Search results for: psychological health

Authors: Afshin Azari, Farzad Peiravian, Nazila Yousefi

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Introduction: Community pharmacies have been always played an important role in public health. Therefore, having a decent service provided by these pharmacies is of paramount importance for the healthcare system. The issue of pharmacy ownership and its possible impact on the quality of services and amount of violations has been argued for many years, and there are different opinions around this debate. Since, so far, no scientific research has been performed to investigate this issue in Iran, this study aimed to examine the differences between these two types of pharmacies ownership in terms of violations and service quality. Method: This study investigates the impact of two different kinds of pharmacy ownership (pharmacists and non-pharmacist’s ownership) on the pharmacies’ amount of violations and services quality. Pharmacies’ amount of violations was examined using “pharmacy inspection reports” between September 2018 and September 2019, in their distinguishable categories: minor, major and critical violations. Then, service quality was examined using a questionnaire from the perspective of pharmacy customers. Results: Considering violations, there was no evidence to prove a significant relationship between critical violations and major violations with the type of pharmacy ownership. However, in minor violations, the average of violations was higher in pharmacies owned by pharmacists in comparison to their non-pharmacist owned counterparts. Regarding service quality, the results showed that there is no significant relationship between the quality of service and the type of pharmacy ownership. Discussion and Conclusion: In this study, no significant relationship was found between the amount of violations and the type of pharmacy ownership. This could indicate that the pharmacy ownership would not influence the rate of violations. Considering that more inspections have been carried out in non-pharmacist owned pharmacies, it can be concluded that these pharmacies are more under control, and in fact, this monitoring has reduced violations in these pharmacies. The quality of services in the two types of pharmacies were not significantly different from each other, and this shows that non-pharmacist-owned pharmacies also try to maintain the desired level of service in competition with their competitors.

Keywords: pharmacy ownership, quality of service, violation, community pharmacy

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Authors: Kebret Kebede, Anthony Scinta

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Obesity is the most prevalent global problem that continues to rise at alarming rates both in the industrialized and developing countries. Adipose tissue is an endocrine tissue that secretes numerous chemical signals, hormones, lipids, cytokines and coagulation factors as well as prompting insulin resistance which is a primary contributor to Type II Diabetes- one of its most common adverse effects on health. Other hormones whose levels are linked to obesity and nutritional state are leptin, IGF-1, and adiponectin. Several studies indicate that obesity is the leading cause of high levels of cholesterol that leads to fatty liver disease, gallstones, hypertension, increased risk for cancer and degenerative joint disease that primarily affects the weight bearing joints of the lower extremities. The activation of inflammatory pathways promotes synovial pathology that results in accelerated degeneration of the joints. The study examines the prevalence of obesity in the US female population in comparison to that of the developing world and its emergence as a significant and potentially modifiable risk factor in degenerative disease of the hip and knee joints that has resulted in staggering healthcare cost. Studies have shown that as the prevalence of obesity rises, we continue to see a rise in degenerative joint disease. The percentage of arthritis cases linked directly to obesity has risen from 3 percent in 1971 to 18 percent in 2002. A person with obesity is around 60 percent more likely to develop arthritis than someone of normal body weight. In women, obesity is associated with increased mortality from breast, cervical, endometrial and ovarian cancer that may accompany debilitating joint diseases and restricted mobility.

Keywords: obesity, endocrine, degenerative, mortality, joint diseases, cancer, debilitating, mobility

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Authors: Ni Luh Putu Harta Wedari

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Background: Clostridium difficile has two main virulence factors, namely TcdA and TcdB. TcdA encoded by the tcdA gene acts as an enterotoxin, pro-inflammatory and fluid accumulation, while TcdB encoded by the tcdB gene is cytotoxic, causes disruption of the actin cytoskeleton, and causes disruption of tight junctions in colon cells. This study aims to explore the relationship between the tcdA and tcdB genes and the duration of diarrhea in elderly patients. Method: This research was an observational analytic with a prospective cross-sectional with samples of elderly diarrhea patients who met the inclusion criteria in Denpasar City health service facilities from 1 December 2022 until 30 June 2023, and then their feces were analyzed using the real-time PCR method. Results: In this study, 40 elderly diarrhea patients met the inclusion criteria and in accordance with the minimum sample size, 28 (70%) men and 12 (30%) women. 5 patients (12.5%) had a history of azithromycin, 4 (10%) levofloxacin, 17 (42.5%) ciprofloxacin, 8 (20%) metronidazole, 1 (2.5%) cefoperazone, 5 (12, 5%) doxycycline. Comorbids, namely 13 (32.5%) type II diabetes mellitus, 4 (10%) chronic kidney disease, 10 (25%) malignancies, 7 (17.5%) urinary tract infections, 3 (7.5%) %) immunocompromised, 2 (5%) cardiac heart failure, and 1 (2.5%) acute on chronic kidney disease. The overall diarrhea duration average was 5 days. 8 samples (20%) were positive for 16s rRNA, and there was no significant difference in diarrhea duration with negative samples (p=0.166). The relationship between the tcdA gene and the duration of diarrhea could not be performed because all samples were negative. Likewise, relationship analysis between the coexistence of tcdA and tcdB could not be performed. There was no significant difference between tcdB positive 3 (7.5%) and negative with diarrhea duration (p=0.739). Conclusion: There is no significant relationship between the presence of the 16s rRNA and tcdB C. difficile genes with the duration of diarrhea in elderly patients.

