Search results for: health information exchange (hie)

Authors: Ngabirano Levis

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One of Africa’s major environmental challenges remains air pollution. In 2017, UNICEF estimated over 400,000 children in Africa died as a result of indoor pollution, while 350 million children remain exposed to the risks of indoor pollution due to the use of biomass and burning of wood for cooking. Over time, indeed, the major causes of mortality across Africa are shifting from the unsafe water, poor sanitation, and malnutrition to the ambient and household indoor pollution, and greenhouse gas (GHG) emissions remain a key factor in this. In addition, studies by the OECD estimated that the economic cost of premature deaths due to Ambient Particulate Matter Pollution (APMP) and Household Air Pollution across Africa in 2013 was about 215 Billion US Dollars and US 232 Billion US Dollars, respectively. This is not only a huge cost for a continent where over 41% of the Sub-Saharan population lives on less than 1.9 US Dollars a day but also makes the people extremely vulnerable to the negative climate change and environmental degradation effects. Such impacts have led to extended droughts, flooding, health complications, and reduced crop yields hence food insecurity. Climate change, therefore, poses a threat to global targets like poverty reduction, health, and famine. Despite efforts towards mitigation, air contributors like carbon dioxide emissions are on a generally upward trajectory across Africa. In Egypt, for instance, emission levels had increased by over 141% in 2010 from the 1990 baseline. Efforts like the climate change adaptation and mitigation financing have also hit obstacles on the continent. The International Community and developed nations stress that Africa still faces challenges of limited human, institutional and financial systems capable of attracting climate funding from these developed economies. By using the qualitative multi-case study method supplemented by interviews of key actors and comprehensive textual analysis of relevant literature, this paper dissects the key emissions and air pollutant sources, their impact on the well-being of the African people, and puts forward suggestions as well as a remedial mechanism to these challenges. The findings reveal that whereas climate change mitigation plans appear comprehensive and good on paper for many African countries like Uganda; the lingering political interference, limited research guided planning, lack of population engagement, irrational resource allocation, and limited system and personnel capacity has largely impeded the realization of the set targets. Recommendations have been put forward to address the above climate change impacts that threaten the food security, health, and livelihoods of the people on the continent.

Keywords: Africa, air pollution, climate change, mitigation, emissions, effective planning, institutional strengthening

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Authors: Ayat-Allah Bouramdane

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Since 2010, there have been sustained decreases in the unit costs of onshore wind energy and large increases in its deployment, varying widely across regions. In fact, the onshore wind production is affected by air density— because cold air is more dense and therefore more effective at producing wind power— and by wind speed—as wind turbines cannot operate in very low or extreme stormy winds. The wind speed is essentially affected by the surface friction or the roughness and other topographic features of the land, which slow down winds significantly over the continent. Hence, the identification of the most appropriate locations of onshore wind systems is crucial to maximize their energy output and therefore minimize their Levelized Cost of Electricity (LCOE). This study focuses on the preliminary assessment of onshore wind energy potential, in several areas in Morocco with a particular focus on the Dakhla city, by analyzing the diurnal and seasonal variability of wind speed for different hub heights, the frequency distribution of wind speed, the wind rose and the wind performance indicators such as wind power density, capacity factor, and LCOE. In addition to climate criterion, other criteria (i.e., topography, location, environment) were selected fromGeographic Referenced Information (GRI), reflecting different considerations. The impact of each criterion on the suitability map of onshore wind farms was identified using the Analytic Hierarchy Process (AHP). We find that the majority of suitable zones are located along the Atlantic Ocean and the Mediterranean Sea. We discuss the sensitivity of the onshore wind site suitability to different aspects such as the methodology—by comparing the Multi-Criteria Decision-Making (MCDM)-AHP results to the Mean-Variance Portfolio optimization framework—and the potential impact of climate change on this suitability map, and provide the final recommendations to the Moroccan energy strategy by analyzing if the actual Morocco's onshore wind installations are located within areas deemed suitable. This analysis may serve as a decision-making framework for cost-effective investment in onshore wind power in Morocco and to shape the future sustainable development of the Dakhla city.

Keywords: analytic hierarchy process (ahp), dakhla, geographic referenced information, morocco, multi-criteria decision-making, onshore wind, site suitability.

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Authors: Theoni Soublis

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The COVID-19 pandemic created a severe interruption in teaching and learning in K-12 schools. It is essential that educational researchers, teachers, and administrators understand the long term effects that COVID-19 had on a variety of stakeholders in education. This investigation aims to analyze the research since the beginning of the pandemic that focuses specifically on teacher retention, resilience, and training. The results of this investigation will help to inform future research in order to better understand how the institution of education can continue to be prepared and to better prepare for future significant shifts in the modalities of instruction. The results of this analysis will directly impact the field of education as it will broaden the scope of understanding regarding how COVID- 19 impacted teaching and learning. The themes that will emerge from the data analysis will directly inform policy makers, administrators, and researchers about how to best implement training and curriculum design in order to support teacher effectiveness this in the classroom. Educational researchers have written about how teacher morale plummeted and how many teachers reported early burnout and higher stress levels. Teachers’ stress and anxiety soared during the COVID-19 pandemic, but so has their resilience and dedication to the field of education. This research aims to understand how public-school teachers overcame teaching obstacles presented to them during COVID-19. Research has been conducted to identify a variety of information regarding the impact the pandemic has had on K-12 teachers, students, and families. This research aims to understand how teachers continued to pursue their teaching objectives without significant training of effective online instruction methods. Not many educators even heard of the video conferencing platform Zoom before the spring of 2020. Researchers are interested in understanding how teachers used their expertise, prior knowledge, and training to institute immediate and effective online learning environments, what types of relationships did teachers build with students while teaching 100% remotely, and how did relationships change with students while teaching remotely? Furthermore, did the teacher-student relationship propel teacher resolve to be successful while teaching during a pandemic. Recent world events have significantly impacted the field of public-school teaching. The pandemic forced teachers to shift their paradigm about how to maintain high academic expectations, meet state curriculum standards, and assess students learning gains to make data-informed decisions while simultaneously adapting modes of instruction through multiple outlets with little to no training on remote, synchronous, asynchronous, virtual, and hybrid teaching. While it would be very interesting to study how teaching positively impacted students learning during the pandemic, I am more interested in understanding how teaches stayed the course and maintained their mental health while dealing with the stress and pressure of teaching during COVID-19.

