Search results for: health care professional

Authors: Alexander K. Edwards

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Introduction: The moral dimension of teacher education globally has assumed a new paradigm of thinking based on the public gain (return-on-investments), value-creation (quality), professionalism (practice), and business strategies (innovations). Abundant literature reveals an interesting revolutionary trend in complimenting the raising of teachers and academic performances. Because of the global competition in the knowledge-creation and service areas, the C21st teacher at all levels is expected to be resourceful, strategic thinker, socially intelligent, relationship aptitude, and entrepreneur astute. This study is a significant contribution to practice and innovations to raise exemplary or primal teachers. In this study, the qualities needed were considered as ‘Quadrant Intelligence (Q-i)’ model for a primal teacher leadership beyond the classroom. The researcher started by examining the issue of the majority of teachers in Ghana Education Services (GES) in need of this Q-i to be effective and efficient. The conceptual framing became determinants of such Q-i. This is significant for global employability and versatility in teacher education to create premium and primal teacher leadership, which are again gaining high attention in scholarship due to failing schools. The moral aspect of teachers failing learners is a highly important discussion. In GES, some schools score zero percent at the basic education certificate examination (BECE). The question is what will make any professional teacher highly productive, marketable, and an entrepreneur? What will give teachers the moral consciousness of doing the best to succeed? Method: This study set out to develop a model for primal teachers in GES as an innovative way to highlight a premium development for the C21st business-education acumen through desk reviews. The study is conceptually framed by examining certain skill sets such as strategic thinking, social intelligence, relational and emotional intelligence and entrepreneurship to answer three main burning questions and other hypotheses. Then the study applied the causal comparative methodology with a purposive sampling technique (N=500) from CoE, GES, NTVI, and other teachers associations. Participants responded to a 30-items, researcher-developed questionnaire. Data is analyzed on the quadrant constructs and reported as ex post facto analyses of multi-variances and regressions. Multiple associations were established for statistical significance (p=0.05). Causes and effects are postulated for scientific discussions. Findings: It was found out that these quadrants are very significant in teacher development. There were significant variations in the demographic groups. However, most teachers lack considerable skills in entrepreneurship, leadership in teaching and learning, and business thinking strategies. These have significant effect on practices and outcomes. Conclusion and Recommendations: It is quite conclusive therefore that in GES teachers may need further instructions in innovations and creativity to transform knowledge-creation into business venture. In service training (INSET) has to be comprehensive. Teacher education curricula at Colleges may have to be re-visited. Teachers have the potential to raise their social capital, to be entrepreneur, and to exhibit professionalism beyond their community services. Their primal leadership focus will benefit many clienteles including students and social circles. Recommendations examined the policy implications for curriculum design, practice, innovations and educational leadership.

Keywords: emotional intelligence, entrepreneurship, leadership, quadrant intelligence (q-i), primal teacher leadership, strategic thinking, social intelligence

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Authors: Ziaul Islam, Asad Sultan, Sarzamin Khan

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Organic acids and micro encapsulated phyto essential oils have revealed great potential as an antibiotic replacement and as an additive to work tremendously for the health maintenance of broiler chicken. To explore more about organic acids, a total of 600 day-old broiler chicks (Cobb-500) were procured from a local hatchery and distributed into 5 treatment groups having 6 replicates of 20 birds each; the duration of the biological trial was of 35 days. Group T1 served as a control group that were fed on corn soy-based diet only. T2 were fed with a diet having 6% poultry by-product meal (PBM) diet, T3, T4, and T5 were served as the same diet as T2 but supplemented with an organic acid, phyto essential oils alone, and a combination, respectively. The findings declared significant improvement (p<0.05) in body weight gain and FCR in groups T3, T4, and T5 while feed intake was not affected. European broiler performance indicators like production efficiency factor (EPEF) and broiler index (EBI) were improved significantly (p<0.05) by the treatments T3, T4, and T5 compared with T1 and T2. Carcass evaluation depicted significantly better (p<0.05) dressed and eviscerated weight along with carcass yield (T3, T4, T5). Broilers fed organic acid and phyto essential oils supplemented diet had significantly lower (p<0.05) Clostridium perfringens, Escherichia coliand Salmonella and increased Lactobacillus counts. Likewise, antibody titer against ND, IB, and IBD were also significantly (p<0.05) improved by the treatments T3, T4 and T5compared with the T1and T2. Litter moisture content was significantly (p<0.05) reduced by treatmentsT3, T4, and T5 on day 28 and 35 compared with the T1 and T2. These findings of the present study revealed that supplementation of organic acids blend and phyto-essential oils as an as an substitute to improve the performance of broilers without the use of feed antibiotics in broilers fed with 6% poultry by-product meal based diet.

Keywords: organic acid, phyto essential oils, growth performance, PBM, gut health, microbiota, immunity

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Authors: Thiwanka Weerakkody, Lakmali Handagiripathira, Poshitha Dabare, Thisari Guruge

