Search results for: urban health

Authors: Shideh Mohseni Movahed, Mansoureh Safari

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Intelligent drug delivery systems (IDDS) are innovative technological innovations and clinical way to advance current treatments. These systems differ in technique of therapeutic administration, intricacy, materials and patient compliance to address numerous clinical conditions that require different pharmacological therapies. IDDS capable of releasing an active molecule at the proper site and at a amount that adjusts in response to the progression of the disease or to certain functions/biorhythms of the organism is particularly appealing. In this paper, we describe the most recent advances in the development of intelligent drug delivery systems.

Keywords: drug delivery systems, IDDS, medicine, health

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Authors: Larissa Bolliger, Junoš Lukan, Mitja Lustrek, Dirk De Bacquer, Els Clays

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Introduction and Aim: Chronic workplace stress and its health-related consequences like mental and cardiovascular diseases have been widely investigated. This project focuses on the sources and context of psychosocial daily workplace stress in a real-world setting. The main objective is to analyze and model real-time relationships between (1) psychosocial stress experiences within the natural work environment, (2) micro-level work activities and events, and (3) physiological signals and behaviors in office workers. Methods: An Ecological Momentary Assessment (EMA) protocol has been developed, partly building on machine learning techniques. Empatica® wristbands will be used for real-life detection of stress from physiological signals; micro-level activities and events at work will be based on smartphone registrations, further processed according to an automated computer algorithm. A field study including 100 office-based workers with high-level problem-solving tasks like managers and researchers will be implemented in Slovenia and Belgium (50 in each country). Data mining and state-of-the-art statistical methods – mainly multilevel statistical modelling for repeated data – will be used. Expected Results and Impact: The project findings will provide novel contributions to the field of occupational health research. While traditional assessments provide information about global perceived state of chronic stress exposure, the EMA approach is expected to bring new insights about daily fluctuating work stress experiences, especially micro-level events and activities at work that induce acute physiological stress responses. The project is therefore likely to generate further evidence on relevant stressors in a real-time working environment and hence make it possible to advise on workplace procedures and policies for reducing stress.

Keywords: ecological momentary assessment, real-time, stress, work

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Authors: Kayode Oshinubi, Brice Kammegne, Jacques Demongeot

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The use of mathematical tools like Partial Differential Equations and Ordinary Differential Equations have become very important to predict the evolution of a viral disease in a population in order to take preventive and curative measures. In December 2019, a novel variety of Coronavirus (SARS-CoV-2) was identified in Wuhan, Hubei Province, China causing a severe and potentially fatal respiratory syndrome, i.e., COVID-19. Since then, it has become a pandemic declared by World Health Organization (WHO) on March 11, 2020 which has spread around the globe. A reaction-diffusion system is a mathematical model that describes the evolution of a phenomenon subjected to two processes: a reaction process in which different substances are transformed, and a diffusion process that causes a distribution in space. This article provides a mathematical study of the Susceptible, Exposed, Infected, Recovered, and Vaccinated population model of the COVID-19 pandemic by the bias of reaction-diffusion equations. Both local and global asymptotic stability conditions for disease-free and endemic equilibria are determined using the Lyapunov function are considered and the endemic equilibrium point exists and is stable if it satisfies Routh–Hurwitz criteria. Also, adequate conditions for the existence and uniqueness of the solution of the model have been proved. We showed the spatial distribution of the model compartments when the basic reproduction rate $\mathcal{R}_0 < 1$ and $\mathcal{R}_0 > 1$ and sensitivity analysis is performed in order to determine the most sensitive parameters in the proposed model. We demonstrate the model's effectiveness by performing numerical simulations. We investigate the impact of vaccination and the significance of spatial distribution parameters in the spread of COVID-19. The findings indicate that reducing contact with an infected person and increasing the proportion of susceptible people who receive high-efficacy vaccination will lessen the burden of COVID-19 in the population. To the public health policymakers, we offered a better understanding of the COVID-19 management.

Keywords: COVID-19, SEIRV epidemic model, reaction-diffusion equation, basic reproduction number, vaccination, spatial distribution

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Authors: Francisco Liaño-Carrera, Jorge Enrique Baños-Illana, Arturo Gómez-Barrero, José Isaac Ramírez-Macías, Erik Omar Paredes-JuáRez, David Salas-Monreal, Mayra Lorena Riveron-Enzastiga

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Topographical changes in coastal areas are usually assessed with airborne LIDAR and conventional photogrammetry. In recent times Unmanned Aerial Vehicles (UAV) have been used several in photogrammetric applications including coastline evolution. However, its use goes further by using the points cloud associated to generate beach Digital Elevation Models (DEM). We present a methodology for monitoring coastal topographic changes along a 50 km coastline in Veracruz, Mexico using high-resolution images (less than 10 cm ground resolution) and dense points cloud captured with an UAV. This monitoring develops in the context of the port of Veracruz expansion project which construction began in 2015 and intends to characterize coast evolution and prevent and mitigate project impacts on coastal environments. The monitoring began with a historical coastline reconstruction since 1979 to 2015 using aerial photography and Landsat imagery. We could define some patterns: the northern part of the study area showed accretion while the southern part of the study area showed erosion. Since the study area is located off the port of Veracruz, a touristic and economical Mexican urban city, where coastal development structures have been built since 1979 in a continuous way, the local beaches of the touristic area are been refilled constantly. Those areas were not described as accretion since every month sand-filled trucks refill the sand beaches located in front of the hotel area. The construction of marinas and the comitial port of Veracruz, the old and the new expansion were made in the erosion part of the area. Northward from the City of Veracruz the beaches were described as accretion areas while southward from the city, the beaches were described as erosion areas. One of the problems is the expansion of the new development in the southern area of the city using the beach view as an incentive to buy front beach houses. We assessed coastal changes between seasons using high-resolution images and also points clouds during 2016 and preliminary results confirm that UAVs can be used in permanent coast monitoring programs with excellent performance and detail.

