Search results for: community health workers masters list (CHWML)

Authors: Shamraiz Ahmad, Riaz Ahmad, Adnan Maqsood

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This paper describes the application of 2k-design of experiment in order to screen the geometric parameters and experimental refinement of ceiling fan blades. The ratio of the air delivery to the power consumed is commonly known as service value (SV) in ceiling fan designer’s community. Service value was considered as the response for 56 inch ceiling fan and four geometric parameters (bend position at root, bend position at tip, bent angle at root and bent angle at tip) of blade were analyzed. With two levels, the 4-design parameters along with their eleven interactions were studied and design of experiment was employed for experimental arrangement. Blade manufacturing and testing were done in a medium scale enterprise. The objective was achieved and service value of ceiling fan was increased by 10.4 % without increasing the cost of production and manufacturing system. Experiments were designed and results were analyzed using Minitab® 16 software package.

Keywords: parametric screening, 2k-design of experiment, ceiling fan, service value, performance improvement

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Authors: Okorowo Cyril Agochi

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The Niger Delta Region of Nigeria is home to about 20 million people and 40 different ethnic groups. The region has an area of seventy thousand square kilometers (70,000 KM2) of wetlands, formed primarily by sediments deposition and makes up 7.5 percent of Nigeria's total landmass. The notable ecological zones in this region includes: coastal barrier islands; mangrove swamp forests; fresh water swamps; and lowland rainforests. This incredibly naturally-endowed ecosystem region, which contains one of the highest concentrations of biodiversity on the planet, in addition to supporting abundant flora and fauna, is threatened by the inhuman act known as gas flaring. Gas flaring is the combustion of natural gas that is associated with crude oil when it is pumped up from the ground. In petroleum-producing areas such as the Niger Delta region of Nigeria where insufficient investment was made in infrastructure to utilize natural gas, flaring is employed to dispose of this associated gas. This practice has impoverished the communities where it is practiced, with attendant environmental, economic and health challenges. This paper discusses the adverse environmental and health implication associated with the practice, the role of Government, Policy makers, Oil companies and the Local communities aimed at bring this inhuman practice to a prompt end.

Keywords: natural combustion, emission, environment, flaring, gas, health, Niger Delta

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Authors: Haripriya Chakraborty

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The healthcare system in the United States is considered to be one of the most inefficient and expensive systems when compared to other developed countries. Consequently, there are persistent concerns regarding the overall functioning of this system. For instance, the large number of uninsured individuals and high premiums are pressing issues that are shown to have a negative effect on health outcomes with possible life-threatening consequences. The Affordable Care Act (ACA), which was signed into law in 2010, was aimed at improving some of these inefficiencies. This paper aims at providing a computational mechanism to examine some of these inefficiencies and the effects that policy proposals may have on reducing these inefficiencies. Agent-based modeling is an invaluable tool that provides a flexible framework to model complex systems. It can provide an important perspective into the nature of some interactions that occur and how the benefits of these interactions are allocated. In this paper, we propose a novel and versatile agent-based model with realistic assumptions to simulate the dynamics of a health insurance marketplace that contains a mixture of private and public insurers and individuals. We use this model to analyze the characteristics, motivations, payoffs, and strategies of these agents. In addition, we examine the effects of certain policies, including some of the provisions of the ACA, aimed at reducing the uninsured rate and the cost of premiums to move closer to a system that is more equitable and improves health outcomes for the general population. Our test results confirm the usefulness of our agent-based model in studying this complicated issue and suggest some implications for public policies aimed at healthcare reform.

Keywords: agent-based modeling, healthcare reform, insurance markets, public policy

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Authors: Siwarak Kitchanapaibul, Warren Gillibrand, Rob Burton

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The prevalence of diabetes mellitus has been rising all over the world. Self-management is required for diabetes mellitus patients. The objective of this study is to explore the self-management among the ethnic groups with type 2 diabetes mellitus in Thailand, an upper middle-income country which is located in South East Asia. The ethnic groups in Thailand are a minority group which has limited education and a different culture, language, costume and lifestyle from Thai people. The qualitative exploratory study was used in this study. In-depth interviews with semi-structured open questions were conducted by 20 participants from purposive sampling. These participants were the ethnic groups who have type 2 diabetes mellitus, received the services from a region hospital, understood Thai and were willing to participate. Content analysis was adopted for the study. The results showed that all of the participants controlled their diet before the appointment day and never miss their appointment. Only 3 participants did their exercise while 2 participants stated that they occasionally forgot to take medicine. 10 participants use the herbs for reducing the sugar level. 12 participants drank a lot of water after a lapse in the diet because they believed that water could dilute the sugar. The findings identified 5 themes; ‘controlling diet before appointment day’; ‘drinking water after a lapse in diet’; ‘medication being a vital importance’; ‘exercise is unimportant’; and ‘taking herbs for sugar reduction’. The results of this study are important to the health professionals to understand the self-management of Ethnic groups and use the data to create the appropriate intervention for promoting health among the ethnic groups with type 2 diabetes mellitus in Thailand. The findings will lead to the revision of health policy and the procedure for promoting health in this special ethnic groups.