Keywords: teacher retention, COVID-19, teacher education, teacher moral

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Authors: Som Pal Baliyan

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Dairy enterprise has been a major source of employment and income generation in most of the economies worldwide. Botswana government has also identified dairy as one of the agricultural sectors towards diversification of the mineral dependent economy of the country. The huge gap between local demand and supply of milk and milk products indicated that there are not only constraints but also; opportunities exist in this sub sector of agriculture. Therefore, this study was an attempt to identify constraints and opportunities in dairy production industry in Botswana. The possible ways to mitigate the constraints were also identified. The findings should assist the stakeholders especially, policy makers in the formulation of effective policies for the growth of dairy sector in the country. This quantitative study adopted a survey research design. A final survey followed by a pilot survey was conducted for data collection. The purpose of the pilot survey was to collect basic information on the nature and extent of the constraints, opportunities and ways to mitigate the constraints in dairy production. Based on the information from pilot survey, a four point Likert’s scale type questionnaire was constructed, validated and tested for its reliability. The data for the final survey were collected from purposively selected twenty five dairy farms. The descriptive statistical tools were employed to analyze data. Among the twelve constraints identified; high feed costs, feed shortage and availability, lack of technical support, lack of skilled manpower, high prevalence of pests and diseases and, lack of dairy related technologies were the six major constraints in dairy production. Grain feed production, roughage feed production, manufacturing of dairy feed, establishment of milk processing industry and, development of transportation systems were the five major opportunities among the eight opportunities identified. Increasing production of animal feed locally, increasing roughage feed production locally, provision of subsidy on animal feed, easy access to sufficient financial support, training of the farmers and, effective control of pests and diseases were identified as the six major ways to mitigate the constraints. It was recommended that the identified constraints and opportunities as well as the ways to mitigate the constraints need to be carefully considered by the stakeholders especially, policy makers during the formulation and implementation of the policies for the development of dairy sector in Botswana.

Keywords: dairy enterprise, milk production, opportunities, production constraints

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Authors: Magdy Abouzeid

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Introduction: Physical activity has been shown to have a positive effect on bone mineral density (BMD) and bone mineral content (BMC) among children, adolescents, and adults. Sports characterized by little or moderate weight bearing or impact have a low osteogenic effect. However, the action of such sports on bone turnover remains unclear. Swimming, as a non-weight-bearing sport, has been considered to be insignificant in the maintenance of bone mass. Purpose: To examine this issue we measured (BMD) and(BMC) of the lumbar spine, proximal femur via dual energy x-ray absorptiometry in the group of elite male swimmers, and determine the effect of swimming training on bone health and compared the results with matched controls group in age, body weight and height. Materials and Methods: Twenty-five male swimmers (age 20.7+/-0.8 years) training for 12-15 hours/week; and the controls group consisted of 25 non-active male (age 21.3 +/-1.3 years) were studied BMD and BMC of lumbar spine, femur were assessed via (DXA) absorptiometry. Results: There was significant difference between swimmers and control group in BMD and BMC, BMD of Swimmers was significantly greater than controls at all sites. The lumbar spine (1, 08 +/-0.202 vs., 0717+0.57 gxcm (-2), right proximal femur (1, 02 +/-, 044 vs., 771+/-, 027 gxcm (-2), and left proximal femur (1.374+/-0.212 vs. 1.01 +/-0.141 gxcm (-2). Swimmers were significantly taller, and had greater BMC and BMD compared to the controls group (P<0.001). Conclusions: These results suggest that swimming training may be beneficial in the prevention or therapy of OSTEOPENIA, and may lead to increased (BMD) and (BMC) for male swimmers. Swimming may be an effective non-pharmacological intervention for the adults and adolescent. Further research with younger athletes of another type of aquatics sport is warranted to better identify the periods of BMD development during which Aquatics sport has the greatest impact on bone health.

Keywords: bone mineral density, lumbar spine, femur, swimming, DXA absorptiometry

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Authors: Sophie Lemoussu, Jean-Charles Chaudemar, Robertus A. Vingerhoeds

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Many innovative projects exist in the field of aeronautics, each addressing specific areas so to reduce weight, increase autonomy, reduction of CO2, etc. In many cases, such innovative developments are being carried out by very small enterprises (VSE’s) or small and medium sized-enterprises (SME’s). A good example concerns airships that are being studied as a real alternative to passenger and cargo transportation. Today, no international regulations propose a precise and sufficiently detailed framework for the development and certification of airships. The absence of such a regulatory framework requires a very close contact with regulatory instances. However, VSE’s/SME’s do not always have sufficient resources and internal knowledge to handle this complexity and to discuss these issues. This poses an additional challenge for those VSE’s/SME’s, in particular those that have system integration responsibilities and that must provide all the necessary evidence to demonstrate their ability to design, produce, and operate airships with the expected level of safety and reliability. The main objective of this research is to provide a methodological framework enabling VSE’s/SME’s with limited resources to organize the development of airships while taking into account the constraints of safety, cost, time and performance. This paper proposes to provide a contribution to this problematic by proposing a Model-Based Systems Engineering approach. Through a comprehensive process modeling approach applied to the development processes, the regulatory constraints, existing best practices, etc., a good image can be obtained as to the process landscape that may influence the development of airships. To this effect, not only the necessary regulatory information is taken on board, also other international standards and norms on systems engineering and project management are being modeled and taken into account. In a next step, the model can be used for analysis of the specific situation for given developments, derive critical paths for the development, identify eventual conflicting aspects between the norms, standards, and regulatory expectations, or also identify those areas where not enough information is available. Once critical paths are known, optimization approaches can be used and decision support techniques can be applied so to better support VSE’s/SME’s in their innovative developments. This paper reports on the adopted modeling approach, the retained modeling languages, and how they all fit together.

