Search results for: public health system

Authors: Miguel García-Ferrús, Yolanda Domínguez, M Angeles Castillo, M Antonia Ferrús, Ana Jiménez-Belenguer

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Antibiotic resistance is a growing public health concern worldwide, and it is now regarded as a critical issue within the "One Health" approach that affects human and animal health, agriculture, and environmental waste management. This concept focuses on the interconnected nature of human, animal and environmental health, and WHO highlights zoonotic diseases, food safety, and antimicrobial resistance as three particularly relevant areas for this framework. Fresh vegetables are garnering attention in the food chain due to the presence of pathogens and because they can act as a reservoir for Antibiotic Resistance Bacteria (ARB) and Antibiotic Resistance Genes (ARG). These fresh products are frequently consumed raw, thereby contributing to the spread and transmission of antibiotic resistance. Therefore, the aim of this research was to study the microbiological quality, the prevalence of ARB, and their role in the dissemination of ARG in fresh vegetables intended for human consumption. For this purpose, 102 samples of fresh vegetables (30 lettuce, 30 cabbage, 18 strawberries and 24 spinach) from different retail establishments in Valencia (Spain) have been analyzed to determine their microbiological quality and their role in spreading ARB and ARG. The samples were collected and examined according to standardized methods for total viable bacteria, coliforms, Shiga toxin-producing Escherichia coli (STEC), Listeria monocytogenes and Salmonella spp. Isolation was made in culture media supplemented with antibiotics (cefotaxime and meropenem). A total of 239 strains resistant to beta-lactam antibiotics (Third-Generation Cephalosporins and Carbapenems) were isolated. Thirty Gram-negative isolates were selected and biochemically identified or partial sequencing of 16S rDNA. Their sensitivity to 12 antibiotic discs was determined using the Kirby-Bauer disc diffusion technique to different therapeutic groups. To determine the presence of ARG, PCR assays for the direct sample and selected isolate DNA were performed for main expanded spectrum beta-lactamase (ESBL)-, carbapenemase-encoding genes and plasmid-mediated quinolone resistance genes. From the total samples, 68% (24/24 spinach, 28/30 lettuce and 17/30 cabbage) showed total viable bacteria levels over the accepted standard 10(2)-10(5) cfu/g range; and 48% (24/24 spinach, 19/30 lettuce and 6/30) showed coliforms levels over the accepted standard 10(2)-10(4) cfu/g range. In 9 samples (3/24 spinach, 3/30 lettuce, 3/30 cabbage; 9/102 (9%)) E. coli levels were higher than the standard 10(3) cfu/g limit. Listeria monocytogenes, Salmonella and STEC have not been detected. Six different bacteria species were isolated from samples. Stenotrophomonas maltophilia (64%) was the prevalent species, followed by Acinetobacter pitii (14%) and Burkholderia cepacia (7%). All the isolates were resistant to at least one tested antibiotic, including meropenem (85%) and ceftazidime (46%). Of the total isolates, 86% were multidrug-resistant and 68% were ESBL productors. Results of PCR showed the presence of resistance genes to beta-lactams blaTEM (4%) and blaCMY-2 (4%), to carbapenemes blaOXA-48 (25%), blaVIM (7%), blaIMP (21%) and blaKPC (32%), and to quinolones QnrA (7%), QnrB (11%) and QnrS (18%). Thus, fresh vegetables harboring ARB and ARG constitute a potential risk to consumers. Further studies must be done to detect ARG and how they propagate in non-medical environments.

Keywords: ESBL, β-lactams, resistances, fresh vegetables.

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Authors: Mahnaz Sanjari, Sedigheh Salemi, Mohammad Mirzabeigi

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Nowadays, the world is facing a crisis of workforce and one of the most striking examples is the shortage of nurses. Nursing workforce productivity is related by various factors such as absenteeism, professional effectiveness and quality care. This cross-sectional study was conducted in 700 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 33 questions and 4 sub categories such as human resource, education and management. The reliability was evaluated by Cronbach's alpha (α=0/85). Statistical analyzes were performed, using SPSS version 16. The result showed that nurses emphasized on "respect to nurse-to-bed ratio" and less importance item was "using less experienced nurse". In addition, another important factor in clinical productivity is "Proper physical structure and amenities","good communication with colleagues" and "having good facilities". Also, "human resources at all levels of standard", "promoting on merit" and "well defined relationship in health system" are another important factors in productivity from nurse` view. The main managerial factor is "justice between employees" and the main educational component of productivity is “updating nursing knowledge”. The results show that more than half of the participants emphasized on the management and educational factors. Productivity as one of the main part of the health care quality leads to appropriate use of human and organizational resources, reduce cost services, and organizational development.

