Search results for: health care screening

Authors: Alaa Badawi, Suzan Sayegh, Mohamed Sallam, Eman Sadoun, Mohamed Al-Thani, Muhammad W. Alam, Paul Arora

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Background: The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has increased over the past decade with DM prevalence increasing in countries already afflicted with a high burden of TB. The coexistence of the two conditions presents a serious threat to global public health. Objective: The present study examines the global relationship between the prevalence of DM and the incidence of TB to evaluate their coexistence worldwide and their contribution to one another. Methods: This is an ecological longitudinal study covering the period between years 2000 to 2012. We utilized data from the WHO and World Bank sources and International Diabetes Federation to estimate prevalence of DM (%) and the incidence of TB (per 100,000). Measures of central tendency and dispersion as well as the harmonic mean and linear regression were used for different WHO regions. The association between DM prevalence and TB incidence was examined by quartile of DM prevalence. Results: The worldwide average (±S.D.) prevalence of DM within the study period was 6.6±3.8% whereas TB incidence was 135.0±190.5 per 100,000. DM prevalence was highest in the Eastern Mediterranean (8.3±4.1) and West Pacific (8.2±5.6) regions and lowest in the Africa (3.5±2.6). TB incidence was highest in Africa (313.1±275.9 per 100,000) and South-East Asia (216.7±124.9) and lowest in the European (46.5±68.6) and American (47.2±52.9) regions. Only countries with high DM prevalence (>7.6%) showed a significant positive association with TB incidence (r=0.17, p=0.013). Conclusion: A positive association between DM and TB may exist in some – but not all – world regions, a dual burden that necessitates identifying the nature of this coexistence to assist in developing public health approaches that curb their rising burden.

Keywords: diabetes mellitus, tuberculosis, disease burden, global association

Procedia PDF Downloads 453

Authors: Alina Svechkina, Boris A. Portnov

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In line with a rapid increase in pollution sources and enforcement of stricter air pollution regulation, which lowers pollution levels, it becomes more difficult to identify actual risk sources behind the observed morbidity patterns, and new approaches are required to identify potential risks and take preventive actions. In the present study, we discuss a probabilistic approach to the spatial identification of a priori unidentified environmental health hazards. The underlying assumption behind the tested approach is that the observed adverse health patterns (morbidity, mortality) can become a source of information on the geographic location of environmental risk factors that stand behind them. Using this approach, we analyzed sources of environmental exposure using data on mortality rates available for the year 2015 for NUTS 3 (Nomenclature of Territorial Units for Statistics) subdivisions of the European Union. We identified several areas in the southwestern part of Europe as primary risk sources for the observed mortality patterns. Multivariate regressions, controlled by geographical location, climate conditions, GDP (gross domestic product) per capita, dependency ratios, population density, and the level of road freight revealed that mortality rates decline as a function of distance from the identified hazard location. We recommend the proposed approach an exploratory analysis tool for initial investigation of regional patterns of population morbidity patterns and factors behind it.

Keywords: mortality, environmental hazards, air pollution, distance decay gradient, multi regression analysis, Europe, NUTS3

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Authors: Audrius Dedele, Aukse Miskinyte

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Air pollution is a major problem, especially in large cities, causing a variety of environmental issues and a risk to human health effects. In order to observe air quality, to reduce and control air pollution in the city, municipalities are responsible for the creation of air quality management plans, air quality monitoring and emission inventories. Atmospheric dispersion modelling systems, along with monitoring, are powerful tools, which can be used not only for air quality management, but for the assessment of human exposure to air pollution. These models are widely used in epidemiological studies, which try to determine the associations between exposure to air pollution and the adverse health effects. The purpose of this study was to determine the concentration of particulate matter smaller than 10 μm (PM10) in different districts of Kaunas city during winter season. ADMS-Urban dispersion model was used for the simulation of PM10 pollution. The inputs of the model were the characteristics of stationary, traffic and domestic sources, emission data, meteorology and background concentrations were entered in the model. To assess the modelled concentrations of PM10 in Kaunas districts, geographic information system (GIS) was used. More detailed analysis was made using Spatial Analyst tools. The modelling results showed that the average concentration of PM10 during winter season in Kaunas city was 24.8 µg/m3. The highest PM10 levels were determined in Zaliakalnis and Aleksotas districts with are the highest number of individual residential properties, 32.0±5.2 and 28.7±8.2 µg/m3, respectively. The lowest pollution of PM10 was modelled in Petrasiunai district (18.4 µg/m3), which is characterized as commercial and industrial neighbourhood.

Keywords: air pollution, dispersion model, GIS, Particulate matter

Procedia PDF Downloads 260

Authors: Prapaipan Phingchim

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The number of women approaching menopausal age in Thailand is increasing, making menopause an important health topic. In order to understand Thai women's different ways of interpreting menopausal experiences and the way they construct meaning relating to menopause, it is necessary to include the context in which meaning is constructed as well as the background of cultural attitudes to menopause existing in the Thai society. The aim of this study was to describe different discourses on menopause in Thailand that present themselves to menopausal women through the use of language and to analyze linguistic strategies used to represent such identity. This study adopts discourse theory and a close pragmatic analysis to examine the discursive construction of menopause for Thai women. Two hundreds and fifteen pieces of text under the heading or subject of `menopause' or `becoming a middle-aged woman', published from 2010 to 2019, were included. All material was addressed to Thai women, and consisted of booklets and informational material, articles from newspapers and magazines and popular science books. Five different discourses on menopause were identified: the biomedical discourse; the health-promotion discourse; the consumer discourse; the alternative discourse; and the feminist/ critical discourse. The biomedical discourse on menopause was found to be dominant, but was expanded or challenged by other discourses by offering different scopes of action and/or resting on different fundamental values. The discourses constructed and positioned individual women differently; thus, the women's position varied noticeably from one discourse to another. There are seven major linguistic strategies used to construct those identities. That is, lexical selection, presupposition manipulation, presupposition denial, the use of implication, the use of passive construction, using the cause and effect sentence structure, and rhetoric questions.

