Search results for: remote patient care

Authors: Rowland R. Ogunrinde, Yusmadi Y. Jusoh, Noraini Che Pa, Wan Nurhayati W. Rahman, Azizol B. Abdullah

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Enterprise Applications (EAs) aid the organizations achieve operational excellence and competitive advantage. Over time, most Small and Medium Enterprises (SMEs), which are known to be the major drivers of most thriving global economies, use the costly on-premise versions of these applications thereby making business difficult to competitively thrive in the same market environment with their large enterprise counterparts. The advent of cloud computing presents the SMEs an affordable offer and great opportunities as such EAs can be cloud-hosted and rented on a pay-per-use basis which does not require huge initial capital. However, as there are numerous Cloud Service Providers (CSPs) offering EAs as Software-as-a-Service (SaaS), there is a challenge of choosing a suitable provider with Quality of Service (QoS) that meet the organizations’ customized requirements. The proposed model takes care of that and goes a step further to select the most affordable among a selected few of the CSPs. In the earlier stage, before developing the instrument and conducting the pilot test, the researchers conducted a structured interview with three experts to validate the proposed model. In conclusion, the validity and reliability of the instrument were tested through experts, typical respondents, and analyzed with SPSS 22. Results confirmed the validity of the proposed model and the validity and reliability of the instrument.

Keywords: cloud service provider, enterprise application, quality of service, selection criteria, small and medium enterprise

Procedia PDF Downloads 177

Authors: P. Kavuma, J. Mukasa, M. Lusunku

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Background and Problem: The widespread poverty in Africa- together with the negative impacts of climate change-are two great global challenges that call for everyone’s involvement including Architects. This in particular places serious challenges on architects to have additional skills in both Entrepreneurship and Environmental Design (SEED). Regrettably, while Architectural Training in most African Universities including those from Uganda lack comprehensive implementation of SEED in their curricula, regulatory bodies have not contributed towards the effective integration of SEED in their professional practice. In response to these challenges, Nkumba University (NU) under Architect Kavuma Paul supported by the Uganda Chambers of Architects– initiated the SEED integration in the undergraduate Architectural curricula to cultivate SEED know-how and examples of best practices. Main activities: Initiated in 2007, going beyond the traditional Architectural degree curriculum, the NU Architect department offers SEED courses including provoking passions for creating desirable positive changes in communities. Learning outcomes are assessed theoretically and practically through field projects. The first set of SEED graduates came out in 2012. As part of the NU post-graduation and alumni survey, in October 2014, the pioneer SEED graduates were contacted through automated reminder emails followed by individual, repeated personal follow-ups via email and phone. Out of the 36 graduates who responded to the survey, 24 have formed four (4) private consortium agencies of 5-7 graduates all of whom have pioneered Ugandan-own-cultivated Architectural social projects that include: fishing farming in shipping containers; solar powered mobile homes in shipping containers, solar powered retail kiosks in rural and fishing communities, and floating homes in the flood-prone areas. Primary outcomes: include being business self –reliant in creating the social change the architects desired in the communities. Examples of the SEED project returns to communities reported by the graduates include; employment creation via fabrication, retail business, marketing, improved diets, safety of life and property, decent shelter in the remote mining and oil exploration areas. Negative outcomes-though not yet evaluated include the disposal of used-up materials. Conclusion: The integration of SEED in Architectural Training has established a baseline benchmark and a replicable model based on best practice projects.

Keywords: architectural training, entrepreneurship, environment, integration

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Authors: Segen Asayehegn

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Introduction: In Tigray, Ethiopia, next to cervical cancer, breast cancer is one of the most common cancer health problems for women. Objectives: This article is proposed to identify the prospective and potential risk factors affecting the time-to-first-recurrence of breast cancer patients in Tigray, Ethiopia. Methods: The data were taken from the patient’s medical record that registered from January 2010 to January 2020. The study considered a sample size of 1842 breast cancer patients. Powerful non-parametric and parametric shared frailty survival regression models (FSRM) were applied, and model comparisons were performed. Results: Out of 1842 breast cancer patients, about 1290 (70.02%) recovered/cured the disease. The median cure time from breast cancer is found at 12.8 months. The model comparison suggested that the lognormal parametric shared a frailty survival regression model predicted that treatment, stage of breast cancer, smoking habit, and marital status significantly affects the first recurrence of breast cancer. Conclusion: Factors like treatment, stages of cancer, and marital status were improved while smoking habits worsened the time to cure breast cancer. Recommendation: Thus, the authors recommend reducing breast cancer health problems, the regional health sector facilities need to be improved. More importantly, concerned bodies and medical doctors should emphasize the identified factors during treatment. Furthermore, general awareness programs should be given to the community on the identified factors.

