Search results for: electronic health records (EHR)

Authors: John Peter Dacanay, Edison Ramos, Cristopher James Dicang

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Waste management is a global concern due to increasing waste production from changing consumption patterns and population growth. Proper waste disposal management is a critical aspect of public health and environmental protection. In the healthcare industry, medical waste is generated in large quantities, and if not disposed of properly, it poses a significant threat to human health and the environment. Efficient waste management conserves natural resources and prevents harm to human health, and implementing an effective waste management system can save human lives. The study aimed to assess the level of awareness and practices on waste disposal management, highlighting the understanding of proper disposal, potential hazards, and environmental implications among Medical Technology students. This would help to provide more recommendations for improving waste management practices in healthcare settings as well as for better waste management practices in educational institutions. From the collected data, a female of 21 years of age stands out among the respondents. With the frequency and percentage of medical technology students' knowledge of laboratory waste management being high, it indicates that all respondents demonstrated a solid understanding of proper disposal methods, regulations, risks, and handling procedures related to laboratory waste. That said, the findings emphasize the significance of education and awareness programs in equipping individuals involved in laboratory practices with the necessary knowledge to handle and dispose of hazardous and infectious waste properly. Most respondents demonstrate positive practices or are highly mannered in laboratory waste management, including proper segregation and disposal in designated containers. However, there are concerns about the occasional mixing of waste types, emphasizing the reiteration of proper waste segregation. Students show a strong commitment to using personal protective equipment and promptly cleaning up spills. Some students admit to improper disposal due to rushing, highlighting the importance of time management and safety prioritization. Overall, students follow protocols for hazardous waste disposal, indicating a responsible approach. The school's waste management system is perceived as adequate, but continuous assessment and improvement are necessary. Encouraging reporting of issues and concerns is crucial for ongoing improvement and risk mitigation. The analysis reveals a moderate positive relationship between the respondents' knowledge and practices regarding laboratory waste management. The statistically significant correlation with a p-value of 0.26 (p-value 0.05) suggests that individuals with higher levels of knowledge tend to exhibit better practices. These findings align with previous research emphasizing the pivotal role of knowledge in influencing individuals' behaviors and practices concerning laboratory waste management. When individuals possess a comprehensive understanding of proper procedures, regulations, and potential risks associated with laboratory waste, they are more inclined to adopt appropriate practices. Therefore, fostering knowledge through education and training is essential in promoting responsible and effective waste management in laboratory settings.

Keywords: waste disposal management, knowledge, attitude, practices

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Authors: Mohammad Ehsani, Elham Karimi, Hashem Koozechian

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Aim: The purpose of current semi-experimental study was a survey on effect of 16 week walking on psychosocial function related quality of life among 60 to 75 years old men. Methodology: For this reason, short from of health – related quality of life questionnaire (SF – 36) and Geriatric Depression Scale (GDS) had been distributed to the subjects at 2 times of pre – test and posttest. Statistical sample of current study was 60 to 75 years old men who placed at Kahrizak house and assessed by considering physically and medical background. Also factors of entrance to the intervention like age range, have satisfaction and have intent to participating in walking program, lack of having diabetic, cardiovascular, Parkinsonism diseases and postural, neurological, musculoskeletal disorders, lack of having clinical background like visual disorders or disordering on equilibrium system, lack of motor limitation, foot print disorders, having surgery and mental health had been determined and assessed. Finally after primary studies, 80 persons selected and categorized accidentally to the 3 experimental group (1, 2, 3 sessions per week, 30 min walking with moderate intension at every sessions) and one control group (without physical activity in period of 16 weeks). Data analysed by employing ANOVA, Pearson coefficient and Scheffe Post – Hoc tests at the significance level of p < 0.05. Results: Results showed that psychosocial function of men with 60 to 75 years old increase by influence of 16 week walking and increase of exercise sessions lead to more effectiveness of walking. Also there was no significant difference between psychosocial function of subjects within 1 session and 3 sessions experimental groups (p > 0.05). Conclusion: On the basis of results, we can say that doing regular walking with efficient and standard dosage for elderly people, can increase their quality of life. Furthermore, designing and action operation regular walking program for elderly men on the basis of special, logical and systematic pattern under the supervision of aware coaches have been recommended on the basis of results.

Keywords: walking, quality of life, psychosocial function, elders

Procedia PDF Downloads 592

Authors: Stanislav Babaev, Vladimir Cuk, Sjef Cobben, Jan Desmet

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The procedures for performing harmonic studies for medium-voltage distribution feeders have become relatively mature topics since the early 1980s. The efforts of various electric power engineers and researchers were mainly focused on handling large harmonic non-linear loads connected scarcely at several buses of medium-voltage feeders. In order to assess the impact of these loads on the voltage quality of the distribution system, specific modeling and simulation strategies were proposed. These methodologies could deliver a reasonable estimation accuracy given the requirements of least computational efforts and reduced complexity. To uphold these requirements, certain analysis assumptions have been made, which became de facto standards for establishing guidelines for harmonic analysis. Among others, typical assumptions include balanced conditions of the study and the negligible impact of impedance frequency characteristics of various power system components. In latter, skin and proximity effects are usually omitted, and resistance and reactance values are modeled based on the theoretical equations. Further, the simplifications of the modelling routine have led to the commonly accepted practice of neglecting phase angle diversity effects. This is mainly associated with developed load models, which only in a handful of cases are representing the complete harmonic behavior of a certain device as well as accounting on the harmonic interaction between grid harmonic voltages and harmonic currents. While these modelling practices were proven to be reasonably effective for medium-voltage levels, similar approaches have been adopted for low-voltage distribution systems. Given modern conditions and massive increase in usage of residential electronic devices, recent and ongoing boom of electric vehicles, and large-scale installing of distributed solar power, the harmonics in current low-voltage grids are characterized by high degree of variability and demonstrate sufficient diversity leading to a certain level of cancellation effects. It is obvious, that new modelling algorithms overcoming previously made assumptions have to be accepted. In this work, a simulation approach aimed to deal with some of the typical assumptions is proposed. A practical low-voltage feeder is modeled in PowerFactory. In order to demonstrate the importance of diversity effect and harmonic interaction, previously developed measurement-based models of photovoltaic inverter and battery charger are used as loads. The Python-based script aiming to supply varying voltage background distortion profile and the associated current harmonic response of loads is used as the core of unbalanced simulation. Furthermore, the impact of uncertainty of feeder frequency-impedance characteristics on total harmonic distortion levels is shown along with scenarios involving linear resistive loads, which further alter the impedance of the system. The comparative analysis demonstrates sufficient differences with cases when all the assumptions are in place, and results indicate that new modelling and simulation procedures need to be adopted for low-voltage distribution systems with high penetration of non-linear loads and renewable generation.

