Search results for: mental health status

Authors: Yi-Fung Lin, Pei-Chen Tsai

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Background: The hospital healthcare team provides 24-hour patient care, and therefore shift-work is inevitable in the nursing field. There is an increased awareness that shift-work affecting circadian rhythms may cause various health problems, especially in poor sleep quality, which may harm the quality of life. Purposes: The purpose of this study was to investigate the influences of demographic characteristics on nurses’ sleep quality and quality of life and the relationship between these predictors of nurses’ quality of life. Methods: A cross-sectional, descriptive correlational study was conducted with purposive sampling of 520 female nurses in a medical center in north Taiwan from July to September 2014. Data were collected with structured questionnaires using Psychometric Evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life (WHOQOL-BREF). Outcomes: The main results include: 1) Irregular menstruation, non-regular exercisers, and more daily caffeine consumption have negative impacts on sleep quality. 2) Younger age, fewer children, low education level, low annual income, irregular menstruation, pain during menstrual cycles, non-regular exercisers, constipation, and poor sleep quality all contribute negative impacts on the quality of life. 3) The odds ratio of sleep disturbance between 12-hour shifts and 8-hour shifts was 2.26, but there was no significant difference regarding their quality of life scores. Conclusion: This study showed that there is a strong correlation between oncology nurses’ sleep quality and quality of life. Sleep quality is a significant predictor of quality of life in oncology nurses.

Keywords: oncology nurses, sleep quality, quality of life, shift-work

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Authors: L. Agneni, F. Carta, C. Micheletta, V. Tersigni

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The development of a qualitative method to profile jobseekers is needed to improve the quality of the Public Employment Services (PES) in Italy. This is why the National Agency for Active Labour Market Policies (ANPAL) decided to introduce a Qualitative Profiling Service in the context of the activities carried out by local employment offices’ operators. The qualitative profiling service provides information and data regarding the jobseeker’s personal transition status, through a semi-structured questionnaire administered to PES clients during the guidance interview. The questionnaire responses allow PES staff to identify, for each client, proper activities and policy measures to support jobseekers in their reintegration into the labour market. Data and information gathered by the qualitative profiling tool are the following: frequency, modalities and motivations for clients to apply to local employment offices; clients’ expectations and skills; difficulties that they have faced during the previous working experiences; strategies, actions undertaken and activated channels for job search. These data are used to assess jobseekers’ personal and career characteristics and to measure their employability level (qualitative profiling index), in order to develop and deliver tailor-made action programmes for each client. This paper illustrates the use of the above-mentioned qualitative profiling service on the national territory and provides an overview of the main findings of the survey: concerning the difficulties that unemployed people face in finding a job and their perception of different aspects related to the transition in the labour market. The survey involved over 10.000 jobseekers registered with the PES. Most of them are beneficiaries of the “citizens' income”, a specific active labour policy and social inclusion measure. Furthermore, data analysis allows classifying jobseekers into a specific group of clients with similar features and behaviours, on the basis of socio-demographic variables, customers' expectations, needs and required skills for the profession for which they seek employment. Finally, the survey collects PES staff opinions and comments concerning clients’ difficulties in finding a new job and also their strengths. This is a starting point for PESs’ operators to define adequate strategies to facilitate jobseekers’ access or reintegration into the labour market.

Keywords: labour market transition, public employment services, qualitative profiling, vocational guidance

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Authors: Seyyed Farzad Motevalli-Haghi, Javad Rafinejad, Mahboobeh Hosseni, Jamshid Yazdani-Charati, Behzad Parsi

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Background and purpose: Pediculosis is a worldwide public health concern. This descriptive study was performed on primary-school-aged children to determine the prevalence of pediculosis and its risk factors in Mazandaran Province, Iran, on basis of geographic information system (GIS). Materials and methods: A random sampling method was used to select 45237 school-aged children from Sari to Ramsar cities during September 2012 to June 2013. Data were collected from the selected schools by five trained nursing inspectors. A detailed questionnaire was filled for each child prior to hair examination following which examination was carried out to detect head lice as well as eggs/nits. Data were analyzed chi-square test. Finally, the GIS map was obtained in province informational chart. Results: 823 primary-school children (of 45237) were infected with lice in Mazandaran Province. The mean infection prevalence was 1.4% in cities 5.64% in rural area from Sari to Ramsar. There were significant relationships between pediculosis and some factors (P<0.05). GIS map revealed that the contamination was less in west than in east and central regions. Conclusion: Increasing awareness and training of teachers and parents, as well as improving standards of personal health can significantly reduce the prevalence of pediculosis.