Keywords: acceleration factor, breast cancer, Ethiopia, shared frailty survival models, Tigray

Procedia PDF Downloads 133

Authors: Varis Ransibrahmanakul, Doug Pirhalla, Scott Sheridan, Cameron Lee

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U.S. coastal areas and ecosystems are facing multiple sea level rise threats and effects: heavy rain events, cyclones, and changing wind and weather patterns all influence coastal flooding, sedimentation, and erosion along critical barrier islands and can strongly impact habitat resiliency and water quality in protected habitats. These impacts are increasing over time and have accelerated the need for new tracking techniques, models and tools of flood risk to support enhanced preparedness for coastal management and mitigation. To address this issue, NOAA National Ocean Service (NOS) evaluated new metrics from satellite altimetry AVISO/Copernicus and MODIS IR flood extents to isolate nodes atmospheric variability indicative of elevated sea level and nuisance flood events. Using de-trended time series of cross-shelf sea surface heights (SSH), we identified specific Self Organizing Maps (SOM) nodes and transitions having a strongest regional association with oceanic spatial patterns (e.g., heightened downwelling favorable wind-stress and enhanced southward coastal transport) indicative of elevated coastal sea levels. Results show the impacts of the inverted barometer effect as well as the effects of surface wind forcing; Ekman-induced transport along broad expanses of the U.S. eastern coastline. Higher sea levels and corresponding localized flooding are associated with either pattern indicative of enhanced on-shore flow, deepening cyclones, or local- scale winds, generally coupled with an increased local to regional precipitation. These findings will support an integration of satellite products and will inform seasonal outlook model development supported through NOAAs Climate Program Office and NOS office of Center for Operational Oceanographic Products and Services (CO-OPS). Overall results will prioritize ecological areas and coastal lab facilities at risk based on numbers of nuisance flood projected and inform coastal management of flood risk around low lying areas subjected to bank erosion.

Keywords: AVISO satellite altimetry SSHA, MODIS IR flood map, nuisance flood, remote sensing of flood

Procedia PDF Downloads 139

Authors: Vilas Warudkar, Dinkar Janghel, Siraj Ahmed

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Rapid development experienced by India requires huge amount of energy. Actual supply capacity additions have been consistently lower than the targets set by the government. According to World Bank 40% of residences are without electricity. In 12th five year plan 30 GW grid interactive renewable capacity is planned in which 17 GW is Wind, 10 GW is from solar and 2.1 GW from small hydro project, and rest is compensated by bio gas. Renewable energy (RE) and energy efficiency (EE) meet not only the environmental and energy security objectives, but also can play a crucial role in reducing chronic power shortages. In remote areas or areas with a weak grid, wind energy can be used for charging batteries or can be combined with a diesel engine to save fuel whenever wind is available. India according to IEC 61400-1 belongs to class IV Wind Condition; it is not possible to set up wind turbine in large scale at every place. So, the best choice is to go for small scale wind turbine at lower height which will have good annual energy production (AEP). Based on the wind characteristic available at MANIT Bhopal, rotor for small scale wind turbine is designed. Various Aero foil data is reviewed for selection of airfoil in the Blade Profile. Airfoil suited of Low wind conditions i.e. at low Reynold’s number is selected based on Coefficient of Lift, Drag and angle of attack. For designing of the rotor blade, standard Blade Element Momentum (BEM) Theory is implanted. Performance of the Blade is estimated using BEM theory in which axial induction factor and angular induction factor is optimized using iterative technique. Rotor performance is estimated for particular designed blade specifically for low wind Conditions. Power production of rotor is determined at different wind speeds for particular pitch angle of the blade. At pitch 15o and velocity 5 m/sec gives good cut in speed of 2 m/sec and power produced is around 350 Watts. Tip speed of the Blade is considered as 6.5 for which Coefficient of Performance of the rotor is calculated 0.35, which is good acceptable value for Small scale Wind turbine. Simple Load Model (SLM, IEC 61400-2) is also discussed to improve the structural strength of the rotor. In SLM, Edge wise Moment and Flap Wise moment is considered which cause bending stress at the root of the blade. Various Load case mentioned in the IEC 61400-2 is calculated and checked for the partial safety factor of the wind turbine blade.

Keywords: annual energy production, Blade Element Momentum Theory, low wind Conditions, selection of airfoil

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Authors: Lela Pintarić, Iva Rezić, Ana Vrsalović Presečki

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Considering an enormous increase of the use of metal nanoparticles with the exactly defined characteristics, the main goal of this research was to found the optimal and environmental friendly method of their synthesis. The synthesis of the inorganic core-shell nanoparticles was optimized as a model. The core-shell nanoparticles are composed of the enzyme core belted with the metal ions, oxides or salts as a shell. In this research, enzyme urease was the core catalyst and the shell nanoparticle was made of silver. Silver nanoparticles are widespread utilized and some of their common uses are: as an addition to disinfectants to ensure an aseptic environment for the patients, as a surface coating for neurosurgical shunts and venous catheters, as an addition to implants, in production of socks for diabetics and athletic clothing where they improve antibacterial characteristics, etc. Characteristics of synthesized nanoparticles directly depend on of their size, so the special care during this optimization was given to the determination of the size of the synthesized nanoparticles. For the purpose of the above mentioned optimization, sixteen experiments were generated by the Design of Experiments (DoE) method and conducted under various temperatures, with different initial concentration of the silver nitrate and constant concentration of the urease of two separate manufacturers. Synthesized nanoparticles were analyzed by the Nanoparticle Tracking Analysis (NTA) method on Malvern NanoSight NS300. Results showed that the initial concentration of the silver ions does not affect the concentration of the synthesized silver nanoparticles neither their size distribution. On the other hand, temperature of the experiments has affected both of the mentioned values.

