Search results for: health care economics

Authors: Wong Ka Fai

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Introduction: Many students are worried before an examination; that is a common picture worldwide. Health problems from stress before examination were insomnia, tiredness, isolation, stomach upset, and anxiety. Nursing students experienced high stress from the examination. Guided imagery is a healing process of applying imagination to help the body heal, survive, or live well. It can bring about significant physiological and biochemical changes, which can trigger the recovery process. A study of nursing students improving their anxiety before examination with guided imagery was proposed. Aim: The aim of this study was to explore the outcome of guided imagery on nursing students’ anxiety before examination in Hong Kong. Method: The qualitative study method was used. 16 first-year students studying nursing programme were invited to practice guided imagery to improve their anxiety before the examination period. One week before the examination, the semi-structured interviews with these students were carried out by the researcher. Result: From the content analysis of interview data, these nursing students showed considerable similarities in their anxiety perception. Nursing students’ perceived improved anxiety was evidenced by a reduction of stressful feelings, improved physical health, satisfaction with daily activities, and enhanced skills for solving problems and upcoming situations. Conclusion: This study indicated that guided imagery can be used as an alternative measure to improve students’ anxiety and psychological problems.

Keywords: nursing students, perception, anxiety, guided imagery

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Authors: Amy Claridge, Tishra Beeson

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Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.

Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic

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Authors: Victor Abu

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Background: Social justice ideals are considered as the foundation of nursing practice. These ideals are not always clearly integrated into nursing professional standards or curricula. This hinders concerted global nursing agendas for becoming aware of social injustice or engaging in action for social justice to improve the health of individuals and groups. Aim and objectives: The aim was to create an educational framework for empowering nursing students for social justice awareness and action. This purpose was attained by understanding the meaning of social justice, the effect of social injustice, the visibility of social justice learning, and ways of integrating social justice in nursing education and practice. Methods: Critical interpretive methodologies and constructivist grounded theory research designs guided the processes of recruiting nursing students (n = 11) and nurse educators (n = 11) at a London nursing university to participate in interviews and focus groups, which were analysed by coding systems. Findings: Firstly, social justice was described as ethical practices that enable individuals and groups to have good access to health resources. Secondly, social injustice was understood as unfair practices that caused minimal access to resources, social deprivation, and poor health. Thirdly, social justice learning was considered to be invisible in nursing education due to a lack of explicit modules, educator knowledge, and organisational support. Lastly, explicit modules, educating educators, and attracting leaders’ support were suggested as approaches for the visible integration of social justice in nursing education and practice. Discussion: This research proposes approaches for nursing awareness and action for the development of critical active nurse-learner, critical conscious nurse-educator, and servant nurse leader. The framework on Awareness for Social Justice Action (ASJA) created in this research is an approach for empowering nursing students for social justice practices. Conclusion: This research contributes to and advocates for greater nursing scholarship to raise the spotlight on social justice in the profession.

Keywords: social justice, nursing practice, nursing education, nursing curriculum, social justice awareness, social justice action, constructivist grounded theory

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Authors: Oluwasaanmi Lawrence Adesuyi, Igbekoyi Kayode Emmanuel

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This study examined vote - commercialization during elections among the voters in Nigeria, a series of elections in Ekiti State, Southwestern Nigeria. Democracy in Nigeria that came to replace the unwanted ruling and dictating mission of the military government has been facing a societal terror “crime of votes commercialization” that stands in jeopardy against its sustainability in Nigeria. Social exchange and action-bound theories were employed as the theoretical framework. Forty-Eight in-depth interviews, key informant interviews, and case studies were conducted with purposively selected respondents in the three senatorial districts that captured the sixteen local governments of the state. The results show that really commercialization of votes has become the order of the day in all series of electioneering among Ekiti people. Also, it was recorded that true democracy is no longer allowed to triumph as a result of vote buying that allows the highest bidder to be the winner. The result also shows that this attitude is not limited to only one political party or one candidate but involved all the political parties that participated in Election. It has become a frequent idea among the electorates during every festive period of election in Ekiti State. The tyrannical attitude has been given a nickname to suit the conditional situation of votes commercialization - (Diboki o se obe), which means vote and have a pot of soup, this implies that you will get money to take care of yourself and the family when you vote and collect money on the vote you cast, notwithstanding the money is being collected from all candidates that participated in the election, but the highest bidder has the day. The main challenge this has on democracy is that the contestants challenge the result of the election results based on the act of vote commercialization. Also, those that bought people’s votes with a huge amount of money relent on their democratic promises. The study showed that the crime of vote commercialization that threatens democracy must be addressed for sustainability.

