Search results for: health triangle

Authors: Man Wai Leung, Margaret O’Donoghue, Lorna K. P. Suen

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Personal and household hygiene measures are important to prevent upper respiratory tract infections (URTIs) and other infectious diseases, including coronavirus disease 2019 (COVID-19). An online survey recruited 414 eligible parents in Hong Kong to study their hygiene knowledge, attitudes, and practices (KAP) in the prevention of URTIs among their children. The average knowledge score was high (10.2/12.0), but some misconceptions were identified. The majority of participants agreed that good personal hygiene (93.5%) and good environmental hygiene (92.8%) can prevent URTIs. The average score for hand hygiene practices was high (3.78/4.00), but only 56.8% of parents always perform hand hygiene before touching their mouth, nose, or eyes. For environmental hygiene, only some household items were disinfected with disinfectants (69.8%: door handles, 60.4%: toilet seats, 42.8%: floor, 24.2%: dining chairs, 20.5%: dining tables). Higher knowledge score was associated with parents having a tertiary educational level or above, working as healthcare professionals, living at private residential flat or staff quarter, and having a household income of $70,000 or above. Hand hygiene practices varied significantly with parents’ age and income. During the 5th wave of the COVID-19 epidemic, misconceptions about hygiene knowledge were found among parents. Health promotion programs should target parents, especially those who are in old age, obtain lower educational levels, live in public housing, or have a lower income. Hand hygiene moments and proper use of disinfectants could be one of the targeted educational topics.

Keywords: hygiene, upper respiratory tract infection, parents, children, COVID-19

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Authors: Luo Guidong, Song Hang, Jim Song, Virginia Martin Torrejon

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Due to their excellent properties, polymer packaging foams have become increasingly essential in our current lifestyles. They are cost-effective and lightweight, with excellent mechanical and thermal insulation properties. However, they constitute a major environmental and health concern due to litter generation, ocean pollution, and microplastic contamination of the food chain. In recent years, considerable efforts have been made to develop more sustainable alternatives to conventional polymer packaging foams. As a result, biobased and compostable foams are increasingly becoming commercially available, such as starch-based loose-fill or PLA trays. However, there is still a need for bulk manufacturing of bio-foams planks for packaging applications as a viable alternative to their fossil fuel counterparts (i.e., polystyrene, polyethylene, and polyurethane). Gelatin is a promising biopolymer for packaging applications due to its biodegradability, availability, and biocompatibility, but its mechanical properties are poor compared to conventional plastics. However, as widely reported for other biopolymers, such as starch, the mechanical properties of gelatin-based bioplastics can be enhanced by formulation optimization, such as the incorporation of fibres from different crops, such as bamboo. This research aimed to produce gelatin-bamboo fibre foams by mechanical foaming and to study the effect of fibre content on the foams' properties and structure. As a result, foams with virtually no shrinkage, low density (<40 kg/m³), low thermal conductivity (<0.044 W/m•K), and mechanical properties comparable to conventional plastics were produced. Further work should focus on developing formulations suitable for the packaging of water-sensitive products and processing optimization, especially the reduction of the drying time.

Keywords: biobased and compostable foam, sustainable packaging, natural polymer hydrogel, cold chain packaging

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Authors: Md Tareq Ferdous Khan, Shrabanti Mazumder, MB Rao

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Background: Substance use during pregnancy is a longstanding public health problem that results in severe consequences for pregnant women and fetuses. Methods: Eight (2011-2018) datasets on pregnant women’s admissions are extracted from TEDS-A. Distributions of sociodemographic, substance abuse behaviors, and clinical characteristics are constructed and compared over the years for trends by the Cochran-Armitage test. Market basket analysis is used in mining the association among polysubstance abuse. Results: Over the years, pregnant woman admissions as the percentage of total and female admissions remain stable, where total annual admissions range from 1.54 to about 2 million with the female share of 33.30% to 35.61%. Pregnant women aged 21-29, 12 or more years of education, white race, unemployed, holding independent living status are among the most vulnerable. Concerns prevail on a significant number of polysubstance users, young age at first use, frequency of daily users, and records of prior admissions (60%). Trends of abused primary substances show a significant rise in heroin (66%) and methamphetamine (46%) over the years, although the latest year shows a considerable downturn. On the other hand, significant decreasing patterns are evident for alcohol (43%), marijuana or hashish (24%), cocaine or crack (23%), other opiates or synthetics (36%), and benzodiazepines (29%). Basket analysis reveals some patterns of co-occurrence of substances consistent over the years. Conclusions: This comprehensive study can work as a reference to identify the most vulnerable groups based on their characteristics and deal with the most hazardous substances from their evidence of co-occurrence.

Keywords: basket analysis, pregnant women, substance abuse, trend analysis

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Authors: Foluke Abimbola

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There are two separate groups of a recognised body of human rights. These are known as Civil and Political Rights, and Economic and Social Rights. There is however an impression that civil and political rights are enforceable in courts while socio-economic rights are not. Nigeria is an example of one of such countries whose constitution has social, economic and cultural rights’ provisions as well as civil and political rights. However, the socio-economic rights provided in the Nigerian constitution are not justiciable or are unenforceable in a court of law. On the other hand, a comparative examination of the socio-economic right provisions in the South African constitution and judgments of the constitutional court of South Africa reveals that socio-economic rights may be enforceable. This position may ensure the protection of the socio-economic rights of the poor and vulnerable groups. These rights include the rights to food, adequate shelter, health, and education. Moreover, the African Charter on Human and Peoples’ Rights (African Charter) which incorporates similar socio-economic right provisions, has been recognized as a domestic law in Nigeria and its provisions are enforceable by the domestic courts by virtue of the African Charter on Human and People’s Rights (Ratification and Enforcement) Act Cap A9 Laws of the Federation of Nigeria 2004. It is not only a regional treaty signed and adopted by Nigeria but has been passed into law by the National Assembly and can be enforced like any other local law. This paper will propose that in view of the provisions of the African Charter and mechanisms for implementation as well as other international conventions and national constitutional provisions on human rights, domestic courts may be able to assess state responsibilities in the light of socio-economic rights. Cases decided by South African courts and other jurisdictions will be discussed in order to lend weight to the notion that socio-economic rights can be enforced in jurisdictions such as Nigeria even though the constitution provides otherwise.