Keywords: digital elevation model, high-resolution images, topographic coast monitoring, unmanned aerial vehicle

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Authors: Bessy Thuranira

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Buildings, as they are designed and used, may contribute to serious environmental problems because of excessive consumption of energy and other natural resources. Buildings in the informal settlements particularly, due to their unplanned physical structure and design, have significantly contributed the global energy problematic scenario typified by high-level inefficiencies. Energy used in buildings in Africa is estimated to be the highest of the total national electricity consumption. Over the last decade, assessments of energy consumption and efficiency/inefficiency has focused on formal and modern buildings. This study seeks to go off the beaten path, by focusing on energy use in informal settlements. Operationally, it sought to establish the contribution of informal buildings in the overall energy consumption in the city and the country at large. This study was carried out in Mukuru kwa Reuben informal settlement where there is distinct manifestation of different settlement morphologies within a small locality. The research narrowed down to three villages (Mombasa, Kosovo and Railway villages) within the settlement, that were representative of the different slum housing typologies. Due to the unpredictability nature and informality in slums, this study takes a multi-methodology approach. Detailed energy audits and measurements are carried out to predict total building consumption, and document building design and envelope, typology, materials and occupancy levels. Moreover, the study uses semi-structured interviews and to access energy supply, cost, access and consumption patterns. Observations and photographs are also used to shed more light on these parameters. The study reveals the high energy inefficiencies in slum buildings mainly related to sub-standard equipment and appliances, building design and settlement layout, poor access and utilization/consumption patterns of energy. The impacts of this inefficiency are high economic burden to the poor, high levels of pollution, lack of thermal comfort and emissions to the environment. The study highlights a set of urban planning and building design principles that can be used to retrofit slums into more energy efficient settlements. The study explores principles of responsive settlement layouts/plans and appropriate building designs that use the beneficial elements of nature to achieve natural lighting, natural ventilation, and solar control to create thermally comfortable, energy efficient, and environmentally responsive buildings/settlements. As energy efficiency in informal settlements is a relatively less explored area of efficiency, it requires further research and policy recommendations, for which this paper will set a background.

Keywords: energy efficiency, informal settlements, renewable energy, settlement layout

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students. 

Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant

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Authors: Emma Avoyan

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The safety standards for flood protection in the Netherlands have been revised recently. It is expected that all major flood-protection structures will have to be reinforced to meet the new standards. The Dutch Flood Protection Programme aims at accomplishing this task through innovative integrated projects such as construction of multi-functional flood defenses. In these projects, flood safety purposes will be combined with spatial planning, nature development, emergency management or other sectoral objectives. Therefore, implementation of dike reinforcement projects requires early involvement and collaboration between public and private sectors, different governmental actors and agencies. The development and implementation of such integrated projects has been an issue in Dutch flood risk management since long. Therefore, this article analyses how cross-sector collaboration within flood risk governance in the Netherlands has evolved over time, and how this development can be explained. The integrative framework for collaborative governance is applied as an analytical tool to map external factors framing possibilities as well as constraints for cross-sector collaboration in Dutch flood risk domain. Supported by an extensive document and literature analysis, the paper offers insights on how the system context and different drivers changing over time either promoted or hindered cross-sector collaboration between flood protection sector, urban development, nature conservation or any other sector involved in flood risk governance. The system context refers to the multi-layered and interrelated suite of conditions that influence the formation and performance of complex governance systems, such as collaborative governance regimes, whereas the drivers initiate and enable the overall process of collaboration. In addition, by applying a method of process tracing we identify a causal and chronological chain of events shaping cross-sectoral interaction in Dutch flood risk management. Our results indicate that in order to evaluate the performance of complex governance systems, it is important to firstly study the system context that shapes it. Clear understanding of the system conditions and drivers for collaboration gives insight into the possibilities of and constraints for effective performance of complex governance systems. The performance of the governance system is affected by the system conditions, while at the same time the governance system can also change the system conditions. Our results show that the sequence of changes within the system conditions and drivers over time affect how cross-sector interaction in Dutch flood risk governance system happens now. Moreover, we have traced the potential of this governance system to shape and change the system context.

Keywords: collaborative governance, cross-sector interaction, flood risk management, the Netherlands

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Authors: Antonio Lopez-Villegas, Rafael Bautista-Mesa, Emilio Robles-Musso, Daniel Catalan-Matamoros, Cesar Leal-Costa

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Objectives: The purpose of this trial was to evaluate the burden borne by and the costs to informal caregivers of users with telemonitoring of pacemakers. Methods: This is a controlled, non-randomised clinical trial, with data collected from informal caregivers, five years after implantation of pacemakers. The Spanish version of the Survey on Disabilities, Personal Autonomy, and Dependency Situations was used to get information on clinical and social characteristics, levels of professionalism, duration and types of care, difficulties in providing care, health status, economic and job aspects, impact on the family or leisure due to informal caregiving for patients with pacemakers. Results: After five years of follow-up, 55 users with pacemakers finished the study. Of which, 50 were helped by a caregiver, 18 were included in the telemonitoring group (TM) and 32 in the conventional follow-up group (HM). Overall, females represented 96.0% of the informal caregivers (88.89% in TM and 100.0% in HM group). The mean ages were 63.17 ± 15.92 and 63.13 ± 14.56 years, respectively (p = 0.83) in the groups. The majority (88.0%) of the caregivers declared that they had to provide their services between 6 and 7 days per week (83.33% in TM group versus 90.63% in HM group), without significant differences between both groups. The costs related to care provided by the informal caregivers were 47.04% higher in the conventional follow-up group than in the TM group. Conclusions: The results of this trial confirm that there were no significant differences between the informal caregivers regarding to baseline characteristics, workload and time worked in both groups of follow-up. The costs incurred by the informal caregivers providing care for users with pacemakers included in telemonitoring group are significantly lower than those in the conventional follow-up group. Trial registration: ClinicalTrials.gov NCT02234245. Funding: The PONIENTE study, has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: costs, disease burden, informal caregiving, pacemaker follow-up, remote monitoring, telemedicine