Keywords: crime, democracy, jeopardy, military, sustainability, votes-commercialization

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Authors: Afnan Ahmad, Shahid Ali, Mujahid Khan

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This research presents the parametric study of an existing earth fill dam located at Latamber, Karak city, Pakistan. The study consists of carrying out seepage analysis, slope stability analysis, and Earthquake analysis of the dam for the existing dam geometry and do the same for modified geometry. Dams are massive as well as expensive hydraulic structure, therefore it needs proper attention. Additionally, this dam falls under zone 2B region of Pakistan, which is an earthquake-prone area and where ground accelerations range from 0.16g to 0.24g peak. So it should be deal with great care, as the failure of any dam can cause irreparable losses. Similarly, seepage as well as slope failure can also cause damages which can lead to failure of the dam. Therefore, keeping in view of the importance of dam construction and associated costs, our main focus is to carry out parametric study of newly constructed dam. GeoStudio software is used for this analysis in the study in which Seep/W is used for seepage analysis, Slope/w is used for Slope stability analysis and Quake/w is used for earthquake analysis. Based on the geometrical, hydrological and geotechnical data, Seepage and slope stability analysis of different proposed geometries of the dam are carried out along with the Seismic analysis. A rigorous analysis was carried out in 2-D limit equilibrium using finite element analysis. The seismic study began with the static analysis, continuing by the dynamic response analysis. The seismic analyses permitted evaluation of the overall patterns of the Latamber dam behavior in terms of displacements, stress, strain, and acceleration fields. Similarly, the seepage analysis allows evaluation of seepage through the foundation and embankment of the dam, while slope stability analysis estimates the factor of safety of the upstream and downstream of the dam. The results of the analysis demonstrate that among multiple geometries, Latamber dam is secure against seepage piping failure and slope stability (upstream and downstream) failure. Moreover, the dam is safe against any dynamic loading and no liquefaction has been observed while changing its geometry in permissible limits.

Keywords: earth-fill dam, finite element, liquefaction, seepage analysis

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Authors: Samaneh Abedini, Diana Coholic

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The transition from adolescence into adulthood involves many changes that result in increased vulnerability to psychological challenges. This developmental stage can be especially stressful for female youth living in underserviced regions. If mental health problems are left untreated in socially marginalized youth, these challenges can extend into adulthood. We know that a lack of access to mental health services and supports can influence adolescents’ psycho-social development and well-being, while resilience and emotion regulation can help them cope with these challenges. Feasible therapeutic programs can play a significant role in assisting youth in developing these characteristics and skills. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) and Holistic Art-Based Program (HAP) are two examples of mindfulness-based interventions (MBIs) that address emotion regulation, coping strategies, and resilience in marginalized youth. While each program’s beneficial effects have been documented, there is a lack of research comparing MBIs with youth, within underserviced geographical locations, and across different cultures. In this study, the sample was 42 female youth between the ages of 12 and 17 years from Iran. 42 female youth from the Elm o Honar High School, located in rural parts of Iran, Isfahan province, have been enrolled in the study. The participants were assigned to one of the MBIs (three MBCT-C experimental groups (n=20) and three HAP experimental groups (n=22)). All participants completed measures including the Child and Youth Resilience Measure-28 (CYRM-28), Child and Adolescent Mindfulness Measure (CAMM), and Difficulties in Emotion Regulation Scale (DERS) at baseline and post-intervention. At the end of intervention, the MBCT-C and HAP experimental groups showed significant changes in resilience and emotion regulation. However, the changes in resilience in HAP groups were not significant; the participants in MBCT-C experimental groups showed significant improvement in resilience. The study provided initial evidence that mindfulness-based intervention can be potentially beneficial for improving mental health status in marginalized Iranian female youth living in the middle east culture.

Keywords: benefits, female, marginalized, mindfulness, youth

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Authors: Jui-Chen Huang, Shou-Hsiung Cheng

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This study examined their willingness to use telecare for people who have had experience falling in the last three months in Taiwan. This study adopted convenience sampling and a structural questionnaire to collect data. It was based on the definition and the constructs related to the Health Belief Model (HBM). HBM is comprised of seven constructs: perceived benefits (PBs), perceived disease threat (PDT), perceived barriers of taking action (PBTA), external cues to action (ECUE), internal cues to action (ICUE), attitude toward using (ATT), and behavioral intention to use (BI). This study adopted Fuzzy Neural Network (FNN) to put forward an effective method. It shows the dependence of ATT on PB, PDT, PBTA, ECUE, and ICUE. The training and testing data RMSE (root mean square error) are 0.028 and 0.166 in the FNN, respectively. The training and testing data RMSE are 0.828 and 0.578 in the regression model, respectively. On the other hand, as to the dependence of ATT on BI, as presented in the FNN, the training and testing data RMSE are 0.050 and 0.109, respectively. The training and testing data RMSE are 0.529 and 0.571 in the regression model, respectively. The results show that the FNN method is better than the regression analysis. It is an effective and viable good way.

