Search results for: Population

Authors: Sumeyra Yakar

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The idea of this research had its genesis from the writer's interest in Shi'i school and religio-political atmosphere in contemporary Iran. The research aims to identify how the past dynamics between political and legal figures and their relationship between each other affect contemporary relationship between political and religious authorities at the local and global level. It attempts to explore religio-politic Shi'i figures and their relationship with the official jurisprudence from the 15th century to the contemporary period. The mutual interaction between the opinion and acts of political figures and jurisprudential institutions enlightens the role of religious values to control the mass population. After the collapse of the Safawīd Dynasty, Shi'i believers lost their political guardian and legal independence, and the situation gave them the inspiration to create unique ideologies or political approaches to solve the governance crisis. The analysis of authoritative political figures and their scholastic contributions elucidate the connection between political powers and religious doctrines under the protection of sectarian oriented theocratic governments. Additionally, understanding the incremental influence of political (historical) Shi'i figures into religious doctrines shed lights on the chronological development of peculiar government style and authoritative hierarchy in contemporary Shi’i communities. The research as being interdisciplinary one offers to create an academic awareness between legal and political factors in Shi’i school of thought and encompasses political, religious, social, financial and cultural atmospheres of the countries in which the political figures lived. The Iranian regime enshrines the principle of vilāyāt-i faqīh (guardianship of the jurist) which enables jurists to solve the conflict between law as an ideal system, in theory, and law in practice. The paper aims to show how the religious, educational system works in harmony with the governmental authorities with the concept of vilāyāt-i faqīh in Iran and contributes to the creation of religious custom in the society. Contemporary relationship between the political figures and religious authorities in Iran will be explained by religio-legal dimensions. The methodology that will be applied by the study has been chosen in order to acquire information and deduce conclusions from the opinions of the scholars. Thus, the research method is mainly descriptive and qualitative. Three lines of description are pursued throughout the study; the explanation of political ideas belonging to the religio-political figures theoretically depending on written texts; the description of approaches adopted by contemporary Iranian and Saudi scholars relating to the legal systems (theoretically); and the explanation of the responses of governmental authorities.

Keywords: clergy (‘ulamā), guardianship of the jurist (vilāyāt-i faqīh), Iran, Shi’i figures

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Authors: B. Salehi, D. Andrews, I. Chaer, A. Gillich, A. Chalk, D. Bush

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With the rapid increase of energy consumption in buildings in recent years, especially with the rise in population and growing economies, the importance of energy savings in buildings becomes more critical. One of the key factors in ensuring energy consumption is controlled and kept at a minimum is to utilise building energy modelling at the very early stages of the design. So, building modelling and simulation is a growing discipline. During the design phase of construction, modelling software can be used to estimate a building’s projected energy consumption, as well as building performance. The growth in the use of building modelling software packages opens the door for improvements in the design and also in the modelling itself by introducing novel methods such as building information modelling-based software packages which promote conventional building energy modelling into the digital building design process. To understand the most effective implementation tools, research projects undertaken should include elements of real-world experiments and not just rely on theoretical and simulated approaches. Upon review of the related studies undertaken, it’s evident that they are mostly based on modelling and simulation, which can be due to various reasons such as the more expensive and time-consuming nature of real-time data-based studies. Taking in to account the recent rise of building energy software modelling packages and the increasing number of studies utilising these methods in their projects and research, the accuracy and reliability of these modelling software packages has become even more crucial and critical. This Energy Performance Gap refers to the discrepancy between the predicted energy savings and the realised actual savings, especially after buildings implement energy-efficient technologies. There are many different software packages available which are either free or have commercial versions. In this study, IES VE (Integrated Environmental Solutions Virtual Environment) is used as it is a common Building Energy Modeling and Simulation software in the UK. This paper describes a study that compares real time results with those in a virtual model to illustrate this gap. The subject of the study is a north west facing north-west (345°) facing, naturally ventilated, conservatory within a domestic building in London is monitored during summer to capture real-time data. Then these results are compared to the virtual results of IES VE, which is a commonly used building energy modelling and simulation software in the UK. In this project, the effect of the wrong position of blinds on overheating is studied as well as providing new evidence of Performance Gap. Furthermore, the challenges of drawing the input of solar shading products in IES VE will be considered.

Keywords: building energy modelling and simulation, integrated environmental solutions virtual environment, IES VE, performance gap, real time data, solar shading products

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Authors: Abrar Almutairi, Alyaa Farouk, Amal Gouda

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Background: Social capital is a factor that helps in bonding in a social network. The individual and the neighborhood social capital affect the health status of members of a particular society. In addition, to the influence of social health on the health of the population, social health has a significant effect on women, especially those with pregnancy. Study objective was to assess the impact of the social capital on the health status of pregnant women Design: A descriptive crosssectional correlational design was utilized in this study. Methods: A convenient sample of 210 pregnant women who attended the outpatient antenatal clinicsfor follow-up in King Fahad hospital (Ministry of National Guard Health Affairs/Riyadh) and King Abdullah bin Abdelaziz University Hospital (KAAUH, Ministry of Education /Riyadh) were included in the study. Data was collected using a self-administered questionnaire that was developed by the researchers based on the “World Bank Social Capital Assessment Tool” and SF-36 questionnaire (Short Form Health Survey). The questionnaire consists of 4 parts to collect information regarding socio-demographic data, obstetric and gynecological history, general scale of health status and social activity during pregnancy and the social capital of the study participants, with different types of questions such as multiple-choice questions, polar questions, and Likert scales. Data analysis was carried out by using Statistical Package for the Social Sciences version 23. Descriptive statistic as frequency, percentage, mean, and standard deviation was used to describe the sample characteristics, and the simple linear regression test was used to assess the relationship between the different variables, with level of significance P≤0.005. Result: This study revealed that only 31.1% of the study participants perceived that they have good general health status. About two thirds (62.8%) of the participants have moderate social capital, more than one ten (11.2٪) have high social capital and more than a quarter (26%) of them have low social capital. All dimensions of social capital except for empowerment and political action had positive significant correlations with the health status of pregnant women with P value ranging from 0.001 to 0.010in all dimensions. In general, the social capital showed high statistically significant association with the health status of the pregnant (P=0.002). Conclusion: Less than one third of the study participants had good perceived health status, and the majority of the study participants have moderate social capital, with only about one ten of them perceived that they have high social capital. Finally, neighborhood residency area, family size, sufficiency of income, past medical and surgical history and parity of the study participants were all significantly impacting the assessed health domains of the pregnant women.

Keywords: impact, social capital, health status, pregnant women

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Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Physical activity is an important factor in the treatment and prevention of type 2 diabetes mellitus (T2DM). Reduction in HbA1c level, an important diabetes biomarker, was reported in patients who increased their daily physical activity. Although the ambient temperature was reported to be positively correlated to a negative impact on health and increase the incidences of diabetes, the exposure to bright sunlight was recently found to be associated with enhanced insulin sensitivity and improved beta-cell function. How Ramadan alters physical activity, and especially sunlight exposure, has not been adequately investigated. Aim: This study aimed to assess the physical activity and sun exposure of Saudis with T2DM over different periods (before, during, and after Ramadan) and related this to HbA1c levels. Methods: This study recruited 82 Saudis with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for this study were obtained from De Montfort University and Saudi Ministry of Health. Physical activity and sun exposure were assessed by a self-administered questionnaire. Physical activity was estimated using the International Physical Activity Questionnaire (IPAQ), while the sun exposure was assessed by asking the patients about their hours per week of direct exposure to the sun, and daily hours spent outdoors. Blood samples were collected in each period for measuring HbA1c. Results: Low physical activity was observed in more than 60% of the patients, with no significant changes between periods. There were no significant variances between periods in the daily hours spent outdoors and the total number of weekly hours of direct exposure to the sun. The majority of patients reported only few hours of exposure to the sun (1h or less per week) and time spent outdoors (1h or less per day). The mean HbA1c significantly changed between periods (P = 0.001), with lowest level during Ramadan. There were significant differences in the mean HbA1c between the groups for the level of physical activity (P < 0.001), with significant lower mean HbA1c in the higher-level group. There were no significant variances in the mean of HbA1c between the groups for the daily hours spent outdoors. The mean HbA1c of the patients, who reported never in their total weekly hours of exposure to the sun, was significantly lower than the mean HbA1c of those who reported 1 hour or less (P = 0.001). Conclusion: Physical inactivity was prevalent among the study population with very little exposure to the sun or time spent outdoors. Higher level of physical activity was associated with lower mean HbA1c levels. Encouraging T2DM patients to achieve the recommended levels of physical activity may help them to obtain greater benefits of Ramadan fasting, such as reducing their HbA1c levels. The impact of low direct exposure to the sun and the time spent outdoors needs to be further investigated in both healthy and diabetic patients.