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The determination of gross alpha and beta activity in water is important in a wide array of environmental studies and these parameters are considered in international legislations on the quality of water. This technique is commonly applied as screening method in radioecology, environmental monitoring, industrial applications, etc. Measuring of Gross Alpha and Beta emitters by using iSolo alpha beta counting system is an adequate nuclear technique to assess radioactivity levels in natural and waste water samples due to its simplicity and low cost compared with the other methods. Twelve water samples (Six samples of commercially available bottled drinking water and six samples of industrial waste water) were measured by standard method EPA 900.0 consisting of the gas-less, firm wear based, single sample, manual iSolo alpha beta counter (Model: SOLO300G) with solid state silicon PIPS detector. Am-241 and Sr90/ Y90 calibration standards were used to calibrate the detector. The minimum detectable activities are 2.32mBq/L and 406mBq/L, for alpha and beta activity, respectively. Each of the 2L water samples was evaporated (at low heat) to a small volume and transferred into 50mm stainless steel counting planchet evenly (for homogenization) and heated by IR lamp and the constant weighted residue was obtained. Then the samples were counted for gross alpha and beta. Sample density on the planchet area was maintained below 5mg/cm. Large quantities of solid wastes sludges and waste water are generated every year due to various industries. This water can be reused for different applications. Therefore implementation of water treatment plants and measuring water quality parameters in industrial waste water discharge is very important before releasing them into the environment. This waste may contain different types of pollutants, including radioactive substances. All these measured waste water samples having gross alpha and beta activities, lower than the maximum tolerance limits for industrial waste water discharge of industrial waste in to inland surface water, that is 10-9µCi/mL and 10-8µCi/mL for gross alpha and beta respectively (National Environmental Act, No. 47 of 1980). This is according to extraordinary gazette of the democratic socialist republic of Sri Lanka in February 2008. The measured water samples were below the recommended radioactivity levels and do not pose any radiological hazard when releasing the environment. Drinking water is an essential requirement of life. All the drinking water samples were below the permissible levels of 0.5Bq/L for gross alpha activity and 1Bq/L for gross beta activity. The values have been proposed by World Health Organization in 2011; therefore the water is acceptable for consumption of humans without any further clarification with respect to their radioactivity. As these screening levels are very low, the individual dose criterion (IDC) would usually not be exceeded (0.1mSv y⁻¹). IDC is a criterion for evaluating health risks from long term exposure to radionuclides in drinking water. Recommended level of 0.1mSv/y expressed a very low level of health risk. This monitoring work will be continued further for environmental protection purposes.

Keywords: drinking water, gross alpha, gross beta, waste water

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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Authors: Benedicta Asante, Catherine Trask, Brenna Bath

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Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, there is the increase in reports of injuries, particularly for common and debilitating musculoskeletal disorders such as low back disorder (LBD). WCWs are likely exposed to diverse work-related hazards that could contribute to LBD. However, there is currently no summary of the state of knowledge on the prevalence and risk factors of LBD within this workforce. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back disorder’ and ‘waste collection workers’. Two reviewers screened articles at title, abstract, and full-text stages. Data were extracted on study design, sampling strategy, socio-demographics, geographical region, and exposure definition, the definition of LBD, response rate, statistical techniques, LBD prevalence and risk factors. The risk of bias was assessed with a standardized tool. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; only thirteen full-text articles met the study criteria and underwent data extraction. The majority of articles reported a 12-month prevalence of LBD between 16-74%. Although none of the included studies quantified relationships between risk factors and LBD, the suggested risk factors for LBD among WCWs included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Conclusion: LBD is a major occupational health issue among WCWs. In light of these risks and future growth in this industry, further research should focus on the investigation of risk factors, with more focus on ergonomic exposure assessment, and LBD prevention efforts.

Keywords: low back pain, scavenger, waste pickers, waste collection workers

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Authors: Brooklyn Rushton, Michelle Rutty, Natalie Knowles, Daniel Scott

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As people are increasingly on the search for extraordinary experiences and connections with nature, adventure tourism is experiencing significant growth and providing tourists with life-changing experiences. Unlike built attraction-based tourism, adventure tourism relies entirely on natural heritage, which leaves communities dependent on adventure tourism extremely vulnerable to environmental and climatic changes. A growing body of evidence suggests that global climate change will influence the future of adventure tourism and mountain outdoor recreation opportunities on a global scale. Across Canada, more specifically, climate change is broadly anticipated to present risks for winter-snow sports, while opportunities are anticipated to arise for green season activities. These broad seasonal shifts do not account for the indirect impacts of climate change on adventure tourism, such as the cost of adaptation or the increase of natural hazards and the associated likelihood of accidents. While some research has examined the impact of climate change on natural environments that adventure tourism relies on, a very small body of research has specifically focused on guides’ perspectives or included hard adventure tourism activities. The guiding industry is unique, as guides are trained through an elegant blend of art and science to make decisions based on experience, observation, and intuition. While quantitative research can monitor change in natural environments, guides local knowledge can provide eye-witness accounts and outline what environmental changes mean for the future sustainability of adventure tourism. This research will capture the extensive knowledge of mountain guides to better understand the implications of climate change for mountain adventure and potential adaptive responses for the adventure tourism industry. This study uses a structured online survey with open and close-ended questions that will be administered using Qualtrics (an online survey platform). This survey is disseminated to current members of the Association of Canadian Mountain Guides (ACMG). Participation in this study will be exclusive to members of the ACMG operating in the outdoor guiding streams. The 25 survey questions are organized into four sections: demographic and professional operation (9 questions), physical change (4 questions), climate change perception (6 questions), and climate change adaptation (6 questions). How mountain guides perceive and respond to climate change is important knowledge for the future of the expanding adventure tourism industry. Results from this study are expected to provide important information to mountain destinations on climate change vulnerability and adaptive capacity. Expected results of this study include guides insight into: (1) experience-safety relevant observed physical changes in guided regions (i.e. glacial coverage, permafrost coverage, precipitation, temperature, and slope instability) (2) changes in hazards within the guiding environment (i.e. avalanches, rockfall, icefall, forest fires, flooding, and extreme weather events), (3) existing and potential adaptation strategies, and (4) key information and other barriers for adaptation. By gaining insight from the knowledge of mountain guides, this research can help the tourism industry at large understand climate risk and create adaptation strategies to ensure the resiliency of the adventure tourism industry.