Keywords: electric power system, harmonic distortion, power quality, public low-voltage network, harmonic modelling

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Authors: Dimuthu Manage

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Introduction: The prevalence of obesity and obesity-related non-communicable diseases are becoming a massive health concern in the whole world. Physical activity is recognized as an effective solution for this matter. The published data on the effectiveness of High-Intensity Interval Training (HIIT) in improving health parameters in overweight and obese individuals in Sri Lanka is sparse. Hence this study is conducted. Methodology: This is a quasi-experimental study that was conducted at the Sports medicine clinic, General Hospital, Kalutara. Participants have engaged in a programme of HIIT three times per week for six weeks. Data collection was based on precise measurements by using structured and validated methods. Ethical clearance was obtained. Results: Registered number for the study was 48, and only 52% have completed the study. The mean age was 32 (SD=6.397) years, with 64% males. All the anthropometric measurements which were assessed (i.e. waist circumference(P<0.001), weight(P<0.001) and BMI(P<0.001)), body fat percentage(P<0.001), VO2 max(P<0.001), and lipid profile (ie. HDL(P=0.016), LDL(P<0.001), cholesterol(P<0.001), triglycerides(P<0.010) and LDL: HDL(P<0.001)) had shown statistically significant improvement after the intervention with the HIIT programme. Conclusions: This study confirms HIIT as a time-saving and effective exercise method, which helps in preventing obesity as well as non-communicable diseases. HIIT ameliorates body anthropometry, fat percentage, cardiopulmonary status, and lipid profile in overweight and obese individuals markedly. As with the majority of studies, the design of the current study is subject to some limitations. The first is the study focused on a correlational study. If it is a comparative study, comparing it with other methods of training programs would have given more validity. Although the validated tools used to measure variables and the same tools used in pre and post-exercise occasions with the available facilities, it would have been better to measure some of them using gold-standard methods. However, this evidence should be further assessed in larger-scale trials using comparative groups to generalize the efficacy of the HIIT exercise program.

Keywords: HIIT, lipid profile, BMI, VO2 max

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Authors: Rachel Jones

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Systemic Family therapy in the Queensland Foster Care System is the implementation of Integrative Practice as a purposeful intervention implemented with complex ‘family’ systems (by expanding the traditional concept of family to include all relevant stakeholders for a child) and is shown to improve the overall wellbeing of children (with developmental delays and trauma) in Queensland out of home care contexts. The importance of purposeful integrative practice in the field of systemic family therapy has been highlighted in achieving change in complex family systems. Essentially, it is the purposeful use of multiple interventions designed to meet the myriad of competing needs apparent for a child (with developmental delays resulting from early traumatic experiences - both in utero and in their early years) and their family. In the out-of-home care context, integrative practice is particularly useful to promote positive change for the child and what is an extended concept of whom constitutes their family. Traditionally, a child’s family may have included biological and foster care family members, but when this concept is extended to include all their relevant stakeholders (including biological family, foster carers, residential care workers, child safety, school representatives, Health and Allied Health staff, police and youth justice staff), the use of integrative family therapy can produce positive change for the child in their overall wellbeing, development, risk profile, social and emotional functioning, mental health symptoms and relationships across domains. By tailoring therapeutic interventions that draw on systemic family therapies from the first and second-order schools of family therapy, neurobiology, solution focussed, trauma-informed, play and art therapy, and narrative interventions, disability/behavioural interventions, clinicians can promote change by mixing therapeutic modalities with the individual and their stakeholders. This presentation will unpack the implementation of systemic family therapy using this integrative approach to formulation and treatment for a child in out-of-home care in Queensland (experiencing developmental delays resulting from trauma). It considers the need for intervention for the individual and in the context of the environment and relationships. By reviewing a case example, this study aims to highlight the simultaneous and successful use of pharmacological interventions, psychoeducational programs for carers and school staff, parenting programs, cognitive-behavioural and trauma-informed interventions, traditional disability approaches, play therapy, mapping genograms and meaning-making, and using family and dyadic sessions for the system associated with the foster child. These elements of integrative systemic family practice have seen success in the reduction of symptoms and improved overall well-being of foster children and their stakeholders. Accordingly, a model for best practice using this integrative systemic approach is presented for this population group and preliminary findings for this approach over four years of local data have been reviewed.

Keywords: systemic family therapy, treating families of children with delays, trauma and attachment in families systems, improving practice and functioning of children and families

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Authors: Warnakulasuriya Arachichige Malisha Ann Rosary Fernando, Udalamatta Gamage Omila Chalanka Jinadasa, Bihini Pabasara Amandi Amarasinghe, Manul Thisuraka Mandalawatta, Uthpala Samarakoon, Manori Gamage

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The surge in sexually transmitted diseases (STDs) has become a critical public health crisis demanding urgent attention and action. Like many other nations, Sri Lanka is grappling with a significant increase in STDs due to a lack of education and awareness regarding their dangers. Presently, the available applications for tracking and managing STDs cover only a limited number of easily detectable infections, resulting in a significant gap in effectively controlling their spread. To address this gap and combat the rising STD rates, it is essential to leverage technology and data. Employing technology to enhance the tracking and management of STDs is vital to prevent their further propagation and to enable early intervention and treatment. This requires adopting a comprehensive approach that involves raising public awareness about the perils of STDs, improving access to affordable healthcare services for early detection and treatment, and utilizing advanced technology and data analysis. The proposed mobile application aims to cater to a broad range of users, including STD patients, recovered individuals, and those unaware of their STD status. By harnessing cutting-edge technologies like image detection, symptom-based identification, prevention methods, doctor and clinic recommendations, and virtual counselor chat, the application offers a holistic approach to STD management. In conclusion, the escalating STD rates in Sri Lanka and across the globe require immediate action. The integration of technology-driven solutions, along with comprehensive education and healthcare accessibility, is the key to curbing the spread of STDs and promoting better overall public health.

Keywords: STD, machine learning, NLP, artificial intelligence

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Authors: Akram Sadat Jafari Roodbandi, Alireza Choobineh, Nazanin Hosseini, Vafa Feyzi

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Introduction: Physical fitness and optimum functional movement are essential for efficiently performing job tasks without fatigue and injury. Functional Movement Screening (FMS) tests are used in screening of athletes and military forces. Nurses and emergency medical staff are obliged to perform many physical activities such as transporting patients, CPR operations, etc. due to the nature of their jobs. This study aimed to assess relationship between FMS test score and the prevalence of musculoskeletal disorders (MSDs) in emergency nurses and emergency medical services (EMS) staff. Methods: 134 male and female emergency nurses and EMS technicians participated in this cross-sectional, descriptive-analytical study. After video tutorial and practical training of how to do FMS test, the participants carried out the test while they were wearing comfortable clothes. The final score of the FMS test ranges from 0 to 21. The score of 14 is considered weak in the functional movement base on FMS test protocol. In addition to the demographic data questionnaire, the Nordic musculoskeletal questionnaire was also completed for each participant. SPSS software was used for statistical analysis with a significance level of 0.05. Results: Totally, 49.3% (n=66) of the subjects were female. The mean age and work experience of the subjects were 35.3 ± 8.7 and 11.4 ± 7.7, respectively. The highest prevalence of MSDs was observed at the knee and lower back with 32.8% (n=44) and 23.1% (n=31), respectively. 26 (19.4%) health worker had FMS test score of 14 and less. The results of the Spearman correlation test showed that the FMS test score was significantly associated with MSDs (r=-0.419, p < 0.0001). It meant that MSDs increased with the decrease of the FMS test score. Age, sex, and MSDs were the remaining significant factors in linear regression logistic model with dependent variable of FMS test score. Conclusion: FMS test seems to be a usable screening tool in pre-employment and periodic medical tests for occupations that require physical fitness and optimum functional movements.

