Search results for: community health

Authors: Tahsen Abdalwahab Ibraheem Albehege

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Exhaust fuel purification is of great importance to prevent the emission of major pollutants into the atmosphere such as diesel particulates and nitrogen oxides and meet environmental regulations, so environmental impacts are a primary concern of Diesel Exhaust Gas (DEG) which contains hazardous substances harmful to the environment as well as human health.We can not plasma formed through directing electrical energy to create free electrons, which in turn can react with gaseous species, but we can by used to treat engine exhaust gases. . By NO that has been reportedly oxidized to HNO3 and then into ammonium nitrate, and then condensed and removed. In general, thermal plasmas are formed by heating a system to high temperatures 2,000 degrees C, however this can be inefficient and can require extensive thermal management.

Keywords: plasma system application, project physics, oxidizing environment, electromagnetically

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Authors: Ruswanto Ruswanto, Richa Mardianingrum, Tita Nofianti, Nur Rahayuningsih

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Tuberculosis (TB) is a chronic disease as a result of Mycobacterium tuberculosis. It can affect all age groups, and hence, is a global health problem that causes the death of millions of people every year. One of the drugs used in tuberculosis treatment is isonicotinohydrazide. In this study, N'-benzoylisonicotinohydrazide derivative compounds (a-l) were prepared using acylation reactions between isonicotinohydrazide and benzoyl chloride derivatives, through the reflux method. Molecular docking studies suggested that all of the compounds had better interaction with Mycobacterium tuberculosis enoyl-acyl carrier protein reductase (InhA) than isonicotinohydrazide. It can be concluded that N'-benzoylisonicotinohydrazide derivatives (a-l) could be used as anti-tuberculosis candidates. From the docking results revealed that all of the compounds interact well with InhA, with compound g (N'-(3-nitrobenzoyl)isonicotinohydrazide) exhibiting the best interaction.

Keywords: anti-tuberculosis , docking, InhA, N'-benzoylisonicotinohydrazide, synthesis

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Authors: Chinelo Igwenagu

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Teenage childbearing in developing countries has been a thing of great concern as it has often led to a number of socioeconomic problems both to the society and to the families affected. The outcome of teenage pregnancy has been generally associated with higher rates of maternal morbidity and mortality, greater risks for delivery complications, low-birth weight infants and child mortality. As a result of teenagers’ physiological and social immaturity and their lack of adequate prenatal care, health risks associated with their pregnancies and childbearing are more pronounced than those of older women. Therefore this study has examined the relationship between the age of teenagers and the outcome of teenage pregnancy. Based on this study, the result of the analysis shows that both teenagers and older mothers suffer similarly during child bearing. Hence improve medical care is paramount in all the situations.

Keywords: childbearing, mortality, Nigeria, pregnancy, prematurity, teenagers

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Authors: M. Bouzid, A. Djadi, C. Aribi, A. Irekti, B. Bezzazi, F. Halouene

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The nature of materials structuring our health institutions promote the development of germs. The sustainability of nosocomial infections remains significant (12% and 15%). One of the major factors is the portland cement which is brittle and porous. As part of a national plan to fight nosocomial infections, led by the University Hospital of Blida, we opted for a composite coating, application by multilayer model, composed of epoxy-polyester resin as a binder and calcium carbonate as mineral fillers. The application of composite materials reinforce the wall coating of hospital units and eliminates the hospital infectious areas. The resistance to impact, chemicals, raising temperature and to a biologically active environment gives satisfactory results.

Keywords: nosocomial infection, microbial load, composite materials, portland cement

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Authors: Edvard P. G. Bruun

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One of the best ways of improving our understanding of reinforced concrete is through large-scale experimental testing. The gathered information is critical in making inferences about structural mechanics and deriving the mathematical models that are the basis for finite element analysis programs and design codes. An effective way of measuring the strains across a region of a specimen is by using a system of surface mounted Linear Variable Differential Transformers (LVDTs). While a single LVDT can only measure the linear strain in one direction, by combining several measurements at known angles a Mohr’s circle of strain can be derived for the whole region under investigation. This paper presents a method that can be used by researchers, which improves the accuracy and removes experimental bias in the calculation of the Mohr’s circle, using four rather than three independent strain measurements. Obtaining high quality strain data is essential, since knowing the angular deviation (shear strain) and the angle of principal strain in the region are important properties in characterizing the governing structural mechanics. For example, the Modified Compression Field Theory (MCFT) developed at the University of Toronto, is a rotating crack model that requires knowing the direction of the principal stress and strain, and then calculates the average secant stiffness in this direction. But since LVDTs can only measure average strains across a plane (i.e., between discrete points), localized cracking and spalling that typically occur in reinforced concrete, can lead to unrealistic results. To build in redundancy and improve the quality of the data gathered, the typical experimental setup for a large-scale shell specimen has four independent directions (X, Y, H, and V) that are instrumented. The question now becomes, which three should be used? The most common approach is to simply discard one of the measurements. The problem is that this can produce drastically different answers, depending on the three strain values that are chosen. To overcome this experimental bias, and to avoid simply discarding valuable data, a more rigorous approach would be to somehow make use of all four measurements. This paper presents the derivation of a method to draw what is effectively a Mohr’s circle of 'best-fit', which optimizes the circle by using all four independent strain values. The four-strain optimized Mohr’s circle approach has been utilized to process data from recent large-scale shell tests at the University of Toronto (Ruggiero, Proestos, and Bruun), where analysis of the test data has shown that the traditional three-strain method can lead to widely different results. This paper presents the derivation of the method and shows its application in the context of two reinforced concrete shells tested in pure torsion. In general, the constitutive models and relationships that characterize reinforced concrete are only as good as the experimental data that is gathered – ensuring that a rigorous and unbiased approach exists for calculating the Mohr’s circle of strain during an experiment, is of utmost importance to the structural research community.