Keywords: african charter, constitutional court of south africa, nigerian constitution, socio-economic rights, south african constitution

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Authors: Alyaa Abdlwahab

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Cutaneous leishmaniasis represents a serious health problem in Syria; this problem has become noticeably aggravated after the civil war in the country. Leishmania tropica parasite is the main cause of cutaneous leishmaniasis in Syria. In order to control the disease, we need an effective vaccine against leishmania parasite. DNA vaccination remains one of the favorable approaches that have been used to face cutaneous leishmaniasis. Ribosomal protein S4 is responsible for important roles in Leishmania parasite life. DNA vaccine based on S4 gene has been used against infections by many species of Leishmania parasite but leishmania tropica parasite, so this gene represents a good candidate for DNA vaccine construction. After proving the existence of ribosomal protein S4 gene in a Syrian strain of Leishmania tropica (LCED Syrian 01), sequencing it and cloning it into pCI plasmid, BALB/C mice were inoculated with pCI-S4 DNA vaccine. The immune response was determined by monitoring the lesion progression in inoculated BALB/C mice for six weeks after challenging mice with Leishmania tropica (LCED Syrian 01) parasites. IL-12, IFN-γ, and IL-4 were quantified in draining lymph nodes (DLNa) of the immunized BALB/C mice by using the RT-qPCR technique. The parasite burden was calculated in the final week for the footpad lesion and the DLNs of the mice. This study proved the existence and the expression of the ribosomal protein S4 gene in Leishmania tropica (LCED Syrian 01) promastigotes. The sequence of ribosomal protein cDNA S4 gene was determined and published in Genbank; the gene size was 822 bp. Expression was also demonstrated at the level of cDNA. Also, this study revealed that pCI-S4 DNA vaccine induces TH1\TH2 response in immunized mice; this response prevents partially developing a dermal lesion of Leishmania.

Keywords: ribosomal protein S4, DNA vaccine, Leishmania tropica, BALB\c

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Authors: Afshin Azari, Farzad Peiravian, Nazila Yousefi

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Introduction: Community pharmacies have been always played an important role in public health. Therefore, having a decent service provided by these pharmacies is of paramount importance for the healthcare system. The issue of pharmacy ownership and its possible impact on the quality of services and amount of violations has been argued for many years, and there are different opinions around this debate. Since, so far, no scientific research has been performed to investigate this issue in Iran, this study aimed to examine the differences between these two types of pharmacies ownership in terms of violations and service quality. Method: This study investigates the impact of two different kinds of pharmacy ownership (pharmacists and non-pharmacist’s ownership) on the pharmacies’ amount of violations and services quality. Pharmacies’ amount of violations was examined using “pharmacy inspection reports” between September 2018 and September 2019, in their distinguishable categories: minor, major and critical violations. Then, service quality was examined using a questionnaire from the perspective of pharmacy customers. Results: Considering violations, there was no evidence to prove a significant relationship between critical violations and major violations with the type of pharmacy ownership. However, in minor violations, the average of violations was higher in pharmacies owned by pharmacists in comparison to their non-pharmacist owned counterparts. Regarding service quality, the results showed that there is no significant relationship between the quality of service and the type of pharmacy ownership. Discussion and Conclusion: In this study, no significant relationship was found between the amount of violations and the type of pharmacy ownership. This could indicate that the pharmacy ownership would not influence the rate of violations. Considering that more inspections have been carried out in non-pharmacist owned pharmacies, it can be concluded that these pharmacies are more under control, and in fact, this monitoring has reduced violations in these pharmacies. The quality of services in the two types of pharmacies were not significantly different from each other, and this shows that non-pharmacist-owned pharmacies also try to maintain the desired level of service in competition with their competitors.

Keywords: pharmacy ownership, quality of service, violation, community pharmacy

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Authors: Kebret Kebede, Anthony Scinta

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Obesity is the most prevalent global problem that continues to rise at alarming rates both in the industrialized and developing countries. Adipose tissue is an endocrine tissue that secretes numerous chemical signals, hormones, lipids, cytokines and coagulation factors as well as prompting insulin resistance which is a primary contributor to Type II Diabetes- one of its most common adverse effects on health. Other hormones whose levels are linked to obesity and nutritional state are leptin, IGF-1, and adiponectin. Several studies indicate that obesity is the leading cause of high levels of cholesterol that leads to fatty liver disease, gallstones, hypertension, increased risk for cancer and degenerative joint disease that primarily affects the weight bearing joints of the lower extremities. The activation of inflammatory pathways promotes synovial pathology that results in accelerated degeneration of the joints. The study examines the prevalence of obesity in the US female population in comparison to that of the developing world and its emergence as a significant and potentially modifiable risk factor in degenerative disease of the hip and knee joints that has resulted in staggering healthcare cost. Studies have shown that as the prevalence of obesity rises, we continue to see a rise in degenerative joint disease. The percentage of arthritis cases linked directly to obesity has risen from 3 percent in 1971 to 18 percent in 2002. A person with obesity is around 60 percent more likely to develop arthritis than someone of normal body weight. In women, obesity is associated with increased mortality from breast, cervical, endometrial and ovarian cancer that may accompany debilitating joint diseases and restricted mobility.

