Search results for: electronic health records (EHR)

Authors: Mireille Canal-Raffin, Nadege Lepage, Antoine Villa

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Context: Most antineoplastic drugs (AD) have a potential carcinogenic, mutagenic and/or reprotoxic effect and are classified as 'hazardous to handle' by National Institute for Occupational Safety and Health Their handling increases with the increase of cancer incidence. AD contamination from workers who handle AD and/or care for treated patients is, therefore, a major concern for occupational physicians. As part of the process of evaluation and prevention of chemical risks for professionals exposed to AD, Biological Monitoring of Occupational Exposure (BMOE) is the tool of choice. BMOE allows identification of at-risk groups, monitoring of exposures, assessment of poorly controlled exposures and the effectiveness and/or wearing of protective equipment, and documenting occupational exposure incidents to AD. This work aims to make proposals for the practical implementation of the BMOE for AD. The proposed strategy is based on the French good practice recommendations for BMOE, issued in 2016 by 3 French learned societies. These recommendations have been adapted to occupational exposure to AD. Results: AD contamination of professionals is a sensitive topic, and the BMOE requires the establishment of a working group and information meetings within the concerned health establishment to explain the approach, objectives, and purpose of monitoring. Occupational exposure to AD is often discontinuous and 2 steps are essential upstream: a study of the nature and frequency of AD used to select the Biological Exposure Indice(s) (BEI) most representative of the activity; a study of AD path in the institution to target exposed professionals and to adapt medico-professional information sheet (MPIS). The MPIS is essential to gather the necessary elements for results interpretation. Currently, 28 urinary specific BEIs of AD exposure have been identified, and corresponding analytical methods have been published: 11 BEIs were AD metabolites, and 17 were AD. Results interpretation is performed by groups of homogeneous exposure (GHE). There is no threshold biological limit value of interpretation. Contamination is established when an AD is detected in trace concentration or in a urine concentration equal or greater than the limit of quantification (LOQ) of the analytical method. Results can only be compared to LOQs of these methods, which must be as low as possible. For 8 of the 17 AD BEIs, the LOQ is very low with values between 0.01 to 0.05µg/l. For the other BEIs, the LOQ values were higher between 0.1 to 30µg/l. Results restitution by occupational physicians to workers should be individual and collective. Faced with AD dangerousness, in cases of workers contamination, it is necessary to put in place corrective measures. In addition, the implementation of prevention and awareness measures for those exposed to this risk is a priority. Conclusion: This work is a help for occupational physicians engaging in a process of prevention of occupational risks related to AD exposure. With the current analytical tools, effective and available, the (BMOE) to the AD should now be possible to develop in routine occupational physician practice. The BMOE may be complemented by surface sampling to determine workers' contamination modalities.

Keywords: antineoplastic drugs, urine, occupational exposure, biological monitoring of occupational exposure, biological exposure indice

Procedia PDF Downloads 137

Authors: Seyyed Abdollah Hojjati

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Review in the areas of secondary education; it is a kind of comparative requires very careful scrutiny in educational structure of different countries,In upcoming review of the basic structure of our educational system in Islamic republic of Iran with somedeveloped countries in the world, Analyzing of strengthsand weaknesses in main areas, A simple review of the above methods do not consider this particular community, Modifythe desired result can be expressed in the secondary school curriculum and academic guidance of under graduate students in a skill-driven and creativity growth, It not just improves the health and dynamism of this period and increases the secondary teachers' authority and the relationship between teacher and student in this course will be meaningful and attractive, But with reduced of false prosperity and guaranteed institutes and quizzes, areas will be provided for students to enjoy the feeling ofthe psychological comfort and to have the highest growth of creativity .

Keywords: comparative, curriculum of secondary education, curriculum, Iran, developed countries

Procedia PDF Downloads 493

Authors: Fety Nurlia Muzayanah, Arif Imam Suroso, Mukhamad Najib

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The market share of organic food in Indonesia just reaches 0.5-2 percents from the entire of agricultural products. The aim of this research is to analyze the relation of gender, work, age and final education toward the buying interest of organic food, to identify the factors influencing the resistance of the purchase of organic food, and to identify the market education process. The analysis result of Structural Equation Modeling (SEM) shows the factors causing the resistance of the purchase of organic food are the negative attitude toward organic food, the lack of affordable in range for organic food product and the lack of awareness toward organic food, while the subjective norms have no significant effect toward the buying interest. The market education process which can be done is the education about the use of the health of organic food, the organic certification and the economic value.

Keywords: market education, organic food, consumer behavior, structural equation modeling

Procedia PDF Downloads 615

Authors: Mina Henneb, Rafik Belabbas, Safia Zenia

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The objective of this study was to determine the prevalence and to identify the risk factors of Eimeria spp. and Giardia spp. infection in rabbits from the local population of four localities in northern Algeria. Dung samples were collected from 16 farms, totalling 111 rabbits, and were analysed by the flotation method. Additional, data regarding the farms and management practices were obtained by means of a questionnaire used in the surveys and interviews. The results revealed that the prevalence of Eimerias pp. contamination was 68.75% (11/16) for farms and 58.56% (65/111) for rabbits, respectively. The prevalence of Giardia spp. was respectively 56.25% (9/16) for farms and 11.7% (13/111) for rabbits. The analyses showed that the prevalence of Eimeria spp. was significantly higher in the farms that did not comply with hygiene and non-conventional feeding and watering. However, the prevalence of Giardia spp. was significant in rabbits kept in poor conditions of rearing. In conclusion, this study showed that the prevalence of these two parasites in rabbits from the local population is relevant and may have important implications for the rabbit industry and public health, especially in rural areas.