Keywords: reinforced concrete, shell tests, Mohr’s circle, experimental research

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Authors: Sinisa J. Vukicevic

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Edmonton is currently one of the youngest North American cities and has achieved significant growth over the past 40 years. Strong urban shift requires a new approach to how the city is envisioned, planned, and built. This approach is evidence-based scenario development, and an urban growth model was a key support tool in framing Edmonton development strategies, developing urban policies, and assessing policy implications. The urban growth model has been developed using the Metronamica software platform. The Metronamica land use model evaluated the dynamic of land use change under the influence of key development drivers (population and employment), zoning, land suitability, and land and activity accessibility. The model was designed following the Big City Moves ideas: become greener as we grow, develop a rebuildable city, ignite a community of communities, foster a healing city, and create a city of convergence. The Big City Moves were converted to three development scenarios: ‘Strong Central City’, ‘Node City’, and ‘Corridor City’. Each scenario has a narrative story that expressed scenario’s high level goal, scenario’s approach to residential and commercial activities, to transportation vision, and employment and environmental principles. Land use demand was calculated for each scenario according to specific density targets. Spatial policies were analyzed according to their level of importance within the policy set definition for the specific scenario, but also through the policy measures. The model was calibrated on the way to reproduce known historical land use pattern. For the calibration, we used 2006 and 2011 land use data. The validation is done independently, which means we used the data we did not use for the calibration. The model was validated with 2016 data. In general, the modeling process contain three main phases: ‘from qualitative storyline to quantitative modelling’, ‘model development and model run’, and ‘from quantitative modelling to qualitative storyline’. The model also incorporates five spatial indicators: distance from residential to work, distance from residential to recreation, distance to river valley, urban expansion and habitat fragmentation. The major finding of this research could be looked at from two perspectives: the planning perspective and technology perspective. The planning perspective evaluates the model as a tool for scenario development. Using the model, we explored the land use dynamic that is influenced by a different set of policies. The model enables a direct comparison between the three scenarios. We explored the similarities and differences of scenarios and their quantitative indicators: land use change, population change (and spatial allocation), job allocation, density (population, employment, and dwelling unit), habitat connectivity, proximity to objects of interest, etc. From the technology perspective, the model showed one very important characteristic: the model flexibility. The direction for policy testing changed many times during the consultation process and model flexibility in applying all these changes was highly appreciated. The model satisfied our needs as scenario development and evaluation tool, but also as a communication tool during the consultation process.

Keywords: urban growth model, scenario development, spatial indicators, Metronamica

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Authors: Subham Ghosh, Arnab Nandi

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Background: The proliferation of Wireless Body Area Networks (WBAN) and Internet of Things (IoT) applications demonstrates the potential for continuous monitoring of physical changes in the body. These technologies are vital for health monitoring tasks, such as identifying coughing and breathing activities, which are necessary for disease diagnosis and management. Monitoring activities such as coughing and deep breathing can provide valuable insights into a variety of medical issues. Wearable radio-based antenna sensors, which are lightweight and easy to incorporate into clothing or portable goods, provide continuous monitoring. This mobility gives it a substantial advantage over stationary environmental sensors like as cameras and radar, which are constrained to certain places. Furthermore, using compressive techniques provides benefits such as reduced data transmission speeds and memory needs. These wearable sensors offer more advanced and diverse health monitoring capabilities. Methodology: This study analyzes the feasibility of using a semi-flexible antenna operating at 2.4 GHz (ISM band) and positioned around the neck and near the mouth to identify three activities: coughing, deep breathing, and idleness. Vector network analyzer (VNA) is used to collect time-varying complex reflection coefficient data from perturbed antenna nearfield. The reflection coefficient (S11) conveys nuanced information caused by simultaneous variations in the nearfield radiation of three activities across time. The signatures are sparsely represented with gaussian windowed Gabor spectrograms. The Gabor spectrogram is used as a sparse representation approach, which reassigns the ridges of the spectrogram images to improve their resolution and focus on essential components. The antenna is biocompatible in terms of specific absorption rate (SAR). The sparsely represented Gabor spectrogram pictures are fed into a lightweight deep learning (DL) model for feature extraction and classification. Two antenna locations are investigated in order to determine the most effective localization for three different activities. Findings: Cross-validation techniques were used on data from both locations. Due to the complex form of the recorded S11, separate analyzes and assessments were performed on the magnitude, phase, and their combination. The combination of magnitude and phase fared better than the separate analyses. Various sliding window sizes, ranging from 1 to 5 seconds, were tested to find the best window for activity classification. It was discovered that a neck-mounted design was effective at detecting the three unique behaviors.

