Search results for: bridge health monitoring

Authors: Y. Y. Babanyara, B. A. Gana, T. Garba, M. A. Batari

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Proper management of dental waste is a crucial issue for maintaining human health and the environment. The waste generated in the dental clinics has the potential for spreading infections and causing diseases, so improper disposal of these dental wastes can cause harm to the dentist, the people in immediate vicinity of the dentist, waste handlers, general public and the environment through production of toxins or as by-products of the destruction process. Staff that provide dental healthcare ought to be aware of the proper handling and the system of management of dental waste used by different dental hospitals. The method of investigation adopted in the paper involved a desk study in which documents and records relating to dental waste handling were studied to obtain background information on existing dental waste management in Nigeria other countries of the world are also mentioned as examples. Additionally, information on generation, handling, segregation, risk associated during handling and treatment of dental medical waste were sought in order to determine the best method for safe disposal. This article provides dentists with the information they need to properly dispose of mercury and amalgam waste, and provides suggestions for managing the other wastes that result from the day-to-day activities of a dental office such as: used X-ray fixers and developers; cleaners for X-ray developer systems; lead foils, shields and aprons; chemiclave/chemical sterilant solutions; disinfectants, cleaners, and other chemicals; and, general office waste. Additionally, this study may be beneficial for authorities and researchers of developing countries to work towards improving their present dental waste management system.

Keywords: clinic, dental, disposal, environment, waste management

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Authors: Ebele V. Okoli, Emmanuel Nwobi, Dozie Ezechukwu, Ijeoma Itanyi

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One in seven people worldwide suffer from a disability. 80% of people with disabilities live in developing countries. Negative attitudes and misconceptions among health-care providers constitute barri¬ers to optimal health care for people with disabilities. This underscores the relevance of a study of the attitude of Nigerian medical students towards disability and their willingness to work in the disability sector. This was a descriptive cross-sectional study conducted among 254 penultimate and final year medical students of a university in southeastern Nigeria. The mean age of the students was 24.8 ± 3.12 years. Majority of the students were male (75.2%), single (96.9%), of the Igbo tribe (86.6%), Christian (97.6%) and grew up in urban areas (68.1%). Results indicated that the medical students had a predominantly positive attitude towards people with disability as 73.8% had a positive attitude and mean attitude score was 67.03 ± 0.14 (positive attitude = 61 – 120, negative attitude = 0 - 60). Chi-square analysis did not show any significant effect of demographic and social factors on the students’ attitude towards People with Disabilities. The students were mostly willing to work in areas that address the challenges of people with disability (70.4%) but a greater proportion had never heard about Disability Studies (67.5%). About a third of the students (33.2%) would like to travel abroad to practice in the disability sector. Conclusions: The students generally had a positive attitude towards people with disability and a greater percentage were willing to work in the disability sector in their future career. About two-thirds had however, never heard about disability studies. There was some potential for brain drain among the students as a third of the population intended to practice abroad on graduation.

Keywords: attitudes, career interest, disability, medical students

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Authors: O. O. Aiyelokun, O. A. Agbede

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Numerical modelling of groundwater flow can be susceptible to calibration errors due to lack of adequate ground-based hydro-metrological stations in river basins. Groundwater resources management in Southwest Nigeria is currently challenged by overexploitation, lack of planning and monitoring, urbanization and climate change; hence to adopt models as decision support tools for sustainable management of groundwater; they must be adequately calibrated. Since river basins in Southwest Nigeria are characterized by missing data, and lack of adequate ground-based hydro-meteorological stations; the need for adopting satellite-based data for constructing distributed models is crucial. This study seeks to evaluate the suitability of satellite-based data as substitute for ground-based, for computing boundary conditions; by determining if ground and satellite based meteorological data fit well in Ogun and Oshun River basins. The Climate Forecast System Reanalysis (CFSR) global meteorological dataset was firstly obtained in daily form and converted to monthly form for the period of 432 months (January 1979 to June, 2014). Afterwards, ground-based meteorological data for Ikeja (1981-2010), Abeokuta (1983-2010), and Oshogbo (1981-2010) were compared with CFSR data using Goodness of Fit (GOF) statistics. The study revealed that based on mean absolute error (MEA), coefficient of correlation, (r) and coefficient of determination (R²); all meteorological variables except wind speed fit well. It was further revealed that maximum and minimum temperature, relative humidity and rainfall had high range of index of agreement (d) and ratio of standard deviation (rSD), implying that CFSR dataset could be used to compute boundary conditions such as groundwater recharge and potential evapotranspiration. The study concluded that satellite-based data such as the CFSR should be used as input when constructing groundwater flow models in river basins in Southwest Nigeria, where majority of the river basins are partially gaged and characterized with long missing hydro-metrological data.

Keywords: boundary condition, goodness of fit, groundwater, satellite-based data

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Authors: Pratishtha Singh

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Gender-based violence (GBV) or gendered violence refers to violence inflicted on a person because of their gender. Majority of men who perpetrate gender-based violence, first do so during their teenage years. Further, the first sexual experience of most girls is coerced. In order to reduce the widespread occurrence of GBV, it is vital to intervene and reach people, especially boys, when their attitudes and beliefs about sexuality and gender are developing. This study aims to understand GBV through an adolescent lens, focusing on their knowledge, attitudes and experiences regarding gendered abuse. This is a cross-sectional, qualitative study. The respondents are Delhi based students in grades 11th and 12th, recruited via snowball sampling. Sixteen in-depth, telephonic interviews were carried out in the month of April, 2020. The data was transcribed verbatim into MS Word and qualitative coding was undertaken in Atlas.ti 8. Twelve out of sixteen respondents admitted experiencing sexual GBV. Out of these, a little more than half of the victims reported it to somebody. Thematic analysis revealed key themes of: (i) Introduction and reinforcement of a patriarchal structure (ii) Violence in teen dating (iii) Acceptability and normalization of violence and (iv) Justice System. Findings reflect a process wherein GBV becomes an intricate part of adolescents’ lives. Participants showed a moderately well-informed understanding of gendered abuse whereas attitudes reflected a complex combination of internalized patriarchy and a desire to bring positive societal reform. The results of this study highlight a need for health promoting, gender-equitable interventions.