Keywords: Algeria, digestive parasites, prevalence, rabbits, risk factors

Procedia PDF Downloads 174

Authors: Xiaoying Zhang

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Forest school – an outdoor educational experience that is undertaken in an outdoor environment with trees – becomes an emerging field of early childhood education recently. In China, the benefits of natural outdoor education to children and young people’s wellness have raised attention. Although different types of outdoor-based activities have been involved in some pre-school of China, few study and practice have been conducted in terms of the notion of forest school. To comprehend the impact of forest school for children and young people, this study aims to systematically review articles on the topic of forest school in preschool education from an ecological perspective, i.e. from individual level (e.g., behavior and mental health) to microsystem level (e.g., the relationship between teachers and children) to ecosystem level. Based on PRISMA framework flow, using the key words of “Forest School” and “Early Childhood Education” for searching in Web-of-science database, a total of 33 articles were identified. Sample participants of 13 studies were not preschool children, five studies were not on forest school theme, and two literature review articles were excluded for further analysis. Finally, 13 articles were eligible for thematic analysis. According to Bronfenbrenner's ecological systems theory, there are some fingdings, on the individual level, current forest school studies are concerned about the children behavioral experience in forest school, how these experience may relate to their achievement or to develop children’s wellbeing/wellness, and how this type of learning experience may enhance children’s self-awareness on risk and safety issues. On the microsystem/mesosystem level, this review indicated that pedagogical development for forest school, risk perception from teachers and parents, social development between peers, and adult’s role in the participation of forest school were concerned, explored and discussed most frequently. On the macrosystem, the conceptualization of forest school is the key theme. Different forms of presentation in various countries with diverse cultures could provide various models of forest school education. However, there was no study investigating forest school on an ecosystem level. As for the potential benefits of physical health and mental wellness that results from forest school, it informs us to reflect the system of preschool education from the ecological perspective for Chinese children. For instance, most Chinese kindergartens ignored the significance of natural outdoor activities for children. Preschool education in China is strongly oriented by primary school system, which means pre-school children are expected to be trained as primary school students to do different subjects, such as math. Hardly any kindergarteners provide the opportunities for children and young people to take risks in a natural environment like forest school does. However, merely copying forest school model for a Chinese preschool education system will be less effective. This review of different level concerns could inform us that the localization the idea of forest school to adapt to a Chinese political, educational and cultural background. More detailed results and profound discussions will be presented in the full paper.

Keywords: early childhood education, ecological system, education development prospects in China, forest school

Procedia PDF Downloads 153

Authors: Baofeng Pan, Heng Liu

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Because of the high strength and large carrying capacity, the semi-rigid base is widely used in modern road engineering. However, hydrodynamic pressure, which is one of the main factors to cause early damage of semi-rigid base, cannot be avoided in the nature environment when pavement is subjected to some loadings such as the passing vehicles. In order to investigating how moisture-induced-damage of semi-rigid base influenced by hydrodynamic pressure, a new and effective experimental research method is provided in this paper. The results show that: (a) The washing action of high hydrodynamic pressure is the direct cause of strength reducing of road semi-rigid base. (b) The damage of high hydrodynamic pressure mainly occurs at the beginning of the scoring test and with the increasing of testing time the influence reduces. (c) Under the same hydrodynamic pressure, the longer the specimen health age, the stronger ability to resist moisture induced damage.

Keywords: semi-rigid base, hydrodynamic pressure, moisture-induced-damage, experimental research

Procedia PDF Downloads 318

Authors: Rasmila Kawan, Sanjay Juvekar, Sandeep Salvi, Gufran Beig, Rainer Sauerborn

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Background: Indoor air pollution especially from the use of biomass fuels, remains a potentially large global health threat. The inefficient use of such fuels in poorly ventilated conditions results in high levels of indoor air pollution, most seriously affecting women and young children. Objectives: The main aim of this study was to measure and compare the lung function of the women exposed in the biomass fuels and LPG fuels and relate it to the indoor emission measured using a structured questionnaire, spirometer and filter based low volume samplers respectively. Methodology: This cross-sectional comparative study was conducted among the women (aged > 18 years) living in rural villages of Pune district who were not diagnosed of chronic pulmonary diseases or any other respiratory diseases and using biomass fuels or LPG for cooking for a minimum period of 5 years or more. Data collection was done from April to June 2017 in dry season. Spirometer was performed using the portable, battery-operated ultrasound Easy One spirometer (Spiro bank II, NDD Medical Technologies, Zurich, Switzerland) to determine the lung function over Forced expiratory volume. The primary outcome variable was forced expiratory volume in 1 second (FEV1). Secondary outcome was chronic obstruction pulmonary disease (post bronchodilator FEV1/ Forced Vital Capacity (FVC) < 70%) as defined by the Global Initiative for Obstructive Lung Disease. Potential confounders such as age, height, weight, smoking history, occupation, educational status were considered. Results: Preliminary results showed that the lung function of the women using Biomass fuels (FEV1/FVC = 85% ± 5.13) had comparatively reduced lung function than the LPG users (FEV1/FVC = 86.40% ± 5.32). The mean PM 2.5 mass concentration in the biomass user’s kitchen was 274.34 ± 314.90 and 85.04 ± 97.82 in the LPG user’s kitchen. Black carbon amount was found higher in the biomass users (black carbon = 46.71 ± 46.59 µg/m³) than LPG users (black carbon=11.08 ± 22.97 µg/m³). Most of the houses used separate kitchen. Almost all the houses that used the clean fuel like LPG had minimum amount of the particulate matter 2.5 which might be due to the background pollution and cross ventilation from the houses using biomass fuels. Conclusions: Therefore, there is an urgent need to adopt various strategies to improve indoor air quality. There is a lacking of current state of climate active pollutants emission from different stove designs and identify major deficiencies that need to be tackled. Moreover, the advancement in research tools, measuring technique in particular, is critical for researchers in developing countries to improve their capability to study the emissions for addressing the growing climate change and public health concerns.