Keywords: adventure tourism, climate change, environmental change, mountain hazards

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Authors: Leixuri Aguirre, Iñaki Milton-Laskibar, Elizabeth Hijona, Luis Bujanda, Agnes M. Rimando, Maria P. Portillo

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Introduction: In recent years great attention has been paid by scientific community to phenolic compounds as active biomolecules naturally present in foodstuffs due to their beneficial effects on health. Pterostilbene is a resveratrol dimethylether derivative which shows higher biodisponibility. Objective. To analyze the effects of two doses of pterostilbene on several markers of thermogenic capacity in a model of genetic obesity, which shows reduced thermogenesis. Methods: The experiment was conducted with thirty Zucker (fa/fa) rats that were distributed in 3 experimental groups, the control group and two groups orally administered with pterostilbene at 15 and 30 mg/kg body weight/day for 6 weeks. Gene expression of Ucp1, Pgc-1α, Cpt1b, Pparα, Nfr1, Tfam and Cox-2 were assessed by RT-PCR, protein expression of UCP1 and GLUT4 by western blot and enzyme activity of carnitine palmitoyl transferase 1b and citrate synthase by spectrophotometry in interscapular brown adipose tissue (iBAT). Statistical analysis was performed by using one way ANOVA and Newman-Keuls as post-hoc test. Results: Pterostilbene did not change gene expression of Pgc-1α. However, significant increases were found in the expression of Ucp1, Pparα, Nfr-1 and Cox-2. Protein expression of UCP1 and GLUT4 was increased in animals treated with pterostilbene, as well as the activities of CPT-1b and CS. These effects were observed with both doses of pterostilbene, without differences between them. Conclusions: These results show that pterostilbene increases thermogenic and oxidative capacity of brown adipose tissue in obese rats. Whether these effects effectively contribute to the anti-obesity properties of these compound needs further research. Acknowledgments: MINECO-FEDER (AGL2015-65719-R), Basque Government (IT-572-13), University of the Basque Country (ELDUNANOTEK UFI11/32), Institut of Health Carlos III (CIBERobn). Iñaki Milton is a fellowship from the Basque Government.

Keywords: brown adipose tissue, pterostilbene, thermogenesis, uncoupling protein 1

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Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric

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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.

Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage

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Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

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Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

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Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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Authors: Sara Khan Mohammadi

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The world is facing a major challenge of feeding a growing population while ensuring the sustainability of food systems. The United Nations estimates that the global population will reach 9.7 billion by 2050, which means that food production needs to increase by 70% to meet the demand. However, this increase in food production should not come at the cost of environmental degradation, loss of biodiversity, and climate change. Therefore, there is a need for sustainable food systems that can provide healthy and nutritious food while minimizing their impact on the environment. Nutrition and Food Engineering: Nutrition and food engineering play a crucial role in promoting sustainable food system. Nutrition is concerned with the study of nutrients in foods, their absorption, metabolism, and their effects on health. Food engineering involves the application of engineering principles to design, develop, and optimize food processing operations. Together, nutrition and food engineering can help to create sustainable food systems by: 1. Developing Nutritious Foods: Nutritionists and food engineers can work together to develop foods that are rich in nutrients such as vitamins, minerals, fiber, and protein. These foods can be designed to meet the nutritional needs of different populations while minimizing waste. 2. Reducing Food Waste: Food waste is a major problem globally as it contributes to greenhouse gas emissions and wastes resources such as water and land. Nutritionists and food engineers can work together to develop technologies that reduce waste during processing, storage, transportation, and consumption. 3. Improving Food Safety: Unsafe foods can cause illnesses such as diarrhea, cholera, typhoid fever among others which are major public health concerns globally. Nutritionists and food engineers can work together to develop technologies that improve the safety of foods from farm to fork. 4. Enhancing Sustainability: Sustainable agriculture practices such as conservation agriculture can help reduce soil erosion while improving soil fertility. Nutritionists and food engineers can work together to develop technologies that promote sustainable agriculture practices.

Keywords: sustainable food, developing food, reducing food waste, food safety

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Authors: Cory B. Portner, Julie A. Grauert, Lisa M. Stromme, Shelby D. Anderson, Franji H. Mayes

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Introduction: WASHINGTON state in the Pacific Northwest of the United States is internationally known for its technology industry, fisheries, agriculture, and vistas. On January 21, 2020, Washington state also became known as the first state with a confirmed COVID-19 case in the United States, thrusting the state into the international spotlight as the world came to grips with the global threat of this disease presented. Tourism is Washington state’s fourth-largest industry. Tourism to the state generates over 1.8 billion dollars (USD) in local and state tax revenue and employs over 180,000 people. Communicating with residents, stakeholders, and visitors on the status of disease activity, prevention measures, and response updates was vital to stopping the pandemic and increasing compliance and awareness. Significance: In order to communicate vital public health updates, guidance implementation, and safety measures to the public, the Washington State Department of Health established routine live virtual media briefings to reach audiences via social media, internet television, and broadcast television. Through close partnership with regional broadcast news stations and the state public affairs news network, the Washington State Department of Health hosted 95 media briefings from January 2020 through September 2022 and continues to regularly host live virtual media briefings to accommodate the needs of the public and media. Methods: Our methods quickly evolved from hosting briefings in the cement closet of a military base to being able to produce and stream the briefings live from any home-office location. The content was tailored to the hot topic of the day and to the reporter's questions and needs. Virtual media briefings hosted through inexpensive or free platforms online are extremely cost-effective: the only mandatory components are WiFi, a laptop, and a monitor. There is no longer a need for a fancy studio or expensive production software to achieve the goal of communicating credible, reliable information promptly. With minimal investment and a small learning curve, facilitators and panelists are able to host highly produced and engaging media availabilities from their living rooms. Results: The briefings quickly developed a reputation as the best source for local and national journalists to get the latest and most factually accurate information about the pandemic. In the height of the COVID-19 response, 135 unique media outlets logged on to participate in the briefing. The briefings typically featured 4-5 panelists, with as many as 9 experts in attendance to provide information and respond to media questions. Preparation was always a priority: Public Affairs staff for the Washington State Department of Health produced over 170 presenter remarks, including guidance on talking points for 63 expert guest panelists. Implication For Practice: Information is today’s most valuable currency. The ability to disseminate correct information urgently and on a wide scale is the most effective tool in crisis communication. Due to our role as the first state with a confirmed COVID-19 case, we were forced to develop the most accurate and effective way to get life-saving information to the public. The cost-effective, web-based methods we developed can be applied in any crisis to educate and protect communities under threat, ultimately saving lives from a laptop.