Keywords: diabetes, fasting, physical activity, sunlight, Ramadan

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Authors: Thaminda Liyanage, Anuga Liyanage, Chamila Kurukulasuriya, Sidath Bandara

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Background: The burden of chronic kidney disease (CKD) is growing rapidly around the world, particularly in Asia. Over the last two decades Sri Lanka has experienced an epidemic of CKD with ever growing number of patients pursuing medical care due to CKD and its complications, specially in the “Mahaweli” river basin in north central region of the island nation. This was apparently a new form of CKD which was not attributable to conventional risk factors such as diabetes mellitus, hypertension or infection and widely termed as “CKD-unknown” or “CKDu”. In the past decade a number of small scale studies were conducted to determine the aetiology, prevalence and complications of CKDu in North Central region. These hospital-based studies did not provide an accurate estimate of the problem as merely 10% or less of the people with CKD are aware of their diagnosis even in developed countries with better access to medical care. Interestingly, similar observations were made on the changing epidemiology of obesity in the region but no formal study was conducted to date to determine the magnitude of obesity burden. Moreover, if increasing obesity in the region is associated with CKD epidemic is yet to be explored. Methods: We will conduct an area wide cross sectional survey among all adult residents of the “Mahaweli” development project area 5, in the North Central Province of Sri Lanka. We will collect relevant medical history, anthropometric measurements, blood and urine for hematological and biochemical analysis. We expect a participation rate of 75%-85% of all eligible participants. Participation in the study is voluntary, there will be no incentives provided for participation. Every analysis will be conducted in a central laboratory and data will be stored securely. We will calculate the prevalence of obesity and chronic kidney disease, overall and by stage using total number of participants as the denominator and report per 1000 population. The association of obesity and CKD will be assessed with regression models and will be adjusted for potential confounding factors and stratified by potential effect modifiers where appropriate. Results: This study will provide accurate information on the prevalence of obesity and CKD in the region. Furthermore, this will explore the association between obesity and CKD, although causation may not be confirmed. Conclusion: Obesity and CKD are increasingly recognized as major public health problems in Sri Lanka. Clearly, documenting the magnitude of the problem is the essential first step. Our study will provide this vital information enabling the government to plan a coordinated response to tackle both obesity and CKD in the region.

Keywords: BMI, Chronic Kidney Disease, obesity, Sri Lanka

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Authors: Karima Adilla

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Aceh province, into which Islam convinced to have entered Indonesia in the 12th Century before spreading throughout the archipelago and the rest of Southeast Asia, has several early Islamic mosques that still exist until today. However, due to some circumstances, the restoration and rehabilitation towards those mosques have been made in some periods, while the background was diverse. Concerning this, the research will examine the physical changing aspects of 3 prominent historical mosques in Aceh Besar and Banda Aceh; those are, Indrapuri Mosque, Baiturrahman Grand Mosque, and Baiturrahim Mosque built coincided with the beginning of Islam’s development in Aceh and regarded as eventful mosques. The existence of Indrapuri Mosque built on the remains of the Lamuri Kingdom’s temple is a historical trace that there was Hindu-Buddhist civilization in Aceh before Islam entered and became the majority religion about 98% from Aceh total population. Also, there was the Dutch who colonialized Aceh behind the existence of two famous mosques in Aceh, namely Baiturrahman Grand Mosque and Baiturrahim Mosque, as the colonizer also assisted to rebuild those 2 sacred Mosques to quell the anger of the Acehnese people because their mosque was burnt by the Dutch. Interestingly, despite underwent a long history successively since the rise of Islam after the Hindu-Buddhist kingdom had collapsed, colonialization, conflict, in Aceh, and even experienced the earthquake and tsunami disaster in 2004, those mosques still exist. Therefore, those mosques have been considered as historical silent witnesses. However, it was not merely those reasons that led the mosques underwent several physical changes, otherwise economic, political, social, cultural and religious factors were also highly influential. Instead of directly illustrating the physical changing of those three mosques, this research intends to identify under what condition the physical appearance continuously changing during the sultanate era, the colonial period until post-independent in terms of the architectural style, detail elements, design philosophy, and how the remnants buildings act as medium to bridge the history. A framework will use qualitative research methods by collecting actual data of the mosque's physical change figures through field studies, investigations, library studies and interviews. This research aims to define every trace of historical issues embedded in the physical changing of those mosques as they are intertwined in collecting historical proof. Thus, the result will reveal the characteristic interrelation between history, the mosque architectural style in a certain period, the physical changes background and its impact. Eventually, this research will also explicate a clear inference of each mosque’s role in representing history in Aceh Besar and Banda Aceh specifically, as well as Aceh generally through architectural design concepts.

Keywords: Aceh ancient mosques, Aceh history, Islamic architecture, physical changing

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Authors: Siddhi Deshpande, Jo Jo Chacko Eapen

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Despite almost half of India’s female population engages in watching sports, their experiences in the sports fandom are concealed by ‘traditional masculinity,’ leading to potential exclusion and harassment. To explore these experiences in-depth, this qualitative study aims to understand what coping strategies Indian women fans employ, to sustain their team identification. Employing criterion sampling, participants were screened using The Sports Spectators Identification Scale (SSIS) to assess team identification and a Brief Sexism Questionnaire to confirm participants’ experience with sexism as it aligns with the purpose of the study. The participants were Indian women who had been following any sport for more than eight years, were fluent in English, and were not professionals in Sports. Ten highly identified fans with gendered experiences were recruited for one-on-one semi-structured, in-depth interviews. The data was analyzed using Interpretive Phenomenological Analysis (IPA) to understand the lived-in experiences of women fans experiencing sexism and gender stereotypes, revealing superordinate themes of (1) Ontogenesis and Emotional Investment; (2) Gendered Expectations and Sexism; (3) Coping Strategies and Resilience; (4) Identity, Femininity, Empowerment; (5) Advocacy for Equality and Inclusivity. The findings reflect that Indian women fans experience social exclusion, harassment, sexualization, and commodification, in both online and offline fandoms, where they are disproportionately targeted with threats, misogynistic comments, and attraction-based assumptions, questioning their ‘authenticity’ as fans due to their gender. Women fans interchange between proactive strategies of assertiveness, humor, and knowledge demonstration with defensive strategies of selective engagement, self-regulatory censorship, and desensitization to deal with sexism. In this interplay, the integration of women’s ‘fan identity’ with their self-concept showcases how being a sports fan adds meaning to their lives, despite the constant scrutiny in a male-dominated space, reflecting that femininity and sports should coexist. As a result, they find refuge in female fan communities due to their similar experiences in the fandom and advocate for an equal and inclusive environment where sports are above gender, and not the other way around. A key practical implication of this research is enabling sports organizations to develop inclusive fan engagement policies that actively encourage female fan participation. This includes sensitizing stadium staff and security personnel, promoting gender-neutral language, and, most importantly, establishing safety protocols to protect female fans from adverse experiences in the fandom.