Keywords: pediculosis capitis, primary school children, epidemiology, geographic information system (GIS), Mazandaran, Iran

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Authors: Jiashu Shen

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Objectives: Spirometry is a basic reference for health evaluation which is widely used in clinical. Previous reference of spirometry is not applicable because of drastic changes of social and natural circumstance in China. A new reference values for the spirometry of the Chinese population is extremely needed. Method: Spirometric reference value was established using the statistical modeling method Generalized Additive Models for Location, Scale and Shape for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and maximal mid-expiratory flow (MMEF). Results: Data from 236,606 healthy non-smokers aged 4–90 years was collected from the MJ Health Check database. Spirometry equations for FEV1, FVC, MMEF, and FEV1/FVC were established, including the predicted values and lower limits of normal (LLNs) by sex. The predictive equations that were developed for the spirometric results elaborated the relationship between spirometry and age, and they eliminated the effects of height as a variable. Most previous predictive equations for Chinese spirometry were significantly overestimated (to be exact, with mean differences of 22.21% in FEV1 and 31.39% in FVC for males, along with differences of 26.93% in FEV1 and 35.76% in FVC for females) or underestimated (with mean differences of -5.81% in MMEF and -14.56% in FEV1/FVC for males, along with a difference of -14.54% in FEV1/FVC for females) the results of lung function measurements as found in this study. Through cross-validation, our equations were established as having good fit, and the means of the measured value and the estimated value were compared, with good results. Conclusions: Our study updates the spirometric reference equations for Chinese people of all ages and provides comprehensive values for both physical examination and clinical diagnosis.

Keywords: Chinese, GAMLSS model, reference values, spirometry

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Authors: Chang-Yong Kim, Dong-Woo Kim, Whon-Hyun Lee, Yong-Joo Kim, Tae-Won Chung, Kyung-Mi Lee, Han-Sol Kim, Eun-Joo Lee, Euh Duck Jeong

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In the past, together with the annual increase in investment on national R&D projects, the government’s budget investment in FE has steadily maintained. In the case of major developed countries, R&D and its supporting works are distinguished and professionalized in their own right, in so far as having a training system for facilities, equipment operation, and maintenance personnel. In Korea, however, research personnel conduct both research and equipment operation, leading to quantitative shortages of operational manpower and qualitative problems due to insecure employment such as maintenance issues or the loss of effectiveness of necessary equipment. Therefore, the purpose of this study was to identify the current status of engineer operated national research FE in Korea based on a 2017 survey results of domestic facilities and to suggest policy implications. A total of 395 research institutes that carried out national R&D projects and registered more than two FE since 2005 were surveyed on-line for two months. The survey showed that 395 non-profit research facilities were operating 45,155 pieces of equipment with 2,211 engineer operated national research FE, meaning that each engineer had to manage 21 items of FE. Among these, 43.9% of the workers were employed in temporary positions, including indefinite term contracts. Furthermore, the salary and treatment of the engineer personnel were relatively low compared to researchers. In short, engineers who exclusively focused on managing and maintaining FE play a very important role in increasing research immersion and obtaining highly reliable research results. Moreover, institutional efforts and government support for securing operators are severely lacking as domestic national R&D policies are mostly focused on researchers. The 2017 survey on FE also showed that 48.1% of all research facilities did not even employ engineers. In order to solve the shortage of the engineer personnel, the government will start the pilot project in 2012, and then only the 'research equipment engineer training project' from 2013. Considering the above, a national long-term manpower training plan that addresses the quantitative and qualitative shortage of operators needs to be established through a study of the current situation. In conclusion, the findings indicate that this should not only include a plan which connects training to employment but also measures the creation of additional jobs by re-defining and re-establishing operator roles and improving working conditions.

Keywords: engineer, Korea, maintenance, operation, research facilities and equipment

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Authors: Obinna Benedict Duru

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This study focuses on the elderly and the challenges that confront them. The elderly are that particular segment of our population who by virtue of the aging process have attained the stage in most cases where they are confronted with the challenges of economic dependency and social marginality. These challenges are as a result of the physical and biological decline occasioned by social myths and realities which portray the elderly as a dependent population whose members could not and should not work and who need social assistance that the younger population is obliged to provide. From the moment of birth to the moment of death, our bodies are constantly changing. We are all enmeshed in the process of growing old, a transition from youthfulness to elderliness. In youth-oriented modern societies like ours, we tend to attach positive importance and significance to the biological changes that occur early in life and define later physical changes in negative terms. Children growing up and young adults receive more attention, greater responsibilities and more legal rights to reward them on their way. But few people are congratulated on getting old. We commiserate with people who are getting old and make jokes about their supposedly physical, mental and biological decline. Wrinkles, loss of weight and vitality are all parts of the aging process. In almost all parts of the world, earlier researches have shown that about fifty percent of the elderly who suffer from stroke, arthritis, senility and other age related diseases are the disengaged and neglected elderly. Rapid technological changes render the knowledge and skills of the elderly obsolete; education is geared toward the young and the generational competition for jobs leads to pressures on the elderly to retire. Control of initial resources are shifted to the middle-aged and older workers are pushed into positions of economic dependency. This study therefore, among other things tend to discover how some government policies have affected the elderly particularly in Africa. To discover the prospects and possibilities of the elderly for a better living. To make a comparison of the advances in healthcare giving made in the advanced western societies to the practice in Sub Saharan Africa etc. The hypotheses of this study include: that the elderly in Sub Saharan Africa are more vulnerable than their counterparts in Europe and America. The elderly are more prone to social isolation, and that the elderly are mostly affected by age-related sickness etc. With a survey method as the research design, and sample size of about 500 respondents,probability sampling technique was used. Data which were analyzed using chi-square and tables were collected through primary and secondary sources. The findings made include: that the elderly suffer pains of old age especially when disengaged from work or social activity. That loss of income condemn the elderly to a life of vegetable existence, and that those who do not have other means of re-integration usually see old age with regret and despair. It is therefore, recommended among other things that social welfare scheme and the process of re-integration at old age be introduced for the non pensionable elderly in Africa.