Keywords: black carbon, biomass fuels, indoor air pollution, lung function, particulate matter

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Authors: Osagiede Efosa Kelvin

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The Ebola virus disease (EVD); also Ebola hemorrhagic fever, is a disease of humans and other primates caused by Ebola viruses. Signs and symptoms typically start between two days and three weeks after contracting the virus as a fever, sore throat, muscle pain, and headaches. Then, vomiting, diarrhoea and rash usually follow, along with decreased function of the liver and kidneys. At this time, some people begin to bleed both internally and externally. The first death in Nigeria was reported on 25 July 2014: a Liberian-American with Ebola flew from Liberia to Nigeria and died in Lagos soon after arrival. As part of the effort to contain the disease, possible contacts were monitored –353 in Lagos and 451 in Port Harcourt On 22 September, the World Health Organisation reported a total of 20 cases, including eight deaths. The WHO's representative in Nigeria officially declared Nigeria Ebola-free on 20 October after no new active cases were reported in the follow-up contact. This paper looks at the Ebola Virus in general and the measures taken by Nigeria to combat its spread.

Keywords: Ebola virus, hemorrhagic fever, Nigeria, outbreak

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Authors: Rose Branch-Allen, John Jayachandran

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Background and purpose: Canada is a pluralistic, multicultural society with an ethno-cultural composition that has been shaped over time by immigrants and their descendants. Although Canada welcomes these immigrants, many will endure hardship and assimilation difficulties. Despite these life hurdles, surveys consistently disclose high life satisfaction for all Canadians. Most research studies on Life Satisfaction/ Subjective Wellbeing (SWB) have focused on one main determinant and a variety of social demographic variables to delineate the determinants of life satisfaction. However, very few research studies examine life satisfaction from a holistic approach. In addition, we need to understand the causal pathways leading to life satisfaction, and develop theories that explain why certain variables differentially influence the different components of SWB. The aim this study was to utilize a holistic approach to construct a causal model and identify major determinants of life satisfaction. Data and measures: This study utilized data from the General Social Survey, with a sample size of 19, 597. The exogenous concepts included age, gender, marital status, household size, socioeconomic status, ethnicity, location, immigration status, religiosity, and neighborhood. The intervening concepts included health, social contact, leisure, enjoyment, work-family balance, quality time, domestic labor, and sense of belonging. The endogenous concept life satisfaction was measured by multiple indicators (Cronbach’s alpha = .83). Analysis: Several multiple regression models were run sequentially to estimate path coefficients for the causal model. Results: Overall, above average satisfaction with life was reported for respondents with specific socio-economic, demographic and lifestyle characteristics. With regard to exogenous factors, respondents who were female, younger, married, from high socioeconomic status background, born in Canada, very religious, and demonstrated high level of neighborhood interaction had greater satisfaction with life. Similarly, intervening concepts suggested respondents had greater life satisfaction if they had better health, more social contact, less time on passive leisure activities and more time on active leisure activities, more time with family and friends, more enjoyment with volunteer activities, less time on domestic labor and a greater sense of belonging to the community. Conclusions and Implications: Our results suggest that a holistic approach is necessary for establishing determinants of life satisfaction, and that life satisfaction is not merely comprised of positive or negative affect rather understanding the causal process of life satisfaction. Even though, most of our findings are consistent with previous studies, a significant number of causal connections contradict some of the findings in literature today. We have provided possible explanation for these anomalies researchers encounter in studying life satisfaction and policy implications.

Keywords: causal model, holistic approach, life satisfaction, socio-demographic variables, subjective well-being

Procedia PDF Downloads 357

Authors: Shailaja Grover, Purvi Tiwari, Vigneshwaran S. R., U. Dinesh Kumar

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In India, grapes are one of the most important horticulture crops. Grapes are most vulnerable to downy mildew, which is one of the most devasting diseases. In the absence of a precise weather-based advisory system, farmers spray pesticides on their crops extensively. There are two main challenges associated with using these pesticides. Firstly, most of these sprays were panic sprays, which could have been avoided. Second, farmers use more expensive "Preventive and Eradicate" chemicals than "Systemic, Curative and Anti-sporulate" chemicals. When these chemicals are used indiscriminately, they can enter the fruit and cause health problems such as cancer. This paper utilizes decision trees and predictive modeling techniques to provide grape farmers with customized advice on grape disease management. This model is expected to reduce the overall use of chemicals by approximately 50% and the cost by around 70%. Most of the grapes produced will have relatively low residue levels of pesticides, i.e., below the permissible level.

Keywords: analytics in agriculture, downy mildew, weather based advisory, decision tree, predictive modelling