Keywords: coping strategies, female sports fans, femininity, gendered experiences, team identification

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Authors: Arun Perumbilavil Anand

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For the past few years, the state of Kerala has been witnessing a large inflow of migrant workers from other states of the country, which emerged as a result of demographic transition and Gulf emigration. The in-migration patterns in Kerala have changed over the time with the migrants having a higher residence history bringing their families to the state, thereby making the process more complicated and divergent in its approach. These developments have led to an increase in the young migrant population at least in some parts of the state, which has opened up doubts and questions related to their future in the host society. At this juncture, the study ponders into the factors that are associated with the assimilation and wellbeing of migrant children in the society of Kerala. As one of the objectives, the study also analyzed the influence and role played by the educational institutions (both public and private) in meeting the needs and aspirations of both the children and their parents. The study gains significance as it tries to identify various impediments that hinder the cognitive skill formation and behaviour patterns of the migrant children in the host society. Data and Methodology: The study is based on the primary data collected through a series of interviews and interactions held with parents, children, and teachers of different educational institutions, including both public and private. The primary survey also made use of research techniques like observation, in-depth interviews, and case study method. The study was conducted in schools in the Kanjikode area of the Palakkad district in Kerala. The findings of the study are on the basis of a survey conducted in four schools and 40 migrant children. Findings: The study found that majority of the children have wholly integrated and assimilated into the host society. The influence of the peer group was quite visible in giving stimulus to the assimilation process. Most of the children do not have any emotional or cultural sentiments attached to their state of origin, and they consider Kerala as their ‘home state’ and the local language (Malayalam) as their ‘mother tongue'. The study could also find that the existing education system in the host society fails to meet the needs and aspirations of migrants as well as that of their children. On a comparative scale, to some extent, private schools have succeeded in fulfiling the special requirements of the migrant children. An interesting point that the study could pinpoint at is that the children of the migrants show better health conditions and wellbeing than compared to the natives, which is usually addressed as an epidemiologic paradox. As a concluding remark, the study recommends the inclusion concept of inclusive education into the education system of the state with giving due emphasis on those who are at higher risk of being excluded or marginalized, along with fostering increased interaction between diverse groups.

Keywords: assimilation, Kerala, migrant children, well-being

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Authors: I. L. Kim, J. Y. Lee, A. K. Tekile

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In consequence of the very high urbanization rate of Korea, the number of traffic noise damages in areas congested with population and facilities is steadily increasing. The current environmental noise levels data in major cities of the country show that the noise levels exceed the standards set for both day and night times. This research was about comparative analysis in search for optimal soundproof panel shape and design factor that can minimize sound reflection noise. In addition to the normal flat-type panel shape, the reflection noise reduction of swelling-type, combined swelling and curved-type, and screen-type were evaluated. The noise source model Nord 2000, which often provides abundant information compared to models for the similar purpose, was used in the study to determine the overall noise level. Based on vehicle categorization in Korea, the noise levels for varying frequency from different heights of the sound source (directivity heights of Harmonize model) have been calculated for simulation. Each simulation has been made using the ray-tracing method. The noise level has also been calculated using the noise prediction program called SoundPlan 7.2, for comparison. The noise level prediction was made at 15m (R1), 30 m (R2) and at middle of the road, 2m (R3) receiving the point. By designing the noise barriers by shape and running the prediction program by inserting the noise source on the 2nd lane to the noise barrier side, among the 6 lanes considered, the reflection noise slightly decreased or increased in all noise barriers. At R1, especially in the cases of the screen-type noise barriers, there was no reduction effect predicted in all conditions. However, the swelling-type showed a decrease of 0.7~1.2 dB at R1, performing the best reduction effect among the tested noise barriers. Compared to other forms of noise barriers, the swelling-type was thought to be the most suitable for reducing the reflection noise; however, since a slight increase was predicted at R2, further research based on a more sophisticated categorization of related design factors is necessary. Moreover, as swellings are difficult to produce and the size of the modules are smaller than other panels, it is challenging to install swelling-type noise barriers. If these problems are solved, its applicable region will not be limited to other types of noise barriers. Hence, when a swelling-type noise barrier is installed at a downtown region where the amount of traffic is increasing every day, it will both secure visibility through the transparent walls and diminish any noise pollution due to the reflection. Moreover, when decorated with shapes and design, noise barriers will achieve a visual attraction than a flat-type one and thus will alleviate any psychological hardships related to noise, other than the unique physical soundproofing functions of the soundproof panels.

Keywords: reflection noise, shaped noise barriers, sound proof panel, traffic noise

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Authors: Jeremiah Mutamba

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Water is a critical resource for sustainable economic growth and social development. It enables societies to thrive and influences every urban center’s future. Thus, water must always be available in the right quantity and quality. However, in South Africa - a known physically water scarce nation – the future of sustainable urban supply of water may be in jeopardy. The country facing a water crisis influenced by insufficient infrastructure investment and maintenance, recurrent droughts and climate variation, human induced water quality deterioration, as well as growing lack of technical capacity in water institutions, particularly local municipalities. Aside of the eight metropolitan municipalities for the country, most municipalities struggle with provision of reliable water to their citizens. These municipalities contend with having now capable engineers, aging infrastructure with concomitant high system water losses (of 30% and upwards), coupled with growing water demand from expanding industries and population growth. Also, a significant portion (44%) of national water treatment plants are in critically poor condition, requiring urgent rehabilitation. Municipalities also struggle to raise funding to instate projects. All these factors militate against sustainable urban water supply in the country. Urgent mitigation measures are required. This paper seeks to review the extent of the current water supply challenges in South Africa’s urban centers, including searching for practical and cost-effective measures. The study followed a qualitative approach, combining desktop literature research, interviews with key sector stakeholders, and a workshop. Phenomenological data analysis technique was used to study and examine interview data and secondary desktop data. Preliminary findings established the building of technical or engineering capacity, reversal of the high physical water losses, rehabilitation of poor condition and dysfunctional water treatment works, diversification of water resource mix, and water scarcity awareness programs as possible practical solutions. Other proposed solutions include the use of performance-based or value-based contracting to fund initiatives to reduce high system water losses. Out-come based arrangements for revenue increasing water loss reduction projects were considered more practical in funding-stressed local municipalities. If proactively implemented in an integrated manner, these proposed solutions are likely to ensure sustainable urban water supply in South African urban centers in the future.

Keywords: sustainable, water scarcity, water supply, South Africa

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Authors: Doreen Mekunda

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This paper is built on the premise that the current socio-political crisis in the two restive regions of Cameroon, though enveloped with destructive and devastating trends (effects) on both property and human lives, is not without its strengths and merits. It is incontestable that many cultures, to a greater extent, are going to be destroyed as people forcibly move from war-stricken habitats to non-violent places. Many cultural potentials, traditional shrines, artifacts, art, and crafts, etc., are unknowingly or knowingly disfigured, and many other ugly things will, by the end of the crisis, affect the cultures of these two regions under siege and of the receiving population. A plethora of other problems like the persecution of Internally Displaced Persons (IDPs) for being displaced and blamed for increased crime rates and the existence of cultural and ethnic differences that produce both inter-tribal and interpersonal conflicts and conflicts between communities will abound. However, there is the emergence of rapid literature, and other forms of cultural productions, whether written or oral, is visible, thereby precipitating a rich cultural diversity due to the coming together of a variety of cultures of both the IDPs and the receiving populations, rapid urbanization, improvement of health-related issues, the rebirth of indigenous cultural practices, the development of social and lingua-cultural competences, dependence on alternative religions, faith and spirituality. Even financial and economic dependence, though a burden to others by IDPs, has its own merits as it improves the living standards of the IDPs. To be able to obtain plausible results, cultural materialism, which is a literary theory that hinges on the empirical study of socio-cultural systems within a materialist infrastructure-super-structure framework, is employed together with the postcolonial theory. Postcolonial theory because the study deals with postcolonial experiences/tenets of migration, hybridity, ethnicity, indignity, language, double consciousness, migration, center/margin binaries, and identity, amongst others. The study reveals that the involuntary movement of persons from their habitual homes brings about movement in cultures, thus, the emergence of new cultures. The movement of people who hold fast to their cultural heritage can only influence new forms of literature, the development of new communication competences, the rise of alternative religion, faith and spirituality, the re-emergence of customary and traditional legal systems that might have been abandoned for the new judicial systems, and above all the revitalization of traditional health care systems.