Keywords: clostridium, difficile, diarrhea, elderly, tcdA, tcdB

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Authors: Bulcha Belay Etana, Benny Malengier, Janarthanan Krishnamoorthy, Timothy Kwa, Lieva Vanlangenhove

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Electromyography measures the electrical activity of muscles using surface electrodes or needle electrodes to monitor various disease conditions. Recent developments in the signal acquisition of electromyograms using textile electrodes facilitate wearable devices, enabling patients to monitor and control their health status outside of healthcare facilities. Here, we have developed and tested wearable textile electrodes to acquire electromyography signals from patients suffering from Parkinson’s disease and incorporated a feedback-control system to relieve muscle cramping through thermal stimulus. In brief, the textile electrodes made of stainless steel was knitted into a textile fabric as a sleeve, and their electrical characteristic, such as signal-to-noise ratio, was compared with traditional electrodes. To relieve muscle cramping, a heating element made of stainless-steel conductive yarn sewn onto a cotton fabric, coupled with a vibration system, was developed. The system integrated a microcontroller and a Myoware muscle sensor to activate the heating element as well as the vibration motor when cramping occurred. At the same time, the element gets deactivated when the muscle cramping subsides. An optimum therapeutic temperature of 35.5°C is regulated and maintained continuously by a heating device. The textile electrode exhibited a signal-to-noise ratio of 6.38dB, comparable to that of the traditional electrode’s value of 7.05 dB. For a given 9 V power supply, the rise time for the developed heating element was about 6 minutes to reach an optimum temperature.

Keywords: smart textile system, wearable electronic textile, electromyography, heating textile, vibration therapy, Parkinson’s disease

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Authors: N. Khodarahmi, L. Ford

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Decades of research on the impact of trauma in early childhood suggest severe risks to the mental health, emotional, social and physical development of a young child. Trauma-exposed students can pose a variety of different levels of challenges to schools and educators of young children and to date, few studies have addressed ECE teachers’ role in providing trauma support. The present study aims to contribute to this literature by exploring the beliefs of British Columbia’s (BC) early childhood education (ECE) teachers in their level of readiness and capability to work within a trauma-informed practice (TIP) framework to support their trauma-exposed students. Through a sequential, mix-methods approach, a self-report questionnaire and semi-structured interviews will be used to gauge BC ECE teachers’ knowledge of TIP, their preparedness, and their ability in using this framework to support their most vulnerable students. Teacher participants will be recruited through the ECEBC organization and various school districts in the Greater Vancouver Area. Questionnaire data will be primarily collected through an online survey tool whereas interviews will be taking place in-person and audio-recorded. Data analysis of survey responses will be largely descriptive, whereas interviews, once transcribed, will be employing thematic content analysis to generate themes from teacher responses. Ultimately, this study hopes to highlight the necessity of utilizing the TIP framework in BC ECE classrooms in order to support both trauma-exposed students and provide essential resources to compassionate educators of young children.

Keywords: early childhood education, early learning classrooms, refugee students, trauma-exposed students, trauma-informed practice

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Authors: Rajrupa Ghosh, Abhijit Mitra

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Future use of animal protein sources in prawn feeds is expected to be considerably reduced as a consequence of increasing economical, environmental and safety issues. Of main concern has been the use of expensive marine protein sources, such as fish meal which often results in fouling of water quality and disease outbreak in cultured species. To determine prawn capacity to use practical feeds with plant proteins as replacement ingredients to animal protein sources, 8-months growth trial was conducted in two sets of ponds using juvenile (0.02 gm) Macrobrachium rosenbergii. Among the two sets, one set (comprising of three ponds) is experimental pond included formulated feed prepared with 30% Porteresia coarctata dust along with other general ingredients and another set (comprising of another three ponds) is control pond with commercial feed. Mean final weight, percent weight gain, final net yield, feed conversion ratio and survival were evaluated. Higher condition index values, survival rate and gain in prawn weight were observed in experimental pond compared to control pond. Low FCR values were observed in the experimental pond than the control pond. Evaluation of production parameters at the end of the study demonstrated significant differences (P ≥ 0.05) among two ponds. The variation may be attributed to specially formulated plant based feed that not only boosted up the growth of prawns, but also upgraded the ambient aquatic health. These results indicate that fish meal can be replaced with algal protein sources in diets without affecting prawn growth and production.

Keywords: macrobrachium rosenbergii, porteresia coarctata, Indian sundarbans, feed

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Authors: Shuji Fujimoto, Fumiko Kojima, Mika Shigematsu

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Biorisk management (Biosafety/Biosecurity) is required for anyone working in a clinical laboratory (including medical/clinical research laboratories) where infectious agents and potentially hazardous biological materials are examined/stored. Proper education and training based on international standards of biorisk management should be provided not only as a part of laboratory safety program in work place but also as a part of introductory training at educational institutions for continuity and to elevate overall baseline of the biorisk management. We reported results of the pilot study of biorisk management education for graduate students majored in laboratory diagnostics previously. However, postgraduate education is still late in their profession and the participants’ interview also revealed importance and demands of earlier biorisk management education for undergraduates. The aim of this study is to identify the need for biosafety/biosecurity education and training program which is designed for undergraduate students who are entering the profession in clinical microbiology. We modified the previous program to include more basic topics and explanations (risk management, principles of safe clinical lab practices, personal protective equipment, disinfection, disposal of biological substances) and provided incorporating in the routine educational system for faculty of medical sciences in Kyushu University. The results of the pre and post examinations showed that the knowledge of the students on biorisk control had developed effectively as a proof of effectiveness of the program even in the undergraduate students. Our study indicates that administrating the basic biorisk management program in the earlier stage of learning will add positive impact to the understanding of biosafety to the health professional education.