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Authors: Jennifer Kehinde, Claire O'donnell, Annmarie Grealish

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Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to lack of adequate breastfeeding education during prenatal stage.This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question which was aimed at determining the effectiveness of prenatal breastfeeding educational programs at improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) were searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum based breastfeeding education program, group prenatal breastfeeding counselling and one-to-one breastfeeding educational programs which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, increase in positive attitude to breastfeeding and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrates a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcome inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.

Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeedng education

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Authors: Hyeon-Kyo Lim, Tong-Il Jang, Yong-Hee Lee

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For an operator in a nuclear power plant, human error is one of the most dreaded factors that may result in unexpected accidents. The possibility of human errors may be low, but the risk of them would be unimaginably enormous. Thus, for accident prevention, it is quite indispensable to analyze the influence of any factors which may raise the possibility of human errors. During the past decades, not a few research results showed that performance of human operators may vary over time due to lots of factors. Among them, stress is known to be an indirect factor that may cause human errors and result in mental illness. Until now, not a few assessment tools have been developed to assess stress level of human workers. However, it still is questionable to utilize them for human performance anticipation which is related with human error possibility, because they were mainly developed from the viewpoint of mental health rather than industrial safety. Stress level of a person may go up or down with work time. In that sense, if they would be applicable in the safety aspect, they should be able to assess the variation resulted from work time at least. Therefore, this study aimed to compare their applicability for safety purpose. More than 10 kinds of work stress tools were analyzed with reference to assessment items, assessment and analysis methods, and follow-up measures which are known to close related factors with work stress. The results showed that most tools mainly focused their weights on some common organizational factors such as demands, supports, and relationships, in sequence. Their weights were broadly similar. However, they failed to recommend practical solutions. Instead, they merely advised to set up overall counterplans in PDCA cycle or risk management activities which would be far from practical human error prevention. Thus, it was concluded that application of stress assessment tools mainly developed for mental health seemed to be impractical for safety purpose with respect to human performance anticipation, and that development of a new assessment tools would be inevitable if anyone wants to assess stress level in the aspect of human performance variation and accident prevention. As a consequence, as practical counterplans, this study proposed a new scheme for assessment of work stress level of a human operator that may vary over work time which is closely related with the possibility of human errors.

Keywords: human error, human performance, work stress, assessment tool, time-variant, accident prevention

Procedia PDF Downloads 661

Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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Authors: R. L. P. de Lima, F. C. B. Boogaard, D. Setyo Rini, P. Arisandi, R. E. de Graaf-Van Dinther

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Water quality in many Asian countries is very poor due to inefficient solid waste management, high population growth and the lack of sewage and purification systems for households and industry. A consortium of Indonesian and Dutch organizations has begun a large-scale international research project to evaluate and propose solutions to face the surface water pollution challenges in Brantas Basin, Indonesia (East Java: Malang / Surabaya). The first phase of the project consisted in a baseline study to assess the current status of surface water bodies and to determine the ambitions and strategies among local stakeholders. This study was conducted with high participatory / collaborative and knowledge sharing objectives. Several methods such as using mobile sensors (attached to boats or underwater drones), test strips and mobile apps, bio-monitoring (sediments), ecology scans using underwater cameras, or continuous / static measurements, were applied in different locations in the regions of the basin, at multiple locations within the water systems (e.g. spring, upstream / downstream of industry and urban areas, mouth of the Surabaya River, groundwater). Results gave an indication of (reference) values of basic water quality parameters such as turbidity, electrical conductivity, dissolved oxygen or nutrients (ammonium / nitrate). An important outcome was that collecting random samples may not be representative of a body of water, given that water quality parameters can vary widely in space (x, y, and depth) and time (day / night and seasonal). Innovative / dynamic monitoring methods (e.g. underwater drones, sensors on boats) can contribute to better understand the quality of the living environment (water, ecology, sediment) and factors that affect it. The field work activities, in particular, underwater drones, revealed potential as awareness actions as they attracted interest from locals and local press. This baseline study involved the cooperation with local managing organizations with Dutch partners, and their willingness to work together is important to ensure participatory actions and social awareness regarding the process of adaptation and strengthening of regulations, or for the construction of facilities such as sewage.

Keywords: water quality monitoring, pollution, underwater drones, social awareness

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Authors: Moetazza M. Al-Shafei, Hala Abdel Karim, Eitedal M. Daoud, Hassan Zaki Hassuna