Keywords: core-shell nanoparticles, optimization, silver, urease

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Authors: Awais Naeem, Osama Shakeel, Aamir Ali Syed, Shahid Khattak

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Introduction: Laparoscopic right hemicolectomy is an advanced cancer surgery in today's era. The aim of this study was to evaluate the surgical and initial oncological outcomes after curative, laparoscopic resection of right sided colonic tumors. Also to compare our results with those of previous randomized trials. Methods And Procedures: We retrospectively analyzed the medical record files of all the patients who presented to our hospital with the diagnosis of right sided colon carcinoma from January 2012 to December 2017 and underwent laparoscopic right hemicolectomy. Demographics, operative findings and histopathological reports were all recorded on a preformed data sheet. All the analysis was performed on SPSS 20. Results: Total of 48 patients were included. There were 37 male and 11 female patients with mean age of 49.7 (range from 25 – 82). Mean hospital stay was 8.25 ± 3.17 days. Blood loss was 80mls and operative mean time was 240 minutes. Eighteen patients had extended right hemicolectomy. Median length of the specimen retrieved was 31cm (range, 14-59cm). Mean size of tumor was 6.44cm + 2.53. Total number of lymph nodes removed was 20.5 + 8.3. All had R0 resection. Post-operatively 2 patients had pelvic collection and there was no 30 day mortality. In 33 patients there was T3 disease, 5 had T2 and 10 had T4 disease. There was distant recurrence in 4 patients with peritoneal metastasis in 3 and liver metastasis in 1 patient. Forty-six patients are still alive and 44 are disease free. The mean follow-up period was 25.31 (12 to 60) months. Conclusion: Our early experience with Laparascopic Right hemicolectomy as a safe and oncologically feasible surgical option. We attained comparable surgical results with curative intent.

Keywords: right hemicolectomy, right sided colonic tumors, laparoscopic, curative intent

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Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Rungrawin Promkul, Chetsadakon Jenpanitpong, Pajit Bunta, Suthap Jaiboon

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Supraventricular tachycardia (SVT) is an abnormally fast atrial tachycardia characterized by narrow (≤ 120 ms) and constant QRS. Adenosine was the drug of choice; the first dose was 6 mg. It can be repeated with the second and third doses of 12 mg, with greater than 90% success. The study found that patients observed at 4 hours after normal sinus rhythm was no recurrence within 24 hours. The objective of this study was to investigate the factors that influence the recurrence of SVT after adenosine in the emergency department (ED). The study was conducted retrospectively exploratory model, prognostic study at the Emergency Department (ED) in Faculty of Medicine, Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand. The study was conducted for ten years period between 2010 and 2020. The inclusion criteria were age > 15 years, visiting the ED with SVT, and treating with adenosine. Those patients were recorded with the recurrence SVT in ED. The multivariable logistic regression model developed the predictive model and prediction score for recurrence PSVT. 264 patients met the study criteria. Of those, 24 patients (10%) had recurrence PSVT. Five independent factors were predictive of recurrence PSVT. There was age>65 years, heart rate (after adenosine) > 100 per min, structural heart disease, and dose of adenosine. The clinical risk score to predict recurrence PSVT is developed accuracy 74.41%. The score of >6 had the likelihood ratio of recurrence PSVT by 5.71 times. The clinical predictive score of > 6 was associated with recurrence PSVT in ED.

Keywords: supraventricular tachycardia, recurrance, emergency department, adenosine

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Authors: Alexander Rodríguez-Hernández, Arnulfo Rojas-Perez, Liz Diaz-Vazquez

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The rise in consumerism over the past century has resulted in the creation of higher amounts of plasticizers, personal care products and other chemical substances, which enter and accumulate in water systems. Other sources of pollutants in Neotropical regions experience large inputs of nutrients with these pollutants resulting in eutrophication of water which consume large quantities of oxygen, resulting in high fish mortality. This dilemma has created a need for the development of targeted detection in complex matrices and remediation of emerging contaminants. We have synthesized carbon nanoparticles from macro algae (Ulva fasciata) by oxidizing the graphitic carbon network under extreme acidic conditions. The resulting material was characterized by STEM, yielding a spherical 12 nm average diameter nanoparticles, which can be fixed into a polysaccharide aerogel synthesized from the same macro algae. Spectrophotometer analyses show a pH dependent fluorescent behavior varying from 450-620 nm in aqueous media. Heavily oxidized edges provide for easy functionalization with enzymes for a more targeted analysis and remediation technique. Given the optical properties of the carbon base nanoparticles and the numerous possibilities of functionalization, we have developed a selective and robust targeted bio-detection and bioremediation technique for the treatment of emerging contaminants in complex matrices like estuarine embayment.