Keywords: biorisk management, biosafety, biosecurity, clinical microbiology, education for undergraduates

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Authors: Matthew Korey, Jeffrey Youngblood, John Howarter

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Background and Significance: Tannic acid (TA) is a bio-based high molecular weight organic, aromatic molecule that has been found to increase thermal stability and flame retardancy of many polymer matrices when used as an additive. Although it is biologically sourced, TA is a pollutant in industrial wastewater streams, and there is a desire to find applications in which to downcycle this molecule after extraction from these streams. Additionally, epoxy thermosets have revolutionized many industries, but are too flammable to be used in many applications without additives which augment their flame retardancy (FR). Many flame retardants used in epoxy thermosets are synthesized from petroleum-based monomers leading to significant environmental impacts on the industrial scale. Many of these compounds also have significant impacts on human health. Various bio-based modifiers have been developed to improve the FR of the epoxy resin; however, increasing FR of the system without tradeoffs with other properties has proven challenging, especially for TA. Methodologies: In this work, TA was incorporated into the thermoset by use of solvent-exchange using methyl ethyl ketone, a co-solvent for TA, and epoxy resin. Samples were then characterized optically (UV-vis spectroscopy and optical microscopy), thermally (thermogravimetric analysis and differential scanning calorimetry), and for their flame retardancy (mass loss calorimetry). Major Findings: Compared to control samples, all samples were found to have increased thermal stability. Further, the addition of tannic acid to the polymer matrix by the use of solvent greatly increased the compatibility of the additive in epoxy thermosets. By using solvent-exchange, the highest loading level of TA found in literature was achieved in this work (40 wt%). Conclusions: The use of solvent-exchange shows promises for circumventing the limitations of TA in epoxy.

Keywords: sustainable, flame retardant, epoxy, tannic acid

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Authors: Shilpi Tripathi

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After independence, Bangladesh had to learn to survive on its own without any economic crutches (aid). Foreign direct investment (FDI) became a crucial economic tool for the country to become economically independent. The government started removing restrictions to encourage foreign investment, economic growth, international trade, and the environment. FDI is considered as a way to bridge the saving-investment gap, reduce poverty, balance trade, create jobs for its vast labour force, increase foreign exchange earnings and acquire new modern technology and management skills in the country. At the same time, spillovers of foreign investments in Bangladesh, such as low wages (compared to laborers of developed countries), poor working conditions and unbridled exploitation of the domestic resources, environmental externalities, etc., cannot be ignored. The most important adverse implications of FDI inflows noticed are the environmental problems, which are further impacting the health and society of the country. This paper empirically studies the relationship between FDI, economic growth, international trade (exports and Imports), and the environment since 1996. The first part of the paper focuses on the background and trends of FDI, GDP, trade, and environment (CO₂). The second part focuses on the literature review on the relationship between all the variables. The last part of the paper examines the results of empirical analysis like co-integration and Granger causality. The findings of the paper reveal that a uni-directional relationship exists between FDI, CO₂, and international trade (exports and imports). The direction of the causality reveals that FDI inflow is one of the major contributors to high-volume international trade. At the same time, FDI and international trade both are contributing to carbon emissions in Bangladesh. The paper concludes with the policy recommendations that will ensure environmentally friendly trade, investment, and growth in Bangladesh for the future.

Keywords: foreign direct investment, GDP, international trade, CO₂, Granger causality, environment

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Authors: Ryan Houser

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Introduction: Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services, even in the accelerating environment of biothreats. Methods: This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS (Emergency Medical Services ) providers. The survey was available for one month in 2021, during which 190 EMS providers responded to the survey. Results: Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a CBRN agent. The provider Clinical Competency levels range from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution and community). Only 10% of the respondents are both willing and able to effectively function in a bioterror environment. Discussion: In order to effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.

Keywords: bioterrorism, prehospital, EMS, disaster, emergency, medicine, preparedness, policy

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Authors: C. F. Jones Couto, L. C. Motlhaolwa, K. Williams

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This article explores the re-imagining of physical education teacher education in South African higher education. Utilising student reflections from a physical education practical module, valuable insights into student experiences were obtained about the current physical education pedagogical approaches and potential areas for improvement. The traditional teaching model of physical education is based on the idea of teaching students a variety of sports and physical activities. However, this model has been shown to be ineffective in promoting lifelong physical activity. The modern world demands a more holistic approach to health and wellness. Data was collected using the arts-based collage method in combination with written group reflections from 139 second-year undergraduate physical education students. This study employed thematic analysis methods to gain a comprehensive understanding of the data and extract a broader perspective on the students' experiences. The study aimed to empower student teachers to learn, think, and act creatively within the many educational models that impact their experience, contributing to the ongoing efforts of re-imagining physical education teacher education in South African higher education. This research is significant as the students' valuable insights reflected that they can think and work across disciplines. Sustainable development goals and graduate attributes are important concepts that can contribute to student preparation. Using a multi-model educational approach based on the cultural-historical theory, higher education institutions can help develop graduate attributes that will prepare students for success in the workplace and life.

Keywords: holistic education, graduate attributes, physical education, teacher education, student experiences, sustainable development goals

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Authors: Mohammad H. Yarmohammadian, Reza Safdari, Mahmoud Keyvanara, Nahid Tavakoli

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One of the greatest challenges in disaster and emergencies is patient tracking. The concept of tracking has different denotations. One of the meanings refers to tracking patients’ physical locations and the other meaning refers to tracking patients ‘medical needs during emergency services. The main goal of patient tracking is to provide patient safety during disaster and emergencies and manage the flow of patient and information in different locations. In most of cases, there are not sufficient and accurate data regarding the number of injuries, medical conditions and their accommodation and transference. The objective of the present study is to survey on patient tracking issue in natural disaster and emergencies. Methods: This was a narrative study in which the population was E-Journals and the electronic database such as PubMed, Proquest, Science direct, Elsevier, etc. Data was gathered by Extraction Form. All data were analyzed via content analysis. Results: In many countries there is no appropriate and rapid method for tracking patients and transferring victims after the occurrence of incidents. The absence of reliable data of patients’ transference and accommodation, even in the initial hours and days after the occurrence of disasters, and coordination for appropriate resource allocation, have faced challenges for evaluating needs and services challenges. Currently, most of emergency services are based on paper systems, while these systems do not act appropriately in great disasters and incidents and this issue causes information loss. Conclusion: Patient tracking system should update the location of patients or evacuees and information related to their states. Patients’ information should be accessible for authorized users to continue their treatment, accommodation and transference. Also it should include timely information of patients’ location as soon as they arrive somewhere and leave therein such a way that health care professionals can be able to provide patients’ proper medical treatment.

