Search results for: alternative and complementary healthcare

Authors: Amaal Almigal

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Technology has been argued to offer distinct advantages and benefits for teaching children with autism spectrum disorder (ASD) to communicate. One aspect of this technology is augmentative and alternative communication (AAC) systems such as picture exchange or speech generation devices. Whilst there has been significant progress in teaching these children to request their wants and needs with AAC, there remains a need for developing technologies that can really make a difference in teaching them to ask questions. iPad-based AAC can be effective for communication. However, the effectiveness of this type of AAC in teaching children to ask questions needs to be examined. Thus, in order to examine the effectiveness of iPad-based AAC in teaching children with ASD to ask questions, This research will test whether iPad leads to more learning than a traditional approach picture and text cards does. Two groups of children who use AAC will be taught to ask ‘What is it?’ questions. With the first group, low-tech AAC picture and text cards will be used, while an iPad-based AAC application called Proloquo2Go will be used with the second group. Interviews with teachers and parents will be conducted before and after the experiment. The children’s perspectives will also be considered. The initial outcomes of this research indicate that iPad can be an effective tool to help children with autism to ask questions.

Keywords: autism, communication, information, iPad, pictures, requesting

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Authors: Alimohammad

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Man's entry into space is one of the most important results of developments and advances made in information technology. But this human step, like many of his other actions, is not free of danger, as space pollution today has become a major problem for the global community. Paying attention to the issue of preserving the space environment is in the interest of all governments and mankind, and ignoring it can increase the possibility of conflict between countries. What many space powers still do not pay attention to is the freedom to explore and exploit space should be limited by banning pollution of the space environment. Therefore, freedom and prohibition are complementary and should not be considered conflicting concepts. The legal system created by the current space treaties for the effective preservation of the space environment has failed. Customary international law also does not have an effective provision and guarantee of sufficient executions in order to prevent damage to the environment. Considering the responsibility of each generation in the healthy transfer of the environment to the next generation and considering the sustainable development concept, the space environment must also be passed on to future generations in a healthy and undamaged manner. As a result, many environmental policies related to Earth should also be applied to the space environment..

Keywords: law, space, environment, responsibility

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Authors: Anton V. Dolzhenko, Tahir Mehmood Khan

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An ability to make an evidence-based decision is a critically important skill required for practicing pharmacists. The development of this skill is incorporated into the pharmacy curriculum. We aimed in our study to estimate perception of pharmacy students regarding herbal medicines and their ability to assess information on herbal medicines professionally. The current Monash University curriculum in Pharmacy does not provide comprehensive study material on herbal medicines and students should find their way to find information, assess its quality and make a professional decision. In the Pharmacy course, students are trained how to apply this process to conventional medicines. In our survey of 93 undergraduate students from year 1-4 of Pharmacy course at Monash University Malaysia, we found that students’ view on herbal medicines is sometimes associated with common beliefs, which affect students’ ability to make evidence-based conclusions regarding the therapeutic potential of herbal medicines. The use of herbal medicines is widespread and 95.7% of the participated students have prior experience of using them. In the scale 1 to 10, students rated the importance of acquiring herbal medicine knowledge for them as 8.1±1.6. More than half (54.9%) agreed that herbal medicines have the same clinical significance as conventional medicines in treating diseases. Even more, students agreed that healthcare settings should give equal importance to both conventional and herbal medicine use (80.6%) and that herbal medicines should comply with strict quality control procedures as conventional medicines (84.9%). The latter statement also indicates that students consider safety issues associated with the use of herbal medicines seriously. It was further confirmed by 94.6% of students saying that the safety and toxicity information on herbs and spices are important to pharmacists and 95.7% of students admitting that drug-herb interactions may affect therapeutic outcome. Only 36.5% of students consider herbal medicines as s safer alternative to conventional medicines. The students use information on herbal medicines from various sources and media. Most of the students (81.7%) obtain information on herbal medicines from the Internet and only 20.4% mentioned lectures/workshop/seminars as a source of such information. Therefore, we can conclude that students attained the skills on the critical assessment of therapeutic properties of conventional medicines have a potential to use their skills for evidence-based decisions regarding herbal medicines.