Keywords: self-management, diabetes, ethnic groups, Thailand

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Authors: Rimon Rafiah

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This paper will present a combination of two seemingly unrelated models, which are the one for estimating economic development impacts as a result of transportation investment and the other for increasing CAV penetration in order to reduce congestion. Measuring economic development impacts resulting from transportation investments is becoming more recognized around the world. Examples include the UK’s Wider Economic Benefits (WEB) model, Economic Impact Assessments in the USA, various input-output models, and additional models around the world. The economic impact model is based on WEB and is based on the following premise: investments in transportation will reduce the cost of personal travel, enabling firms to be more competitive, creating additional throughput (the same road allows more people to travel), and reducing the cost of travel of workers to a new workplace. This reduction in travel costs was estimated in out-of-pocket terms in a given localized area and was then translated into additional employment based on regional labor supply elasticity. This additional employment was conservatively assumed to be at minimum wage levels, translated into GDP terms, and from there into direct taxation (i.e., an increase in tax taken by the government). The CAV model is based on economic principles such as CAV usage, supply, and demand. Usage of CAVs can increase capacity using a variety of means – increased automation (known as Level I thru Level IV) and also by increased penetration and usage, which has been predicted to go up to 50% by 2030 according to several forecasts, with possible full conversion by 2045-2050. Several countries have passed policies and/or legislation on sales of gasoline-powered vehicles (none) starting in 2030 and later. Supply was measured via increased capacity on given infrastructure as a function of both CAV penetration and implemented technologies. The CAV model, as implemented in the USA, has shown significant savings in travel time and also in vehicle operating costs, which can be translated into economic development impacts in terms of job creation, GDP growth and salaries as well. The models have policy implications as well and can be adapted for use in Japan as well.

Keywords: CAV, economic development, WEB, transport economics

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Authors: Cate MacMillan, Nicholas J. Stevens, Johanna Rosier, Steven Boyd

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Choosing where to live is an important decision for anybody, however, this decision is more complex if you are an adult with intellectual disability. Our research asked adults with intellectual disability, parents and carers and disability, housing and built environment decision makers what they considered important in deciding where to live. If medical advances continue to improve the longevity of adults with intellectual disability, many of these adults will outlive their parents. With appropriate community support, and in appropriately designed neighbourhoods, many will be able to live independently. Our research suggests that the key to achieving independent living as an adult with intellectual disability is not so much about the house but the type of neighbourhood and its design. This paper presents the results of interviews and details a practical approach which will better inform urban development decision-makers in establishing safe, inclusive and accessible neighbourhood design.

Keywords: inclusion, independent living, intellectual disability, neighbourhoods, systems thinking, urban design and planning

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Authors: Ruchi Sharma, Rajasekhar Balasubramanian

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Motor vehicles emit a number of air pollutants, among which fine particulate matter (PM₂.₅) is of major concern in cities with high population density due to its negative impacts on air quality and human health. Typically, people spend more than 80% of their time indoors. Consequently, human exposure to traffic-related PM₂.₅ in indoor environments has received considerable attention. Most of the public residential buildings in tropical countries are designed for natural ventilation where indoor air quality tends to be strongly affected by the migration of air pollutants of outdoor origin. However, most of the previously reported traffic-related PM₂.₅ exposure assessment studies relied on ambient PM₂.₅ concentrations and thus, the health impact of traffic-related PM₂.₅ on occupants in naturally ventilated buildings remains largely unknown. Therefore, a systematic field study was conducted to assess indoor human exposure to traffic-related PM₂.₅ with and without mitigation measures in a typical naturally ventilated residential apartment situated near a road carrying a large volume of traffic. Three PM₂.₅ exposure scenarios were simulated in this study, i.e., Case 1: keeping all windows open with a ceiling fan on as per the usual practice, Case 2: keeping all windows fully closed as a mitigation measure, and Case 3: keeping all windows fully closed with the operation of a portable indoor air cleaner as an additional mitigation measure. The indoor to outdoor (I/O) ratios for PM₂.₅ mass concentrations were assessed and the effectiveness of using the indoor air cleaner was quantified. Additionally, potential human health risk based on the bioavailable fraction of toxic trace elements was also estimated for the three cases in order to identify a suitable mitigation measure for reducing PM₂.₅ exposure indoors. Traffic-related PM₂.₅ levels indoors exceeded the air quality guidelines (12 µg/m³) in Case 1, i.e., under natural ventilation conditions due to advective flow of outdoor air into the indoor environment. However, while using the indoor air cleaner, a significant reduction (p < 0.05) in the PM₂.₅ exposure levels was noticed indoors. Specifically, the effectiveness of the air cleaner in terms of reducing indoor PM₂.₅ exposure was estimated to be about 74%. Moreover, potential human health risk assessment also indicated a substantial reduction in potential health risk while using the air cleaner. This is the first study of its kind that evaluated the indoor human exposure to traffic-related PM₂.₅ and identified a suitable exposure mitigation measure that can be implemented in densely populated cities to realize health benefits.

Keywords: fine particulate matter, indoor air cleaner, potential human health risk, vehicular emissions

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Authors: Allison Futter

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Lifetime use of electronic cigarettes (EC) in college students has been estimated at around 50%; recent research shows Mobile Health (mHealth) technology is a promising tool to help address this public health issue, yet the majority of EC cessation mHealth tools found on smartphone app stores lack empirical support of their effectiveness. The Smiling Instead of Smoking (SiS) app is a positive psychology-based smartphone app for nondaily smokers. Due to previous success with brief, self-administered positive psychology exercises for cigarette cessation, this study examined the SiS App’s feasibility and effectiveness for EC cessation. Sixteen undergraduates used the SiS app for 3 weeks: one week before their quit date and 2 weeks after. As hypothesized, participants had significant declines in their craving and maintained pre-cessation levels of positive affect. There were no significant changes in dependency or self-efficacy. In the one-month follow-up survey, 38% of participants reported being abstinent. The app had an almost 4-star rating for its features (e.g., functionality, aesthetics, information, etc.) and participants reported moderate satisfaction with its use. Participants used the app, on average, 10 out of the 21 days of the prescribed app use. This study highlights the promise of mHealth support and positive psychology for EC cessation, adding to the understanding of possible ways to support EC quit attempts.