Keywords: activity recognition, antenna, deep-learning, time-frequency

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Authors: Marc Romero-Estonllo, Judith Ramos-Castro, Yaiza San Miguel, Beatriz Rodríguez-Garrido, Carmela Monterroso

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Mining activity is among the main sources of trace and heavy metal(loid) pollution worldwide, which is a hazard to human and environmental health. That is why several projects have been emerging for the remediation of such polluted places. Phytomanagement strategies draw good performances besides big side benefits. In this work, a glasshouse assay with trace element polluted soils from an old Cu mine ore (NW of Spain) which forms part of the PhytoSUDOE network of phytomanaged contaminated field sites (PhytoSUDOE Project (SOE1/P5/E0189)) was set. The objective was to evaluate improvements induced by the following phytoremediation-related treatments. Three increasingly complex amendments alone or together with plant growth (Populus nigra L. alone and together with Tripholium repens L.) were tested. And three different rhizosphere bioinocula were applied (Plant Growth Promoting Bacteria (PGP), mycorrhiza (MYC), or mixed (PGP+MYC)). After 110 days of growth, plants were collected, biomass was weighed, and tree length was measured. Physical-chemical analyses were carried out to determine pH, effective Cation Exchange Capacity, carbon and nitrogen contents, bioavailable phosphorous (Olsen bicarbonate method), pseudo total element content (microwave acid digested fraction), EDTA extractable metals (complexed fraction), and NH4NO3 extractable metals (easily bioavailable fraction). On plant material, nitrogen content and acid digestion elements were determined. Amendment usage, plant growth, and bioinoculation were demonstrated to improve soil fertility and/or plant health within the time span of this study. Particularly, pH levels increased from 3 (highly acidic) to 5 (acidic) in the worst-case scenario, even reaching 7 (neutrality) in the best plots. Organic matter and pH increments were related to polluting metals’ bioavailability decrements. Plants grew better both with the most complex amendment and the middle one, with few differences due to bioinoculation. Using the less complex amendment (just compost) beneficial effects of bioinoculants were more observable, although plants didn’t thrive very well. On unamended soils, plants neither sprouted nor bloomed. The scheme assayed in this study is suitable for phytomanagement of these kinds of soils affected by mining activity. These findings should be tested now on a larger scale.

Keywords: aided phytoremediation, mine pollution, phytostabilization, soil pollution, trace elements

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Authors: Fei Wan Ngai

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Background: Family and marital functioning has become an important public health issue because it is vital to child development and well-being. Objective: This study was designed to examine the changes in family and marital functioning among Chinese women during the transition to motherhood. Methods: A longitudinal design was used. A convenience sample of 202 Chinese childbearing women completed the Medical Outcomes Study Family and Marital Functioning Measures during pregnancy, at 6 weeks and at 6 months postpartum. Results: The results showed that women experienced substantial decline in their family and marital functioning from pregnancy to 6 weeks and 6 months postpartum. Conclusions: The findings of this study highlight the need for more attention to family and marital functioning among women after childbirth. Culturally relevant interventions should be developed to assist women in facing the challenges of new motherhood and achieving a better family and marital functioning.

Keywords: family and marital functioning, perinatal period, women

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Authors: B. Lefranc, C. Aufauvre-Poupon, C. Martin-Krumm, M. Trousselard

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Isolated and confined environments (ICE) present several challenges which may adversely affect human’s psychology and physiology. Submariners in Sub-Surface Ballistic Nuclear (SSBN) mission exposed to these environmental constraints must be able to perform complex tasks as part of their normal duties, as well as during crisis periods when emergency actions are required or imminent. The operational and environmental constraints they face contribute to challenge human adaptability. The impact of such a constrained environment has yet to be explored. Establishing a knowledge framework is a determining factor, particularly in view of the next long space travels. Ensuring that the crews are maintained in optimal operational conditions is a real challenge because the success of the mission depends on them. This study focused on the evaluation of the impact of stress on mental health and sensory degradation of submariners during a mission on SSBN using cardiac biosignal (heart rate variability, HRV) clustering. This is a pragmatic exploratory study of a prospective cohort included 19 submariner volunteers. HRV was recorded at baseline to classify by clustering the submariners according to their stress level based on parasympathetic (Pa) activity. Impacts of high Pa (HPa) versus low Pa (LPa) level at baseline were assessed on emotional state and sensory perception (interoception and exteroception) as a cardiac biosignal during the patrol and at a recovery time one month after. Whatever the time, no significant difference was found in mental health between groups. There are significant differences in the interoceptive, exteroceptive and physiological functioning during the patrol and at recovery time. To sum up, compared to the LPa group, the HPa maintains a higher level in psychosensory functioning during the patrol and at recovery but exhibits a decrease in Pa level. The HPa group has less adaptable HRV characteristics, less unpredictability and flexibility of cardiac biosignals while the LPa group increases them during the patrol and at recovery time. This dissociation between psychosensory and physiological adaptation suggests two treatment modalities for ICE environments. To our best knowledge, our results are the first to highlight the impact of physiological differences in the HRV profile on the adaptability of submariners. Further studies are needed to evaluate the negative emotional and cognitive effects of ICEs based on the cardiac profile. Artificial intelligence offers a promising future for maintaining high level of operational conditions. These future perspectives will not only allow submariners to be better prepared, but also to design feasible countermeasures that will help support analog environments that bring us closer to a trip to Mars.

