Search results for: medical and health sciences
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11478

Search results for: medical and health sciences

4698 Psychological Distress during the COVID-19 Pandemic in Nursing Students: A Mixed-Methods Study

Authors: Mayantoinette F. Watson

Abstract:

During such an unprecedented time of the largest public health crisis, the COVID-19 pandemic, nursing students are of the utmost concern regarding their psychological and physical well-being. Questions are emerging and circulating about what will happen to the nursing students and the long-term effects of the pandemic, especially now that hospitals are being overwhelmed with a significant need for nursing staff. Expectations, demands, change, and the fear of the unknown during this unprecedented time can only contribute to the many stressors that accompany nursing students through laborious clinical and didactic courses in nursing programs. The risk of psychological distress is at a maximum, and its effects can negatively impact not only nursing students but also nursing education and academia. The high exposures to interpersonal, economic, and academic demands contribute to the major health concerns, which include a potential risk for psychological distress. Achievement of educational success among nursing students is directly affected by the high exposure to anxiety and depression from experiences within the program. Working relationships and achieving academic success is imperative to positive student outcomes within the nursing program. The purpose of this study is to identify and establish influences and associations within multilevel factors, including the effects of the COVID-19 pandemic on psychological distress in nursing students. Neuman’s Systems Model Theory was used to determine nursing students’ responses to internal and external stressors. The research in this study utilized a mixed-methods, convergent study design. The study population included undergraduate nursing students from Southeastern U.S. The research surveyed a convenience sample of undergraduate nursing students. The quantitative survey was completed by 202 participants, and 11 participants participated in the qualitative follow-up interview surveys. Participants completed the Kessler Psychological Distress Scale (K6), the Perceived Stress Scale (PSS4), and the Dundee Readiness Educational Environment Scale (DREEM12) to measure psychological distress, perceived stress, and perceived educational environment. Participants also answered open-ended questions regarding their experience during the COVID-19 pandemic. Statistical tests, including bivariate analyses, multiple linear regression analyses, and binary logistics regression analyses were performed in effort to identify and highlight the effects of independent variables on the dependent variable, psychological distress. Coding and qualitative content analysis were performed to identify overarching themes within participants’ interviews. Quantitative data were sufficient in identifying correlations between psychological distress and multilevel factors of coping, marital status, COVID-19 stress, perceived stress, educational environment, and social support in nursing students. Qualitative data were sufficient in identifying common themes of students’ perceptions during COVID-19 and included online learning, workload, finances, experience, breaks, time, unknown, support, encouragement, unchanged, communication, and transmission. The findings are significant, specifically regarding contributing factors to nursing students’ psychological distress, which will help to improve learning in the academic environment.

Keywords: nursing education, nursing students, pandemic, psychological distress

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4697 Potentials for Change in the MENA Region: A Socioeconomic Perspective

Authors: Shaira Karishma Sheriff, Zarinah Hamid

Abstract:

The Arab Spring, which commenced during the end of 2010 and accelerated during 2011, was caused primarily due to poverty, unemployment and a general recession in the Middle East and North African (MENA) region. The core motivation of this revolution could be said to be the need for political, economic and social reforms that the region desires to experience. Though GDP growth has been significant in the region, the income distribution mechanism in MENA countries has been ineffective. This results in low levels of education, substandard health care facilities, unemployment, and poverty. This paper argues that MENA countries have great potential for experiencing socioeconomic development by being less dependent on oil exports and enhancing their services sector through better education which would eventually lead to job creation. Furthermore, the region can encourage better trade and political integration by forming transparent and accountable governments. The notion of Nation-State needs to be addressed and the countries in the region need to look for ways to develop effective supra-national institutions for better political and economic integration that goes beyond geographical borders.

Keywords: political reforms, social reforms, economic development, nation-state, economic integration

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4696 The Risk of Post-stroke Pneumonia and Its One-Year Disability in Taiwan

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

Abstract:

Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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4695 Generating Biogas from Municipal Kitchen Waste: An Experience from Gaibandha, Bangladesh

Authors: Taif Rocky, Uttam Saha, Mahobul Islam

Abstract:

With a rapid urbanisation in Bangladesh, waste management remains one of the core challenges. Turning municipal waste into biogas for mass usage is a solution that Bangladesh needs to adopt urgently. Practical Action with its commitment to challenging poverty with technological justice has piloted such idea in Gaibandha. The initiative received immense success and drew the attention of policy makers and practitioners. We believe, biogas from waste can highly contribute to meet the growing demand for energy in the country at present and in the future. Practical Action has field based experience in promoting small scale and innovative technologies. We have proven track record in integrated solid waste management. We further utilized this experience to promote waste to biogas at end users’ level. In 2011, we have piloted a project on waste to biogas in Gaibandha, a northern secondary town of Bangladesh. With resource and support from UNICEF and with our own innovative funds we have established a complete chain of utilizing waste to the renewable energy source and organic fertilizer. Biogas is produced from municipal solid waste, which is properly collected, transported and segregated by private entrepreneurs. The project has two major focuses, diversification of biogas end use and establishing a public-private partnership business model. The project benefits include Recycling of Wastes, Improved institutional (municipal) capacity, Livelihood from improved services and Direct Income from the project. Project risks include Change of municipal leadership, Traditional mindset, Access to decision making, Land availability. We have observed several outcomes from the initiative. Up scaling such an initiative will certainly contribute for sustainable cleaner and healthier urban environment and urban poverty reduction. - It reduces the unsafe disposal of wastes which improve the cleanliness and environment of the town. -Make drainage system effective reducing the adverse impact of water logging or flooding. -Improve public health from better management of wastes. -Promotes usage of biogas replacing the use of firewood/coal which creates smoke and indoor air pollution in kitchens which have long term impact on health of women and children. -Reduce the greenhouse gas emission from the anaerobic recycling of wastes and contributes to sustainable urban environment. -Promote the concept of agroecology from the uses of bio slurry/compost which contributes to food security. -Creates green jobs from waste value chain which impacts on poverty alleviation of urban extreme poor. -Improve municipal governance from inclusive waste services and functional partnership with private sectors. -Contribute to the implementation of 3R (Reduce, Reuse, Recycle) Strategy and Employment Creation of extreme poor to achieve the target set in Vision 2021 by Government of Bangladesh.

Keywords: kitchen waste, secondary town, biogas, segregation

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4694 The Analysis of Noise Harmfulness in Public Utility Facilities

Authors: Monika Sobolewska, Aleksandra Majchrzak, Bartlomiej Chojnacki, Katarzyna Baruch, Adam Pilch

Abstract:

The main purpose of the study is to perform the measurement and analysis of noise harmfulness in public utility facilities. The World Health Organization reports that the number of people suffering from hearing impairment is constantly increasing. The most alarming is the number of young people occurring in the statistics. The majority of scientific research in the field of hearing protection and noise prevention concern industrial and road traffic noise as the source of health problems. As the result, corresponding standards and regulations defining noise level limits are enforced. However, there is another field uncovered by profound research – leisure time. Public utility facilities such as clubs, shopping malls, sport facilities or concert halls – they all generate high-level noise, being out of proper juridical control. Among European Union Member States, the highest legislative act concerning noise prevention is the Environmental Noise Directive 2002/49/EC. However, it omits the problem discussed above and even for traffic, railway and aircraft noise it does not set limits or target values, leaving these issues to the discretion of the Member State authorities. Without explicit and uniform regulations, noise level control at places designed for relaxation and entertainment is often in the responsibility of people having little knowledge of hearing protection, unaware of the risk the noise pollution poses. Exposure to high sound levels in clubs, cinemas, at concerts and sports events may result in a progressive hearing loss, especially among young people, being the main target group of such facilities and events. The first step to change this situation and to raise the general awareness is to perform reliable measurements the results of which will emphasize the significance of the problem. This project presents the results of more than hundred measurements, performed in most types of public utility facilities in Poland. As the most suitable measuring instrument for such a research, personal noise dosimeters were used to collect the data. Each measurement is presented in the form of numerical results including equivalent and peak sound pressure levels and a detailed description considering the type of the sound source, size and furnishing of the room and the subjective sound level evaluation. In the absence of a straight reference point for the interpretation of the data, the limits specified in EU Directive 2003/10/EC were used for comparison. They set the maximum sound level values for workers in relation to their working time length. The analysis of the examined problem leads to the conclusion that during leisure time, people are exposed to noise levels significantly exceeding safe values. As the hearing problems are gradually progressing, most people underplay the problem, ignoring the first symptoms. Therefore, an effort has to be made to specify the noise regulations for public utility facilities. Without any action, in the foreseeable future the majority of Europeans will be dealing with serious hearing damage, which will have a negative impact on the whole societies.

Keywords: hearing protection, noise level limits, noise prevention, noise regulations, public utility facilities

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4693 Characterization of Nanoemulsion Incorporating Crude Cocoa Polyphenol

Authors: Suzannah Sharif, Aznie Aida Ahmad, Maznah Ismail

Abstract:

Cocoa bean is the raw material for products such as cocoa powder and chocolate. Cocoa bean contains polyphenol which has been shown in several clinical studies to confer beneficial health effects. However studies showed that cocoa polyphenol absorption in the human intestinal tracts are very low. Therefore nanoemulsion may be one way to increase the bioavailability of cocoa polyphenol. This study aim to characterize nanoemulsion incorporating crude cocoa polyphenol produced using high energy technique. Cocoa polyphenol was extracted from fresh freeze-dried cocoa beans from Malaysia. The particle distribution, particle size, and zeta potential were determined. The emulsion was also analysed using transmission electron microscope to visualize the particles. Solubilization study was conducted by titrating the nanoemulsion into distilled water or 1% surfactant solution. Result showed that the nanoemulsion contains particle which have narrow size distribution. The particles size average at 112nm with zeta potential of -45mV. The nanoemulsions behave differently in distilled water and surfactant solution.

