Search results for: urban health

Authors: Muhammad Asim

Abstract:

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, modern contraceptive use, South Asia, women autonomy

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Authors: May Phyo Wai, Tanyawan Suantawee

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The positive correlation between unhealthy diets (high in fats, sugars, carbohydrates, and low fibers) and the risk of non-communicable diseases (NCDs) like obesity, hypertension, diabetes, and heart diseases has led to a growing interest in healthier lifestyles and diets. Consequently, people are opting for foods rich in fiber and phytochemicals. Wolffia globosa, also known as duckweed or watermeal, is the smallest plant with high nutritional value, including protein, fiber, phytochemicals, and antioxidant properties. It offers numerous health benefits, such as improving gut health and lowering blood glucose levels, and it is widely available in Thailand. The purpose of this study was to develop nutritionally enhanced breadsticks utilizing vacuum heat-dried Wolffia globosa power (WP). Various concentrations of WP (0% as control, 5%, 10%, and 15 % w/w/) were added, and then the breadsticks’ physical properties (hardness, fracturability, and color), phytochemicals (total phenolic compounds: TPC and total flavonoid contents: TFC), and antioxidant properties (DPPH radical scavenging activity (DPPH) and ferric reducing antioxidant power (FRAP) assay) were investigated. Experiments were done by triplicates and data was analyzed by one-way ANOVA. The results showed that the hardness, measured by a texture analyzer, increased significantly (p<0.05) with higher WP concentrations, reaching 2,897.01 ± 77.31 g at 15% WP from 1,314.41 ± 32.52 g of the control. In contrast, the lightness (L*), redness (a*), and yellowness (b*) of the breadsticks significantly decreased (p < 0.05) in a dose-dependent manner with added WP. Incorporating WP, rich in phytochemicals and antioxidants, into the flour significantly enhanced the TPC and TFC of the breadsticks (p<0.05), with TPC and TFC increasing dose-dependently rising to 1.8-fold and 3.5-fold at 15% WP, respectively. The antioxidant power, assessed by DPPH and FRAP assays, also showed a similar trend, with significantly higher values at 10% and 15% WP (p<0.05). These results indicate that adding WP significantly boosted the TPC, TFC, DPPH, and FRAP values of the developed breadsticks. Therefore, incorporating WP into breadsticks might be a promising strategy for creating food products enriched with phytochemicals and antioxidants, offering consumers healthier options in the market.

Keywords: antioxidant properties, breadsticks, phytochemicals, Wolffia globosa

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Authors: Yu Yoshihara, Chika Tada, Moe Takada, Nyam-Osor Purevdorj, Khorolmaa Chimedtseren, Yutaka Nakai

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Water pollution from animal waste and its influence on grazing animals is a current concern regarding Mongolian grazing lands. We allocated 32 free-grazing lambs to four groups and provided each with water from a different source (upper stream, lower stream, well, and pond) for 49 days. We recorded the amount of water consumed by the lambs, as well as their body weight, behavior, white blood cell count, acute phase (haptoglobin) protein level, and fecal condition. We measured the chemical and biological qualities of the four types of water, and we detected enteropathogenic and enterohemorrhagic Escherichia coli in fecal samples by using a genetic approach. Pond water contained high levels of nitrogen and minerals, and well water contained high levels of bacteria. The odor concentration index decreased in order from pond water to upper stream, lower stream, and well. On day 15 of the experiment, the following parameters were the highest in lambs drinking water from the following sources: water intake (pond or lower stream), body weight gain (pond), WBC count (lower stream), haptoglobin concentration (well), and enteropathogenic E. coli infection rate (lower stream). Lambs that drank well water spent more time lying down and less time grazing than the others, and lambs that drank pond water spent more time standing and less time lying down. Lambs given upper or lower stream water exhibited more severe diarrhea on day 15 of the experiment than before the experiment. Mongolian sheep seemed to adapt to chemically contaminated water: their productivity benefited the most from pond water, likely owing to its rich mineral content. Lambs that drank lower stream water showed increases in enteropathogenic E. coli infection, clinical diarrhea, and WBC count. Lambs that drank well water, which was bacteriologically contaminated, had increased serum acute phase protein levels and poor physical condition; they were thus at increased risk of negative health and production effects.

Keywords: DNA, Escherichia coli, fecal sample, lower stream, well water

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Authors: Ni'mal Baroya, Andrei Ramani, Irma Prasetyowati

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The access to reproduction health services, including with safe and effective contraception were human rights regardless of social stratum and residence. In addition to individual factors, family and contextual factors were also believed to be the cause in the use of contraceptive methods. This study aimed to assess the determinants of long-term contraceptive methods (LTCM) by considering all the factors at either the individual level or contextual level. Thereby, this study could provide basic information for program development of prevalence enhancement of MKJP in East Java. The research, which used cross-sectional design, utilized Riskesdas 2013 data, particularly in East Java Province for further analysis about multilevel modeling of MKJP application. The sample of this study consisted of 20.601 married women who were not in pregnant that were drawn by using probability sampling following the sampling technique of Riskesdas 2013. Variables in this study were including the independent variables at the individual level that consisted of education, age, occupation, access to family planning services (KB), economic status and residence. As independent variables in district level were the Human Development Index (HDI, henceforth as IPM) in each districts of East Java Province, the ratio of field officers, the ratio of midwives, the ratio of community health centers and the ratio of doctors. As for the dependent variable was the use of Long-Term Contraceptive Method (LTCM or MKJP). The data were analyzed by using chi-square test and Pearson product moment correlation. The multivariable analysis was using multilevel logistic regression with 95% of Confidence Interval (CI) at the significance level of p < 0.05 and 80% of strength test. The results showed a low CPR LTCM was concentrated in districts in Madura Island and the north coast. The women which were 25 to 35 or more than 35 years old, at least high school education, working, and middle-class social status were more likely to use LTCM or MKJP. The IPM and low PLKB ratio had implications for poor CPR LTCM / MKJP.