Keywords: adaptation, exteroception, HRV, ICE, interoception, SSBN

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Authors: Ting-I Lin

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Purpose: This article explores the care experience of a 34-year-old female breast cancer patient who was admitted to the intensive care unit after undergoing a modified radical mastectomy. The patient discovered a lump in her right breast during a self-examination and, after mammography and ultrasound-guided biopsy, was diagnosed with a malignant tumor in the right breast. The tumor measured 1.5 x 1.4 x 2 cm, and the patient underwent a modified radical mastectomy. Postoperatively, she exhibited feelings of inferiority due to changes in her appearance. Method: During the care period, we engaged in conversations, observations, and active listening, using Gordon's Eleven Functional Health Patterns for a comprehensive assessment. In collaboration with the critical care team, a psychologist, and an oncology case manager, we conducted an interdisciplinary discussion and reached a consensus on key nursing issues. These included pain related to postoperative tumor excision and disturbed body image due to changes in appearance after surgery. Result: During the care period, a private space was provided to encourage the patient to express her feelings about her altered body image. Communication was conducted through active listening and a non-judgmental approach. The patient's anxiety level, as measured by the depression and anxiety scale, decreased from moderate to mild, and she was able to sleep for 6-8 hours at night. The oncology case manager was invited to provide education on breast reconstruction using breast models and videos to both the patient and her husband. This helped rebuild the patient's confidence. With the patient's consent, a support group was arranged where a peer with a similar experience shared her journey, offering emotional support and encouragement. This helped alleviate the psychological stress and shock caused by the cancer diagnosis. Additionally, pain management was achieved through adjusting the dosage of analgesics, administering Ultracet 37.5 mg/325 mg 1# Q6H PO, along with distraction techniques and acupressure therapy. These interventions helped the patient relax and alleviate discomfort, maintaining her pain score at a manageable level of 3, indicating mild pain. Conclusion: Disturbance in body image can cause significant psychological stress for patients. Through support group discussions, encouraging patients to express their feelings, and providing appropriate education on breast reconstruction and dressing techniques, the patient's self-concept was positively reinforced, and her emotions were stabilized. This led to renewed self-worth and confidence.

Keywords: breast cancer, modified radical mastectomy, acupressure therapy, Gordon's 11 functional health patterns

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Authors: Hasen Keder Edris, Ryuji Matsunaga, Toshi Yamanaka

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The issue of climate change and its impact is a major contemporary global concern. Ethiopia is one of the countries experiencing adverse climate change impact including frequent extreme weather events that are exacerbating drought and water scarcity. Due to this reason, the government of Ethiopia develops a strategic document which focuses on the climate resilience green economy. One of the major components of the strategic framework is designed to improve community adaptation capacity and mitigation of drought. For effective implementation of the strategy, identification of regions relative vulnerability to drought is vital. There is a growing tendency of applying Geographic Information System (GIS) and Remote Sensing technologies for collecting information on duration and severity of drought by direct measure of the topography as well as an indirect measure of land cover. This study aims to show an application of remote sensing technology and GIS for developing drought vulnerability index by taking lowland of Ethiopia as a case study. In addition, it assesses integrated Information Communication Technology (ICT) potential of Ethiopia lowland and proposes integrated solution. Satellite data is used to detect the beginning of the drought. The severity of drought risk prone areas of livestock keeping pastoral is analyzed through normalized difference vegetation index (NDVI) and ten years rainfall data. The change from the existing and average SPOT NDVI and vegetation condition index is used to identify the onset of drought and potential risks. Secondary data is used to analyze geographical coverage of mobile and internet usage in the region. For decades, the government of Ethiopia introduced some technologies and approach to overcoming climate change related problems. However, lack of access to information and inadequate technical support for the pastoral area remains a major challenge. In conventional business as usual approach, the lowland pastorals continue facing a number of challenges. The result indicated that 80% of the region face frequent drought occurrence and out of this 60% of pastoral area faces high drought risk. On the other hand, the target area mobile phone and internet coverage is rapidly growing. One of identified ICT solution enabler technology is telecom center which covers 98% of the region. It was possible to identify the frequently affected area and potential drought risk using the NDVI remote-sensing data analyses. We also found that ICT can play an important role in mitigating climate change challenge. Hence, there is a need to strengthen implementation efforts of climate change adaptation through integrated Remote Sensing and web based information dissemination and mobile alert of extreme events.

Keywords: climate changes, ICT, pastoral, remote sensing

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Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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Authors: Abiola O. Temitayo-Oboh, Olugbenga L. Abodunrin, Wasiu O. Adebimpe, Micheal C. Asuzu

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Introduction: Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for contraception. In an ideal situation, all women who want to space or limit their births and are exposed to the risk of conception would use some kind of conception; in practice, however, some women fail to use contraception which put them at risk of having mistimed or unwanted births, induced abortion, or maternal death. This study, therefore, aimed to assess the determinants of unmet need for contraception among currently married women in rural and urban communities of Osun State, South-West Nigeria. Methods: This was an analytical cross-sectional comparative study, which was carried out among currently married women. Three hundred and twenty respondents each were selected for the rural and urban groups from four Local Government Areas using multi-stage sampling technique. Data were collected using a pre-tested semi-structured interviewer-administered questionnaire and focus group discussion (FGD) guide; data analysis was done with Statistical Package for Social Sciences (SPSS) version 17.0 and detailed content analysis method respectively. Statistical analysis of the difference between proportions was done by the use of the Chi-square test and T-test was used to compare the means of the continuous variables. The study also utilized descriptive, bivariate and multivariate analytical techniques to examine the effect of some variables on unmet need. Level of statistical significance was set at p-value < 0.05 for all values. Results: Two hundred and ninety-six (92.5%) of the rural and 306 (95.6%) of the urban study population had heard of contraception, 365 (57.0 %) of the total respondents had good knowledge [162 (50.6 %) for rural respondents and 203 (63.4 %) for urban respondents]. This difference was statistically significant (p < 0.001). Five hundred and twenty-one (81.4%) respondents had a positive attitude towards contraception [243 (75.9%) in the rural and 278 (86.9%) in the urban area], and the difference was also statistically significant (p < 0.001). Only 47 (14.7%) and 59 (18.4%) of rural and urban women were current contraceptive users respectively. The total unmet need for contraception among rural women was 138 (43.1%) of which 82 (25.6%) was for spacing and 56 (17.5%), for limiting. While the total unmet need for contraception among urban women was 145 (45.3%) of which 96 (30.0%) was for spacing and 49 (15.3%) for limiting. Number of living children, knowledge of contraceptive methods, discussion with health workers about family planning, couples discussion about family planning and availability of family planning services were found to be predictors of women’s unmet need for contraception (p < 0.05). Conclusion: It is, therefore, recommended that there is need to intensify reproductive health education in bridging the knowledge gap, improving attitude and modifying practices regarding use of contraception in Nigeria. Hence, this will help to enhance the utilization of family planning services among Nigerian women.