Procedia PDF Downloads 74

Authors: Zikun Li, Regine Talleyrand

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Negative body image is one of the most common causes of eating disorders, and it is not only happening to women. Regardless of the increasing attention that researchers and practitioners have been paying to the male population and their body image concerns, men of color have yet to be fully represented or studied. Given the consensus that the sociocultural experiences of people of color may play a significant role in their health and well-being, this study focused on assessing the mechanism through which sociocultural factors may influence men of color’s perceptions of body image. In particular, this study focused on untangling how interpersonal and media pressure, as well as ethnic-racial identities and perceptions, would impact body dissatisfaction in terms of muscularity, body fat, and height in men of color and how this mechanism is moderated across different ethnic-racial groups. The structural equation modeling approach was therefore applied to achieve the research goal. With the sample size of 181 self-identified Black, Indigenous, and People of Color male participants aged 20-50 (M=33.33, SD=6.9) through surveying on Amazon’s MTurk platform, the proposed model achieved a modestly acceptable model fit with the pooled sample, X2(836) = 1412.184, CFI = 0.900, RMSEA = 0.062 [0.056, 0.067]. And SRMR = 0.088, And it explained 89.5% of the variance in body dissatisfaction. The results showed that of all the direct effects on body dissatisfaction, interpersonal appearance pressure exhibited the strongest effect (β = 0.410***), followed by media appearance pressure (β = 0.272**) and self-hatred feeling (β = 0.245**). The ethnic-racial related factors (i.e., stereotype endorsement, ethnic-racial salience, and nationalistic assimilation) statistically influenced body dissatisfaction through the mediators of media appearance pressure and/or self-hatred feeling. Furthermore, the moderation analysis between Black/African American men and non-Black/African American men revealed the substantial differences in how ethnic/racial identity impacts one’s perception of body image, and the Black/African American men were found to be influenced by sociocultural factors at a higher level, compared with their counterparts. The impacts of demographic characteristics (i.e., SES, weight, height) on body dissatisfaction were also examined. Instead of considering interpersonal appearance pressure and media pressure as two subscales under one construct, this study considered them as two separate and distinct sociocultural factors. The good model fit to the data indicates this rationality and encourages scholars to reconsider the impacts of two sources of social pressures on body dissatisfaction. In addition, this study also provided empirical evidence of the moderation effect existing within the population of men of color, which reveals the heterogeneity existing across different ethnic-racial groups and implies the necessity to study individual ethnic-racial groups so as to better understand the mechanism of sociocultural influences on men of color’s body dissatisfaction. These findings strengthened the current understanding of the body image concerns exciting among men of color and meanwhile provided empirical evidence for practitioners to provide tailored health prevention and treatment options for this growing population in the United States.

Keywords: men of color, body image concerns, sociocultural factors, structural equation modeling

Procedia PDF Downloads 70

Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

Procedia PDF Downloads 154

Authors: Reenu Yadav, S. K. Yadav

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Herbal therapy has been used for daily oral health care to prevent, treat or cure oral conditions from halitosis to periodontal diseases. The importance of mouth and teeth cleanliness has been recognized from the earliest days of civilization to the 21st century. In the present study, leaves and seeds of Cordia obliqua and barks and twigs of Beautea monosperma, which is used traditionally for oral diseases was evaluated for its antimicrobial activity. The antimicrobial activity tests indicated that the methanolic extract exhibited stronger activities against the commonly encountered oral bacterial and fungal pathogens. The mouthwash formulation prepared and it is compared with marketed formulation HiOra. The results indicated that the herbal mouthwash could inhibit the growth of oral pathogens and may prevent plaque and other periodontal diseases caused by dental pathogens.

Keywords: herbal mouthwash, bio medicine, life sciences, herbal extracts

Procedia PDF Downloads 350

Authors: Carole A. South-Winter

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Research-based learning gives students the opportunity to experience problems that require critical thinking and idea development. The skills they gain in working through these problems 'hands-on,' develop into attributes that benefit their careers in the professional field. The partnerships developed between students and industries give advantages to both sides. The students gain knowledge and skills that will increase their likelihood of success in the future and the industries are given research on new advancements that will give them a competitive advantage in their given field of work. The future of these partnerships is dependent on the success of current programs, enabling the enhancement and improvement of the research efforts. Once more students can complete research, there will be an increase in reliability of the results for each industry. The overall goal is to continue the support for research-based learning and the partnerships formed between students and industries.

Keywords: global healthcare, industry partnerships, research-driven decisions, short-term study abroad

Procedia PDF Downloads 126

Authors: Fatimazahrae Elbakri, Azeddine Ibrahimi, Meryem Lemrani, Dris Belghyti

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Leishmaniasis represents a major public health problem because of the number of cases recorded each year and the wide distribution of the disease. It is a parasitic disease of flagellated protozoa transmitted by the bite of certain species of sandfly, causing a spectrum of clinical pathology in humans ranging from disfiguring skin lesions to fatal visceral leishmaniasis. Cutaneous leishmaniasis due to Leishmania major is a polymorphic disease; in fact, the infection can be asymptomatic, localized, or disseminated. The objective of this work is to determine the genomic diversity that contributes to clinical variability by trying to identify the variation in chromosome number and to extract SNPs and SNPs and InDels; it is based on four sequences (WGS) of Leishmania major available on NCBI in Fastq form, from three countries: Tunisia, Algeria, and Israel, the analysis is set up from a pipeline to facilitate the discovery of genetic diversity, in particular SNP and chromosomal somy.

Keywords: Leshmania major, cutaneous Leishmania, NGS, genomic, somy, variant calling