Keywords: adolescents, gender, health, violence

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Authors: Ahmed Zaghawa

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Rift Valley Fever is an economically specific disease of the health and arboviral disease that affects many types of animals, causing significant economic losses in livestock, and it is transmitted to humans and has public health issues. The vaccine program is the backbone for the control of this disease. The goal of this study was to apply a new approach to evaluate the inactivated RVF vaccine developed in Egypt. In this study, the RVF vaccine was evaluated in young puppies and compared with sheep; the findings showed that young puppies were susceptible to infection with the inhibitory RVF virus and had a strong response of antibodies with two doses of the RVF vaccine within the two-week interval. The neutralization indices began to appear to the protective level on the 7th day at 1.35 and steadily elevated at 14,21 and 28 days to 1.35, 1.43, and 1.20, respectively, in comparison to the control group. While in sheep, the neutralization indices began to appear to the protective level on the 7th day at 1.10 and remain strongly at high titer at 14, 21, and 28 days with NI values 1.20, 1.50, and 1.50, respectively. The new approach for comparing the immune response in puppies and sheep via SNT indicated the high response in both species was evident as well as the neutralization indices values in young puppies at different periods after RVF vaccination reported the value of 1.08±0.03, 1.23±0.04, 1.30±0.03, and 1.45±0.02 after 7, 14, 21, and 28 days post-vaccination respectively. On the other side, a nearly similar immune response was noticed in sheep with NI values of 1.15±0.02, 1.27±0.02, 1.42±0.05, and 1.55±0.03 at 7, 14, 21, and 28 days post-vaccination, respectively. In conclusion, young puppies are similar to sheep in developing antibodies after vaccination with the RVF vaccine and can replace sheep for evaluating the efficacy of the RVF vaccine. Further studies are mandatory to assess more recent methods for evaluating inhibition of the RVF vaccine.

Keywords: immune response, puppies, RVF, sheep, vaccine

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Authors: Deepa Shokeen, Bani Tamber Aeri

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Food choice is a complex process influenced by the interplay of multiple factors, including physical, socio-cultural and economic factors comprising macro or micro level food environments. While a clear understanding of the relationship between what we eat and the environmental context in which these food choices are made is still needed; it has however now been shown that food environments do play a significant role in the obesity epidemic and increasing cardio-metabolic risk factors. Evidence in other countries indicates that the food environment may strongly influence the prevalence of obesity and cardio-metabolic risk factors among young adults. Although in the Indian context, data does indicate the associations between sedentary lifestyle, stress, faulty diets but very little evidence supports the role of food environment in influencing cardio-metabolic health among employed adults. Thus, this research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. Methodology: The objective of the present study is to assess the effect of selected food and nutrition environments with emphasis on worksite environment and to analyse its impact on the food choices and dietary behaviour of the employees (25-45 years of age) of the organizations under study. In the proposed study an attempt will be made to randomly select various worksite environments from Delhi and NCR. The study will be conducted in two phases. In phase I, Information will be obtained on their socio-demographic profile and various factors influencing their food choices including most commonly consumed foods and most frequently visited eating outlets in and around the work place. Data will also be gathered on anthropometry (height, weight, waist circumference), biochemical parameters (lipid profile and fasting glucose), blood pressure and dietary intake. Based on the findings of phase I, a list of the most frequently visited eating outlets in and around the workplace will be prepared in Phase II. These outlets will then be subjected to nutrition environment assessment survey (NEMS). On the basis of the information gathered from phase I and phase II, influence of selected food and nutrition environments on food choice, dietary behaviour and prevalence of cardio-metabolic risk factors among employed adults will be assessed. Expected outcomes: The proposed study will try to ascertain the impact of selected food and nutrition environments on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behavior of the adults. In addition to this, anthropometry blood pressure and biochemical assessment of the subjects will be done to assess the prevalence of cardio-metabolic risk factors. If the findings indicate that the work environment, where most of these young adults spend their productive hours of the day, influence their health, than perhaps steps maybe needed to make these environments more conducive to health.

Keywords: food and nutrition environment, cardio-metabolic risk factors, India, worksite environment

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Authors: Kazushige Wada, Mayuko Ueda

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In the present study, we reanalyzed lapse errors in the last phase of a job, by re-counting near lapse errors and increasing the number of participants. We also examined the results of this study from the perspective of prospective memory (PM), which concerns future actions. This study was designed to investigate whether perceiving the importance of PM tasks caused lapse errors in the last phase of a job and to determine if such errors could be explained from the perspective of PM processing. Participants (N = 34) conducted a computerized clicking task, in which they clicked on 10 figures that they had learned in advance in 8 blocks of 10 trials. Participants were requested to click the check box in the start display of a block and to click the checking off box in the finishing display. This task was a PM task. As a measure of PM performance, we counted the number of omission errors caused by forgetting to check off in the finishing display, which was defined as a lapse error. The perceived importance was manipulated by different instructions. Half the participants in the highly important task condition were instructed that checking off was very important, because equipment would be overloaded if it were not done. The other half in the not important task condition was instructed only about the location and procedure for checking off. Furthermore, we controlled workload and the emotion of surprise to confirm the effect of demand capacity and attention. To manipulate emotions during the clicking task, we suddenly presented a photo of a traffic accident and the sound of a skidding car followed by an explosion. Workload was manipulated by requesting participants to press the 0 key in response to a beep. Results indicated too few forgetting induced lapse errors to be analyzed. However, there was a weak main effect of the perceived importance of the check task, in which the mouse moved to the “END” button before moving to the check box in the finishing display. Especially, the highly important task group showed more such near lapse errors, than the not important task group. Neither surprise, nor workload affected the occurrence of near lapse errors. These results imply that high perceived importance of PM tasks impair task performance. On the basis of the multiprocess framework of PM theory, we have suggested that PM task performance in this experiment relied not on monitoring PM tasks, but on spontaneous retrieving.

Keywords: prospective memory, perceived importance, lapse errors, multi process framework of prospective memory.