Keywords: aerogels, carbon nanoparticles, fluorescent, targeted analysis

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Authors: S. R. Shamili, C. Natarajan, J. Karthikeyan

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Rapid growth of world population and widespread urbanization has remarkably increased the development of the construction industry which caused a huge demand for sand and gravels. Environmental problems occur when the rate of extraction of sand, gravels, and other materials exceeds the rate of generation of natural resources; therefore, an alternative source is essential to replace the materials used in concrete. Now-a-days, electronic products have become an integral part of daily life which provides more comfort, security, and ease of exchange of information. These electronic waste (E-Waste) materials have serious human health concerns and require extreme care in its disposal to avoid any adverse impacts. Disposal or dumping of these E-Wastes also causes major issues because it is highly complex to handle and often contains highly toxic chemicals such as lead, cadmium, mercury, beryllium, brominates flame retardants (BFRs), polyvinyl chloride (PVC), and phosphorus compounds. Hence, E-Waste can be incorporated in concrete to make a sustainable environment. This paper deals with the composition, preparation, properties, classification of E-Waste. All these processes avoid dumping to landfills whilst conserving natural aggregate resources, and providing a better environmental option. This paper also provides a detailed literature review on the behaviour of concrete with incorporation of E-Wastes. Many research shows the strong possibility of using E-Waste as a substitute of aggregates eventually it reduces the use of natural aggregates in concrete.

Keywords: dumping, electronic waste, landfill, toxic chemicals

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Authors: Rafael Castilho Carvalho, Edjair de Souza Mota

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As the largest contributor to the biogeochemical functioning of the Earth system, the Amazon Rainforest has the greatest biodiversity on the planet, harboring about 15% of all the world's flora. Recognition and preservation are the focus of research that seeks to mitigate drastic changes, especially anthropic ones, which irreversibly affect this biome. Functional and low-cost monitoring alternatives to reduce these impacts are a priority, such as those using technologies such as Low Power Wide Area Networks (LPWAN). Promising, reliable, secure and with low energy consumption, LPWAN can connect thousands of IoT devices, and in particular, LoRa is considered one of the most successful solutions to facilitate forest monitoring applications. Despite this, the forest environment, in particular the Amazon Rainforest, is a challenge for these technologies, requiring work to identify and validate the use of technology in a real environment. To investigate the feasibility of deploying LPWAN in remote water quality monitoring of rivers in the Amazon Region, a LoRa-based test bed consisting of a Lora transmitter and a LoRa receiver was set up, both parts were implemented with Arduino and the LoRa chip SX1276. The experiment was carried out at the Federal University of Amazonas, which contains one of the largest urban forests in Brazil. There are several springs inside the forest, and the main goal is to collect water quality parameters and transmit the data through the forest in real time to the gateway at the uni. In all, there are nine water quality parameters of interest. Even with a high collection frequency, the amount of information that must be sent to the gateway is small. However, for this application, the battery of the transmitter device is a concern since, in the real application, the device must run without maintenance for long periods of time. With these constraints in mind, parameters such as Spreading Factor (SF) and Coding Rate (CR), different antenna heights, and distances were tuned to better the connectivity quality, measured with RSSI and loss rate. A handheld spectrum analyzer RF Explorer was used to get the RSSI values. Distances exceeding 200 m have soon proven difficult to establish communication due to the dense foliage and high humidity. The optimal combinations of SF-CR values were 8-5 and 9-5, showing the lowest packet loss rates, 5% and 17%, respectively, with a signal strength of approximately -120 dBm, these being the best settings for this study so far. The rains and climate changes imposed limitations on the equipment, and more tests are already being conducted. Subsequently, the range of the LoRa configuration must be extended using a mesh topology, especially because at least three different collection points in the same water body are required.

Keywords: IoT, LPWAN, LoRa, coverage, loss rate, forest

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Authors: Saima Hirani, Emmanuela Ojukwu, Nilanga Aki Bandara

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Background: Mental health challenges that begin during the youth age period may continue across the entire life course. One way to support youth mental health is to encourage youth engagement in prosocial activities. This study aimed to explore youth’s perceptions about helping others and mental well-being, barriers, and enablers for youth to initiate and continue prosocial activities, and strategies for developing the attribute of helping others in youth. Methods: We conducted a qualitative study using semi-structured, virtual interviews with 18 young individuals (aged 16-24 years) living in Vancouver, British Columbia, Canada. Results: Youth perceived helping others as a source of feeling peace and calm, finding meaning in life, experiencing social connection and promoting self-care, and relieving stress. Participants reported opportunities to learn new skills, the role of religion, social connections, previous positive experiences, and role modeling as enablers for their prosocial behaviour. Heavy time commitment, negative behaviour from others, self-doubt, and late exposure to such activities were considered barriers by youth when participating in prosocial activities. Youth also brought forward key recommendations for engaging youth in helping others. Conclusions: The findings of this study support the notion that youth have positive experiences when engaging in helping others and that involving young people in prosocial activities could be used as a protective intervention for promoting youth mental health and overall well-being.