Keywords: productivity, nursing services, workforce, cost services

Procedia PDF Downloads 335

Authors: Yan Yan, Erhong Sun, Lin Peng, Xuchun Ye

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Aims: The present study aimed to explore Intensive Care Unit (ICU) nurses’ mental workload (MWL) and associated factors with it in performing human-machine tasks. Background: A wide range of emerging technologies have penetrated widely in the field of health care, and ICU nurses are facing a dramatic increase in nursing human-machine tasks. However, there is still a paucity of literature reporting on the general MWL of ICU nurses performing human-machine tasks and the associated influencing factors. Methods: A cross-sectional survey was employed. The data was collected from January to February 2021 from 9 tertiary hospitals in 6 provinces (Shanghai, Gansu, Guangdong, Liaoning, Shandong, and Hubei). Two-stage sampling was used to recruit eligible ICU nurses (n=427). The data were collected with an electronic questionnaire comprising sociodemographic characteristics and the measures of MWL, self-efficacy, system usability, and task difficulty. The univariate analysis, two-way analysis of variance (ANOVA), and a linear mixed model were used for data analysis. Results: Overall, the mental workload of ICU nurses in performing human-machine tasks was medium (score 52.04 on a 0-100 scale). Among the typical nursing human-machine tasks selected, the MWL of ICU nurses in completing first aid and life support tasks (‘Using a defibrillator to defibrillate’ and ‘Use of ventilator’) was significantly higher than others (p < .001). And ICU nurses’ MWL in performing human-machine tasks was also associated with age (p = .001), professional title (p = .002), years of working in ICU (p < .001), willingness to study emerging technology actively (p = .006), task difficulty (p < .001), and system usability (p < .001). Conclusion: The MWL of ICU nurses is at a moderate level in the context of a rapid increase in nursing human-machine tasks. However, there are significant differences in MWL when performing different types of human-machine tasks, and MWL can be influenced by a combination of factors. Nursing managers need to develop intervention strategies in multiple ways. Implications for practice: Multidimensional approaches are required to perform human-machine tasks better, including enhancing nurses' willingness to learn emerging technologies actively, developing training strategies that vary with tasks, and identifying obstacles in the process of human-machine system interaction.

Keywords: mental workload, nurse, ICU, human-machine, tasks, cross-sectional study, linear mixed model, China

Procedia PDF Downloads 55

Authors: Suneet Jagdev

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Rapid urbanization has resulted in informal settlements on the periphery of nearly all big cities in the developing world due to lack of affordable housing options in the city. Residents of these communities have to travel long distances to get to work or search for jobs in these cities, and women, children and elderly people are excluded from urban opportunities. Affordable and safe public transport facilities can help them expand their possibilities. The aim of this research is to identify social capital as another important element of livable cities that can be protected and nurtured through transit-oriented development, as a tool to provide real resources that can help these transit-oriented communities become self-sustainable. Social capital has been referred to the collective value of all social networks and the inclinations that arise from these networks to do things for each other. It is one of the key component responsible to build and maintain democracy. Public spaces, pedestrian amenities and social equity are the other essential part of Transit Oriented Development models that will be analyzed in this research. The data has been collected through the analysis of several case studies, the urban design strategies implemented and their impact on the perception and on the community´s experience, and, finally, how these focused on the social capital. Case studies have been evaluated on several metrics, namely ecological, financial, energy consumption, etc. A questionnaire and other tools were designed to collect data to analyze the research objective and reflect the dimension of social capital. The results of the questionnaire indicated that almost all the participants have a positive attitude towards this dimensions of building a social capital with the aid of transit-oriented development. Statistical data of the identified key motivators against against demographic characteristics have been generated based on the case studies used for the paper. The findings suggested that there is a direct relation between urbanization, transit-oriented developments, and social capital.

Keywords: better opportunities, low-income settlements, social capital, social inclusion, transit oriented development

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Authors: Harikrishna Yadav Nanganuru, Narasimhulu Korrapati

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Over the past many years, many sites in the world have been contaminated with heavy metals, which are the largest class of contaminants. Lead is one of the toxic heavy metals contaminated in the environment. Lead is not biodegradable, that’s why it is accumulated in the human body and impacts all the systems of the human body when it has been taken by humans. The accumulation of lead in the water environment has been showing adverse effects on the public health. So the removal of lead from the water environment by the biosorption process, which is emerged as a potential method for the lead removal, is an efficient approach. This work was focused to examine the removal of Lead [Pb (II)] ions from aqueous solution and effluent from battery industry. Lead contamination in water is a widespread problem throughout the world and mainly results from lead acid battery manufacturing effluent. In this work, isolated bacteria from wastewater of lead acid battery industry has been utilized for the removal of lead. First effluent from the lead acid battery industry was characterized by the inductively coupled plasma atomic emission spectrometry (ICP – AES). Then the bacteria was isolated from the effluent and used it’s immobilized dead mass for the biosorption of lead. Scanning electron microscopic (SEM) and Atomic force microscopy (AFM) studies clearly suggested that the Lead (Pb) was adsorbed efficiently. The adsorbed percentage of lead (II) from waste was 97.40 the concentration of lead (II) is measured by Atomic Absorption Spectroscopy (AAS). From the result of AAS it can be concluded that immobilized isolated dead mass was well efficient and useful for biosorption of lead contaminated waste water.

Keywords: biosorption, ICP-AES, lead (Pb), SEM

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Authors: Fines Fatimah, SH. MH.

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Indonesia is one of the countries that has ratified the UNCRPD (United Nations Convention on the Rights of Persons with Disabilities). The ratification of this convention brings consequences on the adjustment of national legislation with the UNCRPD convention, where this ratification at the same time is a measure in the eyes of the international community that a state party could be consistent with the issues and problems of disability. Persons with disabilities often have little access to justice when they are forced to deal with the criminal justice system. Pursuit of justice through litigation are often not in their favor, therefore without any awareness of law enforcement/awareness of disability will further complicate access to justice for persons with disabilities. Under Article 13 of the UNCRPD, it appeared that the convention requires ratifying states to guarantee equal opportunity and treatment in justice for persons with disabilities. The States should also ensure that any judicial rules must be adapted to the circumstances of persons with disabilities so that people with disabilities can fully participate in all stages of the trial court and, for example, as a witness. Finally, the state must provide training to understand these persons with disabilities (for those who work in the judiciary institution such as police or prison officials). Further, this paper aims to describe problem faced by persons with intellectual disabilities to access justice in Indonesian Criminal Justice System. This paper tries to find and propose the alternative solutions to promote the quality of law enforcement in Indonesia, especially for persons with intellectual disabilities.