Keywords: alternative religion, emergence, socio-political crisis, spirituality, lingua-cultural competences

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Authors: Asrarul H. Jeelani

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Arsenic contamination of groundwater and its’ health implications in lower Gangetic plain of Indian states started reporting in the 1980s. The same period was declared as the first water decade (1981-1990) to achieve ‘water for all.’ To fulfill the aim, the Indian government, with the support of international agencies installed millions of hand-pumps through water resources development programs. The hand-pumps improve the accessibility if the groundwater, but over-extraction of it increases the chances of mixing of trivalent arsenic which is more toxic than pentavalent arsenic of dug well water in Gangetic plain and has different physical manifestations. Now after three decades, Bihar (middle Gangetic plain) is also facing arsenic contamination of groundwater and its’ health implications. Objective: This interdisciplinary research attempts to understand the health and social implications of arsenicosis among different castes in Haldi Chhapra village and to find the association of ramifications with water resources development. Methodology: The Study used concurrent quantitative dominant mix method (QUAN+qual). The researcher had employed household survey, social mapping, interviews, and participatory interactions. However, the researcher used secondary data for retrospective analysis of hand-pumps and implications of arsenicosis. Findings: The study found 88.5% (115) household have hand-pumps as a source of water however 13.8% uses purified supplied water bottle and 3.6% uses combinations of hand-pump, bottled water and dug well water for drinking purposes. Among the population, 3.65% of individuals have arsenicosis, and 2.72% of children between the age group of 5 to 15 years are affected. The caste variable has also emerged through quantitative as well as geophysical locations analysis as 5.44% of arsenicosis manifested individual belong to scheduled caste (SC), 3.89% to extremely backward caste (EBC), 2.57% to backward caste (BC) and 3% to other. Among three clusters of arsenic poisoned locations, two belong to SC and EBC. The village as arsenic affected is being discriminated, whereas the affected individual is also facing discrimination, isolation, stigma, and problem in getting married. The forceful intervention to install hand-pumps in the first water decades and later restructuring of the dug well destroyed a conventional method of dug well cleaning. Conclusion: The common manifestation of arsenicosis has increased by 1.3% within six years of span in the village. This raised the need for setting up a proper surveillance system in the village. It is imperative to consider the social structure for arsenic mitigation program as this research reveals caste as a significant factor. The health and social implications found in the study; retrospectively analyzed as the collateral impact of water resource development programs in the village.

Keywords: arsenicosis, caste, collateral impact, water resources

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Authors: Bistra Kunovska, Kremena Ivanova, Jana Djounova, Desislava Djunakova, Zdenka Stojanovska

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The carcinogenic effects of radon as a radioactive noble gas have been studied and show a strong correlation between radon exposure and lung cancer occurrence, even in the case of low radon levels. The major part of the natural radiation dose in humans is received by inhaling radon and its progenies, which originates from the decay chain of U-238. Indoor radon poses a substantial threat to human health when build-up occurs in confined spaces such as homes, mines and caves and the risk increases with the duration of radon exposure and is proportional to both the radon concentration and the time of exposure. Tourist caves are a case of special environmental conditions that may be affected by high radon concentration. Tourist caves are a recognized danger in terms of radon exposure to cave workers (guides, employees working in shops built above the cave entrances, etc.), but due to the sensitive nature of the cave environment, high concentrations cannot be easily removed. Forced ventilation of the air in the caves is considered unthinkable due to the possible harmful effects on the microclimate, flora and fauna. The risks to human health posed by exposure to elevated radon levels in caves are not well documented. Various studies around the world often detail very high concentrations of radon in caves and exposure of employees but without a follow-up assessment of the overall impact on human health. This study was developed in the implementation of a national project to assess the potential health effects caused by exposure to elevated levels of radon in buildings with public access under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018. The purpose of the work is to assess the radon level in Bulgarian caves and the exposure of the visitors and workers. The number of caves (sampling size) was calculated for simple random selection from total available caves 65 (sampling population) are 13 caves with confidence level 95 % and confidence interval (margin of error) approximately 25 %. A measurement of the radon concentration in air at specific locations in caves was done by using CR-39 type nuclear track-etch detectors that were placed by the participants in the research team. Despite the fact that all of the caves were formed in karst rocks, the radon levels were rather different from each other (97–7575 Bq/m3). An assessment of the influence of the orientation of the caves in the earth's surface (horizontal, inclined, vertical) on the radon concentration was performed. Evaluation of health hazards and radon risk exposure causing by inhaling the radon and its daughter products in each surveyed caves was done. Reducing the time spent in the cave has been recommended in order to decrease the exposure of workers.

Keywords: tourist caves, radon concentration, exposure, Bulgaria

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Authors: Hilal Keklicek, Fatih Erbahceci, Elif Kirdi, Ali Yalcin, Semra Topuz, Ozlem Ulger, Gul Sener

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Objectives and Goals: The stride-to-stride fluctuations in gait is a determinant of qualified locomotion as known as gait variability. Gait variability is an important predictive factor of fall risk and useful for monitoring the effects of therapeutic interventions and rehabilitation. Comparison of gait variability in individuals with trans-tibial lower limb loss and trans femoral lower limb loss was the aim of the study. Methods: Ten individuals with traumatic unilateral trans femoral limb loss(TF), 12 individuals with traumatic transtibial lower limb loss(TT) and 12 healthy individuals(HI) were the participants of the study. All participants were evaluated with treadmill. Gait characteristics including mean step length, step length variability, ambulation index, time on each foot of participants were evaluated with treadmill. Participants were walked at their preferred speed for six minutes. Data from 4th minutes to 6th minutes were selected for statistical analyses to eliminate learning effect. Results: There were differences between the groups in intact limb step length variation, time on each foot, ambulation index and mean age (p < .05) according to the Kruskal Wallis Test. Pairwise analyses showed that there were differences between the TT and TF in residual limb variation (p=.041), time on intact foot (p=.024), time on prosthetic foot(p=.024), ambulation index(p = .003) in favor of TT group. There were differences between the TT and HI group in intact limb variation (p = .002), time on intact foot (p<.001), time on prosthetic foot (p < .001), ambulation index result (p < .001) in favor of HI group. There were differences between the TF and HI group in intact limb variation (p = .001), time on intact foot (p=.01) ambulation index result (p < .001) in favor of HI group. There was difference between the groups in mean age result from HI group were younger (p < .05).There were similarity between the groups in step lengths (p>.05) and time of prosthesis using in individuals with lower limb loss (p > .05). Conclusions: The pilot study provided basic data about gait stability in individuals with traumatic lower limb loss. Results of the study showed that to evaluate the gait differences between in different amputation level, long-range gait analyses methods may be useful to get more valuable information. On the other hand, similarity in step length may be resulted from effective prosthetic using or effective gait rehabilitation, in conclusion, all participants with lower limb loss were already trained. The differences between the TT and HI; TF and HI may be resulted from the age related features, therefore, age matched population in HI were recommended future studies. Increasing the number of participants and comparison of age-matched groups also recommended to generalize these result.