Keywords: multilevel, long-term contraceptive methods, east java, contextual factor

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Authors: Samantha Burns, Melissa Brown, Judith Rankin

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Background: As a specialised intervention, NEWPIP provides a service which supports both parents and their babies from conception to two years, who are experiencing issues which may affect the quality of their relationship and development of the infant. This evaluation of the NEWPIP approach was undertaken in response to the need for rich, in-depth data to understand the lived experiences of the parents who experienced the service to improve the service. NEWPIP is currently one of 34 specialised parent–infant relationship teams across England. This evaluation contributes to increasing understanding of the impact and effectiveness of this specialised service to inform future practice. Aim: The aim of this evaluation was to explore the perspectives and experiences of parents or caregivers (service users), to assess the impact of the NEWPIP service on the parents themselves and the relationship with their baby. Methods: The exploratory nature of the aim and focus on service users’ experience and perspectives provided scope for a qualitative approach for this evaluation. This consisted of 10 semi-structured interviews with parents who had received the service within the last two years. Recruitment involved both purposive and convenience sampling. The interviews took place between February 2021 – March 2021, lasting between 30-90 minutes and were guided by open-ended questions from a topic guide. The interviews adopted a narrative approach to enable the parents to share their lived experiences. The researchers transcribed the interviews and analysed the data thematically by using a coding method which is grounded in the data. Results: The analysis and findings from the data gathered illuminated an approach which supports parents to build a better bond with their baby and provides a safe space for parents to heal through their relationships. While the parents shared their experiences, the interviews were intended to receive feedback, so questions were asked about what could be improved and what recommendations could be offered to Children North East. Guided by the voice of the parents, this evaluation provides recommendations to support the future of the NEWPIP approach. Conclusions: The NEWPIP approach appears to successfully provide early and flexible support for new parents, increasing a parent’s confidence in their ability to not only cope but thrive as a new parent.

Keywords: maternal health, mental health, parent infant relationship, therapy

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Authors: Rebecca M. Dagger, Katy Hadgraft, Matthew Teggart, Peter Angell

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Background: There is a growing body of evidence that demonstrates the association between sedentary behaviour, cardiometabolic risk and all-cause mortality. Since full time working adults spend approximately 8 hours per day in the workplace, interventions to reduce sedentary behaviour at work may alleviate some of the negative health outcomes associated with sedentary behaviour. The aims of this pilot study were to assess the impacts of using a Sit-Stand workstation on markers of cardiometabolic health in a cohort of desk workers. Methods: Twenty eight participants were recruited and randomly assigned to a control (n=5 males, 9 females, mean age 37 years ± 9.4 years) or intervention group (n= 5 males, 9 females, mean age 42 years ± 12.7 years). All participants attended the labs on 2 occasion’s pre and post intervention, following baseline measurements the intervention participants had the Sit Stand Workstations (Ergotron, USA) installed for a 10 week intervention period. The Sit Stand workstations allow participants to stand or sit at their usual workstation and participants were encouraged to the use the desk in a standing position at regular intervals throughout the working day. Cardiometabolic risk markers assessed were body mass, body composition (using bio impedance analysis; Tanita, Tokyo), fasting blood Total Cholesterol (TC), lipid profiles (HDL-C, LDL-C, TC: HDL-C ratio), triglycerides and fasting glucose (Cholestech LDX), resting systolic and diastolic blood pressure and resting heart rate. ANCOVA controlling for baseline values was used to assess the group difference in changes in risk markers between pre and post intervention. Results: The 10 week intervention was associated with significant reductions in some cardiometabolic risk factors. There were significant group effects on change in body mass (F (1,25)=5.915, p<0.05), total body fat percentage (F(1,25)=12.615, p<0.01), total fat mass (F (1,25)=6.954, p<0.05), and systolic blood pressure (F (1,25)=5.012, p<0.05). There were no other significant group effects on changes in other cardiometabolic risk markers. Conclusion: This pilot study highlights the importance of reducing sedentary behaviour in the workplace for reduction in cardiometabolic risk markers. Further research is required to support these findings.

Keywords: sedentary behaviour, caridometabolic risk, evidence, risk makers

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Authors: Luís R. Silva, Catarina Bento, Ana C. Gonçalves, Fábio Jesus, Branca M. Silva

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Nowadays, the general population is more and more concerned about nutrition and the health implications of an unbalanced diet. Current knowledge regarding the health benefits and antioxidant properties of certain foods such as fruits and vegetables has gained the interest of both the general public and scientific community. Peach (Prunus persica (L.) Batsch) is one of the most consumed fruits worldwide, with low sugar contents and a broad range of nutrients essential to the normal functioning of the body. Six different peach cultivars from the Fundão region in Portugal were evaluated regarding their phenolic composition by LC-DAD and biological activity. The prepared extracts’ capacity to scavenge free-radicals was tested through the stable free radical DPPH• and nitric oxide (•NO). Additionally, antidiabetic potential and protective effects against peroxyl radical (ROO•) induced damage to erythrocytes were also tested. LC-DAD analysis allowed the identification of 17 phenolic compounds, among which 5-O-caffeoylquinic acids and 3-O-caffeoylquinic acids are pointed out as the most abundant. Regarding the antioxidant activity, all cultivars displayed concentration-dependent free-radical scavenging activity against both nitrogen species and DPPH•. In respect to α-glucosidase inhibitory activity, Royal Magister and Royal Glory presented the highest inhibitory activity (IC50 = 11.7 ± 1.4 and 17.1 ± 1.7 μg/mL, respectively), nevertheless all six cultivars presented higher activity than the control acarbose. As for the protective effect of Royal Lu extract on the oxidative damage induced in erythrocytes by ROO•, the results were quite promising showing inhibition IC50 values of 110.0 ± 4.5 μg/mL and 83.8 ± 6.5 μg/mL for hemolysis and hemoglobin oxidation, respectively. The demonstrated activity is of course associated to the peaches’ phenolic profile, rich in phenolic acids and flavonoids with high hydrogen donating capacity. These compounds have great industrial interest for the manufacturing of natural products. The following step would naturally be the extraction and isolation from the plant tissues and large-scale production through biotechnology techniques.

Keywords: antioxidants, functional food, phenolic compounds, peach

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Authors: Waqas Abrar

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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.

Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services

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Authors: Ari Prasetyo, Taufik Faturohman

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The COVID-19 pandemic in Indonesia is part of the ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was confirmed to have spread to Indonesia on 2 March 2020. Moreover, the government of Indonesia has been conducting a local lockdown to limit people's movement from one city to another city. Therefore, this situation has impact on business operation, especially on highway companies listed on the Indonesia stock exchange. This study evaluates and measures three companies’ financial performance and health conditions before and during the COVID-19 pandemic from 2016 – 2020. The measurement is conducted by using financial ratio analysis and the Altman Z-score method. The ratio used to measure the financial ratio analysis is taken from the decree of the Ministry of SOE’s KEP-100/MBU/2002 about the company’s health level condition. From the decree, there are eight financial ratios used such as return on equity (ROE), return on investment (ROI), current ratio, cash ratio, collection period, inventory turnover, total asset turnover, and total equity to total asset. Altman Z-score is used to calculate the financial distress condition. The result shows that the highway companies for the period 2016 – 2020 are as follows: PT Jasa Marga (Persero) Tbk (AA, BB, BB, BB, C), PT Citra Marga Nusaphala Persada Tbk (BB, AA, BB, BBB, C), and PT Nusantara Infrastructure Tbk (BB, BB, AA, BBB, C). In addition, the Altman Z-score assessment performed in 2016-2020 shows that PT Jasa Marga (Persero) Tbk was in the grey zone area for 2015-2018 and in the distress zone for 2019-2020. PT Citra Marga Nusaphala Persada Tbk was in the grey zone area for 2015-2019 and in the distress zone for 2020. PT Nusantara Infrastructure Tbk was in the grey zone area for 2015-2018 and in the distress zone for 2019-2020.

Keywords: financial performance, financial ratio, Altman Z-score, financial distress, highway company

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Authors: Jerzy Slowik, Elzbieta Grochowska-Niedworok

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The analysis of the market needs and trends in both treatment and prophylaxis shows the growing need to implement comprehensive solutions that would enable safe contact of the beneficiaries with the therapeutic and diagnostic support group. Based on the evaluation of the medical and sports industry services market, projects co-financed by the EFRR in the form of comprehensive care systems using IT tools for patients under treatment in the field of obesity and metabolism using the system were implemented under the Regional Operational Program of the Silesian Voivodeship for 2014-2020. SFAO 1.0 (Support for the Fight Against Obesity) number of the WND-RPSL project. 01.02.00-24-06EA / 16) as well as for competitors in qualified sports SK system (qualified sports) project number WND-RPSL. 01.02.00-24-0630 / 17-002. The service provided in accordance with SFAO 1.0 has shown a wide range of therapy possibilities - from monitoring the body's reactions during sports activities of healthy people to remote care for sick patients. As a result of the introduction of an innovative service, it was possible to increase the effectiveness of the therapy, which was manifested in the reduction of the starting doses of drugs by 10%, improvement of the efficiency of the respiratory and blood circulation system, and a 10% increase in bone density. Innovation in the provision of medical services in the field of qualified sports SK was a response to the needs of the athletes and their parents, coaches, physiotherapists, dieticians, and doctors who take care of people actively practicing qualified sports. The creation of the platform made it possible to constantly monitor the trainers necessary for both the proper training process and the control over the health of patients. Monitoring the patient's health by a specialized team in the field of various specialties allows for the proper targeting of the treatment and training process due to the increase in the availability of medical counseling. Specialists taking care of the patient can provide additional advice and modify the medical treatment of the patient on an ongoing basis, which is why we are dealing with a holistic approach.

Keywords: innovation of medical services, sport, obesity, innovation

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Authors: A. Aceranti, L. Moretti, S. Vernocchi, M. Colorato, P. Caristia

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Irritable bowel syndrome (IBS) is the association between abdominal pain, abdominal distension and intestinal dysfunction for recurring periods. About 10% of the world's population has IBS at any given time in their life, and about 200 people per 100,000 receive an initial diagnosis of IBS each year. Persistent pain is recognized as one of the most pervasive and challenging problems facing the medical community today. Persistent pain is considered more as a complex pathophysiological, diagnostic and therapeutic situation rather than as a persistent symptom. The low efficiency of conventional drug treatments has led many doctors to become interested in the non-drug alternative treatment of IBS, especially for more severe cases. Patients and providers are often dissatisfied with the available drug remedies and often seek complementary and alternative medicine (CAM), a unique and holistic approach to treatment that is not a typical component of conventional medicine. Osteopathic treatment may be of specific interest in patients with IBS. Osteopathy is a complementary health approach that emphasizes the role of the musculoskeletal system in health and promotes optimal function of the body's tissues using a variety of manual techniques to improve body function. Osteopathy has been defined as a patient-centered health discipline based on the principles of interrelation between body structure and function, the body's innate capacity for self-healing and the adoption of a whole person health approach. mainly by practicing manual processing. Studies reported that osteopathic manual treatment (OMT) reduced IBS symptoms, such as abdominal pain, constipation, diarrhea, and improved general well-being. The focus in the treatment of IBS with osteopathy has gone beyond simple spinal alignment, to directly address the abnormal physiology of the body using a series of direct and indirect techniques. The topic of this study was chosen for different reasons: due to the large number of people involved who suffer from this disorder and for the dysfunction itself, since nowadays there is still little clarity about the best type of treatment and, above all, to its origin. The visceral component in the osteopathic field is still a world to be discovered, although it is related to a large part of patient series, it has contents that affect numerous disciplines and this makes it an enigma yet to be solved. The study originated in the didactic practice where the curiosity of a topic is marked that, even today, no one is able to explain and, above all, cure definitively. The main purpose of this study is to try to create a good basis on the osteopathic discipline for subsequent studies that can be exhaustive in the best possible way, resolving some doubts about which treatment modality can be used with more relevance. The path was decided to structure it in such a way that 3 types of osteopathic treatment are used on 3 groups of people who will be selected after completing a questionnaire, which will deem them suitable for the study. They will, in fact, be divided into three groups where: - the first group was given a visceral osteopathic treatment. - The second group was given a manual osteopathic treatment of neurological stimulation. - The third group received a placebo treatment. At the end of the treatment, questionnaires will be re-proposed respectively one week after the session and one month after the treatment from which any data will be collected that will demonstrate the effectiveness or otherwise of the treatment received. The sample of 50 patients examined underwent an oral interview to evaluate the inclusion and exclusion criteria to participate in the study. Of the 50 patients questioned, 17 people who underwent different osteopathic techniques were eligible for the study. Comparing the data related to the first assessment of tenderness and frequency of symptoms with the data related to the first follow-up shows a significant improvement in the score assigned to the different questions, especially in the neurogenic and visceral groups. We are aware of the fact that it is a study performed on a small sample of patients, and this is a penalizing factor. We remain, however, convinced that having obtained good results in terms of subjective improvement in the quality of life of the subjects, it would be very interesting to re-propose the study on a larger sample and fill the gaps.