Procedia PDF Downloads 80

Authors: Amina Sa'id Muhammad, Asmau Ishaq Alhassan, Beba Raymond, Fatima Bello

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Severe acute malnutrition (SAM) remains a major killer of children under five years of age. Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five. An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), and 3.9% of children in northwest Nigeria suffer from SAM, which is significantly higher than the national average of 2.1%. Community-Based Management of Acute Malnutrition (CMAM) has proven to be an effective intervention in the treatment of SAM in children using Ready-to-Use Therapeutic Food (RUTF). Ready-to-use therapeutic food (RUTF) is a key component for the treatment of Severe Acute Malnutrition. It contains all the energy and nutrients required for rapid catch-up growth and used particularly in the treatment of children over 6 months of age with SAM without medical complications. However, almost all RUTFs are currently imported to Nigeria from other countries. Shortages of RUTF due to logistics (shipping costs, delays, donor fatigue etc) and funding issues present a threat to the achievement of the 2030 World Health Assembly (WHA) targets for reducing malnutrition in addition to 2030 SDGs 2 (Zero Hunger), 3 (Good Health and Wellbeing), 12 (Responsible Consumption and Production), and 17 (Partnerships for the Goals), thus undermining its effectiveness in combating malnutrition On the other hand, the availability of human and material resources that will aid local production of RUTF presents an opportunity to fill in the gap in regular RUTF supply. About one thousand Nigerian children die of malnutrition-related causes every day, reaching a total of 361,000 each year. Owing to the high burden of malnutrition in Nigeria, the local production of RUTF is a logical step, that will ensure increased availability, acceptability, access, and efficiency in supply, and at lower costs. Objective(s): The objectives of this study were therefore, to formulate RUTF from locally available resources and to determine its energy and nutrients composition, incommensurate with the standard/commercial RUTF. Methods: Three samples of RUTF were formulated using locally available resources (soya beans, wheat, rice, baobab, brown-sugar, date palm and soya oil); which were subjected to various analysis to determine their energy/proximate composition, vitamin and mineral contents and organoleptic properties were also determined using sensory evaluation. Results: The energy values of the three samples of locally produced RUTF were found to be in conformity with WHO recommendation of ≥ 500 kcal per 100g. The energy values of the three RUTF samples produced in the current study were found to be 563.08, 503.67 and 528.98 kcal respectively. Sample A, B and C had protein content of 13.56% 16.71% and 14.62% respectively, which were higher than that of commercial RUTF (10.9%). Conclusions/recommendations: The locally formulated RUTF samples had energy value of more than 500 kcal per 100g; with an appreciable amount of macro and micro nutrients. The appearance, taste, flavor and general acceptability of the formulated RUTF samples were also commendable.

Keywords: energy, malnutrition, nutrients, RUTF

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Authors: Oznur Ispir, S. Duygulu

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Health institutions are the places where fast and efficient decisions are required and mistakes and uncertainties are not tolerated due to the urgency of the services provided within the body of these institutions. Thus, in those institutions where patient care services are targeted to be provided quality and safety, the nurses attending the decisions, creating the solutions for problems, taking initiative and bearing the responsibility of results in brief having the control over practices are needed. Control over nursing practices is defined as affecting the employment and work environment at the unit level of the institution, perceived freedom for organizing and evaluating nursing practices, the ability to make independent decisions about patient care and accountability for the results of such decisions. This study scrutinizes the concept of control over nursing practices (organizational autonomy), which is frequently confused with other concepts (autonomy) in the literature, by reviewing the literature and making suggestions to improve nurses’ control over nursing practices.

Keywords: control over nursing practice, nurse, nursing, organizational autonomy

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Authors: Joseph Siani

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Over the last decades, dissatisfaction with global indicators of economic performance, such as GDP (Gross Domestic Product) per capita, has shifted the attention to what is now referred to as multidimensional poverty. In this framework, poverty goes beyond income to incorporate aspects of well-being not captured by income measures alone. This paper applies the totally fuzzy approach to estimate the fuzzy index of poverty (FIP) in fourteen Sub-Saharan African (SSA) countries using Demographic and Health Survey (DHS) data and explores whether pictures created by the standard headcount ratio at $1.90 a day and the fuzzy index of poverty tell a similar story. The results suggest that there is indeed considerable mismatch between poverty headcount and the fuzzy index of multidimensional poverty, meaning that the majority of the most deprived people (as identified by the fuzzy index of multidimensional poverty) would not be identified by the poverty headcount ratio. Moreover, we find that poverty is distributed differently by colonial heritage (language). In particular, the most deprived countries in SSA are French-speaking.

Keywords: fuzzy set approach, multidimensional poverty, poverty headcount, overlap, Sub-Saharan Africa

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Authors: Inayat Ur Rehman, Georgia Sakellari

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Cloud computing has evolved into a vital technology for businesses, offering scalability, flexibility, and cost-effectiveness. However, maintaining high availability and optimal performance in the cloud is crucial for reliable services. This paper explores the significance of cloud monitoring and performance optimization in sustaining the high availability of cloud-based systems. It discusses diverse monitoring tools, techniques, and best practices for continually assessing the health and performance of cloud resources. The paper also delves into performance optimization strategies, including resource allocation, load balancing, and auto-scaling, to ensure efficient resource utilization and responsiveness. Addressing potential challenges in cloud monitoring and optimization, the paper offers insights into data security and privacy considerations. Through this thorough analysis, the paper aims to underscore the importance of cloud monitoring and performance optimization for ensuring a seamless and highly available cloud computing environment.

Keywords: cloud computing, cloud monitoring, performance optimization, high availability

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Authors: Mustafa M. Donma, Orkide Donma