Keywords: lower limb loss, amputee, gait variability, gait analyses

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Authors: Neha Awasthi, Ujjwal Kumar

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Density of large carnivores is primarily dictated by the density of their prey. Therefore, optimal management of ungulates populations permits harbouring of viable large carnivore populations within protected areas. Ungulate density is likely to respond to regimes of protection and vegetation types. This has generated the need among conservation practitioners to obtain strata specific seasonal species densities for habitat management. Kanha Tiger Reserve (KTR) of 2074 km2 area comprises of two distinct management strata: The core (940 km2), devoid of human settlements and buffer (1134 km2) which is a multiple use area. In general, four habitat strata, grassland, sal forest, bamboo-mixed forest and miscellaneous forest are present in the reserve. Stratified sampling approach was used to access a) impact of human use and b) effect of habitat and season on ungulate densities. Since 2013 to 2016, ungulates were surveyed in winter and summer of each year with an effort of 1200 km walk in 200 spatial transects distributed throughout Kanha Tiger Reserve. We used a single detection function for each species within each habitat stratum for each season for estimating species specific seasonal density, using program DISTANCE. Our key results state that the core area had 4.8 times higher wild ungulate biomass compared with the buffer zone, highlighting the importance of undisturbed area. Chital was found to be most abundant, having a density of 30.1(SE 4.34)/km2 and contributing 33% of the biomass with a habitat preference for grassland. Unlike other ungulates, Gaur being mega herbivore, showed a major seasonal shift in density from bamboo-mixed and sal forest in summer to miscellaneous forest in winter. Maximum diversity and ungulate biomass were supported by grassland followed by bamboo-mixed habitat. Our study stresses the importance of inviolate core areas for achieving high wild ungulate densities and for maintaining populations of endangered and rare species. Grasslands accounts for 9% of the core area of KTR maintained in arrested stage of succession, therefore enhancing this habitat would maintain ungulate diversity, density and cater to the needs of only surviving population of the endangered barasingha and grassland specialist the blackbuck. We show the relevance of different habitat types for differential seasonal use by ungulates and attempt to interpret this in the context of nutrition and cover needs by wild ungulates. Management for an optimal habitat mosaic that maintains ungulate diversity and maximizes ungulate biomass is recommended.

Keywords: distance sampling, habitat management, ungulate biomass, diversity

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Authors: Nasim Hashemi, Abbas Sheikhtaheri

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Telemedicine is the use of telecommunication and information technologies to provide health care services that would often not be consistently available in distant rural communities to people at these remote areas. Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Thus, teleophthalmology can overcome geographical barriers and improve quality, access, and affordability of eye health care services. Since teleophthalmology has been widespread applied in recent years, the aim of this study was to determine the different applications of teleophthalmology in the world. To this end, three bibliographic databases (Medline, ScienceDirect, Scopus) were comprehensively searched with these keywords: eye care, eye health care, primary eye care, diagnosis, detection, and screening of different eye diseases in conjunction with telemedicine, telehealth, teleophthalmology, e-services, and information technology. All types of papers were included in the study with no time restriction. We conducted the search strategies until 2015. Finally 70 articles were surveyed. We classified the results based on the’type of eye problems covered’ and ‘the type of telemedicine services’. Based on the review, from the ‘perspective of health care levels’, there are three level for eye health care as primary, secondary and tertiary eye care. From the ‘perspective of eye care services’, the main application of teleophthalmology in primary eye care was related to the diagnosis of different eye diseases such as diabetic retinopathy, macular edema, strabismus and aged related macular degeneration. The main application of teleophthalmology in secondary and tertiary eye care was related to the screening of eye problems i.e. diabetic retinopathy, astigmatism, glaucoma screening. Teleconsultation between health care providers and ophthalmologists and also education and training sessions for patients were other types of teleophthalmology in world. Real time, store–forward and hybrid methods were the main forms of the communication from the perspective of ‘teleophthalmology mode’ which is used based on IT infrastructure between sending and receiving centers. In aspect of specialists, early detection of serious aged-related ophthalmic disease in population, screening of eye disease processes, consultation in an emergency cases and comprehensive eye examination were the most important benefits of teleophthalmology. Cost-effectiveness of teleophthalmology projects resulted from reducing transportation and accommodation cost, access to affordable eye care services and receiving specialist opinions were also the main advantages of teleophthalmology for patients. Teleophthalmology brings valuable secondary and tertiary care to remote areas. So, applying teleophthalmology for detection, treatment and screening purposes and expanding its use in new applications such as eye surgery will be a key tool to promote public health and integrating eye care to primary health care.

Keywords: applications, telehealth, telemedicine, teleophthalmology

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

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Introduction: Indigenous LGBTQ individuals face with significant life stress such as racial and gender discrimination and microaggressions, which may lead to negative impacts of their mental health. Although studies relevant to Taiwanese indigenous LGBTQpeople gradually increase, most of them are primarily conceptual or qualitative in nature. This research aims to fulfill the gap by offering empirical quantitative evidence, especially investigating the impact of racial and gender microaggressions on mental health among Taiwanese indigenous LGBTQindividuals with an intersectional perspective, as well as examine whether social support can help them to cope with microaggressions. Methods: Participants were (n=200; mean age=29.51; Female=31%, Male=61%, Others=8%). A cross-sectional quantitative design was implemented using data collected in the year 2020. Standardised measurements was used, including Racial Microaggression Scale (10 items), Gender Microaggression Scale (9 items), Social Support Questionnaire-SF(6 items); Patient Health Questionnaire(9-item); and Generalised Anxiety Disorder(7-item). Covariates were age, gender, and perceived economic hardships. Structural equation modelling (SEM) was employed using Mplus 8.0 with the latent variables of depression and anxiety as outcomes. A main effect SEM model was first established (Model1).To test the moderation effects of perceived social support, an interaction effect model (Model 2) was created with interaction terms entered into Model1. Numerical integration was used with maximum likelihood estimation to estimate the interaction model. Results: Model fit statistics of the Model 1:X2(df)=1308.1 (795), p<.05; CFI/TLI=0.92/0.91; RMSEA=0.06; SRMR=0.06. For Model, the AIC and BIC values of Model 2 improved slightly compared to Model 1(AIC =15631 (Model1) vs. 15629 (Model2); BIC=16098 (Model1) vs. 16103 (Model2)). Model 2 was adopted as the final model. In main effect model 1, racialmicroaggressionand perceived social support were associated with depression and anxiety, but not sexual orientation microaggression(Indigenous microaggression: b = 0.27 for depression; b=0.38 for anxiety; Social support: b=-0.37 for depression; b=-0.34 for anxiety). Thus, an interaction term between social support and indigenous microaggression was added in Model 2. In the final Model 2, indigenous microaggression and perceived social support continues to be statistically significant predictors of both depression and anxiety. Social support moderated the effect of indigenous microaggression of depression (b=-0.22), but not anxiety. All covariates were not statistically significant. Implications: Results indicated that racial microaggressions have a significant impact on indigenous LGBTQ people’s mental health. Social support plays as a crucial role to buffer the negative impact of racial microaggression. To promote indigenous LGBTQ people’s wellbeing, it is important to consider how to support them to develop social support network systems.

Keywords: microaggressions, intersectionality, indigenous population, mental health, social support

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Authors: Jayeon Kim, Eunjung Yu, Taeki Yoon

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Most spontaneous miscarriage is believed to be a consequence of embryo aneuploidies. Transferring eukaryotic embryos selected by PGS is expected to decrease the miscarriage rate. Current PGS indications include advanced maternal age, recurrent pregnancy loss, repeated implantation failure. Recently, use of PGS for healthy women without above indications for the purpose of improving in vitro fertilization (IVF) outcomes is on the rise. However, it is still controversy about the beneficial effect of PGS in this population, especially, in women with a history of no more than 2 miscarriages or miscarriage of eukaryotic abortus. This study aimed to investigate if karyotyping result of abortus is a good indicator of preimplantation genetic screening (PGS) in subsequent IVF cycle in women with a history of spontaneous abortion. A single-center retrospective cohort study was performed. Women who had spontaneous abortion(s) (less than 3) and dilatation and evacuation, and subsequent IVF from January 2016 to November 2016 were included. Their medical information was extracted from the charts. Clinical pregnancy was defined as presence of a gestational sac with fetal heart beat detected on ultrasound in week 7. Statistical analysis was performed using SPSS software. Total 234 women were included. 121 out of 234 (51.7%) underwent karyotyping of the abortus, and 113 did not have the abortus karyotyped. Embryo biopsy was performed on 3 or 5 days after oocyte retrieval, followed by embryo transfer (ET) on a fresh or frozen cycle. The biopsied materials were subjected to microarray comparative genomic hybridization. Clinical pregnancy rate per ET was compared between PGS and non-PGS group in each study group. Patients were grouped by two criteria: karyotype of the abortus from previous miscarriage (unknown fetal karyotype (n=89, Group 1), eukaryotic abortus (n=36, Group 2) or aneuploidy abortus (n=67, Group 3)), and pursuing PGS in subsequent IVF cycle (pursuing PGS (PGS group, n=105) or not pursuing PGS (non-PGS group, n=87)). The PGS group was significantly older and had higher number of retrieved oocytes and prior miscarriages compared to non-PGS group. There were no differences in BMI and AMH level between those two groups. In PGS group, the mean number of transferable embryos (eukaryotic embryo) was 1.3 ± 0.7, 1.5 ± 0.5 and 1.4 ± 0.5, respectively (p = 0.049). In 42 cases, ET was cancelled because all embryos biopsied turned out to be abnormal. In all three groups (group 1, 2, and 3), clinical pregnancy rates were not statistically different between PGS and non-PGS group (Group 1: 48.8% vs. 52.2% (p=0.858), Group 2: 70% vs. 73.1% (p=0.730), Group 3: 42.3% vs. 46.7% (p=0.640), in PGS and non-PGS group, respectively). In both groups who had miscarriage with eukaryotic and aneuploidy abortus, the clinical pregnancy rate between IVF cycles with and without PGS was not different. When we compare miscarriage and ongoing pregnancy rate, there were no significant differences between PGS and non-PGS group in all three groups. Our results show that the routine application of PGS in women who had less than 3 miscarriages would not be beneficial, even in cases that previous miscarriage had been caused by fetal aneuploidy.