Keywords: IBS, osteopathy, colon, intestinal inflammation

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Authors: B. Mohammadi, A. Riazati, P. Soltan Sanjari, S. Azimbeik

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The ever-increasing development of civic demands on one hand; and the urban constrains for newly establish of infrastructures, on the other hand, perforce the engineering committees to apply non-conflicting methods in order to optimize the results. One of these optimized procedures to establish the main sewerage networks is the pipe jacking and micro-tunneling method. The raw information and researches are based on the experiments of the slurry micro-tunneling project of the Tehran main sewerage network that it has executed by the KAYSON co. The 4985 meters route of the mentioned project that is located nearby the Azadi square and the most vital arteries of Tehran is faced to 45% physical progress nowadays. The boring machine is made by the Herrenknecht and the diameter of the using concrete-polymer pipes are 1600 and 1800 millimeters. Placing and excavating several shafts on the ground and direct Tunnel boring between the axes of issued shafts is one of the requirements of the micro-tunneling. Considering the stream of the ground located shafts should care the hydraulic circumstances, civic conditions, site geography, traffic cautions and etc. The profile length has to convert to many shortened segment lines so the generated angle between the segments will be based in the manhole centers. Each segment line between two continues drive and receive the shaft, displays the jack location, driving angle and the path straight, thus, the diversity of issued angle causes the variety of jack positioning in the shaft. The jacking frame fixing conditions and it's associated dynamic load direction produces various patterns of Stress and Strain distribution and creating fatigues in the shaft wall and the soil surrounded the shaft. This pattern diversification makes the shaft wall transformed, unbalanced subsidence and alteration in the pipe jacking Stress Contour. This research is based on experiments of the Tehran's west sewerage plan and the numerical analysis the interaction of the soil around the shaft, shaft walls and the Jacking frame direction and finally, the suitable or unsuitable location of the pipe jacking shaft will be determined.

Keywords: underground structure, micro-tunneling, fatigue analysis, dynamic-soil–structure interaction, underground water, finite element analysis

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Authors: Harshit Garg, Shakshi Gupta

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One of the major problems in today’s world is the growing pollution. The cause for all environmental problems is the increasing pollution rate. Looking upon the statistics, one can find out that most of the pollution is caused by the vehicular pollution which is more than 70 % of the total pollution, effecting the environment as well as human health proportionally. One is aware of the fact that vehicles run on roads so why not having the roads which could adsorb that pollution, not only once but a number of times. Every problem has a solution which can be solved by the state of art of technology, that is one can use the innovative ideas and thoughts to make technology as a solution to the problem of vehicular pollution on roads. Solving the problem up to a certain limit/ percentage can be formulated into a new term called ECO ROADS.

Keywords: environment, pollution, roads, sustainibility

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Authors: Chun-Yu Chen, Kua-Rong Wu, Yu-Cheng Chen, Perng-Jy Tsai

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Cooking fumes are known containing polycyclic aromatic hydrocarbons (PAHs) and aldehydes, and some of them have been proven carcinogenic or possibly carcinogenic to humans. Considering their chronic health effects, long-term exposure data is required for assessing cooking workers’ lifetime health risks. Previous exposure assessment studies, due to both time and cost constraints, mostly were based on the cross-sectional data. Therefore, establishing a long-term exposure data has become an important issue for conducting health risk assessment for cooking workers. An approach was proposed in this study. Here, the generation rates of both PAHs and aldehydes from a cooking process were determined by placing a sampling train exactly under the under the exhaust fan under the both the total enclosure condition and normal operating condition, respectively. Subtracting the concentration collected by the former (representing the total emitted concentration) from that of the latter (representing the hood collected concentration), the fugitive emitted concentration was determined. The above data was further converted to determine the generation rates based on the flow rates specified for the exhaust fan. The determinations of the above generation rates were conducted in a testing chamber with a selected cooking process (deep-frying chicken nuggets under 3 L peanut oil at 200°C). The sampling train installed under the exhaust fan consisted respectively an IOM inhalable sampler with a glass fiber filter for collecting particle-phase PAHs, followed by a XAD-2 tube for gas-phase PAHs. The above was also used to sample aldehydes, however, installed with a filter pre-coated with DNPH, and followed by a 2,4-DNPH-cartridge for collecting particle-phase and gas-phase aldehydes, respectively. PAHs and aldehydes samples were analyzed by GC/MS-MS (Agilent 7890B), and HPLC-UV (HITACHI L-7100), respectively. The obtained generation rates of both PAHs and aldehydes were applied to the near-field/ far-field exposure model to estimate the exposures of cooks (the estimated near-field concentration), and helpers (the estimated far-field concentration). For validating purposes, both PAHs and aldehydes samplings were conducted simultaneously using the same sampling train at both near-field and far-field sites of the testing chamber. The sampling results, together with the use of the mixed-effect model, were used to calibrate the estimated near-field/ far-field exposures. In the present study, the obtained emission rates were further converted to emission factor of both PAHs and aldehydes according to the amount of food oil consumed. Applying the long-term food oil consumption records, the emission rates for both PAHs and aldehydes were determined, and the long-term exposure databanks for cooks (the estimated near-field concentration), and helpers (the estimated far-field concentration) were then determined. Results show that the proposed approach was adequate to determine the generation rates of both PAHs and aldehydes under various fan exhaust flow rate conditions. The estimated near-field/ far-field exposures, though were significantly different from that obtained from the field, can be calibrated using the mixed effect model. Finally, the established long-term data bank could provide a useful basis for conducting long-term exposure assessments for cooking workers exposed to PAHs and aldehydes.

Keywords: aldehydes, cooking oil fumes, long-term exposure assessment, modeling, polycyclic aromatic hydrocarbons (PAHs)

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Authors: Bilal Wajid, Erchin Serpedin

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The health industry is aiming towards personalized medicine. If the patient’s genome needs to be sequenced it is important that the entire analysis be completed quickly. This paper explores use of parallel computing to analyze very large sequences. Two cases have been considered. In the first case, the sequence is kept constant and the effect of increasing the number of MPI-based processes is evaluated in terms of execution time, speed and efficiency. In the second case the number of MPI-based processes have been kept constant whereas, the length of the sequence was increased.