Keywords: aeronautics, certification, process modeling, project management, regulation, SME, systems engineering, VSE

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Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

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Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

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Authors: Nayan Kishore Giri, Ramakar Jha

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Water is a major element for the life of all the mankind in the earth. India’s surface water flows through fourteen major streams. Indian rivers are the main source of potable water in India. In the eastern part of India many toxic hazardous metals discharged into the river from mining industries, which leads many deadly diseases to human being. So the potable water quality is very significant and vital concern at present as it is related with the present and future health perspective of the human race. Consciousness of health risks linked with unsafe water is still very low among the many rural and urban areas in India. Only about 7% of total Indian people using water purifier. This unhealthy situation of water is not only present in India but also present in many underdeveloped countries. The major reason behind this is the high cost of water purifier. This current study geared towards development of economical and efficient technology for the removal of maximum possible toxic metals and pathogen bacteria. The work involves the design of portable purification system and purifying material. In this design Coconut shell granular activated carbon(GAC) and polypropylene filter cloths were used in this system. The activated carbon is impregnated with Iron(Fe). Iron is used because it enhances the adsorption capacity of activated carbon. The thorough analysis of iron impregnated activated carbon(Fe-AC) is done by Scanning Electron Microscope (SEM), X-ray diffraction (XRD) , BET surface area test were done. Then 10 ppm of each toxic metal were infiltrated through the designed purification system and they were analysed in Atomic absorption spectrum (AAS). The results are very promising and it is low cost. This work will help many people who are in need of potable water. They can be benefited for its affordability. It could be helpful in industries and other domestic usage.

Keywords: potable water, coconut shell GAC, polypropylene filter cloths, SEM, XRD, BET, AAS

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Authors: J. M. Geyser

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Lamb is a popular meat throughout the world, particularly in Europe, the Middle East and Oceania. However, the conventional lamb industry faces challenges related to environmental sustainability, climate change, consumer health and dwindling profit margins. This has stimulated an increasing demand for organic lamb, as it is perceived to increase environmental sustainability, offer superior quality, taste, and nutritional value, which is appealing to farmers, including small-scale and female farmers, as it often commands a premium price. Despite its advantages, organic lamb production presents challenges, with a significant hurdle being the high production costs encompassing organic certification, lower stocking rates, higher mortality rates and marketing cost. These costs impact the profitability and competitiveness or organic lamb producers, particularly female and small-scale farmers, who often encounter additional obstacles, such as limited access to resources and markets. Therefore, this paper examines the cost of producing organic lambs and its impact on female farmers and raises the research question: “Is organic lamb production the saving grace for female and small-scale farmers?” Objectives include estimating and comparing production costs and profitability or organic lamb production with conventional lamb production, analyzing influencing factors, and assessing opportunities and challenges for female and small-scale farmers. The hypothesis states that organic lamb production can be a viable and beneficial option for female and small-scale farmers, provided that they can overcome high production costs and access premium markets. The study uses a mixed-method approach, combining qualitative and quantitative data. Qualitative data involves semi-structured interviews with ten female and small-scale farmers engaged in organic lamb production in South Africa. The interview covered topics such as farm characteristics, practices, cost components, mortality rates, income sources and empowerment indicators. Quantitative data used secondary published information and primary data from a female farmer. The research findings indicate that when a female farmer moves from conventional lamb production to organic lamb production, the cost in the first year of organic lamb production exceed those of conventional lamb production by over 100%. This is due to lower stocking rates and higher mortality rates in the organic system. However, costs start decreasing in the second year as stocking rates increase due to manure applications on grazing and lower mortality rates due to better worm resistance in the herd. In conclusion, this article sheds light on the economic dynamics of organic lamb production, particularly focusing on its impact on female farmers. To empower female farmers and to promote sustainable agricultural practices, it is imperative to understand the cost structures and profitability of organic lamb production.

Keywords: cost analysis, empowerment, female farmers, organic lamb production

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Authors: Rubai M. Ochieng

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Cancer, which accounts for 7 percent of deaths per year in Kenya, is the third highest cause of death after infectious and cardiovascular diseases. Awareness Campaigns have tended to focus on leading cancers including breast and cervical for women as well as prostrate and Esophageal for men. Consequently, less common cancers such as Acute Myeloid Leukemia (AML) are rarely properly understood by the general population and a section of the medical fraternity. Diagnoses of AML in patients who may not have heard about it sometimes results in shock, denial and confusion not just to the diagnosed, but also to their family and friends. The diagnosed and caregivers are bound to receive a lot of contradicting information about prognosis, care and treatment of AML. This information, which often comes from diverse sources including doctors, friends, internet and social media platforms, causes further confusion and panic. The situation is handled differently by different people. Religious people sometimes resort to prayer. This paper, written from the perspective of a care giver, is based on data collected from a case of Acute Myeloid Leukemia diagnosed in a 32 year old male who lost his life within six weeks of diagnosis. The sample constitutes of 16 people who participated in prayers. Out of this total, 5 were males including the diagnosed and 11 were females. All the 16 were Christians of protestant orientation including Anglicans, Quakers and Church of God members. Data was collected by the researcher herself through participant of observation. Findings discuss how the 16 participants prayed individually at different times, together in an overnight prayer meeting and every morning through a group social media platform. They shared songs and words of encouragement from the bible. The group prayed for healing, peace and strength to the diagnosed and family, financial breakthrough and doctors’ work and decisions, among other challenges that came with the situation. The paper reveals the immense benefits of prayer to the diagnosed and his close relatives and friends. They include acceptance of the condition and a positive attitude in handling the challenges that arose from the disease and treatment processes. The challenges arising from the prayer approach of handling the situation are also discussed. The paper concludes that prayer as therapy goes a long way in cancer management.