Keywords: access to justice, Indonesian criminal justice system, intellectual disability, ratifying states

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Authors: Zakiya Shireen, Sujin B. Babu

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Irreversible diffusion-limited cluster aggregation (DLCA) of binary sticky spheres was simulated by modifying the Brownian Cluster Dynamics (BCD). We randomly distribute N spheres in a 3D box of size L, the volume fraction is given by Φtot = (π/6)N/L³. We identify NA and NB number of spheres as species A and B in our system both having identical size. In these systems, both A and B particles undergo Brownian motion. Irreversible bond formation happens only between intra-species particles and inter-species interact only through hard-core repulsions. As we perform simulation using BCD we start to observe binary gels. In our study, we have observed that species B always percolate (cluster size equal to L) as expected for the monomeric case and species A does not percolate below a critical ratio which is different for different volume fractions. We will also show that the accessible volume of the system increases when compared to the monomeric case, which means that species A is aggregating inside the cage created by B. We have also observed that for moderate Φtot the system undergoes a transition from flocculation region to percolation region indicated by the change in fractal dimension from 1.8 to 2.5. For smaller ratio of A, it stays in the flocculation regime even though B have already crossed over to the percolation regime. Thus, we observe two fractal dimension in the same system.

Keywords: BCD, fractals, percolation, sticky spheres

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Authors: Wang Yanze

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Architectural design results from the interaction between space and drawing. Stemming from the Beaux-Arts architectural education, drawing kept its dominant position in teaching and learning process for centuries. However, this education system is being challenged in the present time due to the development of the times. Based on the architectural education of China after 1949, a brief introduction to the history of the evolution of the design concept and drawing is given in this paper. Illustrating with the reference to the students’ works in Nanjing Institute of Technology, the predecessor of Southeast University, in China, the paper analyses the relationship between concept and representation, as well as the participation of Space, the modernism discourse. This process contains the transmission of the character of architects, the renovation of drawing skills and the profound social background. With different purposes, the emphasis on representation tends to be combined with the operation on space, and the role of drawing in architectural design process also changes. Therefore, based on the continuity of the traditional architectural education system, the discussion on the “Drawing of Space” in contemporary education system is proposed.

Keywords: architectural education, beaux-arts, drawing, modernism

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Authors: Ipek Krom, Nurdan Tumbek Tekeoglu

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In our globalizing world increased competition between cities have resulted in expanding investments in marketing activities. In order to promote tourism and reinvestments, the cities have been using marketing activities to create more attractive sites and make use of their resources more efficiently. In becoming a branded city marketing activities play a major role in building brand value, which in turn results in the attraction of newcomers, revisits, settlements, reinvestments and the development of the city. This paper focuses on the Istanbul brand, which carries an important role in the promotion of Turkey as being its cultural, economic and financial center. As one of the most historical and appealing metropolitans in the world with remains of ancient civilizations, Istanbul has attracted 11 million 843 thousand tourists in 2014. Increasing number of marketing activities developed by numerous actors of private and public sector are among the reasons why tourists prefer Istanbul. Among these reasons we can list the increasing number of hotels, developed infrastructure and better transportation, modern shopping malls, international festivals, exportation of Turkish TV series, gastronomy investments, congress tourism, health tourism, student exchange programs, expatriation opportunities, recreational activities and new tourism destinations. In this paper we explore the marketing activities in Istanbul in order to make the city of the most visited metropolitans in the world. Decision making people in the tourism sector have been interviewed to provide better insight to the addressed topics.

Keywords: brand cities, marketing, tourism in istanbul, tourism marketing

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Authors: Emanuele Bonamente, Andrea Aquino

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This study presents an innovative design for geothermal heat pumps with the goal of maximizing the system efficiency (COP - Coefficient of Performance), reducing the soil use (e.g. length/depth of geothermal boreholes) and initial investment costs. Based on experimental data obtained from a two-year monitoring of a working prototype implemented for a commercial building in the city of Perugia, Italy, an upgrade of the system is proposed and the performance is evaluated via CFD simulations. The prototype was designed to include a thermal heat storage (i.e. water), positioned between the boreholes and the heat pump, acting as a flywheel. Results from the monitoring campaign show that the system is still capable of providing the required heating and cooling energy with a reduced geothermal installation (approx. 30% of the standard length). In this paper, an optimization of the system is proposed, re-designing the heat storage to include phase change materials (PCMs). Two stacks of PCMs, characterized by melting temperatures equal to those needed to maximize the system COP for heating and cooling, are disposed within the storage. During the working cycle, the latent heat of the PCMs is used to heat (cool) the water used by the heat pump while the boreholes independently cool (heat) the storage. The new storage is approximately 10 times smaller and can be easily placed close to the heat pump in the technical room. First, a validation of the CFD simulation of the storage is performed against experimental data. The simulation is then used to test possible alternatives of the original design and it is finally exploited to evaluate the PCM-storage performance for two different configurations (i.e. single- and double-loop systems).

Keywords: geothermal heat pump, phase change materials (PCM), energy storage, renewable energies

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Authors: Emmanuel Kamal Aziz Saba, Hussein Al-Moghazy Sultan

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The aim of this study was to evaluate clinically and electro physiologically the autonomic nervous system changes associated with rheumatoid arthritis (RA). The present study included 25 patients with RA [22 women (88%)] and 30 apparently healthy control subjects [27 women (90%)]. A thorough clinical examination was carried out. Disease activity and functional disability were assessed. Tests for assessment of autonomic functions include active and passive orthostatic stress tests, and sympathetic skin response (SSR). The presence of abnormality in 2 tests or more was a clue for the presence of autonomic neuropathy (AN). Sural sensory nerve conduction study and posterior tibial motor nerve conduction study were done. There was a statistically significant decrease in standing systolic and diastolic blood pressure (BP) components of the active orthostatic stress test and SSR amplitude as well as statistically significant prolongation of SSR latency of RA patients when compared to control. Three patients (12%) had clinical symptoms suggestive of AN; increased to 14 patients (56 %) when orthostatic stress tests and SSR were utilized. There were no statistically significant differences between patients with different disease activity score 28 with 4 variables grades of RA activity and SSR latency and amplitude. There were no statistically significant differences between patients with different Stanford Health Assessment Questionnaire Disability Index grades of RA functional disability and SSR latency and amplitude. In conclusion, autonomic neuropathy is a common extra-articular manifestation of RA affecting sympathetic and parasympathetic fibers.