Keywords: parallel computing, alignment, genome assembly, alignment

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Authors: P. Mambanga, T. G. Tshitangano, H. Akinsola

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Background: Unintended pregnancies constitute a most serious public health challenge to women to an extent that they sometimes end in illegal abortions resulting in adverse consequences. However, the introduction of emergency contraception has served as the last chance for women to avoid unintended pregnancies, though, in countries like Zimbabwe the cause for underutilisation of emergency contraception has been hardly investigated. Purpose: The main purpose of this study was to assess the knowledge, attitude and practice of female students regarding emergency contraception among in preventing unintended pregnancy. Methodology: A quantitative approach using descriptive cross-sectional survey design was conducted among 319 stratified random sampled female university students of Midland State University, Zimbabwe. Self-administered close-ended questionnaire was used to collect the data. To ensure validity, the development of the instrument was guided by a wide range of literature and the inputs of experts. The instrument was retested for reliability and the responses will be comparing using Cronbach’s alpha which yielded high reliability alpha (α) value of 0.84. Data was coded and entered into a computer using Microsoft Excel 2010 and analysed using Statistical Package for Social Scientists (SPSS) version 22.0. Descriptive statistics were used to analyse data in the form of cross tabulation and the results were presented in table, graphs and pie charts. Results: The results indicated that apart from all sources of information about EC, mass media has shown to be the most famous. Although female students knows about EC, the knowledge about effective level and correct use of EC poor. The attitudes of female students at MSU are unfavourable for EC as they gave reasons like EC promotes promiscuity and it can pose risk. The practice of EC at MSU is low with only 47% of respondents said they have once use EC. Conclusion and recommendation: The study concluded the lack of actual knowledge about EC which has directly influenced attitudes and practices. The study concluded that there MSU female students has fair knowledge about EC which has resulted in negative and attitudes towards EC with few EC practices. The study, therefore, recommends the adoption and use of Health Belief Model approach in promoting the young to use EC to prevent unwanted pregnancies.

Keywords: emergency contraception, knowledge, attitude, practice, female students

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Authors: A. Gonzalez Aguna, J. M. Santamaria Garcia, J. L. Gomez Gonzalez, R. Barchino Plata, M. Fernandez Batalla, S. Herrero Jaen

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Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.

Keywords: care, learning, nursing, technology

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Authors: Charlotte Jeavons, Charitini Stavropoulous, Nicolas Drey

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Background: Over one-third of five-year-olds and almost half of all eight-year-olds in the UK have obvious caries experience that can be detected by visual screening techniques. School-based caries preventions programs to apply fluoride varnish to young children’s teeth operate in many areas in the UK. Their aim is to reduce dental caries in children. The Department of Health guidance (2009) on consent states information must be provided to parents to enable informed autonomous decision-making prior to any treatment involving their young children. Fluoride varnish schemes delivered in primary schools use letters for this purpose. Parents are expected to return these indicating their consent or refusal. A large proportion of parents do not respond. In the absence of positive consent, these children are excluded from the program. Non-response is more common in deprived areas creating inequality. The reason for this is unknown. The consent process used is underpinned by the ethical theory of deontology that is prevalent in clinical dentistry and widely accepted in bio-ethics. Objective: To investigate parents’ views, understanding and experience of the fluoride varnish program taking place in their child’s school, including their views about the practical consent arrangements. Method: Schools participating in the fluoride varnish scheme operating in Enfield, North London, were asked to take part. Parents with children in nursery, reception, or year one were invited to participate via semi-structured interviews and focus groups. Thematic analysis was conducted. Findings: 40 parents were recruited from eight schools. The global theme of ‘trust’ was identified as the strongest influence on parental responses. Six themes were identified; protecting children from harm is viewed by parents as their role, parents have the capability to decide but lack confidence, sharing responsibility for their child’s oral health with the State is welcomed by a parent, existing relationships within parents’ social networks strongly influences consent decisions, official dental information is not communicated effectively, sending a letter to parents’ and excluding them from meeting dental practitioners is ineffective. The information delivered via a letter was not strongly identified by parents as influencing their response. Conclusions: Personal contact with the person(s) providing information and requesting consent has a greater impact on parental consent responses than written information provided alone. This demonstrates that traditional bio-ethical ideas about rational decision-making where emotions are transcended and interference is not justified unless preventing harm to an unaware person are outdated. Parental decision-making is relational and the consent process should be adapted to reflect this. The current system that has a deontology view of decision making at its core impoverishes parental autonomy and may, ultimately, increase dental inequalities as a result.

Keywords: consent, decision, ethics, fluoride, parents

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Authors: Andrea Giacomelli, Luciano Massetti, Elena Maggi, Antonio Raschi

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The presentation will report the activities managed during the Summer of 2017 by a team composed by staff from a University Department, a National Research Council Institute, and an outreach NGO, collecting measurements of night sky brightness and other information on artificial lighting, in order to characterize light pollution issues on portions of the Tuscan coast, in Central Italy. These activities combine measurements collected by the principal scientists, citizen science observations led by students, and outreach events targeting a broad audience. This campaign aggregates the efforts of three actors: the BuioMetria Partecipativa project, which started collecting light pollution data on a national scale in 2008 with an environmental engineering and free/open source GIS core team; the Institute of Biometeorology from the National Research Council, with ongoing studies on light and urban vegetation and a consolidated track record in environmental education and citizen science; the Department of Biology from the University of Pisa, which started experiments to assess the impact of light pollution in coastal environments in 2015. While the core of the activities concerns in situ data, the campaign will account also for remote sensing data, thus considering heterogeneous data sources. The aim of the campaign is twofold: (1) To test actions of citizen and student engagement in monitoring sky brightness (2) To collect night sky brightness data and test a protocol for applications to studies on the ecological impact of light pollution, with a special focus on marine coastal ecosystems. The collaboration of an interdisciplinary team in the study of artificial lighting issues is not a common case in Italy, and the possibility of undertaking the campaign in Tuscany has the added value of operating in one of the territories where it is possible to observe both sites with extremely high lighting levels, and areas with extremely low light pollution, especially in the Southern part of the region. Combining environmental monitoring and communication actions in the context of the campaign, this effort will contribute to the promotion of night skies with a good quality as an important asset for the sustainability of coastal ecosystems, as well as to increase citizen awareness through star gazing, night photography and actively participating in field campaign measurements.