Keywords: fall, fuzzy neural network, health belief model, telecare, willingness

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Authors: Ligia Nascimento, Manuela Faia Correia

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Nowadays, Information and Communication Technologies (ICT) are embedded in most professions. Technostress - or stress induced by the use of ICTs, has been studied in various sectors of activity and in different geographical areas, mainly from the perspective of its harmful impacts. In the context of work, the technological contexts capable of causing stress have been examined in-depth, as well as the type of individuals most likely to experience its negative effects. However, new lines of the research argue that the stress generated by the use of ICTs may not necessarily be detrimental (technodistress), admitting that, in contrast, and in addition, it may actually be beneficial to organizations and their employees (technoeustress). Any measures that succeed in reducing technodistress do not necessarily lead to the creation of technoeustress, justifying the study of this phenomenon in a focused and independent manner. Adopting the transactional model of stress as the basic theoretical framework, an ongoing research project aims to study technoeustress independently. Given the role played in the qualification and progress of society and the economy, it becomes particularly critical to care for the well-being of the higher education teacher. Particularly in recent times, when teleworking is prevalent, these professionals have made a huge, compulsive effort to adapt to a new teaching reality. Rather than limiting itself to mitigating adverse effects of ICT use, which featured earlier approaches, the present study seeks to understand how to activate the positive side of technostress in higher education teachers in order to obtain favorable personal and organizational outcomes from ICT use at work. The research model seeks to understand, upstream, the ICT characteristics that increase the perception of technoeustress among higher education teachers, studying the direct and moderating effects of individual and organizational variables and, downstream, the impacts that technoeustress has on job satisfaction and performance. This research contributes both to expanding the knowledge of the technostress phenomenon and to identify possible recommendations for management.

Keywords: higher education teachers, ICT, stress, technoeustress

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Authors: Melike Orhan

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Along with impetuous physical change, configuration and increase in the density of cities, urban public spaces have started to become a transition area rather than spaces to inhabit. The insufficiency of public spaces, one of the most significant components of a city, where communal life is maintained and the decrease in the quality of urban spaces have led to an increase in the use of semi-public spaces as urban space. Semi-public spaces are those that ensure transition between private and public spaces and can be seen, observed, reached and used by urban-dwellers. Humans are in a constant relation to their surroundings and care for integration as part of their surroundings. Semi-public spaces providing balance for the individual between private spaces (structures) and urban-public spaces make this integration easier. Spaces with a semi-public characteristic serve for a particular neighboring unit and the user (i.e. common use areas in residential spaces and dwellings, common outdoor areas situated between office buildings, and etc.) These spaces, whose density of usage is increased with distinctive functions and activities, gain different attributions according to the characteristics of the urban space they are located in (commercial, residential, touristic, and etc.) and to the functions of the structures with which they are in relation. At the same time, they begin to serve other neighboring units along with an increase in public usage. As a result, the interaction between environment-space-structure-humans changes, which directly affects the urban space quality. The aim of this study is to determine how and depending on what characteristics the public usage density of semi-public spaces change and to put forth the effects of this change on the urban environment it is located in and to designate its role in terms of 'urban space quality'. In conclusion, within the scope of this study, semi-public spaces located in urban spaces with distinctive functions will be explored through examples, and the effects of these spaces with altered public usage and density on urban space and quality of life will be put forward. Accordingly, applicable criteria will be determined by means of semi-public spaces oriented at increasing and sustaining the quality of urban space.

Keywords: semi-public spaces, urban public spaces, urban space quality, public usage

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Authors: Adepoju A. A., Olapade-Ogunwole F., Ganiyu M. O.

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This study examined women's empowerment in cassava production in southwest Nigeria. The contributions of the five domains namely decision about agricultural production, decision-making power over productive resources, control of the use of income, leadership and time allocation to women disempowerment, profiled the women based on their socio-economics features and determined factors influencing women's disempowerment. Primary data were collected from the women farmers and processors through the use of structured questionnaires. Purposive sampling was used to select the LGAs and villages based on a large number of cassava farmers and processors, while cluster sampling was used to select 360 respondents in the study area. Descriptive statistics such as bar charts and percentages, Women Empowerment in Agriculture (WEAI), and the Logit regression model were used to analyze the data collected. The results revealed that 63.88% of the women were disempowered. Lack of decision-making power over productive resources; 36.47% and leadership skills; 33.26% contributed mostly to the disempowerment of the women. About 85% of the married women were disempowered, while 76.92% of the women who participated in social group activities were more empowered than their disempowered counterparts. The findings showed that women with more years of processing experience have the probability of being disempowered while those who engage in farming as a primary livelihood activity, and participate in social groups among others have the tendency to be empowered. In view of this, it was recommended that women should be encouraged to farm and contribute to social group activities.