Keywords: patient tracking, challenges, disaster, emergency

Procedia PDF Downloads 304

Authors: Kayode A. Olaniyi, Adeola A. Ogunleye, Tola M. Osifeko

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Electric Vehicles (EV) appear to be gaining increasing patronage as a feasible alternative to Internal Combustion Engine Vehicles (ICEVs) for having low emission and high operation efficiency. The EV energy storage systems are required to handle high energy and power density capacity constrained by limited space, operating temperature, weight and cost. The choice of strategies for energy storage evaluation, monitoring and control remains a challenging task. This paper presents review of various energy storage technologies and recent researches in battery evaluation techniques used in EV applications. It also underscores strategies for the hybrid energy storage management and control schemes for the improvement of EV stability and reliability. The study reveals that despite the advances recorded in battery technologies there is still no cell which possess both the optimum power and energy densities among other requirements, for EV application. However combination of two or more energy storages as hybrid and allowing the advantageous attributes from each device to be utilized is a promising solution. The review also reveals that State-of-Charge (SoC) is the most crucial method for battery estimation. The conventional method of SoC measurement is however questioned in the literature and adaptive algorithms that include all model of disturbances are being proposed. The review further suggests that heuristic-based approach is commonly adopted in the development of strategies for hybrid energy storage system management. The alternative approach which is optimization-based is found to be more accurate but is memory and computational intensive and as such not recommended in most real-time applications.

Keywords: battery state estimation, hybrid electric vehicle, hybrid energy storage, state of charge, state of health

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Authors: Joo-Heon Lee, Seo-Yeon Park, Chanyang Sur, Ho-Won Jang

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Satellite-based remote sensing technique has been widely used in the area of drought and environmental monitoring to overcome the weakness of in-situ based monitoring. There are many advantages of remote sensing for drought watch in terms of data accessibility, monitoring resolution and types of available hydro-meteorological data including environmental areas. This study was focused on the applicability of drought monitoring based on satellite imageries by applying to the historical drought events, which had a huge impact on meteorological, agricultural, and hydrological drought. Satellite-based drought indices, the Standardized Precipitation Index (SPI) using Tropical Rainfall Measuring Mission (TRMM) and Global Precipitation Mission (GPM); Vegetation Health Index (VHI) using MODIS based Land Surface Temperature (LST), and Normalized Difference Vegetation Index (NDVI); and Scaled Drought Condition Index (SDCI) were evaluated to assess its capability to analyze the complex topography of the Korean peninsula. While the VHI was accurate when capturing moderate drought conditions in agricultural drought-damaged areas, the SDCI was relatively well monitored in hydrological drought-damaged areas. In addition, this study found correlations among various drought indices and applicability using Receiver Operating Characteristic (ROC) method, which will expand our understanding of the relationships between hydro-meteorological variables and drought events at global scale. The results of this research are expected to assist decision makers in taking timely and appropriate action in order to save millions of lives in drought-damaged areas.

Keywords: drought monitoring, moderate resolution imaging spectroradiometer (MODIS), remote sensing, receiver operating characteristic (ROC)

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Authors: Mohammed Jarrar, Shalini Behl, Nadia Shaheen, Abeer Fatima, Reem Nasab

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Skin aging is a slow multifactorial process influenced by both internal as well as external factors. Ultra-violet radiations (UV), diet, smoking and personal habits are the most common environmental factors that affect skin aging. Fat contents and fibrous proteins as collagen and elastin are core internal structural components. The direct influence of UV on elastin integrity and health is crucial on aging of skin by time. The deposition of abnormal elastic material is a major marker in a photo-aged skin. Searching for compounds that may protect against cutaneous photo-damage is highly valued. Retinoids and Alpha Hydroxy Acids protective and or repairing effects of UV have been endorsed by some researchers. For consolidating a better understanding of anti and protective effects of such anti-aging agents, we evaluated the combinatory effects of various dosages of lactic acid and retinol on the dermal fibroblasts elastin levels exposed to UV. The UV exposed cells showed significant reduction in the elastin levels. A combination of drugs with a higher concentration of lactic acid (30-35 mM) and a lower concentration of retinol (10-15mg/mL) showed to work better in enhancing elastin concentration in UV exposed cells. We assume this enhancement could be the result of increased tropo-elastin gene expression stimulated by retinol and lactic acid probably repaired the UV irradiated damage by enhancing the amount and integrity of the elastin fibers.