Keywords: e-cigarette cessation, mHealth, positive psychology, smartphone app

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Authors: Marutani M, Kawajiri H, Usui C, Takai Y, Kawaguchi T

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Background: To build the inclusive society, the Japanese government provides “transition support for employment system” for Persons with Disabilities (PWDs). It is, however, difficult to provide appropriate accommodations due to their changeable health conditions. Mobile phone applications (App) are useful to monitor their health conditions and their environments, and effective to improve reasonable accommodations for PWDs. Purpose: This study aimed to develop an App that PWDs input their self-assessment and make their health conditions and environment conditions visible. To attain the goal, we investigated the items of the App for the first step. Methods: Qualitative and descriptive design was used for this study. Study participants were recruited by snowball sampling in July and August 2023. They had to have had minimum of five-years of experience to support PWDs’ employment. Semi-structured interviews were conducted on their assessment regarding PWDs’ conditions of daily activities, their health conditions, and living and working environment. Verbatim transcript was created from each interview content. We extracted the following items in tree groups from each verbatim transcript: daily activities, health conditions, and living and working. Results: Fourteen participants were involved (average years of experience: 10.6 years). Based on the interviews, tree item groups were enriched. The items of daily activities were divided into fifty-five. The example items were as follows: “have meals on one’s style” “feel like slept well” “wake-up time, bedtime, and mealtime are usually fixed.” “commute to the office and work without barriers.” Thirteen items of health conditions were obtained like “feel no anxiety” “relieve stress” “focus on work and training” “have no pain” “have the physical strength to work for one day.” The items of categories of living and working environments were divided into fifteen-two. The example items were as follows: “have no barrier in home” “have supportive family members” “have time to take medication on time while at work” “commute time is just right” “people at the work understand the symptoms” “room temperature and humidity are just right” “get along well with friends in my own way.” The participants also mentioned the styles to input self-assessment like that a face scale would be preferred to number scale. Conclusion: The items were enriched existent paper-based assessment items in terms of living and working environment because those were obtained from the perspective of PWDs. We have to create the app and examine its usefulness with PWDs toward inclusive society.

Keywords: occupational health, innovatiove tool, people with disability, employment

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Authors: Carolina Alcântara, Ileno Costa

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This study had the objective to systemize the main psycho-social and socioeducational aspects that related with the psychic suffering of adolescents in conflict of law and freedom privation. This research wanted to verify the signals and symptoms identified trough themselves perceptions related to their condition of health/insanity. In a similar way, it was objectified to know the opinions of the ambient conditions of the institution the use of the currently available resources for Health Service and Educational Service. The methodological proposal is based on the quant-qualitative analysis of interviews half-structuralized carried through with 36 teenagers was using psychiatric medication continuously. The data had pointed the experiences of sleeplessness and nightmares, associates or not with experiences of loss of reality (hallucinations) had constituted the illness most frequent. The self-punishment behavior appeared at second place. With regard to the ambient factors, it was verified that institution had, in general way, guaranteed the physical integrity and the maintenance of the health. Amongst the current available resources of Health Service, the administration of anticonvulsivants, in association with other psychotropic drugs has been widely used. The school was viewed as important device of available in the institution. By means of the adolescent’s understanding who do not like to go to the school, they don’t disqualify the knowledge, in contrast, they wanted for knowledge, however, they were frustrated for not having their educational supplies adequately, affirming that the school is weak or they do not learn. Finally, among the possible conclusions guided for the Winnicott’s thought, it was observed that institution in analysis is a representative of the paternal function. However, to begin the self-cure process is necessary that formation of therapeutical bonds. The group of teachers is identified as the main tool of change.

Keywords: serious psychic suffering, adolescent in conflict with the law, delinquency, privation of freedom

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Authors: D. Supaporn, B. Julaluk

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The purposes of this study were to study symptom cluster, functional status and quality of life of patients with chronic obstructive pulmonary disease (COPD), and to examine factors related to and predicting symptom cluster, functional status and quality of life of COPD patients. The sample was 180 COPD patients multi-stage random sampling from 4 hospitals in the eastern region, Thailand. The research instruments were 8 questionnaires and recorded forms measuring personal and illness data, co-morbidity, physical and psychological symptom, health status perception, social support, and regimen adherence, functional status and quality of life. Spearman rank and Pearson correlation coefficient, exploratory factors analysis and standard multiple regression were used to analyzed data. The findings revealed that two symptom clusters were generated: physical symptom cluster including dyspnea, fatigue and insomnia; and, psychological symptom cluster including anxiety and depression. Scores of physical symptom cluster was at moderate level while that of psychological symptom cluster was at low level. Scores on functional status, social support and overall regimen adherence were at good level whereas scores on quality of life and health status perception were at moderate level. Disease severity was positively related to physical symptom cluster, psychological symptom cluster and quality of life, and was negatively related to functional status at a moderate level (rs = .512, .509, .588 and -.611, respectively). Co-morbidity was positively related to physical symptom cluster and psychological symptom cluster at a low level (r = .179 and .176, respectively). Regimen adherence was negatively related to quality of life and psychological symptom cluster at a low level (r=-.277 and -.309, respectively), and was positively related to functional status at a moderate level (r=.331). Health status perception was negatively related to physical symptom cluster, psychological symptom cluster and quality of life at a moderate to high level (r = -.567, -.640 and -.721, respectively) and was positively related to functional status at a high level (r = .732). Social support was positively related to functional status (r=.235) and was negatively related to quality of life at a low level (r=-.178). Physical symptom cluster was negatively related to functional status (r= -.490) and was positively related to quality of life at a moderate level (r=.566). Psychological symptom cluster was negatively related to functional status and was positively related to quality of life at a moderate level (r= -.566 and .559, respectively). Disease severity, co-morbidity and health status perception could predict 40.2% of the variance of physical symptom cluster. Disease severity, co-morbidity, regimen adherence and health status perception could predict 49.8% of the variance of psychological symptom cluster. Co-morbidity, regimen adherence and health status perception could predict 65.0% of the variance of functional status. Disease severity, health status perception and physical symptom cluster could predict 60.0% of the variance of quality of life in COPD patients. The results of this study can be used for enhancing quality of life of COPD patients.