Keywords: obesity, endocrine, degenerative, mortality, joint diseases, cancer, debilitating, mobility

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Authors: Ni Luh Putu Harta Wedari

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Background: Clostridium difficile has two main virulence factors, namely TcdA and TcdB. TcdA encoded by the tcdA gene acts as an enterotoxin, pro-inflammatory and fluid accumulation, while TcdB encoded by the tcdB gene is cytotoxic, causes disruption of the actin cytoskeleton, and causes disruption of tight junctions in colon cells. This study aims to explore the relationship between the tcdA and tcdB genes and the duration of diarrhea in elderly patients. Method: This research was an observational analytic with a prospective cross-sectional with samples of elderly diarrhea patients who met the inclusion criteria in Denpasar City health service facilities from 1 December 2022 until 30 June 2023, and then their feces were analyzed using the real-time PCR method. Results: In this study, 40 elderly diarrhea patients met the inclusion criteria and in accordance with the minimum sample size, 28 (70%) men and 12 (30%) women. 5 patients (12.5%) had a history of azithromycin, 4 (10%) levofloxacin, 17 (42.5%) ciprofloxacin, 8 (20%) metronidazole, 1 (2.5%) cefoperazone, 5 (12, 5%) doxycycline. Comorbids, namely 13 (32.5%) type II diabetes mellitus, 4 (10%) chronic kidney disease, 10 (25%) malignancies, 7 (17.5%) urinary tract infections, 3 (7.5%) %) immunocompromised, 2 (5%) cardiac heart failure, and 1 (2.5%) acute on chronic kidney disease. The overall diarrhea duration average was 5 days. 8 samples (20%) were positive for 16s rRNA, and there was no significant difference in diarrhea duration with negative samples (p=0.166). The relationship between the tcdA gene and the duration of diarrhea could not be performed because all samples were negative. Likewise, relationship analysis between the coexistence of tcdA and tcdB could not be performed. There was no significant difference between tcdB positive 3 (7.5%) and negative with diarrhea duration (p=0.739). Conclusion: There is no significant relationship between the presence of the 16s rRNA and tcdB C. difficile genes with the duration of diarrhea in elderly patients.

Keywords: clostridium, difficile, diarrhea, elderly, tcdA, tcdB

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Authors: Bulcha Belay Etana, Benny Malengier, Janarthanan Krishnamoorthy, Timothy Kwa, Lieva Vanlangenhove

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Electromyography measures the electrical activity of muscles using surface electrodes or needle electrodes to monitor various disease conditions. Recent developments in the signal acquisition of electromyograms using textile electrodes facilitate wearable devices, enabling patients to monitor and control their health status outside of healthcare facilities. Here, we have developed and tested wearable textile electrodes to acquire electromyography signals from patients suffering from Parkinson’s disease and incorporated a feedback-control system to relieve muscle cramping through thermal stimulus. In brief, the textile electrodes made of stainless steel was knitted into a textile fabric as a sleeve, and their electrical characteristic, such as signal-to-noise ratio, was compared with traditional electrodes. To relieve muscle cramping, a heating element made of stainless-steel conductive yarn sewn onto a cotton fabric, coupled with a vibration system, was developed. The system integrated a microcontroller and a Myoware muscle sensor to activate the heating element as well as the vibration motor when cramping occurred. At the same time, the element gets deactivated when the muscle cramping subsides. An optimum therapeutic temperature of 35.5°C is regulated and maintained continuously by a heating device. The textile electrode exhibited a signal-to-noise ratio of 6.38dB, comparable to that of the traditional electrode’s value of 7.05 dB. For a given 9 V power supply, the rise time for the developed heating element was about 6 minutes to reach an optimum temperature.

Keywords: smart textile system, wearable electronic textile, electromyography, heating textile, vibration therapy, Parkinson’s disease

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Authors: N. Khodarahmi, L. Ford

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Decades of research on the impact of trauma in early childhood suggest severe risks to the mental health, emotional, social and physical development of a young child. Trauma-exposed students can pose a variety of different levels of challenges to schools and educators of young children and to date, few studies have addressed ECE teachers’ role in providing trauma support. The present study aims to contribute to this literature by exploring the beliefs of British Columbia’s (BC) early childhood education (ECE) teachers in their level of readiness and capability to work within a trauma-informed practice (TIP) framework to support their trauma-exposed students. Through a sequential, mix-methods approach, a self-report questionnaire and semi-structured interviews will be used to gauge BC ECE teachers’ knowledge of TIP, their preparedness, and their ability in using this framework to support their most vulnerable students. Teacher participants will be recruited through the ECEBC organization and various school districts in the Greater Vancouver Area. Questionnaire data will be primarily collected through an online survey tool whereas interviews will be taking place in-person and audio-recorded. Data analysis of survey responses will be largely descriptive, whereas interviews, once transcribed, will be employing thematic content analysis to generate themes from teacher responses. Ultimately, this study hopes to highlight the necessity of utilizing the TIP framework in BC ECE classrooms in order to support both trauma-exposed students and provide essential resources to compassionate educators of young children.