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Epilepsy is a common neurological disorder affecting all age groups. It is one of the world's most prevalent non-communicable diseases. Increased evidence suggesting that long term usage of anti-epileptic drugs can have adverse effects on bone mineralization and bone molding .Aiming to study these effects and to give guide lines to support bone health through early intervention. From Neurology Out-Patient Clinic kaser Elaini University Hospital, 60 Patients were enrolled, 40 patients on antiepileptic drugs for at least two years and 20 controls matched with age and sex, epileptic but before starting treatment both chosen under specific criteria. Patients were divided into four groups, three groups with monotherapy treated with either Phynetoin, Valporic acid or Carbamazipine and fourth group treated with both Valporic acid and Carbamazipine. Estimation of serum Carboxy-Terminal Telopeptide of Type I- Collagen(ICTP) bone resorption marker, serum 25(OH )vit D3, calcium ,magnesium and phosphorus were done .Results showed that all patients on AED had significant low levels of 25(OH) vit D3 (p<0.001) ,with significant elevation of ICTP (P<0.05) versus controls. In group treated with Phynotoin highly significant elevation of (ICTP) marker and decrease of both serum 25(OH) vit D3 (P<0, 0001) and serum calcium(P<0.05)versus control. Double drug group showed significant decrease of serum 25(OH) vit D3 (P<0.0001) and decrease in Phosphorus (P<0.05) versus controls. Serum magnesium showed no significant differences between studied groups. We concluded that Anti- epileptic drugs appears to be an aggravating factor on bone mineralization ,so therapeutically it can be worth wile to supplement calcium and vitamin D even before initiation of antiepileptic therapy. ICTP marker can be used to evaluate change in bone resorption before and during AED therapy.

Keywords: antiepileptic drugs, bone minerals, carboxy teminal telopeptidetype-1-collagen bone resorption marker, vitamin D

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Authors: Rui Pedro Fonseca

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This paper presents the results of a research about carnism on Portuguese television. It begins by presenting a case study of MasterChef program (TVI) which conveys carnism in both practices and language, and from which some characteristics of their dominant representations are described. Subsequently, the paper presents the indicators of the presence of carnism in the Portuguese television programming, between 2013 and 2014, in the TVI, RTP1, and SICS channels. The data reveals that there is the hegemony of the carnist ideology in the main channels of the Portuguese television. Also, the samples collected and viewed show no mention of the impacts of carnism in its various dimensions (non-human animals, environment, human health and sustainability).

Keywords: carnism, speciesism, television, Portugal

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Authors: Jade Fersterer, Tristan Snell, Mark Rickinson

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This paper is designed to provide a review of the literature concerning the impact of natural environments on student learning and wellbeing in Australia. Specific areas of interest include how child-led and teacher-led pedagogies differ in outdoor learning settings, and the impact of each approach on children’s well-being, behavior, relationships with others as well as educational outcomes. The review will include links to possibilities for future research, including a Ph.D. currently being undertaken in Australia, which aims to fulfill a considerable gap in psychological, educational and outdoor learning research, regarding how natural environments are being used by teachers to improve learning and wellbeing among primary school students. The proposed study aims to understand if children’s experience of learning, 1. in a natural environment, and 2. in a child-led way, can support and strengthen their skills across several areas of development, including those required for positive educational outcomes. Data will be collected from a sample of primary school students and teachers via both quantitative and qualitative methods, including a pre- and post-questionnaire, direct observation, and semi-structured interviews. The study will have valuable implications for the provision of quality education as well as the promotion of good health and wellbeing. The implications of the research will be useful not only for teachers and parents but also for Psychologists working with children and young people in both a school and clinical setting. Understanding the impacts and implications of child-led learning and exposure to natural environments provides the opportunity to build on the current school curriculum. The inclusion of child-led experiences in nature may provide a simple way to build enthusiasm for school and learning, cultivating skills for life and relationships as well as meeting current curriculum requirements and building capacity for ongoing academic pursuits. In addition, understanding the impact of learning in a natural environment on wellbeing will assist in the development and dissemination of an educational model that could help mitigate the negative health outcomes associated with reduced physical activity and decreasing contact with nature among children.

Keywords: child-led learning, educational outcomes, natural environments, wellbeing

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Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

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Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

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Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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Authors: G. P. Gunasinghe, Lilani Ruhunage, N. P. Ratnayake, G. V. I. Samaradivakara, H. M. R. Premasiri, A. S. Ratnayake, Nimila Dushantha, W. A. P. Weerakoon, K. B. A. Silva

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Sri Lanka is affected by different natural disasters such as tsunami, landslides, lightning, and riverine flood. Out of them, riverine floods act as a major disaster in the country. Different strategies are applied to control the impacts of flood hazards, and the expansion of river mouth is considered as one of the main activities for flood mitigation and disaster reduction. However, due to this expansion process, natural sand barriers including sand spits, barrier islands, and tidal planes are destroyed or subjected to change. This, in turn, can change the hydrodynamics and sediment dynamics of the area leading to other damages to the natural coastal features. The removal of a considerable portion of naturally formed sand barrier at Kaluganga River outlet (Calido Beach), Sri Lanka to control flooding event at Kaluthara urban area on May 2017, has become a serious issue in the area causing complete collapse of river mouth barrier spit bar system leading to rapid coastal erosion Kaluganga river outlet area and saltwater intrusion into the Kaluganga River. The present investigation is focused on assessing effects due to the removal of a considerable portion of naturally formed sand barrier at Kaluganga river mouth. For this study, the beach profiles, the bathymetric surveys, and Google Earth historical satellite images, before and after the flood event were collected and analyzed. Furthermore, a beach boundary survey was also carried out in October 2018 to support the satellite image data. The results of Google Earth satellite images and beach boundary survey data analyzed show a chronological breakdown of the sand barrier at the river outlet. The comparisons of pre and post-disaster bathymetric maps and beach profiles analysis revealed a noticeable deepening of the sea bed at the nearshore zone as well. Such deepening in the nearshore zone can cause the sea waves to break very near to the coastline. This might also lead to generate new diffraction patterns resulting in differential coastal accretion and erosion scenarios. Unless immediate mitigatory measures were not taken, the impacts may cause severe problems to the sensitive Kaluganag river mouth system.