Keywords: autonomic neuropathy, orthostatic stress test, rheumatoid arthritis, sympathetic skin response

Procedia PDF Downloads 345

Authors: Aliyu Shitu Said

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One of the major setbacks of every society is the proliferation of crimes that results in the inducement of fear, destruction of properties and loss of lives of people. The rising incidence of crime and general insecurity rate in the society and the inability of the policing agencies to curtail the menace necessitated the introduction of community policing in order to have a collaborative effort with community members in addressing the problem of crime. Thus, this study assessed the impact of community policing in crime prevention and control in Fagge Local Government area, Kano State, Nigeria. The study also examined the elements, roles, and challenges of community policing in crime prevention and control in the study area. The study adopted Broken Window and Routine Activity theories as frame of analysis. Mixed methods of data collection (quantitative and qualitative) were utilized for the study. Multi stage and purposive sampling techniques were adopted in selection of the study population. A total of 308 respondents were sampled for the study. These include 300 members of the public who were sampled through a multi stage sampling for questionnaire administration and 8 other respondents who were purposively sampled for in-depth interview. Findings of the study revealed that community policing has significant impact on crime prevention and control in the study area. Findings of the study further revealed that the elements and roles of community policing are effective and fully utilized, and there is cordial relationship between the police and the community members in the study area. This study therefore recommends that government should provide adequate support to community policing programmes and give more awareness to public, so as to boost the morale of the community in having a collaborative effort with the police in crime prevention and control.

Keywords: community, policing, crime, prevention, control

Procedia PDF Downloads 56

Authors: Domingos Viegas, Miguel Almeida, Carmen Rocha, Ilda Novo, Yolanda Luna

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Forest fires along the more than 1200km of the Spanish-Portuguese border are more and more frequent, currently achieving around 2000 fire events per year. Some of these events develop to large international wildfire requiring concerted operations based on shared information between the two countries. The fire event of Valencia de Alcantara (2003) causing several fatalities and more than 13000ha burnt, is a reference example of these international events. Currently, Portugal and Spain have a specific cross-border cooperation protocol on wildfires response for a strip of about 30km (15 km for each side). It is recognized by public authorities the successfulness of this collaboration however it is also assumed that this cooperation should include more functionalities such as the development of a common risk information system for transboundary fire events. Since Portuguese and Spanish authorities use different approaches to determine the fire risk indexes inputs and different methodologies to assess the fire risk, sometimes the conjoint firefighting operations are jeopardized since the information is not harmonized and the understanding of the situation by the civil protection agents from both countries is not unique. Thus, a methodology aiming the harmonization of the fire risk calculation and perception by Portuguese and Spanish Civil protection authorities is hereby presented. The final results are presented as well. The fire risk index used in this work is the Canadian Fire Weather Index (FWI), which is based on meteorological data. The FWI is limited on its application as it does not take into account other important factors with great effect on the fire appearance and development. The combination of these factors is very complex since, besides the meteorology, it addresses several parameters of different topics, namely: sociology, topography, vegetation and soil cover. Therefore, the meaning of FWI values is different from region to region, according the specific characteristics of each region. In this work, a methodology for FWI calibration based on the number of fire occurrences and on the burnt area in the transboundary regions of Portugal and Spain, in order to assess the fire risk based on calibrated FWI values, is proposed. As previously mentioned, the cooperative firefighting operations require a common perception of the information shared. Therefore, a common classification of the fire risk for the fire events occurred in the transboundary strip is proposed with the objective of harmonizing this type of information. This work is integrated in the ECHO project SpitFire - Spanish-Portuguese Meteorological Information System for Transboundary Operations in Forest Fires, which aims the development of a web platform for the sharing of information and supporting decision tools to be used in international fire events involving Portugal and Spain.

Keywords: data harmonization, FWI, international collaboration, transboundary wildfires

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Authors: Isha Sharawat, R. P. Dahiya, T. R. Sreekrishnan

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One of the environmental challenges in India is urban wastewater management as regulations and infrastructural development has not kept pace with the urbanization and growing population. The quality of life of people is also improving with the rapid growth of the gross domestic product. This has contributed to the enhancement in the per capita water requirement and consumption. More domestic water consumption generates more wastewater. The scarcity of potable water is making the situation quite serious, and water supply has to be regulated in most parts of the country during summer. This requires elaborate and concerted efforts to efficiently manage the water resources and supply systems. In this article, a system dynamics modelling approach is used for estimating the water demand and wastewater generation in a district headquarter city of North India. Projections are made till the year 2035. System dynamics is a software tool used for formulation of policies. On the basis of the estimates, policy scenarios are developed for sustainable development of water resources in conformity with the growing population. Mitigation option curtailing the water demand and wastewater generation include population stabilization, water reuse and recycle and water pricing. The model is validated quantitatively, and sensitivity analysis tests are carried out to examine the robustness of the model.