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Authors: Salman Imran, Chris Healey

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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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Authors: Ritvik Chauhan, Vijay Kumar Baraik

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Crime is a rare event on earth surface. It is not simple but a complex event occurring in a spatio- temporal environment. Crime is one of the most serious security threats to human environments as it may result in harm to the individuals through the loss of property, physical and psychological injuries. The conventional studies done on different nature crime was mostly related to laws, psychological, social and political themes. The geographical areas are heterogeneous in their environmental conditions, associations between structural conditions, social organization which contributing specific crimes. The crime pattern analysis is made through theories in which criminal events occurs in persistent, identifiable patterns in a particular space and time. It will be the combined analysis of spatial factors and rational factors to the crime. In this study, we are analyzing the combined factors for the origin of crime against children. Children have always been vulnerable to victimization more because they are silent victims both physically and mentally to crimes and they even not realize what is happening with them. Their trusting nature and innocence always misused by criminals to perform crimes. The nature of crime against children is changed in past years like child rape, kidnapping &abduction, selling & buying of girls, foeticide, infanticide, prostitution, child marriage etc turned to more cruel and inhuman. This study will focus on understanding the space-time pattern of crime against children during the period 2001-2012. It also makes an attempt to explore and ascertain the association of crimes categorised against children, its rates with various geographical and socio-demographic factors through causal analysis using selected indicators (child sex-ratio, education, literacy rate, employment, income, etc.) obtained from the Census of India and other government sources. The outcome of study will help identifying the high crime regions with specified nature of crimes. It will also review the existing efforts and exploring the new plausible measure for tracking, monitoring and minimization of crime rate to meet the end goal of protecting the children from crimes committed against them.

Keywords: crime against children, geographic profiling, spatio-temporal analysis, hotspot

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Authors: S. Somerset, D. J. Hoare

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Participation in sport is linked to better mental and physical health in children and adults. Studies have shown children who participate in sports benefit from improved social skills, self-confidence, communication skills and a better quality of life. Children who participate in sports from a young age are also more likely to continue to have active lifestyles during adulthood. This is an important consideration with a nation where physical activity levels are declining and the incidences of obesity are rising. Getting children active and keeping them active can provide long term health benefits to the individual but also a potential reduction in health costs in the future. This systematic review aims to identify the barriers to participation in sport for children aged up to 18 years and encompasses both qualitative and quantitative studies. The bibliographic databases, EMBASE, Medline, CINAHL and SportDiscus were searched. Additional hand searches were carried out on review articles found in the searches to identify any studies that may have been missed. Studies involving children up to 18 years without additional needs focusing on barriers to participation in sport were included. Randomised control trials, policy guidelines, studies with sport as an intervention, studies focusing on the female athlete triad, tobacco abuse, alcohol abuse, drug abuse, pre exercise testing, and cardiovascular disease were excluded. Abstract review, full paper review and quality appraisal were conducted by two researchers. A consensus meeting took place to resolve any differences at the abstract, full text and data extraction / quality appraisal stages. The CASP qualitative studies appraisal tool and the CASP cohort studies tool (excluding question 3 and 4 which refer to interventions) were used for quality appraisal in this review. The review identified several salient barriers to participation in sport for children. These barriers ranged from the uniform worn during school physical education lessons to the weather during participation in sport. The most commonly identified barriers in the review include parental support, time allocation, location of the activity and the cost of the activity. Therefore, it would be beneficial for a greater provision to be made within the school environment for children to participate sport. This can reduce the cost and time commitment required from parents to encourage participation. This would help to increase activity levels of children, which ultimately can only be a good thing.

Keywords: barrier, children, participation, sport

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Authors: Timmis W., Simms M., Thomas C.

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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.

Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco

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Authors: Eugene Y. C. Wong, Daniel Y. W. Mo, Cosmo T. Y. Ng, Jessica K. Y. Chan, Leith K. Y. Chan, Henry Y. K. Lau

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The real-time planning visualisation, precise allocation and loading optimisation in air cargo load planning operations are increasingly important as more considerations are needed on dangerous cargo loading, locations of lithium batteries, weight declaration and limited aircraft capacity. The planning of the unit load devices (ULD) can often be carried out only in a limited number of hours before flight departure. A dynamic air cargo load planning system is proposed with the optimisation of cargo load plan and visualisation of planning results in virtual reality systems. The system aims to optimise the cargo load planning and visualise the simulated loading planning decision on air cargo terminal operations. Adopting simulation tools, Cave Automatic Virtual Environment (CAVE) and virtual reality technologies, the results of planning with reference to weight and balance, Unit Load Device (ULD) dimensions, gateway, cargo nature and aircraft capacity are optimised and presented. The virtual reality system facilities planning, operations, education and training. Staff in terminals are usually trained in a traditional push-approach demonstration with enormous manual paperwork. With the support of newly customized immersive visualization environment, users can master the complex air cargo load planning techniques in a problem based training with the instant result being immersively visualised. The virtual reality system is developed with three-dimensional (3D) projectors, screens, workstations, truss system, 3D glasses, and demonstration platform and software. The content will be focused on the cargo planning and loading operations in an air cargo terminal. The system can assist decision-making process during cargo load planning in the complex operations of air cargo terminal operations. The processes of cargo loading, cargo build-up, security screening, and system monitoring can be further visualised. Scenarios are designed to support and demonstrate the daily operations of the air cargo terminal, including dangerous goods, pets and animals, and some special cargos.