Keywords: early childhood education, early learning classrooms, refugee students, trauma-exposed students, trauma-informed practice

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Authors: Rajrupa Ghosh, Abhijit Mitra

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Future use of animal protein sources in prawn feeds is expected to be considerably reduced as a consequence of increasing economical, environmental and safety issues. Of main concern has been the use of expensive marine protein sources, such as fish meal which often results in fouling of water quality and disease outbreak in cultured species. To determine prawn capacity to use practical feeds with plant proteins as replacement ingredients to animal protein sources, 8-months growth trial was conducted in two sets of ponds using juvenile (0.02 gm) Macrobrachium rosenbergii. Among the two sets, one set (comprising of three ponds) is experimental pond included formulated feed prepared with 30% Porteresia coarctata dust along with other general ingredients and another set (comprising of another three ponds) is control pond with commercial feed. Mean final weight, percent weight gain, final net yield, feed conversion ratio and survival were evaluated. Higher condition index values, survival rate and gain in prawn weight were observed in experimental pond compared to control pond. Low FCR values were observed in the experimental pond than the control pond. Evaluation of production parameters at the end of the study demonstrated significant differences (P ≥ 0.05) among two ponds. The variation may be attributed to specially formulated plant based feed that not only boosted up the growth of prawns, but also upgraded the ambient aquatic health. These results indicate that fish meal can be replaced with algal protein sources in diets without affecting prawn growth and production.

Keywords: macrobrachium rosenbergii, porteresia coarctata, Indian sundarbans, feed

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Authors: Shuji Fujimoto, Fumiko Kojima, Mika Shigematsu

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Biorisk management (Biosafety/Biosecurity) is required for anyone working in a clinical laboratory (including medical/clinical research laboratories) where infectious agents and potentially hazardous biological materials are examined/stored. Proper education and training based on international standards of biorisk management should be provided not only as a part of laboratory safety program in work place but also as a part of introductory training at educational institutions for continuity and to elevate overall baseline of the biorisk management. We reported results of the pilot study of biorisk management education for graduate students majored in laboratory diagnostics previously. However, postgraduate education is still late in their profession and the participants’ interview also revealed importance and demands of earlier biorisk management education for undergraduates. The aim of this study is to identify the need for biosafety/biosecurity education and training program which is designed for undergraduate students who are entering the profession in clinical microbiology. We modified the previous program to include more basic topics and explanations (risk management, principles of safe clinical lab practices, personal protective equipment, disinfection, disposal of biological substances) and provided incorporating in the routine educational system for faculty of medical sciences in Kyushu University. The results of the pre and post examinations showed that the knowledge of the students on biorisk control had developed effectively as a proof of effectiveness of the program even in the undergraduate students. Our study indicates that administrating the basic biorisk management program in the earlier stage of learning will add positive impact to the understanding of biosafety to the health professional education.

Keywords: biorisk management, biosafety, biosecurity, clinical microbiology, education for undergraduates

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Authors: Matthew Korey, Jeffrey Youngblood, John Howarter

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Background and Significance: Tannic acid (TA) is a bio-based high molecular weight organic, aromatic molecule that has been found to increase thermal stability and flame retardancy of many polymer matrices when used as an additive. Although it is biologically sourced, TA is a pollutant in industrial wastewater streams, and there is a desire to find applications in which to downcycle this molecule after extraction from these streams. Additionally, epoxy thermosets have revolutionized many industries, but are too flammable to be used in many applications without additives which augment their flame retardancy (FR). Many flame retardants used in epoxy thermosets are synthesized from petroleum-based monomers leading to significant environmental impacts on the industrial scale. Many of these compounds also have significant impacts on human health. Various bio-based modifiers have been developed to improve the FR of the epoxy resin; however, increasing FR of the system without tradeoffs with other properties has proven challenging, especially for TA. Methodologies: In this work, TA was incorporated into the thermoset by use of solvent-exchange using methyl ethyl ketone, a co-solvent for TA, and epoxy resin. Samples were then characterized optically (UV-vis spectroscopy and optical microscopy), thermally (thermogravimetric analysis and differential scanning calorimetry), and for their flame retardancy (mass loss calorimetry). Major Findings: Compared to control samples, all samples were found to have increased thermal stability. Further, the addition of tannic acid to the polymer matrix by the use of solvent greatly increased the compatibility of the additive in epoxy thermosets. By using solvent-exchange, the highest loading level of TA found in literature was achieved in this work (40 wt%). Conclusions: The use of solvent-exchange shows promises for circumventing the limitations of TA in epoxy.

Keywords: sustainable, flame retardant, epoxy, tannic acid

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Authors: Shilpi Tripathi

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After independence, Bangladesh had to learn to survive on its own without any economic crutches (aid). Foreign direct investment (FDI) became a crucial economic tool for the country to become economically independent. The government started removing restrictions to encourage foreign investment, economic growth, international trade, and the environment. FDI is considered as a way to bridge the saving-investment gap, reduce poverty, balance trade, create jobs for its vast labour force, increase foreign exchange earnings and acquire new modern technology and management skills in the country. At the same time, spillovers of foreign investments in Bangladesh, such as low wages (compared to laborers of developed countries), poor working conditions and unbridled exploitation of the domestic resources, environmental externalities, etc., cannot be ignored. The most important adverse implications of FDI inflows noticed are the environmental problems, which are further impacting the health and society of the country. This paper empirically studies the relationship between FDI, economic growth, international trade (exports and Imports), and the environment since 1996. The first part of the paper focuses on the background and trends of FDI, GDP, trade, and environment (CO₂). The second part focuses on the literature review on the relationship between all the variables. The last part of the paper examines the results of empirical analysis like co-integration and Granger causality. The findings of the paper reveal that a uni-directional relationship exists between FDI, CO₂, and international trade (exports and imports). The direction of the causality reveals that FDI inflow is one of the major contributors to high-volume international trade. At the same time, FDI and international trade both are contributing to carbon emissions in Bangladesh. The paper concludes with the policy recommendations that will ensure environmentally friendly trade, investment, and growth in Bangladesh for the future.