Keywords: acute myeloid leukemia, Kenya, participant observation, prayer

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Authors: Hameed Rukayat Opeyemi, Pericles Pilidis, Pagone Emanuele

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Climate change represents one of the single most challenging problems facing the world today. According to the National Oceanic and Administrative Association, Atmospheric temperature rose almost 25% since 1958, Artic sea ice has shrunk 40% since 1959 and global sea levels have risen more than 5.5 cm since 1990. Power plants are the major culprits of GHG emission to the atmosphere. Several technologies have been proposed to reduce the amount of GHG emitted to the atmosphere from power plant, one of which is the less researched Advanced zero emission power plant. The advanced zero emission power plants make use of mixed conductive membrane (MCM) reactor also known as oxygen transfer membrane (OTM) for oxygen transfer. The MCM employs membrane separation process. The membrane separation process was first introduced in 1899 when Walter Hermann Nernst investigated electric current between metals and solutions. He found that when a dense ceramic is heated, current of oxygen molecules move through it. In the bid to curb the amount of GHG emitted to the atmosphere, the membrane separation process was applied to the field of power engineering in the low carbon cycle known as the Advanced zero emission power plant (AZEP cycle). The AZEP cycle was originally invented by Norsk Hydro, Norway and ABB Alstom power (now known as Demag Delaval Industrial turbo machinery AB), Sweden. The AZEP drew a lot of attention because its ability to capture ~100% CO2 and also boasts of about 30-50 % cost reduction compared to other carbon abatement technologies, the penalty in efficiency is also not as much as its counterparts and crowns it with almost zero NOx emissions due to very low nitrogen concentrations in the working fluid. The advanced zero emission power plants differ from a conventional gas turbine in the sense that its combustor is substituted with the mixed conductive membrane (MCM-reactor). The MCM-reactor is made up of the combustor, low temperature heat exchanger LTHX (referred to by some authors as air pre-heater the mixed conductive membrane responsible for oxygen transfer and the high temperature heat exchanger and in some layouts, the bleed gas heat exchanger. Air is taken in by the compressor and compressed to a temperature of about 723 Kelvin and pressure of 2 Mega-Pascals. The membrane area needed for oxygen transfer is reduced by increasing the temperature of 90% of the air using the LTHX; the temperature is also increased to facilitate oxygen transfer through the membrane. The air stream enters the LTHX through the transition duct leading to inlet of the LTHX. The temperature of the air stream is then increased to about 1150 K depending on the design point specification of the plant and the efficiency of the heat exchanging system. The amount of oxygen transported through the membrane is directly proportional to the temperature of air going through the membrane. The AZEP cycle was developed using the Fortran software and economic analysis was conducted using excel and Matlab followed by optimization case study. This paper discusses techno-economic analysis of four possible layouts of the AZEP cycle. The Simple bleed gas heat exchange layout (100 % CO2 capture), Bleed gas heat exchanger layout with flue gas turbine (100 % CO2 capture), Pre-expansion reheating layout (Sequential burning layout) – AZEP 85 % (85 % CO2 capture) and Pre-expansion reheating layout (Sequential burning layout) with flue gas turbine– AZEP 85 % (85 % CO2 capture). This paper discusses Montecarlo risk analysis of four possible layouts of the AZEP cycle.

Keywords: gas turbine, global warming, green house gases, power plants

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Authors: Lamia Bouzgarrou, Irtyah Merchaoui, Amira Omrane, Salma Kammoun, Amine Daafa, Neila Chaari

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Backgrounds: Currently, low back pain (LBP) is one of the most prevalent public health problems, which caused severe morbidity among a large portion of the adult population. It is also associated with heavy direct and indirect costs, in particular, related to absenteeism and early retirement. Health care workers are one of most occupational groups concerned by LBP, especially because of biomechanical and psycho-organizational risk factors. Our current study aims to investigate risk factors associated with chronic low back pain among Tunisian caregivers in university-hospitals. Methods: Cross-sectional study conducted over a period of 14 months, with a representative sample of caregivers, matched according to age, sex and work department, in two university-hospitals in Tunisia. Data collection included items related to socio-professional characteristics, the evaluation of the working capacity index (WAI), the occupational stress (Karazek job strain questionnaire); the quality of life (SF12), the musculoskeletal disorders Nordic questionnaire, and the examination of the spine flexibility (distance finger-ground, sit-stand maneuver and equilibrium test). Results: Totally, 293 caregivers were included with a mean age equal to 42.64 ± 11.65 years. A body mass index (BMI) exceeding 30, was noted in 20.82% of cases. Moreover, no regular physical activity was practiced in 51.9% of cases. In contrast, domestic activity equal or exceeding 20 hours per week, was reported by 38.22%. Job strain was noted in 19.79 % of cases and the work capacity was 'low' to 'average' among 27.64% of subjects. During the 12 months previous to the investigation, 65% of caregivers complained of LBP, with pain rated as 'severe' or 'extremely severe' in 54.4% of cases and with a frequency of discomfort exceeding one episode per week in 58.52% of cases. During physical examination, the mean distance finger-ground was 7.10 ± 7.5cm. Caregivers assigned to 'high workload' services had the highest prevalence of LBP (77.4%) compared to other categories of hospital services, with no statistically significant relationship (P = 0.125). LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p < 10⁻³). Moreover, the increase of the distance finger-ground was statistically associated with LBP (p = 0.05), advanced age (p < 10⁻³), professional seniority (p < 10⁻³) and the BMI ≥ 25 (p = 0.001). Furthermore, others physical tests of spine flexibility were underperformed among LBP suffering workers with a statistically significant difference (sit-stand maneuver (p = 0.03); equilibrium test (p = 0.01)). According to the multivariate analysis, only the domestic activity exceeding 20H/week, the degraded quality of physical life, and the presence of neck pain were significantly corelated to LBP. The final model explains 36.7% of the variability of this complaint. Conclusion: Our results highlighted the elevate prevalence of LBP among caregivers in Tunisian public hospital and identified both professional and individual predisposing factors. The preliminary analysis supports the necessity of a multidimensional approach to prevent this critical occupational and public health problem. The preventive strategy should be based both on the improvement of working conditions, and also on lifestyle modifications, and reinforcement of healthy behaviors in these active populations.

Keywords: health care workers, low back pain, prevention, risk factor

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Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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Authors: Jureerat Kilsomporn, Chularat Howharn

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The aim of this qualitative study was to describe the meaning of leisure and the role of leisure among elderly people aged more than 80. Participants were purposive selected. Inclusion criteria were age more than 80 year, has no disease, and independent for daily life activities. Data were collected by in-depth interview. Each participant was interviewed two times and 45-60 minutes in each time of interview. Content analyses were conducted to describe the findings. The findings were as followed. Ten active aging participated in this study. All of them are Buddhist with age between 83-89 years old. Most of them completed the primary school. All of them were active members of community club such as elderly club, women club, and funeral association. Active aging described leisure as activities that connected them with their communities. Leisure could be categorized into three groups which were religious activities, entertainment activities, and hobbies. Examples of religious activities were ordination, house-blessing ceremony, and wedding ceremony. Examples of entertainment activities were Thai dance, beat a drum, and sang local songs. Participants described more that they joined and did in leisure for a sake of pleasure. These leisure played significant roles; significantly affect were their minds and their spiritual. Religious activities play a significant role in spiritual well-being while entertainment activities play a significant role in maintaining good status of mental health. Effect of hobby activities which most of these were payable activities were increased their self-valued. Although it was not high incomes but they can use their own money as they designed. Moreover, participants describe that they have a feeling of use their time wisely since they can earn the money, they can have an exercise, and they can share the time with their neighborhood with these activities. Suggestions from this study were that authorized personnel should promote leisure for aging regularly and continuously. Any facilities that meet with their need and their desired should be promoted since these can facilitate aging to maintain their good health status.