Keywords: discourse analysis, discursive construction, menopause, Thai women

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Authors: Dorit Olenik-Shemesh, Tali Heiman

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The rapid increase in the massive use of the internet in recent yearshas led to an increase in the prevalence of a phenomenon called 'Problematic Internet use' (PIU), an emerging, growing health problem, especially during adolescents, that poses a challenge for mental health research and practitioners. Problematic Internet use (PIU) is defined as an excessive overuse of the internet, including an inability to control time spent on the internet, cognitivepreoccupation with the Internet, and continued use in spite of the adverse consequences, which may lead to psychological, social, and academic difficulties in one's life and daily functioning. However, little is known about the nature of the nexusbetween PIU and subjective well-being among adolescents. The main purpose of the current study was to explore in depth the network of connections between PIU, sense of well-being, and fourpersonal-emotional factors (resilience, self-control, depressive mood, and loneliness) that may mediate these relationships. A total sample of 433 adolescents, 214 (49.4%) girls and 219 (50.6%) boys between the ages of 12–17 (mean = 14.9, SD = 2.16), completed self-reportquestionnaires relating to the study variables. In line with the hypothesis, analysis of a Structural Equation modeling (SEM) revealed the main following results: high levels of PIU predicted low levels of well-being among adolescents. In addition, low levels of resilience and high levels of depressivemood (together), as well as low levels of self control and high levels of depressivemood (together), as well as low levels of resilience and high levels of loneliness, mediated the relationships between PIU and well-being. In general, girls were found to be higher in PIU and inresilience than boys. The study results revealed specific implications for developing intervention programs for adolescents in the context of PIU; aiming at more balanced adjusted use of the Internet along withpreventingthe decrease in well being.

Keywords: probelmatic inetrent Use, well-being, adolescents, SEM model

Procedia PDF Downloads 157

Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Manutchanok Jongprasithporn, Rawiphorn Srivilai, Paweena Pongsopha

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Fall is the most serious accident leading to increased unintentional injuries and mortality. Falls are not only the cause of suffering and functional impairments to the individuals, but also the cause of increasing medical cost and days away from work. The early detection of falls could be an advantage to reduce fall-related injuries and consequences of falls. Smartphones, embedded accelerometer, have become a common device in everyday life due to decreasing technology cost. This paper explores a physical activity monitoring and fall detection application in smartphones which is a non-invasive biomedical device to determine physical activities and fall event. The combination of application and sensors could perform as a biomedical sensor to monitor physical activities and recognize a fall. We have chosen Android-based smartphone in this study since android operating system is an open-source and no cost. Moreover, android phone users become a majority of Thai’s smartphone users. We developed Thai 3 Axis (TH3AX) as a physical activities and fall detection application which included command, manual, results in Thai language. The smartphone was attached to right hip of 10 young, healthy adult subjects (5 males, 5 females; aged< 35y) to collect accelerometer and gyroscope data during performing physical activities (e.g., walking, running, sitting, and lying down) and falling to determine threshold for each activity. Dependent variables are including accelerometer data (acceleration, peak acceleration, average resultant acceleration, and time between peak acceleration). A repeated measures ANOVA was performed to test whether there are any differences between DVs’ means. Statistical analyses were considered significant at p<0.05. After finding threshold, the results were used as training data for a predictive model of activity recognition. In the future, accuracies of activity recognition will be performed to assess the overall performance of the classifier. Moreover, to help improve the quality of life, our system will be implemented with patients and elderly people who need intensive care in hospitals and nursing homes in Thailand.

Keywords: activity recognition, accelerometer, fall, gyroscope, smartphone

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Authors: Anuruddhi Edirisinghe, Anusha Edirisinghe, Maithree Wicramasinghe, Sagarika Kannangara, Annista Wijayanayake

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SGBV which refer to acts of inflicting physical, mental or sexual harm or sufferings that deprive a person’s liberty based on one’s gender or sexuality is known to occur in various forms. Ragging in educational institutions can often be one such form of SGBV. Ragging related SGBV is a growing problem despite various legal, policy and programme initiatives introduced over the years. While the punishment of perpetrators through the criminal justice system is expected to bring a deterrent effect, other strategies such as awareness-raising, attitudinal changes, and the empowerment of students to say no to ragging and SGBV will lead to enlightened attitudes about the practice in universities. Thus, effective regular prevention programmes are the need of the hour. The objectives of the paper are to engage with the case of a female fresher subjected to verbal abuse, physical assault and sexual harassment due to events which started as a result of wearing a trouser to the university during the ragging season. The case came to the limelight since a complaint was made to the police and 10 students were arrested under the anti-ragging act. This led to dividend opinions among the student population and a backlash from the student union. Simultaneously, this resulted in the society demanding the stricter implementation of laws and the punishment of perpetrators. The university authority appointed a task force comprising of academics, non-academics, parents, community leaders, stakeholders and students to draw up an action plan to respond to the immediate situation as well as future prevention. The paper will also discuss the implementation of task force plan. The paper is based on interviews with those involved with the issue and the experiences of the task force members and is expected to provide an in-depth understanding of the intricacies and complications associated with dealing with a contentious problem such as ragging. Given the political and ethical issues involved with insider research as well as the sensationalism of the topic, maximum care will be taken to safeguard the interests of those concerned.

Keywords: fresher, sexual and gender based violence (SGBV), sexual harassment, ragging

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Authors: Nalluri Lakshmi Ramu, C. Venkat Nihit, Narayana Kumar, Dillep