Keywords: chronic obstructive pulmonary disease, functional status, quality of life, symptom cluster

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Authors: Kazi Ashief Mahmood

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Geographically Bangladesh is located in a natural hazard prone area. Compared to the rest of the areas, the coastal sub-districts are more vulnerable to climate variability and change. However, the hydro-geophysical reality of the sub-districts predominantly determines their contexts of vulnerability and its nature differs accordingly. Intriguingly enough, the poorest of the areas appear to be the most cornered among the different vulnerable sectors. Among of these deprived segments; however, the women, the persons with disability and the minorities are generally more vulnerable and they face a high risk of marginalized. The most threatening hydro-geophysical climate vulnerability have been created by prolonged dry season as observed at Koyra Upazilla in Khulna districts and Shyamnagar in Satkhira districts. The prolonged dry season creates severe surface salinity by which farmers cannot produce or use their to cultivate. The absence of land-based production and employment in the area has led to severe food insecurity. As a result, farmers tend to change their livelihood option and many of them are forced to migrate to the other areas of the country in search of livelihood. Besides salinity intrusion, water logging, drought and different climate change induced hazards are endangering safe drinking water sources and putting small-holders out of agriculture-based livelihoods in the Koyra and Shyamnagar Upazilla. A sizeable fraction of small-holders are still trying to hold on to their small scale shrimp production, despite being under pressure to sell off their cultivating lands to their influential shrimp merchants. While their desperate effort to take advantage of the increasing salinity is somewhat successful, their families still face a greater risk of health hazards owing to the lack of safe drinking water. Unless the issues of salinity in drinking water cannot be redressed, the state of the affected people will be in great jeopardy. Most of the inhabitants of oKyra and Shyamnagar Upazilla are living under the poverty line. Thus, poverty is a major factor that intensifies the vulnerability caused by hydro-geophysical climatic conditions. The government and different NGOs are trying to improve the present scenario by implementing different disaster risk reduction projects along with poverty reduction for community empowerment.

Keywords: assessment, climate change, climate induced hazards, coastal zone

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Authors: M. Sirajul Islam Molla

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Noise pollution has been a continuous and an increasing threat to human health in urban population all over the world. The situation in Bangladesh particularly in major cities has been dangerously aggravating. Despite the government of Bangladesh have laws in its hand to curb the noise pollution the authority’s reluctance in enforcing it, is making the situation worse. We do not see any difference in some other major cities of the South Asian Regional Countries like Delhi and Kathmandu, both of the cities are facing the same situation like Dhaka. With the expansion of technology-based township all over the world, the noise pollution has been an emerging threat to urban health. The information for this review has been derived from websites of GOs, NGOs, peer-reviewed papers, seminars and symposia. The worse situation of noise pollution results in people’s irritation and protest, but in many cases, the protesters are facing the wrath of the polluters. Two such consequences in Bangladesh have resulted in killing the protesters by the polluters – one happened in Dhaka city and the other in a rural town. The law-enforcing agencies proactively do not attempt to impose the law. Noise pollution has been increasing so rapidly that it has become a burden on human health in urban populations. Prolonged exposure to higher noise causes mental stress, sleeplessness, high blood pressure, cardiac failure, respiratory disorder, miscarriage and breaks attention of students to their studies and also irritates their behavior. The noise pollution-caused mortality has also been increasing all over the world. Recommendations from the international conferences such as ICUH should be forwarded to the United Nations. The UN then should pass it on to the concerned countries. The UN should also keenly monitor if the countries have appropriate plan to curb noise pollution to meet the sustainable development goals.

Keywords: decibel, environment, noise, pollution

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Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman

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For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.

Keywords: acute medicine, clinical governance, intensive care, patient centered decision making

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Authors: Felix Y. Mahenge, Abiud L. Kaswamila, Davis G. Mwamfupe

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Grapevine is a drought resistant crop, although in recent years it has been observed to be affect by climate change. This compelled investigation of grapevine farmers’ adaptation strategies to climate change in Dodoma, Tanzania. A mixed research approach was adopted. Likewise, purposive and random sampling techniques were used to select individuals for the study. About 248 grapevine farmers and 64 key informants and members of focus group discussions were involved. Primary data were collected through surveys, discussions, interviews, and observations, while secondary data were collected through documentary reviews. Quantitative data were analysed through descriptive statistics by means of IBM (SPSS) software while the qualitative data were analysed through content analysis. The findings indicate that climate change has adversely affected grapevine production leading to the occurrence of grapevine pests and diseases, drought which increases costs for irrigation and uncertainties which affect grapevine markets. For the purpose of lessening grapevine production constraints due to climate change, farmers have been using several adaptation strategies. Some of the strategies include application of pesticides, use of scarers to threaten birds, irrigation, timed pruning, manure fertilisers and diversification to other farm or non-farm activities. The use of pesticides and industrial fertilizers were regarded as increasing human health risks in the study area. The researchers recommend that the Tanzania government should strengthen the agricultural extension services in the study area so that the farmers undertake adaptation strategies with the consideration of human health safety.