Keywords: crisis communications, public relations, media management, news media

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Authors: Chandra Shekhar Majumder, Orin Sultana Jamie

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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.

Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction

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Authors: Spencer Liu, William Chan, Marlena Komatz, Tommy Ramos, Mark Trentalange, Faye Rim, Dae Kim, Mary Kelly, Samuel Schuessler, Roberta Stack, Justas Lauzadis, Kathryn DelPizzo, Seth Waldman, Alexandra Sideris

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Background & Significance: The increasing prevalence of cannabis use in the United States has important safety considerations in the perioperative setting, as chronic or heavy preoperative cannabis use may increase the risk of intraoperative complications, postoperative nausea and vomiting (PONV), increased postoperative pain levels, and acute side effects associated with cannabis use cessation. In this retrospective chart review study, we sought to determine the prevalence of self-reported cannabis use in the past 5-years at a single institution in New York City. We hypothesized that there is an increasing prevalence of preoperative self-reported cannabis use among adult and adolescent patients undergoing orthopedic surgery. Methods: After IRB approval for this retrospective study, surgical cases performed on patients 12 years of age and older at the hospital’s main campus and two ambulatory surgery centers between January 1st, 2018, and December 31st, 2023, with preoperatively self-disclosed cannabis use entered in the social history intake form were identified using the tool SlicerDicer in Epic. Case and patient characteristics were extracted, and trends in utilization over time were assessed by the Cochran-Armitage trend test. Results: Overall, the prevalence of self-reported cannabis use increased from 6.6% in 2018 to 10.6% in 2023. By age group, the prevalence of self-reported cannabis use among adolescents remained consistently low (2018: 2.6%, 2023: 2.6%) but increased with significant evidence for a linear trend (p < 0.05) within every adult age group. Among adults, patients who were 18-24 years old (2018: 18%, 2023: 20.5%) and 25-34 years old (2018: 15.9%, 2023: 24.2%) had the highest prevalences of disclosure, whereas patients who were 75 years of age or older had the lowest prevalence of disclosure (2018: 1.9%, 2023: 4.6%). Patients who were 25-34 years old had the highest percent difference in disclosure rates of 8.3%, which corresponded to a 52.2% increase from 2018 to 2023. The adult age group with the highest percent change was patients who were 75 years of age or older, with a difference of 2.7%, which corresponded to a 142.1% increase from 2018 to 2023. Conclusions: These trends in preoperative self-reported cannabis use among patients undergoing orthopedic surgery have important implications for perioperative care and clinical outcomes. Efforts are underway to refine and standardize cannabis use data capture at our institution.

Keywords: orthopedic surgery, cannabis, postoperative pain, postoperative nausea

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Authors: Zahraa Albasry, Hadeel D. Najim, Anmar Al-Taie

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Background: Hypertension is considered as one of the most important causes of cardiovascular complications and one of the leading causes of worldwide mortality. Identifying the potential risk factors associated with this medical health problem plays an important role in minimizing its incidence and related complications. The objective of this study is to explore the prevalence of receptor sensitivity regarding assess and understand the perception of specific predictive confounding factors on the prevalence of hypertension (HT) among a sample of Iraqi population in Baghdad, Iraq. Materials and Methods: A randomized cross sectional study was carried out on 100 adult subjects during their visit to the outpatient clinic at a certain sector of Baghdad Province, Iraq. Demographic, clinical and health records alongside specific screening and laboratory tests of the participants were collected and analyzed to detect the potential of confounding factors on the prevalence of HT. Results: 63% of the study participants suffered from HT, most of them were female patients (P < 0.005). Patients aged between 41-50 years old significantly suffered from HT than other age groups (63.5%, P < 0.001). 88.9% of the participants were obese (P < 0.001) and 47.6% had diabetes with HT. Positive family history and sedentary lifestyle were significantly higher among all hypertensive groups (P < 0.05). High salt and fatty food intake was significantly found among patients suffered from isolated systolic hypertension (ISHT) (P < 0.05). A significant positive correlation between packed cell volume (PCV) and systolic blood pressure (SBP) (r = 0.353, P = 0.048) found among normotensive participants. Among hypertensive patients, a positive significant correlation found between triglycerides (TG) and both SBP (r = 0.484, P = 0.031) and diastolic blood pressure (DBP) (r = 0.463, P = 0.040), while low density lipoprotein-cholesterol (LDL-c) showed a positive significant correlation with DBP (r = 0.443, P = 0.021). Conclusion: The prevalence of HT among Iraqi populations is of major concern. Further consideration is required to detect the impact of potential risk factors and to minimize blood pressure (BP) elevation and reduce the risk of other cardiovascular complications later in life.