Keywords: foreign direct investment, GDP, international trade, CO₂, Granger causality, environment

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Authors: Ramesh K. Adsul, V. R. Shinde, S. S. Jadhav

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The main aim of the present study was to explore the effect of various levels of parental acceptance – avoidance attitude on various areas of adjustment of urban and rural junior college students. It was hypothesized that 1. There exists no significant effect of various levels of parental acceptance attitude on adjustment of urban and rural junior college students. 2. There exists no significant effect of various levels of parental avoidance attitude on adjustment of urban and rural junior college students. 3. There would be no significant difference between urban and rural Junior College students on various areas of (home, health, social, and emotional) adjustment. The 847 students (427 boys and 420 girls) studying in 11th class of various Junior colleges in Sangli ,Satara and Kolhapur districts of Maharashtra State, India were selected by random sampling method. Study was conducted by using two psychological tests namely 1. Family Relationship Inventory. 2.Bell’s Adjustment Inventory. One way ANOVA was employed to find out the effect of parental acceptance – avoidance attitude and adjustment in various areas of urban and rural junior college students. ‘t’ test was used to find out the difference between urban and rural students on various areas of adjustment. The results of the study indicate that (1) It is observed that three groups of parental acceptance attitude (PA) are significantly varied on home and social adjustment. It means that PA affects home and social adjustment of adolescents. High PA creates excellent adjustment and low PA creates poor adjustment in adolescents. (2) Study revealed that PV significantly affects adjustment of adolescents. High PV significantly creates poor adjustment in adolescents than average and low PV. (3) There is significant difference between urban and rural adolescents on adjustment. Urban adolescents have better adjustment than rural adolescents.

Keywords: parental acceptance, avoidance attitude, adjustment, urban-rural student

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Authors: Ryan Houser

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Introduction: Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services, even in the accelerating environment of biothreats. Methods: This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS (Emergency Medical Services ) providers. The survey was available for one month in 2021, during which 190 EMS providers responded to the survey. Results: Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a CBRN agent. The provider Clinical Competency levels range from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution and community). Only 10% of the respondents are both willing and able to effectively function in a bioterror environment. Discussion: In order to effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.

Keywords: bioterrorism, prehospital, EMS, disaster, emergency, medicine, preparedness, policy

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Authors: Shabnam Etemadi

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Background: Infertility is one of the most important issues in any society due to its psychological, medical and economic consequences that can greatly influence overall health and life. This study aims to assess the relationship between inhalation or exposing workplace pollution and dysfunction of the male reproductive system. Semen samples are male employees in south of Iran who exposed to work environmental pollutants for long hours. Method: Due to descriptive-analytical, the analysis of all interviews of all male patients of Bu Ali Medical Center and Pasteur Laboratory are conducted within 6 months. Random sampling numbered and patients signed informed consent. To analyze the data, Miller's fertility motivation questionnaires and the Miller-Smith lifestyle assessment inventory are used and Working Conditions Survey is developed. For analyzing the collecting data SPSS is used. Findings: Although sperm motility and volume had no statistically significant relationship with any of the lifestyle components, the weak relationship between sperm movement and work environment conditions (P = 0.07) lead to other factors to be investigated. * Among the factors of Working Environment Condition, smoking, work in the open environment and presence of more than 6 hours in the work environment with sperm mobility, smoking, contact with chemicals and radioactive with sperm volume at a level less than 0.05 had a statistically significant relationship. Conclusion: Finding revealed the environment pollution is one of the important factors in male infertility and strengthens this hypothesis. Working Environmental pollutants in the field of metropolitan pollution should be considered as a unifying hypothesis, possibly could interfere with male reproductive function.

Keywords: infertility, lifestyle, workplace pollution, male infertility

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Authors: C. F. Jones Couto, L. C. Motlhaolwa, K. Williams

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This article explores the re-imagining of physical education teacher education in South African higher education. Utilising student reflections from a physical education practical module, valuable insights into student experiences were obtained about the current physical education pedagogical approaches and potential areas for improvement. The traditional teaching model of physical education is based on the idea of teaching students a variety of sports and physical activities. However, this model has been shown to be ineffective in promoting lifelong physical activity. The modern world demands a more holistic approach to health and wellness. Data was collected using the arts-based collage method in combination with written group reflections from 139 second-year undergraduate physical education students. This study employed thematic analysis methods to gain a comprehensive understanding of the data and extract a broader perspective on the students' experiences. The study aimed to empower student teachers to learn, think, and act creatively within the many educational models that impact their experience, contributing to the ongoing efforts of re-imagining physical education teacher education in South African higher education. This research is significant as the students' valuable insights reflected that they can think and work across disciplines. Sustainable development goals and graduate attributes are important concepts that can contribute to student preparation. Using a multi-model educational approach based on the cultural-historical theory, higher education institutions can help develop graduate attributes that will prepare students for success in the workplace and life.