Keywords: elderly, social isolation, dependency, re-integration

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Authors: Munir Ashraf, Shagufta Riaz

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Personal protective equipment (PPE) and bioactive textiles are highly important for the health care of front line hospital workers, patients, and the general population to be safe from highly infectious diseases. This was even more critical in the wake of COVID-19 outbreak. Most of the medical textiles are inactive against various viruses and bacteria, hence there is a need to wash them frequently to avoid the spread of microorganisms. According to survey conducted by the world health organization, more than 500 million people get infected from hospitals, and more than 13 million died due to these hospitals’ acquired deadly diseases. The market available PPE are though effective against the penetration of pathogens and to kill bacteria but, they are not breathable and active against different viruses. Therefore, there was a great need to develop textiles that are not only effective against bacteria, fungi, and viruses but also are comfortable to the medical personnel and patients. In the present study, waterproof breathable, and biologically active textiles were developed using antiviral and antibacterial nanomaterials. These nanomaterials like TiO₂, ZnO, Cu, and Ag were immobilized at the surface of cotton fabric by using different silane coupling agents and electroless deposition that they retained their functionality even after 30 industrial laundering cycles. Afterwards, the treated fabrics were coated with a waterproof breathable film to prevent the permeation of liquid droplets, any particle or microorganisms greater than 80 nm. The developed cotton fabric was highly active against bacteria and viruses. The good durability of nanomaterials at the cotton surface after several industrial washing cycles makes this fabric an ideal candidate for bioactive textiles used in the medical field.

Keywords: antibacterial, antiviral, cotton, durable

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Authors: Rehan Mohammad

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Background: Improved Water, Sanitation and Hygiene (WASH) practices in schools ensure children’s health, well-being and cognitive performance. In India under various WASH interventions in schools, teachers, and other staff make every possible effort to educate children about personal hygiene, sanitation practices and harms of open defecation. However, once children get back to their families, they see other practicing inappropriate WASH behaviors, and they consequently start following them. This show disconnect between school behavior and family behavior, which needs to be bridged to achieve desired WASH outcomes. Aims and Objectives: The aim of this study is to assess the factors causing disconnect of WASH-related behaviors between school and the family of children. It also suggests behavior change interventions to bridge the gap. Methodology: The present study has chosen a mixed- method approach. Both quantitative and qualitative methods of data collection have been used in the present study. The purposive sampling for data collection has been chosen. The data have been collected from 20% children in each age group of 04-08 years and 09-12 years spread over three primary schools and 20% of households to which they belong to which is spread over three slum communities in south district of Delhi. Results: The present study shows that despite of several behavior change interventions at school level, children still practice inappropriate WASH behaviors due to disconnect between school and family behaviors. These behaviors show variation from one age group to another. The inappropriate WASH behaviors being practiced by children include open defecation, wrong disposal of garbage, not keeping personal hygiene, not practicing hand washing practices during critical junctures and not washing fruits and vegetables before eating. The present study has highlighted that 80% of children in the age group of 04-08 years still practice inappropriate WASH behaviors when they go back to their families after school whereas, this percentage has reduced to 40% in case of children in the age group 09-12 years. Present study uncovers association between school and family teaching which creates a huge gap between WASH-related behavioral practices. The study has established that children learn and de-learn the WASH behaviors due to the evident disconnect between behavior change interventions at schools and household level. The study has also made it clear that children understand the significance of appropriate WASH practices but owing to the disconnect the behaviors remain unsettled. The study proposes several behavior change interventions to sync the behaviors of children at school and family level to ensure children’s health, well-being and cognitive performance.

Keywords: behavioral interventions, child health, family behavior, school behavior, WASH