Keywords: cocoa, nanoemulsion, cocoa polyphenol, solubilisation study

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4692 Developing Innovative Participatory Visual Toolkits for Community Story Collection

Authors: Jiawei Dai, Xinrong Li, Yulong Sun, Yunxiao Hao

Abstract:

Recently, participatory approaches have become popular in a variety of fields, including social work, community, and population health, as important research tools for researchers to understand and immerse communities and conceptualize social phenomena. The participatory visual research methods promote the diversification and depth of the exploration process and communication forms to support the feasibility and practicality of the scheme, which helps to further inspire designers and avoid blind spots caused by the solidification of single thinking. This paper focuses on how to develop visual toolkits for participatory methods to assist and shape crowd participation and trigger idea generation in community issues. This project helps to verify the value of participatory visual tools in shaping participation and arousing expression, which provides support for gaining community diversity insights and community problem-solving. In addition, a visual toolbox was developed based on an actual case in a community for field testing, and further discussion was carried out after the data results were analyzed.

Keywords: participatory design, community service, visual toolbox, visual metaphor

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4691 The Immunosuppressive Effects of Silymarin with Rapamaycin on the Proliferation and Apoptosis of T Cell

Authors: Nahid Eskandari, Marjan Ghagozolo, Ehsan Almasi

Abstract:

Introduction: Silymarin, as a polyphenolic flavonoid derived from milk thistle (Silybum marianum), is known to have antioxidant, immunomodulatory, antiproliferative, antifibrotic, and antiviral effects. The goal of this study was to determine immunosuppressive effect of Silymarin on proliferation and apoptosis of human T cells in comparison with Rapamycin and FK506. Methods: Peripheral Blood Mononuclear Cells (PBMCs) from healthy individuals were activated with Con A (5µg/ml) and then treated with Silymarin, Rapamycin and FK506 in various concentrations (0.001, 0.01, 0.1, 1, 10,100 and 200M) for 5 days. PBMCs were examined for proliferation using CFSE assay and the concentration that inhibited 50% of the cell proliferation (IC50) was determined for each treatment. For apoptosis assay using flow cytometry, PBMCs were activated with Con A and treated with IC50 dose of Silymarin, Rapamycin and FK506 for 5 days, then cell apoptosis was analysed by FITC-annexin V/PI staining and flow cytometry. The effects of Silymarin, Rapamycin and FK506 on the activation of PARP (poly ADP ribose polymerase) pathway in PBMCs stimulated with Con A and treated with IC50 dose of drugs for 5 days evaluated using the PathScan cleaved PARP sandwich ELISA kit. Results: This study showed that Silymarin had the ability to inhibit T cell proliferation in vitro. Moreover, our results indicated that 100 μM (P < 0.001) and 200 μM (P < 0.001) of Silymarin has more inhibitory effect on T cells proliferation than FK506 and Rapamycin. Our data showed that the effective doses (IC50) of Silymarin, FK506 and Rapamycin were 3×10-5 µM, 10-8 µM and 10-6 µM respectively. Data showed that the inhibitory effect of Silymarin, FK506 and Rapamycin on T cell proliferation was not due to cytotoxicity and none of these drugs at IC50 concentration had not affected the level of cleaved PARP. Conclusion: Silymarin could be a good candidate for immunosuppressive therapy for certain medical conditions with superior efficacy and lesser toxicity in comparison with other immunosuppressive drugs.

Keywords: silymarin, immunosuppressive effect, rapamycin, immunology

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4690 Discrimination and Classification of Vestibular Neuritis Using Combined Fisher and Support Vector Machine Model

Authors: Amine Ben Slama, Aymen Mouelhi, Sondes Manoubi, Chiraz Mbarek, Hedi Trabelsi, Mounir Sayadi, Farhat Fnaiech

Abstract:

Vertigo is a sensation of feeling off balance; the cause of this symptom is very difficult to interpret and needs a complementary exam. Generally, vertigo is caused by an ear problem. Some of the most common causes include: benign paroxysmal positional vertigo (BPPV), Meniere's disease and vestibular neuritis (VN). In clinical practice, different tests of videonystagmographic (VNG) technique are used to detect the presence of vestibular neuritis (VN). The topographical diagnosis of this disease presents a large diversity in its characteristics that confirm a mixture of problems for usual etiological analysis methods. In this study, a vestibular neuritis analysis method is proposed with videonystagmography (VNG) applications using an estimation of pupil movements in the case of an uncontrolled motion to obtain an efficient and reliable diagnosis results. First, an estimation of the pupil displacement vectors using with Hough Transform (HT) is performed to approximate the location of pupil region. Then, temporal and frequency features are computed from the rotation angle variation of the pupil motion. Finally, optimized features are selected using Fisher criterion evaluation for discrimination and classification of the VN disease.Experimental results are analyzed using two categories: normal and pathologic. By classifying the reduced features using the Support Vector Machine (SVM), 94% is achieved as classification accuracy. Compared to recent studies, the proposed expert system is extremely helpful and highly effective to resolve the problem of VNG analysis and provide an accurate diagnostic for medical devices.