Keywords: holistic education, graduate attributes, physical education, teacher education, student experiences, sustainable development goals

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Authors: Mohammad H. Yarmohammadian, Reza Safdari, Mahmoud Keyvanara, Nahid Tavakoli

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One of the greatest challenges in disaster and emergencies is patient tracking. The concept of tracking has different denotations. One of the meanings refers to tracking patients’ physical locations and the other meaning refers to tracking patients ‘medical needs during emergency services. The main goal of patient tracking is to provide patient safety during disaster and emergencies and manage the flow of patient and information in different locations. In most of cases, there are not sufficient and accurate data regarding the number of injuries, medical conditions and their accommodation and transference. The objective of the present study is to survey on patient tracking issue in natural disaster and emergencies. Methods: This was a narrative study in which the population was E-Journals and the electronic database such as PubMed, Proquest, Science direct, Elsevier, etc. Data was gathered by Extraction Form. All data were analyzed via content analysis. Results: In many countries there is no appropriate and rapid method for tracking patients and transferring victims after the occurrence of incidents. The absence of reliable data of patients’ transference and accommodation, even in the initial hours and days after the occurrence of disasters, and coordination for appropriate resource allocation, have faced challenges for evaluating needs and services challenges. Currently, most of emergency services are based on paper systems, while these systems do not act appropriately in great disasters and incidents and this issue causes information loss. Conclusion: Patient tracking system should update the location of patients or evacuees and information related to their states. Patients’ information should be accessible for authorized users to continue their treatment, accommodation and transference. Also it should include timely information of patients’ location as soon as they arrive somewhere and leave therein such a way that health care professionals can be able to provide patients’ proper medical treatment.

Keywords: patient tracking, challenges, disaster, emergency

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Authors: Kayode A. Olaniyi, Adeola A. Ogunleye, Tola M. Osifeko

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Electric Vehicles (EV) appear to be gaining increasing patronage as a feasible alternative to Internal Combustion Engine Vehicles (ICEVs) for having low emission and high operation efficiency. The EV energy storage systems are required to handle high energy and power density capacity constrained by limited space, operating temperature, weight and cost. The choice of strategies for energy storage evaluation, monitoring and control remains a challenging task. This paper presents review of various energy storage technologies and recent researches in battery evaluation techniques used in EV applications. It also underscores strategies for the hybrid energy storage management and control schemes for the improvement of EV stability and reliability. The study reveals that despite the advances recorded in battery technologies there is still no cell which possess both the optimum power and energy densities among other requirements, for EV application. However combination of two or more energy storages as hybrid and allowing the advantageous attributes from each device to be utilized is a promising solution. The review also reveals that State-of-Charge (SoC) is the most crucial method for battery estimation. The conventional method of SoC measurement is however questioned in the literature and adaptive algorithms that include all model of disturbances are being proposed. The review further suggests that heuristic-based approach is commonly adopted in the development of strategies for hybrid energy storage system management. The alternative approach which is optimization-based is found to be more accurate but is memory and computational intensive and as such not recommended in most real-time applications.

Keywords: battery state estimation, hybrid electric vehicle, hybrid energy storage, state of charge, state of health

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Authors: Joo-Heon Lee, Seo-Yeon Park, Chanyang Sur, Ho-Won Jang

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Satellite-based remote sensing technique has been widely used in the area of drought and environmental monitoring to overcome the weakness of in-situ based monitoring. There are many advantages of remote sensing for drought watch in terms of data accessibility, monitoring resolution and types of available hydro-meteorological data including environmental areas. This study was focused on the applicability of drought monitoring based on satellite imageries by applying to the historical drought events, which had a huge impact on meteorological, agricultural, and hydrological drought. Satellite-based drought indices, the Standardized Precipitation Index (SPI) using Tropical Rainfall Measuring Mission (TRMM) and Global Precipitation Mission (GPM); Vegetation Health Index (VHI) using MODIS based Land Surface Temperature (LST), and Normalized Difference Vegetation Index (NDVI); and Scaled Drought Condition Index (SDCI) were evaluated to assess its capability to analyze the complex topography of the Korean peninsula. While the VHI was accurate when capturing moderate drought conditions in agricultural drought-damaged areas, the SDCI was relatively well monitored in hydrological drought-damaged areas. In addition, this study found correlations among various drought indices and applicability using Receiver Operating Characteristic (ROC) method, which will expand our understanding of the relationships between hydro-meteorological variables and drought events at global scale. The results of this research are expected to assist decision makers in taking timely and appropriate action in order to save millions of lives in drought-damaged areas.

Keywords: drought monitoring, moderate resolution imaging spectroradiometer (MODIS), remote sensing, receiver operating characteristic (ROC)

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Authors: Mohammed Jarrar, Shalini Behl, Nadia Shaheen, Abeer Fatima, Reem Nasab

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Skin aging is a slow multifactorial process influenced by both internal as well as external factors. Ultra-violet radiations (UV), diet, smoking and personal habits are the most common environmental factors that affect skin aging. Fat contents and fibrous proteins as collagen and elastin are core internal structural components. The direct influence of UV on elastin integrity and health is crucial on aging of skin by time. The deposition of abnormal elastic material is a major marker in a photo-aged skin. Searching for compounds that may protect against cutaneous photo-damage is highly valued. Retinoids and Alpha Hydroxy Acids protective and or repairing effects of UV have been endorsed by some researchers. For consolidating a better understanding of anti and protective effects of such anti-aging agents, we evaluated the combinatory effects of various dosages of lactic acid and retinol on the dermal fibroblasts elastin levels exposed to UV. The UV exposed cells showed significant reduction in the elastin levels. A combination of drugs with a higher concentration of lactic acid (30-35 mM) and a lower concentration of retinol (10-15mg/mL) showed to work better in enhancing elastin concentration in UV exposed cells. We assume this enhancement could be the result of increased tropo-elastin gene expression stimulated by retinol and lactic acid probably repaired the UV irradiated damage by enhancing the amount and integrity of the elastin fibers.