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Authors: Brenda Russell

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Police officers spend a great deal of time responding to domestic violence calls. Recent research has found that men and women in heterosexual and same-sex relationships are equally likely to initiate intimate partner violence IPV) and likewise susceptible to victimization, yet police training tends to focus primarily on male perpetration and female victimization. Criminal justice studies have found that male perpetrators of IPV are blamed more than female perpetrators who commit the same offense. While previous research has examined officer’s response in IPV cases with male and female heterosexual offenders, research has yet to investigate police response in same-sex relationships. This study examined officers’ decisions to arrest, perceptions of blame, perceived danger to others, disrespect, and beliefs in prosecution, guilt and sentencing. Officers in the U.S. (N = 248) were recruited using word of mouth and access to police association websites where a link to an online study was made available. Officers were provided with one of 4 experimentally manipulated scenarios depicting a male or female perpetrator (heterosexual or same-sex) in a clear domestic assault situation. Officer age, experience with IPV and IPV training were examined as possible covariates. Training in IPV was not correlated to any dependent variable of interest. Age was correlated with perpetrator arrest and blame (.14 and .16, respectively) and years of experience was correlated to arrest, offering informal advice, and mediating the incident (.14 to -.17). A 2(perpetrator gender) X 2 (victim gender) factorial design was conducted. Results revealed that officers were more likely to provide informal advice and mediate in gay male relationships, and were less likely to arrest perpetrators in same-sex relationships. When officer age and years of experience with domestic violence were statistically controlled, effects for perpetrator arrest and providing informal advice were no longer significant. Officers perceived heterosexual male perpetrators as more dangerous, blameworthy, disrespectful, and believed they would receive significantly longer sentences than all other conditions. When officer age and experience were included as covariates in the analyses perpetrator blame was no longer statistically significant. Age, experience and training in IPV were not related to perceptions of victims. Police perceived victims as more truthful and believable when the perpetrator was a male. Police also believed victims of female perpetrators were more responsible for their own victimization. Victims were more likely to be perceived as a danger to their family when the perpetrator was female. Female perpetrators in same-sex relationships and heterosexual males were considered to experience more mental illness than heterosexual female or gay male perpetrators. These results replicate previous research suggesting male perpetrators are more blameworthy and responsible for their own victimization, yet expands upon previous research by identifying potential biases in police response to IPV in same-sex relationships. This study brings to the forefront the importance of evidence-based officer training in IPV and provides insight into the need for a gender inclusive approach as well as addressing the necessity of the practical applications for police.

Keywords: domestic violence, heterosexual, intimate partner violence, officer response, police officer, same-sex

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Authors: Junbeom Lee, Jaehyuck Cho, Wookyeong Jeong, Jonghan Won, Jungmin Hwang, Youngseok Song, Taikyeong Jeong

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This paper investigates and analyzes meta-learning technologies that use multiple-cameras to monitor and check abnormal behavior in people in real-time in the area of healthcare fields. Advances in artificial intelligence and computer vision technologies have confirmed that cameras can be useful for individual health monitoring and abnormal behavior detection. Through this, it is possible to establish a system that can respond early by automatically detecting abnormal behavior of the elderly, such as patients and the elderly. In this paper, we use a technique called meta-learning to analyze image data collected from cameras and develop a commercial product to determine abnormal behavior. Meta-learning applies machine learning algorithms to help systems learn and adapt quickly to new real data. Through this, the accuracy and reliability of the abnormal behavior discrimination system can be improved. In addition, this study proposes a meta-learning-based abnormal behavior detection system that includes steps such as data collection and preprocessing, feature extraction and selection, and classification model development. Various healthcare scenarios and experiments analyze the performance of the proposed system and demonstrate excellence compared to other existing methods. Through this study, we present the possibility that camera-based meta-learning technology can be useful for monitoring and testing abnormal behavior in the healthcare area.

Keywords: artificial intelligence, abnormal behavior, early detection, health monitoring

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Authors: Edwin Dankano

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Evident by incessant and sporadic attacks on Nigerians poise a serious threat to the unity of Nigeria, and secondly, the single biggest security nightmare to confront Nigeria since after amalgamation of the Southern and Northern protectorates by the British colonialist in 1914 is “Boko Haram” a terrorist organization also known as “Jama’atul Ahli Sunnah Lidda’wati wal Jihad”, or “people committed to the propagation of the Prophet’s teachings and jihad”. The sect also upholds an ideology translated as “Western Education is forbidden”, or rejection of Western civilization and institutions. By some estimates, more than 5,500 people were killed in Boko Haram attacks in 2014, and Boko Haram attacks have already claimed hundreds of lives and territories {caliphates}in early 2015. In total, the group may have killed more than 10,000 people since its emergence in the early 2000s. More than 1 million Nigerians have been displaced internally by the violence, and Nigerian refugee figures in neighboring countries continue to rise. This paper is predicated on secondary sources of data and anchored on the Huntington’s theory of clash of civilization. As such, the paper argued that the rise of Boko Haram with its violent disposition against Western values is a counter response to Western civilization that is fast eclipsing other civilizations. The paper posits that the Boko Haram insurrection going by its teachings, and destruction of churches is a validation of the propagation of the sect as a religious revolt which has resulted in dire humanitarian situation in Adamawa, Borno, Yobe, Bauchi, and Gombe states all in north eastern Nigeria as evident in human casualties, human right abuses, population displacement, refugee debacle, livelihood crisis, and public insecurity. The paper submits that the Nigerian state should muster the needed political will in terms of a viable anti-terrorism measures and build strong legitimate institutions that can adequately curb the menace of corruption that has engulfed the military hierarchy, respond proactively to the challenge of terrorism in Nigeria and should embrace a strategic paradigm shift from anti-terrorism to counter-terrorism as a strategy for containing the crisis that today threatens the secular status of Nigeria.