Keywords: helping others, prosocial behaviour, youth, mental well-being

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Authors: Marina Fomina

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The paper focuses on the category of semantic subject within the framework of a functional approach to linguistics. The semantic subject is related to similar notions such as the grammatical subject and the bearer of predicative feature. It is the multifaceted nature of the category of subject that 1) triggers a number of issues that, syntax-wise, remain to be dealt with (cf. semantic vs. syntactic functions / sentence parts vs. parts of speech issues, etc.); 2) results in a variety of approaches to the category of subject, such as formal grammatical, semantic/syntactic (functional), communicative approaches, etc. Many linguists consider the prototypical approach to the category of subject to be the most instrumental as it reveals the integrity of denotative and linguistic components of the conceptual category. This approach relates to subject as a source of non-passive predicative feature, an element of subject-predicate-object situation that can take on a variety of semantic roles, cf.: 1) an agent (He carefully surveyed the valley stretching before him), 2) an experiencer (I feel very bitter about this), 3) a recipient (I received this book as a gift), 4) a causee (The plane broke into three pieces), 5) a patient (This stove cleans easily), etc. It is believed that the variety of roles stems from the radial (prototypical) structure of the category with some members more central than others. Translation-wise, the most “treacherous” subject types are the peripheral ones. The paper 1) features a peripheral status of spatial impersonal sentence models such as U menia v ukhe zvenit (lit. I-Gen. in ear buzzes) within the category of semantic subject, 2) makes a structural and semantic analysis of the models, 3) focuses on their Russian-English translation patterns, 4) reveals non-prototypical features of subjects in the English equivalents.

Keywords: bearer of predicative feature, grammatical subject, impersonal sentence model, semantic subject

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Authors: Harini Chakkera

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Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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Authors: A. H. Bekhet, N. Helmy

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Background: Physical therapists are knowledgeable in treatment and prevention of musculoskeletal injuries; however, they have occupational musculoskeletal injuries because Physical therapy profession requires effort that may lead to work-related musculoskeletal disorders. No previous studies among physical therapists have been reported in Egypt. We aim to assess the prevalence and risk factors of musculoskeletal disorders among physical therapist’s seniors versus internship students. Method: We conducted a cross-sectional study in faculty of physical therapy Cairo university Prevalence and risk factors of musculoskeletal injuries were assessed using self-administered questionnaire with closed-ended questions. Seniors therapist was defined as a physical therapist with more than 5 years of work experience. Data were analyzed using SPSS 22.0 for Windows. Results: The study included 106 physical therapists (Junior = 72; senior = 34), the mean age of senior therapists was 30.1 (SD 6.3) years and junior therapists were 22.8 (SD 2.4). Female subjects constituted 83.9% of the studied sample. The mean hours of contact with patients was higher among junior therapists 6.4 (SD 2.6) vs. 5.7 (SD 2.1) among senior therapists. The prevalence of a musculoskeletal injury, once or more in their lifetime, was significantly higher among senior therapists (86% vs. 66.7%; p = 0.04). The highest risk factor in increasing the symptoms of the injury among junior therapists was maintaining a position for a prolonged period of time at 28% while performing manual therapy techniques was the highest risk factor among senior therapists at 32%. 53% of senior therapists have limited their patient contact time as a result of their injury in comparison to 25% of junior therapists (p = 0.09). Conclusion: the presented study shows that the prevalence of musculoskeletal injuries, once or more in their lifetime, is significantly higher among senior therapists.

Keywords: musculoskeletal injuries, occupational injuries, physical therapists, work related disorders

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Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

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Authors: Sri Suparwitri

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When an orthodontic force is applied to a tooth, an inflammatory response is initiated then lead to bone remodeling process, and the process accommodates tooth movement. One of cytokine that plays a prominent role in bone remodeling process was transforming growth factor-beta 1 (TGF-β1). The purpose of this study was to identify and compare changes of TGF-β1 in human gingival crevicular fluid during canine retraction using elastic chain and closed coil spring. Ten patients (mean age 20.7 ± 2.9 years) participated. The patients were entering the space closure phase of fixed orthodontic treatment. An upper canine of each patient was retracted using elastic chain, and the contralateral canine was retracted using closed coil spring. Gingival crevicular fluid samples were collected from the canine teeth before and 7 days after the force was applied. Transforming growth factor-beta 1 was determined by enzyme-linked immunosorbent assay (ELISA). The concentrations of TGF-β1 at 7 days were significantly higher compared to before canine retraction in both groups. In the evaluation of between-group difference, before retraction, the difference was insignificant, whereas at 7 days significantly higher values were determined in the closed coil spring group compared to elastic chain group. The result suggests that TGF-β1 is associated with the bone remodeling that occurs during canine distalization movement. Closed coil spring gave higher TGF-β1 concentrations thus more bone remodeling occurred and may be considered the treatment of choice.

Keywords: closed coil spring, elastic chain, gingival crevicular fluid, TGF-β1

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Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix

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In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.

Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference

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Authors: Professor Jo Angouri, Polina Mesinioti, Chris Turner

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In order for a group of ad-hoc professional to perform as a team, a shared understanding of the problem at hand and an agreed action plan are necessary components. This is particularly significant in complex, time sensitive professional settings such as in trauma emergencies. In this context, team briefings prior to the patient arrival (pre-briefings) constitute a critical event for the performance of the team; they provide the necessary space for co-constructing a shared understanding of the situation through summarising information available to the team: yet the act of summarising is widely assumed in medical practice but not systematically researched. In the vast teamwork literature, terms such as ‘shared mental model’, ‘mental space’ and ‘cognate labelling’ are used extensively, and loosely, to denote the outcome of the summarising process, but how exactly this is done interactionally remains under researched. This paper reports on the forms and functions of pre-briefings in a major trauma centre in the UK. Taking an interactional approach, we draw on 30 simulated and real-life trauma emergencies (15 from each dataset) and zoom in on the use of pre-briefings, which we consider focal points in the management of trauma emergencies. We show how ad hoc teams negotiate sharedness of future orientation through summarising, synthesising information, and establishing common understanding of the situation. We illustrate the role, characteristics, and structure of pre-briefing sequences that have been evaluated as ‘efficient’ in our data and the impact (in)effective pre-briefings have on teamwork. Our work shows that the key roles in the event own the act of summarising and we problematise the implications for leadership in trauma emergencies. We close the paper with a model for pre-briefing and provide recommendations for clinical practice, arguing that effective pre-briefing practice is teachable.

Keywords: summarising, medical emergencies, interaction analysis, shared/mental models

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Authors: Shivam Patel, Abdullah Y. Usmani

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Physiological flow under rest and exercise conditions in patient-specific cerebral aneurysm models is numerically investigated. A finite-volume based code with BiCGStab as the linear equation solver is used to simulate unsteady three-dimensional flow field through the incompressible Navier-Stokes equations. Flow characteristics are first established in a healthy cerebral artery for both physiological conditions. The effect of saccular aneurysm on cerebral hemodynamics is then explored through a comparative analysis of the velocity distribution, nature of flow patterns, wall pressure and wall shear stress (WSS) against the reference configuration. The efficacy of coil embolization as a potential strategy of surgical intervention is also examined by modelling coil as a homogeneous and isotropic porous medium where the extended Darcy’s law, including Forchheimer and Brinkman terms, is applicable. The Carreau-Yasuda non-Newtonian blood model is incorporated to capture the shear thinning behavior of blood. Rest and exercise conditions correspond to normotensive and hypertensive blood pressures respectively. The results indicate that the fluid impingement on the outer wall of the arterial bend leads to abnormality in the distribution of wall pressure and WSS, which is expected to be the primary cause of the localized aneurysm. Exercise correlates with elevated flow velocity, vortex strength, wall pressure and WSS inside the aneurysm sac. With the insertion of coils in the aneurysm cavity, the flow bypasses the dilatation, leading to a decline in flow velocities and WSS. Particle residence time is observed to be lower under exercise conditions, a factor favorable for arresting plaque deposition and combating atherosclerosis.

Keywords: 3D FVM, Cerebral aneurysm, hypertension, coil embolization, non-Newtonian fluid

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Authors: Mutshinye Manguvhewa, Maria Florence, Mansoo Yu, Elize Koch, Kamal Kamaloodien

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Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential factors are associated with substance use among women of childbearing age. The study explored factors associated with substance use among pregnant women using a qualitative research design and the bio-ecological theoretical framework to explore and guide the researcher throughout the study. Participants were selected using purposive sampling. Only participants accessed from the Department of Social Development meeting the inclusion criteria of the study were interviewed using semi structured interviews. Immediate referral for psychological intervention during the interview was available for participants who needed it. Braun and Clarke's six phases of thematic analysis were utilised to analyse the data. The study adheres to ethical guidelines for the participants' protection. Participants were informed about the study before the initiation of the interviews and the details of their voluntary participation were explained. The key findings from this study illustrate that socio-cultural factors, personal factors, emotional response and intimate relationships are the major contributing factors to substance use among pregnant women in this sample. The results outline the preventative measures that pregnant women implement. Lastly, the study reveals the positive and negative perceptions of substance use programmes that participants share. Some of the study findings are similar to the existing literature and some of the findings differed. Recommendations emanating from the study include that the stakeholders, rehabilitation centres, Department of Health and future researchers should act proactively against substance use during pregnancy.

Keywords: substance addiction, antenatal care, pregnancy, substance use

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Authors: Mohammed A. Alhoot, Rathika A/P Nagarajan

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Climate change and variability are affecting human health and diseases direct or indirectly through many mechanisms. Change in rain pattern, an increase of temperature and humidity are showing an increased trend in Malaysia. This will affect the biological, physical and chemical component of water through different pathways and will enhance the risk of waterborne diseases. Besides, the warm temperature and humid climate provide very suitable conditions for the growth of pathogenic bacteria. This study is intended to highlight the relationship between the climate changes and the incidence food and water associated infections. Incidences of food and water associated infection and climate data were collected from Malaysian Ministry of health and Malaysian Metrological Department respectively. Maximum and minimum temperature showed high correlation with incidence of typhoid, hepatitis A, dysentery, food poisoning (P value <0.05 significant with 2 tailed / 0.5<[r]). Heavy rainfall does not associated with any outbreaks. Climate change brings out new challenges in controlling food and water associated infections. Adaptation strategies should involve all key stakeholders with a strong regional cooperation to prevent and deal with cross-boundary health crises. Moreover, the role of health care personnel at local, state and national levels is important to ensure the success of these programmes. As has been shown herein, climate variability is an important element influencing the food and water associated epidemiology in Malaysia. The results of this study are crucial to implementing climate changes as a factor to reduce any future outbreaks.