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Masonry bridges are the iconic heritage transportation infrastructure throughout the world. Continuous increase in traffic loads and speed have kept engineers in dilemma about their structural performance and capacity. Henceforth, research community has an urgent need to propose an effective methodology and validate on real-time bridges. The presented research aims to assess the structural health of an Eighty-year-old masonry railway bridge in India using wireless accelerometer sensors. The bridge consists of 44 spans with length of 24.2 m each and individual pier is 13 m tall laid on well foundation. To calculate the dynamic characteristic properties of the bridge, ambient vibrations were recorded from the moving traffic at various speeds and the same are compared with the developed three-dimensional numerical model using finite element-based software. The conclusions about the weaker or deteriorated piers are drawn from the comparison of frequencies obtained from the experimental tests conducted on alternative spans. Masonry is a heterogeneous anisotropic material made up of incoherent materials (such as bricks, stones, and blocks). It is most likely the earliest largely used construction material. Masonry bridges, which were typically constructed of brick and stone, are still a key feature of the world's highway and railway networks. There are 1,47,523 railway bridges across India and about 15% of these bridges are built by masonry, which are around 80 to 100 year old. The cultural significance of masonry bridges cannot be overstated. These bridges are considered to be complicated due to the presence of arches, spandrel walls, piers, foundations, and soils. Due to traffic loads and vibrations, wind, rain, frost attack, high/low temperature cycles, moisture, earthquakes, river overflows, floods, scour, and soil under their foundations may cause material deterioration, opening of joints and ring separation in arch barrels, cracks in piers, loss of brick-stones and mortar joints, distortion of the arch profile. Few NDT tests like Flat jack Tests are being employed to access the homogeneity, durability of masonry structure, however there are many drawbacks because of the test. A modern approach of structural health assessment of masonry structures by vibration analysis, frequencies and stiffness properties is being explored in this paper.

Keywords: masonry bridges, condition assessment, wireless sensors, numerical analysis modal frequencies

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Authors: Adedoyin Akintunde Adedayo, Onilude Abiodun Anthony

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The continuous usage of synthetic antibiotics in livestock production has led to the resistance of microbial pathogens. This has prompted research to find alternative sources. This study aims to compare the growth and intestinal health of broilers fed scent leaf meal (SLM) as an alternative to synthetic antibiotics. The study used a completely randomized design (CRD) with 300 one-week-old Arbor Acres broiler chicks. The chicks were divided into six treatments with five replicates of ten birds each. The feeding trial lasted 49 days, including a one-week acclimatization period. Commercial broiler diets were used. The diets included a negative control (no leaf meal or antibiotics), a positive control (0.10% oxy-tetracycline), and four diets with different levels of SLM (0.5%, 1.0%, 1.5%, and 2.0%). The supplementation of both oxy-tetracycline and SLM improved feed intake during the finisher phase. Birds fed SLM at a 1% inclusion level showed significantly (P<0.05) improved average body weight gain (ABWG), lowered feed-to-gain ratio, and cost per kilogram of weight gain compared to other diets. The mortality (2.0%) rate was significantly higher in the negative control group. White blood cell levels varied significantly (P<0.05) in birds fed SLM-supplemented diets, and the use of 2% SLM led to an increase in liver weight. However, welfare indices were not compromised.

Keywords: Arbor Acres, phyto-biotic, synthetic antibiotic, white blood cell, liver weight

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Authors: Mohamad Bolandmartabe, Nafiseh Hassani, Saeed Abdi Darake, Maryam Asghari

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Dogs are highly susceptible to diseases, nutritional problems, toxins, and parasites, with parasitic infections being common and causing hardship in their lives. Some important internal parasites include worms (such as roundworms and tapeworms) and protozoa, which can lead to anemia in dogs. Important bloodborne parasites in dogs include microfilariae and adult forms of Dirofilaria immitis, Dipetalonema reconditum, Babesia, Trypanosoma, Hepatozoon, Leishmania, Ehrlichia, and Hemobartonella. Babesia and Hemobartonella are parasites that reside inside red blood cells and cause regenerative anemia by directly destroying the red blood cells. Hepatozoon, Leishmania, and Ehrlichia are also parasites that reside within white blood cells and can infiltrate other tissues, such as the liver and lymph nodes. Since intermediate hosts are more commonly found in the open environment, the prevalence of parasites in stray and free-roaming dogs is higher compared to pet dogs. Furthermore, pet dogs are less exposed to internal and external parasites due to better care, hygiene, and being predominantly indoors. Therefore, they are less likely to be affected by them. Among the parasites, Leishmania carries significant importance as it is shared between dogs and humans, causing a dangerous disease known as visceral Leishmaniasis or kala-azar and cutaneous Leishmaniasis. Furthermore, dogs can act as reservoirs and spread the disease agent within human communities. Therefore, timely and accurate diagnosis of these diseases in dogs can be highly beneficial in preventing their occurrence in humans. In this article, we employed the Giemsa staining technique under a light microscope for the identification of bloodborne parasites in dogs. However, considering the negative impact of these parasites on the natural life of dogs, the development of chronic diseases, and the gradual loss of the animal's well-being, rapid and timely diagnosis is essential. Serological methods and PCR are available for the diagnosis of certain parasites, which have high sensitivity and desirable characteristics. Therefore, this research aims to investigate the molecular aspects of bloodborne parasites in dogs referred to veterinary hospitals in Tehran city.

Keywords: leishmaniasis, babesiosis, ehrlichiosis, dirofilariasis, hepatozoonosis

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Authors: Demetrio L. Valle Jr., Juliana Janet M. Puzon, Windell L. Rivera