Keywords: active aging, activities, elderly, leisure

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Authors: Sven Gehrke, Johannes Ruhland

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Data is the oil of our time, without them progress would come to a hold [1]. On the other hand, the mistrust of data mining is increasing [2]. The paper at hand shows different aspects of the concept of trust and describes the information asymmetry of the typical stakeholders of a data mining project using the CRISP-DM phase model. Based on the identified influencing factors in relation to trust, problematic aspects of the current approach are verified using various interviews with the stakeholders. The results of the interviews confirm the theoretically identified weak points of the phase model with regard to trust and show potential research areas.

Keywords: trust, data mining, CRISP DM, stakeholder management

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Authors: Usama Bin Zubair, Syed Azhar Ali

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Introduction: Depression is emerging as a major public health problem in all parts of the world. Developing countries have a unique socioeconomic structure that affects the lives of its inhabitants in several ways. Going abroad for employment is one of the common social problems which have been faced by young males in developing countries. This included both highly qualified individuals as well as the labor class. Objective: To determine the difference in the presence of depressive symptoms among pregnant women with husbands living abroad and those with husbands living with them in Azad Jammu and Kashmir. Methods: The sample population comprised of pregnant women reporting for an antenatal checkup at Amna hospital Rawalakot. Cases constituted the pregnant women with husbands living abroad while controls were the pregnant women with husbands living with them. Patient health questionnaire-9 (PHQ-9) was used to record the presence and severity of depressive symptoms. Age, gestation, parity, rural or urban origin, education, level of family income, daily contact hours on the telephone or what’s app, previous pregnancy loss or complications, number of years abroad and visits to home per year were associated with the presence of depressive symptoms. Findings: The mean age of the study participants was 29.73 ±5.395 years. Sixty-six had significant depression in the case group, while 14 had in the control group (p-value<0.001). Education and rural background had a significant difference between the case and the control group. Less number of visits per year of the husband was strongly linked with the presence of depressive symptoms among the cases. Conclusion: Pregnant women with husbands abroad were found more prone to develop depressive symptoms as compared to those with husbands living with them. Special attention should be paid to the women whose husband had a lesser number of visits to the country.

Keywords: depression, pregnancy, lack of support, war zone

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Authors: Mohammed Khalil Ur Rahman, Pradnya Chigle, Bushra Farhen

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Indian mythology believes that Vedas are eternal treatises. Vedas are categorized into four divisions viz., Rigveda, Yajurveda, Samveda, Atharveda. All these spiritual classics not only deal with rituals and customs but also consist of inclusion of many references related to health. Out of these four, Atharveda deals with maximum principles pertaining to health sciences. Therefore, it is said that the science and the art of Ayurveda has developed from Atharveda. Ayurveda deals with many medicinal plants either as a single therapeutic use or in combination. One such medicinal plant is Snuhi (Euphorbia neriifolia Linn.) which finds its extensive importance along with Haridra and Apamargakshar, in the preparation of Ksharsutra which in turn is used for the treatment of Fistula in Ano. It is interesting to note that this plant Snuhi is also referred in Holy Quran as the Tree of Zaqqum advocated as the food for the sinners as a part of torment. The reference in Surat Ad-Dukhan is as follows: - 44:43-46. “Verily, the tree of Zaqqum will be the food of the sinners, Like boiling oil, it will boil in the bellies, like the boiling of scalding water.” The above verse implies that plant Snuhi/Zaqqum due to irritant property acts as a drastic purgative but at the same time it also possesses anti inflammatory properties in order to relieve the irritation. These properties of Zaqqum has been unfolded in the modern research which states that, Diterpene polycyclic esters are responsible for its toxic and irritant nature whereas; triterpenes are responsible for its anti inflammatory property. Present work will be an effort to review the concept of Quran about latex of the Tree of Zaqqum in terms of its phytochemistry and its therapeutic use in Ksharsutra pertaining to irritant and anti inflammatory property.

Keywords: ayurveda, Quran, zaqqum, ksharsutra, latex piles, inflammation

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Authors: Lewis Mehl-Madrona, Barbara Mainguy, Patrick McFarlane

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Introduction: There are many risk factors for attempting suicide, including young age, “minority stress,” which would include Transgender and Gender Diverse orientations (TGD). The rate of TGD youths for suicide attempts is 3 times higher than heterosexual cis-gender youth. Half of TGD youth have seriously contemplated taking their own lives; of those, about half attempted suicide; and 18% of the TGD teenagers reported suicidal thoughts linked to their gender identity. Native American TGD have a six times higher suicide attempt rate. Conventional mental health has not generally helped these individuals. Stigma and discrimination contribute to healthcare disparities. Storytelling plays a crucial role in the development of human culture and individual identities. Sharing narrative artwork, creative writing, and personal stories allow people to build trust and to share their vulnerabilities. This helps people become aware of themselves in relation to others and gain a sense of comfort that their stories are similar; they may also be transformed in the process. Art provides a means to reach people who are otherwise difficult to engage in services. Methods: TGD individuals are recruited through a snowballing procedure. Following a life story interview, participants complete a scale of gender dysphoria, identification with conventional masculinity, patient-reported anxiety, and depression measure, and a quality-of-life scale. The interview completes the Columbia Suicide Scale. Following this, an artist and a therapist works with the participant to create a story related to their gender identity using the six-part story method. This story is then rendered to an artists’ book, which combines narrative with art (drawings, collage, computer images, etc.) and can take the form of a graphic novella, a zine, or a comic book. The pages can range from plain to ornate, as can the covers. Participants describe their process of making the books as the work unfolds and then participate in an exit interview at the completion of their book, remarking on what has changed for them and how the process affected them. Results: Preliminary results show high levels of suicidal thoughts among this population, as expected. Participants participate enthusiastically in the life story interview process and in the construction of a story related to gender identity. They enthusiastically participate in the studio process of putting their story into the form of a graphic novel, zine, or comic book. Participants reported feeling more comfortable with their TGD identity after the process and more able to resist negative judgments of family members and society. Suicidal thoughts diminish, and participants reported improved emotional wellbeing. Quantitative analysis of questionnaire data is underway Conclusions: A process in which narrative therapy is combined with art therapy shows promise for attracting and helping TGD individuals to reduce their risk for suicide without the stigma of going for mental health treatment. This process can be done outside of conventional mental health settings, on college and University campuses. This can provide an exciting alternative pathway for minority stressed and stigmatized individuals to engage in reflective, psychotherapeutic work without the trappings of psychotherapy or mental health treatment.