Keywords: nystagmus, vestibular neuritis, videonystagmographic system, VNG, Fisher criterion, support vector machine, SVM

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4689 Disordered Eating Behaviors Among Sorority Women

Authors: Andrea J. Kirk-Jenkins

Abstract:

Women in late adolescence and young adulthood are particularly vulnerable to disordered eating, and prior research indicates that those within the college and sorority communities may be especially susceptible. Research has primarily involved comparing eating disorder symptoms between sorority women and non-sorority members using formal eating disorder assessments. This phenomenological study examined sorority members’ (N = 10) perceptions of and lived experiences with various disordered eating behaviors within the sorority culture. Data from individual interviews and photographs indicated two structural themes and 11 textural themes related to factors associated with disordered eating behaviors. These findings point to the existence of both positive and negative aspects of sorority culture, normalization of disordered eating behaviors, and pressure to attain or maintain an ideal body image. Implications for university stakeholders, including college counselors, health center staff, and extracurricular program leaders, are discussed. Further research on the identified textural themes as well as a longitudinal study exploring how perceptions change from rush to alumnae status is suggested.

Keywords: eating disorders, disorder eating behaviors, sorority women, sorority culture, college women

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4688 Status of India towards Achieving the Millennium Development Goals

Authors: Rupali Satsangi

Abstract:

14 years ago, leaders from every country agreed on a vision for the future – a world with less poverty, hunger and disease, greater survival prospects for mothers and their infants, better educated children, equal opportunities for women, and a healthier environment; a world in which developed and developing countries work in partnership for the betterment of all. This vision took the shape of eight Millennium Development Goals, which provide countries around the world a framework for development and time-bound targets by which progress can be measured. However, India has found 35 of the indicators as relevant to India. India’s MDG-framework has been contextualized through a concordance with the existing official indicators of corresponding dimensions in the national statistical system. The present study based on secondary data analyzed the status of India towards achieving the MDGs after reviewing the data study find out that India can miss the MDGs Bus in women health, sanitation and global partnership. These goals were less addressed by India in his policies and takeoffs.

Keywords: millennium development goals, national statistical system, global partnership, healthier environment

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4687 'Get the DNR': Exploring the Impact of an Educational eModule on Internal Medicine Residents' Attitudes and Approaches to Goals of Care Conversations

Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

Abstract:

Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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4686 Levels and Trends of Under-Five Mortality in South Africa from 1998 to 2012

Authors: T. Motsima, K. Zuma, E Rapoo

Abstract:

Childhood mortality is a key sign of the coverage of child survival interventions, social and economic progressions. Although the level of under-five mortality has been declining, it is still unacceptably high. The primary aim of this paper is to establish and analyse the levels and trends of under-five mortality for the periods 1998, 2003 and 2012 in South Africa. Methods: The data used for analysis came from the 1998 SADHS, the 2003 SADHS and the 2012 SABSSM which collected information on the survival status of children. The Kaplan-Meier estimate of the survival function method was used to determine the probabilities of failure (death) from birth up to 59 months. Results and Conclusion: The overall U5MR declined by 28.2% from 53.1 in 1998 to 38.1 in 2012. The U5MR of male children declined from 59.2 in 1998 to 46.2 in 2003 and dropped further to 41.4 in 2012. The U5MR of children of mothers aged 40 years and older increased from 64.0 in 1998 to 89.0 in 2003 and rose further to 129.9 in 2012. The U5MR of children of mothers with education level of 12 years or more increased from 32.2 in 1998 to 35.2 in 2003 and declined substantially to 17.5 in 2012.

Keywords: demographic and health survey, Kaplan-Meier, levels and trends, under-five mortality

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4685 Effect of Non-Surgical Periodontal Therapy According to Periodontal Severity

Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji

Abstract:

Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.

Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy

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4684 A Randomized, Controlled Trial to Test Behavior Change Techniques to Improve Low Intensity Physical Activity in Older Adults

Authors: Ciaran Friel, Jerry Suls, Mark Butler, Patrick Robles, Samantha Gordon, Frank Vicari, Karina W. Davidson

Abstract:

Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant engagement. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit® fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. In the 8-week intervention phase of the study, participants received each of the four BCTs, in random order, for a two-week period. Text message prompts were delivered daily each morning at a consistent time. All prompts required participant engagement to acknowledge receipt of the BCT message. Engagement is dependent upon the BCT message and may have included recording that a detailed plan for walking has been made or confirmed a daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves to their baseline average step count (self-monitoring, feedback). At the end of each two-week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances, and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. The analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, five days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of an N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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4683 The Impact of Social Protection Intervention on Alleviating Social Vulnerability (Evidence from Ethiopian Rural Households)

Authors: Tewelde Gebresslase Haile, S. P. Singh

Abstract:

To bridge the existing knowledge gap on public intervention implementations, this study estimates the impact of social protection intervention (SPI) on alleviating social vulnerability. Following a multi-stage sampling, primary information was gathered through a self-administered questionnaire, FGD, and interviews from the target households located at four systematically selected districts of Tigrai, Ethiopia. Factor analysis and Propensity Score Matching are applied to construct Social Vulnerability Index (SVI) and measuring the counterfactual impact of selected intervention. As a multidimensional challenge, social vulnerability is found as an important concept used to guide policy evaluation. Accessibility of basic services of Social Affairs, Agriculture, Health and Education sectors, and Food Security Program are commonly used as SPIs. Finally, this study discovers that the households who had access to SPI have scored 9.65% lower SVI than in the absence of the intervention. Finally, this study suggests the provision of integrated, proactive, productive, and evidence-based SPIs to alleviate social vulnerability.

Keywords: social protection, livelihood assets, social vulnerability, public policy SVI

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4682 Filled Polymer Composite

Authors: Adishirin Mammadov

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Polymers and polymer composites play vital roles in diverse industries, including food and beverage packaging, transportation innovations, and medical advancements. However, the advancements in polymer technology bring certain risks, particularly concerning water and soil pollution due to the presence of polymers. The creation of new polymers is a critical aspect of this field. While the primary focus is on improving their physical and chemical properties, ensuring their ecological compatibility is equally important. An advanced method for developing innovative polymer types involves integrating fillers with diverse characteristics, offering advantages such as cost reduction and improved quality indicators. In the conducted research, efforts were made to enhance environmental aspects by employing waste fillers. Specifically, low-density polyethylene (LDPE) was used as the polymer, and waste from cocoon factories was chosen as the filler. Following a process of cleaning, drying, and crushing the filler to specific dimensions, it was incorporated into polyethylene through a mechanical-chemical method under laboratory conditions. The varied rheological properties of the resulting polyethylene compositions examined at temperatures ranging from 145 to 165 degrees Celsius. These compositions demonstrated different rheological properties at various temperature intervals. Achieving homogeneity in the obtained compositions is crucial in the polymers mechanochemical process. Beyond rheological properties, swelling rates in different environments and percentages of mass loss at different temperatures learned using the differential thermal analysis method. The research revealed that, to a certain extent, the physico-chemical properties of polyethylene were not significantly affected by the polymer compositions. This suggests that incorporating cocoon waste enables cost reduction in composite production while positively impacting the environment.

Keywords: polyethylene, polymer, composites, filler, reology

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4681 Feasibility and Efficacy of Matrix Model in Arabic Countries

Authors: Yasin Ibrahim, Hisham Almohandes, Chia Hsu, Regina Baronia, Jesse Worsham, Sara Abdelgawad, Mansour Shawky, Mohammed Abdelfattah, Nesif Alhemiary

Abstract:

Background: The matrix model (MM) is an evidence-based program for treating substance use disorders. Since first translated into Arabic in 2010, the MM has been gaining popularity in Arabic countries. However, there is no published data as pertains to its efficacy and feasibility in Arabic communities. Here we aimed at exploring providers’ perspectives on its feasibility and efficacy. Methods: Eight addiction treatment centers from four Arabic countries, namely Egypt, Kingdom of Saudi Arabia, the United Arab Emirates, and Iraq, were contacted via email. They were asked to fill in a 21-item questionnaire. Results: Matrix model continues to be utilized in 6 out of the 8 contacted programs. One center in Egypt has discontinued the MM as the providers felt it was not suitable for substance disorders other than stimulants, which are not common in Egypt. Baghdad University Medical Center has substituted MM with Colombo Program as there have been more training opportunities available for it. Data showed wide variability in regards to number of clients treated with the MM (from 300 to 2500). The Arabic version was utilized for training providers in 5 out of the 8 centers while the providers of the other 3 have been trained in the United States. All providers reported that MM made their job significantly easier, and seven providers believed that MM has favorably affected the relapse rate. In all of the six centers, MM is being utilized for many substance use disorders in addition to stimulant use disorders. Reported challenges included the acceptability of patients and their families, difficulty understanding some concepts, and high drop rates in some centers. Conclusion: Matrix model seems to be a valuable modality for the treatment of substance use disorders in Arabic countries. It has its own challenges and limitations that call for more culturally adapted versions.