Keywords: contraception, married women, Nigeria, rural, urban, unmet need

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Authors: Erika Ruiz, Nestor Ortiz

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Lean philosophy has evolved over time and has been implemented both in manufacturing and services, more recently lean has been integrated in the companies of the health sector. Currently it is important to understand the successful way to implement this philosophy and try to identify barriers and enablers to the sustainability of lean healthcare. The main purpose of this research is to identify the barriers and enablers in the implementation of Lean Healthcare based on case studies of Colombian healthcare centers. In order to do so, we conducted semi-structured interviews based on a maturity model. The main results indicate that the success of Lean implementation depends on its adaptation to contextual factors. In addition, in the Colombian context were identified new factors such as organizational culture, management models, integration of the care and administrative departments and triple helix relationship.

Keywords: barriers, enablers, implementation, lean healthcare, sustainability

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Authors: Ngoc Thao Linh Dang

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Urban waterfront redevelopment is a global phenomenon, and thousands of schemes are being carried out in large metropoles, medium-sized cities, and even small towns all over the world. This opportunity brings the city back to the river and rediscovers waterfront revitalization as a unique opportunity for cities to reconnect with their unique historical and cultural image. The redevelopment can encourage economic investments, serve as a social platform for public interactions, and allow dwellers to express their rights to the city. Many coastal cities have effectively transformed the perception of their waterfront area through years of redevelopment initiatives, having been neglected for over a century. However, this process has never been easy due to the particular complexity of the space: local culture, history, and market-led development. Moreover, municipal governments work out the balance of diverse stakeholder interests, especially when repurposing high-profile and redundant spaces that form the core of urban economic investment while also accommodating the present and future generations in sustainable environments. Urban critics consistently grapple with the effectiveness of the planning process on the new waterfront, where public spaces are criticized for presenting a lack of opportunities for actual public participation due to privatization and authoritarian governance while no longer doing what they are ‘meant to’: all arise in reaction to the perceived failure of these places to meet expectations. The planning culture and the decision-making context determine the level of public involvement in the planning process; however, in the context of competing market forces and commercial interests dominating cities’ planning agendas, planning for public space in urban waterfronts tends to be for economic gain rather than supporting residents' social needs. These newly pleasing settings satisfied the cluster of middle-class individuals, new communities living along the waterfront, and tourists. A trend of public participatory exclusion is primarily determined by the nature of the planning being undertaken and the decision-making context in which it is embedded. Starting from this context, the research investigates the influence of planning on waterfront regeneration and the role of participation in this process. The research aims to look specifically at the characteristics of the planning process of the waterfront in Da Nang and its impact on the regeneration of the place to regain the city’s historical value and enhance local cultural identity and images. Vietnam runs a top-down planning system where municipal governments have control or power over what happens in their city following the approved planning from the national government. The community has never been excluded from development; however, their participation is still marginalized. In order to ensure social equality, a proposed approach called "bottom-up" should be considered and implemented alongside the traditional "top-down" process and provide a balance of perspectives, as it allows for the voices of the most underprivileged social group involved in a planning project to be heard, rather than ignored. The research provides new insights into the influence of the planning process on the waterfront regeneration in the context of Da Nang.

Keywords: planning process, public participation, top-down planning, waterfront regeneration

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Authors: Honey Bryant, Elvina Chu

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Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

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Authors: Mehrdad Nouri Khajavi, Gollamhassan Payganeh, Mohsen Fallah Tafti

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Fault diagnosis is an important aspect of maintaining rotating machinery health and increasing productivity. Many researches has been done in this regards. Many faults such as unbalance, misalignment, looseness, bearing faults, etc. have been considered and diagnosed with different techniques. Most of the researches in fault diagnosis of rotating machinery deal with single fault. Where as in reality faults usually occur simultaneously and it is, therefore, necessary to recognize them at the same time. In this research, two of the most common faults namely unbalance and misalignment have been considered simultaneously with different intensity and then identified and classified with the use of Multi-Layer Perception Neural Network (MLPNN). Processed Vibration signals are used as the input to the MLPNN, and the class of mixed unbalancy, and misalignment is the output of the NN.

Keywords: unbalance, parallel misalignment, combined faults, vibration signals

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Authors: Abderrhamane Jarou, Dominique Sauter, Christophe Aubrun