Keywords: climate change, typhoid, hepatitis A, dysentery, food poisoning

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Authors: África Vicario, Fernando J. Álvarez, Felipe Parralejo, Fernando Aranda

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The irrigation systems of traditional agriculture, such as gravity-fed irrigation, produce a great waste of water because, generally, there is no control over the amount of water supplied in relation to the water needed. The AIRON Project tries to solve this problem by implementing an IoT-based system to sensor the irrigation plots so that the state of the crops and the amount of water used for irrigation can be known remotely. The IoT system consists of a sensor network that measures the humidity of the soil, the weather conditions (temperature, relative humidity, wind and solar radiation) and the irrigation water flow. The communication between this network and a central gateway is conducted by means of long-range wireless communication that depends on the characteristics of the irrigation plot. The main objective of the AIRON project is to deploy an IoT sensor network in two different plots of the irrigation community of Aranjuez in the Spanish region of Madrid. The first plot is 2 km away from the central gateway, so LoRa has been used as the base communication technology. The problem with this plot is the absence of mains electric power, so devices with energy-saving modes have had to be used to maximize the external batteries' use time. An ESP32 SOC board with a LoRa module is employed in this case to gather data from the sensor network and send them to a gateway consisting of a Raspberry Pi with a LoRa hat. The second plot is located 18 km away from the gateway, a range that hampers the use of LoRa technology. In order to establish reliable communication in this case, the long-term evolution (LTE) standard is used, which makes it possible to reach much greater distances by using the cellular network. As mains electric power is available in this plot, a Raspberry Pi has been used instead of the ESP32 board to collect sensor data. All data received from the two plots are stored on a proprietary server located at the irrigation management company's headquarters. The analysis of these data by means of machine learning algorithms that are currently under development should allow a short-term prediction of the irrigation water demand that would significantly reduce the waste of this increasingly valuable natural resource. The major finding of this work is the real possibility of deploying a remote sensing system for irrigated plots by using Commercial-Off-The-Shelf (COTS) devices, easily scalable and adaptable to design requirements such as the distance to the control center or the availability of mains electrical power at the site.

Keywords: internet of things, irrigation water control, LoRa, LTE, smart farming

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Authors: Ohoud Abdullatif Alshaiji

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Child-rearing is considered as the most important family role and with the modern lifestyle and busy families social institutions has taken this role from the family to encourage the individuals active's role in the social life, this study aimed to acknowledge the contributions of the social institutions in child-rearing the Saudi children and to acknowledge The Role of the community's partnership in activating the social child-rearing for the Saudi children. The research main question was how much the community's partnership is actually participating in activating the process of the social development of the Saudi children. The importance of this study comes from the massive care that has been given from all over the world, children international organizations, and this research is focusing on the participating of five social organization in child-rearing the Saudi children. The study was limited on the mothers of the children who are enrolled in the government's kindergarten the tool that has been used was the Questionnaire, using the descriptive and analytical approach. The important role of the family in encouraging the social development for the Saudi child, and the results has shown the importance of the mosque in encouraging the good social behaviors. And the kindergarten role has shown after the mosque because of the changes that made most of the families relying on the educational institutions to help the child to adapt in a different cultures. To spread the community's partnership in all the social actions, to support and encourage the role of community's partnership in activating the process of the social development of the Saudi children, to minimize the difficulties and the provide the need to fully support the community's partnership.

Keywords: child-rearing, social development, acknowledge the contributions

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Authors: Muhammad Awais Kiani

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The field of electronics engineering plays a vital role in the marketing of smart materials. Smart materials are innovative, adaptive materials that can respond to external stimuli, such as temperature, light, or pressure, in order to enhance performance or functionality. As the demand for smart materials continues to grow, it is crucial to understand how electronics engineering can contribute to their marketing strategies. This abstract presents an overview of the role of electronics engineering in the marketing of smart materials. It explores the various ways in which electronics engineering enables the development and integration of smart features within materials, enhancing their marketability. Firstly, electronics engineering facilitates the design and development of sensing and actuating systems for smart materials. These systems enable the detection and response to external stimuli, providing valuable data and feedback to users. By integrating sensors and actuators into materials, their functionality and performance can be significantly enhanced, making them more appealing to potential customers. Secondly, electronics engineering enables the creation of smart materials with wireless communication capabilities. By incorporating wireless technologies such as Bluetooth or Wi-Fi, smart materials can seamlessly interact with other devices, providing real-time data and enabling remote control and monitoring. This connectivity enhances the marketability of smart materials by offering convenience, efficiency, and improved user experience. Furthermore, electronics engineering plays a crucial role in power management for smart materials. Implementing energy-efficient systems and power harvesting techniques ensures that smart materials can operate autonomously for extended periods. This aspect not only increases their market appeal but also reduces the need for constant maintenance or battery replacements, thus enhancing customer satisfaction. Lastly, electronics engineering contributes to the marketing of smart materials through innovative user interfaces and intuitive control mechanisms. By designing user-friendly interfaces and integrating advanced control systems, smart materials become more accessible to a broader range of users. Clear and intuitive controls enhance the user experience and encourage wider adoption of smart materials in various industries. In conclusion, electronics engineering significantly influences the marketing of smart materials by enabling the design of sensing and actuating systems, wireless connectivity, efficient power management, and user-friendly interfaces. The integration of electronics engineering principles enhances the functionality, performance, and marketability of smart materials, making them more adaptable to the growing demand for innovative and connected materials in diverse industries.