Keywords: system dynamics, wastewater, water pricing, water recycle

Procedia PDF Downloads 248

Authors: Raffaele Danilo Esposito, Domingo Planes Meseguer, Maria Del Pilar Dorado Rodriguez

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As far as we know, it is still unavailable a commercial solution which would allow to manage, openly and configurable up to user needs, the huge amount of data generated in a modern Radiation Oncology Department. Currently, available information management systems are mainly focused on Record & Verify and clinical data, and only to a small extent on physical data. Thus, results in a partial and limited use of the actually available information. In the present work we describe the implementation at our department of a centralized information management system based on a web server. Our system manages both information generated during patient planning and treatment, and information of general interest for the whole department (i.e. treatment protocols, quality assurance protocols etc.). Our objective it to be able to analyze in a simple and efficient way all the available data and thus to obtain quantitative evaluations of our treatments. This would allow us to improve our work flow and protocols. To this end we have implemented a relational data base which would allow us to use in a practical and efficient way all the available information. As always we only use license free software.

Keywords: information management system, radiation oncology, medical physics, free software

Procedia PDF Downloads 223

Authors: A. Ghodbane, M. Saad, J. F. Boland, C. Thibeault

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Historically, actuators’ redundancy was used to deal with faults occurring suddenly in flight systems. This technique was generally expensive, time consuming and involves increased weight and space in the system. Therefore, nowadays, the on-line fault diagnosis of actuators and accommodation plays a major role in the design of avionic systems. These approaches, known as Fault Tolerant Flight Control systems (FTFCs) are able to adapt to such sudden faults while keeping avionics systems lighter and less expensive. In this paper, a (FTFC) system based on the Geometric Approach and a Reconfigurable Flight Control (RFC) are presented. The Geometric approach is used for cosmic ray fault reconstruction, while Sliding Mode Control (SMC) based on Lyapunov stability theory is designed for the reconfiguration of the controller in order to compensate the fault effect. Matlab®/Simulink® simulations are performed to illustrate the effectiveness and robustness of the proposed flight control system against actuators’ faulty signal caused by cosmic rays. The results demonstrate the successful real-time implementation of the proposed FTFC system on a non-linear 6 DOF aircraft model.

Keywords: actuators’ faults, fault detection and diagnosis, fault tolerant flight control, sliding mode control, geometric approach for fault reconstruction, Lyapunov stability

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Authors: Allaw Kamel, Bazzi Hasan

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Municipal solid waste (MSW) generation is among the most significant sources which threaten the global environmental health. Solid Waste Management has been an important environmental problem in developing countries because of the difficulties in finding sustainable solutions for solid wastes. Therefore, more efforts are needed to be implemented to overcome this problem. Lebanon has suffered a severe solid waste management problem in 2015, and a new landfill site was proposed to solve the existing problem. The study aims to identify and locate the most suitable area to construct a landfill taking into consideration the sustainable development to overcome the present situation and protect the future demands. Throughout the article, a landfill site selection methodology was discussed using Geographic Information System (GIS) and Multi Criteria Decision Analysis (MCDA). Several environmental, economic and social factors were taken as criterion for selection of a landfill. Soil, geology, and LUC (Land Use and Land Cover) indices with the Sustainable Development Index were main inputs to create the final map of Environmentally Sensitive Area (ESA) for landfill site. Different factors were determined to define each index. Input data of each factor was managed, visualized and analyzed using GIS. GIS was used as an important tool to identify suitable areas for landfill. Spatial Analysis (SA), Analysis and Management GIS tools were implemented to produce input maps capable of identifying suitable areas related to each index. Weight has been assigned to each factor in the same index, and the main weights were assigned to each index used. The combination of the different indices map generates the final output map of ESA. The output map was reclassified into three suitability classes of low, moderate, and high suitability. Results showed different locations suitable for the construction of a landfill. Results also reflected the importance of GIS and MCDA in helping decision makers finding a solution of solid wastes by a sanitary landfill.

Keywords: sustainable development, landfill, municipal solid waste (MSW), geographic information system (GIS), multi criteria decision analysis (MCDA), environmentally sensitive area (ESA)

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Authors: Zerzouri Nora, Benalia Nadia, Bensiali Nadia

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This paper presents a grid-connected wind power generation scheme using Doubly Fed Induction Generator (DFIG). This can supply power at constant voltage and constant frequency with the rotor speed varying. This makes it suitable for variable speed wind energy application. The DFIG system consists of wind turbine, asynchronous wound rotor induction generator, and inverter with Space Vector Modulation (SVM) controller. In which the stator is connected directly to the grid and the rotor winding is in interface with rotor converter and grid converter. The use of back-to-back SVM converter in the rotor circuit results in low distortion current, reactive power control and operate at variable speed. Mathematical modeling of the DFIG is done in order to analyze the performance of the systems and they are simulated using MATLAB. The simulation results for the system are obtained and hence it shows that the system can operate at variable speed with low harmonic current distortion. The objective is to track and extract maximum power from the wind energy system and transfer it to the grid for useful work.