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Over the past decade, the growing demand for energy efficiency in buildings has attracted the attention of the control community. Failures in HVAC (heating, ventilation and air conditioning) systems in buildings can have a significant impact on the desired and expected energy performance of buildings and on the user's comfort as well. FTC is a recent technology area that studies the adaptation of control algorithms to faulty operating conditions of a system. The application of Fault-Tolerant Control (FTC) in HVAC systems has gained attention in the last two decades. The objective is to maintain the variations in system performance due to faults within an acceptable range with respect to the desired nominal behavior. This paper considers the so-called active approach, which is based on fault and identification scheme combined with a control reconfiguration algorithm that consists in determining a new set of control parameters so that the reconfigured performance is "as close as possible, "in some sense, to the nominal performance. Thermal models of buildings and their HVAC systems are described by non-linear (usually bi-linear) equations. Most of the works carried out so far in FDI (fault diagnosis and isolation) or FTC consider a linearized model of the studied system. However, this model is only valid in a reduced range of variation. This study presents a new fault diagnosis (FD) algorithm based on a bilinear observer for the detection and accurate estimation of the magnitude of the HVAC system failure. The main contribution of the proposed FD algorithm is that instead of using specific linearized models, the algorithm inherits the structure of the actual bilinear model of the building thermal dynamics. As an immediate consequence, the algorithm is applicable to a wide range of unpredictable operating conditions, i.e., weather dynamics, outdoor air temperature, zone occupancy profile. A bilinear fault detection observer is proposed for a bilinear system with unknown inputs. The residual vector in the observer design is decoupled from the unknown inputs and, under certain conditions, is made sensitive to all faults. Sufficient conditions are given for the existence of the observer and results are given for the explicit computation of observer design matrices. Dedicated observer schemes (DOS) are considered for sensor FDI while unknown input bilinear observers are considered for actuator or system components FDI. The proposed strategy for FTC works as follows: At a first level, FDI algorithms are implemented, making it also possible to estimate the magnitude of the fault. Once the fault is detected, the fault estimation is then used to feed the second level and reconfigure the control low so that that expected performances are recovered. This paper is organized as follows. A general structure for fault-tolerant control of buildings is first presented and the building model under consideration is introduced. Then, the observer-based design for Fault Diagnosis of bilinear systems is studied. The FTC approach is developed in Section IV. Finally, a simulation example is given in Section V to illustrate the proposed method.

Keywords: bilinear systems, fault diagnosis, fault-tolerant control, multi-zones building

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Authors: Hee Soo Kim, Ha Young Kyung

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This paper examines the role of positive emotions in human psychology. By understanding Fredrickson and Lyubomirsky et al.’s on positive emotions, one can better understand people’s intuitive understanding, mental health and well-being. Fredrickson asserts that positive emotions create positive affects and personal resources, and Lyubomirsky et al. relate such positive resources to the creation of happiness and personal development. This paper finds that positive emotions play a significant role in the learning process, and they are instrumental in creating a long-lasting repertoire of personal resources and play an essential role in the development of the intuitive understanding of life variables, resilience in coping with life challenges, and ability to build more successful lives.

Keywords: Positive emotions, positive affects, personal resources, negative emotions, development

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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Authors: Alexandra McKinzie, Lucy Brown, Sarah Komanapalli, Sarah Swiezy, Caitlin Bernard

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Background: While 25% of US women will seek an abortion before age 45, targeted laws have led to a decline in abortion clinics, subsequently leaving 96% of Indiana counties and the 70% of Hoosier women residing in these counties without access to services they desperately need.1,2 Despite the need for a physician workforce that is educated and able to provide full-spectrum reproductive health care, few medical institutions have a standardized family planning and abortion pre-clinical curriculum. Methods: A Qualtrics survey was disseminated to students from Indiana University School of Medicine (IUSM) to evaluate (1) student interest in curriculum reform, (2) self-assessed preparedness to counsel on contraceptive and pregnancy options, and (3) preferred modality of instruction for family planning and abortion topics. Based on the pre-panel survey feedback, a case-based pregnancy options counseling panel will be implemented in the students’ pre-clinical, didactic course Endocrine, Reproductive, Musculoskeletal, Dermatologic Systems (ERMD) in February 2022. A Qualtrics post-panel survey will be disseminated to evaluate students’ perceived efficacy and quality of the panel, as well as their self-assessed preparedness to counsel on pregnancy options. Results: Participants in the pre-panel survey (n=303) were primarily female (61.72%) and White (74.43%). Across all class levels, many (60.80%) students expected to learn about family planning and abortion in their pre-clinical education. While most (84-88%) participants felt prepared to counsel about common, non-controversial pharmacotherapies (e.g. beta-blockers and diuretics), only 20% of students felt prepared to counsel on abortion options. Overall, 85.67% of students believed that IUSM should enhance its reproductive health coverage in pre-clinical, didactic courses. Traditional lectures, panels, and direct clinical exposure were the most popular instructional modalities. Expected Results: The authors predict that following the panel, students will indicate improved confidence in providing pregnancy options counseling. Additionally, students will provide constructive feedback on the structure and content of the panel for incorporation into future years’ curriculum. Conclusions: IUSM students overwhelmingly expressed interest in expanding their pre-clinical curriculum’s coverage of family planning and abortion topics. To specifically improve students’ self-assessed preparedness to provide pregnancy options counseling and address students’ self-cited learning gaps, a case-based provider panel session will be implemented in response to students’ preferred modality feedback.

Keywords: options counseling, family planning, abortion, curriculum reform, case-based panel

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Authors: Rose Mwanza

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This paper investigates security factors influencing primary school pupils’ school participation in Kenya. Schools, communities and the Government all have roles to play in enhancing primary school pupil’s school participation. The effective security system of a country provides the necessary avenues to facilitate improved health services protection of children and allows free movement of the country’s citizens which leads to a conducive atmosphere for school participation. Kenya is a signatory to international commitments and conventions related to security such as the National Policy on Peace Building and Conflict Management, United Nations Development Assistance Framework and Key Security Unity, which enable primary school pupils to participate in education. The paper also looks at the strategies the Government of Kenya has put in place to ensure effective pupil school participation.

Keywords: ethnicity, social media, participation in school, poverty, terrorism

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Authors: Gil Soriano, Aubreyrose Casilang

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Soil-transmitted helminth infection remains to be one of the leading public health problem worldwide, which is common in the rural developing regions especially among children. This study aimed to detect the presence of soil transmitted helminths among children and its associated transmission factors. Descriptive cross sectional research was the design used in the study and questionnaires were administered. Stool samples were collected among the samples (n=108) and were analyzed using kato thick method. Results showed that 61 out of 108 respondents are infected by soil transmitted helminth infection with A. lumbricoides the highest, followed by hookworm and T. trichuria. Parent's educational attainment, hand washing practices, and water sources were found to be associated with presence of Soil Transmitted Helminth infection.