Keywords: alpha hydroxy acid, elastin, retinol, ultraviolet radiations

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Authors: R. Botrugno, S Basyuni, G. Nugent, I. Jenkyn, A. Ferro, H. Bennett, C. Hjalmarsson, J. Chu, V. Santhanam

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This trainee led randomised controlled trial (RCT) aims to assess various outcomes for resorbable versus non-resorbable sutures for traumatic lacerations to the face. Within this trial of resorbable versus non-resorbable sutures for traumatic lacerations of the face (TORNFace), patient recruitment was facilitated by trainees who were employed at an NHS University Teaching Hospital in the United Kingdom. The trainees received appropriate training prior to recruiting patients for the trial. This included the completion of a national research e-learning module and face-to-face training that was provided locally. The locally delivered training provided an understanding of the eligibility criteria for the trial and the consent process. Existing trainee skills were utilised involving clinical photography to record baseline data and delivering the intervention based on the treatment arm selected. Eligible patients who required primary closure of traumatic lacerations of the face were randomised into one of two treatment arms. These comprised of resorbable (vicryl rapide) or non-resorbable sutures (ethilon). Primarily the cosmetic outcome was assessed. Secondary outcomes included: complications rates, health care economics, and patient-reported outcomes. Remote follow-up of recruited patients utilised photographs of the facial laceration which had received the intervention. These took place at 1 week, 3 months and 6 months post-intervention. This study aims to demonstrate an example of trainee-led research within the specialty of oral and maxillofacial surgery. The available data for the randomised controlled trial will also be presented.

Keywords: laceration, suture, trauma, trial

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Authors: Mahmood Alsaadi, Alexei Lisitsa

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Nowadays, medical devices rely completely on software whether as whole software or as embedded software, therefore, the organization that develops medical device software can benefit from adopting agile practices. Using agile practices in healthcare software development industries would bring benefits such as producing a product of a high-quality with low cost and in short period. However, medical device software development companies faced challenges in adopting agile practices. These due to the gaps that exist between agile practices and the requirements of healthcare regulations such as documentation, traceability, and formality. This research paper will conduct a study to investigate the adoption rate of agile practice in medical device software development, and they will extract and outline the requirements of healthcare regulations such as Food and Drug Administration (FDA), Health Insurance Portability and Accountability Act (HIPAA), and Medical Device Directive (MDD) that affect directly or indirectly on software development life cycle. Moreover, this research paper will evaluate the suitability of using agile practices in healthcare industries by analyzing the most popular agile practices such as eXtream Programming (XP), Scrum, and Feature-Driven Development (FDD) from healthcare industry point of view and in comparison with the requirements of healthcare regulations. Finally, the authors propose an agile mixture model that consists of different practices from different agile methods. As result, the adoption rate of agile practices in healthcare industries still low and agile practices should enhance with regard to requirements of the healthcare regulations in order to be used in healthcare software development organizations. Therefore, the proposed agile mixture model may assist in minimizing the gaps existing between healthcare regulations and agile practices and increase the adoption rate in the healthcare industry. As this research paper part of the ongoing project, an evaluation of agile mixture model will be conducted in the near future.

Keywords: adoption of agile, agile gaps, agile mixture model, agile practices, healthcare regulations

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Authors: Levente Kovács, Fruzsina Luca Kézér, Ottó Szenci

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Prediction of the onset of calving and recognizing difficulties at calving has great importance in decreasing neonatal losses and reducing the risk of health problems in the early postpartum period. In this study, changes of rumination time, reticuloruminal pH and temperature were investigated in eutocic (EUT, n = 10) and dystocic (DYS, n = 8) dairy cows around parturition. Rumination time was continuously recorded using an acoustic biotelemetry system, whereas reticuloruminal pH and temperature were recorded using an indwelling and wireless data transmitting system. The recording period lasted from 3 d before calving until 7 days in milk. For the comparison of rumination time and reticuloruminal characteristics between groups, time to return to baseline (the time interval required to return to baseline from the delivery of the calf) and area under the curve (AUC, both for prepartum and postpartum periods) were calculated for each parameter. Rumination time decreased from baseline 28 h before calving both for EUT and DYS cows (P = 0.023 and P = 0.017, respectively). After 20 h before calving, it decreased onwards to reach 32.4 ± 2.3 and 13.2 ± 2.0 min/4 h between 8 and 4 h before delivery in EUT and DYS cows, respectively, and then it decreased below 10 and 5 min during the last 4 h before calving (P = 0.003 and P = 0.008, respectively). Until 12 h after delivery rumination time reached 42.6 ± 2.7 and 51.0 ± 3.1 min/4 h in DYS and EUT dams, respectively, however, AUC and time to return to baseline suggested lower rumination activity in DYS cows than in EUT dams for the 168-h postpartum observational period (P = 0.012 and P = 0.002, respectively). Reticuloruminal pH decreased from baseline 56 h before calving both for EUT and DYS cows (P = 0.012 and P = 0.016, respectively), but did not differ between groups before delivery. In DYS cows, reticuloruminal temperature decreased from baseline 32 h before calving by 0.23 ± 0.02 °C (P = 0.012), whereas in EUT cows such a decrease was found only 20 h before delivery (0.48 ± 0.05 °C, P < 0.01). AUC of reticuloruminal temperature calculated for the prepartum period was greater in EUT cows than in DYS cows (P = 0.042). During the first 4 h after calving, it decreased from 39.7 ± 0.1 to 39.00 ± 0.1 °C and from 39.8 ± 0.1 to 38.8 ± 0.1 °C in EUT and DYS cows, respectively (P < 0.01 for both groups) and reached baseline levels after 35.4 ± 3.4 and 37.8 ± 4.2 h after calving in EUT and DYS cows, respectively. Based on our results, continuous monitoring of changes in rumination time and reticuloruminal temperature seems to be promising in the early detection of cows with a higher risk of dystocia. Depressed postpartum rumination time of DYS cows highlights the importance of the monitoring of cows experiencing difficulties at calving.