Keywords: Correlation, Hypertension, Iraq, Risk factors

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Authors: Binaya Tamang, Buddhi R. Pokharel, Narayan Gautam, Puspa R. Dhakal, Yuresh Twayana

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Background and Objective: Microalbuminuria is often regarded as a sign of end-organ damage due to hypertension, with an increased risk for renal diseases. The present study was designed to find the prevalence of microalbuminuria in hypertensive patients by determining albumin creatinine ratio (ACR) and the association of ACR and microalbuminuria status with different stages and duration of hypertension (HTN). Also, to establish the correlation of systolic and diastolic blood pressure (SBP and DBP) with various parameters viz; ACR, urinary microalbumin (UMA), estimated glomerular filtration rate (eGFR), urinary creatinine (Ucreat), serum creatinine (Screat), and find out their significance among HTN and ACR status. Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Internal Medicine, UCMS, Bhairahawa, Nepal from April 2019 to September 2019 after obtaining ethical approval from institutional review committee (IRC), UCMS. A total of 120 hypertensive patients were enrolled whose blood, and spot urine samples were taken. eGFR was calculated by using Cockcroft-Gault formula after determining Screat while ACR was calculated after measuring Ucreat and UMA from the spot urine sample. Creatinine was estimated from modified jaffes’ reaction, whereas urinary micro albumin was done by Mispa i3 analyzer. Data were analyzed by using SPSS. 20 using p-value ≤ 0.05 as statistically significant. Results: In our study, the highest enrolled were grade II HTN (36.7%) followed by normal (33.3%), grade I (20.8%) and grade III (9.2%). Evaluating the ACR status, 19.2% were microalbuminuria, and the rest were normal. Though the ACR status (normal and microalbuminuria) was not statistically significant with HTN status (P=0.860) and the duration of HTN status (P=0.165), 5 (45.5%) out of 11 grade III HTN were microalbuminuria and the prevalence was also higher for longer duration .i.e., more than 10 years. In microalbuminuria, both the SBP (p=0.023, r=0.471) and DBP (P=0.034, r= 0.444) were strongly and positively correlated with Screat, in contrast to eGFR, which was negatively but weakly correlated. With the significant difference between the HTN group, the mean ACR (P=0.047) and UMA (P=0.02) were found to be highest among grade III patients, i.e., 84.3 ± 113.3 mg/gm. and 88.4 ± 83.9 mg/l respectively. The mean eGFR (64.2 ± 24.8 vs 77.2 ± 18.1 ml/min) was considerably lower in microalbuminuria ( p=0.026) than the normal in contrast to the SBP (160 ± 33.7 vs. 146.6 ± 19.5 mm of Hg) which was significantly higher (P=0.008). Among the different BMI category, the mean ACR was found to be significantly different (P= 0.01) with the highest value in underweight (115.2 ± 51.5 mg/gm.) and lowest in overweight (31.8 ± 4.3 mg/gm.). Conclusion: The study recommends that the microalbuminuria can be a very useful and imperative predictor of deranged kidney functions in hypertensive patients. The high value of ACR and UMA in hypertensive patients along with significant increased Screat, SBP whereas decreased eGFR in microalbuminuria patients explicitly supports the above statement.

Keywords: albumin creatinine ratio, hypertension, microalbuminuria, renal disease

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Authors: John Peter Dacanay, Edison Ramos, Cristopher James Dicang

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Waste management is a global concern due to increasing waste production from changing consumption patterns and population growth. Proper waste disposal management is a critical aspect of public health and environmental protection. In the healthcare industry, medical waste is generated in large quantities, and if not disposed of properly, it poses a significant threat to human health and the environment. Efficient waste management conserves natural resources and prevents harm to human health, and implementing an effective waste management system can save human lives. The study aimed to assess the level of awareness and practices on waste disposal management, highlighting the understanding of proper disposal, potential hazards, and environmental implications among Medical Technology students. This would help to provide more recommendations for improving waste management practices in healthcare settings as well as for better waste management practices in educational institutions. From the collected data, a female of 21 years of age stands out among the respondents. With the frequency and percentage of medical technology students' knowledge of laboratory waste management being high, it indicates that all respondents demonstrated a solid understanding of proper disposal methods, regulations, risks, and handling procedures related to laboratory waste. That said, the findings emphasize the significance of education and awareness programs in equipping individuals involved in laboratory practices with the necessary knowledge to handle and dispose of hazardous and infectious waste properly. Most respondents demonstrate positive practices or are highly mannered in laboratory waste management, including proper segregation and disposal in designated containers. However, there are concerns about the occasional mixing of waste types, emphasizing the reiteration of proper waste segregation. Students show a strong commitment to using personal protective equipment and promptly cleaning up spills. Some students admit to improper disposal due to rushing, highlighting the importance of time management and safety prioritization. Overall, students follow protocols for hazardous waste disposal, indicating a responsible approach. The school's waste management system is perceived as adequate, but continuous assessment and improvement are necessary. Encouraging reporting of issues and concerns is crucial for ongoing improvement and risk mitigation. The analysis reveals a moderate positive relationship between the respondents' knowledge and practices regarding laboratory waste management. The statistically significant correlation with a p-value of 0.26 (p-value 0.05) suggests that individuals with higher levels of knowledge tend to exhibit better practices. These findings align with previous research emphasizing the pivotal role of knowledge in influencing individuals' behaviors and practices concerning laboratory waste management. When individuals possess a comprehensive understanding of proper procedures, regulations, and potential risks associated with laboratory waste, they are more inclined to adopt appropriate practices. Therefore, fostering knowledge through education and training is essential in promoting responsible and effective waste management in laboratory settings.

Keywords: waste disposal management, knowledge, attitude, practices

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Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles

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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.