Keywords: alpha hydroxy acid, elastin, retinol, ultraviolet radiations

Procedia PDF Downloads 342

Authors: R. Botrugno, S Basyuni, G. Nugent, I. Jenkyn, A. Ferro, H. Bennett, C. Hjalmarsson, J. Chu, V. Santhanam

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This trainee led randomised controlled trial (RCT) aims to assess various outcomes for resorbable versus non-resorbable sutures for traumatic lacerations to the face. Within this trial of resorbable versus non-resorbable sutures for traumatic lacerations of the face (TORNFace), patient recruitment was facilitated by trainees who were employed at an NHS University Teaching Hospital in the United Kingdom. The trainees received appropriate training prior to recruiting patients for the trial. This included the completion of a national research e-learning module and face-to-face training that was provided locally. The locally delivered training provided an understanding of the eligibility criteria for the trial and the consent process. Existing trainee skills were utilised involving clinical photography to record baseline data and delivering the intervention based on the treatment arm selected. Eligible patients who required primary closure of traumatic lacerations of the face were randomised into one of two treatment arms. These comprised of resorbable (vicryl rapide) or non-resorbable sutures (ethilon). Primarily the cosmetic outcome was assessed. Secondary outcomes included: complications rates, health care economics, and patient-reported outcomes. Remote follow-up of recruited patients utilised photographs of the facial laceration which had received the intervention. These took place at 1 week, 3 months and 6 months post-intervention. This study aims to demonstrate an example of trainee-led research within the specialty of oral and maxillofacial surgery. The available data for the randomised controlled trial will also be presented.

Keywords: laceration, suture, trauma, trial

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Authors: Mahmood Alsaadi, Alexei Lisitsa

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Nowadays, medical devices rely completely on software whether as whole software or as embedded software, therefore, the organization that develops medical device software can benefit from adopting agile practices. Using agile practices in healthcare software development industries would bring benefits such as producing a product of a high-quality with low cost and in short period. However, medical device software development companies faced challenges in adopting agile practices. These due to the gaps that exist between agile practices and the requirements of healthcare regulations such as documentation, traceability, and formality. This research paper will conduct a study to investigate the adoption rate of agile practice in medical device software development, and they will extract and outline the requirements of healthcare regulations such as Food and Drug Administration (FDA), Health Insurance Portability and Accountability Act (HIPAA), and Medical Device Directive (MDD) that affect directly or indirectly on software development life cycle. Moreover, this research paper will evaluate the suitability of using agile practices in healthcare industries by analyzing the most popular agile practices such as eXtream Programming (XP), Scrum, and Feature-Driven Development (FDD) from healthcare industry point of view and in comparison with the requirements of healthcare regulations. Finally, the authors propose an agile mixture model that consists of different practices from different agile methods. As result, the adoption rate of agile practices in healthcare industries still low and agile practices should enhance with regard to requirements of the healthcare regulations in order to be used in healthcare software development organizations. Therefore, the proposed agile mixture model may assist in minimizing the gaps existing between healthcare regulations and agile practices and increase the adoption rate in the healthcare industry. As this research paper part of the ongoing project, an evaluation of agile mixture model will be conducted in the near future.

Keywords: adoption of agile, agile gaps, agile mixture model, agile practices, healthcare regulations

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Authors: Levente Kovács, Fruzsina Luca Kézér, Ottó Szenci

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Prediction of the onset of calving and recognizing difficulties at calving has great importance in decreasing neonatal losses and reducing the risk of health problems in the early postpartum period. In this study, changes of rumination time, reticuloruminal pH and temperature were investigated in eutocic (EUT, n = 10) and dystocic (DYS, n = 8) dairy cows around parturition. Rumination time was continuously recorded using an acoustic biotelemetry system, whereas reticuloruminal pH and temperature were recorded using an indwelling and wireless data transmitting system. The recording period lasted from 3 d before calving until 7 days in milk. For the comparison of rumination time and reticuloruminal characteristics between groups, time to return to baseline (the time interval required to return to baseline from the delivery of the calf) and area under the curve (AUC, both for prepartum and postpartum periods) were calculated for each parameter. Rumination time decreased from baseline 28 h before calving both for EUT and DYS cows (P = 0.023 and P = 0.017, respectively). After 20 h before calving, it decreased onwards to reach 32.4 ± 2.3 and 13.2 ± 2.0 min/4 h between 8 and 4 h before delivery in EUT and DYS cows, respectively, and then it decreased below 10 and 5 min during the last 4 h before calving (P = 0.003 and P = 0.008, respectively). Until 12 h after delivery rumination time reached 42.6 ± 2.7 and 51.0 ± 3.1 min/4 h in DYS and EUT dams, respectively, however, AUC and time to return to baseline suggested lower rumination activity in DYS cows than in EUT dams for the 168-h postpartum observational period (P = 0.012 and P = 0.002, respectively). Reticuloruminal pH decreased from baseline 56 h before calving both for EUT and DYS cows (P = 0.012 and P = 0.016, respectively), but did not differ between groups before delivery. In DYS cows, reticuloruminal temperature decreased from baseline 32 h before calving by 0.23 ± 0.02 °C (P = 0.012), whereas in EUT cows such a decrease was found only 20 h before delivery (0.48 ± 0.05 °C, P < 0.01). AUC of reticuloruminal temperature calculated for the prepartum period was greater in EUT cows than in DYS cows (P = 0.042). During the first 4 h after calving, it decreased from 39.7 ± 0.1 to 39.00 ± 0.1 °C and from 39.8 ± 0.1 to 38.8 ± 0.1 °C in EUT and DYS cows, respectively (P < 0.01 for both groups) and reached baseline levels after 35.4 ± 3.4 and 37.8 ± 4.2 h after calving in EUT and DYS cows, respectively. Based on our results, continuous monitoring of changes in rumination time and reticuloruminal temperature seems to be promising in the early detection of cows with a higher risk of dystocia. Depressed postpartum rumination time of DYS cows highlights the importance of the monitoring of cows experiencing difficulties at calving.