Keywords: addiction, Arabic countries, developing countries, matrix model

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4680 Investigating Flutter Energy Harvesting through Piezoelectric Materials in Both Experimental and Theoretical Modes

Authors: Hassan Mohammad Karimi, Ali Salehzade Nobari, Hosein Shahverdi

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With the advancement of technology and the decreasing weight of aerial structures, there is a growing demand for alternative energy sources. Structural vibrations can now be utilized to power low-power sensors for monitoring structural health and charging small batteries in drones. Research on extracting energy from flutter using piezoelectric has been extensive in recent years. This article specifically examines the use of a single-jointed beam with a free surface attached to its free end and a bimorph piezoelectric patch connected to the joint, providing two degrees of torsional and bending freedom. The study investigates the voltage harvested at various wind speeds and bending and twisting stiffness in a wind tunnel. The results indicate that as flutter speed increases, the output voltage also increases to some extent. However, at high wind speeds, the limited cycle created becomes unstable, negatively impacting the harvester's performance. These findings align with other research published in reputable scientific journals.

Keywords: energy harvesting, piezoelectric, flutter, wind tunnel

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4679 Automatic Near-Infrared Image Colorization Using Synthetic Images

Authors: Yoganathan Karthik, Guhanathan Poravi

Abstract:

Colorizing near-infrared (NIR) images poses unique challenges due to the absence of color information and the nuances in light absorption. In this paper, we present an approach to NIR image colorization utilizing a synthetic dataset generated from visible light images. Our method addresses two major challenges encountered in NIR image colorization: accurately colorizing objects with color variations and avoiding over/under saturation in dimly lit scenes. To tackle these challenges, we propose a Generative Adversarial Network (GAN)-based framework that learns to map NIR images to their corresponding colorized versions. The synthetic dataset ensures diverse color representations, enabling the model to effectively handle objects with varying hues and shades. Furthermore, the GAN architecture facilitates the generation of realistic colorizations while preserving the integrity of dimly lit scenes, thus mitigating issues related to over/under saturation. Experimental results on benchmark NIR image datasets demonstrate the efficacy of our approach in producing high-quality colorizations with improved color accuracy and naturalness. Quantitative evaluations and comparative studies validate the superiority of our method over existing techniques, showcasing its robustness and generalization capability across diverse NIR image scenarios. Our research not only contributes to advancing NIR image colorization but also underscores the importance of synthetic datasets and GANs in addressing domain-specific challenges in image processing tasks. The proposed framework holds promise for various applications in remote sensing, medical imaging, and surveillance where accurate color representation of NIR imagery is crucial for analysis and interpretation.

Keywords: computer vision, near-infrared images, automatic image colorization, generative adversarial networks, synthetic data

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4678 PTSD in Peacekeepers: A Systematic Review

Authors: Laura Rodrigues Carmona, Maria José Chambel, Vânia Sofia Carvalho

Abstract:

Background: In peacekeeping operations, military personnel are often exposed to the same traumatic stress factors found during conventional war and may also be subject to the physical risks and psychological stressors associated with posttraumatic stress disorder (PTSD). Objectives: To discuss the prevalence of PTSD among peacekeepers as well as the risks of and protective factors against this disorder and its comorbidities and/or consequences. Methods: A systematic literature search was performed with relevant keywords, and 53 articles were identified for this review. Results and conclusions: Military personnel deployed in peacekeeping operations have a higher prevalence of PTSD than nonmilitary personnel, a prevalence similar to that of military personnel deployed in war situations. Concerning the salient risk factors, the contextual factors are highlighted, and in regard to the protective factors, the individual factors are highlighted. This study thus demonstrates that there are factors in which the role of the military is essential, via both its selection and monitoring of peacekeepers during and after their deployment, to protect deployed personnel’s mental health.

Keywords: peacekeepers, peacekeeping, military, PTSD, post-traumatic stress disorder, posttraumatic stress disorder

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4677 Knowledge Attitude and Practices of COVID-19 among Tamil Nadu Residence

Authors: Shivanand Pawar

Abstract:

In India, a collective range of measurements had been adopted to control the massive spread of the COVID-19 pandemic, but World Health Organization (2022) revealed 525 930 fatalities and 43,847,065 confirmed cases. There are currently 30,857 cases per million people. Lack of knowledge, attitude and practices are the main causes thought to be increased COVID-19. The present study aims to assess the knowledge, attitude, and practice among Tamil Nadu residents. The participants (N=332) were aged 20 to 50 (mean=42.78, & SD=13.98) and were selected using purposive sampling, and data were collected online using knowledge, attitude and practice scale. Data were analyzed using person correlation and multiple regression analysis. The result found that 31.30% had satisfactory knowledge, 68.70% had non-satisfactory knowledge, followed by 45.20% had a positive attitude, 54.80% had a negative attitude, and 34.30% had a good practice, and 65.70% had poor practice towards COVID-19. Correlation results revealed that age has a negative and significant relationship with Knowledge and Practice towards COVID-19. The current study results contribute to the existing literature on knowledge, attitude and practice of COVID-19 to reduce the COVID-19 cases by managing unhealthy knowledge, attitude and practice to control the massive spread of COVID-19.