Keywords: general surgery, telemedicine, patient satisfaction, patient safety

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Authors: Mohammad Ehsani, Elham Karimi, Hashem Koozechian

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Aim: The purpose of current semi-experimental study was a survey on effect of 16 week walking on psychosocial function related quality of life among 60 to 75 years old men. Methodology: For this reason, short from of health – related quality of life questionnaire (SF – 36) and Geriatric Depression Scale (GDS) had been distributed to the subjects at 2 times of pre – test and posttest. Statistical sample of current study was 60 to 75 years old men who placed at Kahrizak house and assessed by considering physically and medical background. Also factors of entrance to the intervention like age range, have satisfaction and have intent to participating in walking program, lack of having diabetic, cardiovascular, Parkinsonism diseases and postural, neurological, musculoskeletal disorders, lack of having clinical background like visual disorders or disordering on equilibrium system, lack of motor limitation, foot print disorders, having surgery and mental health had been determined and assessed. Finally after primary studies, 80 persons selected and categorized accidentally to the 3 experimental group (1, 2, 3 sessions per week, 30 min walking with moderate intension at every sessions) and one control group (without physical activity in period of 16 weeks). Data analysed by employing ANOVA, Pearson coefficient and Scheffe Post – Hoc tests at the significance level of p < 0.05. Results: Results showed that psychosocial function of men with 60 to 75 years old increase by influence of 16 week walking and increase of exercise sessions lead to more effectiveness of walking. Also there was no significant difference between psychosocial function of subjects within 1 session and 3 sessions experimental groups (p > 0.05). Conclusion: On the basis of results, we can say that doing regular walking with efficient and standard dosage for elderly people, can increase their quality of life. Furthermore, designing and action operation regular walking program for elderly men on the basis of special, logical and systematic pattern under the supervision of aware coaches have been recommended on the basis of results.

Keywords: walking, quality of life, psychosocial function, elders

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Authors: Dimuthu Manage

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Introduction: The prevalence of obesity and obesity-related non-communicable diseases are becoming a massive health concern in the whole world. Physical activity is recognized as an effective solution for this matter. The published data on the effectiveness of High-Intensity Interval Training (HIIT) in improving health parameters in overweight and obese individuals in Sri Lanka is sparse. Hence this study is conducted. Methodology: This is a quasi-experimental study that was conducted at the Sports medicine clinic, General Hospital, Kalutara. Participants have engaged in a programme of HIIT three times per week for six weeks. Data collection was based on precise measurements by using structured and validated methods. Ethical clearance was obtained. Results: Registered number for the study was 48, and only 52% have completed the study. The mean age was 32 (SD=6.397) years, with 64% males. All the anthropometric measurements which were assessed (i.e. waist circumference(P<0.001), weight(P<0.001) and BMI(P<0.001)), body fat percentage(P<0.001), VO2 max(P<0.001), and lipid profile (ie. HDL(P=0.016), LDL(P<0.001), cholesterol(P<0.001), triglycerides(P<0.010) and LDL: HDL(P<0.001)) had shown statistically significant improvement after the intervention with the HIIT programme. Conclusions: This study confirms HIIT as a time-saving and effective exercise method, which helps in preventing obesity as well as non-communicable diseases. HIIT ameliorates body anthropometry, fat percentage, cardiopulmonary status, and lipid profile in overweight and obese individuals markedly. As with the majority of studies, the design of the current study is subject to some limitations. The first is the study focused on a correlational study. If it is a comparative study, comparing it with other methods of training programs would have given more validity. Although the validated tools used to measure variables and the same tools used in pre and post-exercise occasions with the available facilities, it would have been better to measure some of them using gold-standard methods. However, this evidence should be further assessed in larger-scale trials using comparative groups to generalize the efficacy of the HIIT exercise program.

Keywords: HIIT, lipid profile, BMI, VO2 max

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Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

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Authors: Rohit Kothari

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Background: Leprosyis a chronic granulomatous diseasecaused by Mycobacterium leprae (M. Lepra). Reactions may interrupt its usual chronic course.Type-1 (T1R)and type-2 lepra reaction(T2R) are acute events and signifytype-IV and type-III hypersensitivity responses, respectively. Various chemokines like CCL3, 5, 11, and CCL24 may be increased during the course of leprosy or during reactions and may serve as markers of early diagnosis, response to therapy, and prognosis. Objective: To find correlation of CCL3, 5, 11, and CCL24 in leprosy patients on multidrug therapy and their family contacts after ruling out active disease during leprosy treatment and during periods of lepra reactions. Methodology: This randomized control trial was conducted in 50 clinico-histopathologically diagnosed cases of leprosy in a tertiary care hospital in Bengaluru, India. 50 of their family contacts were adequately examined and investigated should the need be to rule out active disease. The two study-groups comprised of leprosy cases, and the age, sex, and area of residence matched healthy contactswho were given single-dose rifampicin prophylaxis, respectively. Blood samples were taken at baseline, six months, and after one yearin both the groups (on completion of MDT in leprosy cases)and also during periods of reaction if occurred in leprosy cases. Results: Our study found that at baseline, CCL5, 11, and 24 were higher in leprosy cases as compared to the healthy contacts, and the difference was statistically significant.CCL3 was also found to be higherat baseline in leprosy cases, however, the difference was not statistically significant. At six months and one year, the levels of CCL 5, 11, and 24 reduced, and the difference was statistically significant in leprosy cases, whereas it remained almost static in all the healthy contacts. Twenty patients of leprosy developed lepra reaction during the course of one year, and during reaction, the increase in CCL11 and 24 was statistically significant from baseline, whereas CCL3 and 5 did not rise significantly. One of the healthy contacts developed signs of leprosy in the form of hypopigmented numb patch and was clinico-histopathologically, and CCL11 and 24 were found to be higher with a statistically significant difference from the baseline values. Conclusion: CCL5, 11, and 24 are sensitive markers of diagnosing leprosy, response to MDT, and prognosis and are not increased in healthy contacts. CCL11 and 24 are sensitive markers of lepra reactions and may serve as one of the early diagnostic modalities for identifying lepra reaction and also leprosy in healthy contacts. To the best of our knowledge, this is the first study to evaluate these biomarkers in leprosy cases and their healthy contacts with a follow-up of upto one year with one of them developing the disease, and the same was confirmed based on these biomarkers as well.