Keywords: citizen science, light pollution, marine coastal biodiversity, environmental education

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Authors: Karitikeya Sonker

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Religion as a discrete system through its lawful internal working produces an output in the form of realised spatial order with its social logic and a social order with its spatial logic. Thus, it appears to exhibit its duality of spatial and trans-spatial. The components of this system share a relevance forming a collective. This shared relevance creates meaning forming a group where all collectives share one identity. This group with its new social order and its spatial logic revive the already existing spatial order. These religious groups do so having a tendency to expand resulting in the production of space in a situation of encounter where they have found relevance. But an encounter without a lawful internal working of a discrete system results in anomaly because groups do not find relevance due to the absence of collective identity. Events happen all around. One of the main reasons we could say that something became an event is because of conflict. Conflict not in its definitive sense but any occurrence that happens because of an intervention that creates an event worth remembering. The unfolding of such events creates Cities and Urban spaces which exhibit their duality of spatial and trans-spatial by behaving as a discrete system. This system through its lawful internal working produces an output in the form of realized spatial order with its social logic and a social order with spatial logic. The components of this system form a collective through a shared a relevance. This shared relevance creates meaning forming a group where all collectives share one identity. This group with its new social order and its spatial logic revives the already existing spatial order. These groups do so having a tendency to expand resulting in the production of space in a situation of encounter where they have found relevance. But an encounter without a lawful internal working of the discrete system results in anomaly because groups do not find relevance due to the absence of collective identity. This paper makes an effort to explore one such even in the case of Babri Mosque and Ramjanmabhumi, Ayodhya to explain the anomaly as transposition of social and spatial. The paper through the case studies makes an attempt to generate an equation explaining the two different situations of religious encounters, former reviving the social and spatial order and the other resulting in anomaly. Through the case study, it makes an attempt to generate an equation explaining the two different situations of religious encounters, former reviving the social and spatial order and the other resulting in anomaly.

Keywords: Babri Masjid, Ayodhya, conflict, religion

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Authors: Ojochenemi J. Onubi, Debbi Marais, Lorna Aucott, Friday Okonofua, Amudha Poobalan

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Background: Obesity is a worldwide epidemic with major health and economic consequences. Pregnancy is a trigger point for the development of obesity, and maternal obesity is associated with significant adverse effects in the mother and child. Nigeria is experiencing a double burden of under- and over-nutrition with rising levels of obesity particularly in women. However, there is scarcity of data on maternal obesity in Nigeria and other African countries. Aims and Objectives: This project aimed at identifying crucial components of potential interventions for maternal obesity in Nigeria. The objectives were to assess the prevalence, effects, and distribution of maternal obesity; knowledge, attitude and practice (KAP) of pregnant women and maternal healthcare providers; and identify existing interventions for maternal obesity in Nigeria. Methodology: A systematic review and meta-analysis were initially conducted to appraise the existing literature on maternal obesity in Africa. Following this, a quantitative questionnaire survey of the KAP of pregnant women and a qualitative interview study of the KAP of Health Care Workers (HCW) were conducted in seven secondary and tertiary hospitals across Nigeria. Quantitative data was analysed using SPSS statistical software, while thematic analysis was conducted for qualitative data. Results: Twenty-nine studies included in the systematic review showed significant prevalence, socio-demographic associations, and adverse effects of maternal obesity on labour, maternal, and child outcomes in Africa. The questionnaire survey of 435 mothers revealed a maternal obesity prevalence of 17.9% among mothers who registered for antenatal care in the first trimester. The mothers received nutrition information from different sources and had insufficient knowledge of their own weight category or recommended Gestational Weight Gain (GWG), causes, complications, and safe ways to manage maternal obesity. However, majority of the mothers were of the opinion that excess GWG is avoided in pregnancy and some practiced weight management (diet and exercise) during pregnancy. For the qualitative study, four main themes were identified: ‘Concerns about obesity in pregnancy’, ‘Barriers to care for obese pregnant women’, ‘Practice of care for obese pregnant women’, and ‘Improving care for obese pregnant women’. HCW expressed concerns about rising levels of maternal obesity, lack of guidelines for the management of obese pregnant women and worries about unintended consequences of antenatal interventions. ‘Barriers’ included lack of contact with obese women before pregnancy, late registration for antenatal care, and perceived maternal barriers such as socio-cultural beliefs of mothers and poverty. ‘Practice’ included anticipatory care and screening for possible complications, general nutrition education during antenatal care and interdisciplinary care for mothers with complications. HCW offered suggestions on improving care for obese women including timing, type, and settings of interventions; and the need for involvement of other stake holders in caring for obese pregnant women. Conclusions: Culturally adaptable/sensitive interventions should be developed for the management of obese pregnant women in Africa. Education and training of mothers and health care workers, and provision of guidelines are some of the components of potential interventions in Nigeria.

Keywords: Africa, maternal, obesity, pregnancy

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Authors: Wenli Tsou, Jessica Wu

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Courses of English for specific academic purposes (ESAP) have become popular for higher education in Taiwan; however, no standardized tests have been developed for evaluating learners’ English proficiency in individual designated fields. Assuming a learner’s proficiency in a specific academic area is built up with one’s general proficiency in English with specific knowledge and vocabulary in the content areas, an adequate ESAP proficiency test may be constructed by some selected test items related to the designated academic areas. In this study, through collaboration between a language testing institution and a university in Taiwan, three sets of ESAP tests, covering three disciplinary areas of business and the workplace, science and engineering, and health and medicine majors, were developed and administered to sophomore students (N=1704) who were enrolled in ESAP courses at a university in southern Taiwan. For this study, the courses were grouped into the above-mentioned three disciplines, and students took the specialized proficiency test based on the ESAP course they were taking. Because students were free to select which ESAP course to take, each course had both major and non-major students. Toward the end of the one-semester course, ending in January, 2015, each student took two tests, one of general English (General English Proficiency Test, or GEPT) and the other ESAP. Following each test, students filled out a survey, reporting their test taking experiences. After comparing students’ two test scores, it was found that business majors and health and medical students performed better in ESAP than the non-majors in the class, whereas science and engineering majors did about the same as their non-major counterparts. In addition, test takers with CERF B2 (upper intermediate) level or above performed well in both tests, while students who are below B2 did slightly better in ESAP. The findings suggest that students’ test performance have been enhanced by their specialist content and vocabulary knowledge. Furthermore, results of the survey show that the difficulty levels reported by students are consistent with their test performances. Based on the item analysis, the findings can be used to develop proficiency tests for specific disciplines and to identify ability indicators for college students in their designated fields.