Keywords: cassava, production, empowerment, southwest, Nigeria

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Authors: Amirreza Razzaghipour Sorkhab

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Hearing loss is one of the greatest common chronic health situations of older people. Hearing aids are the common treatment, and they recover the quality of life in older adults. Even so, comparatively few older adults with simple, mild to moderate, adult-onset, sensorineural hearing loss use hearing aids. It shouldn’t be expected that more expensive hearing aids always produce better outcomes. Given the importance of quality pledge, approaches of quantifying hearing aid fitting achievement are needed. Studies showed an important reduction in handicap following 3 weeks of hearing aid use, signifying the feasibility of using the Hearing Hindrance Inventory for the Elderly as an outcome measure for hearing aid success after a brief interval of hearing aid use. The results showed important development of the quality of life after three months of using a hearing aid in all members and improvement of their most important problems, i.e., the communication and exchange of data. Hearing loss can impair the conversation of information and so decreases the quality of life. Hearing aids have progressivemeaningfully over the past decade, chiefly due to the growing of digital technology. The next decade should see an even greater number of innovations to hearing aid technology. Development in digital hearing aids will be driven by investigate advances in the next fields such as wireless technology, hearing science, and cognitive scienceMoreover, emerging trends such as connectivity and individuation will also drive new technology. We hope that the advancement of technology will be enough to meet the needs of people with hearing aids.

Keywords: hearing loss, hearing aid, hearing aid technology, health

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Authors: Ethelbert C. Njoku

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The primary determination of any individual is the achievement of wholesome health. This is applicable to the government too. This desire becomes a reality with the efforts of medical practitioners who work day and night to ensure that the health of people is not compromised in any form. To achieve this laudable goal, the psychological wellbeing of the practitioners must be unparalleled. They must be psychologically fit in order to deliver as expected. More so, the organization must be able to provide the basic ingredients of trust in the daily management of the organization. Significantly, proper Interpersonal Communication Competence remains a necessity in the overall realization of this goal. 200 participants took part in the study, and they were selected through convenient sampling method from hospitals in Imo State. The current study adopted cross sectional survey design in trying to find out if Interpersonal Communication Competence and Organizational Trust can predict Psychological Wellbeing of medical practitioners in Imo State. Standard Multiple Regression Analysis was used for data analysis. Interestingly, the results indicate that interpersonal communication competence and organizational trust predicted psychological wellbeing among medical practitioners. The implication of this study hinges on the fact that since Interpersonal Communication Competence and Organizational Trust are important for psychological wellbeing of medical practitioners, the government and managers should try to provide opportunities that enhance these variables in the organization for the psychological wellbeing of medical practitioners.

Keywords: interpersonal communication competence, medical practitioners, organizational trust, psychological wellbeing

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Authors: Chow Fah Yee, Eu Chye Tan

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The main purpose of developing a modern and sophisticated financial system is to mobilize and allocate the country’s resources for productive uses and in the process contribute to economic growth. Financial liberalization introduced in Malaysia in 1978 was said to be a step towards this goal. According to Mc-Kinnon and Shaw, the deregulation of a country’s financial system will create a more efficient and competitive market driven financial sector; with savings being channelled to the most productive users. This paper aims to assess whether financial liberalization resulted in bank credit being allocated to the more productive users, for the case of Malaysia by: firstly, using Chi-square test to if there exists a relationship between financial liberalization and bank lending in Malaysia. Secondly, to analyze on a comparative basis, the share of loans secured by 9 major economic sectors, using data on bank loans from 1975 to 2003. Lastly, present value analysis and rank correlation was used to determine if the recipients of bigger loans are the more efficient users. Chi-square test confirmed the generally observed trend of an increase in bank credit with the adoption of financial liberalization. While the comparative analysis of loans showed that the bulk of credit were allocated to service sectors, consumer loans and property related sectors, at the expense of industry. Results for rank correlation analysis showed that there is no relationship between the more productive users and amount of loans obtained. This implies that the recipients (sectors) that received more loans were not the more efficient sectors.

Keywords: allocation of resources, bank credit, financial liberalization, economics

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Authors: Cora Fernandez Dacosta, John A. Posada, Andrea Ramirez

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The biodegradable family of polymers polyhydroxyalkanoates are interesting substitutes for convectional fossil-based plastics. However, the manufacturing and environmental impacts associated with their production via intracellular bacterial fermentation are strongly dependent on the raw material used and on energy consumption during the extraction process, limiting their potential for commercialization. Industrial wastewater is studied in this paper as a promising alternative feedstock for waste valorization. Based on results from laboratory and pilot-scale experiments, a conceptual process design, techno-economic analysis and life cycle assessment are developed for the large-scale production of the most common type of polyhydroxyalkanoate, polyhydroxbutyrate. Intracellular polyhydroxybutyrate is obtained via fermentation of microbial community present in industrial wastewater and the downstream processing is based on chemical digestion with surfactant and hypochlorite. The economic potential and environmental performance results help identifying bottlenecks and best opportunities to scale-up the process prior to industrial implementation. The outcome of this research indicates that the fermentation of wastewater towards PHB presents advantages compared to traditional PHAs production from sugars because the null environmental burdens and financial costs of the raw material in the bioplastic production process. Nevertheless, process optimization is still required to compete with the petrochemicals counterparts.