Keywords: Boko Haram, civilization, fundamentalism, Islam, religion revolt, terror

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Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

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Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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Authors: L. U. Dumuje, R. Leite

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There is an ongoing debate in terms of corporate social responsibility (CSR) initiative in Niger Delta, Nigeria, that originates from existing gap between stated objective of organizations in the Nigerian oil sector and their main activities that threaten the society. CSR in developing countries is becoming popular, and to contribute to scientific knowledge, we need to research on CSR practices and discourse in indigenous Nigeria that is scarce. Despite governments mandate in terms of unofficial blazing, methane gas is released into the air around refinery area which contributes to global warming. There is a need to understand if this practice applies to indigenous oil companies in Nigeria. To get a better understanding of CSR among indigenous oil companies in Nigeria, our study focuses on discourse and rhetoric regarding CSR. This current paper contributions is twofold: on the one hand, it aims to better understand practitioner’s rationale and fundamentals of CSR in Nigerian oil companies. On the other hand, it intends to identify the stages of CSR initiatives, advantages and difficulties of CSR implementation in indigenous Nigeria oil sector. This current paper uses the qualitative research as a methodological strategy. Instrument for data collection is semi-structured interview. Besides 28 interviews, we conduct five focus group discussions with stakeholders. Participant for this study consist of: employees, managers and executives of indigenous oil companies in Nigeria. It is relevant to mention, key informants as government institution, environmental organization and community leader/member are part of our sample. It is important that despite significant findings in some studies, there are still some gaps. To help filling this existing gaps, we have formulated some research questions, as follows: ‘What are the stages, opportunities and obstacles of having corporate social responsibility practice in indigenous oil companies in Nigeria’. This ongoing research sub-questions as follows: What are the CSR discourses and practices among indigenous companies in the Nigerian oil sector; what is the actual status regarding CSR development; what are the main perceptions of opportunities and obstacles with regard to CSR in indigenous Nigerian oil companies; who are the main stakeholders of indigenous Nigerian oil companies and their different meanings and understandings of CSR practices. Regarding the above questions, the following objectives have been determined: first, we conduct a literature review with the aim of understanding and identifying importance of CSR practises in western and developing countries. Second, this current paper identify specific characteristics of the national context in terms of CSR engagement in Nigeria, so we perform empirical research with relevant stakeholder in indigenous Nigerian, as well as key informants, in order to identify development of CSR and different perception of this praised initiative, CSR.

Keywords: corporate social responsibility, indigenous, oil organizations, Nigeria, practice

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Authors: Elena Listo, Miguel Marchamalo

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This research studies the soil properties located in the watershed of Jabillo River in the Guanacaste province, Costa Rica. The soils are classified as Alfisols (T. Haplustalfs), in the flatter parts with grazing as Fluventic Haplustalfs or as a consequence of bad drainage as F. Epiaqualfs. The objective of this project is to define the status of the soil, to use remote sensing as a tool for analyzing the evolution of land use and determining the water balance of the watershed in order to improve the efficiency of the water collecting systems. Soil samples were analyzed from trial pits taken from secondary forests, degraded pastures, mature teak plantation, and regrowth -Tectona grandis L. F.- species developed favorably in the area. Furthermore, to complete the study, infiltration measurements were taken with an artificial rainfall simulator, as well as studies of soil compaction with a penetrometer, in points strategically selected from the different land uses. Regarding remote sensing, nearly 40 data samples were collected per plot of land. The source of radiation is reflected sunlight from the beam and the underside of leaves, bare soil, streams, roads and logs, and soil samples. Infiltration reached high levels. The majority of data came from the secondary forest and mature planting due to a high proportion of organic matter, relatively low bulk density, and high hydraulic conductivity. Teak regrowth had a low rate of infiltration because the studies made regarding the soil compaction showed a partial compaction over 50 cm. The secondary forest presented a compaction layer from 15 cm to 30 cm deep, and the degraded pasture, as a result of grazing, in the first 15 cm. In this area, the alfisols soils have high content of iron oxides, a fact that causes a higher reflectivity close to the infrared region of the electromagnetic spectrum (around 700mm), as a result of clay texture. Specifically in the teak plantation where the reflectivity reaches values of 90 %, this is due to the high content of clay in relation to others. In conclusion, the protective function of secondary forests is reaffirmed with regards to erosion and high rate of infiltration. In humid climates and permeable soils, the decrease of runoff is less, however, the percolation increases. The remote sensing indicates that being clay soils, they retain moisture in a better way and it means a low reflectivity despite being fine texture.