Keywords: electronics engineering, smart materials, marketing, power management

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Authors: Giovanni Matheus Rech, Gilberto Zan, Filipe P. Aguiar

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The current pandemic scenario raises questions that many times would have previously gone unnoticed. One of these issues is the quality of the air we breathe in the most diverse environments in which we are inserted in an everyday. It is plausible to suppose that, at times like this, there is apprehension regarding the possibility of contamination by pathological agents such as viruses and bacterias through the airways. However, the renewal of indoor air, combined with a properly sanitized air conditioning system, are important tools for the prevention of viral diseases, as is the case with COVID-19. The bus is an example of an environment where renovation is applied to improve the quality of indoor air, helping to reduce the possibility of spreading pathological agents. Together with other care, such as an alcohol gel dispenser, curtains to separate the passengers, cleaning the environment more frequently, and mandatory use of masks, help to reduce the transmission of pathologies, such as COVID-19. Knowing the reality of a large part of the population regarding the need for public transport, there are standards and devices dedicated to promoting air quality, ensuring greater comfort and safety for users. This paper seeks to present such standards and recommendations to improve the quality of indoor air, as well as the equipment responsible for the renewal of the air in the body of a bus. Experimental measurement of the flow rates of the renewal devices present in the bus body allows quantifying the average volume of external air admitted in each type of body. This way, it was possible to compare, in terms of airflow per person, the values of a bus in relation to a series of other environments, using recommendations for air renewal are described through the Brazilian standard ABNT NBR 16401.

Keywords: air quality, air renewal, buses, Covid-19

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Authors: Christine Maleesha Withanachchi, Eithne Heffernan, Derek Hoare

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Background: Social isolation (SI} is a major consequence of hearing loss (HL}. Isolation can lead to serious health problems (e.g., dementia and depression). Hearing Aids (HA) is the primary intervention for HL. However, these are less effective in social situations. Interventions are needed for SI in adults with hearing loss (AHL). Objectives: Investigated the relationship between HL and SI. Explored the views of AHL and hearing healthcare professionals (HHP) towards interventions for isolation. Methods: Individual and group semi-structured interviews were conducted. Interviews were conducted at the Nottingham Institute of Health Research (NIHR) Biomedical Research Centre (BRC). Six AHL and seven HHP were recruited via maximum variation sampling. The interview transcripts were analyzed using inductive thematic analysis. Results: Social impacts of HL: Most participants described that HL hurt them. This was in the form of social withdrawal, strain on relationships, and identity loss. Downstream effects of HL: Most audiologists acknowledged that isolation from HL could lead to depression. HL can also lead to exhaustion and unemployment. Impact of stigma: There are negative connotations around HL and HA (e.g. old age) and there is difficulty talking about isolation. The complexity of SI: There can be difficulty separating SI due to HL from SI due to other contributing factors (e.g. comorbidities). Potential intervention for isolation: Participants were unfamiliar with interventions for isolation and few, if any, were targeted for AHL specifically. Most participants thought an intervention should be patient-centered and run by an AHL in the community. Opinions differed regarding whether it should hear specific or generic. Implementation of intervention: Challenges to the implementation of an intervention for SI exist due to the sensitivity of the subject. Conclusions: This study demonstrated that SI is a major consequence of HL and uncovered novel findings related to its interventions. Uptake of interventions offered to AHL to reduce loneliness and social isolation is expected to be better if led by AHL in the community as opposed to HHP led interventions in the hospital or clinic settings.

Keywords: adults with hearing loss, hearing aids, interventions, social isolation

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Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

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Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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Authors: N. Dlamini, Mpumelelo G. Ndlela, Philisiwe Dlamini, Nicholus Kisyeri, Bhekizitha Sithole

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Accessing health services during the COVID-19 pandemic have exacerbated scarcity to routine medication. To ensure continuous accessibility to services, Eswatini launched Community Health Commodities Distribution (CHCD). Eligible Antiretroviral Therapy(ART) stable clients (VL<1,000) and patients on Non-Communicable Disease (NCD) medications were attended at community pick up points (PUP) based on distance between clients’ residence and the public health facility. Services provided includes ART and Pre-Exposure prophylaxis (PrEP) refills and NCD drug refills). The number of community PUP was 14% higher than health facility visits. Among all medications and commodities distributed between April and October 2020 at the PUP, 64% were HIV-related (HIV rapid test, HIVST, VL test, PrEP meds), and 36% were NCD related. The rapid roll out of CHCD during COVID-19 pandemic reduced the risk of COVID-19 transmission to clients as travel to health facilities was eliminated. It Additionally increased access to commodities during COVID-19-driven lockdown, decongested health facilities, integrated model of care, and increase service coverage. It was also noted that CHCD added different curative and HIV related services based on client specific needs and availability of the commodities.

Keywords: community health commodities distribution, pick up points, antiretroviral therapy, pre-exposure prophylaxis

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Authors: Kristen Erekson, Sarah Spendlove Caswell

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Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

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