Keywords: air cargo load planning, optimisation, virtual reality, weight and balance, unit load device

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Authors: Lovro Štefan

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The main purpose of the present study was to investigate the associations between the overweight/obesity status and lifestyle factors. In this cross-sectional study, participants were 1950 urban secondary-school students (54.7% of female students) aged 17-18 years old. Dependent variable was body-mass index status derived from self-reported height and weight. The outcome was binarised, where participants with value <25 kg/m2 were collapsed into „normal“, while those ≥25 kg/m2 into „overweight/obesity“ category. Independent variables were gender, type of school, physical activity, sedentary behaviour, self-rated health, self-perceived socioeconomic status and psychological distress. The associations between the dependent and independent variables were analyzed by using multiple logistic regression analysis. In the univariate model, being overweight/obese was significantly associated with being a male student (OR 0.31; 95% CI 0.23 to 0.42), attending a vocational school (OR 1.87; 95% CI 1.42 to 2.48), not meeting the recommendations for moderate-to-vigorous physical activity (OR 0.44; 95% CI 0.22 to 0.88), more time spending in sedentary behaviour (OR 1.53; 95% CI 1.07 to 2.19), poor self-rated health (OR 0.35, 95% CI 0.20 to 0.56) and lower socioeconomic status (OR 0.63; 95% CI 0.48 to 0.84). In the multivariate model, the same associations occured between the dependent and independent variable. In both models, psychological distress was not associated with being overweight/obese. In conclusion, our findings suggest, that lifestyle factors are independently associated with body-mass index

Keywords: body mass index, secondary-school students, Croatia, physical activity, sedentary behaviour, logistic regression

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Authors: Andi Tenri Ayu Rahman, Citrakesumasari, Devintha Virani

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Breast milk is the complex biological fluid mix of macronutrient and micronutrient that are considered as perfect food for babies. Zinc has a role in various biological functions and physical growth. This research aims to know the average zinc (Zn) micronutrients content of breast milk by determinants of infant (birth weight) and mother (nutritional status and food intake) and description of the pattern of mothers breastfeeding. The type of research used is observational analytic with cross-sectional study design. The population was 41 mothers in Kassi-Kassi health center within one month. Sample research is mothers who gave birth at term and breastfed her baby. Sampling was done with random sampling technique involving 37 people. Samples of breast milk were analyzed in the laboratory by using the method of Atomic Absorption Spectrofotometry (AAS). This research find that from the samples (n=37) the average contents of zinc in the breast milk is 0,88±0,54 mg/L with the highest value on the group of low birth weight babies (1,13 ± 0,67mg/L), mothers who had normal nutritional status (0,981 ± 0,514 mg/L) and intake low zinc (0,94 ± 0,54 mg/L). Regarding breastfeeding pattern, 67,6% of the samples had had breastfeeding experience and 81,1% of breastfed more than eight times a day. In summary, the highest average value of the zinc content of breast milk was in the group of low birth weight babies, mother with normal nutritional status, and mothers having relatively low intake pattern.

Keywords: zinc, breastmilk, mother, baby

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Authors: Comsun Thongchai, Vorapoj Promasatayaprot

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Background: Child development center is a day care center that gathers large numbers of children in the same areas. As a result, it provides high opportunity for infection, especially gastrointestinal and respiratory infections. Ubon Ratchathani has been a province with an increasing number of cases of Hand foot and mouth disease each year reported between 2014 and 2016. Accorded to a recent investigation reported, HFMD occurred in the Child Development Center and kindergartens, this was a place where HFMD spreads. This research was aimed to investigate the knowledge, attitude and behavior about hand foot and mouth disease preventing of child caregivers in child development centers, Ubon Ratchathani Province. Method: Descriptive study was conducted between April and July, 2017. The study instruments used questionnaires and in-depth interviews on their practices of prevention and environment management of HFMD. The samples of survey questionnaires were caregivers who are working in 160 child development centers of the 160 parishes in Ubon Ratchathani province. The data was analyzed by percentages, means and standard deviations and Pearson Product Moment Correlation Coefficient. Result: The results showed that the majority were female (96.3%), average age 41 years (68.3%), marital status were couples (85.7%) and studied in undergraduate (75.2%). with a period of performance as teachers in child development centers range from 10 to 14 years were percentage 58.7 and 71.8 percent of them had been trained by health worker about the control HFMD. The knowledge for preventive in hand foot mouth disease on child caregivers was at high level. The mean score was 2.76 (S.D. = 0.114). The attitude of child caregivers was at a moderate level. Its mean score was 2.28 (S.D. = 0.247). On the other hand, the level of environmental management to prevent HFMD was low. The mean score was 1.34 (S.D. = 0.215). The factor of personal characteristics as gender, age, educational level, duration at work, knowledge and attitude of preventive HFMD was associated with Preventive of Behaviors to a statistically significant level (p<0.05 respectively). Conclusion: These results should be concerned to develop knowledge and improving practice for preventive hand foot mouth disease of child caregivers in child development centers by training. Preparation of media education, Surveillance of hand foot mouth disease and health behaviors promotion with community participation need to be supported continuously.

Keywords: preventive behavior, child development center, hand foot mouth disease, Thailand

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Authors: N. F. Mikhailova, M. E. Fattakhova, M. A. Mironova, E. V. Vyacheslavova

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For the mental and social adaptation of the deaf and hard-of-hearing people, cultural and social aspects - the formation of identity (acculturation) and educational conditions – are highly significant. We studied 137 deaf and hard-of-hearing students in different educational situations. We used these methods: Big Five (Costa & McCrae, 1997), TRF (Becker, 1989), WCQ (Lazarus & Folkman, 1988), self-esteem, and coping strategies (Jambor & Elliott, 2005), self-stigma scale (Mikhailov, 2008). Type of self-identification of students depended on the degree of deafness, type of education, method of communication in the family: large hearing loss, education in schools for deaf, and gesture communication increased the likelihood of a 'deaf' acculturation. Less hearing loss, inclusive education in public school or school for the hearing-impaired, mixed communication in the family contributed to the formation of 'hearing' acculturation. The choice of specific coping depended on the degree of deafness: a large hearing loss increased coping 'withdrawal into the deaf world' and decreased 'bicultural skills' coping. People with mild hearing loss tended to cover-up it. In the context of ongoing discussion, we researched personality characteristics in deaf and hard on-hearing students, coping and other deafness associated factors depending on their acculturation type. Students who identified themselves with the 'hearing world' had a high self-esteem, a higher level of extraversion, self-awareness, personal resources, willingness to cooperate, better psychological health, emotional stability, higher ability to empathy, a greater satiety of life with feelings and sense and high sense of self-worth. They also actively used strategies, problem-solving, acceptance of responsibility, positive revaluation. Student who limited themselves within the culture of deaf people had more severe hearing loss and accordingly had more communication barriers. Lack of use or seldom use of coping strategies by these students point at decreased level of stress in their life. Their self-esteem have not been challenged in the specific social environment of the students with the same severity of defect, and thus this environment provided sense of comfort (we can assume that from the high scores on psychological health, personality resources, and emotional stability). Students with bicultural acculturation had higher level of psychological resources - they used Positive Reappraisal coping more often and had a higher level of psychological health. Lack of belonging to certain culture (marginality) leads to personality disintegration, social and psychological disadaptation: deaf and hard-of-hearing students with marginal identification had a lower self-estimation level, worse psychological health and personal resources, lower level of extroversion, self-confidence and life satisfaction. They, in fact, become 'risk group' (many of them dropped out of universities, divorced, and one even ended up in the ranks of ISIS). All these data argue the importance of cultural 'anchor' for people with hearing deprivation. Supported by the RFBR No 19-013-00406.