Keywords: COVID-19, knowledge, practice, attitude, Fisherman community

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4676 How Do Undergraduates of Ethnic Minorities Perceive Their Sense of Belonging to School? A Mixed Study in China

Authors: Xiao-Fang Wang

Abstract:

Researchers of educational psychology have proved that students' sense of belonging to school is conducive to their academic achievement, social relations and mental health. However, little attention is paid to undergraduates' sense of belonging, especially, the distinctive student group, i.e., undergraduate students of ethnic minorities. This article utilized a mixed study approach to investigate the perceptions of undergraduates of ethnic minority toward their sense of belonging to school. The findings from qualitative and quantitative data indicate: 1) generally, the sense of belonging to school of ethnic minority undergraduate students was at the middle level. 2) Gender had an important impact on the sense of belonging, and the sense of girls was much larger than boys’. 3) The sense of belonging to school of students who come from city and town was much larger than the one of students who come from the countryside. 4) The category of subjects had significantly effected on the sense of belonging to school, and, the students from social and art science was larger than those from engineer science. The article is concluded with some valuable and relevant suggestions for university' student management activities and teachers' teaching practice.

Keywords: ethnic minority, undergraduate students, sense of belonging, China

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4675 Psychological Alarm among Individuals Suffering from Irritable Bowel Syndrome

Authors: Selim A., Albasher N., Bakrmom G., Alanzi S.

Abstract:

Irritable bowel syndrome (IBS) is a chronic functional bowel disorder characterized by abdominal discomfort or pain and associated with alteration in frequency and/or form of bowel habit among other symptoms. This diagnosis is associated with increased levels of psychological distress, maladaptive coping, genetic risk factors, abnormal small and colonic intestine transit, change in stool frequency or form and abdominal discomfort or pain. Aim: The aim of the study was to assess psychological alarm among individuals suffering from Irritable Bowel Syndrome (IBS). Methods: A cross-sectional correlational research design was used to conduct the current study. A convenience sample of 504 participants was included in the present study. Data were collected using a self-report questionnaire. The questionnaire included socio-demographic data, ROME III to identify Irritable Bowel Syndrome (IBS) and Psychological Alarm Questionnaire. Results: Out of 504 participants who reported abdominal discomfort, 297 (58.9 %) participants met the diagnostic criteria of IBS. The mean age of the IBS participants was 30.16 years, females composed 75.1% of the IBS participants, and 55.2% did not seek medical help. Psychological alarms such as feeling anxious, feeling depressed, having suicidal ideations, bodily pain, having impaired functioning due to pain and feeling unable to cope with pain were significantly high among IBS individuals when compared to individuals not suffering from IBS. Psychological alarms such as feeling anxious, feeling depressed, having suicidal ideations, bodily pain, having impaired functioning due to pain and feeling unable to cope with pain were significantly high among IBS individuals compared to individuals not suffering from IBS. Conclusion: IBS is highly associated with significant psychological alarms including depression, anxiety and suicidal ideas.

Keywords: abdominal pain , irritable bowel syndrome, distress, psychological alarms

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4674 Manage an Acute Pain Unit based on the Balanced Scorecard

Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho

Abstract:

The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Keywords: acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal

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4673 Clustering Using Cooperative Multihop Mini-Groups in Wireless Sensor Network: A Novel Approach

Authors: Virender Ranga, Mayank Dave, Anil Kumar Verma

Abstract:

Recently wireless sensor networks (WSNs) are used in many real life applications like environmental monitoring, habitat monitoring, health monitoring etc. Due to power constraint cheaper devices used in these applications, the energy consumption of each device should be kept as low as possible such that network operates for longer period of time. One of the techniques to prolong the network lifetime is an intelligent grouping of sensor nodes such that they can perform their operation in cooperative and energy efficient manner. With this motivation, we propose a novel approach by organize the sensor nodes in cooperative multihop mini-groups so that the total global energy consumption of the network can be reduced and network lifetime can be improved. Our proposed approach also reduces the number of transmitted messages inside the WSNs, which further minimizes the energy consumption of the whole network. The experimental simulations show that our proposed approach outperforms over the state-of-the-art approach in terms of stability period and aggregated data.