Keywords: alfisols, Costa Rica, infiltration, remote sensing

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Authors: Inger Eriksson, Lisbeth Ohlsson, Jeremias Rosenqvist

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Ingress: Focus in the study is directed towards phenomena and concepts of segregation, integration, and inclusion of students attending a special school form in Sweden, namely compulsory school for pupils with learning disabilities (in Swedish 'särskola') as an alternative to mainstream compulsory school. Aim: The aim of the study is to examine the school situation for students attending särskola from a historical perspective focussing the 1980s, 1990s and the 21st century, from an integration perspective, and from a perspective of power. Procedure: Five sub-studies are reported, where integration and inclusion are looked into by observation studies and interviews with school leaders, teachers, special and remedial teachers, psychologists, coordinators, and parents in the special schools/särskola. In brief, the study about special school students attending mainstream classes from 1998 takes its point of departure in the idea that all knowledge development takes place in a social context. A special interest is taken in the school’s role for integration generally, and the role of special education particularly and on whose conditions the integration is taking place – the special school students' or the other students,' or may be equally, in the class. Pedagogical and social conditions for so called individually integrated special school students in elementary school classes were studied in eleven classes. Results: The findings are interpreted in a power perspective supported by Foucault and relationally by Vygotsky. The main part of the data consists of extensive descriptions of the eleven cases, here called integration situations. Conclusions: In summary, this study suggests that the possibilities for a special school student to get into the class community and fellowship and thereby be integrated with the class are to a high degree dependant on to what extent the student can take part in the pedagogical processes. The pedagogical situation for the special school student is affected not only by the class teacher and the support and measures undertaken but also by the other students in the class as they, in turn, are affected by how the special school student is acting. This mutual impact, which constitutes the integration process in itself, might result in a true integration if the special school student attains the status of being accepted on his/her own terms not only being cared for or cherished by some classmates. A special school student who is not accepted even on the terms of the class will often experience severe problems in the contacts with classmates and the school situation might thus be a mere placement.

Keywords: integration/inclusion, mainstream school, power, special school students

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Authors: Najmeh Hamid, Vajiheh Hamedy , Zahra Rostamianasl

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Background: Cancer is one of the medical problems that have been associated with pain. Moreover, the pain is combined with negative emotions such as anxiety, depression and anger. Poor pain management causes negative effects on the quality of life, which results in negative effects that continue a long time after the painful experiences. Objectives: The aim of this research was to compare the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, depression, anger and anxiety in children with cancer. Methods: The research method of this “Randomized Controlled Clinical Trial” was a pre, post-test and follow-up with a control group. In this research, we have examined the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, anxiety, depression and anger in children with cancer in Ahvaz. Two psychological interventions (cognitive behavioral therapy for pain and the computerized version) were compared with the control group. The sample consisted of 60 children aged 8 to 12 years old with different types of cancer at Shafa hospital in Ahwaz. According to the including and excluding criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria, 60 subjects were selected. Then, randomly, 45 subjects were selected. The subjects were randomly divided into three groups of 15 (two experimental and one control group). The research instruments included Spielberger Anxiety Inventory (STAY-2) and International Pain Measurement Scale. The first experimental group received 6 sessions of cognitive-behavioral therapy for 6 weeks, and the second group was subjected to a computerized version of cognitive-behavioral therapy for 6 weeks, but the control group did not receive any interventions. For ethical considerations, a version of computerized cognitive-behavioral therapy was provided to them. After 6 weeks, all three groups were evaluated as post-test and eventually after a one-month follow-up. Results: The findings of this study indicated that both interventions could reduce the negative emotions (pain, anger, anxiety, depression) associated with cancer in children in comparison with a control group (p<0.0001). In addition, there were no significant differences between the two interventions (p<0.01). It means both interventions are useful for reducing the negative effects of pain and enhancing adjustment. Conclusion: we can use CBT in situations in which there is no access to psychologists and psychological services. In addition, it can be a useful alternative to conventional psychological interventions.

Keywords: pain, children, psychological intervention, cancer, anger, anxiety, depression

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Authors: Ekemini M. Okon, Reuben C. Okocha, Babatunde T. Adesina, Judith O. Ehigie, Babatunde M. Falana, Boluwape T. Okikiola