Keywords: minority stress, narrative process, artists' books, life story interview

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Authors: Chaebong Kim, Yongmin Cho, Minkyung Han, Mooyoung Kim, KooSang Kim

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Background: Air pollution from global warming has a considerable influence on respiratory disease and atopic dermatitis (AD). Present studies base on a hypothesis about correlation between air pollutant and AD, and the results are analyzed from various points of view. Objectives: This study aimed to integrate the relevant researches for air pollutant and AD, and to perform the systematic literature review and meta-analysis to provide the basis of air pollutant control. Methods: Research materials were collected from original articles published in English academic journals including medicine, nursing and health science from August 1 to 31, 2016. We collected the materials from Pubmed, Medline, Embase, Cochrane Central database with Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) based on the Cochrane Systematic Review Manual, and performed the evaluation and analysis for selected materials. We got the research results for risk of bias using Rev-Man ver. 5.2, and meta analyses using STATA. Results: The prevalence of infantile atopic dermatitis were 1.05 times higher than other groups who were exposed to air pollution, and exposure to NO2 (1.08, 95% CI: 1.02 – 1.14), O3 (1.09, 95% CI: 1.04 – 1.15), SO2 (1.07, 95% CI: 1.02 – 1.12) in subgroup air pollutant was considerably associated with infantile atopic dermatitis. The prevalence of infantile atopic dermatitis was 1.03 times higher than other groups who were exposed to PM2.5, but the results were not statistically similar. Conclusion: Health effect from environmental pollution risen people’s interest in environmental diseases. Air pollutant was associated with AD in this study, but selected literature was based on non-RCT (Randomized Controlled Trial) study. Therefore, there was a limit in study method including control, matching, and correction of confounding variables. For clear conclusion, it is necessary to develop the appropriate tool for object of study and clear standard to measure of air pollutant.

Keywords: air pollution, atopic dermatitis, children, meta-analysis

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Authors: Vicki R. Voskuil, Jorgie M. Watson

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Despite the well-established health benefits of physical activity (PA), most adolescents do not meet guidelines recommending 60 minutes of moderate to vigorous physical activity (MVPA) each day. Adolescent girls engage in less PA than boys, a difference that increases with age. By the 9th grade, only 20% of girls report meeting recommendations for PA with lower percentages for black and Hispanic girls compared to white girls. The purpose of the study was to explore the physical activity (PA) behavior and needs of adolescent girls. Study aims included assessment of adolescent girls’ PA behavior; facilitators of and barriers to PA, PA needs, and acceptability of the Fitbit-Flex 2 activity tracker. This exploratory study used a qualitative and quantitative approach. The qualitative approach involved a focus group using a semi-structured interview technique. PA was measured using the Fitbit-Flex 2 activity tracker. Steps, distance, and active minutes were recorded for one week. A Fitbit survey was also administered to assess acceptability. SPSS Version 22.0 and ATLAS.ti Version 8 were used to analyze data. Girls in the ninth grade were recruited from a high school in the Midwest (n=11). Girls were excluded if they were involved in sports or other organized PA ≥ 3 days per week, had a health condition that prevented or limited PA, or could not read and write English. Participants received a Fitbit-Flex 2 activity tracker to wear for one week. At the end of the week, girls returned the Fitbit and participated in a focus group. Girls responded to open-ended questions regarding their PA behavior and shared their ideas for future intervention efforts aimed at increasing PA among adolescents. Girls completed a survey assessing their perceptions of the Fitbit. Mean age of the girls was 15.3 years (SD=0.44). On average girls took 6,520 steps and walked 2.73 miles each day. Girls stated their favorite types of PA were walking, riding bike, and running. Most girls stated they did PA for 30 minutes or more at a time once a day or every other day. The top 3 facilitators of PA reported by girls were friends, family, and transportation. The top 3 barriers included health issues, lack of motivation, and weather. Top intervention ideas were community service projects, camps, and using a Fitbit activity tracker. Girls felt the best timing of a PA program would be in the summer. Fitbit survey results showed 100% of girls would use a Fitbit on most days if they had one. Ten (91%) girls wore the Fitbit on all days. Seven (64%) girls used the Fitbit app and all reported they liked it. Findings indicate that PA participation for this sample is consistent with previous studies. Adolescent girls are not meeting recommended daily guidelines for PA. Fitbit activity trackers were positively received by all participants and could be used in future interventions aimed at increasing PA for adolescent girls. PA interventions that take place in the summer with friends and include community service projects may increase PA and be well received by this population.

Keywords: adolescents, girls, interventions, physical activity

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Authors: S. A. Gayvoronsky, T. A. Ezangina

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The robust control system objects with interval-undermined parameters is considers in this paper. Initial information about the system is its characteristic polynomial with interval coefficients. On the basis of coefficient estimations of quality indices and criterion of the maximum stability degree, the methods of synthesis of a robust regulator parametric is developed. The example of the robust stabilization system synthesis of the rope tension is given in this article.