Keywords: preimplantation genetic diagnosis, miscarriage, kpryotyping, in vitro fertilization

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Genute Gedviliene, Vidmantas Tutlys

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The aim of this paper is to reveal the deployment and development of the social competence in the higher education programmes of adult education and in the continuing training and competence development of the andragogues. There will be compared how the issues of cooperation and communication in the learning and teaching processes are treated in the study programmes and in the courses of continuing training of andragogues. Theoretical and empirical research methods were combined for research analysis. For the analysis the following methods were applied: 1) Literature and document analysis helped to highlight the communication and cooperation as fundamental phenomena of the social competence, it’s important for the adult education in the context of digitalization and globalization. There were also analyzed the research studies on the development of social competence in the field of andragogy, as well as on the place and weight of the social competence in the overall competence profile of the andragogue. 2) The empirical study is based on questionnaire survey method. The population of survey consists of 240 students of bachelor and master degree studies of andragogy in Lithuania and of 320 representatives of the different bodies and institutions involved in the continuing training and professional development of the adult educators in Lithuania. The themes of survey questionnaire were defined on the basis of findings of the literature review and included the following: 1) opinions of the respondents on the role and place of a social competence in the work of andragogue; 2) opinions of the respondents on the role and place of the development of social competence in the curricula of higher education studies and continuing training courses; 3) judgements on the implications of the higher education studies and courses of continuing training for the development of social competence and it’s deployment in the work of andragogue. Data analysis disclosed a wide range of ways and modalities of the deployment and development of social competence in the preparation and continuing training of the adult educators. Social competence is important for the students and adult education providers not only as the auxiliary capability for the communication and transfer of information, but also as the outcome of collective learning leading to the development of new capabilities applied by the learners in the learning process, their professional field of adult education and their social life. Equally so, social competence is necessary for the effective adult education activities not only as an auxiliary capacity applied in the teaching process, but also as a potential for improvement, development and sustainability of the didactic competence and know-how in this field. The students of the higher education programmes in the field of adult education treat social competence as important generic capacity important for the work of adult educator, whereas adult education providers discern the concrete issues of application of social competence in the different processes of adult education, starting from curriculum design and ending with assessment of learning outcomes.

Keywords: adult education, andragogues, social competence, curriculum

Procedia PDF Downloads 142

Authors: Tomi Lois Olatunji, Frances Siebert, Ademola Emmanuel Adetunji, Brian Harvey, Johane Gericke, Josias Hamman, Frank Van Der Kooy

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Ethnopharmacological relevance: Sceletium tortuosum (L.) N.E.Br, the most sought after and widely researched species in the genus Sceletium is a succulent forb endemic to South Africa. Traditionally, this medicinal plant is mainly masticated or smoked and used for the relief of toothache, abdominal pain, and as a mood-elevator, analgesic, hypnotic, anxiolytic, thirst and hunger suppressant, and for its intoxicating/euphoric effects. Sceletium tortuosum is currently of widespread scientific interest due to its clinical potential in treating anxiety and depression, relieving stress in healthy individuals, and enhancing cognitive functions. These pharmacological actions are attributed to its phytochemical constituents referred to as mesembrine-type alkaloids. Aim of the review: The aim of this review was to comprehensively summarize and critically evaluate recent research advances on the phytochemistry, pharmacokinetics, biological and clinical activities of the medicinal plant S. tortuosum. Additionally, current ongoing research and future perspectives are also discussed. Methods: All relevant scientific articles, books, MSc and Ph.D. dissertations on botany, behavioral pharmacology, traditional uses, and phytochemistry of S. tortuosum were retrieved from different databases (including Science Direct, PubMed, Google Scholar, Scopus and Web of Science). For pharmacokinetics and pharmacological effects of S. tortuosum, the focus fell on relevant publications published between 2009 and 2021. Results: Twenty-five alkaloids belonging to four structural classes viz: mesembrine, Sceletium A4, joubertiamine, and tortuosamine, have been identified from S. tortuosum, of which the mesembrine class is predominant. The crude extracts and commercially available standardized extracts of S. tortuosum have displayed a wide spectrum of biological activities (e.g. antimalarial, anti-oxidant, immunomodulatory, anti-HIV, neuroprotection, enhancement of cognitive function) in in vitro or in vivo studies. This plant has not yet been studied in a clinical population, but has potential for enhancing cognitive function, and managing anxiety and depression. Conclusion: As an important South African medicinal plant, S. tortuosum has garnered many research advances on its phytochemistry and biological activities over the last decade. These scientific studies have shown that S. tortuosum has various bioactivities. The findings have further established the link between the phytochemistry and pharmacological application, and support the traditional use of S. tortuosum in the indigenous medicine of South Africa.

Keywords: Aizoaceae, Mesembrine, Serotonin, Sceletium tortuosum, Zembrin®, psychoactive, antidepressant

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Authors: Hind Alshoubaki

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The world is now confronting a widespread urban phenomenon: refugee camps, which have mostly been established in ‘rushing mode,’ pointing toward affording temporary settlements for refugees that provide them with minimum levels of safety, security and protection from harsh weather conditions within a very short time period. In fact, those emergency settlements are transforming into permanent ones since time is a decisive factor in terms of construction and camps’ age. These play an essential role in transforming their temporary character into a permanent one that generates deep modifications to the city’s territorial structure, shaping a new identity and creating a contentious change in the city’s form and history. To achieve a better understanding for the transformation of refugee camps, this study is based on a mixed-methods approach: the qualitative approach explores different refugee camps and analyzes their transformation process in terms of population density and the changes to the city’s territorial structure and urban features. The quantitative approach employs a statistical regression analysis as a reliable prediction of refugees’ satisfaction within the Zaatari camp in order to predict its future transformation. Obviously, refugees’ perceptions of their current conditions will affect their satisfaction, which plays an essential role in transforming emergency settlements into permanent cities over time. The test basically discusses five main themes: the access and readiness of schools, the dispersion of clinics and shopping centers; the camp infrastructure, the construction materials, and the street networks. The statistical analysis showed that Syrian refugees were not satisfied with their current conditions inside the Zaatari refugee camp and that they had started implementing changes according to their needs, desires, and aspirations because they are conscious about the fact of their prolonged stay in this settlement. Also, the case study analyses showed that neglecting the fact that construction takes time leads settlements being created with below-minimum standards that are deteriorating and creating ‘slums,’ which lead to increased crime rates, suicide, drug use and diseases and deeply affect cities’ urban tissues. For this reason, recognizing the ‘temporary-eternal’ character of those settlements is the fundamental concept to consider refugee camps from the beginning as definite permanent cities. This is the key factor to minimize the trauma of displacement on both refugees and the hosting countries. Since providing emergency settlements within a short time period does not mean using temporary materials, having a provisional character or creating ‘makeshift cities.’