Keywords: functional movement, musculoskeletal disorders, health care worker, screening test

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Authors: Carmen Silvia Gabriel, Dsniele Bernardi da Costa, Andrea Bernardes, Sabrina Elias Mikael, Daniele da Silva Ramos

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The goal of this quantitative study is to investigate patient safety culture from the perspective of professional from the hospital nursing team.It was conducted in two Brazilian hospitals,.The sample included 282 nurses Data collection occurred in 2013, through the questionnaire Hospital Survey on Patient Safety Culture.Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor overlooks patient safety problems.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.On hospital management support for patient safety, 52.8% refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.On frequency of event reporting, 64.7% said often and always notify events with no damages to patients..About teamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8 % disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6 % classified it as very good. it is concluded that there are positive points in the safety culture, and some weaknesses as a punitive culture and impaired patient safety due to work overload .

Keywords: quality of health care, health services evaluation, safety culture, patient safety, nursing team

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Authors: Sonia P. Marrero Duran, Lilian Noya Dominguez, Lisandra Quintana Alvarez, Evert Martinez Perez, Ana Julia Acevedo Urquiaga

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Cuban business and economic policy are in the constant update as well as facing a client ever more knowledgeable and demanding. For that reason become fundamental for companies competitiveness through the optimization of its processes and services. One of the Cuban’s pillars, which has been sustained since the triumph of the Cuban Revolution back in 1959, is the free health service to all those who need it. This service is offered without any charge under the concept of preserving human life, but it implied costly management processes and logistics services to be able to supply the necessary medicines to all the units who provide health services. One of the key actors on the medicine supply chain is the Havana Distribution Center (HDC), which is responsible for the delivery of medicines in the province; as well as the acquisition of medicines from national and international producers and its subsequent transport to health care units and pharmacies in time, and with the required quality. This HDC also carries for all distribution centers in the country. Given the eminent need to create an actor in the supply chain that specializes in the medicines supply, the possibility of centralizing this operation in a logistics service provider is analyzed. Based on this decision, pharmacies operate as clients of the logistic service center whose main function is to centralize all logistics operations associated with the medicine supply chain. The HDC is precisely the logistic service provider in Havana and it is the center of this research. In 2017 the pharmacies had affectations in the availability of medicine due to deficiencies in the distribution routes. This is caused by the fact that they are not based on routing studies, besides the long distribution cycle. The distribution routs are fixed, attend only one type of customer and there respond to a territorial location by the municipality. Taking into consideration the above-mentioned problem, the objective of this research is to optimize the routes system in the Havana Distribution Center. To accomplish this objective, the techniques applied were document analysis, random sampling, statistical inference and tools such as Ishikawa diagram and the computerized software’s: ArcGis, Osmand y MapIfnfo. As a result, were analyzed four distribution alternatives; the actual rout, by customer type, by the municipality and the combination of the two last. It was demonstrated that the territorial location alternative does not take full advantage of the transportation capacities or the distance of the trips, which leads to elevated costs breaking whit the current ways of distribution and the currents characteristics of the clients. The principal finding of the investigation was the optimum option distribution rout is the 4th one that is formed by hospitals and the join of pharmacies, stomatology clinics, polyclinics and maternal and elderly homes. This solution breaks the territorial location by the municipality and permits different distribution cycles in dependence of medicine consumption and transport availability.

Keywords: computerized geographic software, distribution, distribution routs, vehicle problem routing (VPR)

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Authors: Genziana Lay

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A wide majority of older children and adolescents who enter the juvenile court system present with an array of problematic symptoms and behaviors including anxiety, depression, aggressive acting out, detachment, and substance abuse. Attachment theory offers a framework for understanding normative and pathological functioning, which during development is influenced by emotional, social and cognitive elements. There is clear evidence that children and adolescents with the highest risk of developing adaptation problems present an insecure attachment profile. Most offending minors have experienced dysfunctional family relationships as well as social and/or economic deprivation. Their maladaptive attachment develops not only through their relationship with caregivers but with the environment at large. Activation of their faulty attachment system leads them to feel emotionally overwhelmed and engage in destructive behaviors and decision-making. A psycho-social intervention with this population conceptualized as attachment therapy is a multi-faceted, practical approach that has shown excellent results in terms of increased psychological well-being and drastically reduced rates of re-offense/ destructive behavior. Through several; components including psychotherapy, monitoring, volunteering, meditation and socialization, the program focuses on seven dimensions: self-efficacy, responsibility, empathy/reparation, autonomy/security, containment/structure, insight building, and relational health. This paper presents the program and illustrates how the framework of attachment theory practically applied to psycho-social intervention has great therapeutic and social reparation potential. Preliminary evidence drawn from the Sassari Juvenile Court is very promising; this paper will illustrate these results and propose an even more comprehensive, applicable approach to psycho-social reparative intervention that leads to greater psychological health and reduced recidivism in the child and adolescent population.

Keywords: attachment, child, adolescent, crime, juvenile, psychosocial

Procedia PDF Downloads 173

Authors: Cristobal García

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The visual inspection of bolted joints in wind turbines is dangerous, expensive, and impractical due to the non-possibility to access the platform by workboat in certain sea state conditions, as well as the high costs derived from the transportation of maintenance technicians to offshore platforms located far away from the coast, especially if helicopters are involved. Consequently, the wind turbine operators have the need for simpler and less demanding techniques for the analysis of the bolts tightening. Vibration-based structural health monitoring is one of the oldest and most widely-used means for monitoring the health of onshore and offshore wind turbines. The core of this work is to find out if the modal parameters can be efficiently used as a key performance indicator (KPIs) for the assessment of joint bolts in a 1:50 scale tower of a floating offshore wind turbine (12 MW). A non-destructive vibration test is used to extract the vibration signals of the towers with different damage statuses. The procedure can be summarized in three consecutive steps. First, an artificial excitation is introduced by means of a commercial shaker mounted on the top of the tower. Second, the vibration signals of the towers are recorded for 8 s at a sampling rate of 20 kHz using an array of commercial accelerometers (Endevco, 44A16-1032). Third, the natural frequencies, damping, and overall vibration mode shapes are calculated using the software Siemens LMS 16A. Experiments show that the natural frequencies, damping, and mode shapes of the tower are directly dependent on the fixing conditions of the towers, and therefore, the variations of both parameters are a good indicator for the estimation of the static axial force acting in the bolt. Thus, this vibration-based structural method proposed can be potentially used as a diagnostic tool to evaluate the tightening torques of the bolted joints with the advantages of being an economical, straightforward, and multidisciplinary approach that can be applied for different typologies of connections by operation and maintenance technicians. In conclusion, TSI, in collaboration with the consortium of the FIBREGY project, is conducting innovative research where vibrations are utilized for the estimation of the tightening torque of a 1:50 scale steel-based tower prototype. The findings of this research carried out in the context of FIBREGY possess multiple implications for the assessment of the bolted joint integrity in multiple types of connections such as tower-to-nacelle, modular, tower-to-column, tube-to-tube, etc. This research is contextualized in the framework of the FIBREGY project. The EU-funded FIBREGY project (H2020, grant number 952966) will evaluate the feasibility of the design and construction of a new generation of marine renewable energy platforms using lightweight FRP materials in certain structural elements (e.g., tower, floating platform). The FIBREGY consortium is composed of 11 partners specialized in the offshore renewable energy sector and funded partially by the H2020 program of the European Commission with an overall budget of 8 million Euros.