Keywords: evidence-based decision, pharmacy education, student perception, traditional medicines

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Authors: Naci Büyükkaracığan, Murat Ahmet Ökmen

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Emerging demand for energy in developing countries rapid population growth and industrialization are causing a rapid increase, such as Turkey. Energy is an important and indispensable factor in the industry. At the same time, energy is one of the main indicators that reflect a country's economic and social development potential. There is a linear relationship between the energy consumption and social development, and in parallel this situation, it is seen that energy consumption increase with economic growth and prosperity. In recent year’s, energy sources consumption is increasingly continuing, because of population growth and economy in Turkey. 80% of the energy used in Turkey is supplied from abroad. At the same time, while almost all of the energy obtained from our country is met by hydropower. Alternatively, studies of determining and using potential renewable energy sources such as solar energy have been realized for recent years. In this study, first of all, the situation of energy sources was examined in Turkey. Information of reserve/capacity, production and consumption values of energy sources were emphasized. For this purpose, energy production and consumption, CO2 emission and electricity energy consumption of countries were investigated. Energy consumption and electricity energy consumption per capita were comparatively analyzed.

Keywords: energy potential, alternative energy sources, solar energy, Turkey

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Authors: Simon Mwima, Evans Jennifer Mann, Agnes Nzomene, Edson Chipalo, Eusebius Small, Moses Okumu, Bosco Mukuba

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Introduction: In Uganda, sexual minorities experience exacerbated intersectional stigma and discrimination that exposes them to elevated HIV infections and impedes access to HIV testing and PrEP with low treatment adherence. We contribute to the lack of information about sexual minorities living with HIV in Uganda by using modified social-ecological theory to explore social influences impacting HIV services engagement. Findings from focused group discussion (FGD) involving 31 sexual minorities, ages 18-25, recruited through urban HIV clinics in Kampala reveal the protective and promotive social influence within the individual and interpersonal relationships (sexual partners and peers). Further, inhibitive social influences were found within family, community, societal, and healthcare settings. During the COVID-19 pandemic, these adolescents strategically used promotive social influences to increase their engagement with HIV care services. Interviews were recorded in English, transcribed verbatim, and analyzed using Dedoose. Conclusions: The findings revealed that young people (identified as sexual minorities) strategically used promotive social influences and supported each other to improve engagement with HIV care in the context of restrictive laws in Uganda during the COVID-19-Pandemic. Future HIV prevention, treatment, and care responses could draw on how peers support each other to navigate the heavily criminalized and stigmatized settings to access healthcare services.

Keywords: HIV/AIDS services, intersectional stigma, discrimination, adolescents, sexual minorities, COVID-19 pandemic Uganda

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Authors: Ivana Tadic, Snjezana Pivac

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Although human resources are recognized as the crucial companies’ resources and their positive influence on companies’ performances has been confirmed through different researches, scientists are still debating it. In order to contribute this debate, this paper firstly discusses the most important human resource management elements and practices and its influence on companies’ success. Afterwards it defines human resource “bundles” – interrelated and internally consistent human resource practices, complementary to each other, or the most important human resource practices and elements regarding Croatian companies and its human resource management activities. Finally, the paper provides empirical results; more precisely it reveals the relation of the level of development of human resource management function (“bundles”) and companies’ financial performances (using profitability ratios, liquidity ratios, solvency ratios and a group of additional ratios related to employees’ indicators).

Keywords: companies’ performances, human resource bundles, multivariate statistical analysis, marketing

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Authors: Christina Killian, Katie Wall, Séamus Fanning, Guerrino Macori

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Deep-level metagenomics offers a useful technical approach to explore the three dynamic One Health axes: healthcare, domiciliary and veterinary. There is currently limited understanding of the composition of complex biofilms, natural abundance of AMR genes and gene transfer occurrence in these ecological niches. By using a newly established small-scale complex biofilm model, COMBAT has the potential to provide new information on microbial diversity, antimicrobial resistance (AMR)-encoding gene abundance, and their transfer in complex biofilms of importance to these three One Health axes. Shotgun metagenomics has been used to sample the genomes of all microbes comprising the complex communities found in each biofilm source. A comparative analysis between untreated and biocide-treated biofilms is described. The basic steps include the purification of genomic DNA, followed by library preparation, sequencing, and finally, data analysis. The use of long-read sequencing facilitates the completion of metagenome-assembled genomes (MAG). Samples were sequenced using a PromethION platform, and following quality checks, binning methods, and bespoke bioinformatics pipelines, we describe the recovery of individual MAGs to identify mobile gene elements (MGE) and the corresponding AMR genotypes that map to these structures. High-throughput sequencing strategies have been deployed to characterize these communities. Accurately defining the profiles of these niches is an essential step towards elucidating the impact of the microbiota on each niche biofilm environment and their evolution.