Keywords: clustering, cluster-head, mini-group, stability period

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4672 Rare-Earth Ions Doped Zirconium Oxide Layers for Optical and Photovoltaic Applications

Authors: Sylwia Gieraltowska, Lukasz Wachnicki, Bartlomiej S. Witkowski, Marek Godlewski

Abstract:

Oxide layers doped with rare-earth (RE) ions in optimized way can absorb short (ultraviolet light), which will be converted to visible light by so-called down-conversion. Down-conversion mechanisms are usually exploited to modify the incident solar spectrum. In down conversion, multiple low-energy photons are generated to exploit the energy of one incident high-energy photon. These RE-doped oxide materials have attracted a great deal of attention from researchers because of their potential for optical manipulation in optical devices (detectors, temperature sensors, and compact solid-state lasers, light-emitting diodes), bio-analysis, medical therapy, display technologies, and light harvesting (such as in photovoltaic cells). The zirconium dioxide (ZrO2) doped RE ions (Eu, Tb, Ce) multilayer structures were tested as active layers, which can convert short wave emission to light in the visible range (the down-conversion mechanism). For these applications original approach of deposition ZrO2 layers using the Atomic Layer Deposition (ALD) method and doping these layers with RE ions using the spin-coating technique was used. ALD films are deposited at relatively low temperature (well below 250°C). This can be an effective method to achieve the white-light emission and to improve on this way light conversion efficiency, by an extension of absorbed spectral range by a solar cell material. Photoluminescence (PL), X-ray diffraction (XRD), scanning electron microscope (SEM) and atomic force microscope (AFM) measurement are analyzed. The research was financially supported by the National Science Centre (decision No. DEC-2012/06/A/ST7/00398 and DEC- 2013/09/N/ST5/00901).

Keywords: ALD, oxide layers, photovoltaics, thin films

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4671 Triangular Hesitant Fuzzy TOPSIS Approach in Investment Projects Management

Authors: Irina Khutsishvili

Abstract:

The presented study develops a decision support methodology for multi-criteria group decision-making problem. The proposed methodology is based on the TOPSIS (Technique for Order Performance by Similarity to Ideal Solution) approach in the hesitant fuzzy environment. The main idea of decision-making problem is a selection of one best alternative or several ranking alternatives among a set of feasible alternatives. Typically, the process of decision-making is based on an evaluation of certain criteria. In many MCDM problems (such as medical diagnosis, project management, business and financial management, etc.), the process of decision-making involves experts' assessments. These assessments frequently are expressed in fuzzy numbers, confidence intervals, intuitionistic fuzzy values, hesitant fuzzy elements and so on. However, a more realistic approach is using linguistic expert assessments (linguistic variables). In the proposed methodology both the values and weights of the criteria take the form of linguistic variables, given by all decision makers. Then, these assessments are expressed in triangular fuzzy numbers. Consequently, proposed approach is based on triangular hesitant fuzzy TOPSIS decision-making model. Following the TOPSIS algorithm, first, the fuzzy positive ideal solution (FPIS) and the fuzzy negative-ideal solution (FNIS) are defined. Then the ranking of alternatives is performed in accordance with the proximity of their distances to the both FPIS and FNIS. Based on proposed approach the software package has been developed, which was used to rank investment projects in the real investment decision-making problem. The application and testing of the software were carried out based on the data provided by the ‘Bank of Georgia’.

Keywords: fuzzy TOPSIS approach, investment project, linguistic variable, multi-criteria decision making, triangular hesitant fuzzy set

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4670 Ventriculo-Gallbladder Shunt: Case Series and Literature Review

Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

Abstract:

BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

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4669 Toxicological Risk Analysis in Different Crops and Vegetables Exposed to High Fluoride-Contaminated Water

Authors: Pankaj Kumar

Abstract:

Despite few works reported about fluoride enrichment in the groundwater, no studies have done on exposure analysis for biological components in Patan district, Gujarat, Western India. Considering its vital importance, this study strives to quantify the bioaccumulation of fluoride in seven different crops and vegetables, viz. Spinach and Mustard leaves, Cauliflower, Wheat grains, Amaranth seed, Radish, and Garlic grown in the potentially fluoride contaminated area. Result shows that the order for fluoride accumulation among different analyzed plants are spinach (63.3 mg/kg) > mustard (48.9 mg/kg) > cauliflower (41.1 mg/kg) > radish (35.7 mg/kg) > garlic (33.2 mg/kg) > amaranth seed (26.7 mg/kg) > wheat (22.5 mg/kg). Fluoride concentration was highest in leafy vegetable, whereas the lowest was in wheat grains. Finally, estimated daily intake (EDI) and hazard index (HI) were calculated for local consumers of different age group, where it was found that young people (4-15 years) are at the highest risk of fluorosis. This study is relevant for better crop management, like substituting crops with woody plants, flowers, and people awareness.

Keywords: fluoride, bioaccumulation, health risk, water

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