Keywords: grapevine farmers, adaptation, climate change, human health

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Authors: Mikailzade Parvin, Gurbanova Jamila, Alizade Samaya, Hasanova Afat

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It is known that in March 2020, the World Health Organization (WHO) declared a global pandemic of the 2019 coronovirus disease COVID-19, caused by the severe acute respiratory syndrome coronovirus (SARS-CoV-2). In this period, ensuring the safety of pregnancy and childbirth has become one of the necessary issues. The measures taken in this direction naturally consisted of strengthening and improving preventive measures among pregnant women. It should be noted that the lethality of SARS-CoV-2 infection among women reached 25%. The relevance of studying the effect of COVID-19 on reproductive health in women is due to its wide spread worldwide, severe clinical course, and the occurrence of numerous complications or lethality. It is of urgent importance to study the impact of the mentioned coronavirus infection on the health of pregnant women and the serious complications caused by it.Taking these into account, 230 pregnant women infected with the COVID-19 virus infection were registered. The average age of the pregnant women included in the study was: 29.24±6.0. The diagnosis of corona virus infection was made on the basis of polymerase chain reaction (PCR), serological tests (IgG, IgM). In 57.4% of cases, bilateral pneumonia was recorded in pregnant women and confirmed on the basis of radiological (RH) examination. RH examination revealed pneumonia with infiltrate in the lungs. Among clinical symptoms in pregnant women infected with COVID-19 virus infection: in 86 (37.4%) cases, symptoms such as high fever (t-39.0oC), shortness of breath, fatigue, and hypoxia were noted in pregnant women. A decrease in SpO2 to a minimal level was recorded. Laboratory-instrumental examinations were carried out. The obtained results showed: the average limit of D-dimer was 0.8±0.5; prothrombin time 13.2±1.1 seconds; INR 0.98±0.08, prothrombin index 104.3±19.5%, EHS - 34.8±13.6 mm/s. It should be noted that respiratory distress syndrome (RDS), premature birth, malformed and extremely malformed newborns, asphyxia or hypoxia have been reported in infants born to pregnant women infected with the coronavirus disease.Thus, from the obtained indicators, it is known that pregnant women infected with the virus have a high risk of serious illness and death for both themselves and their babies. It has been proven that the majority of babies born to SARS-CoV-2 positive mothers have a negative impact on their health.

Keywords: Covid 19, reproductive health, preqnancy, premature birth

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Authors: Kalpana Rajouriya, Ajay Taneja

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Particulates are ubiquitous in the air environment and cause serious threats to human beings, such as lung cancer, Chronic obstructive pulmonary disease (COPD), and Asthma. Particulates mainly arise from industrial effluent, vehicular emission, and other anthropogenic activities. In the glass industrial city Firozabad, real-time monitoring (mass as well as a number) of size segregated Particulate Matter (PM) and black carbon was done by Aerosol Black Carbon Detector (ABCD) and GRIMM portable aerosol Spectrometer at two different sites in which one site is urban, and another is rural. The average mass concentration of size segregated PM during the study period (March & April 2022) was recorded as PM₁₀ (223.73 g/m-³), PM₅.₀ (44.955 g/m-³), PM₂.₅ (59.275 g/m-³), PM₁.₀ (33.02 g/m-³), PM₀.₅ (2.05 g/m-³), and PM₀.₂₅ (2.99 g/m- ³). In number mode, PM concentration was found as PM₁₀ (27.46g/m-³), PM₅.₀ (233.48g/m-³), PM₂.₅ (646.61g/m-³), PM₁.₀ (1134.94 g/m-³), PM₀.₅ (14056.04g/m-³), and PM₀.₂₅ (182906.4 g/m-³). The highest concentration of BC was found in Urban due to the emissions from diesel engines and wood burning while NO2 was highest at the rural sites. The concentrations of PM₁₀ and PM₂.₅ exceeded the NAAQS and WHO guidelines. The sensitive, exposed population may be at risk of developing health-related problems from exposure to size-segregated PM and BC.

Keywords: particulate matter, black carbon, NO2, health risk

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Authors: Rebecca Zahra, Joseph G. Vella, Ernest Cachia

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The notion of cloud computing is rapidly gaining ground in the IT industry and is appealing mostly due to making computing more adaptable and expedient whilst diminishing the total cost of ownership. This paper focuses on the software as a service (SaaS) architecture of cloud computing which is used for the outsourcing of databases with their associated business processes. One approach for offering SaaS is basing the system’s architecture on multi-tenancy. Multi-tenancy allows multiple tenants (users) to make use of the same single application instance. Their requests and configurations might then differ according to specific requirements met through tenant customisation through the software. Despite the known advantages, companies still feel uneasy to opt for the multi-tenancy with data security being a principle concern. The fact that multiple tenants, possibly competitors, would have their data located on the same server process and share the same database tables heighten the fear of unauthorised access. Security is a vital aspect which needs to be considered by application developers, database administrators, data owners and end users. This is further complicated in cloud-based multi-tenant system where boundaries must be established between tenants and additional access control models must be in place to prevent unauthorised cross-tenant access to data. Moreover, when altering the database state, the transactions need to strictly adhere to the tenant’s known business processes. This paper focuses on the fact that security in cloud databases should not be considered as an isolated issue. Rather it should be included in the initial phases of the database design and monitored continuously throughout the whole development process. This paper aims to identify a number of the most common security risks and threats specifically in the area of multi-tenant cloud systems. Issues and bottlenecks relating to security risks in cloud databases are surveyed. Some techniques which might be utilised to overcome them are then listed and evaluated. After a description and evaluation of the main security threats, this paper produces a list of software requirements to ensure that proper security policies are implemented by a software development team when designing and implementing a multi-tenant based SaaS. This would then assist the cloud service providers to define, implement, and manage security policies as per tenant customisation requirements whilst assuring security for the customers’ data.