Keywords: reticuloruminal pH, reticuloruminal temperature, rumination time, dairy cows, dystocia

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Authors: Melkamu A. Zeru, Aweke A. Mitiku, Endashaw Amuka

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Background: Under-five mortality is the likelihood that a baby will pass away before turning exactly 5 years old, represented as a percentage per 1,000 live births. Exploring the spatial distribution and identifying the temporal pattern is important to reducing under-five child mortality globally, including in Ethiopia. Thus, this study aimed to identify the risk factors of under-five mortality and the spatiotemporal variation in Ethiopian administrative zones. Method: This study used the 2000-2016 Ethiopian Demographic and Health Survey (EDHS) data, which were collected using a two-stage sampling method. A total of 43,029 (10,873 in 2000, 9,861 in 2005, 11,654 in 2011, and 10,641 in 2016) weighted sample under-five child mortality was used. The space-time dynamic model was employed to account for spatial and time effects in 65 administrative zones in Ethiopia. Results: From the result of a general nesting spatial-temporal dynamic model, there was a significant space-time interaction effect [γ = -0.1444, 95 % CI (-0.6680, -0.1355)] for under-five mortality. The increase in the percentages of mothers illiteracy [𝛽 = 0.4501, 95% CI (0.2442, 0.6559)], not vaccinated[𝛽= 0.7681, 95% CI (0.5683, 0.9678)], unimproved water[𝛽= 0.5801, CI (0.3793, 0.7808)] were increased death rates for under five children while increased percentage of contraceptive use [𝛽= -0.6609, 95% CI (-0.8636, -0.4582)] and ANC visit > 4 times [𝛽= -0.1585, 95% CI(-0.1812, -0.1357)] were contributed to the decreased under-five mortality rate at the zone in Ethiopia. Conclusions: Even though the mortality rate for children under five has decreased over time, still there is still higher in different zones of Ethiopia. There exists spatial and temporal variation in under-five mortality among zones. Therefore, it is very important to consider spatial neighbourhoods and temporal context when aiming to avoid under-five mortality.

Keywords: under-five children mortality, space-time dynamic, spatiotemporal, Ethiopia

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Zouhair Haddi, Stephane Delliaux, Jean-Francois Pons, Ismail Kechaf, Jean-Claude De Haro, Mustapha Ouladsine

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Atrial fibrillation (AF) has been considered as the most common cardiac arrhythmia, and a major public health burden associated with significant morbidity and mortality. Nowadays, telemedical approaches targeting cardiac outpatients situate AF among the most challenged medical issues. The automatic, early, and fast AF detection is still a major concern for the healthcare professional. Several algorithms based on univariate analysis have been developed to detect atrial fibrillation. However, the published results do not show satisfactory classification accuracy. This work was aimed at resolving this shortcoming by proposing multivariate data analysis methods for automatic AF detection. Four publicly-accessible sets of clinical data (AF Termination Challenge Database, MIT-BIH AF, Normal Sinus Rhythm RR Interval Database, and MIT-BIH Normal Sinus Rhythm Databases) were used for assessment. All time series were segmented in 1 min RR intervals window and then four specific features were calculated. Two pattern recognition methods, i.e., Principal Component Analysis (PCA) and Learning Vector Quantization (LVQ) neural network were used to develop classification models. PCA, as a feature reduction method, was employed to find important features to discriminate between AF and Normal Sinus Rhythm. Despite its very simple structure, the results show that the LVQ model performs better on the analyzed databases than do existing algorithms, with high sensitivity and specificity (99.19% and 99.39%, respectively). The proposed AF detection holds several interesting properties, and can be implemented with just a few arithmetical operations which make it a suitable choice for telecare applications.

Keywords: atrial fibrillation, multivariate data analysis, automatic detection, telemedicine

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Authors: E. M. Hoballah, M. Saber, A. Turky, N. Awad, A. M. Zaghloul

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Remediation of cultivated sewage soils in Egypt become an important aspect in last decade for having healthy crops and saving the human health. In this respect, a greenhouse experiment was conducted where contaminated sewage soil was treated with modified forms of 2% bentonite (T1), 2% kaolinite (T2), 1% bentonite+1% kaolinite (T3), 2% probentonite (T4), 2% prokaolinite (T5), 1% bentonite + 0.5% kaolinite + 0.5% rock phosphate (RP) (T6), 2% iron oxide (T7) and 1% iron oxide + 1% RP (T8). These materials were applied as remediative materials. Untreated soil was also used as a control. All soil samples were incubated for 2 months at 25°C at field capacity throughout the whole experiment. Carbon dioxide (CO2) efflux from both treated and untreated soils as a biomass indicator was measured through the incubation time and kinetic parameters of the best fitted models used to describe the phenomena were taken to evaluate the succession of sewaged soils remediation. The obtained results indicated that according to the kinetic parameters of used models, CO2 effluxes from remediated soils was significantly decreased compared to control treatment with variation in rate values according to type of remediation material applied. In addition, analyzed microbial biomass parameter showed that Ni and Zn were the most potential toxic elements (PTEs) that influenced the decreasing order of microbial activity in untreated soil. Meanwhile, Ni was the only influenced pollutant in treated soils. Although all applied materials significantly decreased the hazards of PTEs in treated soil, modified bentonite was the best treatment compared to other used materials. This work discussed different mechanisms taking place between applied materials and PTEs founded in the studied sewage soil.

Keywords: remediation, potential toxic elements, soil biomass, sewage

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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