Keywords: interval polynomial, controller synthesis, analysis of quality factors, maximum degree of stability, robust degree of stability, robust oscillation, system accuracy

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Authors: Adebayo-Victoria Tobi Dada, Dada Emmanuel

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This study assessed households’ food security and hunger levels among different communities with varying educational and economic background in Ile-Ife, Nigeria, and its environment. It also examined the impacts of varying demography on the household food security level in the area. This was with a view to providing information on the food security status of the subjects within the study area. Ten different communities with varying demography (Parakin, Mokuro, Ilare, Obafemi Awolowo University (OAU) Staff Quarters, Ibadan Road, Aba-Iya Gani, Eleweran, Iraye, Boosa, and Eku-Isobo) were identified within the study area. Fieldwork was then carried out from 7th to 14th of March, 2016 in each of these communities through survey of market prices of food stuff, diet, and nutrition, social well-being, food accessibility and affordability as well as price fluctuation and variation in household’s social background. Selection of households for the survey was done using stratified random sampling method. Key informants included community heads, landlords, tenants, and household heads. Similarly, information on food security levels with respect to demographic backgrounds was obtained from the use of modified Food and Hunger Insecurity Module (FHIM) structured questionnaire. The questionnaire was administered to one percent of the households’ population per community. The results showed that communities such as Parakin and OAU Senior Staff Quarters were dominated by civil servants, while community such as Boosa was dominated by artisans. Respondents earning between ₦11,000 and ₦20,000 per month, during the study period, had the highest percentage across the selected communities. The household food security indices showed that about 41% of the investigated respondents could not guarantee their household food for a month, while 18% reduced or skipped meals. There were positive significant relationships between monthly income (F-value = 132.04), educational status (F-value = 102.30), occupation (F-value = 104.05) and food budget (F-value = 122.09), all at p < 0.05. However, there was no significant relationship between the monthly food budget and household sizes (t-value = -1.4074, p > 0.05). Food secured households’ had the household heads with a higher level of educational attainment. The study concluded that large variations which existed between socio-economic and educational background among the communities had significant effects on households’ food security level in the study area.

Keywords: food security, households, hunger level, market prices

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Authors: Ashir Ahmed

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Generally, radicalization happens when a person's thinking and behaviour become significantly different from how most of the members of their society and community view social issues and participate politically. Radicalization often leads to violent extremism that refers to the beliefs and actions of people who support or use violence to achieve ideological, religious or political goals. Studies on radicalization negate the common myths that someone must be in a group to be radicalised or anyone who experiences radical thoughts is a violent extremist. Moreover, it is erroneous to suggest that radicalisation is always linked to religion. Generally, the common motives of radicalization include ideological, issue-based, ethno-nationalist or separatist underpinning. Moreover, there are number of factors that further augments the chances of someone being radicalised and may choose the path of violent extremism and possibly terrorism. Since there are numbers of factors (and sometimes quite different) contributing in radicalization and violent extremism, it is highly unlikely to devise a single solution that could produce effective outcomes to deal with radicalization, violent extremism and terrorism. The pathway to deradicalization, like the pathway to radicalisation, is different for everyone. Considering the need of having customized deradicalization resolution, this study proposes a multi-tier framework, called ‘pyramid of deradicalization’ that first help identifying the stage at which an individual could be on the radicalization pathway and then propose a customize strategy to deal with the respective stage. The first tier (tier 1) addresses broader community and proposes a ‘universal approach’ aiming to offer community-based design and delivery of educational programs to raise awareness and provide general information on possible factors leading to radicalization and their remedies. The second tier focuses on the members of community who are more vulnerable and are disengaged from the rest of the community. This tier proposes a ‘targeted approach’ targeting the vulnerable members of the community through early intervention such as providing anonymous help lines where people feel confident and comfortable in seeking help without fearing the disclosure of their identity. The third tier aims to focus on people having clear evidence of moving toward extremism or getting radicalized. The people falls in this tier are believed to be supported through ‘interventionist approach’. The interventionist approach advocates the community engagement and community-policing, introducing deradicalization programmes to the targeted individuals and looking after their physical and mental health issues. The fourth and the last tier suggests the strategies to deal with people who are actively breaking the law. ‘Enforcement approach’ suggests various approaches such as strong law enforcement, fairness and accuracy in reporting radicalization events, unbiased treatment by law based on gender, race, nationality or religion and strengthen the family connections.It is anticipated that the operationalization of the proposed framework (‘pyramid of deradicalization’) would help in categorising people considering their tendency to become radicalized and then offer an appropriate strategy to make them valuable and peaceful members of the community.

Keywords: deradicalization, framework, terrorism, violent extremism

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Authors: Rishi Kanth Saripalle

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Medical experts highly recommend to include physical activity in everyone’s daily routine irrespective of gender or age as it helps to improve various medical issues or curb potential issues. Simultaneously, experts are also diligently trying to provide various healthcare services (interventions, plans, exercise routines, etc.) for promoting healthy living and increasing physical activity in one’s ever increasing hectic schedules. With the introduction of wearables, individuals are able to keep track, analyze, and visualize their daily physical activities. However, there seems to be no common agreed standard for representing, gathering, aggregating and analyzing an individual’s physical activity data from disparate multiple sources (exercise pans, multiple wearables, etc.). This issue makes it highly impractical to develop any data-driven physical activity applications and healthcare programs. Further, the inability to integrate the physical activity data into an individual’s Electronic Health Record to provide a wholistic image of that individual’s health is still eluding the experts. This article has identified three primary reasons for this potential issue. First, there is no agreed standard, both structure and semantic, for representing and sharing physical activity data across disparate systems. Second, various organizations (e.g., LA fitness, Gold’s Gym, etc.) and research backed interventions and programs still primarily rely on paper or unstructured format (such as text or notes) to keep track of the data generated from physical activities. Finally, most of the wearable devices operate in silos. This article identifies the underlying problem, explores the idea of reusing existing standards, and identifies the essential modules required to move forward.

