantial. Male pharmacists outnumber females, mainly due to the cultural and social factors that limit the participation of women in community pharmacy, which is the largest employment sector. The employment rate shows limited opportunities for Saudi pharmacists at the Ministry of Health (MOH) as they have already Saudised almost all pharmacy positions at the MOH healthcare facilities. However, the private sector needs to assume responsibility for their share of the re-nationalisation of the profession in order to provide jobs for local pharmacists. Regular, more detailed profiling of the pharmacy workforce is an essential step to achieving effective pharmacy workforce planning. Currently, a large gap exists in our knowledge of the workforce in the country, especially regarding their supply and demand and employment prospects.

Keywords: employment prospects, pharmacy workforce, Saudi Arabia, supply and demand

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: A. Swetha

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This study aims to prioritize and explore critical risks in construction project assessment, employing the Weighted Average Index method and Principal Component Analysis (PCA). Through extensive literature review and expert interviews, project assessment risk factors were identified across Budget and Cost Management Risk, Schedule and Time Management Risk, Scope and Planning Risk, Safety and Regulatory Compliance Risk, Resource Management Risk, Communication and Stakeholder Management Risk, and Environmental and Sustainability Risk domains. A questionnaire was distributed to stakeholders involved in construction activities in Hyderabad, India, with 180 completed responses analyzed using the Weighted Average Index method to prioritize risk factors. Subsequently, PCA was used to understand relationships between these factors and uncover underlying patterns. Results highlighted dependencies on critical resources, inadequate risk assessment, cash flow constraints, and safety concerns as top priorities, while factors like currency exchange rate fluctuations and delayed information dissemination ranked lower but remained significant. These insights offer valuable guidance for stakeholders to mitigate risks effectively and enhance project outcomes. By adopting systematic risk assessment and management approaches, construction projects in Hyderabad and beyond can navigate challenges more efficiently, ensuring long-term viability and resilience.

Keywords: construction project assessment risk factor, risk prioritization, weighted average index, principal component analysis, project risk factors

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Authors: Samson F. Agberotimi, Rachel B. Asagba, Choja Oduaran

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Disturbing rate of use of different substances such as cannabis, alcohol, as well as pharmaceutical drugs among Nigerian youth in recent times has been affirmed in the literature. There is, however, a paucity of literature addressing the pattern of usage of such drugs, especially for clinical relevance and intervention planning. The present study investigated the prevalence and pattern of drug usage among youth in Ogbomoso, Nigeria. A cross-sectional survey involving 92 purposively selected participants comprising of 82 males and 10 females aged between 15 and 24 years was conducted. A measure of drug involvement and demographic characteristics was administered to the participants. Descriptive analysis was done using the SPSS v.21. Cannabis (79.4%), alcohol (77.2%), codeine (70.7%), tobacco (65.2%) and tramadol (47.8%) are the five most frequently used substances. However, the majority of the users of tobacco (68.3%) and alcohol (62.0%) are casual users indicating a mild level of use of the substances among the participants. On the other hand, 49.2% of the codeine users, 27.3% of the tramadol users, and 21.9% of the cannabis users reported harmful/intensive levels of use. Furthermore, the results revealed individuals at the pathological level of use as 28.8% for cannabis, 25.0% for tramadol, and 21.6% for codeine, and thus require clinical/therapeutic intervention. In conclusion, cannabis remains the most frequently used substance among youths. However, there appears to be a shift from the use of conventional psychoactive substances to pharmaceutical/prescription drugs such as codeine and tramadol. The findings of this study raised the need for both preventive and therapeutic interventions addressing the problem of substance use disorder among youth in contemporary society.

Keywords: Ogbomoso, pattern of drug use, prevalence of drug use, youth

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Authors: Souhir Chelly, Asma Ben Cheikh, Hela Ghali, Salwa Khefacha, Lamine Dhidah, Mohamed Ben Rejeb, Houyem Said Latiri

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The hospital risk management department is firstly involved in the methodological analysis of grade zero sterilization incidents. The system is based on a subsequent analysis process in compliance with the ongoing requirements of the Haute Autorité de santé (HAS) for a reactive approach to risk, allowing to identify failures and start the appropriate preventive and corrective measures. The use of the association of litigation and risk management (ALARM) method makes easier the grade zero analysis and brings to light the team or institutional, organizational, temporal, individual factors representative of undesirable effects. Two main factors come out again from this analysis, pre-disinfection step of the emergency block unsupervised instrumentalist intern was poorly done since she did not remove the battery from micro air motor. At the sterilization unit, the worker who was not supervised by the nurse did the conditioning of the motor without having checked it if it still contained the battery. The main cause is that the management of human resources was inadequate at both levels, the instrumental trainee in the block who was not supervised by his supervisor and the worker of the sterilization unit who was not supervised by the responsible nurse. There is a lack of research help, advice, and collaboration. The difficulties encountered during this type of analysis are multiple. The first is based on its necessary acceptance by the various actors of care involved, which should not perceive it as a tool leading to individual punishment, but rather as a means to improve their practices.

Keywords: ALARM (Association of Litigation and Risk Management Method), incident, risk management, sterilization

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Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

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Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

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