Keywords: circular economy, life cycle assessment, polyhydroxyalkanoates, waste valorization

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Authors: Andhiani Sharfina Arnellya, Mochammad Indra Permana, Dika Pramita Destiani, Ellin Febrina

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Health Research Data, Ministry of Health of Indonesia in 2007, showed coronary heart disease (CHD) or coronary artery disease (CAD) was the third leading cause of death in Indonesia after hypertension and stroke with 7.2% incidence rate. Antiplatelet is one of the important therapy in management of patients with CHD. In addition to therapeutic effect on patients, quality of life is one aspect of another assessment to see the success of antiplatelet therapy. The purpose of this study was to determine the quality of life of patients on oral antiplatelet therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This research is a cross sectional by collecting data through quality of life questionnaire of patients which performed prospectively as primary data and secondary data from medical record of patients. The results of this study showed that 54.3% of patients had a good quality of life, 45% had a moderate quality of life, and 0.7% had a poor quality of life. There are no significant differences in quality of life-based on age, gender, diagnosis, and duration of drug use.

Keywords: antiplatelet, quality of life, coronary artery disease, coronary heart disease

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Authors: Yutong Xu, Wanting Zhang, Jia Wang, Zihan Guo, Weiguang Ma

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Background: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. Aims: To evaluate the resilience level of Chinese nursing interns and identify the factors affecting resilience early in their careers. Methods: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment scale for Nurse, and the Career Adapt-Abilities Scale. Structural equation modeling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped Confidence Intervals. Results: The nursing interns showed a moderately high level of resilience[M(SD)=70.15(19.90)]. Gender, scholastic attainment, had a scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns’ resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.58, 0.12, respectively, p＜0.01). career adaptability also positively affected career adaptability (β = 0.26, p < 0.01), and played a fully mediating role in the relationship between clinical learning environment and resilience. Conclusion: Career adaptability can enhance the influence of clinical learning environment on resilience. The promotion of career adaptability and the clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for those female nursing interns with low academic performance. Implications for Nursing Educators Nursing educators should pay attention to the cultivation of nursing students' resilience; for example, by helping them integrate to the clinical learning environment and improving their career adaptability. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution No patient or public contribution.

Keywords: resilience, clinical learning environment, career adaptability, nursing interns

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: Olawole Emmanuel Aina, Liziwe Lizbeth Mugivhisa, Joshua Oluwole Olowoyo, Chikwela Lawrence Obi

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In sustained and consistent efforts to improve food security, numerous and different methods are proposed and used in the production of food crops, and farm produce to meet the demands of consumers. However, unregulated and indiscriminate methods of production present another problem that may expose consumers of these food crops to potential health risks. Therefore, it is imperative that a thorough assessment of farm produce is carried out due to the growing trend of health-conscious consumers preference for minimally processed or raw farm produce. This study evaluated the safety and nutritional quality of food crops. The objectives were to compare the nutritional quality of organic and inorganic farm produce in one hand and, on the other, evaluate the safety of farm produce with respect to trace metal and pathogenic contamination. We conducted a broad systematic search of peer-reviewed published literatures from databases and search engines such as science direct, web-of-science, Google scholar, and Scopus. This study concluded that there is no conclusive evidence to support the notion of nutritional superiority of organic food crops over their inorganic counterparts and there are documented reports of pathogenic and metal contaminations of food crops.

Keywords: food crops, fruits and vegetables, pathogens, nutrition, trace metals

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Authors: Swathi Ganesan, Nalinda Somasiri, Rebecca Jeyavadhanam, Gayathri Karthick

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The COVID-19 crisis presents a substantial and critical hazard to worldwide health. Since the occurrence of the disease in late January 2020 in the UK, the number of infected people confirmed to acquire the illness has increased tremendously across the country, and the number of individuals affected is undoubtedly considerably high. The purpose of this research is to figure out a predictive machine learning archetypal that could forecast COVID-19 cases within the UK. This study concentrates on the statistical data collected from 31st January 2020 to 31st March 2021 in the United Kingdom. Information on total COVID cases registered, new cases encountered on a daily basis, total death registered, and patients’ death per day due to Coronavirus is collected from World Health Organisation (WHO). Data preprocessing is carried out to identify any missing values, outliers, or anomalies in the dataset. The data is split into 8:2 ratio for training and testing purposes to forecast future new COVID cases. Support Vector Machines (SVM), Random Forests, and linear regression algorithms are chosen to study the model performance in the prediction of new COVID-19 cases. From the evaluation metrics such as r-squared value and mean squared error, the statistical performance of the model in predicting the new COVID cases is evaluated. Random Forest outperformed the other two Machine Learning algorithms with a training accuracy of 99.47% and testing accuracy of 98.26% when n=30. The mean square error obtained for Random Forest is 4.05e11, which is lesser compared to the other predictive models used for this study. From the experimental analysis Random Forest algorithm can perform more effectively and efficiently in predicting the new COVID cases, which could help the health sector to take relevant control measures for the spread of the virus.