Keywords: reticuloruminal pH, reticuloruminal temperature, rumination time, dairy cows, dystocia

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Authors: Melkamu A. Zeru, Aweke A. Mitiku, Endashaw Amuka

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Background: Under-five mortality is the likelihood that a baby will pass away before turning exactly 5 years old, represented as a percentage per 1,000 live births. Exploring the spatial distribution and identifying the temporal pattern is important to reducing under-five child mortality globally, including in Ethiopia. Thus, this study aimed to identify the risk factors of under-five mortality and the spatiotemporal variation in Ethiopian administrative zones. Method: This study used the 2000-2016 Ethiopian Demographic and Health Survey (EDHS) data, which were collected using a two-stage sampling method. A total of 43,029 (10,873 in 2000, 9,861 in 2005, 11,654 in 2011, and 10,641 in 2016) weighted sample under-five child mortality was used. The space-time dynamic model was employed to account for spatial and time effects in 65 administrative zones in Ethiopia. Results: From the result of a general nesting spatial-temporal dynamic model, there was a significant space-time interaction effect [γ = -0.1444, 95 % CI (-0.6680, -0.1355)] for under-five mortality. The increase in the percentages of mothers illiteracy [𝛽 = 0.4501, 95% CI (0.2442, 0.6559)], not vaccinated[𝛽= 0.7681, 95% CI (0.5683, 0.9678)], unimproved water[𝛽= 0.5801, CI (0.3793, 0.7808)] were increased death rates for under five children while increased percentage of contraceptive use [𝛽= -0.6609, 95% CI (-0.8636, -0.4582)] and ANC visit > 4 times [𝛽= -0.1585, 95% CI(-0.1812, -0.1357)] were contributed to the decreased under-five mortality rate at the zone in Ethiopia. Conclusions: Even though the mortality rate for children under five has decreased over time, still there is still higher in different zones of Ethiopia. There exists spatial and temporal variation in under-five mortality among zones. Therefore, it is very important to consider spatial neighbourhoods and temporal context when aiming to avoid under-five mortality.

Keywords: under-five children mortality, space-time dynamic, spatiotemporal, Ethiopia

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Zouhair Haddi, Stephane Delliaux, Jean-Francois Pons, Ismail Kechaf, Jean-Claude De Haro, Mustapha Ouladsine

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Atrial fibrillation (AF) has been considered as the most common cardiac arrhythmia, and a major public health burden associated with significant morbidity and mortality. Nowadays, telemedical approaches targeting cardiac outpatients situate AF among the most challenged medical issues. The automatic, early, and fast AF detection is still a major concern for the healthcare professional. Several algorithms based on univariate analysis have been developed to detect atrial fibrillation. However, the published results do not show satisfactory classification accuracy. This work was aimed at resolving this shortcoming by proposing multivariate data analysis methods for automatic AF detection. Four publicly-accessible sets of clinical data (AF Termination Challenge Database, MIT-BIH AF, Normal Sinus Rhythm RR Interval Database, and MIT-BIH Normal Sinus Rhythm Databases) were used for assessment. All time series were segmented in 1 min RR intervals window and then four specific features were calculated. Two pattern recognition methods, i.e., Principal Component Analysis (PCA) and Learning Vector Quantization (LVQ) neural network were used to develop classification models. PCA, as a feature reduction method, was employed to find important features to discriminate between AF and Normal Sinus Rhythm. Despite its very simple structure, the results show that the LVQ model performs better on the analyzed databases than do existing algorithms, with high sensitivity and specificity (99.19% and 99.39%, respectively). The proposed AF detection holds several interesting properties, and can be implemented with just a few arithmetical operations which make it a suitable choice for telecare applications.

Keywords: atrial fibrillation, multivariate data analysis, automatic detection, telemedicine

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Authors: E. M. Hoballah, M. Saber, A. Turky, N. Awad, A. M. Zaghloul

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Remediation of cultivated sewage soils in Egypt become an important aspect in last decade for having healthy crops and saving the human health. In this respect, a greenhouse experiment was conducted where contaminated sewage soil was treated with modified forms of 2% bentonite (T1), 2% kaolinite (T2), 1% bentonite+1% kaolinite (T3), 2% probentonite (T4), 2% prokaolinite (T5), 1% bentonite + 0.5% kaolinite + 0.5% rock phosphate (RP) (T6), 2% iron oxide (T7) and 1% iron oxide + 1% RP (T8). These materials were applied as remediative materials. Untreated soil was also used as a control. All soil samples were incubated for 2 months at 25°C at field capacity throughout the whole experiment. Carbon dioxide (CO2) efflux from both treated and untreated soils as a biomass indicator was measured through the incubation time and kinetic parameters of the best fitted models used to describe the phenomena were taken to evaluate the succession of sewaged soils remediation. The obtained results indicated that according to the kinetic parameters of used models, CO2 effluxes from remediated soils was significantly decreased compared to control treatment with variation in rate values according to type of remediation material applied. In addition, analyzed microbial biomass parameter showed that Ni and Zn were the most potential toxic elements (PTEs) that influenced the decreasing order of microbial activity in untreated soil. Meanwhile, Ni was the only influenced pollutant in treated soils. Although all applied materials significantly decreased the hazards of PTEs in treated soil, modified bentonite was the best treatment compared to other used materials. This work discussed different mechanisms taking place between applied materials and PTEs founded in the studied sewage soil.