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Antimicrobial resistance (AMR) has evolved to become a significant threat to global public health and food safety. The development of AMR in animals has been associated with antimicrobial overuse. In recent years, the number of antimicrobials used in food animals such as fish and poultry has escalated. It, therefore, becomes imperative to understand the patterns of AMR in fish and poultry and map out future directions for better surveillance efforts. This study used the Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA) to assess the trend, patterns, and spatial distribution for AMR research in Egypt, Nigeria, and South Africa. A literature search was conducted through the Scopus and Web of Science databases in which published studies on AMR between 1989 and 2021 were assessed. A total of 172 articles were relevant for this study. The result showed progressive attention on AMR studies in fish and poultry from 2018 to 2021 across the selected countries. The period between 2018 (23 studies) and 2021 (25 studies) showed a significant increase in AMR publications with a peak in 2019 (28 studies). Egypt was the leading exponent of AMR research (43%, n=74) followed by Nigeria (40%, n=69), then South Africa (17%, n=29). AMR studies in fish received relatively little attention across countries. The majority of the AMR studies were on poultry in Egypt (82%, n=61), Nigeria (87%, n=60), and South Africa (83%, n=24). Further, most of the studies were on Escherichia and Salmonella species. Antimicrobials frequently researched were ampicillin, erythromycin, tetracycline, trimethoprim, chloramphenicol, and sulfamethoxazole groups. Multiple drug resistance was prevalent, as demonstrated by antimicrobial resistance patterns. In poultry, Escherichia coli isolates were resistant to cefotaxime, streptomycin, chloramphenicol, enrofloxacin, gentamycin, ciprofloxacin, oxytetracycline, kanamycin, nalidixic acid, tetracycline, trimethoprim/sulphamethoxazole, erythromycin, and ampicillin. Salmonella enterica serovars were resistant to tetracycline, trimethoprim/sulphamethoxazole, cefotaxime, and ampicillin. Staphylococcusaureus showed high-level resistance to streptomycin, kanamycin, erythromycin, cefoxitin, trimethoprim, vancomycin, ampicillin, and tetracycline. Campylobacter isolates were resistant to ceftriaxone, erythromycin, ciprofloxacin, tetracycline, and nalidixic acid at varying degrees. In fish, Enterococcus isolates showed resistance to penicillin, ampicillin, chloramphenicol, vancomycin, and tetracycline but sensitive to ciprofloxacin, erythromycin, and rifampicin. Isolated strains of Vibrio species showed sensitivity to florfenicol and ciprofloxacin, butresistance to trimethoprim/sulphamethoxazole and erythromycin. Isolates of Aeromonas and Pseudomonas species exhibited resistance to ampicillin and amoxicillin. Specifically, Aeromonashydrophila isolates showed sensitivity to cephradine, doxycycline, erythromycin, and florfenicol. However, resistance was also exhibited against augmentinandtetracycline. The findings constitute public and environmental health threats and suggest the need to promote and advance AMR research in other countries, particularly those on the global hotspot for antimicrobial use.

Keywords: antibiotics, antimicrobial resistance, bacteria, environment, public health

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of Covid-19 infection. Understanding novel treatment approaches are important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with virtual reality (VR) included. This game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with covid-19 related CVA. The safety of newly developed instruments for such cases provides new approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: covid-19, stroke, virtual reality, rehabilitation

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Authors: Georgiana Onicescu, Yuqian Shen

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Due to the complex nature of geo-referenced data, multicollinearity of the risk factors in public health spatial studies is a commonly encountered issue, which leads to low parameter estimation accuracy because it inflates the variance in the regression analysis. To address this issue, we proposed a two-stage variable selection method by extending the least absolute shrinkage and selection operator (Lasso) to the Bayesian spatial setting, investigating the impact of risk factors to health outcomes. Specifically, in stage I, we performed the variable selection using Bayesian Lasso and several other variable selection approaches. Then, in stage II, we performed the model selection with only the selected variables from stage I and compared again the methods. To evaluate the performance of the two-stage variable selection methods, we conducted a simulation study with different distributions for the risk factors, using geo-referenced count data as the outcome and Michigan as the research region. We considered the cases when all candidate risk factors are independently normally distributed, or follow a multivariate normal distribution with different correlation levels. Two other Bayesian variable selection methods, Binary indicator, and the combination of Binary indicator and Lasso were considered and compared as alternative methods. The simulation results indicated that the proposed two-stage Bayesian Lasso variable selection method has the best performance for both independent and dependent cases considered. When compared with the one-stage approach, and the other two alternative methods, the two-stage Bayesian Lasso approach provides the highest estimation accuracy in all scenarios considered.

Keywords: Lasso, Bayesian analysis, spatial analysis, variable selection

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Authors: Albert Perez-Bellmunt, Eila Rivera, Aida Valls, Berta Estragues, Sara Ortiz, Roberto Seijas, Pedro Alvarez

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INTRODUCTION: Physical and sports activity on a regular basis present numerous health benefits such as the prevention of cardiovascular and metabolic diseases. Also, there is a relation between sport and the psychological or the cognitive process of children and young people. The objective of the present study is to know if the sports practice has any positive influence on the university academic performance. MATERIALS AND METHODS: The level of the physical activity of 220 students of different degrees in health science was evaluated and compared with the academic results (grades). To assess the level of physical and sports activity, the Global Physical Activity Questionnaire (to calculate the sporting level in a general way) and the International Physical Activity Questionnaire (to estimate the physical activity carried out during the days leading up to the academic exams) were used. RESULTS: The students that realized an average level of sports activity the days before the exam obtained better grades than the rest of their classmate and the result was statistically significant. Controversially, if the sports level was analyzed in a general way, no relationship was observed between academic performance and the level of sport realized. CONCLUSION: A moderate physical activity, on the days leading up to an assessment, can be a positive factor for the university academic performance. Despite the fact that a regular sports activity improves many cognitive and physiological processes, the present study did not observe a direct relationship between sport/physical activity and academic performance.

Keywords: academic performance, academic results, global physical activity questionnaire, physical activity questionnaire, sport, sport practice

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Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell

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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.