Keywords: refugee, refugee camp, temporary, Zaatari

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Authors: Rabia Genc, Aysun Eksioglu, Emine Serap Sarican, Sibel Icke

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Today the habit of cigarette smoking is among one of the most important public health concerns because of the health problems it leads to. The most important and hazardous group to use tobacco and tobacco products is adolescents and teenagers. And one of the most effective ways to prevent them from starting to smoke is education. This research is a kind of educational intervention study which was carried out in order to evaluate the effect of peer education on the teenagers' knowledge about smoking. The research was carried out between October 15, 2013 and September 9, 2015 at Ege University Ataturk Vocational Health School. The population of the research comprised of the students that have been studying at Ege University Atatürk Vocational Health School, Midwifery Department (N=390). The peer educator group that would give training on smoking consisted of 10 people, and the peer groups that would be trained were divided into two groups via simple randomization as experimental group (n=185) and control group (n=185). Questionnaire, information evaluation form, and informed consent forms were used as date collection tools. The analysis of the data which were collected in the study was carried out on Statistical Package for Social Science (SPSS 15.0). It was found out that 62.5 % of the students who were in peer educator group had smoked in some period of their lives; however, none of them continued to smoke. When they were asked about their reasons to start smoking, 25% said they just wanted to try it, and 25% of them answered that it was because of their friend groups. When the pre-peer education and post-peer education point averages of peer educator group were evaluated, the results showed that there was a significant difference between the point averages (p < 0.05). When the cigarette use of experimental group and the control group were evaluated, it was clear that 18.2% of the experimental group and 24.2%of the control group still smokes. 9.1% of the experimental group and 14.8% of control group stated that they started smoking because of their friend groups. Among the students who smoke 15.9% of the ones who belongs to the experimental group and 21.9% of the ones who belong to the control group stated they are thinking of quitting smoking. It was clear that there is a significant difference between the pre-education and post-education point averages of experimental group statistically (p ≤ 0.05); however, in terms of control group, there were no significant differences between the pre-test post-test averages statistically. Between the pre-test post-test averages of experimental and control groups there were not any statistically significant differences (p > 0.05). It was found out in the study that the peer education programme is not effective on the smoking habit of Vocational Health School students. When the future studies are being planned in order to evaluate the peer education activity, it can be taken into consideration that the peer education takes a long term and the students in the educator group will be more enthusiastic and a kind of leader in their environment.

Keywords: midwifery, peer, peer education, smoking

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Authors: Amardass Dhami, Clare Samuelson

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Background: Sickle cell disease (SCD) is a complex, multisystem condition that significantly impacts patients' quality of life, characterized by acute illness episodes, progressive organ damage, and reduced life expectancy. In the UK, over 13,000 individuals are affected, with South Yorkshire having the fifth highest prevalence, including approximately 800 patients. Retinal complications in SCD can manifest as either proliferative or non-proliferative disease, with proliferative changes being more prevalent. These retinal issues can cause significant morbidity, including visual loss and increased care requirements, underscoring the need for regular monitoring. An integrated approach was applied to ensure timely interventions, ultimately enhancing patient outcomes and reduce ‘did not attend’ rates. Aim: To assess the factors which may influence attendance to Haematology and Ophthalmology Clinics with attention towards levels of deprivation towards non-attendance. Method : A retrospective study on 84 eligible patients, from the regional tertiary Centre for Sickle Cell Care (Sheffield Teaching Hospital) from 2017 to 2023. The study focused on the incidence of sickle cell eye disease, specifically examining the outcomes of patients who attended the combined haematology and ophthalmology clinics. Patients who did not attend either clinic were excluded from the analysis to ensure a clear understanding of the combined clinic's impact. This data was then compared with the United Kingdom’s Index of Multiple Deprivation (IMD) datasets to assess if inequalities of care affected this population. Results: The study concluded that the effectiveness of combining haematology and ophthalmology clinics was reduced following the intervention. The DNA rates increased to 40% for the haematology clinic. Additionally, a significant proportion of the cohort was classified as residing in areas of deprivation, suggesting a possible link between socioeconomic factors and non-attendance rates Conclusion: These findings underscore the challenges of integrating care for SCD patients, particularly in relation to socioeconomic barriers. Despite the intent to streamline care and improve patient outcomes, the increase in DNA rates points to the need for further investigation into the underlying causes of non-attendance. Addressing these issues, especially in deprived areas, could enhance the effectiveness of combined clinics and ensure that patients receive the necessary monitoring and interventions for their eye health and overall well-being. Future strategies may need to focus on improving accessibility, outreach, and support for patients to mitigate the impact of socioeconomic factors on healthcare attendance.

Keywords: south yorkshire, sickle cell anemia, deprivation, factors, haematology

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Authors: Siddhartha Khare, Nitish Kr Boro, Omm Animesh Mishra

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Recent food price hikes may signal the end of an era of predictable global grain crop plenty due to climate change, population expansion, and dietary changes. Food consumption will treble in 20 years, requiring enormous production expenditures. Climate and the atmosphere changed owing to rainfall and seasonal cycles in the past decade. India's tropical agricultural relies on evapotranspiration and monsoons. In places with limited resources, the global environmental change affects agricultural productivity and farmers' capacity to adjust to changing moisture patterns. Motivated by these difficulties, satellite remote sensing might be combined with near-surface imaging data (smartphones, UAVs, and PhenoCams) to enable phenological monitoring and fast evaluations of field-level consequences of extreme weather events on smallholder agriculture output. To accomplish this technique, we must digitally map all communities agricultural boundaries and crop kinds. With the improvement of satellite remote sensing technologies, a geo-referenced database may be created for rural Indian agriculture fields. Using AI, we can design digital agricultural solutions for individual farms. Main objective is to Geo-enable each farm along with their seasonal crop information by combining Artificial Intelligence (AI) with satellite and near-surface data and then prepare long term crop monitoring through in-depth field analysis and scanning of fields with satellite derived vegetation indices. We developed an AI based algorithm to understand the timelapse based growth of vegetation using PhenoCam or Smartphone based images. We developed an android platform where user can collect images of their fields based on the android application. These images will be sent to our local server, and then further AI based processing will be done at our server. We are creating digital boundaries of individual farms and connecting these farms with our smart phone application to collect information about farmers and their crops in each season. We are extracting satellite-based information for each farm from Google earth engine APIs and merging this data with our data of tested crops from our app according to their farm’s locations and create a database which will provide the data of quality of crops from their location.

Keywords: artificial intelligence, satellite remote sensing, crop monitoring, android and web application

Procedia PDF Downloads 100

Authors: İlknur Gökşin, Sultan Ayaz Alkaya

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Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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Authors: Tamar Grdzelishvili, Zaza Sinauridze

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Introduction: Preeclampsia is a complication of the second trimester of pregnancy, which is characterized by high morbidity and multiorgan damage. Many complex pathogenic mechanisms are now implicated to be responsible for this disease (1). Preeclampsia is one of the leading causes of maternal mortality worldwide. Statistics are enough to convince you of the seriousness of this pathology: about 100,000 women die of preeclampsia every year. It occurs in 3-14% (varies significantly depending on racial origin or ethnicity and geographical region) of pregnant women, in 75% of cases - in a mild form, and in 25% - in a severe form. During severe pre-eclampsia-eclampsia, perinatal mortality increases by 5 times and stillbirth by 9.6 times. Considering that the only way to treat the disease is to end the pregnancy, the main thing is timely diagnosis and prevention of the disease. Identification of high-risk pregnant women for PE and giving prophylaxis would reduce the incidence of preterm PE. First-trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses the Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE (2) Methods: Retrospective single center screening study. The study population consisted of women from the Tbilisi maternity hospital “Pineo medical ecosystem” who met the following criteria: they spoke Georgian, English, or Russian and agreed to participate in the study after discussing informed consent and answering questions. Prior to the study, the informed consent forms approved by the Institutional Review Board were obtained from the study subjects. Early assessment of preeclampsia was performed between 11-13 weeks of pregnancy. The following were evaluated: anamnesis, dopplerography of the uterine artery, mean arterial blood pressure, and biochemical parameter: Pregnancy-associated plasma protein A (PAPP-A). Individual risk assessment was performed with performed by Fast Screen 3.0 software ThermoFisher scientific. Results: A total of 513 women were recruited and through the study, 51 women were diagnosed with preeclampsia (34.5% in the pregnant women with high risk, 6.5% in the pregnant women with low risk; P<0.000 1). Conclusions: First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting. More patient studies are needed for final conclusions. The research is still ongoing.