Keywords: chemokine profile, healthy contacts, leprosy, lepra reactions

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Authors: Warnakulasuriya Arachichige Malisha Ann Rosary Fernando, Udalamatta Gamage Omila Chalanka Jinadasa, Bihini Pabasara Amandi Amarasinghe, Manul Thisuraka Mandalawatta, Uthpala Samarakoon, Manori Gamage

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The surge in sexually transmitted diseases (STDs) has become a critical public health crisis demanding urgent attention and action. Like many other nations, Sri Lanka is grappling with a significant increase in STDs due to a lack of education and awareness regarding their dangers. Presently, the available applications for tracking and managing STDs cover only a limited number of easily detectable infections, resulting in a significant gap in effectively controlling their spread. To address this gap and combat the rising STD rates, it is essential to leverage technology and data. Employing technology to enhance the tracking and management of STDs is vital to prevent their further propagation and to enable early intervention and treatment. This requires adopting a comprehensive approach that involves raising public awareness about the perils of STDs, improving access to affordable healthcare services for early detection and treatment, and utilizing advanced technology and data analysis. The proposed mobile application aims to cater to a broad range of users, including STD patients, recovered individuals, and those unaware of their STD status. By harnessing cutting-edge technologies like image detection, symptom-based identification, prevention methods, doctor and clinic recommendations, and virtual counselor chat, the application offers a holistic approach to STD management. In conclusion, the escalating STD rates in Sri Lanka and across the globe require immediate action. The integration of technology-driven solutions, along with comprehensive education and healthcare accessibility, is the key to curbing the spread of STDs and promoting better overall public health.

Keywords: STD, machine learning, NLP, artificial intelligence

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Authors: Genziana Lay

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A wide majority of older children and adolescents who enter the juvenile court system present with an array of problematic symptoms and behaviors including anxiety, depression, aggressive acting out, detachment, and substance abuse. Attachment theory offers a framework for understanding normative and pathological functioning, which during development is influenced by emotional, social and cognitive elements. There is clear evidence that children and adolescents with the highest risk of developing adaptation problems present an insecure attachment profile. Most offending minors have experienced dysfunctional family relationships as well as social and/or economic deprivation. Their maladaptive attachment develops not only through their relationship with caregivers but with the environment at large. Activation of their faulty attachment system leads them to feel emotionally overwhelmed and engage in destructive behaviors and decision-making. A psycho-social intervention with this population conceptualized as attachment therapy is a multi-faceted, practical approach that has shown excellent results in terms of increased psychological well-being and drastically reduced rates of re-offense/ destructive behavior. Through several; components including psychotherapy, monitoring, volunteering, meditation and socialization, the program focuses on seven dimensions: self-efficacy, responsibility, empathy/reparation, autonomy/security, containment/structure, insight building, and relational health. This paper presents the program and illustrates how the framework of attachment theory practically applied to psycho-social intervention has great therapeutic and social reparation potential. Preliminary evidence drawn from the Sassari Juvenile Court is very promising; this paper will illustrate these results and propose an even more comprehensive, applicable approach to psycho-social reparative intervention that leads to greater psychological health and reduced recidivism in the child and adolescent population.

Keywords: attachment, child, adolescent, crime, juvenile, psychosocial

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Authors: Cristobal García

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The visual inspection of bolted joints in wind turbines is dangerous, expensive, and impractical due to the non-possibility to access the platform by workboat in certain sea state conditions, as well as the high costs derived from the transportation of maintenance technicians to offshore platforms located far away from the coast, especially if helicopters are involved. Consequently, the wind turbine operators have the need for simpler and less demanding techniques for the analysis of the bolts tightening. Vibration-based structural health monitoring is one of the oldest and most widely-used means for monitoring the health of onshore and offshore wind turbines. The core of this work is to find out if the modal parameters can be efficiently used as a key performance indicator (KPIs) for the assessment of joint bolts in a 1:50 scale tower of a floating offshore wind turbine (12 MW). A non-destructive vibration test is used to extract the vibration signals of the towers with different damage statuses. The procedure can be summarized in three consecutive steps. First, an artificial excitation is introduced by means of a commercial shaker mounted on the top of the tower. Second, the vibration signals of the towers are recorded for 8 s at a sampling rate of 20 kHz using an array of commercial accelerometers (Endevco, 44A16-1032). Third, the natural frequencies, damping, and overall vibration mode shapes are calculated using the software Siemens LMS 16A. Experiments show that the natural frequencies, damping, and mode shapes of the tower are directly dependent on the fixing conditions of the towers, and therefore, the variations of both parameters are a good indicator for the estimation of the static axial force acting in the bolt. Thus, this vibration-based structural method proposed can be potentially used as a diagnostic tool to evaluate the tightening torques of the bolted joints with the advantages of being an economical, straightforward, and multidisciplinary approach that can be applied for different typologies of connections by operation and maintenance technicians. In conclusion, TSI, in collaboration with the consortium of the FIBREGY project, is conducting innovative research where vibrations are utilized for the estimation of the tightening torque of a 1:50 scale steel-based tower prototype. The findings of this research carried out in the context of FIBREGY possess multiple implications for the assessment of the bolted joint integrity in multiple types of connections such as tower-to-nacelle, modular, tower-to-column, tube-to-tube, etc. This research is contextualized in the framework of the FIBREGY project. The EU-funded FIBREGY project (H2020, grant number 952966) will evaluate the feasibility of the design and construction of a new generation of marine renewable energy platforms using lightweight FRP materials in certain structural elements (e.g., tower, floating platform). The FIBREGY consortium is composed of 11 partners specialized in the offshore renewable energy sector and funded partially by the H2020 program of the European Commission with an overall budget of 8 million Euros.