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From the various medicinal plants available in the Philippines, crude ethanol extracts of twelve (12) Philippine medicinal plants, namely: Senna alata L. Roxb. (akapulko), Psidium guajava L. (bayabas), Piper betle L. (ikmo), Vitex negundo L. (lagundi), Mitrephora lanotan (Blanco) Merr. (Lanotan), Zingiber officinale Roscoe (luya), Curcuma longa L. (Luyang dilaw), Tinospora rumphii Boerl (Makabuhay), Moringga oleifera Lam. (malunggay), Phyllanthus niruri L. (sampa-sampalukan), Centella asiatica (L.) Urban (takip kuhol), and Carmona retusa (Vahl) Masam (tsaang gubat) were studied. In vitro methods of evaluation against selected Gram-positive and Gram-negative multidrug-resistant (MDR), bacteria were performed on the plant extracts. Although five of the plants showed varying antagonistic activities against the test organisms, only Piper betle L. exhibited significant activities against both Gram-negative and Gram-positive multidrug-resistant bacteria, exhibiting wide zones of growth inhibition in the disk diffusion assay, and with the lowest concentrations of the extract required to inhibit the growth of the bacteria, as supported by the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays. Further antibacterial studies of the Piper betle L. leaf, obtained by three extraction methods (ethanol, methanol, supercritical CO2), revealed similar inhibitory activities against a multitude of Gram-positive and Gram-negative MDR bacteria. Thin layer chromatography (TLC) assay of the leaf extract revealed a maximum of eight compounds with Rf values of 0.92, 0.86, 0.76, 0.53, 0.40, 0.25, 0.13, and 0.013, best visualized when inspected under UV-366 nm. TLC- agar overlay bioautography of the isolated compounds showed the compounds with Rf values of 0.86 and 0.13 having inhibitory activities against Gram-positive MDR bacteria (MRSA and VRE). The compound with an Rf value of 0.86 also possesses inhibitory activity against Gram-negative MDR bacteria (CRE Klebsiella pneumoniae and MBL Acinetobacter baumannii). Gas Chromatography-Mass Spectrometry (GC-MS) was able to identify six volatile compounds, four of which are new compounds that have not been mentioned in the medical literature. The chemical compounds isolated include 4-(2-propenyl)phenol and eugenol; and the new four compounds were ethyl diazoacetate, tris(trifluoromethyl)phosphine, heptafluorobutyrate, and 3-fluoro-2-propynenitrite. Phytochemical screening and investigation of its antioxidant, cytotoxic, possible hemolytic activities, and mechanisms of antibacterial activity were also done. The results showed that the local variant of Piper betle leaf extract possesses significant antioxidant, anti-cancer and antimicrobial properties, attributed to the presence of bioactive compounds, particularly of flavonoids (condensed tannin, leucoanthocyanin, gamma benzopyrone), anthraquinones, steroids/triterpenes and 2-deoxysugars. Piper betle L. is also traditionally known to enhance wound healing, which could be primarily due to its antioxidant, anti-inflammatory and antimicrobial activities. In vivo studies on mice using 2.5% and 5% of the ethanol leaf extract cream formulations in the excised wound models significantly increased the process of wound healing in the mice subjects, the results and values of which are at par with the current antibacterial cream (Mupirocin). From the results of the series of studies, we have definitely proven the value of Piper betle L. as a source of bioactive compounds that could be developed into therapeutic agents against MDR bacteria.

Keywords: Philippine herbal medicine, multidrug-resistant bacteria, Piper betle, TLC-bioautography

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Authors: Horng-Ji Lai

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The intuitive design features and friendly interface of smartphone attract older adults. In Taiwan, many senior education institutes offer smartphone training courses for older adult learners who are interested in learning this innovative technology. It is expected that the training courses can help them to enjoy the benefits of using smartphone and increase their life satisfaction. Therefore, it is important to investigate the factors that influence older adults’ behavior of using smartphone. The purpose of the research was to develop and test a research model that investigates the factors (self-efficacy, social connection, the need to seek health information, and the need to seek financial information) affecting older adult learners’ Internet behaviour and their life satisfaction with use of smartphone. Also, this research sought to identify the relationship between the proposed variables. Survey method was used to collect research data. A Structural Equation Modeling was performed using Partial Least Squares (PLS) regression for data exploration and model estimation. The participants were 394 older adult learners from smartphone training courses in active aging learning centers located in central Taiwan. The research results revealed that self-efficacy significantly affected older adult learner’ social connection, the need to seek health information, and the need to seek financial information. The construct of social connection yielded a positive influence in respondents’ life satisfaction. The implications of these results for practice and future research are also discussed.

Keywords: older adults, smartphone, internet behaviour, life satisfaction

Procedia PDF Downloads 179

Authors: E. Grochowska-Niedworok, K. Brukało, M. Hadasik, M. Kardas

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Consumption of vegetables by school children and adolescents is essential for their normal growth, development and health, but a significant minority of the world's population consumes the right amount of these products. The aim of the study was to evaluate the preferences and frequency of consumption of vegetables by school children and adolescents. It has been assumed that effectively implemented nutrition education programs should have an impact on increasing the frequency of vegetable consumption among the recipients. The study covered 514 students of five schools in the Opole Voivodeship aged 9 years to 22 years. The research tool was an author's questionnaire, which consisted of closed questions on the frequency of vegetable consumption and the use of 10 ways to treat them. Preferences and frequencies are shown in percentages, while correlations were estimated on the basis of Cramer`s V and gamma coefficients. In each of the examined age groups, the relationship between sex and vegetable consumption (the Cramer`s V coefficient value was 0.06 to 0.38) was determined and the various methods of culinary processing were used (V Craméra was 0.08 to 0.34). For both sexes, the relationship between age and frequency of vegetable consumption was shown (gamma values ranged from ~ 0.00 to 0.39) and different cooking methods (gamma values were 0.01 to 0.22). The most important determinant of nutritional choices is the taste and availability of products. The fact that they have a positive effect on their health is only in third position. As has been shown, obesity prevention programs can not only address nutrition education but also teach about new flavors and increase the availability of healthy foods. In addition, the frequency of vegetable consumption can be a good indicator reflecting the healthy behaviors of children and adolescents.