Keywords: remediation, potential toxic elements, soil biomass, sewage

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Amr Amer

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Cheeses are among those high-protein-containing foodstuffs in which enzymatic and microbial activities cause the formation of biogenic amines from amino acids decarboxylation. The amount of biogenic amines in cheese may act as a useful indicator of the hygienic quality of the product. In other words, their presence in cheese is related to its spoilage and safety. Formation of biogenic amines during Ras cheese (Egyptian hard cheese) ripening was investigated for 4 months. Three batches of Ras cheese were manufactured using Egyptian traditional method. From each batch, Samples were collected at 1, 7, 15, 30, 60, 90 and 120 days after cheese manufacture. The concentrations of biogenic amines (Tyramine, Histamine, Cadaverine and Tryptamine) were analyzed by high performance liquid chromatography (HPLC). There was a significant increased (P<0.05) in Tyramine levels from 4.34± 0.07 mg|100g in the first day of storage till reached 88.77± 0.14 mg|100g at a 120-day of storage. Also, Histamine and Cadaverine levels had the same increased pattern of Tyramine reaching 64.94± 0.10 and 28.28± 0.08 mg|100g in a 120- day of storage, respectively. While, there was a fluctuation in the concentration of Tryptamine level during ripening period as it decreased from 3.24± 0.06 to 2.66± 0.11 mg|100g at 60-day of storage then reached 5.38±0.08 mg|100g in a 120- day of storage. Biogenic amines can be formed in cheese during production and storage: many variables, as pH, salt concentration, bacterial activity as well as moisture, storage temperature and ripening time, play a relevant role in their formation. Comparing the obtained results with the recommended standard by Food and Drug Administration "FDA" (2001), High levels of biogenic amines in various Ras cheeses consumed in Egypt exceeded the permissible value (10 mg%) which seemed to pose a threat to public health. In this study, presence of high concentrations of biogenic amines (Tyramine, Histamine, cadaverine and Tryptamine) in Egyptian Ras cheeses reflects the bad hygienic conditions under which they produced and stored. Accordingly, the levels of biogenic amines in different cheeses should be come in accordance with the safe permissible limit recommended by FDA to ensure human safety.

Keywords: Ras cheese, biogenic amines, tyramine, histamine, cadaverine

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Authors: Vicent Lwanga

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Background: Elderly Widows Orphans Family Support, a Community Based Organization operating in Kapchorwa with the main focus of reducing economic and social vulnerability among children affected by HIV/AIDS. The survey on reducing vulnerability targeted HIV/AIDS affected households, which included 111 adults and 185 children. The broad objective of the study was to determine how the needs of the children affected by HIV/AIDS could be appropriately met by specifically examining the situation of children affected by HIV/AIDS and establishing their needs. Methodology: The survey applied a structured questionnaire. Parents whose consent for the interview of the children had been obtained then communicated to the selected child/children. If the child consented, an arrangement for the interview was made as regards the time and place of the interview. Lessons: Adult respondents included 22.2% males and 77.8% females. Child respondents were males, 49.5%, and females 50.5%. The majority of the households are from lower economic strata. 74.1% and 63.0% of males and females, respectively, indicated that their illness had affected their income-earning activities; some of the adults have lost their jobs due to AIDS. A fair number of the children are engaged in economic activity: some of those still in school worked after school for wages and looked after their siblings. The income earned was spent mostly on household needs and school fees — one-fifth of children linked parents` inability to do more of what they desired to their ill-health. Elderly Widows Orphans Family Support secured sponsors to educate 22 girls and 16 boys in the community. Income-generating projects like piggery and skill training are given to orphans. The specific vulnerability of HIV/AIDS orphan's needs is responded to now more than ever. Community organisations interventions such as financial support to orphans introduced to moderate the impact of the disease on orphans and families.

Keywords: aids, children, needs, vulnerability

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Authors: Anjuri Srivastava, Akhouri Nishant Bhanu

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Soil is a natural material with a distinctive form. It is regarded to be a natural source of nutrients and minerals for plants. It meets many of our needs through the crops, trees, and inhabited places that have grown on or underneath it. Productive and rich soil plays a crucial role in both its wealth and well-being. If any external substance changes the soil's composition, it directly impacts the plant that was grown in that soil. If the soil is deficient in one or more essential components, fly ash can be utilized as fertilizer by incorporating it into the soil. This can also increase the porosity of the soil. Fly ash has a sufficient concentration of essential components to promote the growth of plants. The high concentration of elements in fly ash, including C, Na, K, Fe, and Zn, increases crop yields. Hazardous compounds harm plant life as soon as they get into the soil. The US Environmental Protection Agency and other regulatory agencies have found it as non-hazardous. By employing fly ash as a potential fertilizer supplement for degraded soils, the problem of disposing of solid waste can be partially handled. Fly ash's rapid growth can slow down mineralization because it contains a higher proportion of harmful heavy metals. The chemical characteristics, inclusion ratio, and composting process of fly ash have a significant impact on the fly ash compost’s potential to improve soil nutrition. Research institutions and regulatory agencies have been thoroughly investigating fly ash for a long time. Guard cells on plant leaves that accumulate fly ash trigger the regulatory system. Fly ash increases both chemical and physical damage at certain humidity levels. The lengthy sowing period is caused by the high levels of fly ash in the soil, which also slows down seedling germination and growth. For the sake of human health, it is crucial to consider the bioaccumulation of dangerous heavy metals and their necessary concentrations in plant tissues and soil.

Keywords: soil, fly ash, plant, fertilizer, composts

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Authors: Beyene Daniel, Herbert Ntuli

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Agritourism in Eritrea is increasingly threatened by climate change, manifesting through rising temperatures, shifting rainfall patterns, and resource scarcity. This study employs quantitative methods to assess the economic and environmental impacts of climate change on agritourism, utilizing metrics such as annual income fluctuations, changes in visitor numbers, and energy consumption patterns. The methodology relies on secondary data sourced from the World Bank, government reports, and academic publications to analyze the economic viability of integrating solar energy into agritourism operations. Key variables include the Benefits from Renewable Energy (BRE), encompassing cost savings from reduced energy expenses and the monetized value of avoided greenhouse gas emissions. Using a net present value (NPV) framework, the research compares the impact of solar energy against traditional fossil fuel sources by evaluating the Value of Reduced Greenhouse Gas Emissions (CO2) and the Value of Health-Related Costs (VHRC) due to air pollution. The preliminary findings of this research are of utmost importance. They indicate that the adoption of solar energy can enhance energy independence by up to 40%, reduce operational costs by 25%, and stabilize agritourism activities in climate-sensitive regions. This research aims to provide actionable insights for policymakers and stakeholders, supporting the sustainable development of agritourism in Eritrea and contributing to broader climate adaptation strategies. By employing a comprehensive cost-benefit analysis, the study highlights the economic advantages and environmental benefits of transitioning to renewable energy in the face of climate change.