Keywords: SHM, vibrations, connections, floating offshore platform

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Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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Authors: Ana Carolina Felizardo Da Silva

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People with disabilities are those who have limitations of a physical, mental, intellectual or sensory nature and who, therefore, should not be excluded or marginalized. In Brazil, the Brazilian Law for the Inclusion of People with Disabilities defines that people with disabilities have the right to culture, sport, tourism and leisure on an equal basis with other people. Sport for people with disabilities, in its genesis, had a character aimed at rehabilitating men and soldiers, that is, the male figure who returned wounded from war and needed care. By gaining practitioners, the marketing issue emerges and, successively, high performance, what we call Paralympic sport. We found that sport for people with disabilities was designed for men, corroborating the social idea that sport is a masculine and masculinizing environment. In this way, the inclusion of women with disabilities in sports becomes a double challenge because they are women and have a disability. From data collected from official documents of the International Paralympic Committee, it is found that the first report on the participation of women in the Paralympic Games was in 1948, in England, in Stoke Mandeville, a championship considered the firstborn of the games, later, became called the “Paralympic Games”. However, due to the lack of information, the return of the appearance of women participating in the Paralympics took place after long 40 years, in 1984, which demonstrates a large gap of records on the official website referring to women in the games. Despite the great challenge, the number of women has been growing substantially. When collecting data from participants of all 16 editions of the Paralympic Games, in its last edition, held in Tokyo, out of 4,400 competing athletes, 1,853 were women, which represents 42% of the total number of athletes. In this same edition, we had the largest delegation of Brazilian women, represented by 96 athletes out of a total of 260 Brazilian athletes. It is estimated that in the next edition, to be taken place in Paris in 2024, the participation of women will equal or surpass that of men. The certain invisibility of women participating in the Paralympic Games is noticed when we access the database of the Brazilian Paralympic Committee website. It is possible to identify all women medalists of a given edition. On the other side, participating female athletes who did not medal are not registered on the site. Regarding the participation of Brazilian women in the Paralympics, there was a considerable growth in the last two editions, in 2012 there were only 69 women participating, going to 102 in 2016 and 96 in 2021. The same happened in relation to the medalists, going from 8 Brazilians in 2012 to 33 in 2016 and 27 in 2021. In this sense, the present study, aims to analyze how Brazilian women participate in the Paralympics, giving visibility and voice to female athletes. Structured interviews are being carried out with the participants of the games, identifying the difficulties and potentialities of participating with athletes in the competition. The analysis will be carried out through Bardin’s content analysis.

Keywords: paralympics, sport for people with disabilities, woman, woman in sport

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Authors: Nasrin Akter, Bilkis Banu, Farhana Faruque, Fatema Afrin, Sujana Haque Chowdhury, Sarder Mahmud Hossain

Abstract:

Objectives: To combat the growing prevalence of hypertension in Bangladesh, it is pivotal to have an in-depth understanding of quality of life (QOL) among hypertensive people. The aim of this study was to measure QOL of hypertensive people and its determinants in a selected tertiary hospital in Dhaka city. Design & Methods: This analytical cross-sectional study was conducted among randomly selected 300 hypertensive patients from two cardiac departments of Square Hospitals Limited. Data were collected through the face-to-face interview method. WHOQOL-BREF questionnaire was used to assess the QOL. Mean scores of quality of life were analyzed through descriptive statistics. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analyses were used to measure the association between QOL domains and independent variables. Results: Both overall QOL and domains had a good internal consistency, (r = 0.13–0.77, p< 0.01). The QOL among hypertensive patients was found to be poor in the psychological (71%) and social (74.7%) domains and good in the environmental (63%) and physical (65%) domains. Backward binary regressions revealed that being older (p=0.01), diabetic (p=0.02), having history of COVID-19 (p=0.01), and poor monthly income (USD ≤853.14) (p=0.01) were significantly associated with poor QOL in all domain. Moreover, older age (p=0.01) and poor lifestyle (p=0.02) were significantly associated with poor overall quality of life and poor general health perception. Conclusion: The results revealed low QOL in the psychological and social domain including significant factors associated with the poor QOL in all domains. To enhance the quality of life for hypertensive patients—especially those who are older, diabetic, have lower incomes, experienced COVID-19, and maintain poor lifestyles—effective interventions and health system strengthening are crucial.

Keywords: quality of life, hypertension, WHOQOL-BREF, analytical cross-sectional study

Procedia PDF Downloads 15

Authors: Ruben Peralta, Sam Thomas, Nazia Hirani, Ayman El-Menyar, Hassan Al-Thani, Mohammed Al-Thani, Mohammed Al-Hajjaj, Rafael Consunji

Abstract:

Moderate to severe work-related injuries [WRI's] are a leading cause of trauma admission in Qatar but information on risk factors for their incidence are lacking. This study aims to document and analyze the predictive characteristics for WRI to inform the creation of targeted interventions to improve worker safety in Qatar. This study was conducted as part of the NPRP grant # 7 - 1120 - 3 - 288, titled "A Unified Registry for Occupational Injury Prevention in Qatar”. 266 workers were interviewed using a standard questionnaire, during ‘World Day for Safety and Health at Work’, a Ministry of Public Health event, none refused interview. Nurses and doctors from the Hamad Trauma Center conducted the interviews. Questions were translated into the worker’s native language when it was deemed necessary. Standard information on epidemiologic characteristics and incidence of work-related injury were collected and compared between nationalities and those injured versus those not injured. 262 males and 4 females were interviewed. 17 [6.4%] reported a WRI in the last 24 months. More than half of the injured worked in construction [59%] followed by water supply [11.8%]. Factors significantly associated with recent injury were: Working for a company with > 500 employees and speaking Hindi. Protective characteristics included: Being from the Philippines or Sri Lanka, speaking Arabic, working in healthcare, an office or trading and company size between 100-500 employees. Years of schooling and working in Qatar were not predictive factor for WRI. The findings from this survey should guide future research that will better define worker populations at an increased risk for WRI and inform recruiters and sending countries. A focus on worker language skills, interventions in the construction industry and occupational safety in large companies is needed.

Keywords: occupational injury, prevention, safety, trauma, work related injury

Procedia PDF Downloads 323