Keywords: Doubly Fed Induction Generator, Wind Energy Conversion Systems, Space Vector Modulation, distortion harmonics

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Authors: Gema Gómez-Casado, Alba Rodríguez-Muñoz, Virginia Mela-Rivas, Pallavi Kompella, Francisco José Tinahones-Madueña, Isabel Moreno-Indias, Almudena Ortega-Gómez

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Obesity is a high-priority health problem worldwide due to its high prevalence. The proportion of obese and overweight subjects in industrialized countries exceeds half of the population in most cases. Beyond the metabolic problem, obesity boosts inflammation levels in the organism. The gut microbiota, considered an organ by itself, controls a high variety of processes at a systemic level. In fact, the microbiota interacts closely with the immune system, being crucial in determining the maturation state of neutrophils, key effectors of the innate immune response. It is known that changes in the diet exert strong effects on the variety and activity of the gut microbiota. The effect that those changes have on the axis microbiota-immune response is an unexplored field. In this study, 10 patients with obesity (weight 114,3 ± 14,5Kg, BMI 40,47±3,66) followed a Mediterranean-hypocaloric diet for 3 months, reducing their initial weight by 12,71 ± 3%. A transplant of microbiota from these patients before and after the diet was performed into wild type “germ-free” mice (n=10/group), treated with antibiotics. Six weeks after the transplant, mice were euthanized, and the presence of cells from the innate immune system were analysed in different organs (bone marrow, blood, spleen, visceral adipose tissue, and intestine) by flow cytometry. No differences were observed in the number of myeloid cells in bone marrow, blood, spleen, or visceral adipose tissue of mice transplanted with patient’s microbiota before and after following the Mediterranean diet. However, the intestine of mice that received post-diet microbiota presented a marked decrease in the number of neutrophils (whose presence is associated with tissue inflammation), as well as macrophages. In line with these findings, intestine monocytes from mice with post-diet microbiota showed a less inflammatory profile (lower Ly6Gˡᵒʷ proportion of cells). These results point toward a decrease in the inflammatory state of the intestinal tissue, derived from changes in the gut microbiota, which occurred after a 3-month Mediterranean diet.

Keywords: obesity, nutrition, Mediterranean diet, gut microbiota, immune system

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Authors: Ramūnas Antanaitis, Lina Anskienė, Robertas Stoškus

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This study was conducted during 2021.05.01 – 2021.08.31 at the Lithuanian University of health sciences and one Lithuanian dairy farm with 500 dairy cows (55.911381565736, 21.881321760608195). Average calving – 50 cows per month. Cows (n=20) in the treatment group (TG) were fed with feed supplement Optipartum C+ 200 (Enzymes: Alfa- Amylase 57 Units; Beta-Glucanase 107 Units) from 21 days before calving till 30 days after calving with feeding rate 200g/cow/day. Cows in the control group (CG) were fed a feed ration without feed supplement. Measurements started from 6 days before calving and continued till 21 days after calving. The following indicators were registered: with the RumiWatch System: Rumination time; Eating time; Drinking time; Rumination chews; Eating chews; Drinking gulps; Bolus; Chews per minute; Chews per bolus. With SmaXtec system - the temperature, pH of the contents of cows' reticulorumens and cows' activity. According to our results, we found that feeding of cows, from 21 days before calving to 30 days after calving, with a feed supplement with alfa- amylase and beta-glucanase (Optipartum C+ 200) (with dose 200g/cow/day) can produce an increase in: 9% rumination time and eating time, 19% drinking time, 11% rumination chews, 16% eating chews,13% number of boluses per rumination, 5% chews per minute and 16% chews per bolus. We found 1.28 % lower reiticulorumen pH and 0.64% lower reticulorumen temperature in cows fed with the supplement compared with control group cows. Also, cows feeding with enzymes were 8.80% more active.

Keywords: Alfa-Amylase, Beta-Glucanase, cows, in-line, sensors

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Authors: Christina Albertina Ludwinia Parung, I Gusti Ayu Maya Vratasti

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Sexual transmission of HIV among Men who have Sex with Men (MSM) is believed to be one of the sources of the AIDS epidemic. Nowadays, government, communities, and NGOs are taking action to prevent its spread by assisting and educating groups of MSM in their countries. This assistance involves experts in many fields of study, including psychology. In the field of psychology, psychoeducation is believed to be one of the ways to assist the MSM groups. Just like in other countries, this psychoeducation assistance is also needed in Indonesia, where MSM groups are found in many cities within. Surabaya, as the second largest and densely populated city in Indonesia, is known to have a big number of MSM population. In September to December 2020, the author and a colleague conducted a mentoring effort to the MSM community at the MSM community gathering location called Gang Pattaya, in the city of Surabaya. The existence of this community is disguised by the general public, but is well known by NGOs. Community members do MSM out of their liking, although some do it in exchange for money. However, safety factors, such as using condoms for MSM, are not a priority for this community. They do MSM whether they receive a reward or not, just out of a boost of pleasure. There is no attempt to find out the health of the partner once they are attracted to each other. In general, they do not know whether they are infected with HIV. Most of them feel healthy and since they do not show any symptoms, they think it is not necessary to get tested. In the mentoring process, the researchers conduct psychoeducation, which begins with an approach to certain individuals so that they are comfortable with the researchers’ presence, then increasing awareness of safe sex behavior for HIV prevention for groups in the form of counseling using the Theory of Reasoned Action (TRA) approach. Counseling is carried out in various forms including roleplay, games, and seminars. The number of participants was 11 people, varying from 19-47 years old. Pretest related to knowledge of safe sex was carried out before conducting the intervention and post-test after the intervention. The normality test used is the Shapiro-Wilk analysis. Different tests on the data obtained were carried out using the non-parametric Wilcoxon Signed Ranks Test. None of the participants had lower post-test knowledge scores than the pre-test. Prestest and post test for safer sex behavior showed 2 participants with safer sex behavior did not change. Both belong to the senior group, while other participants have an improvement in their safer sex behavior. These findings suggest that intervention programs for MSM as an effort to reduce HIV transmission should pay attention to affective and cognitive coping strategies.