Keywords: english for specific academic purposes (ESAP), general english proficiency test (GEPT), higher education, proficiency test

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Authors: Arunas Emeljanovas, Brigita Mieziene, Tomas Venckunas

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Background statement: Level of aerobic capacity in school age children provides important information about the current and future cardiovascular, skeletal and mental health. It is widely recognised that risk factors for modern chronic diseases of the adults have their origins in childhood and adolescence. The aim of the study was to analyse the trends of aerobic capacity across decades within groups of gender and age. Methods. The research included data of participants from the three nationally representative cohort studies performed in Lithuania in the years 1992, 2002 and 2012 among 11 to 18-years-old school children. Total of 18,294 school children were recruited for testing. Only those who had their body weight and height measured and completed 20 m shuttle endurance test were included in the analysis. The total number of students included in the analyses was 15,213 (7608 boys and 7605 girls). The permission to conduct the study was obtained from the Lithuanian Bioethics Committee (permission number BE-2-45). Major findings: Results are performed across gender and age groups. The comparison of shuttle endurance test, controlling for body mass index, indicated that in general there is a constant decrease of aerobic capacity across decades in both genders and age groups. The deterioration in aerobic capacity in boys accounted for 17 to 43 percent across age groups within decades. The biggest decrease was in 14 years-old boys. The deterioration in girls accounted for 19 to 37 percent across age groups with the highest decrease in 11 years-old girls. Though, girls had lower levels of aerobic capacity through all age groups and across three decades. Body mass index, as a covariate, accounted for up to six percent in deterioration of aerobic capacity. Final statement: The detected relationships may reflect the level and pattern of engagement in physical activity and sports where increased activity associates with superior performance in the tests because of the upregulated physiological function and instigated competitive/motivational level. The significance of the decade indirectly supports the importance of the recently changed activity among schoolchildren for this relationship.

Keywords: aerobic capacity, cardiovascular health, endurance, school age children

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Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

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We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

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Authors: Bibiana Matilde Bernal Gómez, Manuel Salvador Rodríguez Susa, Mildred Fernanda Lemus Perez

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In chlorinated drinking water, Haloacetic acids have been identified and are classified as disinfection byproducts originating from reaction between natural organic matter and/or bromide ions in water sources. These byproducts can be generated through a variety of chemical and pharmaceutical processes. The term ‘Total Haloacetic Acids’ (THAAs) is used to describe the cumulative concentration of dichloroacetic acid, trichloroacetic acid, monochloroacetic acid, monobromoacetic acid, and dibromoacetic acid in water samples, which are usually measured to evaluate water quality. Chronic presence of these acids in drinking water has a risk of cancer in humans. The detection of THAAs for the first time in 15 municipalities of Boyacá was accomplished in 2023. Aim is to describe the correlation between the levels of THAAs and digestive cancer in Tunja, a city in Colombia with higher rates of digestive cancer and to compare the risk across 15 towns, taking into account factors such as water quality. A research project was conducted with the aim of comparing water sources based on the geographical features of the town, describing the disinfection process in 15 municipalities, and exploring physical properties such as water temperature and pH level. The project also involved a study of contact time based on habits documented through a survey, and a comparison of socioeconomic factors and lifestyle, in order to assess the personal risk of exposure. Data on the levels of THAAs were obtained after characterizing the water quality in urban sectors in eight months of 2022. This, based on the protocol described in the Stage 2 DBP of the United States Environmental Protection Agency (USEPA) from 2006, which takes into account the size of the population being supplied. A cancer risk assessment was conducted to evaluate the likelihood of an individual developing cancer due to exposure to pollutants THAAs. The assessment considered exposure methods like oral ingestion, skin absorption, and inhalation. The chronic daily intake (CDI) for these exposure routes was calculated using specific equations. The lifetime cancer risk (LCR) was then determined by adding the cancer risks from the three exposure routes for each HAA. The risk assessment process involved four phases: exposure assessment, toxicity evaluation, data gathering and analysis, and risk definition and management. The results conclude that there is a cumulative higher risk of digestive cancer due to THAAs exposure in drinking water.

Keywords: haloacetic acids, drinking water, water quality, cancer risk assessment

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Authors: Kara J. Coffman-Rea, Karen E. Samonds

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Microplastic pollution is an urgent global threat to our planet and human health. Microplastic particles have been detected within our food, water, and atmosphere, and found within the human stool, placenta, and lung tissue. However, most spectrometric microplastic detection methods require chemical digestion which can alter or destroy microplastic particles and makes it impossible to acquire information about their in-situ distribution. MALDI TOF MS (Matrix-assisted laser desorption ionization-time of flight mass spectrometry) is an analytical method using a soft ionization technique that can be used for polymer analysis. This method provides a valuable opportunity to both acquire information regarding the in-situ distribution of microplastics and also minimizes the destructive element of chemical digestion. In addition, MALDI TOF MS allows for expanded analysis of the microplastics including detection of specific additives that may be present within them. MALDI TOF MS is particularly sensitive to sample preparation and has not yet been used to analyze environmental microplastics within their specific location (e.g., biological tissues, sediment, water). In this study, microplastics were created using polyethylene gloves, polystyrene micro-foam, and polyethylene terephthalate cable sleeving. Plastics were frozen using liquid nitrogen and ground to obtain small fragments. An artificial tissue was created using a cellulose sponge as scaffolding coated with a MaxGel Extracellular Matrix to simulate human lung tissue. Optimal preparation techniques (e.g., matrix, cationization reagent, solvent, mixing ratio, laser intensity) were first established for each specific polymer type. The artificial tissue sample was subsequently spiked with microplastics, and specific polymers were detected using MALDI-TOF-MS. This study presents a novel method for the detection of environmental polyethylene, polyethylene terephthalate, and polystyrene microplastics within a complex sample. Results of this study provide an effective method that can be used in future microplastics research and can aid in determining the potential threats to environmental and human health that they pose.