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Cardiovascular pathology is one of the expected consequences of excessive fat gain. The role of zinc in thyroid hormone metabolism is an important matter. The concentrations of both thyroid stimulating hormone (TSH) and zinc are subject to variation in obese individuals. Zinc exhibits protective effects on cardiovascular health and is inversely correlated with cardiovascular markers in childhood obesity. The association between subclinical hypothyroidism (SCHT) and metabolic disorders is under investigation due to its clinical importance. Underactive thyroid gland causes high TSH levels. Subclinical hypothyroidism is defined as the elevated serum TSH levels in the presence of normal free thyroxin (T4) concentrations. The aim of this study was to evaluate the associations between TSH levels and zinc concentrations in morbid obese (MO) children exhibiting SCHT. The possibility of using the probable association between these parameters was also evaluated for the discrimination of metabolic syndrome positive (MetS+) and metabolic syndrome negative (MetS-) groups. Forty-two children were present in each group. Informed consent forms were obtained. Institutional Ethics Committee approved the study protocol. Tables prepared by World Health Organization were used for the definition of MO children. Children, whose age- and sex-dependent body mass index percentile values were above 99, were defined as MO. Children with at least two MetS components were included in MOMetS+ group. Elevated systolic/diastolic blood pressure values, increased fasting blood glucose, triglycerides (TRG)/decreased high density lipoprotein-cholesterol (HDL-C) concentrations in addition to central obesity were listed as MetS components. Anthropometric measures were recorded. Routine biochemical analyses were performed. Thirteen and fifteen children had SCHT in MOMetS- and MOMetS+ groups, respectively. Statistical analyses were performed. p<0.05 was accepted as statistically significant. In MOMetS- and MOMetS+ groups, TSH levels were 4.1±2.9 mU/L and 4.6±3.1 mU/L, respectively. Corresponding values for SCHT cases in these groups were 7.3±3.1 mU/L and 8.0±2.7 mU/L. Free T4 levels were within normal limits. Zinc concentrations were negatively correlated with TSH levels in both groups. The significant negative correlation calculated in MOMetS+ group (r= -0.909; p<0.001) was much stronger than that found in MOMetS- group (r= -0.706; p<0.05). This strong correlation (r= -0.909; p<0.001) calculated for cases with SCHT in MOMetS+ group was much lower (r= -0.793; p<0.001) when all MOMetS+ cases were considered. Zinc is closely related to T4 and TSH therefore, it participates in thyroid hormone metabolism. Since thyroid hormones are required for zinc absorption, hypothyroidism can lead to zinc deficiency. The presence of strong correlations between TSH and zinc in SCHT cases found in both MOMetS- and MOMetS+ groups pointed out that MO children were under the threat of cardiovascular pathologies. The detection of the much stronger correlation in MOMetS+ group in comparison with the correlation found in MOMetS- group was the indicator of greater cardiovascular risk due to the presence of MetS. In MOMetS+ group, correlation in SCHT cases found higher than correlation calculated for all cases confirmed much higher cardiovascular risk due to the contribution of SCHT.

Keywords: cardiovascular risk, children, morbid obesity, subclinical hypothyroidism, zinc

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Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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Authors: M. Rezki, A. Belaidi

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This paper deals with a method of learning to solve a real problem in biomedical engineering from a technical study of muscle fatigue. Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles (viewpoint: anatomical and physiological). EMG is used as a diagnostics tool for identifying neuromuscular diseases, assessing low-back pain and muscle fatigue in general. In order to study the EMG signal for detecting fatigue in a muscle, we have taken a real problem which touches the tramway conductor the handle bar. For the study, we have used a typical autonomous platform in order to get signals at real time. In our case study, we were confronted with complex problem to do our experiments in a tram. This type of problem is recurring among students. To teach our students the method to solve this kind of problem, we built a similar system. Through this study, we realized a lot of objectives such as making the equipment for simulation, the study of detection of muscle fatigue and especially how to manage a study of biomedical looking.

Keywords: EMG, health platform, conductor’s tram, muscle fatigue

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Authors: M. Shahana

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Introduction: Leprosy (Hansens) is one of the major health problems in the developing countries. Sixty percent of the world leprosy cases are in India. According to the 2006 census India has about 54% of the total new cases detected globally. The National Leprosy Elimination Programme in 2012 has reported 9.7% of childhood leprosy. There are only few studies related to paediatric leprosy. Aim: To study the epidemiology and various clinical presentations of leprosy in the paediatric age group. Material and Methods: A 4-year prospective study was done in the out-patient department of dermatology in a tertiary care hospital. All the patients were screened for leprosy and children with a confirmed diagnosis of leprosy were taken up for the study. Results: Total of 321 cases of Hansens were recorded during this period out of which 41 were children. The male to female ratio was 2.72:1. A positive family history was found in 18%. Most of them presented with single hypopigmented hypoanesthetic patch. Conclusions: Children presented with more of Borderline tuberculoid type and reactions or deformities were less common.

Keywords: Hansens, hypoaneasthetic patch, leprosy, reactions

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Authors: I. Brezeanu, J. Mackrill, A. Cajo, C. Mogollon

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Modern Slavery is a serious crime, where often the victims are unable to leave their situation of exploitation, being controlled by threats, punishment, violence, coercion, and deception. In the UK, this term encompasses both Slavery and Human Trafficking. The number of potential victims who were referred to the National Referral Mechanism (NRM) increased exponentially in the past decade, passing from fewer than 700 potential victims referred in 2010 to more than 12.000 in 2021. Our study aims to explore how the concept of Trauma-Informed Care (TIC) approach can be adopted by services working with survivors of Modern Slavery and Trafficking (MST). Notably, in this paper, we will elaborate on how the complex needs of survivors are related to their traumatic experiences and what are the necessary steps and resources for implementing a Modern Slavery Trauma-Informed model. While there are relatively few services in the UK that have a deep understanding of the survivors’ and practitioners’ views of how trauma impacts their daily life, there is a strong need for developing services that are organised and delivered in ways that prevent retraumatisation and enable trauma survivors to engage safely with the right professionals at the right time, promoting healing through positive relationships. Such models, known as Trauma-Informed Approaches (TIAs), are seen as crucial to the empowerment of survivors, yet they remain a marginal implementation model by governments, law enforcement, judiciary, or care providers, who are frequently survivors’ first point of contact in the recovery process. In order to understand better how to provide best practice and to adopt the concept, this study is based on a multi-disciplinary approach, encompassing both theoretical perspectives and co-production. By combining qualitative and quantitative research and comparing different analysis of applied examples of TIC in the US and the UK, we gained important insights about the prevention and impact of trauma on survivors’ life. The articulation between more general expertise on Trauma-Informed Care developed by other institutions operating in the field, and the SJOG delivery, based on the Salvation Army’s Modern Slavery Victim Care and Coordination Contract (MSVCC) and the Care Quality Commission regulations, allowed to identify on one side what are the complex needs of survivors derived from their traumatic experiences, and on the other side, how could MST services prevent retraumatisation. Additional, two in-depth interviews with survivors, who receive support from one of our services at Olallo House in London, and a survey shared among all colleagues working with MST services completed the findings of the research with their personal experience and knowledge. Ultimately, we developed an evidence-based Trauma-Informed Care Pathway that aims to improve the wellbeing of survivors and to support them to live a meaningful life. The establishedpathway delivers three main outcomes belonging to the social determinants of health criteria – health and wellbeing, purpose and relationship, and covers key themes of the context of trauma, needs of individuals, and service support.