Keywords: bathymetry, beach profiles, coastal features, river outlet, sand barrier, Sri Lanka

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Authors: Fangjing Zhou, Wen Chen, Brian J. Hall, Yu Wang, Carl Latkin, Li Ling, Joseph D. Tucker

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Background: Economic and social reforms designed to open China to the world has been successful, but also appear to have rapidly laid the foundation for the reemergence of STIs since 1980s. Changes in sexual behaviors, relationships, and norms among Chinese contributed to the STIs epidemic. As the massive population moved during the last 30 years, early coital debut, multiple sexual partnerships, and unprotected sex have increased within the general population. Our objectives were to assess associations between residences location, sexual risk behaviors and sexually transmitted infections (STIs) among adults living in Guangzhou, China. Methods: Stratified cluster sampling followed a two-step process was used to select populations aged 18-59 years in Guangzhou, China. Spatial methods including Geographic Information Systems (GIS) were utilized to identify 1400 coordinates with latitude and longitude. Face-to-face household interviews were conducted to collect self-report data on sexual risk behaviors and diagnosed STIs. Kulldorff’s spatial scan statistic was implemented to identify and detect spatial distribution and clusters of sexual risk behaviors and STIs. The presence and location of statistically significant clusters were mapped in the study areas using ArcGIS software. Results: In this study, 1215 of 1400 households attempted surveys, with 368 refusals, resulting in a sample of 751 completed surveys. The prevalence of self-reported sexual risk behaviors was between 5.1% and 50.0%. The self-reported lifetime prevalence of diagnosed STIs was 7.06%. Anal intercourse clustered in an area located along the border within the rural-urban continuum (p=0.001). High rate clusters for alcohol or other drugs using before sex (p=0.008) and migrants who lived in Guangzhou less than one year (p=0.007) overlapped this cluster. Excess cases for sex without a condom (p=0.031) overlapped the cluster for college students (p<0.001). Conclusions: Short-term migrants and college students reported greater sexual risk behaviors. Programs to increase safer sex within these communities to reduce the risk of STIs are warranted in Guangzhou. Spatial analysis identified geographical clusters of sexual risk behaviors, which is critical for optimizing surveillance and targeting control measures for these locations in the future.

Keywords: cluster analysis, migrant, sexual risk behaviors, spatial distribution

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Authors: Diya Kohli, Amalia Ardeljan, Lexi Frankel, Jose Garcia, Lokesh Manjani, Omar Rashid

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Gonorrhea is the second most common sexually transmitted disease (STDs) in the United States of America. Gonorrhea affects the urethra, rectum, or throat and the cervix in females. Lymphoma is a cancer of the immune network called the lymphatic system that includes the lymph nodes/glands, spleen, thymus gland, and bone marrow. Lymphoma can affect many organs in the body. When a lymphocyte develops a genetic mutation, it signals other cells into rapid proliferation that causes many mutated lymphocytes. Multiple studies have explored the incidence of cancer in people infected with STDs such as Gonorrhea. For instance, the studies conducted by Wang Y-C and Co., as well as Caini, S and Co. established a direct co-relationship between Gonorrhea infection and incidence of prostate cancer. We hypothesize that Gonorrhea infection also increases the incidence of Lymphoma in patients. This research study aimed to evaluate the correlation between Gonorrhea infection and the incidence of Lymphoma. The data for the research was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. This database was utilized to evaluate patients infected with Gonorrhea versus the ones who were not infected to establish a correlation with the prevalence of Lymphoma using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for academic research. Standard statistical methods were applied throughout. Between January 2010 and December 2019, the query was analyzed and resulted in 254 and 808 patients in both the infected and control group, respectively. The two groups were matched by Age Range and CCI score. The incidence of Lymphoma was 0.998% (254 patients out of 25455) in the Gonorrhea group (patients infected with Gonorrhea that was Lymphoma Positive) compared to 3.174% and 808 patients in the control group (Patients negative for Gonorrhea but with Lymphoma). This was statistically significant by a p-value < 2.210-16 with an OR= 0.431 (95% CI 0.381-0.487). The patients were then matched by antibiotic treatment to avoid treatment bias. The incidence of Lymphoma was 1.215% (82 patients out of 6,748) in the Gonorrhea group compared to 2.949% (199 patients out of 6748) in the control group. This was statistically significant by a p-value <5.410-10 with an OR= 0.468 (95% CI 0.367-0.596). The study shows a statistically significant correlation between Gonorrhea and a reduced incidence of Lymphoma. Further evaluation is recommended to assess the potential of Gonorrhea in reducing Lymphoma.

Keywords: gonorrhea, lymphoma, STDs, cancer, ICD

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Authors: Kyra Kannen, Sonja D. Roelen, Sebastian Schnieder, Jarek Krajewski, Steffen Holsteg, André Karger, Johanna Askeridis, Celina Slawik, Philip Mildner, Jens Piesk, Ruslan David, Holger Kürten, Benjamin Oster, Robert Malzan, Mike Ludemann

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Virtual Reality (VR) is increasingly recognized for its potential in transforming mental disorder treatment, offering advantages such as cost-effectiveness, time efficiency, accessibility, reduced stigma, and scalability. While the application of VR in the context of anxiety disorders has been extensively evaluated and demonstrated to be effective, the utilization of VR as a therapeutic treatment for depression remains under-investigated. Our goal is to pioneer immersive VR therapy modules for treating major depression, alongside a web-based system for home use. We develop a modular digital therapy platform grounded in psychodynamic therapy interventions which addresses stress reduction, exploration of social situations and relationship support, social skill training, avoidance behavior analysis, and psychoeducation. In addition, an automated depression monitoring system, based on acoustic voice analysis, is implemented in the form of a speech-based diary to track the affective state of the user and depression severity. The use of immersive VR facilitates patient immersion into complex and realistic interpersonal interactions with high emotional engagement, which may contribute to positive treatment acceptance and satisfaction. In a proof-of-concept study, 45 depressed patients were assigned to VR or web-platform modules, evaluating user experience, usability and additional metrics including depression severity, mindfulness, interpersonal problems, and treatment satisfaction. The findings provide valuable insights into the effectiveness and user-friendliness of VR and web modules for depression therapy and contribute to the refinement of more tailored digital interventions to improve mental health.