Keywords: electronic physical activity record, physical activity in EHR EIM, tracking physical activity data, physical activity data standards

Procedia PDF Downloads 279

Authors: Mykah W. Sumoldao, Maria Erissa C. Susa, Triny Cate M. Telan, Christian Arvin M. Torres, Jasmine I. Udasco, Franceis Jeramil M. Walis, Shellyn S. Wandagan, Janine May M. Warding, Queenie Diana Rose P. Zalun Hope Lulet A. Lomioan

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This descriptive phenomenological study explored the lived experiences of the primary caregiver of schizophrenia patients at the Acute Crisis Intervention Service in Cagayan Valley Medical Center. The research aimed to understand the emotional, physical, and financial challenges these primary caregivers face. Data was gathered through interviews with nine (9) primary caregivers and analyzed using Colaizzi’s seven-step method. Two main themes emerged: Experience/ Challenges (Emotional, Physical, and Financial Challenges) and Managing Mechanisms (Support Systems and Resilience and Commitment). The study found that primary caregivers deal with a complex mix of difficulties, often with limited resources. They rely heavily on personal strength, faith, family, friends and community support to manage their roles. The findings highlighted the need for better support systems to ease primary caregivers' burdens. Financial aid, respite care, and mental health support are crucial for improving primary caregivers' quality of life and the care they provide. Additionally, raising awareness about primary caregivers' challenges can foster a supportive community, with more help from local organizations and government entities. Thus, this study provided insights into the caregiving experiences of those supporting schizophrenia patients. It emphasized the importance of practical support and emotional resilience. By addressing these needs, a more supportive environment can be created, benefiting both primary caregivers and their patients.

Keywords: primary caregiver burden, mental health, primary caregiver well-being, primary caregiver

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Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

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Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

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Authors: Andrew John Zeller, Francis Pouatcha

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Working according to the DevOps principle has gained in popularity over the past decade. While its extension DevSecOps started to include elements of cybersecurity, most real-life projects do not focus risk and security until the later phases of a project as teams are often more familiar with engineering and infrastructure services. To help bridge the gap between security and engineering, this paper will take six building blocks of cybersecurity and apply them to the DevOps approach. After giving a brief overview of the stages in the DevOps lifecycle, the main part discusses to what extent six cybersecurity blocks can be utilized in various stages of the lifecycle. The paper concludes with an outlook on how to stay up to date in the dynamic world of cybersecurity.

Keywords: information security, data security, cybersecurity, devOps, IT management

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Authors: Hritik Bhattarai

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Land use and land cover play a crucial role in preserving and managing Earth's natural resources. Various factors, such as economic, demographic, social, cultural, technological, and environmental processes, contribute to changes in land use and land cover (LULC). Rupandehi District is significantly influenced by a combination of driving forces, including its geographical location, rapid population growth, economic opportunities, globalization, tourism activities, and political events. Urbanization and urban growth in the region have been occurring in an unplanned manner, with internal migration and natural population growth being the primary contributors. Internal migration, particularly from neighboring districts in the higher and lower Himalayan regions, has been high, leading to increased population growth and density. This study utilizes geospatial technology, specifically geographic information system (GIS), to analyze and illustrate the land cover and land use changes in the Rupandehi district for the years 2009 and 2019, using freely available Landsat images. The identified land cover categories include built-up area, cropland, Das-Gaja, forest, grassland, other woodland, riverbed, and water. The statistical analysis of the data over the 10-year period (2009-2019) reveals significant percentage changes in LULC. Notably, Das-Gaja shows a minimal change of 99.9%, while water and forest exhibit increases of 34.5% and 98.6%, respectively. Riverbed and built-up areas experience changes of 95.3% and 39.6%, respectively. Cropland and grassland, however, show concerning decreases of 102.6% and 140.0%, respectively. Other woodland also indicates a change of 50.6%. The most noteworthy trends are the substantial increase in water areas and built-up areas, leading to the degradation of agricultural and open spaces. This emphasizes the urgent need for effective urban planning activities to ensure the development of a sustainable city. While Das-Gaja seems unaffected, the decreasing trends in cropland and grassland, accompanied by the increasing built-up areas, are unsatisfactory. It is imperative for relevant authorities to be aware of these trends and implement proactive measures for sustainable urban development.

Keywords: land use and land cover, geospatial, urbanization, geographic information system, sustainable urban development

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Authors: Adil Hassabo

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In this paper, a horizontal circular curve computations calculator is developed in Microsoft Windows. The developed calculator can be used for determining the necessary information required for setting out horizontal curves. Three methods are applied in the developed program namely: incremental chord method, total chord method, and the coordinates method. Computations of horizontal curves by the developed calculator is faster, easier, accurate, and less subject to errors comparable to the traditional method of calculations. Finally, the results obtained by the traditional method and by the developed calculator are presented for checking the behavior of the developed calculator.

Keywords: calculator, circular, computations, curve

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Authors: O. Ekrami, P. Claes, S. Van Dongen

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Fluctuating asymmetry (FA) has been studied for many years as an indicator of developmental stability or ‘genetic quality’ based on the assumption that perfect symmetry is ideally the expected outcome for a bilateral organism. Further studies have also investigated the possible link between FA and attractiveness or levels of masculinity or femininity. These hypotheses have been mostly examined using 2D images, and the structure of interest is usually presented using a limited number of landmarks. Such methods have the downside of simplifying and reducing the dimensionality of the structure, which will in return increase the error of the analysis. In an attempt to reach more conclusive and accurate results, in this study we have used high-resolution 3D scans of human faces and have developed an algorithm to measure and localize FA, taking a spatially-dense approach. A symmetric spatially dense anthropometric mask with paired vertices is non-rigidly mapped on target faces using an Iterative Closest Point (ICP) registration algorithm. A set of 19 manually indicated landmarks were used to examine the precision of our mapping step. The protocol’s accuracy in measurement and localizing FA is assessed using simulated faces with known amounts of asymmetry added to them. The results of validation of our approach show that the algorithm is perfectly capable of locating and measuring FA in 3D simulated faces. With the use of such algorithm, the additional captured information on asymmetry can be used to improve the studies of FA as an indicator of fitness or attractiveness. This algorithm can especially be of great benefit in studies of high number of subjects due to its automated and time-efficient nature. Additionally, taking a spatially dense approach provides us with information about the locality of FA, which is impossible to obtain using conventional methods. It also enables us to analyze the asymmetry of a morphological structures in a multivariate manner; This can be achieved by using methods such as Principal Components Analysis (PCA) or Factor Analysis, which can be a step towards understanding the underlying processes of asymmetry. This method can also be used in combination with genome wide association studies to help unravel the genetic bases of FA. To conclude, we introduced an algorithm to study and analyze asymmetry in human faces, with the possibility of extending the application to other morphological structures, in an automated, accurate and multi-variate framework.

Keywords: developmental stability, fluctuating asymmetry, morphometrics, 3D image processing

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