Keywords: COVID-19, machine learning, supervised learning, unsupervised learning, linear regression, support vector machine, random forest

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Authors: Bulcha Belay Etana

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Electromyography is used to measure the electrical activity of muscles for various health monitoring applications using surface electrodes or needle electrodes. Recent developments in electromyogram signal acquisition using textile electrodes open the door for wearable health monitoring which enables patients to monitor and control their health issues outside of traditional healthcare facilities. The aim of this research is therefore to develop and analyze wearable textile electrodes for the acquisition of electromyography signals for Parkinson’s patients and apply an appropriate thermal stimulus to relieve muscle cramping. In order to achieve this, textile electrodes are sewn with a silver-coated thread in an overlapping zigzag pattern into an inextensible fabric, and stainless steel knitted textile electrodes attached to a sleeve were prepared and its electrical characteristics including signal to noise ratio were compared with traditional electrodes. To relieve muscle cramping, a heating element using stainless steel conductive yarn Sewn onto a cotton fabric, coupled with a vibration system were developed. The system was integrated using a microcontroller and a Myoware muscle sensor so that when muscle cramping occurs, measured by the system activates the heating elements and vibration motors. The optimum temperature considered for treatment was 35.50c, so a Temperature measurement system was incorporated to deactivate the heating system when the temperature reaches this threshold, and the signals indicating muscle cramping have subsided. The textile electrode exhibited a signal to noise ratio of 6.38dB while the signal to noise ratio of the traditional electrode was 7.05dB. The rise time of the developed heating element was about 6 minutes to reach the optimum temperature using a 9volt power supply. The treatment of muscle cramping in Parkinson's patients using heat and muscle vibration simultaneously with a wearable electromyography signal acquisition system will improve patients’ livelihoods and enable better chronic pain management.

Keywords: electromyography, heating textile, vibration therapy, parkinson’s disease, wearable electronic textile

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Authors: U.-B. Schaer, M. Wehr, R. Hodler

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Background: Most nursing students require more training time for necessary nursing skills than defined by nursing schools curriculum to acquire basic nursing skills. Given skills training lessons are too brief to enable effective student learning, meaning in-depth skills practice and repetition various learning steps. This increases stress levels and the pressure to succeed for a nursing student with slower learning capabilities. Another possible consequence is that nursing students are less prepared in the required skills for future clinical practice. Intervention: The Bern College of Higher Education of Nursing, Switzerland, started the independent peer practice learning program in 2012. A concept was developed which defines specific aims and content as well as student’s rights and obligations. Students enlist beforehand and order the required materials. They organize themselves and train in small groups in allocated training location in the area of Learning Training and Transfer (LTT). During the peer practice, skills and knowledge can be repeatedly trained and reflected in the peer groups without the presence of a tutor. All invasive skills are practiced only on teaching dummies. This allows students to use all their potential. The students may access learning materials as literature and their own student notes. This allows nursing students to practice their skills and to deepen their knowledge on corresponding with their own learning rate. Results: Peer group discussions during the independent peer practice learning support the students in gaining certainty and confidence in their knowledge and skills. This may improve patient safety in future daily care practice. Descriptive statics show that the number of students who take advantage of the independent peer practice learning increased continuously (2012-2018). It has to be mentioned that in 2012, solely students of the first semester attended the independent peer practice learning program, while in 2018 over one-third of the participating students were in their fifth semester and final study year. It is clearly visible that the demand for independent peer practice learning is increasing. This has to be considered in the development of future teaching curricula.

Keywords: learning program, nursing students, peer learning, skill training

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Authors: Petar Kurecic, Josipa Penic

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The paper represents a product of mentor-graduate student cooperation, developed at the graduate study of Business Economics, major Tourism. The analysis was made through the anonymous questionnaire filled by the respondents from Croatia. Following the latest threatening events and having in mind those yet to come, it can be concluded that no country can benefit from the tourism industry if at the same time does not develop its security system as an integral part of the standard tourist offer. Analyzing the trends in contemporary tourism, the safety and security issues became the decisive factors for the choice of a certain destination. Consequently, countries must not perceive security systems and measures as an unnecessary expense but as an essential element in organizing their tourist services. All hotels and respectable tourist agencies should have a crisis management, with detailed, thoroughly elaborated procedures for emergency situations. Tourists should be timely informed about the potential dangers and risks and the measures taken to prevent them, as well as on procedures for emergency situations. Additionally, it would be good to have mobile applications that would enable tourists to make direct emergency calls with instructions on behavior in crisis situations. It is also essential to implement and put into effect sophisticated security measures such as using surveillance cameras, controlling access to buildings, information exchange with colleagues and neighbors, reporting the suspicious occurrences to the security services, and training staff for crisis management. The security issue is definitely one of the crucial factors in the development of tourism in a certain country.