Keywords: virtual reality therapy, digital health, depression, psychotherapy

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Authors: Riina I. Bray, Yifan Wang, Nikolas Argiropoulos, Stephanie Robins, John Molot, Kelly Tragash, Lynn M. Marshall, Margaret E. Sears, Marie-Andrée Pigeon, Michel Gaudet, Pierre Auger, Emily Bélanger, Rohini Peris

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Multiple chemical sensitivity (MCS) is a chronic medical condition characterized by intolerances to chemical substances. Since the arrival of the COVID-19 pandemic and associated health measures, people experiencing MCS (PEMCS) are at a heightened risk of environmental exposures associated with cleaners, disinfectants, and sanitizers. Little attention has been paid to the well-being of PEMCS in the context of the COVID-19 pandemic. Objective: This study assesses the lived experiences of Canadian adults with MCS in relation to their living environment, access to healthcare, and levels of perceived social support before and during the pandemic. Methods: A total of 119 PEMCS completed an online questionnaire. McNemar Chi-Squared and Wilcoxon Signed Rank tests were used to evaluate if there were statistically significant changes in participants’ perception of their living environment, access to healthcare, and levels of social support before and after March 11, 2020. Results: Both positive and negative outcomes were noted. Participants reported an increase in exposure to disinfectants/sanitizers that entered their living environment (p<.001). There was a reported decrease in access to a family doctor during the pandemic (p<0.001). Although PEMCS experienced increased social isolation (p<0.001), they also reported an increase in understanding from family (p<0.029) and a decrease in stigma for wearing personal protective equipment (p<0.001). Conclusion: PEMCS reported experiencing: increased exposure to disinfectants or sanitizers, a loss of social support, and barriers in accessing healthcare during the pandemic. However, COVID-19 provided an opportunity to normalize the living conditions of PEMCS, such as wearing masks and social isolation. These findings can guide decision-makers on the importance of implementing nontoxic alternatives for cleaning and disinfection, as well as improving accommodation measures for PEMCS.

Keywords: covid-19, multiple chemical sensitivity, MCS, quality of life, social isolation, physical environment, healthcare

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Authors: Concetta Papapicco

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The spreading of new Coronavirus (COVID-19) in addition to becoming a global phenomenon, following the declaration of a pandemic state, has generated excessive access to information, sometimes not thoroughly screened, which makes it difficult to navigate a given topic because of the difficulty of finding reliable sources. As a result, there is a high level of contagion, understood as the spread of the virus, but also as the spread of information in a viral and harmful way, which prompted the World Health Organization to coin the term Infodemia to give 'a name' the phenomenon of excessive information. With neologism 'Infodemia', the World Health Organization (OMS) wanted, in these days when fear of the coronavirus is raging, point out that perhaps the greatest danger of global society in the age of social media. This phenomenon is the distortion of reality in the rumble of echoes and comments of the global community on real or often invented facts. The general purpose of the exploratory study is to investigate how the coronavirus situation is described from journalistic communication. Starting from La Repubblica online, as a reference journalistic magazine, as a specific objective, the research aims to understand the way in which journalistic communication describes the phenomenon of the COVID-19 virus spread, the spread of contagion and restrictive measures of social distancing in the Italian context. The study starts from the hypothesis that if the circulation of information helps to create a social representation of the phenomenon, the excessive accessibility to sources of information (Infodemia) can be modulated by the 'how' the phenomenon is described by the journalists. The methodology proposed, in fact, in the exploratory study is a quanti-qualitative (mixed) method. A Content Analysis with the SketchEngine software is carried out first. In support of the Content Analysis, a Diatextual Analysis was carried out. The Diatextual Analysis is a qualitative analysis useful to detect in the analyzed texts, that is the online articles of La Repubblica on the topic of coronavirus, Subjectivity, Argomentativity, and Mode. The research focuses mainly on 'Mode' or 'How' are the events related to coronavirus in the online articles of La Repubblica about COVID-19 phenomenon. The results show the presence of the contrast vision about COVID-19 situation in Italy.

Keywords: coronavirus, Italian infodemia, La Republica online, mix method

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Authors: Muhammad Asim

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Background: Less than half of women in South Asia (SA) use any modern contraceptive method which leads to a huge burden of unintended pregnancies, unsafe abortions, maternal deaths, and socioeconomic loss. Women empowerment plays a pivotal role in improving various health seeking behaviours, including contraceptive use. The objective of this study to explore the association between women's empowerment and modern contraceptive, among rich and poor segment of population in SA. Methods: We used the most recent, large-scale, demographic health survey data of five South Asian countries, namely Afghanistan, Pakistan, Bangladesh, India, and Nepal. The outcome variable was the current use of modern contraceptive methods. The main exposure variable was a combination (interaction) of socio-economic status (SES) and women’s level of empowerment (low, medium, and high), where SES was bifurcated into poor and rich; and women empowerment was divided into three categories: decision making, attitude to violence and social independence. Moreover, overall women empowerment indicator was also created by using three dimensions of women empowerment. We applied both descriptive statistics and multivariable logistic regression techniques for data analyses. Results: Most of the women possessed ‘medium’ level of empowerment across South Asian Countries. The lowest attitude to violence empowerment was found in Afghanistan, and the lowest social independence empowerment was observed in Bangladesh across SA. However, Pakistani women have the lowest decision-making empowerment in the region. The lowest modern contraceptive use (22.1%) was found in Afghanistan and the highest (53.2%) in Bangladesh. The multivariate results depict that the overall measure of women empowerment does not affect modern contraceptive use among poor and rich women in most of South Asian countries. However, the decision-making empowerment plays a significant role among both poor and rich women to use modern contraceptive methods across South Asian countries. Conclusions: The effect of women’s empowerment on modern contraceptive use is not consistent across countries, and among poor and rich segment of population. Of the three dimensions of women’s empowerment, the autonomy of decision making in household affairs emerged as a stronger determinant of mCPR as compared with social independence and attitude towards violence against women.