Keywords: associated risk factors, barangay, school children, soil transmitted helminth infection

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Authors: Eman AbdelSabour

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Sustainability is increasingly being considered as a critical aspect in shaping the urban environment. It works as an invention development basis for global urban growth. Currently, different models and structures impact the means of interpreting the criteria that would be included in defining a sustainable city. There is a collective need to improve the growth path to an extremely durable path by presenting different suggestions regarding multi-scale initiatives. The global rise in urbanization has led to increased demand and pressure for better urban planning choice and scenarios for a better sustainable urban alternative. The need for an assessment tool at the urban scale was prompted due to the trend of developing increasingly sustainable urban development (SUD). The neighborhood scale is being managed by a growing research committee since it seems to be a pertinent scale through which economic, environmental, and social impacts could be addressed. Although neighborhood design is a comparatively old practice, it is in the initial years of the 21st century when environmentalists and planners started developing sustainable assessment at the neighborhood level. Through this, urban reality can be considered at a larger scale whereby themes which are beyond the size of a single building can be addressed, while it still stays small enough that concrete measures could be analyzed. The neighborhood assessment tool has a crucial role in helping neighborhood sustainability to perform approach and fulfill objectives through a set of themes and criteria. These devices are also known as neighborhood assessment tool, district assessment tool, and sustainable community rating tool. The primary focus of research has been on sustainability from the economic and environmental aspect, whereas the social, cultural issue is rarely focused. Therefore, this research is based on Doha, Qatar, the current urban conditions of the neighborhoods is discussed in this study. The research problem focuses on the spatial features in relation to the socio-cultural aspects. This study is outlined in three parts; the first section comprises of review of the latest use of wellbeing assessment methods to enhance decision process of retrofitting physical features of the neighborhood. The second section discusses the urban settlement development, regulations and the process of decision-making rule. An analysis of urban development policy with reference to neighborhood development is also discussed in this section. Moreover, it includes a historical review of the urban growth of the neighborhoods as an atom of the city system present in Doha. Last part involves developing quantified indicators regarding subjective well-being through a participatory approach. Additionally, applying GIS will be utilized as a visualizing tool for the apparent Quality of Life (QoL) that need to develop in the neighborhood area as an assessment approach. Envisaging the present QoL situation in Doha neighborhoods is a process to improve current condition neighborhood function involves many days to day activities of the residents, due to which areas are considered dynamic.

Keywords: neighborhood, subjective wellbeing, decision support tools, Doha, retrofiring

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Authors: Matt Fullmer, Carol Wilkinson, Keven Prusak, Dennis Eggett, Todd Pennington

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Obesity and chronic health issues are linked to physical inactivity. Physical education (PE) programs in school can play a major role in combating these health-related issues. This study focused on supporting competence through keeping a leisure-time physical activity (LTPA) record as part of PE. Keeping a daily LTPA record may be an effective intervention helping students feel more competent toward exercise, and thus, self-determined (within the context of self-determination theory) to exercise. Little is known about the relationship between daily LTPA records and perceived competence, motivational profiles, and LTPA levels of students enrolled in PE. This study examined the relationship between keeping a daily, online LTPA record and adolescent (a) motivational profiles toward LTPA, (b) perceived competence toward LTPA, and (c) LTPA behaviors. Secondary students (N = 124) in physical education classes completed a baseline questionnaire which consisted of the Behavioural Regulation in Exercise Questionnaire–2, the Perceived Competence Scale, and the Godin Leisure-Time Exercise Questionnaire. For three weeks, the students were assigned to keep the Presidential Active Lifestyle Award Challenge (PALAC) as their online LTPA record. They completed the questionnaire after each week. A 2 (gender) x 4 (trials) repeated measures ANCOVA examined the relationships between recording compliance and motivation, perceived competence, and physical activity. Results showed that recording compliance was not a significant predictor of perceived competence to participate in LTPA. Examining motivational factors, a significant interaction between recording compliance and introjected regulation was found. The more students recorded the less motivated they were by guilt or obligation to exercise in their leisure-time. Also, a significant interaction was found between recording compliance and intrinsic regulation, indicating that the more students recorded the more intrinsically motivated they were to exercise in their leisure-time. Lastly, there was a significant interaction between recording compliance and LTPA. As students kept the LTPA record, girls’ LTPA levels significantly decreased and boys’ LTPA levels significantly increased. The key findings are that, as implemented in this study: a) the lack of PALAC compliance suggests that daily LTPA records may NOT be the most effective intervention for this population, b) keeping a daily LTPA record did NOT help students feel more competent to exercise in their leisure-time, c) a daily LTPA record may help students move towards being more self-determined in their feelings towards LTPA, and d) the outcome of keeping a LTPA record on LTPA behavior is statistically significant, although actual differences may not be practically important.