Keywords: BME, UK, meta-ethnographic, adults

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Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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Authors: Roni Granot

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Musical intervals are the building blocks of melody and harmony. Intervals differ in terms of their size, direction, or quality as consonants or dissonants. In Western music, perceptual dissonance is mostly associated with the sensation of beats or periodicity, whereas cognitive dissonance is associated with rules of harmony and voice leading. These two perceptions can be studied separately in musical cultures which include melodic with little or no harmonic structures. In the Arab musical system, there is a number of different quarter- tone intervals creating various combinations of consonant and dissonant intervals. While traditional Arab music includes only melody, today’s Arab pop music includes harmonization of songs, often using typical Western harmonic sequences. Therefore, the Arab population in Israel presents an interesting case which enables us to examine the distinction between perceptual and cognitive dissonance. In the current study, we compared the responses of 34 Jewish Western listeners and 56 Arab listeners to two types of stimuli and their relationships: Harmonic sequences and isolated harmonic intervals (dyads). Harmonic sequences were presented in synthesized piano tones and represented five levels of Harmonic prototypicality (Tonic ending; Tonic ending with half flattened third; Deceptive cadence; Half cadence; and Dissonant unrelated ending) and were rated on 5-point scales of closure and surprise. Here we report only findings related to the harmonic sequences. One-way repeated measures ANOVA with one within subjects factor with five levels (Type of sequence) and one between- subjects factor (Musical background) indicates a main effect of Type of sequence for surprise ratings F (4, 85) = 51 p<.001, and for closure ratings F (4, 78) 9.54 p < .001, no main effect of Background on either surprise or closure ratings, and a marginally significant Type X Background interaction for surprise F (4, 352) = 6.05 p = .069 and closure ratings F (4, 324) 3.89 p < .01). Planned comparisons show that the interaction of Type of sequence X Background center around surprise and closure ratings of the regular versus the half- flattened third tonic and the deceptive versus the half cadence. The half- flattened third tonic is rated as less surprising and as demanding less continuation than the regular tonic by the Arab listeners as compared to the Western listeners. In addition, the half cadence is rated as more surprising but demanding less continuation than the deceptive cadence in the Arab listeners as compared to the Western listeners. Together, our results suggest that despite the vast exposure of Arab listeners to Western harmony, sensitivity to harmonic rules seems to be partial with preference to oriental sonorities such as half flattened third. In addition, the percept of directionality which demands sensitivity to the level on which closure is obtained and which is strongly entrenched in Western harmony, may not be fully integrated into the Arab listeners’ mental harmonic scheme. Results will be discussed in terms of broad differences between Western and Eastern aesthetic ideals.

Keywords: harmony, cross cultural, Arab music, closure

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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The translation of healthcare technologies is an expensive, complex affair, current healthcare challenges in Asian countries and their efforts to meet Millennium Development Goals (MDGs), necessitates continuous technology advancement to save countless lives, improve the quality of life and for socio-economic development. India’s consistently improving global innovation index (57) demonstrates its innovation potential, but access to health care is asymmetric and lacks priority in India. Therefore, there is utmost need of a robust translation system for point-of-care (POC) solutions, inexpensive, low-maintenance, reliable, and easy-to-use diagnostic technologies. Few cases of POC technologies viz. Elisa based diagnostic kits for regional viral disease, a device for detection of cancerous lesions were studied to understand the process and challenges involved in their translation. Accordingly, the entire translation ecosystem was summarized proposing a nexus of various actors such as technology developer, technology transferor technology receiver, funding entities, government/regulatory bodies and their effect on translation of different medical technologies. This study highlights the role and concerns pertaining to these actors for POC such as unsystematic and unvalidated research roadmap, low profit preposition, unfocused approach of up-scaling, low market acceptability and multiple window regulatory framework, etc. This provides an opportunity to devise solutions to overcome problem areas in translation path.

Keywords: healthcare technologies, point-of-care solutions, public health, translation

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Authors: Gülden Küçükakça, Şefika Dilek Güven, Rahşan Kolutek, Seçil Taylan

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Objective: Nursing students face with stress factors affecting academic performance and quality of life as from first moments of their educational life. Stress causes health problems in students such as physical, psycho-social, and behavioral disorders and might damage formation of professional identity by decreasing efficiency of education. In addition to determination of stress experienced by nursing students during their education, it was aimed to help review theoretical and clinical education settings for bringing stress of nursing students into positive level and to raise awareness of educators concerning their own professional behaviors. Methods: The study was conducted with 315 students studying at nursing department of Semra and Vefa Küçük Health High School, Nevşehir Hacı Bektaş Veli University in the academic year of 2015-2016 and agreed to participate in the study. “Personal Information Form” prepared by the researchers upon the literature review and “Nursing Education Stress Scale (NESS)” were used in this study. Data were assessed with analysis of variance and correlation analysis. Results: Mean NESS Scale score of the nursing students was estimated to be 66.46±16.08 points. Conclusions: As a result of this study, stress level experienced by nursing undergraduate students during their education was determined to be high. In accordance with this result, it can be recommended to determine sources of stress experienced by nursing undergraduate students during their education and to develop approaches to eliminate these stress sources.

Keywords: stress, nursing education, nursing student, nursing education stress

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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

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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

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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: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

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Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

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