Keywords: HIV, men who have sex with men, psychoeducation, psychology health, safer sex behavior, theory of reasoned action

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Authors: Sanaa Riaz

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The free people, Amazigh (plural Imazighen), often known by the more popular exonym, Berber, are spread across several North African countries with the highest population in Morocco have been substantially misunderstood and differentially showcased by entities from western-school educated scholars to human, health and women’s rights organizations, to the State to the international community. This paper is an examination of the various conceptualization of the Imazighen. With the popularity of the Arab Spring movement to oust monarchical and dictatorial rulers across the Middle East and North Africa in Morocco, the Moroccan monarchy introduced various reform programs to win public favor. These included social, economic and educational reforms to incorporate marginalized groups such as the Imazighen. The monarchy has ushered Amazigh representation in public offices and landscape through Amazigh script, even though theirs has been an oral culture. After the Arab Spring, the Justice and Development party, an Islamist party took over in Morocco due to its accessibility to the masses, In Sept. 2021, unlike the case of Egypt and Tunisia where military and constitutional means were sought, Morocco successfully removed it from power through the ballot, resulting in a real victory for the neutral monarchy and its representation as a moderate, secular and liberal force for the nation. As a result, supporting the perpetuation of Amazigh linguistic identity also became synonymous to making a secular statement as a Muslim. It has led to the telling of Amazigh identity at state museums as one representing the indigenous, pure, diverse, culturally-rich and united Morocco. Reform efforts have also prioritized an amiable look towards the economic and familial links of Moroccan Jews with the few thousand families still left in the country and a showcasing through museums and cultural centers of the Jewish identity as Moroccan first. In that endeavor, it is interesting to note the coverage of Jews as the indigenous of Morocco through the embracing of their “folk” cultural and religious practices, those that are not continued outside Morocco. In this epistemology, the concept of the Moroccan Jew becomes similar to the indigenous Amazigh, both cherished as the oldest peoples of Morocco and symbols of its unity and resilience. In the urban discourse, Amazigh identity is a concept that continues to be part of the deliberations of elites and scholars graduating from French schools on the incorporation of rural and illiterate Morocco in economic and educational advancement. Yet, with the constant influx of migrants from Western Sahara into cities like Fez and Marrakesh, Amazigh has often been described as the umbrella term of those of “mixed” ethnic ancestry who constitute the country’s free population. In sum, Amazigh identity highlights the changing discourse on marginalized communities, human rights, representation, Moroccan nationhood, and regional and transnational politics. The aim of this paper is to analyze perceptions of Amazigh identity in Morocco post-2021 ousting of the Islamist party using data from state-sponsored museum displays and cultural centers collected in Summer 2022 and scholarly analyses of Amazigh identity, representation and rights in Morocco.

Keywords: Amazigh identity, Morocco, representation, state politics

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Authors: Nashed Atef Nashed Farag

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Introduction: Reporting adverse events following vaccination remains a challenge. WHO has mandated pharmacovigilance centers around the world to submit Adverse Events Following Immunization (AEFI) reports from different countries to a large electronic database of adverse drug event data called Vigibase. Despite sufficient information about AEFIs on Vigibase, they are not available to the general public. However, the WHO has an alternative website called VigiAccess, an open-access website that serves as an archive for reported adverse reactions and AEFIs. The aim of the study was to establish a reporting model for a number of commonly used vaccines in the VigiAccess system. Methods: On February 5, 2018, VigiAccess comprehensively searched for ESSI reports on the measles vaccine, oral polio vaccine (OPV), yellow fever vaccine, pneumococcal vaccine, rotavirus vaccine, meningococcal vaccine, tetanus vaccine, and tuberculosis vaccine (BCG). These are reports from all pharmacovigilance centers around the world since they joined the WHO Drug Monitoring Program. Results: After an extensive search, VigiAccess found 9,062 AEFIs from the measles vaccine, 185,829 AEFIs from the OPV vaccine, 24,577 AEFIs from the yellow fever vaccine, 317,208 AEFIs from the pneumococcal vaccine, 73,513 AEFIs from the rotavirus vaccine, and 145,447 AEFIs from meningococcal cal vaccine, 22,781 EI FI vaccines against tetanus and 35,556 BCG vaccines against AEFI. Conclusion: The study found that among the eight vaccines examined, pneumococcal vaccines were associated with the highest number of AEFIs, while measles vaccines were associated with the fewest AEFIs.

Keywords: surgical approach, anatomical approach, decompression, axillary nerve, quadrangular space adverse events following immunization, cameroon, COVID-19 vaccines, nOPV, ODK vaccines, adverse reactions, VigiAccess, adverse event reporting

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Authors: Yoseph Halala Handiso, Zewdi Gebregziabher

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Background: Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Despite the fact that malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical patients in Ethiopia, while nutritional assessment is also often a neglected component of the health service practice. Objective: This study aimed to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022. Methods: A facility-based prospective cohort study was conducted among 398 adult surgical patients admitted to the hospital. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 hours within 48 hours after admission (SGA). Data were collected using the open data kit (ODK) version 2022.3.3 software, while Stata version 14.1 software was employed for statistical analysis. The Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusting for several potential confounders taken at admission. Adjusted hazard ratio (HR) with a 95% confidence interval was used to show the effect of malnutrition. Results: The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59%-69%) according to the SGA classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11-13) as compared to well-nourished patients (8 days: 95% CI: 8-9), means adult surgical patients who were malnourished at admission were at higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29-0.47) as compared to well-nourished patients. Presence of comorbidity (AHR: 0.68, 95% CI: 0.50-90), poly medication (AHR: 0.69, 95% CI: 0.55-0.86), and history of admission (AHR: 0.70, 95% CI: 0.55-0.87) within the previous five years were found to be the significant covariates of the length of hospital stay (LOS). Conclusion: The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, polymedication, and history of admission were found to be the significant covariates of LOS. All stakeholders should give attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.