Keywords: SHM, vibrations, connections, floating offshore platform

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Authors: Nasrin Akter, Bilkis Banu, Farhana Faruque, Fatema Afrin, Sujana Haque Chowdhury, Sarder Mahmud Hossain

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Objectives: To combat the growing prevalence of hypertension in Bangladesh, it is pivotal to have an in-depth understanding of quality of life (QOL) among hypertensive people. The aim of this study was to measure QOL of hypertensive people and its determinants in a selected tertiary hospital in Dhaka city. Design & Methods: This analytical cross-sectional study was conducted among randomly selected 300 hypertensive patients from two cardiac departments of Square Hospitals Limited. Data were collected through the face-to-face interview method. WHOQOL-BREF questionnaire was used to assess the QOL. Mean scores of quality of life were analyzed through descriptive statistics. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analyses were used to measure the association between QOL domains and independent variables. Results: Both overall QOL and domains had a good internal consistency, (r = 0.13–0.77, p< 0.01). The QOL among hypertensive patients was found to be poor in the psychological (71%) and social (74.7%) domains and good in the environmental (63%) and physical (65%) domains. Backward binary regressions revealed that being older (p=0.01), diabetic (p=0.02), having history of COVID-19 (p=0.01), and poor monthly income (USD ≤853.14) (p=0.01) were significantly associated with poor QOL in all domain. Moreover, older age (p=0.01) and poor lifestyle (p=0.02) were significantly associated with poor overall quality of life and poor general health perception. Conclusion: The results revealed low QOL in the psychological and social domain including significant factors associated with the poor QOL in all domains. To enhance the quality of life for hypertensive patients—especially those who are older, diabetic, have lower incomes, experienced COVID-19, and maintain poor lifestyles—effective interventions and health system strengthening are crucial.

Keywords: quality of life, hypertension, WHOQOL-BREF, analytical cross-sectional study

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Authors: Ruben Peralta, Sam Thomas, Nazia Hirani, Ayman El-Menyar, Hassan Al-Thani, Mohammed Al-Thani, Mohammed Al-Hajjaj, Rafael Consunji

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Moderate to severe work-related injuries [WRI's] are a leading cause of trauma admission in Qatar but information on risk factors for their incidence are lacking. This study aims to document and analyze the predictive characteristics for WRI to inform the creation of targeted interventions to improve worker safety in Qatar. This study was conducted as part of the NPRP grant # 7 - 1120 - 3 - 288, titled "A Unified Registry for Occupational Injury Prevention in Qatar”. 266 workers were interviewed using a standard questionnaire, during ‘World Day for Safety and Health at Work’, a Ministry of Public Health event, none refused interview. Nurses and doctors from the Hamad Trauma Center conducted the interviews. Questions were translated into the worker’s native language when it was deemed necessary. Standard information on epidemiologic characteristics and incidence of work-related injury were collected and compared between nationalities and those injured versus those not injured. 262 males and 4 females were interviewed. 17 [6.4%] reported a WRI in the last 24 months. More than half of the injured worked in construction [59%] followed by water supply [11.8%]. Factors significantly associated with recent injury were: Working for a company with > 500 employees and speaking Hindi. Protective characteristics included: Being from the Philippines or Sri Lanka, speaking Arabic, working in healthcare, an office or trading and company size between 100-500 employees. Years of schooling and working in Qatar were not predictive factor for WRI. The findings from this survey should guide future research that will better define worker populations at an increased risk for WRI and inform recruiters and sending countries. A focus on worker language skills, interventions in the construction industry and occupational safety in large companies is needed.

Keywords: occupational injury, prevention, safety, trauma, work related injury

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Authors: Lucia Carrion Gordon, Jaime Santiago Sanchez Reinoso

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According to the relation of Digital Preservation and the Health field as a case of study, the architectural model help us to explain that definitions. .The principal goal of Data Preservation is to keep information for a long term. Regarding of Mediacal information, in order to perform a heart transplant, physicians need to preserve this organ in an adequate way. This approach between the two perspectives, the medical and the technological allow checking the similarities about the concepts of preservation. Digital preservation and medical advances are related in the same level as knowledge improvement.

Keywords: medical management, digital, data, heritage, preservation

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Authors: Rajkumar Ghosh, Bhabani Prasad Mukhopadhay

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Groundwater contamination with fluoride has emerged as a global concern affecting millions of people, leading to the widespread occurrence of fluorosis. It affects bones and teeth, leading to dental and skeletal fluorosis. This study presents a comprehensive analysis of the relationship between groundwater contamination and fluorosis. It delves into the causes of fluoride contamination in groundwater, its spatial distribution, and adverse health impacts of fluorosis on affected communities. Fluoride contamination in groundwater can be attributed to both natural and anthropogenic sources. Geogenic sources involve the dissolution of fluoride-rich minerals present in the aquifer materials. On the other hand, anthropogenic activities such as industrial discharges, agricultural practices, and improper disposal of fluoride-containing waste contribute to the contamination of groundwater. The spatial distribution of fluoride contamination varies widely across different regions and geological formations. High fluoride levels are commonly observed in areas with fluorine-rich geological deposits. Additionally, agricultural and industrial centres often exhibit elevated fluoride concentrations due to anthropogenic contributions. Excessive fluoride ingestion during tooth development leads to dental fluorosis, characterized by enamel defects, discoloration, and dental caries. The severity of dental fluorosis varies based on fluoride exposure levels during tooth development. Long-term consumption of fluoride-contaminated water causes skeletal fluorosis, resulting in bone and joint pain, decreased joint mobility, and skeletal deformities. In severe cases, skeletal fluorosis can lead to disability and reduced quality of life. Various defluoridation techniques such as activated alumina, bone char, and reverse osmosis have been employed to reduce fluoride concentrations in drinking water. These methods effectively remove fluoride, but their implementation requires careful consideration of cost, maintenance, and sustainability. Diversifying water sources, such as rainwater harvesting and surface water supply, can reduce the reliance on fluoride-contaminated groundwater, especially in regions with high fluoride concentrations. Groundwater contamination with fluoride remains a significant public health challenge, leading to the widespread occurrence of fluorosis globally. This scientific report emphasizes the importance of understanding the relationship between groundwater contamination and fluorosis. Implementing effective mitigation strategies and preventive measures is crucial to combat fluorosis and ensure sustainable access to safe drinking water for communities worldwide. Collaborative efforts between government agencies, local communities, and scientific researchers are essential to address this issue and safeguard the health of vulnerable populations. Additionally, the report explores various mitigation strategies and preventive measures to address the issue and offers recommendations for sustainable management of groundwater resources to combat fluorosis effectively.