Keywords: cloud computing, data management, multi-tenancy, requirements, security

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Authors: Kristine D. de Leon, Junifer A. Abatayo, Jose Cristina M. Pariña

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The current study is a comparative analysis of the use of shell nouns as a cohesive device (CD) in an English for Second Language (ESL) setting in order to identify their use and relationship in the quality of second language (L2) writing. As these nouns were established to anticipate the meaning within, across or outside the text, their use has fascinated writing researchers. The corpus of the study included published articles from reputable journals and graduate students’ papers in order to analyze the frequency of shell nouns using “highly prevalent” nouns in the academic community, to identify the different lexicogrammatical patterns where these nouns occur and to the functions connected with these patterns. The result of the study implies that published authors used more shell nouns in their paper than graduate students. However, the functions of the different lexicogrammatical patterns for the frequently occurring shell nouns are somewhat similar. These results could help students in enhancing the cohesion of their text and in comprehending it.

Keywords: anaphoric, cataphoric, lexico-grammatical, shell nouns

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Authors: Marco Magasic

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This article examines how a local newspaper’s closure impacts the way everyday people in a rural Australian town are informed about and engage with political affairs. It draws on a two-month focused ethnographic study in the outback town of Lighting Ridge, New South Wales and explores people’s media-related practices following the closure of the towns’ only newspaper, The Ridge News, in 2015. While social media is considered to have partly filled the news void, there is an increasingly fragmented and less vibrant local public sphere that has led to growing complacency among individuals about political affairs. Local residents highlight a dearth of reliable, credible information and lament the loss of the newspaper and its role in community advocacy and fostering people’s engagement with political institutions, especially local government.

Keywords: public sphere, political participation, local news, democratic deficit

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Authors: Zainab Olabisi Tairu

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The human species is facing some of the most challenging issues encountered as civilization and development occurs. The most salient factors threatening all species globally are habitats loss and degradation, overexploitation, competition with unwanted invasive species, pollution, global climate and various individual lifestyles of indigenous species. In order to avoid or minimize the effect of our actions on the environment and to balance employee work life with their private life, Green Human Resource is important and must be practiced in every organization including Higher Learning Institutions. This study addressed Green HRM from an institutional perspective, University systems are involved in numerous and complex social, educational and extra-curricular activities. The University community must be challenged to rethink and re-construct their environmental policies and practices in order to contribute to sustainable development. Many institutions only look at sustainability from the technology improvement aspect and waste management. People are the principal actors for sustainability development at the institutional level. The aim of the study is to explore the concept of Green Human Resource Management at a case site. Divine Word University (DWU) an Institution of Higher Education that embraced the ‘Printing & Paper use Policy’, also commonly referred to as the ‘paperless policy’, the use of solar as an alternative source of energy, water conservation and improvement in internet technology (IT) with the aim of becoming a green institution in effort to help save the environment. This study used Participatory Action Research as the Overarching methodological framework and Egg of sustainability and Wellbeing as the theoretical perspective in analyzing the data, engaging Case study strategy and a mixed method design at DWU. Focus group interview were conducted with three departments at the University, semi-structure interviews with the senior managers, survey questionnaire administered to students and staff with a sample size of 176 participants, in addition, policy documents were also exploited as extra source of data. Waste management including e-waste appeared to be one of the main concerns at DWU. A vast majority of DWU staff and students expressed the need for their institution to do more on sustainability education. The findings revealed that members of the community are not fully integrated like the Egg of sustainability and wellbeing in order to achieve sustainable development goal. The concept of Green Human Resource Management in Universities lies with the idea that Universities must bear profound responsibilities to manage its stakeholders in an environmental friendly way. Human resource management can help local institutions to recognize the need for changes of lifestyle, production, consumption as well as the end product in order to combat or at least reduce human Induced which produce or aggravate it.

Keywords: sustainability, environmental management, higher education institutions, green human resource management

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Authors: Dongping Fang, Lian Duan, Xiaojing Yuan, Mike Xu, Allyn Klunder, Kevin Tan, Suiting Cao, Yeqing Ji