Keywords: children and adolescents, frequency, welfare rate, vegetables

Procedia PDF Downloads 194

Authors: Leo Byrne, Neil Watts

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In the complex and evolving landscape of global trade, maritime sanctions emerge as a critical tool wielded by the international community to curb illegal activities and alter the behavior of non-compliant states and entities. These sanctions, designed to restrict or prohibit trade by sea with sanctioned jurisdictions, entities, or individuals, face continuous challenges due to the sophisticated evasion tactics employed by countries like North Korea. As the Democratic People's Republic of Korea (DPRK) diverts significant resources to circumvent these measures, understanding the nuances of their methodologies becomes imperative for maintaining the integrity of global trade systems. The DPRK, one of the most sanctioned nations globally, has developed an intricate network to facilitate its trade in illicit goods, ensuring the flow of revenue from designated activities continues unabated. Given its geographic and economic conditions, North Korea predominantly relies on maritime routes, utilizing foreign ports to route its illicit trade. This reliance on the sea is exploited through various sophisticated methods, including the use of front companies, falsification of documentation, commingling of bulk cargos, and physical alterations to vessels. These tactics enable the DPRK to navigate through the gaps in regulatory frameworks and lax oversight, effectively undermining international sanctions regimes Maritime sanctions carry significant implications for global trade, imposing heightened risks in the maritime domain. The deceptive practices employed not only by the DPRK but also by other high-risk jurisdictions, necessitate a comprehensive understanding of UN targeted sanctions. For stakeholders in the maritime sector—including maritime authorities, vessel owners, shipping companies, flag registries, and financial institutions serving the shipping industry—awareness and compliance are paramount. Violations can lead to severe consequences, including reputational damage, sanctions, hefty fines, and even imprisonment. To mitigate risks associated with these deceptive practices, it is crucial for maritime sector stakeholders to employ rigorous due diligence and regulatory compliance screening measures. Effective sanctions compliance serves as a protective shield against legal, financial, and reputational risks, preventing exploitation by international bad actors. This requires not only a deep understanding of the sanctions landscape but also the capability to identify and manage risks through informed decision-making and proactive risk management practices. As the DPRK and other sanctioned entities continue to evolve their sanctions evasion tactics, the international community must enhance its collective efforts to demystify and counter these practices. By leveraging more stringent compliance measures, stakeholders can safeguard against the illicit use of the maritime domain, reinforcing the effectiveness of maritime sanctions as a tool for global security. This paper seeks to dissect North Korea's adaptive strategies in the face of maritime sanctions. By examining up-to-date, geographically, and temporally relevant case studies, it aims to shed light on the primary nodes through which Pyongyang evades sanctions and smuggles goods via third-party ports. The goal is to propose multi-level interaction strategies, ranging from governmental interventions to localized enforcement mechanisms, to counteract these evasion tactics.

Keywords: maritime, maritime sanctions, international sanctions, compliance, risk

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Authors: Tomohiko Utsuki

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Currently, brain resuscitation becomes increasingly important due to revising various clinical guidelines pertinent to emergency care. In brain resuscitation, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) is required for stabilizing physiological state of brain, and is described as the essential treatment points in many guidelines of disorder and/or disease such as brain injury, stroke, and encephalopathy. Thus, an integrated control system of BT, ICP, and CBF will greatly contribute to alleviating the burden on medical staff and improving treatment effect in brain resuscitation. In order to develop such a control system, models related to BT, ICP, and CBF are required for control simulation, because trial and error experiments using patients are not ethically allowed. A static model of cerebral blood circulation from intracranial arteries and vertebral artery to jugular veins has already constructed and verified. However, it is impossible to represent the pooling of blood in blood vessels, which is one cause of cerebral hypertension in this model. And, it is also impossible to represent the pulsing motion of blood vessels caused by blood pressure change which can have an affect on the change of cerebral tissue pressure. Thus, a dynamic model of cerebral blood circulation is constructed in consideration of the elasticity of the blood vessel and the inertia of the blood vessel wall. The constructed dynamic model was numerically analyzed using the normal data, in which each arterial blood flow in cerebral blood circulation, the distribution of blood pressure in the Circle of Willis, and the change of blood pressure along blood flow were calculated for verifying against physiological knowledge. As the result, because each calculated numerical value falling within the generally known normal range, this model has no problem in representing at least the normal physiological state of the brain. It is the next task to verify the accuracy of the present model in the case of disease or disorder. Currently, the construction of a migration model of extracellular fluid and a model of heat transfer in cerebral tissue are in progress for making them parts of an integrated model of brain physiological state, which is necessary for developing an future integrated control system of BT, ICP and CBF. The present model is applicable to constructing the integrated model representing at least the normal condition of brain physiological state by uniting with such models.

Keywords: dynamic model, cerebral blood circulation, brain resuscitation, automatic control

Procedia PDF Downloads 144

Authors: Erimias Firre

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This study is situated within the religio-cultural milieu of Coptic Orthodox Christians of the Tigrinya ethnic group in Eritrea. With this ethnic group being conservative and traditionally bound, extended family structures dissected along various clans and expansive community networks are the distinguishing mark of its members. Notably, Coptic Tigrinya constitutes the largest percentage of all Christian denominations in Eritrea. As religious, cultural beliefs, rituals and teachings permeate in all aspects of social life, a distinct worldview and traditionalized health and illness conceptualization are common. Accordingly, this study argues that religio-culturally bound illness ideologies immensely determine the perception, help seeking behavior and healing preference of Coptic Tigrinya in Eritrea. The study bears significance in the sense that it bridges an important knowledge gap, given that it is ethno-linguistically (within the Tigrinya ethnic group), spatially (central region of Eritrea) and religiously (Coptic Christianity) specific. The conceptual framework guiding this research centered on the social determinants of mental health, and explores through the lens of critical theory how existing systems generate social vulnerability and structural inequality, providing a platform to reveal how the psychosocial model has the capacity to emancipate and empower those with mental disorders to live productive and meaningful lives. A case study approach was employed to explore the interrelationship between religio-cultural beliefs and practices and perception of common mental disorders of depression, anxiety, bipolar affective, schizophrenia and post-traumatic stress disorders and the impact of these perceptions on people with those mental disorders. Purposive sampling was used to recruit 41 participants representing seven diverse cohorts; people with common mental disorders, family caregivers, general community members, ex-fighters , priests, staff at St. Mary’s and Biet-Mekae Community Health Center; resulting in rich data for thematic analysis. Findings highlighted current religio-cultural perceptions, causes and treatment of mental disorders among Coptic Tigrinya result in widespread labelling, stigma and discrimination, both of those with mental disorders and their families. Traditional healing sources are almost exclusively tried, sometimes for many years, before families and sufferers seek formal medical assessment and treatment, resulting difficult to treat illness chronicity. Service gaps in the formal medical system result in the inability to meet the principles enshrined in the WHO Mental Health Action Plan 2013-2020 to which the Eritrean Government is a signatory. However, the study found that across all participant cohorts, there was a desire for change that will create a culture whereby those with mental disorders will have restored hope, connectedness, healing and self-determination.