Keywords: environmental plastic pollution, MALDI-TOF MS, microplastics, polymer identification

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Authors: Tamar Arieli

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Cross-border cooperation has long been hailed as a means for stabilizing and normalizing relations between former enemies. Cooperation in problem-solving and realizing of local interests in post-conflict environments can indeed serve as a basis for developing dialogue and meaningful relations between neighbors across borders. Hence the potential for formerly sealed borders to serve as a basis for generating local and national perceptions of interdependence and as a buffer against the resume of conflict. Central questions which arise for policy-makers and third parties are how to facilitate cross-border cooperation and which areas of cooperation best serve to normalize post-conflict border regions. The Israel-Jordan border functions as a post-conflict border, in that it is a peaceful border since the 1994 Israel-Jordan peace treaty yet cross-border relations are defined but the highly securitized nature of the border region and the ongoing Arab-Israel regional conflict. This case study is based on long term qualitative research carried out in the border regions of both Israel and Jordan, which mapped and analyzed cross-border in a wide range of activities – social interactions sponsored by peace-facilitating NGOs, government sponsored agricultural cooperation, municipal initiated emergency planning in cross-border continuous urban settings, private cross-border business ventures and various environmental cooperative initiatives. These cooperative initiatives are evaluated through multiple interviews carried out with initiators and partners in cross-border cooperation as well as analysis of documentation, funding and media. These cooperative interactions are compared based on levels of cross-border local and official awareness and involvement as well as sustainability over time. This research identifies environmental cooperation as the most sustainable area of cross- border cooperation and as most conducive to generating perceptions of regional interdependence. This is a variation to the ‘New Middle East’ vision of business-based cooperation leading to conflict amelioration and regional stability. Environmental cooperation serving the public good rather than personal profit enjoys social legitimization even in the face of widespread anti-normalization sentiments common in the post-conflict environment. This insight is examined in light of philosophical and social aspects of the natural environment and its social perceptions. This research has theoretical implications for better understanding dynamics of cooperation and conflict, as well as practical ramifications for practitioners in border region policy and management.

Keywords: borders, cooperation, post-conflict, security

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Authors: Rafael Castilho Carvalho, Edjair de Souza Mota

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As the largest contributor to the biogeochemical functioning of the Earth system, the Amazon Rainforest has the greatest biodiversity on the planet, harboring about 15% of all the world's flora. Recognition and preservation are the focus of research that seeks to mitigate drastic changes, especially anthropic ones, which irreversibly affect this biome. Functional and low-cost monitoring alternatives to reduce these impacts are a priority, such as those using technologies such as Low Power Wide Area Networks (LPWAN). Promising, reliable, secure and with low energy consumption, LPWAN can connect thousands of IoT devices, and in particular, LoRa is considered one of the most successful solutions to facilitate forest monitoring applications. Despite this, the forest environment, in particular the Amazon Rainforest, is a challenge for these technologies, requiring work to identify and validate the use of technology in a real environment. To investigate the feasibility of deploying LPWAN in remote water quality monitoring of rivers in the Amazon Region, a LoRa-based test bed consisting of a Lora transmitter and a LoRa receiver was set up, both parts were implemented with Arduino and the LoRa chip SX1276. The experiment was carried out at the Federal University of Amazonas, which contains one of the largest urban forests in Brazil. There are several springs inside the forest, and the main goal is to collect water quality parameters and transmit the data through the forest in real time to the gateway at the uni. In all, there are nine water quality parameters of interest. Even with a high collection frequency, the amount of information that must be sent to the gateway is small. However, for this application, the battery of the transmitter device is a concern since, in the real application, the device must run without maintenance for long periods of time. With these constraints in mind, parameters such as Spreading Factor (SF) and Coding Rate (CR), different antenna heights, and distances were tuned to better the connectivity quality, measured with RSSI and loss rate. A handheld spectrum analyzer RF Explorer was used to get the RSSI values. Distances exceeding 200 m have soon proven difficult to establish communication due to the dense foliage and high humidity. The optimal combinations of SF-CR values were 8-5 and 9-5, showing the lowest packet loss rates, 5% and 17%, respectively, with a signal strength of approximately -120 dBm, these being the best settings for this study so far. The rains and climate changes imposed limitations on the equipment, and more tests are already being conducted. Subsequently, the range of the LoRa configuration must be extended using a mesh topology, especially because at least three different collection points in the same water body are required.

Keywords: IoT, LPWAN, LoRa, coverage, loss rate, forest

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Authors: Madan Khadka, Dhruba Uprety, Rubina Rai

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Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss

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Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Calvin Pak-Wing Cheng, Julie Sittlington, Yu-Tao Xiang, Tim Man Ho Li

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Insomnia is one of the most common health problems in the general population. Insomnia can be acute, intermittent, and become chronic, often due to comorbidity with other physical and mental health conditions. Although there are conventional pharmaceutical and psychotherapeutic treatments to treat symptoms of insomnia, however; there is no robust and novel randomized controlled trial (RCT) using transdermal neurostimulation on individuals with insomnia symptoms. This gives us the impetus to execute the first nationwide RCT. Aim: To evaluate the efficacy of Electrical Vestibular Stimulation (VeNS) on individuals with insomnia in Hong Kong. Design: This study was a two-armed, double blinded, randomized, sham-controlled trial. Sampling: 60 community-dwelling adults aged 18 and 60 years with moderate insomnia symptoms or above (Insomnia Severity Index > 14) were recruited. All subjects were computerized randomized into either the active VeNS group or the sham VeNS group on a 1:1 ratio. Intervention: All participants received a home-use VeNS device and used 30-min VeNS sessions during five consecutive days across a 4-week period (total treatment hours: 10). Baseline measurements and post-VeNS evaluation of the psychological outcomes, including 1) insomnia severity, 2) sleep quality, and 3) quality of life were investigated. The short-and long-term sustainability of the VeNS intervention was assessed immediately after poststim and at a 1-month and 3-month follow-up period. Data analysis: A mixed GEE model was used to analyze the repeated measures data. Missing data were managed by multiple imputations. The level of significance was set to p < 0.05. Significance of the study: This is the first trial to examine the efficacy and safety of VeNS among adults with insomnia symptoms in Hong Kong. Findings that emerged were used to determine whether this VeNS device can be considered a self-help technological device to reduce the severity of insomnia in the community setting and to reduce the global disease burden. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04452981.

Keywords: adults, insomnia, neuromodulation, rct, vestibular stimulation

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