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Accurate prediction of a medical condition with straight clinical evidence is a long-sought topic in the medical management and health insurance field. Although great progress has been made with machine learning algorithms, the medical community is still, to a certain degree, suspicious about the model's accuracy and interpretability. This paper presents an innovative hierarchical attention deep learning model to achieve good prediction and clear interpretability that can be easily understood by medical professionals. This deep learning model uses a hierarchical attention structure that matches naturally with the medical history data structure and reflects the member’s encounter (date of service) sequence. The model attention structure consists of 3 levels: (1) attention on the medical code types (diagnosis codes, procedure codes, lab test results, and prescription drugs), (2) attention on the sequential medical encounters within a type, (3) attention on the medical codes within an encounter and type. This model is applied to predict the occurrence of stage 3 chronic kidney disease (CKD3), using three years’ medical history of Medicare Advantage (MA) members from a top health insurance company. The model takes members’ medical events, both claims and electronic medical record (EMR) data, as input, makes a prediction of CKD3 and calculates the contribution from individual events to the predicted outcome. The model outcome can be easily explained with the clinical evidence identified by the model algorithm. Here are examples: Member A had 36 medical encounters in the past three years: multiple office visits, lab tests and medications. The model predicts member A has a high risk of CKD3 with the following well-contributed clinical events - multiple high ‘Creatinine in Serum or Plasma’ tests and multiple low kidneys functioning ‘Glomerular filtration rate’ tests. Among the abnormal lab tests, more recent results contributed more to the prediction. The model also indicates regular office visits, no abnormal findings of medical examinations, and taking proper medications decreased the CKD3 risk. Member B had 104 medical encounters in the past 3 years and was predicted to have a low risk of CKD3, because the model didn’t identify diagnoses, procedures, or medications related to kidney disease, and many lab test results, including ‘Glomerular filtration rate’ were within the normal range. The model accurately predicts members A and B and provides interpretable clinical evidence that is validated by clinicians. Without extra effort, the interpretation is generated directly from the model and presented together with the occurrence date. Our model uses the medical data in its most raw format without any further data aggregation, transformation, or mapping. This greatly simplifies the data preparation process, mitigates the chance for error and eliminates post-modeling work needed for traditional model explanation. To our knowledge, this is the first paper on an interpretable deep-learning model using a 3-level attention structure, sourcing both EMR and claim data, including all 4 types of medical data, on the entire Medicare population of a big insurance company, and more importantly, directly generating model interpretation to support user decision. In the future, we plan to enrich the model input by adding patients’ demographics and information from free-texted physician notes.

Keywords: deep learning, interpretability, attention, big data, medical conditions

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Authors: Oloruntoba Kayode, Mohd Hisyam Rasidi, Ismail Said

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This study investigates the influence of public space in developing social cohesion among residents in science cities. The study takes into consideration the need for social cohesion in knowledge-based development and focuses on Cyberjaya Malaysia being a science city that is characterized by public spaces. As such, we adopted validated measuring tools for this study we developed a theoretical framework that links public space utilization with people's social cohesion. A total of 211 survey questions were administered by the residents in the study area on public space utilization and their social cohesion potentials. The research framework was validated to confirm its fit using structural equation modeling (SEM). The findings indicated that the observed public space utilization variables significantly influenced people's social cohesion, while group social ties have a positive influence on their collective minds.

Keywords: public space, social cohesion, knowledge-based development, theoretical framework

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Authors: Kedar Nath Nepal, Tek Bahadur Thapa, David Guerena;

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The community participation is central to the in-situ project objectives, as farming communities are key stakeholders in the on-farm conservation of agricultural bio- diversity. Besides technical means to adding benefits, the complimentary strategy includes creating market-based value adding measures by increasing users’ awareness of the value of traditional foods and nutritional values; exhibitions and improved processing; and policy incentives. This paper presents various participatory activities carried out in Nepal as options for enhancing benefits to local communities by increased utilization of local crop diversity on -the farm through non-breeding discussed, and outcomes are documented using farmers’ perception data and secondary information. The paper focuses on three major areas of public awareness, market incentives and non-market incentives that may enhance on -farm conservation and use of biodiversity.

Keywords: biodiversity, in-situ, market-based, non-market

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Authors: Antonella D'Alessandro, Filippo Ubertini, Annibale Luigi Materazzi

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The progress of nanotechnology resulted in the development of new instruments in the field of civil engineering. In particular, the introduction of carbon nanofillers into construction materials can enhance their mechanical and electrical properties. In construction, concrete is among the most used materials. Due to the characteristics of its components and its structure, concrete is suitable for modification, at the nanometer level too. Moreover, to guarantee structural safety, it is desirable to achieve a widespread monitoring of structures. The ideal thing would be to realize structures able to identify their behavior modifications, states of incipient damage or conditions of possible risk for people. This paper presents a research work about novel cementitious composites with conductive carbon nanoinclusions able of monitoring their state of deformation, with particular attention to concrete. The self-sensing ability is achieved through the correlation between the variation of stress or strain and that of electrical resistance. Carbon nanofillers appear particularly suitable for such applications. Nanomodified concretes with different carbon nanofillers has been tested. The samples have been subjected to cyclic and dynamic loads. The experimental campaign shows the potentialities of this new type of sensors made of nanomodified concrete for diffuse Structural Health Monitoring.

Keywords: carbon nanofillers, cementitious nanocomposites, smart sensors, structural health monitoring.

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Authors: Remya Radhakrishnan, Hema Perinbanathan, Anukriti Rath, Reshmi Ramachandran, Rohith Thazhathuvetil Sasindrababu, Maria Karizhenskaia

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Childhood adversities have lasting effects on health and well-being. This abstract explores the connection between adverse childhood experiences (ACEs) and health consequences, including substance abuse and obesity. Understanding the impact of childhood trauma and emphasizing the importance of culturally sensitive treatments and focused interventions help to mitigate these effects. Research consistently shows a strong link between ACEs and poor health outcomes. Our team conducted a comprehensive literature review of depression and anxiety in Canadian children and youth, exploring diverse treatment methods, including medical, psychotherapy, and alternative therapies like art and music therapy. We searched Medline, Google Scholar, and St. Lawrence College Library. Only original research papers, published between 2012 and 2023, peer-reviewed, and reporting on childhood adversities on health and its treatment methods in children and youth in Canada were considered. We focused on their significance in treating depression and anxiety. According to the study's findings, the prevalence of adverse childhood experiences (ACEs) is still a significant concern. In Canada, 40% of people report having had multiple ACEs, and 78% report having had at least one ACE, highlighting the persistence of childhood adversity and indicating that the issue is unlikely to fade off in the near future. Likewise, findings revealed that individuals who experienced abuse, neglect, or violence during childhood are likelier to engage in harmful behaviors like polydrug use, suicidal ideation, and victimization and suffer from mental health problems such as depression and post-traumatic stress disorder (PTSD).