Keywords: fluorosis, fluoride contamination, groundwater contamination, groundwater resources

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Authors: Adebusoye Michael, Anthony Gloria, Fasan Temitope, Jacob Anayo

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Background: The culture of fast food consumption has gradually become a common lifestyle in Nigeria especially among young people in urban areas, in spite of the associated adverse health consequences. The adolescent pattern of fast foods consumption and their perception of this practice, as a risk factor for Non-Communicable Diseases (NCDs), have not been fully explored. This study was designed to assess fast food consumption pattern and the perception of it as a risk factor for NCDs among undergraduates of Federal Polytechnic, Bauchi. Methodology: The study was descriptive cross-sectional in design. One hundred and eighty-five students were recruited using systematic random sampling method from the two halls of residence. A structured questionnaire was used to assess the consumption pattern of fast foods. Data collected from the questionnaires were analysed using statistical package for the social sciences (SPSS) version 16. Simple descriptive statistics, such as frequency counts and percentages were used to interpret the data. Results: The age range of respondents was 18-34 years, 58.4% were males, 93.5% singles and 51.4% of their parents were employed. The majority (100%) were aware of fast foods and (75%) agreed to its implications as NCD. Fast foods consumption distribution included meat pie (4.9%), beef roll/ sausage (2.7%), egg roll (13.5%), doughnut (16.2%), noodles(18%) and carbonated drinks (3.8%). 30.3% consumed thrice in a week and 71% attached workload to high consumption of fast food. Conclusion: It was revealed that a higher social pressure from peers, time constraints, class pressure and school programme had the strong influence on high percentages of higher institutions’ students consume fast foods and therefore nutrition educational campaigns for campus food outlets or vendors and behavioural change communication on healthy nutrition and lifestyles among young people are hereby advocated.

Keywords: fast food consumption, Nigerian polytechnic, risk factors, undergraduate

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Authors: Molnar Catalina, Lexi Frankel, Amalia Ardeljan, Enoch Kim, Marissa Dallara, Omar Rashid

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Introduction: Clostridium difficile (C. diff) is a toxin-producing bacteria that can cause diarrhea and colitis. U.S. Center for Disease Control and Prevention revealed that C. difficile infection (CDI) has increased from 31 cases per 100,000 persons per year in 1996 to 61 per 100,000 in 2003. Approximately 500,000 cases per year occur in the United States. After exposure, the bacteria colonize the colon, where it adheres to the intestinal epithelium where it produces two toxins: TcdA and TcdB. TcdA affects the intestinal epithelium, causing fluid secretion, inflammation, and tissue necrosis, while TcdB acts as a cytotoxin purpose of this study was to evaluate the association between C diff infection and bronchial lung cancer development. Methods: Using ICD- 9 and ICD-10 codes, the data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to assess the patients infected with C diff as opposed to the non-infected patients. The Holy Cross Health, Fort Lauderdale, granted access to the database for the purpose of academic research. Patients were matched for age and Charlson Comorbidity Index (CCI). Standard statistical methods were used. Results: Bronchial lung cancer occurrence in the population not infected with C diff infection was 4741, as opposed to the population infected with C. diff, where 2039 cases of lung cancer were observed. The difference was statistically significant (p-value < 2.2x10^e-16), which reveals that C diff might be protective against bronchial lung cancer. The data was then matched by treatment to create to minimize the effect of treatment bias. Bronchial cancer incidence was 422 and 861 in infected vs. non-infected (p-value of < 2.2x10^e-16), which once more indicates that C diff infection could be beneficial in diminishing bronchial cancer development. Conclusion: This retrospective study conveys a statistical correlation between C diff infection and decreased incidence of lung bronchial cancer. Further studies are needed to comprehend the protective mechanisms of C. Diff infection on lung cancer.

Keywords: C. diff, lung cancer, protective, microbiology

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Authors: M. Naidoo

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Artificial intelligence often requires large amounts of good quality data. Within important fields, such as healthcare, the training of AI systems predominately relies on health and personal data; however, the usage of this data is complicated by various layers of law and ethics that seek to protect individuals’ privacy rights. This research seeks to establish the challenges AI and data sciences pose to (i) informational rights, (ii) privacy rights, and (iii) data protection. To solve some of the issues presented, various methods are suggested, such as embedding values in technological development, proper balancing of rights and interests, and others.

Keywords: artificial intelligence, data science, law, policy

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Authors: Gina Cecilia Pistol, Loredana Calin, Mariana Stancu, Veronica Chedea, Ionelia Taranu

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Inflammatory-associated diseases have an increased trend in the past decades. The pharmacological strategies aimed to treat these inflammatory diseases are very expensive and with non-beneficial results. The current trend is to find alternative strategies to counteract or to control inflammatory component of diseases. The grape by-products either seeds or pomace are rich in bioactive compounds (e.g. polyphenols) which may be beneficial in prevention of inflammation associated with cancer progression and other pathologies with inflammatory component. The in vivo models are very useful for studying the immune and inflammatory status. The domestic pig (Sus scrofa domesticus) is related to human from anatomic and physiologic point of view, representing a feasible model for studying the human inflammatory pathologies. Starting from these data, we evaluated the effect of a diet containing 5% grape seed cakes (GS) on piglets blood biochemical parameters and immune pro- and anti-inflammatory biomarkers (IL-1 beta, IL-8, TNF-alpha, IL-6, IFN-gamma, IL-10, IL-4) in spleen and lymph nodes. 12 weaned piglets were fed for 30 days with a control diet or an experimental diet containing 5% GS. At the end of trial, plasma and tissue samples (spleen and lymph nodes) were collected and the biochemical and inflammatory markers were analysed by using biochemistry analyser and ELISA techniques. Our results showed that diet included 5% GS did not influence the health status determined by plasma biochemical parameters. Only a tendency for a slight increase of the biochemical parameters associated with energetic profile (glucose, cholesterol, triglycerides) was observed. Also, GS diet had no effect on pro- and anti-inflammatory cytokines content in spleen and lymph nodes tissue. Further experiments are needed in order to investigate other rate of dietary inclusion which could provide more evidence about the effect of grape bioactive compounds on pigs used as animal model.