Keywords: effect of malnutrition, length of hospital stay, surgical patients, Ethiopia

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Authors: Szymon Szemik, Małgorzata Kowalska

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Objective: Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK (POLski LEKarz, eng. Polish Physician) study aims to identify and evaluate the quality of life, mental health status, and ever-recognized chronic diseases by simultaneously assessing their determinants in Polish medical students during long-term observation. Material and Methods: The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2). Results: The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. Obtained results confirmed that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domains. Moreover, we observed a significant increase in self-declared scoring of somatic symptoms year by year (from M=4.75 at T1 to M=8.06 at T2, p<0.001) in the GHQ-28 questionnaire survey. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the first year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in meat consumption. Conclusions: The QoL in medical students and selected determinants of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.

Keywords: quality of life, mental health, medical students, follow-up study

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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Authors: Malani Herath, Sohan Wijesekera, Jagath Munasingha

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The impact of recent floods become significant, and the extraordinary flood events cause considerable damage to lives, properties, environment and negatively affect the whole development of Colombo urban region. Even though the Colombo urban region experiences recurrent flood impacts, several spatial planning interventions have been taken from time to time since early 20th century. All past plans have adopted a traditional approach to flood management, using infrastructural measures to reduce the chance of flooding together with rigid planning regulations. The existing flood risk management practices do not operate to be acceptable by the local community particular the urban poor. Researchers have constantly reported the differences in estimations of flood risk, priorities, concerns of experts and the local community. Risk-based decision making in flood management is not only a matter of technical facts; it has a significant bearing on how flood risk is viewed by local community and individuals. Moreover, sustainable flood management is an integrated approach, which highlights joint actions of experts and community. This indicates the necessity of further societal discussion on the acceptable level of flood risk indicators to prioritize and identify the appropriate flood management measures in Colombo. The understanding and evaluation of flood risk by local people are important to integrate in the decision-making process. This research questioned about the gap between the acceptable level of flood risk to spatial planners and to the local communities in Colombo. A comprehensive literature review was conducted to prepare a framework to analyze the public perception in Colombo. This research work identifies the factors that affect the variation of flood risk and acceptable levels to both local community and planning authorities.

Keywords: Colombo basin, public perception, urban flood risk, multi-criteria analysis

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Authors: Brittany Joi B. Kirsch

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Textbooks carry a crucial role in imparting ideologies that stimulate inclusivity and social diversity. In the Philippines, a law on inclusive education (IE) for differently-abled learners has recently been signed in order to ensure their rights to quality and IE are protected and upheld (Republic Act No. 11650, 2022). With the presence of ableism in textbooks, the promotion of IE may be challenged. A considerable amount of research has been done on disability representation and ableism in foreign countries; however, none, to the extent of the researcher’s knowledge, has been conducted on ableist ideologies in primary education English language textbooks in the Philippines. Hence, this paper aims to investigate the negotiation of ableist ideologies in primary education English language textbooks in the Philippines. Utilizing Fairclough’s (1995) three-dimensional model of critical discourse analysis (CDA) as the framework, six prescribed primary education English language textbooks from different grade levels were analyzed to examine instances of ableism in the texts. To further support the analysis of the study, supplemental data were gathered from the accounts of six public elementary school English language teachers. Findings reveal that the textbooks contain ableist ideologies with a limited representation of differently-abled people; by disclosing them as (1) invisible, (2) equipped with negative abilities, and (3) plagued with delicate health. By identifying ableist ideologies in textbooks, educational institutions and publishers may benefit in assessing and reforming instructional materials to resolve the presence of such ideologies, thereby abiding by the country’s law on IE and strengthening its overall implementation.

Keywords: textbooks, ideologies, inclusive education, critical discourse analysis, ableism

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Authors: Reza Safari, Ali Rajabzadeh Ghatari, Raheleh Hossseinzadeh Mahabadi

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In the present world, there are different pressures on firms such as competition, legislations, social etc. these pressures force the firms to follow “survival” as their primary goal and then growth. One of the main factors that helps firms to reach their goals is proper financial performance. To find out about the financial performance, a firm should monitors its financial performance. Financial performance affected by many factors. This research seeks to clear which financial performance indicators are most important according to Environmental situation of a firm and what are their priorities. To do so, environmental indicators specified as presented on OECD Key Environmental Indicators 2008 and so the financial performance indicators such as Profitability, Liquidity, Gearing, Investor ratios, and etc. At this stage, the affections questioned through questionnaires. After gaining the results, data analyzed using Promethee technique. By using decision matrixes extracted from those techniques an expert system designed. This expert system suggests the suitable financial performance indicators and their ranking by receiving the environment situation given environment indicators weight.

Keywords: environment indicators, financial performance indicators, promethee, expert system

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Authors: Abid Khan

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A recognized engineering challenge is related to personnel protection from fatal arc flash incident energy in the line side of the 480-volt switchgear incomer breakers during maintenance activities. The incident energy is typically high due to slow fault clearance, and it can be higher than the available personnel protective equipment (PPE) ratings. A fault in this section of the switchgear is cleared by breakers or fuses in the upstream higher voltage system (4160 Volt or higher). The current reflection in the higher voltage upstream system for a fault in the 480-volt switchgear is low, the clearance time is slower, and the inversely proportional incident energy is hence higher. The installation of overcurrent protection at a 480-volt system upstream of the incomer breaker will operate fast enough and trips the upstream higher voltage breaker when a fault develops at the incomer breaker. Therefore, fault current reduction as reflected in the upstream higher voltage system is eliminated. Since the fast overcurrent protection is permanently installed, it is always functional, does not require human interventions, and eliminates exposure to human errors. It is installed at the maintenance activities location, and its operations can be locally monitored by craftsmen during maintenance activities.

Keywords: arc flash, mitigation, maintenance switch, energy level

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