Keywords: trauma-informed care, modern slavery, human trafficking, trauma, retraumatisation

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Authors: Zoe Polk

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In cities across the US, race continues to predict an individual’s likelihood to be employed, to receive a quality education, to live in a safe neighborhood, to life expectancy to contacts with the criminal justice system. Deep and pervasive disparities exist despite laws enacted at the federal, state and local level to eliminate discrimination. This paper examines the strengths of the U.S. civil rights movement in making discrimination a moral issue. Following the passage of the 1964 Civil Rights Act, cities throughout the US adopted laws that mirror the language, theories of practice and enforcement of the law. This paper argues that while those laws were relevant to the way discrimination was conducted in that time, they are limited in their ability to help cities address discrimination today. This paper reviews health indicators This paper concludes that in order for cities to create environments where race no longer predicts one’s success, cities must conduct institutional and structural racism audits.

Keywords: racism, racial equity, constitutional law, social justice

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Authors: I. C. Okwulehie, J. A. Ogoke

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The phytocemical, mineral, proximate and heavy metals compositions of six edible and non-edible species of mushrooms were investigated. Fully fleshy mushrooms were used for the analysis. On the averagely, the bioactive constituents of the mushrooms were as follows Alkaloids 0.12 ± 0.02 – 1.01 ± 03 %, Tannins 0.44 ± 0.09 – 1.38 ± 0.6,). Phenols,(0.13 ± 0.01 – 0.26± 0.00, Saponins 0.14 ± 0.03 – 0.32 ± 0.04%, Flavonoids 0.08 ± 0.02 – 0.34 ± 0.02%. The result of proximate composition indicated that the mushroom contained (5.17 ± 0.06 – 12.28 ± 0.16% protein, 0.16 ± 0.02 – 0.67 ± 0.02% fats, 1.06 ± 0.03 – 8.49 ± 0.03 % fibre, (62.06 ± 0.52 – 80.01 ± 4.71% and carbohydrate. The mineral composition of the mushrooms were as follows, calcium 81.49 ± 2.32 - .914 ± 2.32mg/100g, Magnesium(8 ± 1.39-24 ± 2.40mg/100g, Potassium 64.54 ± 0.43 – 164.54 ± 1.23 mg/100g, sodium 9.47 ± 0.12 – 30.97 ± 0.16 mg/100g, and Phosphorus 22.19 ± 0.57-53.2± 0.44 mg/100g. Heavy metals concentration indicated Cadmium 0.7-0.94ppm. Zinc 27.82 – 70.98 ppm. Lead 0.66 – 2.86ppm and Copper 1.8-22.32ppm. The result obtained indicates that the mushrooms are of good sources of phytochemicals, proximate and minerals needed for maintenance of good health and can also be exploited in manufacture of drugs. Heavy metals obtained indicate that when consume intentionally in high content may cause liver, kidney damage and even death.

Keywords: bioactive, heavy metals, mushroom, nutritive

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Authors: Susana Aldaba Yaben, Marga Echauri Ozcoidi, Rosario Osinaga Cenoz

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It was decided to make a diagnosis with students of Berriozar High School between 12 and 15 years (both included) for their lifestyles in relation to eating habits, BMI (Body Mass Index), physical activity, drugs, interpersonal relationships and screen time. The aim of this survey is identifying needs of this population and depending on the results, we could program socio-educational activities. This action is part of the Community Health Promotion Programme and healthy lifestyles in childhood and youth of Berriozar. The eating habits, a lack of physical activity and an excessive screen time are causes of 26,75% of obese or overweight young people. First of all, many of them have got a diet enriched in saturated fats and sugars. Secondly, most of them do not practise physical exercise daily and finally, their screen time are higher than the recommendation (until 2 hours a day).

Keywords: lifestyle, diet, BMI, physical activity, screen time, education, youth

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Authors: K. J. Sannapapamma, H. Malligawad Lokanath, Sakeena Naikwadi