Keywords: behavioural regulation in exercise questionnaire–2, Godin leisure–time exercise questionnaire, online physical activity log, perceived competence scale, self-determination theory

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Authors: Chu-Tzu Chen, Angela S. Huang, Yu-Min Chou, Chin-Hui Yang

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Dengue is a major public health concern throughout tropical and sub-tropical regions. Taiwan is located in the Pacific Ocean and overlying the tropical and subtropical zones. The island remains humid throughout the year and receives abundant rainfall, and the temperature is very hot in summer at southern Taiwan. It is ideal for the growth of dengue vectors and would be increasing the risk on dengue outbreaks. During the first half of the 20th century, there were three island-wide dengue outbreaks (1915, 1931, and 1942). After almost forty years of dormancy, a DEN-2 outbreak occurred in Liuchiu Township, Pingtung County in 1981. Thereafter, more dengue outbreaks occurred with different scales in southern Taiwan. However, there were more than ten thousands of dengue cases in 2014 and in 2015. It did not only affect human health, but also caused widespread social disruption and economic losses. The study would like to reveal the epidemiology of dengue on Taiwan, especially the severe outbreak in 2015, and try to find the effective interventions in dengue control including dengue vaccine development for the elderly. Methods: The study applied the Notifiable Diseases Surveillance System database of the Taiwan Centers for Disease Control as data source. All cases were reported with the uniform case definition and confirmed by NS1 rapid diagnosis/laboratory diagnosis. Results: In 2014, Taiwan experienced a serious DEN-1 outbreak with 15,492 locally-acquired cases, including 136 cases of dengue hemorrhagic fever (DHF) which caused 21 deaths. However, a more serious DEN-2 outbreak occurred with 43,419 locally-acquired cases in 2015. The epidemic occurred mainly at Tainan City (22,760 cases) and Kaohsiung City (19,723 cases) in southern Taiwan. The age distribution for the cases were mainly adults. There were 228 deaths due to dengue infection, and the case fatality rate was 5.25 ‰. The average age of them was 73.66 years (range 29-96) and 86.84% of them were older than 60 years. Most of them were comorbidities. To review the clinical manifestations of the 228 death cases, 38.16% (N=87) of them were reported with warning signs, while 51.75% (N=118) were reported without warning signs. Among the 87 death cases reported to dengue with warning signs, 89.53% were diagnosed sever dengue and 84% needed the intensive care. Conclusion: The year 2015 was characterized by large dengue outbreaks worldwide. The risk of serious dengue outbreak may increase significantly in the future, and the elderly is the vulnerable group in Taiwan. However, a dengue vaccine has been licensed for use in people 9-45 years of age living in endemic settings at the end of 2015. In addition to carry out the research to find out new interventions in dengue control, developing the dengue vaccine for the elderly is very important to prevent severe dengue and deaths.

Keywords: case fatality rate, dengue, dengue vaccine, the elderly

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Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

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Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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Authors: Poulomi Bhadra, Manjushree Palit, Sanjeev P. Sahni

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Forensic science uses all branches of science for criminal investigation and trial and has increasingly emerged as an important tool in the administration of justice. However, the growth and development of this field in India has not been as rapid or widespread as compared to the more developed Western countries. For successful administration of justice, it is important that all agencies involved in law enforcement adopt an inter-professional approach towards forensic science, which is presently lacking. In light of the alarmingly high average acquittal rate in India, this study aims to examine the lack of understanding and appreciation of the importance and scope of forensic evidence and expert opinions amongst law professionals such as lawyers and judges. Based on a study of trial court cases from Delhi and surrounding areas, the study underline the areas in forensics where the criminal justice system has noticeably erred. Using this information, the authors examine the extent of forensic understanding amongst legal professionals and attempt to conclusively identify the areas in which they need further appraisal. A cross-sectional study done using a structured questionnaire was conducted amongst law professionals across age, gender, type and years of experience in court, to determine their understanding of DNA, fingerprints and other interdisciplinary scientific materials used as forensic evidence. In our study, we understand the levels of understanding amongst lawyers with regards to DNA and fingerprint evidence, and how it affects trial outcomes. We also aim to understand the factors that prevent credible and advanced awareness amongst legal personnel, amongst others. The survey identified the areas in modern and advanced forensics, such as forensic entomology, anthropology, cybercrime etc., in which Indian legal professionals are yet to attain a functional understanding. It also brings to light, what is commonly termed as the ‘CSI-effect’ in the Western courtrooms, and provides scope to study the existence of this phenomenon and its effects on the Indian courts and their judgements. This study highlighted the prevalence of unchallenged expert testimony presented by the prosecution in criminal trials and impressed upon the judicial system the need for independent analysis and evaluation of the scientist’s data and/or testimony by the defense. Overall, this study aims to define a clearer and rigid understanding of why legal professionals should have basic understanding of the interdisciplinary nature of forensic sciences. Based on the aforementioned findings, the author suggests various measures by which judges and lawyers might obtain an extensive knowledge of the advances and promising potentialities of forensic science. This includes promoting a forensic curriculum in legal studies at Bachelor’s and Master’s level as well as in mid-career professional courses. Formation of forensic-legal consultancies, in consultation with the Department of Justice, will not only assist in training police, military and law personnel but will also encourage legal research in this field. These suggestions also aim to bridge the communication gap that presently exists between law practitioners, forensic scientists and the general community’s awareness of the criminal justice system.

Keywords: forensic science, Indian legal professionals, interdisciplinary awareness, legal education

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Authors: Chloe Zivot, Natasha Vattikonda, Debbie Bell

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We conducted interviews with refugee mothers (n=28) participating in the Home Instruction for Parents of Preschool Youngsters (HIPPY) program in Calgary to explore experiences of wellbeing and resilience during the COVID-19 pandemic. Disruptions to education and increased isolation, and parental duties contributed to decreased wellbeing. Mothers identified tangible protective factors at the micro, meso, and macro levels. HIPPY played a substantial role in pandemic resilience, speaking to the potential of home-based intervention models in mitigating household adversity.

Keywords: refugee resettlement, family wellbeing, COVID-19, motherhood, resilience, gender, health

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