Keywords: Coptic Tigrinya, mental disorders, psychosocial model social integration and recovery, traditional healing

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Authors: S. M. D. Y. S. A. Wijayarathna, A. C. A. Jayasundera

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Mahaweli River is the longest and largest river in Sri Lanka and it is the major drinking water source for a large portion of 2.5 million inhabitants in the Central Province. The aim of this study was to the determination of water quality and aquatic life health quality in a selected region of Mahaweli River. Six sampling locations (Site 1: 7° 16' 50" N, 80° 40' 00" E; Site 2: 7° 16' 34" N, 80° 40' 27" E; Site 3: 7° 16' 15" N, 80° 41' 28" E; Site 4: 7° 14' 06" N, 80° 44' 36" E; Site 5: 7° 14' 18" N, 80° 44' 39" E; Site 6: 7° 13' 32" N, 80° 46' 11" E) with various anthropogenic activities at bank of the river were selected for a period of three months from Tennekumbura Bridge to Victoria Reservoir. Temperature, pH, Electrical Conductivity (EC), Total Dissolved Solids (TDS), Dissolved Oxygen (DO), 5-day Biological Oxygen Demand (BOD5), Total Suspended Solids (TSS), hardness, the concentration of anions, and metal concentration were measured according to the standard methods, as physicochemical parameters. Planktons were considered as biological parameters. Using a plankton net (20 µm mesh size), surface water samples were collected into acid washed dried vials and were stored in an ice box during transportation. Diversity and abundance of planktons were identified within 4 days of sample collection using standard manuals of plankton identification under the light microscope. Almost all the measured physicochemical parameters were within the CEA standards limits for aquatic life, Sri Lanka Standards (SLS) or World Health Organization’s Guideline for drinking water. Concentration of orthophosphate ranged between 0.232 to 0.708 mg L-1, and it has exceeded the standard limit of aquatic life according to CEA guidelines (0.400 mg L-1) at Site 1 and Site 2, where there is high disturbance by cultivations and close households. According to the Pearson correlation (significant correlation at p < 0.05), it is obvious that some physicochemical parameters (temperature, DO, TDS, TSS, phosphate, sulphate, chloride fluoride, and sodium) were significantly correlated to the distribution of some plankton species such as Aulocoseira, Navicula, Synedra, Pediastrum, Fragilaria, Selenastrum, Oscillataria, Tribonema and Microcystis. Furthermore, species that appear in blooms (Aulocoseira), organic pollutants (Navicula), and phosphate high eutrophic water (Microcystis) were found, indicating deteriorated water quality in Mahaweli River due to agricultural activities, solid waste disposal, and release of domestic effluents. Therefore, it is necessary to improve environmental monitoring and management to control the further deterioration of water quality of the river.

Keywords: bio indicator, environmental variables, planktons, physicochemical parameters, water quality

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Authors: Divyani Redhu, Manisha Rathaur

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India has emerged as a very lucrative market for the smartphones in a very short span of time. The number of smartphone users here is growing massively with each passing day. Also, the expansion of internet services to far corners of the nation has also given a push to the smartphone revolution in India. Millennial, also known as Generation Y or the Net Generation is the generation born between the early 1980s and mid-1990s (some definitions extending further to early 2000s). Spanning roughly over 15 years, different social classes, cultures, and continents; it is irrational to imagine that millennial have a unified identity. But still, it cannot be denied that the growing millennial population is not only young but is highly tech-savvy too. It is not just the appearance of the device that today; we call it ‘smart’. Rather, it is the numerous tasks and functions that it can perform which has led its name to evolve as that of a ‘smartphone’. From usual tasks that were earlier performed by a simple mobile phone like making calls, sending messages, clicking photographs, recording videos etc.; today, the time has come where most of our day – to – day tasks are being taken care of by our all-time companion, i.e. smartphones. From being our alarm clock to being our note-maker, from our watch to our radio, our book-reader to our reminder, smartphones are present everywhere. Smartphone has now become an essential device for particularly the millennial to communicate not only with their friends but also with their family, colleagues, and teachers. The study by the researchers would be quantitative in nature. For the same, a survey would be conducted in particularly the capital of India, i.e. Delhi and the National Capital Region (NCR), which is the metropolitan area covering the entire National Capital Territory of Delhi and urban areas covering states of Haryana, Uttarakhand, Uttar Pradesh and Rajasthan. The tool of the survey would be a questionnaire and the number of respondents would be 200. The results derived from the study would primarily focus on the increasing reach of smartphones in India, smartphones as technological innovation and convergent tools, smartphone usage pattern of millennial in India, most used applications by the millennial, the average time spent by them, the impact of smartphones on the personal interactions of millennial etc. Thus, talking about the smartphone technology and the millennial in India, it would not be wrong to say that the growth, as well as the potential of the smartphones in India, is still immense. Also, very few technologies have made it possible to give a global exposure to the users and smartphone, if not the only one is certainly an immensely effective one that comes to the mind in this case.

Keywords: Delhi – NCR, India, millennial, smartphone

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Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

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Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

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Authors: Martin Cai, Khadijah B. Hashim, Leng Leo, Edmund F. Tian

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Analysis of traditional Chinese medicinal (TCM) supplements has always been a laborious task, particularly in the case of multi‐ingredient formulations. Traditionally, herbal extracts are analysed using one or few markers compounds. In the recent years, however, pharmaceutical companies are introducing health supplements of TCM active ingredients to cater to the needs of consumers in the fast-paced society in this age. As such, new problems arise in the aspects of composition identification as well as quality analysis. In most cases of products or supplements formulated with multiple TCM herbs, the chemical composition, and nature of each raw material differs greatly from the others in the formulation. This results in a requirement for individual analytical processes in order to identify the marker compounds in the various botanicals. Thin-layer Chromatography (TLC) is a simple, cost effective, yet well-regarded method for the analysis of natural products, both as a Pharmacopeia-approved method for identification and authentication of herbs, and a great analytical tool for the discovery of chemical compositions in herbal extracts. Recent technical advances introduced High-Performance TLC (HPTLC) where, with the help of automated equipment and improvements on the chromatographic materials, both the quality and reproducibility are greatly improved, allowing for highly standardised analysis with greater details. Here we report an industrial consultancy project with ONI Global Pte Ltd for the analysis of LAC Liver Protector, a TCM formulation aimed at improving liver health. The aim of this study was to identify 4 key components of the supplement using HPTLC, following protocols derived from Chinese Pharmacopeia standards. By comparing the TLC profiles of the supplement to the extracts of the herbs reported in the label, this project proposes a simple and cost-effective analysis of the presence of the 4 marker compounds in the multi‐ingredient formulation by using 4 different HPTLC methods. With the increasing trend of small and medium-sized enterprises (SMEs) bringing natural products and health supplements into the market, it is crucial that the qualities of both raw materials and end products be well-assured for the protection of consumers. With the technology of HPTLC, science can be incorporated to help SMEs with their quality control, thereby ensuring product quality.