Keywords: animal model, inflammation, grape seed by-product, immune organs

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Authors: Tuba Tekin, Nurcan Baglam, Emine Dincer

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This study aimed to examine the effects of nutrition education received by university students on sustainable healthy eating behaviors and adherence to the Mediterranean diet. The 2nd, 3rd, and 4th-grade university students studying at the Faculty of Health Sciences, Nutrition and Dietetics, Midwifery, Nursing, Physical Therapy, and Rehabilitation departments of universities in Turkey were included in the study. Students' adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Scale, and their sustainable and healthy eating behaviors were evaluated using the Sustainable and Healthy Eating Behaviors Scale. In addition, the body weight and height of the students were measured by the researchers, and the Body Mass Index (BMI) value was calculated. A total of 181 students, 85 of whom were studying in the Department of Nutrition and Dietetics and 96 of whom were educated in other departments, were included in the study. 75.7% of the students in the sample are female, while 24.3% are male. The average body weight of the students was 61.17±10.87 kg, and the average BMI was 22.04±3.40 kg/m2. While the mean score of the Mediterranean Diet Adherence Scale was 6.72±1.84, in the evaluation of adherence to the Mediterranean diet, it was determined that 25.4% of the students had poor adherence and 66.9% needed improvement. When the adherence scores of students who received and did not receive nutrition education were compared, it was discovered that the students who received nutrition education had a higher score (p<0.05). Students who received nutrition education had a higher total score on the Sustainable and Healthy Eating Behaviors scale (p<0.05). A moderately positive correlation was found between the Sustainable and Healthy Eating Behaviors scale total score and the Mediterranean Diet Adherence scores (p<0.05). As a result of the linear regression analysis, it was revealed that a 1-unit increase in the Mediterranean diet adherence score would result in a 1.3-point increase in the total score of the Sustainable and Healthy Eating Behaviors scale. Sustainable and healthy diets are important for improving and developing health and the prevention of diseases. The Mediterranean diet is defined as a sustainable diet model. The findings revealed the relationship between the Mediterranean diet and sustainable nutrition and showed that nutrition education increased knowledge and awareness about sustainable nutrition and increased adherence to the Mediterranean diet. For this reason, courses or seminars on sustainable nutrition can be organized during educational periods.

Keywords: healthy eating, Mediterranean diet, nutrition education, sustainable nutrition

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Authors: Akhil Raj Pushparajan, Ranjit Ramachandran, Jijimole Gopi Reji, Ajay Kumar Ramakrishnan

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Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is one of the leading causes of death by an infectious disease. In spite of the availability of effective drugs and a vaccine, TB is a major health concern and was declared a global emergency by the World Health Organization (WHO). The success of intracellular pathogens like Mtb depends on its ability to overcome the challenging environment in the host. Gene regulation controlled by transcriptional regulators (TRs) plays a crucial role for the bacteria to adapt to the host environment. In vitro studies on gene regulatory mechanisms during dormancy and reactivation have provided insights into the adaptations employed by Mtb to survive in the host. Here we present our efforts to functionally characterize Rv1019, a putative TR of Mtb H37Rv which was found to be present at significantly varying levels during dormancy and reactivation in vitro. The expression of this protein in the dormancy-reactivation model was validated by qRT-PCR and western blot. By DNA- protein interaction studies and reporter assays we found that under normal laboratory conditions of growth this protein behaves as an auto-repressor and tetracycline was found to abrogate this repression by interfering with its ability to bind DNA. Further, by cDNA analysis, we found that this TR is co-transcribed with its downstream genes Rv1020 (mfd) and Rv1021 (mazG) which are involved in DNA damage response in Mtb. Constitutive expression of this regulator in the surrogate host M. smegmatis showed downregulation of the orthologues of downstream genes suggested that Rv1019 could negatively regulate these genes. Our finds also show that M. smegmatis expressing Rv1019 is sensitive to DNA damage suggests the role of this protein in regulating DNA damage response induced by oxidative stress. Because of its role in regulating DNA damage response which may help in the persistence of Mtb, Rv1019 could be used as a prospective target for therapeutic intervention to fight TB.

Keywords: auto-repressor, DNA repair, mycobacterium smegmatis, mycobacterium tuberculosis, tuberculosis

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Authors: Irina Mizeva, Elena Potapova, Viktor Dremin, Mikhail Mezentsev, Valeri Shupletsov

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The local tissue perfusion is regulated by the microvascular tone which is under the control of a number of physiological mechanisms. Laser Doppler flowmetry (LDF) together with wavelet analyses is the most commonly used technique to study the regulatory mechanisms of cutaneous microcirculation. External factors such as temperature, local pressure of the probe on the skin, etc. influence on the blood flow characteristics and are used as physiological tests to evaluate microvascular regulatory mechanisms. Local probe pressure influences on the microcirculation parameters measured by optical methods: diffuse reflectance spectroscopy, fluorescence spectroscopy, and LDF. Therefore, further study of probe pressure effects can be useful to improve the reliability of optical measurement. During pressure tests variation of the mean perfusion measured by means of LDF usually is estimated. An additional information concerning the physiological mechanisms of the vascular tone regulation system in response to local pressure can be obtained using spectral analyses of LDF samples. The aim of the present work was to develop protocol and algorithm of data processing appropriate for study physiological response to the local pressure test. Involving 6 subjects (20±2 years) and providing 5 measurements for every subject we estimated intersubject and-inter group variability of response of both averaged and oscillating parts of the LDF sample on external surface pressure. The final purpose of the work was to find special features which further can be used in wider clinic studies. The cutaneous perfusion measurements were carried out by LAKK-02 (SPE LAZMA Ltd., Russia), the skin loading was provided by the originally designed device which allows one to distribute the pressure around the LDF probe. The probe was installed on the dorsal part of the distal finger of the index figure. We collected measurements continuously for one hour and varied loading from 0 to 180mmHg stepwise with a step duration of 10 minutes. Further, we post-processed the samples using the wavelet transform and traced the energy of oscillations in five frequency bands over time. Weak loading leads to pressure-induced vasodilation, so one should take into account that the perfusion measured under pressure conditions will be overestimated. On the other hand, we revealed a decrease in endothelial associated fluctuations. Further loading (88 mmHg) induces amplification of pulsations in all frequency bands. We assume that such loading leads to a higher number of closed capillaries, higher input of arterioles in the LDF signal and as a consequence more vivid oscillations which mainly are formed in arterioles. External pressure higher than 144 mmHg leads to the decrease of oscillating components, after removing the loading very rapid restore of the tissue perfusion takes place. In this work, we have demonstrated that local skin loading influence on the microcirculation parameters measured by optic technique; this should be taken into account while developing portable electronic devices. The proposed protocol of local loading allows one to evaluate PIV as far as to trace dynamic of blood flow oscillations. This study was supported by the Russian Science Foundation under project N 18-15-00201.

Keywords: blood microcirculation, laser Doppler flowmetry, pressure-induced vasodilation, wavelet analyses blood

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Authors: Gideon Baffoe, Hirotaka Matsuda

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Rural livelihood systems are known to be inherently vulnerable. Attempt to reduce vulnerability is linked to developing resilience to both internal and external shocks, thereby increasing the overall sustainability of livelihood systems. The shocks and stresses could be induced by natural processes such as the climate and/or by social dynamics such as institutional failure. In this wise, livelihood vulnerability is understood as a combined effect of biophysical, economic, and social processes. However, previous empirical studies on livelihood vulnerability in the context of rural areas across the globe have tended to focus more on climate-induced vulnerability assessment with few studies empirically partially considering the multiple dimensions of livelihood vulnerability. This has left a gap in our understanding of the subject. Using the Livelihood Vulnerability Index (LVI), this study aims to comprehensively assess the livelihood vulnerability level of rural households using Ehiamenkyene, a community in the forest zone of Eastern Ghana as a case study. Though the present study adopts the LVI approach, it differs from the original framework in two respects; (1) it introduces institutional influence into the framework and (2) it appreciates the gender differences in livelihood vulnerability. The study utilized empirical data collected from 110 households’ in the community. The overall study results show a high livelihood vulnerability situation in the community with male-headed households likely to be more vulnerable than their female counterparts. Out of the seven subcomponents assessed, only two (socio-demographic profile and livelihood strategies) recorded low vulnerability scores of less than 0.5 with the remaining five (health status, food security, water accessibility, institutional influence and natural disasters and climate variability) recording scores above 0.5, with institutional influence being the component with the highest impact score. The results suggest that to improve the livelihood conditions of the people; there is the need to prioritize issues related to the operations of both internal and external institutions, health status, food security, water and climate variability in the community.