Keywords: acculturation, coping, deafness, marginality

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Authors: Essam Amerian

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The aim of this study was to investigate the effects of improving waist-to-hip ratio (WHR) and visceral fat components on the health of shift workers in an offshore petrochemical company. A total of 100 male shift workers participated in the study, with an average age of 40.5 years and an average BMI of 28.2 kg/m². The study employed a randomized controlled trial design, with participants assigned to either an intervention group or a control group. The intervention group received a 12-week program that included dietary counseling, physical activity recommendations, and stress management techniques. The control group received no intervention. The outcomes measured were changes in WHR, visceral fat components, blood pressure, and lipid profile. The results showed that the intervention group had a statistically significant improvement in WHR (p<0.001) and visceral fat components (p<0.001) compared to the control group. Furthermore, there were statistically significant improvements in systolic blood pressure (p=0.015) and total cholesterol (p=0.034) in the intervention group compared to the control group. These findings suggest that implementing a 12-week program that includes dietary counseling, physical activity recommendations, and stress management techniques can effectively improve WHR, visceral fat components, and cardiovascular health among shift workers in an offshore petrochemical company.

Keywords: body composition, waist-hip-ratio, visceral fat, shift worker, work efficiency

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Authors: Isabel Latz, Mark Lusk, Josiah Heyman

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The rise of restrictive U.S. immigration policies and their strengthened enforcement has reportedly caused concerns among providers about their inadvertent effects on service utilization among Latinx and immigrant communities. This study presents perceptions on this issue from twenty service providers in health care, mental health, nutrition assistance, legal assistance, and immigrant advocacy in El Paso, Texas. All participants were experienced professionals, with fifteen in CEO, COO, executive director, or equivalent positions, and based at organizations that provide services for immigrant and/or low-income populations in a bi-national border community. Quantitative and qualitative data were collected by two primary investigators via semi-structured telephone interviews with an average length of 20 minutes. A survey script with closed and open-ended questions inquired about participants’ demographic information and perceptions of impacts of immigration enforcement policies under the current federal administration on their work and patient or client populations. Quantitative and qualitative data were analyzed to produce descriptive statistics and identify salient themes, respectively. Nearly all respondents stated that their work has been negatively (N=13) or both positively and negatively (N=5) affected by current immigration enforcement policies. Negative effects were most commonly related to immigration enforcement-related fear and uncertainty among patient or client populations. Positive effects most frequently referred to a sense of increased community organizing and greater cooperation among organizations. Similarly, the majority of service providers either reported an increase (N=8) or decrease (N=6) in service utilization due to changes in immigration enforcement policies. Increased service needs were primarily related to a need for public education about immigration enforcement policy changes, information about how new policies impact individuals’ service eligibility, legal status, and civil rights, as well as a need to correct misinformation. Decreased service utilization was primarily related to fear-related service avoidance. While providers observed changes in service utilization among undocumented immigrants and mixed-immigration status families, in particular, participants also noted ‘spillover’ effects on the larger Latinx community, including legal permanent and temporary residents, refugees or asylum seekers, and U.S. citizens. This study reveals preliminary insights into providers’ widespread concerns about the effects of current immigration enforcement policies on health, social, and legal service utilization among Latinx individuals. Further research is necessary to comprehensively assess impacts of immigration enforcement policies on service utilization in Latinx and immigrant communities. This information is critical to address gaps in service utilization and prevent an exacerbation of health disparities among Latinx, immigrant, and border populations. In a global climate of rising nationalism and xenophobia, it is critical for policymakers to be aware of the consequences of immigration enforcement policies on the utilization of essential services to protect the well-being of minority and immigrant communities.

Keywords: immigration enforcement, immigration policy, provider perceptions, service utilization

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Authors: Bylhah Mugotitsa, Jim Todd, Agnes Kiragga, Jay Greenfield, Evans Omondi, Lukoye Atwoli, Reinpeter Momanyi

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The INSPIRE network aims to build an open, ethical, sustainable, and FAIR (Findable, Accessible, Interoperable, Reusable) data science platform, particularly for longitudinal mental health (MH) data. While studies have been done at the clinical and population level, there still exists limitations in data and research in LMICs, which pose a risk of underrepresentation of mental disorders. It is vital to examine the existing longitudinal MH data, focusing on how FAIR datasets are. This landscape analysis aimed to provide both overall level of evidence of availability of longitudinal datasets and degree of consistency in longitudinal studies conducted. Utilizing prompters proved instrumental in streamlining the analysis process, facilitating access, crafting code snippets, categorization, and analysis of extensive data repositories related to depression, anxiety, and psychosis in Africa. While leveraging artificial intelligence (AI), we filtered through over 18,000 scientific papers spanning from 1970 to 2023. This AI-driven approach enabled the identification of 228 longitudinal research papers meeting inclusion criteria. Quality assurance revealed 10% incorrectly identified articles and 2 duplicates, underscoring the prevalence of longitudinal MH research in South Africa, focusing on depression. From the analysis, evaluating data and metadata adherence to FAIR principles remains crucial for enhancing accessibility and quality of MH research in Africa. While AI has the potential to enhance research processes, challenges such as privacy concerns and data security risks must be addressed. Ethical and equity considerations in data sharing and reuse are also vital. There’s need for collaborative efforts across disciplinary and national boundaries to improve the Findability and Accessibility of data. Current efforts should also focus on creating integrated data resources and tools to improve Interoperability and Reusability of MH data. Practical steps for researchers include careful study planning, data preservation, machine-actionable metadata, and promoting data reuse to advance science and improve equity. Metrics and recognition should be established to incentivize adherence to FAIR principles in MH research