Keywords: security, security measures in tourism, tourism, tourist destinations

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Authors: Dagmawit Tewahido

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Purpose: This qualitative study was conducted to explore social norms around adolescent girls’ marriage practices in West Hararghe, Ethiopia, where early marriage is prohibited by law. Methods: Twenty Focus Group Discussions were conducted with Married and Unmarried adolescent girls, adolescent boys and parents of girls using locally developed vignettes. A total of 32 in-depth interviews were conducted with married and unmarried adolescent girls, husbands of adolescent girls and mothers-in-law. Key informant interviews were conducted with 36 district officials. Data analysis was assisted by Open Code computer software. The Social Norms Analysis Plot (SNAP) framework developed by CARE guided the development and analysis of vignettes. A thematic data analysis approach was utilized to summarize the data. Results: Early marriage is seen as a positive phenomenon in our study context, and girls who are not married by the perceived ideal age of 15 are socially sanctioned. They are particularly influenced by their peers to marry. Marrying early is considered a chance given by God and a symbol of good luck. The two common types of marriage are decided: 1) by adolescent girl and boy themselves without seeking parental permission (’Jalaa-deemaa’- meaning ‘to go along’), and 2) by just informing girl’s parents (‘Cabsaa’- meaning ‘to break the culture’). Relatives and marriage brokers also arrange early marriages. Girls usually accept the first marriage proposal regardless of their age. Parents generally tend not to oppose marriage arrangements chosen by their daughters. Conclusions: In the study context social norms encourage early marriage despite the existence of a law prohibiting marriage before the age of eighteen years. Early marriage commonly happens through consensual arrangements between adolescent girls and boys. Interventions to reduce early marriage need to consider the influence of Reference Groups on the decision makers for marriages, especially girls’ own peers.

Keywords: adolescent girls, social norms, early marriage, Ethiopia

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Authors: Abdulwahab Alalyani, Mahbub Rashid

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Public Open Space (POS) availability and distribution among urban communities have a central role to promotes community health. However, growing health challenges in a city would raise attention to the planning quality of these community's assets. This research aims to measure the existing availability and distribution equity of POS in the context of Saudi Arabia using Riyadh city as a case study. The methodology for the POS availability was by calculating the total POS with respect to the population total (m²/inhabitant). All POS were mapped using geographical information systems (GIS), and the total area availability of POS was compared to global, regional, and local standards. To evaluate the significant differences in POS availability across low, medium, and high-income Riyadh neighborhoods, we used a One-way ANOVA analysis of covariance to test the differences. The results are as follows; POS availability was lower than global standers. Riyadh has only 1.40m² per capita of POS. Spatial equity of the availability were significantly different among Riyadh neighborhoods based on socioeconomic status. The future development of POS should be focused on increasing general POS availability and should be given priority to those low-income and unhealthy communities. Accessibility indicators of POS should be considered in future studies.

Keywords: open spaces availability, open spaces distribution, spatial equity, healthy city, Riyadh City

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Authors: Rimel Mwamba, Mohan Gundeti

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Introduction: The use of robot-assisted laparoscopic surgeries (RALS) has largely increased in recent years, offering faster and safer treatment options for pediatric patients. In the field of urology, RALS has shown a significant advantage over laparoscopic and open surgeries but continues to be controversial in pediatric cases due to limited comprehensive data on its use. Methods: In this review, we aim to summarize the factors associated with RALS use in pediatric cases involving pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction. We used PubMed, EMBASE, and the Cochrane Database of Systematic Reviews to systematically search for literature on the topic. We then critically assessed and compiled data on RALS outcomes, complications, and associated factors. Results: To date, numerous comparative studies have been conducted on pediatric RALS, with only one randomized control trial investigating the nuances of robotic use against standard of care treatments. These robotic approaches have shown promise in post-surgical outcomes for pediatric patients undergoing upper and lower urinary tract reconstruction. Barriers to use still persist, however, showcasing a need to increase access to the technology, refine instruments for pediatric use, address cost barriers, and provide proper training for surgeons. Conclusion: RALS providesan opportunity to improve pediatric patient outcomes for numerous urologic complications. Additional studies are required to better compare the use of RALS with current standard practices. Due to the difficult nature of conducting randomized control trials, additional prospective observational studies are needed.