Keywords: traditional Chinese medicine supplement, high performance thin layer chromatography, active ingredients, product quality

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Authors: Shailja Thakur

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In this paper it is shown that how farmers are suffering from all sides including vagaries of weather then price fluctuations, demand supply constraints, poor soil health etc. Also the ICT can prove to be of great help if incorporated rightly into Indian agriculture. Some innovative ways to reward farmers and distribution of subsidies to them can improve the current scenario.

Keywords: cost of farming, information and communication technology, innovative steps, roof gardening, vermicomposting

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Authors: Saira Iqbal

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Occupational Health and Safety issues nowadays have become an important esteem in the context of Industrial Production. This study is designed to measure the workplace hazards at Kohinoor Energy Limited. Mainly focused hazards were Heat Stress, Noise Level, Light Level and Ergonomics. Measurements for parameters like Wet, Dry, Globe, WBGTi and RH% were taken directly by visiting the Study Area. The temperature in Degrees was recoded at Control Room and Engine Hall. Highest Temperature was recoded in Engine Hall which was about 380C. Efforts were made to record emissions of Noise Levels from the main area of concern like Engines in Engine hall, parking area, and mechanical workshop. Permissible level for measuring Noise is 85 and its Unit of Measurement is dB (A). In Engine Hall Noise was very high which was about 109.6 dB (A) and that level was exceeding the limits. Illumination Level was also recorded at different areas of Power Plant. The light level was though under permissible limits but in some areas like Engine Hall and Boiler Room, level of light was very low especially in Engine Hall where the level was 29 lx. Practices were performed for measuring hazards in context of ergonomics like extended reaching, deviated body postures, mechanical stress, and vibration exposures of the worker at different units of plants by just observing workers during working hours. Since KEL is ISO 8000 and 14000 certified, the researcher found no serious problems in the parameter Ergonomics however it was a common scenario that workers were reluctant to apply PPEs.

Keywords: workplace hazards, heat hazard, noise hazard, illumination, ergonomics

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Authors: Vitheejongjaroen P., Jaisin Y., Pachekrepapol U., Taweechotipatr M.

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Lactic acid bacteria (LAB) are the most common type of microorganisms that had been used as probiotics also known for many beneficial health effects. The antioxidant activity of LAB is associated with numerous health-protective effects. This research aimed to investigate the antioxidant activity of lactic acid bacteria isolated from Thai sour pork sausage for their application in fermented milk products. Antioxidant activity determined by DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging assay showed that the isolate FN33-7, as 1 of 8 isolated exhibited scavenging activity in intact cell 5-7%, and supernatant 13-16%, intracellular cell free extract 42-48% respectively. This isolate was identified using 16S ribosomal DNA sequence analysis as Lactobacillus plantarum. The effect of milk fermented with L. plantarum FN33-7 on microbial count, pH and syneresis was assessed during refrigerated storage period of 28 days. The strain showed increased viability, pH level decreased, while syneresis increased. These results are similar to dairy products fermented with commercial starter cultures. Additionally, microstructure analysis of fermented milk by fluorescent microscopy showed that curd structure appeared to be dense and less porous in this fermented milk than commercial yogurt. The results of this study indicated that L. plantarum FN33-7 was a good probiotic candidate to be used in cultured milk products to reduce the risk of diseases caused by oxidative stress.

Keywords: Lactobacillus plantarum, probiotics, free radical, antioxidant, oxidative stress, fermented milk products

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Authors: Calassandra Nwokoro

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Introduction: The nursing profession requires a lot of commitment, effort, and time to efficiently manage patients and provide them quality healthcare services, this work load may eventually cause the nurses to become burned out and experience psychological distress. This study assessed the prevalence of burnout, risk factors, and the coping strategies among nurses working in Lagos University Teaching Hospital (LUTH), Lagos state, Nigeria. Methodology: A descriptive cross-sectional study design was conducted among 308 nurses working in LUTH. Simple random sampling was used in selection of study respondents. The questionnaire comprised three parts; the sociodemographic characteristics of the respondents, the extent of burnout syndrome using the Maslach Burnout Inventory, and the coping strategies used among the respondents using the BRIEF-COPE Inventory. Results: This study revealed relatively high levels of burnout among the nurses in LUTH with a prevalence of 16.9%, 31.2% and 20.1% for high emotional exhaustion, high depersonalization and reduced professional accomplishment respectively. It also showed that burnout was significantly associated with long working hours. Religion was found to be the most commonly used coping strategy overall, while emotional support was the most frequently used coping strategy among nurses who had burnout. Conclusion: This study has revealed a relatively high prevalence of burnout among the nurses in Lagos University Teaching Hospital. In order to minimize the negative health impacts of burnout, the government should collaborate with psychologists and psychiatrists to implement regular stress management and stress inoculation programs for nurses and other health professionals in the country.

Keywords: burnout, nurses, coping strategies, healthcare

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Authors: Gayan Mapitiya

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Maintaining good occupational health and safety (OHS) performance is significant at the coalface, especially in industries such as mining, power, and construction. Coalface workers are vulnerable to high OHS risks such as working at heights, working with mobile plants and vehicles, working with underground and above ground services, chemical emissions, radiation hazards and explosions at everyday work. To improve OHS performance of workers, OHS key performance indicators (KPIs) (for example, lost time injuries (LTI), serious injury frequency rate (SIFR), total reportable injury frequency rate (TRIFR) and number of near misses) are widely used by managers in making OHS business decisions such as investing in safety equipment and training programs. However, in many organizations, workers at the coalface hardly see any relevance or value addition of OHS KPIs to their everyday work. Therefore, the aim of the study was to understand why coalface workers perceive that OHS KPIs are not practically relevant to their jobs. Accordingly, this study was conducted as a qualitative case study focusing on a large electricity and gas firm in Australia. Semi-structured face to face interviews were conducted with selected coalface workers to gather data on their attitude towards OHS KPIs. The findings of the study revealed that workers at the coalface generally have no understanding of the purpose of KPIs, the meaning of each KPI, origin of KPIs, and how KPIs are correlated to organizational performance. Indeed, KPIs are perceived as ‘meaningless obstacles’ imposed on workers by managers without a rationale. It is recommended to engage coalface workers (a fair number of representatives) in both KPIs setting and revising processes while maintaining a continuous dialogue between workers and managers in regards OHS KPIs.