Keywords: longitudinal mental health research, data sharing, fair data principles, Africa, landscape analysis

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Authors: Jaden Lu, Olivia Lu

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Despite the remarkable advancement of solar cell technology, the challenge of optimizing total solar energy harvest efficiency persists, primarily due to significant heat loss. This excess heat not only diminishes solar panel output efficiency but also curtails its operational lifespan. A promising approach to address this issue is the conversion of surplus heat into electricity. In recent years, there is growing interest in the use of thermoelectric generators (TEG) as a potential solution. The integration of efficient TEG devices holds the promise of augmenting overall energy harvest efficiency while prolonging the longevity of solar panels. While certain research groups have proposed the integration of solar cells and TEG devices, a substantial gap between conceptualization and practical implementation remains, largely attributed to low thermal energy conversion efficiency of TEG devices. To bridge this gap and meet the requisites of practical application, a feasible strategy involves the incorporation of a substantial number of p-n junctions within a confined unit volume. However, the manufacturing of high-density TEG p-n junctions presents a formidable challenge. The prevalent solution often leads to large device sizes to accommodate enough p-n junctions, consequently complicating integration with solar cells. Recently, the adoption of 3D printing technology has emerged as a promising solution to address this challenge by fabricating high-density p-n arrays. Despite this, further developmental efforts are necessary. Presently, the primary focus is on the 3D printing of vertically layered TEG devices, wherein p-n junction density remains constrained by spatial limitations and the constraints of 3D printing techniques. This study proposes a novel device configuration featuring horizontally arrayed p-n junctions of Bi2Te3. The structural design of the device is subjected to simulation through the Finite Element Method (FEM) within COMSOL Multiphysics software. Various device configurations are simulated to identify optimal device structure. Based on the simulation results, a new TEG device is fabricated utilizing 3D Selective laser melting (SLM) printing technology. Fusion 360 facilitates the translation of the COMSOL device structure into a 3D print file. The horizontal design offers a unique advantage, enabling the fabrication of densely packed, three-dimensional p-n junction arrays. The fabrication process entails printing a singular row of horizontal p-n junctions using the 3D SLM printing technique in a single layer. Subsequently, successive rows of p-n junction arrays are printed within the same layer, interconnected by thermally conductive copper. This sequence is replicated across multiple layers, separated by thermal insulating glass. This integration created in a highly compact three-dimensional TEG device with high density p-n junctions. The fabricated TEG device is then attached to the bottom of the solar cell using thermal glue. The whole device is characterized, with output data closely matching with COMSOL simulation results. Future research endeavors will encompass the refinement of thermoelectric materials. This includes the advancement of high-resolution 3D printing techniques tailored to diverse thermoelectric materials, along with the optimization of material microstructures such as porosity and doping. The objective is to achieve an optimal and highly integrated PV-TEG device that can substantially increase the solar energy harvest efficiency.

Keywords: thermoelectric, finite element method, 3d print, energy conversion

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Authors: Karoline Reis de Sena

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Endocrine disruptors are unregulated or not fully regulated compounds, even in the most developed countries, and which can be a danger to the environment and human health. They pass untreated through the secondary stage of conventional wastewater treatment plants, then the effluent from the wastewater treatment plants is discharged into the rivers, upstream and downstream from the drinking water treatment plants that use the same river water as the tributary. Long-term consumption of drinking water containing low concentrations of these compounds can cause health problems; these are persistent in nature and difficult to remove. In this way, research on emerging pollutants is expanding and is fueled by progress in finding the appropriate method for treating wastewater. Adsorption is the most common separation process, it is a simple and low-cost operation, but it is not eco-efficient. Concomitant to this, biosorption arises, which is a subcategory of adsorption where the biosorbent is biomass and which presents numerous advantages when compared to conventional treatment methods, such as low cost, high efficiency, minimization of the use of chemicals, absence of need for additional nutrients, biosorbent regeneration capacity and the biomass used in the production of biosorbents are found in abundance in nature. Thus, the use of alternative materials, such as sewage sludge, for the synthesis of adsorbents has proved to be an economically viable alternative, together with the importance of valuing the generated by-product flows, as well as managing the problem of their correct disposal. In this work, an alternative for the management of sewage sludge is proposed, transforming it into activated carbon and using it in the adsorption process of 17a-ethinylestradiol.

Keywords: 17α-ethinylestradiol, adsorption, activated carbon, sewage sludge, micropollutants

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Authors: Alexandra Telitsyna, Galina Semya, Elvira Garifulina

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Introduction: Starting from 2012 Russia conducts deinstitutionalization policy and now the main indicator of success is the number of children living in institutions. Active family placement process has resulted in residents of the institution now mainly consists of adolescents with behavioral and emotional problems, children with disabilities and groups of siblings. Purpose of science research: The purpose of science research is to identify factors for child’s wellbeing while temporary stay in an orphanage and the subjective assessment of children's level of well-being (psychological well-being). Methods: The data used for this project was collected by the questionnaire of 72 indicators, a tool for monitoring the behavior of children and caregivers, an additional questionnaire for children; well-being assessment questionnaire containing 10 scales for three age groups from preschool to older adolescents. In 2016-2018, the research was conducted in 1873 institution in 85 regions of Russia. In each region a team of academics, specialists from Non-profits, independent experts was created. Training was conducted for team members through a series of webinars prior to undertaking the assessment. The results: To ensure the well-being of the children, the following conditions are necessary: 1- Life of children in institution is organised according to the principles of family care (including the creation of conditions for attachment to be formed); 2- Contribution to find family-based placement for children (including reintegration into the primary family); 3- Work with parents of children, who are placed in an organization at the request of parents; 4- Children attend schools according to their needs; 5- Training of staff and volunteers; 6- Special environment and services for children with special needs and children with disabilities; 7- Cooperation with NGOs; 8 - Openness and accessibility of the organization. Conclusion: A study of the psychological well-being of children showed that the most emotionally stressful for children were questions about the presence and frequency of contact with relatives, and the level of well-being is higher in the presence of a trusted adult and respect for rights. The greatest contribution to the trouble is made by the time the child is in the orphanage, the lack of contact with parents and relatives, the uncertainty of the future.