Keywords: climate change, renewable energy, resilience, cost-benefit analysis

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Authors: Malgorzata Sekulowicz, Krystyna Boron-Krupinska, Paulina Morga, Blazej Cieslik

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Burnout is highly prevalent in health care employees, especially in physicians. It significantly reduces the efficiency of these employees, which can have negative consequences for both physicians and patients. Resilience and mindfulness enhancing positive emotions, leading to sustainable development and personal commitment, can have a significant impact on burnout. Therefore, the aim of this study was to determine the relationship between burnout symptoms and mindfulness and resilience among physicians. The authors conducted a cross-sectional survey study among seventy-four polish physicians. Participants filled out the following psychometric tools: the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), Five Facet Mindfulness Questionnaire (FFMQ), Areas of Work-Life Survey (AWS), International Personality Item Pool (IPIP), the Resilience Assessment Scale (SPP-25) and the Mini-COPE Inventory. The relationship between burnout and resilience and mindfulness was assessed with path analysis. Analyzing the relationship between MBI-HSS components and mindfulness, a significant negative correlation of the FFMQ score with emotional exhaustion (-0.50, p < 0.05) and depersonalization (-0.43, p < 0.05) and a positive correlation with personal accomplishment (0.50, p < 0.05) was demonstrated. Analyzing resilience, a statistically significant relationship of SPP-25 with all tested components of MBI-HSS was demonstrated: emotional exhaustion (-0.54, p < 0.05), depersonalization (-0.31, p < 0.05) and personal accomplishment (0.35, p < 0.05). In the group of medical doctors, the higher the level of mindfulness and resilience, the lower the risk of burnout. Furthermore, the more frequently used active coping strategies (planning, acceptance), the lower the risk of burnout, while the use of passive, evasive strategies increases the risk of burnout. It may be worth considering implementing mindfulness intervention to effectively manage burnout symptoms in this group.

Keywords: burnout, medical doctors, mindfulness, physicians, resilience

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Authors: Zubair Ahmad

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The aim of this study is to analyze the risks factors and issues with waste management in developing nations as barriers. Depending on their content and categorization, wastes are managed differently. Waste management strategies differ for liquid, solid, and organic wastes. The final stage of trash disposal entails procedures like burning, interment, recycling, and treatment. Due to the rising creation of solid waste, the growing urban population has a magnified impact on the environment and public health. All regions, but especially informal urban neighborhoods, tribal villages, and official rural settlements have a protracted backlog in waste services. Another significant impediment seen in the developing world is a lack of education and awareness of effective waste-management practices. Unauthorized dumpsites pose a serious risk to the environment since they could contain dangerous elements like radioactive, infectious, and toxic waste. Wealthier individuals are more inclined to think that their actions will have an impact on environmental problems and to act to address them. Waste managers need to take action to make sure the public is given information that is consistent with what they currently know. The results of the data analysis conducted with the aid of the various methodologies discussed in the preceding chapter are presented in this chapter by the researcher. Descriptive analysis has been used in research to determine whether or not there are relationships between variables and to determine the importance of the variables. According to a survey, there are no efforts being made to lessen the odor that garbage dump sites emit (in terms of treating or recycling the material placed at dumpsite) This might be the case since respondents only commented on the waste management conditions in their immediate surroundings and may not have fully understood the steps taken to resolve this issue.

Keywords: risk factor of waste material, lack of awareness, developing countries struggles, waste management

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Authors: Pamela E. Mukaire

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Anemia and chronic energy deficiency are significant manifestations of poor nutritional health. Anaemia and nutritional status screening are practical ways for assessing the prevalence of iron deficiency anemia in the food insecure populations with large groups of childbearing women and children. The objective of the study was to assess anemia prevalence and other clinical manifestations of malnutrition among pairs of mothers and young children in rural Uganda. This community cross-sectional study used consecutive sampling to select 214 mothers and 214 children for the study. Data was generated using structured questionnaire, anthropometric measurements and on site analysis for anemia. Bivariable and multivariable analyses were used to assess the effect of different factors on anaemia. Of the 214 mothers, 54.2% were 25-34 years of age, 76.7% unmarried, 63% low income, and 55% had more than four children. Of the 214 children, 57% were female, 50% between 1 to 3 years of age and 35% under one year, and. Overall, 38% of the households had more 4 children under the age of 12. The prevalence of anemia was 48% for mothers and 72% for children; 20.6% of mothers had moderate to severe chronic energy deficiency, 39% had moderately-severe anaemia (10 to 7.1 g/dL). Among children, 53% had moderately-severe anaemia, and 18.2% had severe anaemia. Parity X2 =20, p < .037, number of children under 12 years living in a household X2 =10, p < .015, and child’s gender X2 =6.5, p < .038, had a significant relationship with maternal anaemia. There was a significant relationship between household income X2 =10, p < .005, marital status X2 =9, p < .011, owing a piece of land X2 =18, p < .000, owing home X2 =7, p < .036, and anaemia in children. The prevalence of anemia was high in both mothers and children. Income, marital status, owing a piece of land, owing home, number of children under age 12 in a household were associated with anaemia. Hence, efforts should be made for early diagnosis and management of anaemia deficiencies with special emphasis on those households with large number of children under age 12.

Keywords: anemia, maternal-child, nutrition, rural population

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