Keywords: women empowerment, contraceptive use, South Asia, women autonomy

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Authors: S. Sansone-Casaburi

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The pandemic that the world is going through is causing important changes in the daily life of all cities, which can translate into opportunities to rearrange pending situations. Among others: the town-city relationship and sustainability. On the one hand, the city continues to be the center of attention, and the countryside is assumed as the supplier of food. However, the temporary closure of cities highlighted the importance of the rural environment, and many people are reassessing this context as an alternative for life. Furthermore, the countryside is not simply the home and the center of activity of the people who inhabit it, but rather constitutes the active group of all citizens, both rural and urban. On the other hand, the pandemic is the opportunity to meet sustainable development goals. Sustainable development is understood as the capital to be transferred to future generations made up of three types of wealth: natural capital (environment), human capital (people, relationships, culture), and artificial or built capital, made up of buildings and infrastructure, or by cities and towns. The 'new normal' can mean going back to the countryside, but not to a merely agricultural place but to a sustainable, affordable, and healthy place, which, with the appropriate infrastructures, allows work from a distance, a new post-COVID-19 modality. The contribution of the research is towards the recovery of traditional villages from the perspective of populations that have managed to maintain their vitality with innovative solutions. It is assumed that innovation is a path for the recovery of traditional villages, so we ask: what conditions are necessary for innovation to be successful and sustainable? In the research, several variables were found, among which culture is named, so the objective of this article is to understand Uruena, a town in the province of Valladolid, which with only 182 inhabitants houses five museums and twelve bookstores that make up the first Villa del Libro in Spain. The methodology used is mixed: inductive and deductive and the results were specified in determining the formula of innovative peoples in culture: PIc = Pt + C [E (Aec) + S (pp) + A (T + s + t + enc)]. Where the innovative villages in culture PIc are the result of traditional villages Pt that from a cultural innovation C, integrates into the economic, economic and cultural activities E (Aec); in the social sphere, the public and private actors S (pp); and in the environmental (A), Territory (T), services (s), technology (t) and natural and built spaces (enc). The results of this analysis will focus on determining what makes the structure of innovative peoples sustainable and understanding what variables make up that structure to verify if they can be applied in other contexts and repower abandoned places to provide a solution for people who migrate to this context. That is, learn from what has been done to replicate it in similar cases.

Keywords: culture as innovation, depopulation, sustainability, traditional villages

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Authors: Lahcen Daoudi, Fatima Zahra Omdi, Abldelali Gourfi

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In Morocco, as in most Mediterranean countries, water scarcity is a common situation because of low and unevenly distributed rainfall. The expansions of irrigated lands, as well as the growth of urban and industrial areas and tourist resorts, contribute to an increase of water demand. Therefore in the 1960s Morocco embarked on an ambitious program to increase the number of dams to boost water retention capacity. However, the decrease in the capacity of these reservoirs caused by sedimentation is a major problem; it is estimated at 75 million m3/year. Dams and reservoirs became unusable for their intended purposes due to sedimentation in large rivers that result from soil erosion. Soil erosion presents an important driving force in the process affecting the landscape. It has become one of the most serious environmental problems that raised much interest throughout the world. Monitoring soil erosion risk is an important part of soil conservation practices. The estimation of soil loss risk is the first step for a successful control of water erosion. The aim of this study is to estimate the soil loss risk and its spatial distribution in the different fields of Morocco and to prioritize areas for soil conservation interventions. The approach followed is the Revised Universal Soil Loss Equation (RUSLE) using remote sensing and GIS, which is the most popular empirically based model used globally for erosion prediction and control. This model has been tested in many agricultural watersheds in the world, particularly for large-scale basins due to the simplicity of the model formulation and easy availability of the dataset. The spatial distribution of the annual soil loss was elaborated by the combination of several factors: rainfall erosivity, soil erodability, topography, and land cover. The average annual soil loss estimated in several basins watershed of Morocco varies from 0 to 50t/ha/year. Watersheds characterized by high-erosion-vulnerability are located in the North (Rif Mountains) and more particularly in the Central part of Morocco (High Atlas Mountains). This variation of vulnerability is highly correlated to slope variation which indicates that the topography factor is the main agent of soil erosion within these basin catchments. These results could be helpful for the planning of natural resources management and for implementing sustainable long-term management strategies which are necessary for soil conservation and for increasing over the projected economic life of the dam implemented.