Keywords: assessment, gender, livelihood, rural, vulnerability

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Authors: Naveen Kumar B. T., Anuj Tyagi, Prabjeet Singh, Shanthanagouda A. H., Sumeet Rai

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Inland saline water resources are gaining the importance in expanding the aquaculture activities to mitigate the nutritional and food security issues of the world. For profitable and sustainable aquaculture practices, scientific farming, biosecurity measure, and best fish health management should be the integral part of developmental activities. Keeping in line with global awareness and trends, the Indian government has taken an innovative step to conduct disease surveillance and awareness programme for aquatic disease through network project. This ‘National Surveillance Programme for Aquatic Animal Diseases (NSPAAD)’ is being implemented in collaboration of national institutes and state agriculture universities with funding support from National Fisheries Development Board (NFDB), Govt. of India. Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, an NSPAAD collaborator, has been actively engaged in disease surveillance in the Indian state of Punjab. Shrimp farming in inland saline areas of Punjab is expanding at a tremendous pace under the guidance of GADVASU along with the support of State Fisheries Department. Under this national disease surveillance programme, we reported Enterocytozoon hepatopenaei (EHP) infection in the Litopenaeus vannamei cultured in the inland saline waters. Polymerase chain reaction (PCR) based diagnosis was carried out using the OIE (World Organisation for Animal Health) protocol. It was observed that out of 20 shrimp farms, two farms were 1st step PCR positive and two more farms were nested PCR positive. All the EHP positive ponds had shown the white faeces along with mortalities at very low rate. Therefore, implementation of biosecurity and continuous surveillance and monitoring program for finfish and shellfish aquaculture are in need of the hour to prevent and control the large-scale disease outbreaks and subsequent economic losses.

Keywords: disease, EHP, inland saline water, shrimp culture

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Authors: Ilse Kreme

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To the best of this author’s knowledge, no studies have been identified on the connection between a refusal to engage in health-protective behaviors and a basic understanding of viral biology among community college students, faculty, and staff during the COVID-19 pandemic. Lack of scientific knowledge could prevent understanding of why these behaviors are important to prevent the community spread of COVID-19, even when they are not shown to offer much individual protection. In this study, a possible correlation was examined between a basic knowledge level of viral disease that comes from having taken a college biology course and disease perceptions of COVID-19. In particular, disease risk perception, disease severity percept and mask-wearing behaviors were examined as they correlated with having taken an undergraduate biology course. The effect of covariates of age, gender, and education level were investigated along with the main dependent variables. A representative sample of the population included students, faculty, and staff at Paradise Valley Community College (PVCC) in Phoenix, Arizona. Participants were recruited by an email sent to all students, faculty, and staff at PVCC using an all-college email distribution. Disease risk and severity perception were assessed with the Brief Illness Perception Questionnaire 5 (BIP-Q5), which was modified to include questions measuring participant age, education level, and whether they took or ever took a college biology course. Two additional questions measured compliance of willingness to wear a face mask. The results showed an effect of gender on mask-wearing behavior and a correlation between having taken a biology course and disease severity perception. No differences were seen in mask-wearing behavior and disease risk perception as a result of having taken a biology course. These findings suggest that taking an undergraduate biology course leads to a greater awareness of COVID-19 disease severity through an understanding of the basic biological principles of viral disease transmission. The results can be used to modify existing health education strategies. Further research is needed on how to best reach target audiences in all education brackets.

Keywords: COVID-19, education, gender, mask wearing, disease risk perception, disease severity perception

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Authors: Thirakorn Maneerat, Darunee Jongudomkarn, Jiraporn Khiewyoo

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Family quality of life of families who have persons with disabilities is a core concern in government services and community health promotion to deal with the multidimensionality of today’s health and societal issues. The number of families who have persons with disabilities in Thailand is gradually increasing. However, facilitation and evaluation of such family quality of life are limited by the lack of feasible tools. As a consequence, service provided for the families is not optimally facilitated and evaluated. This paper is part of a larger project which is aimed to develop a scale for measuring of family quality of life of families who have persons with developmental disabilities in Thailand, presenting the results of a three-round Delphi method involving 11 experts. The study was obtained during December 2013 to May 2014. The first round consisted of open-ended questionnaire and content analysis of the answers. The second round comprised a 5-point Likert scale structured questionnaire based on the first round analysis, with required the experts to identify the most relevant studied tool aspects. Their feedbacks levels of agreements were statistic analysis using the median, interquartile range and quartile deviation. The included criteria for items acceptance were greater than 3.50 of the median, lesser than 1.50 of interquartile range, and 0.65 or less of a quartile deviation. Finally, the proposed questionnaire was structured and validated by the experts in the third round. The results found that across all three rounds, the experts achieved 100% agreement on the five factors regarding to quality of life of a family who have person with disability were considered. These five factors with 38 items were included: 1) 10 items of family interactions; 2) 9 items of child rearing; 3) 7 items of physical and material resources; 4) 5 items of social-emotional status; and 7 items of disability-related services and welfare. Next step of the study was examined the construct validity by using factor analysis methods.

Keywords: tool development, family quality of life scale, person with disability, Delphi study

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Authors: Pavel E. Golosov, Vladimir I. Gorelov, Oksana L. Karelova

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There are visible changes in the world organization, environment and health of national conscience that create a background for discussion on possible redefinition of global, state and regional management goals. Authors apply the sustainable development criteria to a hierarchical management scheme that is to lead the world community to non-contradictory growth. Concrete definitions are discussed in respect of decision-making process representing the state mostly. With the help of system analysis it is highlighted how to understand who would carry the distinctive sign of world leadership in the nearest future.

Keywords: decision-making, information technology, public administration

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Authors: Il Ho Park, Joong Seob Lee, Sung Hun Kang, Jae-Min Shin, Il Seok Park, Seok Min Hong, Seok Jin Hong

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Introduction: The human microbiota is the aggregate of microorganisms, and the bacterial microbiome of the human digestive tract contributes to both health and disease. In health, bacteria are key components in the development of mucosal barrier function and in innate and adaptive immune responses, and they also work to suppress the establishment of pathogens. In human upper airway, the sinonasal microbiota might play an important role in chronic rhinosinusitis (CRS). The purpose of this study is to investigate the human upper airway microbiome in CRS patients and to compare the sinonasal microbiome of adults with children. Materials and methods: A total of 19 samples from 19 patients (Group1; 9 CRS in children, aged 5 to 14 years versus Group 2; 10 CRS in adults aged 21 to 59 years) were examined. Swabs were collected from the middle meatus and/or anterior ethmoid region under general anesthesia during endoscopic sinus surgery or tonsillectomy. After DNA extraction from swab samples, we analysed bacterial microbiome consortia using 16s rRNA gene sequencing approach (the Illumina MiSeq platform). Results: In this study, relatively abundance of the six bacterial phyla and tremendous genus and species found in substantial amounts in the individual sinus swab samples, include Corynebacterium, Hemophilus, Moraxella, and Streptococcus species. Anaerobes like Fusobacterium and Bacteroides were abundantly present in the children group, Bacteroides and Propionibacterium were present in adults group. In genus, Haemophilus was the most common CRS microbiome in children and Corynebacterium was the most common CRS microbiome in adults. Conclusions: Our results show the diversity of human upper airway microbiome, and the findings will suggest that CRS is a polymicrobial infection. The Corynebacterium and Hemophilus may live as commensals on mucosal surfaces of sinus in the upper respiratory tract. The further study will be needed for analysis of microbiome-human interactions in upper airway and CRS.