Keywords: pediatric urology, robot-assisted laparoscopic surgeries (RALS), pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction

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Authors: Chien-Yeh Hsu, Yuan-Ching Chiang, Zi-Jie Chien, Sih-Li Chen

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In this study, a field experiment and performance analysis of air-tunnel heat exchanger integrated with water-filled raft foundation of residential building were performed. In order to obtain better performance, conventional applications of air-tunnel inevitably have high initial cost or issues about insufficient installation space. To improve the feasibility of air tunnel heat exchanger in high-density housing, an integrated system consisting of air pipes immersed in the water-filled raft foundation was presented, taking advantage of immense amount of water and relatively stable temperature in raft foundation of building. The foundation-integrated air tunnel was applied to a residential building located in Yilan, Taiwan, and its thermal performance was measured in the field experiment. The results indicated that the cooling potential of integrated system was close to the potential of soil-based EAHE at 2 m depth or deeper. An analytical model based on thermal resistance method was validated by measurement results, and was used to carry out the dimensioning of foundation-integrated air tunnel. The discrepancies between calculated value and measured data were less than 2.7%. In addition, the return-on-investment with regard to thermal performance and economics of the application was evaluated. Because the installation for air tunnel is scheduled in the building foundation construction, the utilization of integrated system spends less construction cost compare to the conventional earth-air tunnel.

Keywords: air tunnel, ground heat exchanger, raft foundation, residential building

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Authors: Rui Calejo Rodrigues

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Building Refurbishing and Maintenance is a major area of knowledge ultimately dispensed to user/occupant criteria. The optimization of the service life of a building needs a special background to be assessed as it is one of those concepts that needs proficiency to be implemented. ISO 15686-2 Buildings and constructed assets - Service life planning: Part 2, Service life prediction procedures, states a factorial method based on deterministic data for building components life span. Major consequences result on a deterministic approach because users/occupants are not sensible to understand the end of components life span and so simply act on deterministic periods and so costly and resources consuming solutions do not meet global targets of planet sustainability. The estimation of 2 thousand million conventional buildings in the world, if submitted to a probabilistic method for service life planning rather than a deterministic one provide an immense amount of resources savings. Since 1989 the research team nowadays stating for CEES–Center for Building in Service Studies developed a methodology based on Montecarlo method for probabilistic approach regarding life span of building components, cost and service life care time spans. The research question of this deals with the importance of probabilistic approach of buildings life planning compared with deterministic methods. It is presented the mathematic model developed for buildings probabilistic lifespan approach and experimental data is obtained to be compared with deterministic data. Assuming that buildings lifecycle depends a lot on component replacement this methodology allows to conclude on the global impact of fixed replacements methodologies such as those on result of deterministic models usage. Major conclusions based on conventional buildings estimate are presented and evaluated under a sustainable perspective.

Keywords: building components life cycle, building maintenance, building sustainability, Montecarlo Simulation

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Authors: Mitzi S. Brammer

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Given that the cultural make-up of programs of study in institutions of higher learning is becoming increasingly diverse, much has been written about cultural diversity from a university-level perspective. However, there are little data in the way of specific programs and how they address inclusive practices when teaching and working with marginalized populations. This research study aimed to discover baseline knowledge and attitudes of health sciences faculty, instructional staff, and students related to inclusive teaching/learning and interactions. Quantitative data were collected via an anonymous online survey (one designed for students and another designed for faculty/instructional staff) using a web-based program called Qualtrics. Quantitative data were analyzed amongst the faculty/instructional staff and students, respectively, using descriptive and comparative statistics (t-tests). Additionally, some participants voluntarily engaged in a focus group discussion in which qualitative data were collected around these same variables. Collecting qualitative data to triangulate the quantitative data added trustworthiness to the overall data. The research team analyzed collected data and compared identified categories and trends, comparing those data between faculty/staff and students, and reported results as well as implications for future study and professional practice.

Keywords: inclusion, higher education, pedagogy, equity, diversity

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Authors: Meida Laely Ramdani, Earmporn Thongkrajai, Dedy Purwito

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Lifestyle is one of the most important factors affecting health. Measurement of lifestyle behaviors is necessary for the identification of causal associations between unhealthy lifestyle and health outcomes. There was many instruments have been measured for lifestyle, but not specific for stroke recurrence. This study aimed to develop a new questionnaire of Lifestyle Adjustment Scale (LSAS) among recurrent stroke patients in Indonesia and to measure the reliability and validity of LSAS. The instrument consist of 33 items was developed from the responses of 30 recurrent stroke patients with the maximum age 60 years. Data was collected during October to November 2015. The properties of the instrument were evaluated by validity assessment and reliability measures. The content validity was judged adequate by a panel of five experts, with the result of I-CVI was 0.97. The Cronbach’s alpha analysis was carried out to measure the reliability of LSAS. The result showed that Cronbach’s alpha coefficient was 0.819. LSAS were classified under the domains of dietary habit, smoking habit, physical activity, and stress management. The results of Cronbach’s alpha coefficient for each subscale were 0.60, 0.39, 0.67, 0.65 and 0.76 respectively. LSAS instrument was valid and reliable therefore can be used as research tool among recurrent stroke patients. The development of this questionnaire has been adapted to the socio-cultural context in Indonesia.

Keywords: LSAS, recurrent stroke patients, lifestyle, Indonesia

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Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

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