Keywords: KPIs, coalface, OHS risks, case-study

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Authors: Rubisha Adhikari, Rajani Shah

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Introduction: Aging is a natural, global and inevitable phenomenon every single person has to go through, and nobody can escape the process. One of the emerging challenges to public health is to improve the quality of later years of life as life expectancy continues to increase. Quality of life (QoL) has grown to be a key goal for many public health initiatives. Population aging has become a global phenomenon as they are growing more quickly in emerging nations than they are in industrialized nations, leaving minimal opportunities to regulate the consequences of the demographic shift. Methods: A community-based descriptive analytical approach was used to examine the quality of life and associated factors among elderly people. A mixed method was chosen for the study. For the quantitative data collection, a household survey was conducted using the WHOQOL-OLD tool. In-depth interviews were conducted among twenty participants for qualitative data collection. Data generated through in-depth interviews were transcribed verbatim. In-depth interviews lasted about an hour and were audio recorded. The in-depth interview guide had been developed by the research team and pilot-tested before actual interviews. Results: This study result showed the association between quality of life and socio-demographic variables. Among all the variables under socio-demographic variable of this study, age (ꭓ2=14.445, p=0.001), gender (ꭓ2=14.323, p=<0.001), marital status (ꭓ2=10.816, p=0.001), education status (ꭓ2=23.948, p=<0.001), household income (ꭓ2=13.493, p=0.001), personal income (ꭓ2=14.129, p=0.001), source of personal income (ꭓ2=28.332,p=<0.001), social security allowance (ꭓ2=18.005,p=<0.001), alcohol consumption (ꭓ2=9.397,p=0.002) are significantly associated with quality of life of elderly. In addition, affordability (ꭓ2=12.088, p=0.001), physical activity (ꭓ2=9.314, p=0.002), emotional support (ꭓ2=9.122, p=0.003), and economic support (ꭓ2=8.104, p=0.004) are associated with quality of life of elderly people. Conclusion: In conclusion, this mixed method study provides insight into the attributes of the quality of life of elderly people in Nepal and similar settings. As the geriatric population is growing in full swing, maintaining a high quality of life has become a major challenge. This study showed that determinants such as age, gender, marital status, education status, household income, personal income, source of personal income, social security allowance and alcohol consumption, economic support, emotional support, affordability and physical activity have an association with quality of life of the elderly.

Keywords: ageing, chitwan, elderly, health status, quality of life

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Authors: Lamia Ismayil

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The COVID-19 pandemic has drastically changed the everyday lives of people all over the world. This pandemic affects heavily the lifestyle of people in different aspects of life, including eating habits. The objective of this paper is to study the impact of the COVID-19 pandemic on key factors affecting food habits among the Community College of Qatar (CCQ) students. Method: The research is a cross-sectional survey that deployed a questionnaire among 217 CCQ students. Results: The results showed that 47.5% of the respondents were male and 52.5% female. In our previous study about 30% percentage obesity with a BMI of 30-35 was shown. Surprisingly, during the pandemic, the obesity percentage remains almost the same, but the BMI range jumped to 30-46. The nutritional knowledge of CCQ students is at an average level. Besides, during pandemic the personal eating habits continued to be imbalanced and getting unhealthier than in the pre-pandemic period. Regarding the key factors that could affect eating habits, most of the respondents reported that during the pandemic in the absence of restaurants they had daily meals with their families, and had a lack of physical activity. Besides, most of the respondents agree that they gained weight during the pandemic. These findings indicate that the pandemic changed the food habits and the lifestyle of Qatari students. Accordingly, increasing the awareness among college students (and Qatari community at large) is recommended. College students can be given some recommendations related to healthy eating tips to overcome the effect of pandemic on their health status. The detailed comparative analysis between pre- and post-pandemic eating habits of students can help reveal the main differences and give effective guidance to improve body composition and health status of students.

Keywords: food habits, BMI, obesity, COVID-19, nutritional knowledge, community college of Qatar, pandemic

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Authors: Hasibe Caballero-Gomez, Richard Pepino

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Childhood lead poisoning is an issue that continues to plague major U.S. cities. Lead poisoning has been linked to decreases in academic achievement and IQ at levels as low as 5 ug/dL. Despite efforts from the Philadelphia Health Department to curtail systemic childhood lead poisoning, children continue to be identified with elevated blood lead levels (EBLLs) above the CDC reference level for diagnosis. This problem disproportionately affects low-income Black communities. At the moment, remediation is costly, and with the current policies in place, comprehensive remediation seems unrealistic. This research investigates community engagement policy and the ways pre-exisiting resources in target communities can be adjusted to decrease childhood lead poisoning. The study was done with two methods: content analysis and case studies. The content analysis includes 12 interviews from stakeholders and five published policy recommendations. The case studies focus on Baltimore, Chicago, Rochester, and St. Louis, four cities with significant childhood lead poisoning. Target communities were identified by mapping five factors that indicate a higher risk for lead poisoning. Seven priority zipcodes were identified for the model developed in this study. For these urban centers, 28 policy solutions and suggestions were identified, with three being identified at least four times in the content analysis and case studies. These three solutions create an interdependent model that offers increased community awareness and engagement with the issue that could potentially improve health and social outcomes for at-risk children.

Keywords: at-risk populations, community engagement, environmental justice, policy translation

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Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan

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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.

Keywords: audit, clinical, radiotherapy, improving functionality

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