Keywords: adverse childhood experiences (ACEs), obesity, post-traumatic stress disorder (PTSD), resilience, substance abuse, trauma-informed care

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Authors: Baiju Soren

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This research investigates village residents' feelings about rural landscapes and their attitudes toward preserving them, as well as the impact of attachment on participation in preserving those environments. To understand these relationships, 100 respondents from Bandudumha village : a tribal village, Mayurbhanj district of Odisha, were interviewed with a set of questionnaires and photographs. This framework is based on the idea that establishing environmental oversight and desire to cooperate in the development and preservation process can help to establish community values and meaning tied to places. As a result, a personal connection to the rural environment will be explored through an examination of place attachment, landscape choice, and the possible conservation value of landscapes to the people who live there. The findings suggest that commitment to a place can lead to unique ideas on collaborative preservation and the creation of truly relevant, socially inclusive landscapes. Furthermore, the data show how emotional ties to locations provide social support and provide insight into people–place relationships.

Keywords: participation in preservation, place attachment, preservation, rural landscape, sense of place

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Authors: N. S. B. Ambarini, Tito Sofyan, Edra Satmaidi

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Coastal and marine are two potential natural resource one of the pillars of the national economy. The Indonesian archipelago has marine and coastal which is quite spacious. Various important natural resources such as fisheries, mining and so on are in coastal areas and the sea, so that this region is a unique area with a variety of interests to exploit it. Therefore, to preserve a sustainable manner need good management and comprehensive. To the national and local level legal regulations have been published relating to the management of coastal and marine areas. However, in practice it has not been able to function optimally. Substantially has not touched the problems of the region, especially concerning the interests of local communities (local). This study is a legal non-doctrinal approach to socio-legal studies. Based on the results of research in some coastal and marine areas in Bengkulu province - Indonesia, there is a fact that the system of customary law and local wisdom began to weaken implementation. Therefore harmonization needs to be done in implementing laws and regulations that apply to the values of indigenous and local knowledge that exists in the community.

Keywords: coastal and marine, harmonization, law, local

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Authors: Qiong Hu, Ming Yue

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Language variation signals the newest usage of language community, which might become the developmental trend of that language. The personal pronoun we is prescribed as a plural pronoun in grammar, but its number value is more flexible in actual use. Based on the homemade Friends corpus, the present research explores the number value of the first person pronoun we in nowadays American spoken English. With consideration of the subjectivity of we, this paper used ‘we+ PCU (Perception-cognation-utterance) verbs’ collocations and ‘we+ plural categories’ as the parameters. Results from corpus data and manual annotation show that: 1) the overall frequency of we has been increasing; 2) we has been increasingly used with other plural categories, indicating a weakening of its plural reference; and 3) we has been increasingly used with PCU (perception-cognition-utterance) verbs of strong subjectivity, indicating a strengthening of its singular reference. All these seem to support our hypothesis that we is undergoing the process of further grammaticalization towards a singular reference, though future evidence is needed to attest the bold prediction.

Keywords: number, PCU verbs, personal pronoun we,

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Authors: Najma Najam, Rukhsana Kausar, Rabia Hussain Kanwal, Saira Batool, Anum Javed

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In Pakistan, elderly population though increasing but it has been neglected by the researchers and policy makers which resulted in compromised quality of life of the ageing population. Two regions, Punjab and Gilgit-Baltistan (GB) were selected for comparison as Lahore and Multan (Punjab) are highly urbanized, large cities whereas Gilgit and Skardu are remote and mountain bounded valleys in GB. This study focuses on psychological and emotional functioning of elderly and a series of measures translated and adapted in Urdu language was used to assess quality of life, psychological and mental well-being, actual and perceived social support, attachment patterns, forgiveness, affects, geriatric depression, and emotional disturbance patterns (depression, anxiety, and stress) in elderly. A gender-equated sample of 201 elderly participants, 93 from GB (60 from Gilgit, 33 from Skardu) and 108 from Punjab (61 from Lahore, 47 from Multan) with over 60 years age was collected from the multiethnic community of Punjab and GB through purposive convenient sampling technique. Findings revealed that elderly from Multan have better psychological and emotional functioning, higher levels of social support, tendency to forgive, better mental wellbeing and quality of life and lower levels of stress, anxiety, depression, negative affect and attachment avoidance and anxiety related to partner as compared to the elderly from Lahore. Furthermore, both elderly male of Gilgit & Skardu have adequate mental well-being including subjective well-being and psychological functioning which showed positive aspects of mental health but elderly female are more attached to their home and neighbourhood which shows their social and environmental mastery. Gilgiti elderly male reported more degree of positive affect such as enthusiasm, active, alertness, excitement and strong whereas among elderly from Skardu shows more negative affect i.e. aversive mood states, irritability, hostility, and general distress. The need of psychosocial therapy and family counseling for the elderly in urban areas has been identified, which can facilitate in reducing or preventing the depressive and stressful tendencies. The findings are expected to have implications for improving quality of life of the elderly, designing interventions, support system and rehabilitation services to help them. However, findings may attract attention of policy makers and researchers as currently this is the most neglected population in Pakistan.

Keywords: psychological, emotional, aging, elderly, quality of life

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