Keywords: microbiome, upper airway, chronic rhinosinusitis, adult and children

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Authors: Izabela P. Vatanabe, Rafaela Peron, Patricia Manzine, Marcia R. Cominetti

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Introduction: Considering the increase in life expectancy of world population, there is an emerging concern in health services to allocate better care and care to elderly, through promotion, prevention and treatment of health. It has been observed that frailty syndrome is prevalent in elderly people worldwide and this complex and heterogeneous clinical syndrome consist of the presence of physical frailty associated with cognitive dysfunction, though in absence of dementia. This can be characterized by exhaustion, unintentional weight loss, decreased walking speed, weakness and low level of physical activity, in addition, each of these symptoms may be a predictor of adverse outcomes such as hospitalization, falls, functional decline, institutionalization, and death. Cognitive frailty is a recent concept in literature, which is defined as the presence of physical frailty associated with mild cognitive impairment (MCI) however in absence of dementia. This new concept has been considered as a subtype of frailty, which along with aging process and its interaction with physical frailty, accelerates functional declines and can result in poor quality of life of the elderly. MCI represents a risk factor for Alzheimer's disease (AD) in view of high conversion rate for this disease. Comorbidities and physical frailty are frequently found in AD patients and are closely related to heterogeneity and clinical manifestations of the disease. The decreased platelets ADAM10 levels in AD patients, compared to cognitively healthy subjects, matched by sex, age and education. Objective: Based on these previous results, this study aims to evaluate whether ADAM10 platelet levels of could act as a biomarker of cognitive frailty. Methods: The study was approved by Ethics Committee of Federal University of São Carlos (UFSCar) and conducted in the municipality of São Carlos, headquarters of Federal University of São Carlos (UFSCar). Biological samples of subjects were collected, analyzed and then stored in a biorepository. ADAM10 platelet levels were analyzed by western blotting technique in subjects with MCI and compared to subjects without cognitive impairment, both with and without presence of frailty. Statistical tests of association, regression and diagnostic accuracy were performed. Results: The results have shown that ADAM10/β-actin ratio is decreased in elderly individuals with cognitive frailty compared to non-frail and cognitively healthy controls. Previous studies performed by this research group, already mentioned above, demonstrated that this reduction is still higher in AD patients. Therefore, the ADAM10/β-actin ratio appears to be a potential biomarker for cognitive frailty. The results bring important contributions to an accurate diagnosis of cognitive frailty from the perspective of ADAM10 as a biomarker for this condition, however, more experiments are being conducted, using a high number of subjects, and will help to understand the role of ADAM10 as biomarker of cognitive frailty and contribute to the implementation of tools that work in the diagnosis of cognitive frailty. Such tools can be used in public policies for the diagnosis of cognitive frailty in the elderly, resulting in a more adequate planning for health teams and better quality of life for the elderly.

Keywords: ADAM10, biomarkers, cognitive frailty, elderly

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Authors: Alexandria Carey, Angela Starkweather, Ann Horgas, Hwayoung Cho, Jason Beneciuk

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Background/Significance: Over 3.4 million acute axial low back pain (aLBP) cases are treated annually in the United States (US) emergency departments (ED). ED patients with aLBP receive varying verbal and written discharge routine care (RC), leading to ineffective patient self-management. Ineffective self-management increase chronic low back pain (cLPB) transition risks, a chief cause of worldwide disability, with associated costs >$60 million annually. This research addresses this significant problem by evaluating an ED digital pain self-management intervention (EDPSI) focused on improving self-management through improved knowledge retainment, skills, and self-efficacy (confidence) (KSC) thus reducing aLBP to cLBP transition in ED patients discharged with aLBP. The research has significant potential to increase self-efficacy, one of the most potent mechanisms of behavior change and improve health outcomes. Focusing on accessibility and usability, the intervention may reduce discharge disparities in aLBP self-management, especially with low health literacy. Study Questions: This research will answer the following questions: 1) Will an EDPSI focused on improving KSC progress patient self-management behaviors and health status?; 2) Is the EDPSI sustainable to improve pain severity, interference, and pain recurrence?; 3) Will an EDPSI reduce aLBP to cLBP transition in patients discharged with aLBP? Aims: The pilot randomized-controlled trial (RCT) study’s objectives assess the effects of a 12-week digital self-management discharge tool in patients with aLBP. We aim to 1) Primarily assess the feasibility [recruitment, enrollment, and retention], and [intervention] acceptability, and sustainability of EDPSI on participant’s pain self-management; 2) Determine the effectiveness and sustainability of EDPSI on pain severity/interference among participants. 3) Explore patient preferences, health literacy, and changes among participants experiencing the transition to cLBP. We anticipate that EDPSI intervention will increase likelihood of achieving self-management milestones and significantly improve pain-related symptoms in aLBP. Methods: The study uses a two-group pilot RCT to enroll 30 individuals who have been seen in the ED with aLBP. Participants are randomized into RC (n=15) or RC + EDPSI (n=15) and receive follow-up surveys for 12-weeks post-intervention. EDPSI innovative content focuses on 1) highlighting discharge education; 2) provides self-management treatment options; 3) actor demonstration of ergonomics, range of motion movements, safety, and sleep; 4) complementary alternative medicine (CAM) options including acupuncture, yoga, and Pilates; 5) combination therapies including thermal application, spinal manipulation, and PT treatments. The intervention group receives Booster sessions via Zoom to assess and reinforce their knowledge retention of techniques and provide return demonstration reinforcing ergonomics, in weeks two and eight. Outcome Measures: All participants are followed for 12-weeks, assessing pain severity/ interference using the Brief Pain Inventory short-form (BPI-sf) survey, self-management (measuring KSC) using the short 13-item Patient Activation Measure (PAM), and self-efficacy using the Pain Self-Efficacy Questionnaire (PSEQ) weeks 1, 6, and 12. Feasibility is measured by recruitment, enrollment, and retention percentages. Acceptability and education satisfaction are measured using the Education-Preference and Satisfaction Questionnaire (EPSQ) post-intervention. Self-management sustainment is measured including PSEQ, PAM, and patient satisfaction and healthcare utilization (PSHU) requesting patient overall satisfaction, additional healthcare utilization, and pain management related to continued back pain or complications post-injury.

Keywords: digital, pain self-management, education, tool

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