Keywords: identifying factors, orphans, Russia, wellbeing

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Authors: Ya-Lin Chang, Chia Chen Chang, Yu-Ru Liang, Joyce Chen, You-Kang Chang, Tina Chiu

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Physical activity and mental health status are important for health. The purpose of this study was to examine levels of physical activities and depression in Taiwanese vegetarians (VEG) and omnivores (OMNI). Sixty-three vegetarians (20 males) and 56 omnivores (23 males) with an average age of 51 years were recruited for a food frequency validation study at Taipei Tzu Chi Hospital from July to September in 2016. Participants filled out a validated Chinese version international physical activity questionnaire-short-form (IPAQ), Beck Depression Inventory-II-Chinese version (BDI), food frequency questionnaire (FFQ) and a questionnaire on demographics and medical history upon recruitment. Total BDI scores were calculated for depression and the metabolic equivalent of task (MET) was calculated for physical activity levels. Mann-Whitney U tests and Chi-square test were used to compare demographics, physical activity levels and depression scores. VEG and OMNI did not differ significantly on MET (1441.9 ± 3387.3 vs. 1605.8 ± 2486.1. p=0.2652, respectively). VEG scored slightly lower on BDI compared to OMNI without statistical significance (5.6 ± 5.7 vs. 7.4 ± 6.3. p=0.06). In addition, we found that regardless of diet practice, those who held a college degree and above scored better on MET (1788.1 ± 2532.6 vs. 1215.5 ± 3425.5. p=0.0014) and BDI (5.2 ± 5.1 vs. 7.8 ± 6.7. p=0.03). In this cross-sectional study, Taiwanese vegetarians and omnivores scored comparatively on physical activity levels and depression. However, education is a significant determinant of physical activity and depression.

Keywords: BDI, diet, education, physical activity

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Authors: Preeti Khanna, Bani T. Aeri

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Background: Recent studies have indicated challenges that hamper health and wellbeing of a vast majority of adolescents in developing countries. Many modifiable factors like behavior and temperament related to food intake among adolescents have not been adequately explored. The aim of the proposed research is to study the impact of behavior and temperament on food intake and diet quality of adolescents. Objectives: In the present study data on dietary behavior and anthropometry of adolescent boys & girls (aged 13-16 years) studying in public schools of Delhi will be gathered to ascertain the quality of diet among adolescent boys and girls and to study the effect of behavior and temperament on diet quality of adolescents. Methods: In total, 400 adolescents will participate in this cross-sectional study. Weight and height of adolescents will be measured and BMI will be calculated. Information will be obtained on their socio-demographic profile and various factors influencing their Food Choices and diet quality such as body image perception, Behavior, temperament, locus of control and parental influence. Expected results: Several direct effects of adolescent traits and behavior on food intake will be observed. Maturational patterns and gender differences in behavior traits will be assessed. By profiling of the behavior and temperament traits, we will have a better understanding of impact of these factors on weight and eating behaviors in overweight/obese or even underweight adolescents. Conclusions: The proposed study will highlight the association of behavioral factors with nutritional status of adolescents. It will also serve as a strategic approach for the obesity prevention and health management policies designed for adolescents.

Keywords: behaviour, temperament, food intake, adolescents

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Authors: Erez Yerushalmi, Sani Ziv

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The rising demand for healthcare services, without a corresponding rise in public supply, led to a debate on whether to increase private healthcare provision - especially in hospital services and second-tier healthcare. Proponents for increasing private healthcare highlight gains in efficiency, while opponents its risk to social welfare. None, however, provide a measure of the social value and its impact on the economy in terms of a monetary value. In this paper, we impute a minimum social value of public healthcare that corresponds to indifference between gains in efficiency, with losses to social welfare. Our approach resembles contingent valuation methods that introduce a hypothetical market for non-commodities, but is different from them because we use numerical simulation techniques to exploit certain market failure conditions. In this paper, we develop a general equilibrium model that distinguishes between public-private healthcare services and public-private financing. Furthermore, the social value is modelled as a by product of healthcare services. The model is then calibrated to our unique health focused Social Accounting Matrix of Israel, and simulates the introduction of a hypothetical health-labour market - given that it is heavily regulated in the baseline (i.e., the true situation in Israel today). For baseline parameters, we estimate the minimum social value at around 18% public healthcare financing. The intuition is that the gain in economic welfare from improved efficiency, is offset by the loss in social welfare due to a reduction in available social value. We furthermore simulate a deregulated healthcare scenario that internalizes the imputed value of social value and searches for the optimal weight of public and private healthcare provision.

Keywords: contingent valuation method (CVM), general equilibrium model, hypothetical market, private-public healthcare, social value of public healthcare

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Authors: M. Adamczak-Retecka, O. Hołub-Śniadach

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Dangerous of climate change is now global problem and as such has a strategic priority also for the European Union. Europe and European citizens try to do their best to cut greenhouse gas emissions, moreover they substantially encourage other nations and regions to follow the same way. The European Commission and a number of Member States have developed adaptation strategies in order to help strengthen EU's resilience to the inevitable impacts of climate change. The EU has long been a driving force in international negotiations on climate change and was instrumental in the development of the UN Framework Convention on Climate Change. As the world's leading donor of development aid, the EU also provides substantial funding to help developing countries tackle climate change problem. Global warming influences human health, biodiversity, ecosystems but also many social and economic sectors. The aim of this paper is to focus on impact of claimant change on for food security. Food security challenges are directly related to globalization, climate change. It means that current and future food policy is exposed to all cross-cutting and that must be linked with environmental and climate targets, which supposed to be achieved. In the 7th EAP —The new general Union Environment Action Program to 2020, called “Living well, within the limits of our planet” EU has agreed to step up its efforts to protect natural capital, stimulate resource efficient, low carbon growth and innovation, and safeguard people’s health and wellbeing– while respecting the Earth’s natural limits.