Keywords: first-trimester, preeclampsia, screening, pregnancy-associated plasma protein

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Authors: Roman Khanferyan, Levon Gevorkyan, Ivan Radysh

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Skin barrier dysfunction induces multiple inflammatory skin diseases. Epidemiological studies clearly support the link between most dermatological pathologies, immune disorders and metabolic disorders. Among them most common are psoriasis (PS) and Atopic dermatitis (AD). Psoriasis is a chronic immune-mediated inflammatory skin disease that affects 1.5 to 3.0% of the world's population. Comorbid metabolic disorders play an important role in the progression of PS and AD, as well. It is well known that PS, AD and overweight/obesity are associated with common pathophysiological mechanisms of mild chronic inflammation. The goal of the study was to study the immune disturbances in patients with PS, AD and comorbid metabolic disorders. To study the prevalence of comorbidity of PS and AD (data from 1406 patient’s histories of diseases) were analyzed. The severity of the disease is assessed using the PASI index (Psoriasis Area and Severity Index). 59 patients with psoriasis of different localizations of lesions and severity, as well as with different body mass index (BMI), were examined. The determination of the concentration of pro-inflammatory cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNFa) and chemokines (RANTES, IP-10, MCP-1 and Eotaxin) in sera and supernatants of 48h-cultivated peripheral blood mononuclear cell (PBMC) of psoriasis patients and healthy volunteers (36 adults) have been carried out by multiplex assay (Luminex Corporation, USA). It has been demonstrated that 42% of PS patients had comorbidity with different types of atopies. The most common was bronchial asthma and allergic rhinitis. At the same time, the prevalence of AD in PS patients was determined in 8.7% of patients. It has been shown that serum levels of all studied cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNF) in most of the studied patients were higher in PS patients than in those with AD and healthy controls (p<0.05). An in vitro synthesis of the IL-6 and IFNγ by PBMC demonstrated similar results to those determined in blood sera. There was a high correlation between BMI, immune mediators and the concentrations of adipokines and chemokines (p<0.05). The concentrations of Leptin and Resistin in obese psoriatic patients were greater by 28.6% and 17%, respectively, compared to non-obese psoriatic patients. In obese patients with psoriasis the serum levels of adiponectin were decreased up to 1.3-fold. The mean serum RANTES, IP-10, MCP-1, EOTAXIN levels in obese psoriatic patients were decreased by up to 13.1%, 21.9%, 40.4% and 28.2%, respectively. Similar results have been demonstrated in AD patients with comorbid overweight and obesity. Thus, the study demonstrated the important role of cytokines and chemokines dysregulation in inflammatory skin diseases, especially in patients with comorbid obesity and overweight. Metabolic disorders promote the severity of PS and AD, highly increase immune dysregulation, and synthesis of adipokines, which correlates with the production of proinflammatory immune mediators in comorbid obesity and overweight.

Keywords: psoriasis, atopic dermatitis, pro-inflammatory cytokines, chemokines, comorbid obesity

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Authors: Rhommel Grutas, Ishmael Narag, Harley Lacbawan

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Construction of high-rise buildings is a means to address the increasing population in Metro Manila, Philippines. The existence of the Valley Fault System within the metropolis and other nearby active faults poses threats to a densely populated city. The distant, shallow and large magnitude earthquakes have the potential to generate slow and long-period vibrations that would affect medium-to-high rise buildings. Heavy damage and building collapse are consequences of prolonged shaking of the structure. If the ground and the building have almost the same period, there would be a resonance effect which would cause the prolonged shaking of the building. Microzoning the long-period ground response would aid in the seismic design of medium to high-rise structures. The shear-wave velocity structure of the subsurface is an important parameter in order to evaluate ground response. Borehole drilling is one of the conventional methods of determining shear-wave velocity structure however, it is an expensive approach. As an alternative geophysical exploration, microtremor array measurements can be used to infer the structure of the subsurface. Microtremor array measurement system was used to survey fifty sites around Metro Manila including some municipalities of Rizal and Cavite. Measurements were carried out during the day under good weather conditions. The team was composed of six persons for the deployment and simultaneous recording of the microtremor array sensors. The instruments were laid down on the ground away from sewage systems and leveled using the adjustment legs and bubble level. A total of four sensors were deployed for each site, three at the vertices of an equilateral triangle with one sensor at the centre. The circular arrays were set up with a maximum side length of approximately four kilometers and the shortest side length for the smallest array is approximately at 700 meters. Each recording lasted twenty to sixty minutes. From the recorded data, f-k analysis was applied to obtain phase velocity curves. Inversion technique is applied to construct the shear-wave velocity structure. This project provided a microzonation map of the metropolis and a profile showing the long-period response of the deep sedimentary basin underlying Metro Manila which would be suitable for local administrators in their land use planning and earthquake resistant design of medium to high-rise buildings.

Keywords: earthquake, ground motion, microtremor, seismic microzonation

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Authors: Einat E. Peles, Shaul Schreiber, Miriam Adelson

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Background: Since established more than 50 years ago, methadone maintenance treatment (MMT) is the most effective treatment for opioid addiction, a chronic relapsing brain disorder that became an epidemic in western societies. Treatment includes daily individual optimal medication methadone dose (a long acting mu opioid receptor full agonist), accompanied with psychosocial therapy. It is well established that the longer retention in treatment the better outcome and survival occur. It reduces the likelihood to infectious diseases and overdose death that associated with drug injecting, enhanced social rehabilitation and eliminate criminal activity, and lead to healthy productive life. Aim: To evaluate predictors for long term retention in treatment we analyzed our prospective follow up of a major MMT clinic affiliated to a big tertiary medical center. Population Methods: Between June 25, 1993, and June 24, 2016, all 889 patients ( ≥ 18y) who ever admitted to the clinic were prospectively followed-up until May 2017. Duration in treatment from the first admission until the patient quit treatment or until the end of follow-up (24 years) was taken for calculating cumulative retention in treatment using survival analyses (Kaplan Meier) with log-rank and Cox regression for multivariate analyses. Results: Of the 889 patients, 25.2% were females who admitted to treatment at younger age (35.0 ± 7.9 vs. 40.6 ± 9.8, p < .0005), but started opioid usage at same age (22.3 ± 6.9). In addition to opioid use, on admission to MMT 58.5% had positive urine for benzodiazepines, 25% to cocaine, 12.4% to cannabis and 6.9% to amphetamines. Hepatitis C antibody tested positive in 55%, and HIV in 7.8% of the patients and 40%. Of all patients, 75.7% stayed at least one year in treatment, and of them, 67.7% stopped opioid usage (based on urine tests), and a net reduction observed in all other substance abuse (proportion of those who stopped minus proportion of those who have started). Long term retention up to 24 years was 8.0 years (95% Confidence Interval (CI) 7.4-8.6). Predictors for longer retention in treatment (Cox regression) were being older on admission ( ≥ 30y) Odds Ratio (OR) =1.4 (CI 1.1-1.8), not abusing opioids after one year OR=1.8 (CI 1.5-2.1), not abusing benzodiazepine after one year OR=1.7 (CI 1.4-2.1) and treating with methadone dose ≥ 100mg/day OR =1.8 (CI 1.5-2.3). Conclusions: Treating and following patients over 24 years indicate success of two main outcomes, high rate of retention after one year (75.7%) and high proportion of opiate abuse cessation (67.7%). As expected, longer cumulative retention was associated with patients treated with high adequate methadone dose that successfully result in opioid cessation. Based on these findings, in order to reduce morbidity and mortality, we find the establishment of more MMT clinics within a general hospital, a most urgent necessity.

Keywords: methadone maintenance treatment, epidemic, opioids, retention

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