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Eco-friendly textiles are gaining importance among the consumers and textile manufacturers in the healthcare sector due to increased environmental pollution which leads to several health and environmental hazards. Hence, the research was designed to cultivate and develop the organic cotton knit, to prepare and characterize the Vetiver oil microcapsules for textile finishing and to access the wash durability of finished knits. The cotton SAHANA variety grown under organic production systems was processed and spun into 30 single yarn dyed with four natural colorants (Arecanut slurry, Eucalyptus leaves, Pomegranate rind and Indigo) and eco dyed yarn was further used for development of single jersy knitted fabric. Vetiveria zizanioides is an aromatic grass which is being traditionally used in medicine and perfumery. Vetiver essential oil was used for preparation of microcapsules by interfacial polymerization technique subjected to Gas Chromatography Mass Spectrometry (GCMS), Fourier Transform Infrared Spectroscopy (FTIR), Thermo Gravimetric Analyzer (TGA) and Scanning Electron Microscope (SEM) for characterization of microcapsules. The knitted fabric was finished with vetiver oil microcapsules by exhaust and pad dry cure methods. The finished organic knit was assessed for laundering on antimicrobial efficiency and aroma intensity. GCMS spectral analysis showed that, diethyl phthalate (28%) was the major compound found in vetiver oil followed by isoaromadendrene epoxide (7.72%), beta-vetivenene (6.92%), solavetivone (5.58%), aromadenderene, azulene and khusimol. Bioassay explained that, the vetiver oil and diluted vetiver oil possessed greater zone of inhibition against S. aureus and E. coli than the coconut oil. FTRI spectra of vetiver oil and microcapsules possessed similar peaks viz., C-H, C=C & C꞊O stretching and additionally oil microcapsules possessed the peak of 3331.24 cm^-1 at 91.14 transmittance was attributed to N-H stretches. TGA of oil microcapsules revealed that, there was a minimum weight loss (5.835%) recorded at 467.09°C compared to vetiver oil i.e., -3.026% at the temperature of 396.24°C. The shape of the microcapsules was regular and round, some were spherical in shape and few were rounded by small aggregates. Irrespective of methods of application, organic cotton knits finished with microcapsules by pad dry cure method showed maximum zone of inhibition compared to knits finished by exhaust method against S. aureus and E. coli. The antimicrobial activity of the finished samples was subjected to multiple washing which indicated that knits finished with pad dry cure method showed a zone of inhibition even after 20^th wash and better aroma retention compared to knits finished with the exhaust method of application. Further, the group of respondents rated that the 5^th washed samples had the greater aroma intensity in both the methods than the other samples. Thus, the vetiver microencapsulated organic cotton knits are free from hazardous chemicals and have multi-functional properties that can be suitable for medical and healthcare textiles.

Keywords: exhaust and pad dry cure finishing, interfacial polymerization, organic cotton knits, vetiver oil microcapsules

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Authors: Abebe Yimer, Sirawdink Fikereyesus Forsido, Getachew Addis, Abebe Ayelign

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Background: Oxidative stress has been an important health problem as itinduceschronic diseases such as cancer, cardiovascular, diabetics, and neurodegenerative disease. Plant source natural antioxidant has gained attention as synthetic antioxidant negatively impact human health. Wild edible plants arecheap source of dietary-medicine in mainly rural communityin south-west Ethiopia and elsewhere the country. Thus, the study aimed to determine total pheneol,flavoinoids, antioxidant, vitamin C, and beta-carotene content from wild edible plants Solanum nigrum L., Vigna membranacea A. Rich, Dioscorea praehensilis Benth., Trilepisium madagascariense D.C.andCleome gynandra L. Methods: Methanol was used to extract samples of oven-dried edible plants. Total phenolic compound (TPC) was determined using a Folin Ciocalteu method, whereas total flavonoid content (TFC) was determined using the Aluminium chloride colorimetric method. By using 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) tests, antioxidant activities were evaluated in vitro. Additionally, beta-carotene was assessed using a spectrophotometric technique, whilst vitamin C was determined using a titration approach. Results: Total flavonoid contentranged from 0.85±0.03 to 11.25±0.01 mg CE/g in D. praehensilis Benth. tuber and C. gynandra L, respectively. Total phenolic compounds varied from 0.25±0.06 GAE/g in D. praehensilis Benth tuber to 35.73±2.52 GAE/g in S.nigrum L. leaves. In the DPPH test, the highest antioxidant value (87.65%) was obtained in the S.nigrum L. leaves, whereas the smallest amount of antioxidant (50.12%)was contained in D. praehensilis Benth tuber. Similarly in FRAP assay,D. praehensilis Benth tuber showed the least reducing potential(49.16± 2.13mM Fe2+/100 g)whilst the highest reducing potential was presented in the S.nigrum L. leaves(188.12±1.13 mM Fe2+/100 g). The beta-carotene content was found between 11.81±0.00 mg/100g in D. praehensilis Benth tubers to 34.49±0.95 mg/100g in V. membranacea A. Rich leaves. The concentration of vitamin C ranged from 10.00±0.61 in D. praehensilis Benth tubers to 45±1.80 mg/100g in V. membranacea A. Rich leaves. The results showed that high positive linear correlations between TPC and TFC of WEPs (r=0.828), as well as between FRAP and total phenolic contents (r = 0.943) and FRAP and vitamin C (r= 0.928). Conclusion: These findings showed the total phenolic and flavonoid contents of Solanum nigrum L. and Cleome gynandra L, respectively, are abundant. The outcome may be used as a natural supply of dietary antioxidants, which may be useful in preventing oxidative stress. The study's findings also showed that Vigna membranacea A. Rich leaves were cheap source of vitamin C and beta-carotene for people who consumed these wild green. Additional research on the in vivo antioxidant activity, toxicological analysis, and promotion of these wild food plants for agricultural production should be taken into consideration.

Keywords: antioxidant activity, beta-carotene, flavonoids, phenolic content, and vitamin c

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Authors: Balwinder Singh, Veerpaul Kaur Mann

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The COVID-19 had a dramatic impact on several countries across the world. National governments have imposed widespread restrictions to prevent the growth of this pandemic. The new health competitive scenario induced by the COVID-19 crisis raised many issues on how business activities should be reorganized due to the difficulties of physical interactions with distributors, suppliers and customers. The pandemic has particularly affected the whole marketing processes because of the relevant issues emerged in managing physical sale channels and interactions with one another, both in the Business-to-Consumer and in the Business-to-Business markets. Recent research about the appropriate actions and strategies that could help firms overcome the crisis has highlighted the key role of digital technologies that may ensure connections and, thus, help business activities to run smoothly. This could be true, especially with the emergence of strong limitations on physical interactions during the COVID-19 pandemic. In such a scenario, the online channel becomes the most important conducive for online customers to get in contact with the firm and carry out online purchasing activities.

Keywords: COVID-19, business, digital marketing, online customers

Procedia PDF Downloads 57