Keywords: climate change, food security, sustainable food consumption, climate governance

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Authors: Yung-Feng Yen, Yun-Ju Lai

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Background: Animal studies have shown that alcohol exposure may cause immunosuppression and increase the susceptibility to tuberculosis (TB) infection. However, the temporality of alcohol consumption with subsequent TB development remains unclear. This nationwide population-based cohort study aimed to investigate the impact of alcohol exposure on TB development in Taiwanese adults. Methods: We included 46 196 adult participants from three rounds (2001, 2005, 2009) of the Taiwan National Health Interview Survey. Alcohol consumption was classified into heavy, regular, social, or never alcohol use. Heavy alcohol consumption was defined as intoxication at least once/week. Alcohol consumption and other covariates were collected by in-person interviews at baseline. Incident cases of active TB were identified from the National Health Insurance database. Multivariate logistic regression was used to estimate the association between alcohol consumption and active TB, with adjustment for age, sex, smoking, socioeconomic status, and other covariates. Results: A total of 279 new cases of active TB occurred during the study follow-up period. Heavy (adjusted odds ratio [AOR], 5.21; 95% confident interval [CI], 2.41-11.26) and regular alcohol use (AOR, 1.73; 95% CI, 1.26-2.38) were associated with higher risks of incident TB after adjusting for the subject demographics and comorbidities. Moreover, a strong dose-response effect was observed between increasing alcohol consumption and incident TB (AOR, 2.26; 95% CI, 1.59-3.21; P <.001). Conclusion: Heavy and regular alcohol consumption were associated with higher risks of active TB. Future TB control programs should consider strategies to lower the overall level of alcohol consumption to reduce the TB disease burden.

Keywords: alcohol consumption, tuberculosis, risk factor, cohort study

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Authors: Ram Sharan Mehta, Sanjeev Sharma

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Introduction: Haemodialysis (HD) is a mechanical process of removing waste products from the blood and replacing essential substances in patients with renal failure. First artificial kidney developed in Netherlands in 1943 AD First successful treatment of CRF reported in 1960AD, life-saving treatment begins for CRF in 1972 AD. In 1973 AD Medicare took over financial responsibility for many clients and after that method become popular. BP Koirala institute of health science is the only center outside the Kathmandu, where HD service is available. In BPKIHS PD started in Jan.1998, HD started in August 2002 till September 2003 about 278 patients received HD. Day by day the number of HD patients is increasing in BPKIHS as with institutional growth. No such type of study was conducted in past hence there is lack of valid & reliable baseline data. Hence, the investigators were interested to conduct the study on " Profile of the Renal Failure patients under Haemodialysis at B.P. Koirala Institute of Health Sciences Nepal". Objectives: The objectives of the study were: to find out the Socio-demographic characteristics of the patients, to explore the knowledge of the patients regarding disease process and Haemodialysis and to identify the problems encountered by the patients. Methods: It is a hospital-based exploratory study. The population of the study was the clients under HD and the sampling method was purposive. Fifty-four patients undergone HD during the period of 17 July 2012 to 16 July 2013 of complete one year were included in the study. Structured interview schedule was used for collect data after obtaining validity and reliability. Results: Total 54 subjects had undergone for HD, having age range of 5-75 years and majority of them were male (74%) and Hindu (93 %). Thirty-one percent illiterate, 28% had agriculture their occupation, 80% of them were from very poor community, and about 30% subjects were unaware about the disease they suffering. Majority of subjects reported that they had no complications during dialysis (61%), where as 20% reported nausea and vomiting, 9% Hypotension, 4% headache and 2%chest pain during dialysis. Conclusions: CRF leading to HD is a long battle for patients, required to make major and continuous adjustment, both physiologically and psychologically. The study suggests that non-compliance with HD regimen were common. The socio-demographic and knowledge profile will help in the management and early prevention of disease and evaluate aspects that will influence care and patients can select mode of treatment themselves properly.

Keywords: profile, haemodialysis, Nepal, patients, treatment

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Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

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Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

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Authors: Ying Shi, June Zhang, Lu Shao, Xiyan Xie, Aidi Lao, Zhangan Wang

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Background: Low levels of physical activity are associated with poorer health outcomes, and this situation is more critical in older adults living in long‐term care facilities. Objectives: To systematically identify, appraise, and synthesize current qualitative research evidence regarding the barriers and facilitators to physical activity as reported by older adults and care staff in long‐term care facilities. Design: This is a systematic review with qualitative evidence synthesis adhering to PRISMA guidelines. Methods: We conducted a systematic search on PubMed, Science Citation Index Expanded, Social Sciences Citation Index, EMBASE, CINAHL, and PsychInfo databases from inception until 30 June 2023. Thematic synthesis was undertaken to identify the barriers and facilitators relating to physical activity. Then, we mapped them onto the Capability, Opportunity, Motivation, and Behavior model and Theoretical Domains Framework. Methodological quality was assessed using the CASP Qualitative Studies Checklist, and confidence in review findings was assessed using the GRADE-CERQual approach. Results: We included 32 studies after screening 10496 citations and 177 full texts. Seven themes and 17 subthemes were identified relating to barriers and facilitators influencing physical activity in elderly residents. The main themes were mapped onto COM-B) model-Capability (physical activity knowledge gaps and individual health issues), Opportunity (social support and macro-level resources) and Motivation (health beliefs, fear of falling or injury, and personal and social incentives to physical activity). Most subthemes were graded as high (n = 9) or moderate (n = 3) confidence. Conclusions and Implications: Our comprehensive synthesis of 32 studies provides a wealth of knowledge of barriers and facilitators to physical activity from both residents and care staff’s perspectives. Intervention components were also suggested within the context of long‐term care facilities. End users such as older residents, care staff, and researchers can have confidence in our findings when formulating policies and guidance on promoting physical activity among elderly residents in long‐term care facilities.

Keywords: long‐term care, older adults, physical activity, qualitative, systematic review

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