Keywords: soil loss, RUSLE, GIS-remote sensing, watershed, Morocco

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Authors: Gal Zagron, Nitza Abramson, Deena R. Zimmerman, Chen Stein-Zamir

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Background: Salmonella enteritidis is a common cause of foodborne outbreaks, primarily associated with poultry eggs. S. enteritidis This is the only Salmonella type that is found inside the eggshell. A rise in Salmonella enteritidis notifications was noted in spring 2017. Aims: The aim of this study is to describe the epidemiological investigation of the outbreak in the Jerusalem district, along with the containment measures taken. Methods: This study is a population-based epidemiological study with a description of environmental control activities. Results: During the months May - July, 2017 848 salmonellosis cases were reported to the Jerusalem district health office compared to 294 cases May - July 2016. Salmonella enteritidis was isolated in 58% of reported cases. Clusters and outbreaks ( > 2 cases) were reported among nursery schools, nursing homes, persons residing in one kibbutz and several cases in different food service establishments in the Jerusalem district. Epidemiological investigations revealed eggs consumption as a common feature among the cases (uncooked or undercooked eggs in most cases). A national investigation among egg suppliers revealed that most cases consumed eggs provided by a single provider with isolation of Salmonella enteritidis at the source as well. Containment measures were taken to control the epidemic including distributing information via electronic and written media to the public, searching for all egg distribution centers, informing local authorities, the poultry council and food stores. The eggs originating from the provider were recalled and extinguished. Written instructions to all food preparation facilities in the district were distributed regarding the proper storage and preparation of eggs. The number of reported cases declined and the outbreak vanished during correlating months of 2018. Conclusions: The investigation of Salmonella enteritidis outbreaks should include epidemiological and laboratory investigations, tracing the source of the eggs and testing the eggs and the source of eggs. Health education activities are essential as to the proper handling of eggs and egg products aiming to minimize susceptibility to Salmonella infection.

Keywords: epidemiological investigation, food-borne disease, food safety, Salmonella enteritidis

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Authors: Safwan Mawlood Hussien

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Internet of Things (IoT) is a promising technology has received considerable attention in different fields such as health, industry, defence, and agro, etc. Due to the limitation capacity of computing, storage, and communication, IoT objects are more vulnerable to attacks. Many solutions have been proposed to solve security issues, such as key management using symmetric-key ciphers. This study provides a scalable group distribution key management based on ECcryptography; with less transmitted messages The method has been validated through simulations in OMNeT++.

Keywords: elliptic curves, Diffie–Hellman, discrete logarithm problem, secure key exchange, WSN security, IoT security, smart-agro

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Authors: Joseph Dodson, Robert Roth, Alexander Hodakowski, Leah Greenfield, Melissa Porterhouse, Natalie Maltby, Rachel Sadowsky

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Introduction: Throughout the COVID-19 pandemic, countless research publications were released regarding SARS-CoV-2 and its variants, suggested treatments, and vaccine safety and efficacy. Daily publication of research became overwhelming for health professionals and the general public to stay informed. To address this problem, a group of 70 students across the four colleges at Rush University created the “Rush University COVID-19 Journal Club.” To broaden the available audience, the journal club then expanded to social media. Methods: Easily accessible and understandable summaries of the research were written by students and sent to faculty sponsors for feedback. Following the revision, summaries were published weekly on the Rush University COVID-19 Journal Club website for clinicians and students to use for reference. An Instagram page was then created, and information was further condensed into succinct posts to address COVID-19 “FAQs.” Next, a survey was distributed to followers of the Instagram page with questions meant to assess the effectiveness of the platform and gain feedback. A 5-point Likert scale was used as the primary question format. Results: The Instagram page accrued 749 followers and posted 52 unique posts over a 2 year period. Preliminary results from the surveys demonstrate that over 80% of respondents strongly agree that the Instagram posts 1) are an effective platform for the public presentation of factual COVID-19-related information; 2) provide relevant and valuable information; 3) provide information that is clear, concise, and can be easily understood. Conclusion: These results suggest that the Rush COVID-19 Journal Club was able to successfully create a social media presence and convey information without sacrificing scholarly integrity. Other academic institutions may benefit from the application of this model to help students and clinicians with the interpretation and evaluation of research topics with large bodies of evidence.

Keywords: SARS-CoV-2, COVID-19, public health, social media, SARS-CoV-2 vaccine, SARS-CoV-2 variants

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Authors: Daniela Nedeltcheva-Antonova, Kamelia Getchovska, Vera Deneva, Stanislav Bozhanov, Liudmil Antonov

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Rosa damascena Mill. (Damask rose) is one of the most important plants belonging to the Rosaceae family, with a long historical use in traditional medicine and as a valuable oil-bearing plant. Many pharmacological effects have been reported from this plant, including anti-inflammatory, hypnotic, analgesic, anticonvulsant, anti-depressant, antianxiety, antitussive, antidiabetic, relaxant effects on tracheal chains, laxative, prokinetic and hepatoprotective activities. Pharmacological studies have shown that the various health effects of R. damascena flowers can mainly be attributed to its large amount of polyphenolic components. Phenolics possess a wide range of pharmacological activities, such as antioxidants, free-radical scavengers, anticancer, anti-inflammatory, antimutagenic, and antidepressant, with flavonoids being the most numerous group of natural polyphenolic compounds. According to the technological process in the production of rose concrete (solvent extraction with non-polar solvents of fresh rose flowers), it can be assumed that the resulting plant residue would be as rich of polyphenolics, as the plant itself, and could be used for the development of novel products with promising health-promoting effect. Therefore, an optimisation of the extraction procedure of the by-product from the rose concrete production was carried out. An assay of the extracts in respect of their total polyphenols and total flavonoids content was performed. HPLC analysis of quercetin and kaempferol, the two main flavonoids found in R. damascena, was also carried out. The preliminary results have shown that the flavonoid content in the rose extracts is comparable to that of the green tea or Gingko biloba, and they could be used for the development of various products (food supplements, natural cosmetics and phyto-pharmaceutical formulation, etc.). The fact that they are derived from the by-product of industrial plant processing could add the marketing value of the final products in addition to the well-known reputation of the products obtained from Bulgarian roses (R. damascena Mill.).

Keywords: gas chromatography-mass-spectromrtry, dry extract, flavonoids, Rosa damascena Mill

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