Keywords: COMBAT, biofilm, metagenomics, high-throughput sequencing

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Authors: Leong Tatt Loh, Ming Kun Yew, Ming Chian Yew, Lip Huat Saw, Jing Han Beh, Siong Kang Lim, Foo Wei Lee

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Oil palm shell (OPS) is the solid waste product from the palm oil sector of the agricultural industry and can be used as alternative coarse aggregates to substitute depleting conventional raw materials. This research aims to investigate the incorporation of various high-performance polypropylene (HPP) fibres with different geometry to enhance the mechanical properties and thermal conductivity of OPS lightweight concrete. The effect of different volume fractions (Vf) (0.05%, 0.10% and 0.15%) were studied for each fibre. The results reveal that the effectiveness of HPP fibres to increase the compressive strength at later ages was more pronounced than at early age. It is found that the use of HPP fibres reinforced OPS lightweight concrete (LWC) induced the advantageous of improving mechanical properties (compressive strength, flexural strength and splitting tensile strength) and thermal conductivity. Hence, this HPP fibres is a promising alternative solution to compensate lower mechanical properties as well as contribute to energy efficiency building material in the construction industry.

Keywords: oil palm shell, high performance polypropylene fibre, lightweight concrete, mechanical properties, thermal conductivity

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Authors: K. A. Adeleke

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Often in epidemiological research, introducing stratified Cox model can account for the existence of interactions of some inherent factors with some major/noticeable factors. This research work aimed at modelling correlated variables in infant mortality with the existence of some inherent factors affecting the infant survival function. An alternative semiparametric Stratified Cox model is proposed with a view to take care of multilevel factors that have interactions with others. This, however, was used as a tool to model infant mortality data from Nigeria Demographic and Health Survey (NDHS) with some multilevel factors (Tetanus, Polio, and Breastfeeding) having correlation with main factors (Sex, Size, and Mode of Delivery). Asymptotic properties of the estimators are also studied via simulation. The tested model via data showed good fit and performed differently depending on the levels of the interaction of the strata variable Z*. An evidence that the baseline hazard functions and regression coefficients are not the same from stratum to stratum provides a gain in information as against the usage of Cox model. Simulation result showed that the present method produced better estimates in terms of bias, lower standard errors, and or mean square errors.

Keywords: stratified Cox, semiparametric model, infant mortality, multilevel factors, cofounding variables

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Authors: Yasin I. Tayem, Jamil Ahmed, Mahmood Bahzad, Abdullah Alnama, Fahad Al Asfoor, Mahmood A. Jalil, Mohammed Radhi, Ahmed Alenezi, Khalid A. J. Al-Khaja

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Drug-drug interactions (DDIs) represent a significant cause of patient’s morbidity and mortality. The rate of DDIs is rapidly increasing worldwide with the increasing proportion of ageing population and frequent requirement of polypharmacy-prescription of multiple drugs to treat comorbidities. Prescribing physicians are responsible for checking their prescriptions for the presence and severity of DDIs. However, since a large number of new drugs are approved and marketed every year, new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely only upon their previous knowledge of medicine to avoid potential DDIs. The aim of this study was to explore the perceptions of physicians working at primary healthcare centers in Bahrain towards DDIs and how they manage them during their practice. Methodology: In this cross-sectional study, physicians working at all governmental primary healthcare centers in Bahrain were invited to voluntarily, privately and anonymously respond to a self-administered questionnaire. The questionnaire aims to assess their self-reported knowledge of DDIs and how they check for them in their practice. The participants were requested to provide socio demographic data and information related to their attitudes towards DDIs including strategies they employ for detecting and managing them, and their awareness of drugs which commonly cause DDIs. At the end of the questionnaire, an open-ended item was added to allow participants to further add any comment. Findings and Conclusions: The study is going on currently, and the results and conclusions will be presented at the conference.

Keywords: awareness, drug interactions, health centres, physicians

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Authors: Bilge Demir, Ahmet Durgutlu, Mustafa Acarer

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In this study, the butt welding of the commercial AZ31 magnesium alloy sheets have been carried out by using Tungsten Inert Gas (TIG) welding process with alternative and pulsed current. Welded samples were examined with regards to hardness and microstructure. Despite some recent developments in welding of magnesium alloys, they have some problems such as porosity, hot cracking, oxide formation and so on. Samples of the welded parts have undergone metallographic and mechanical examination. Porosities and homogeneous micron grain oxides were rarely observed. Orientations of the weld microstructure in terms of heat transfer also were rarely observed and equiaxed grain morphology was dominant grain structure as in the base metal. As results, fusion zone and few locations of the HAZ of the welded samples have shown twin’s grains. Hot cracking was not observed for any samples. Weld bead geometry of the welded samples were evaluated as normal according to welding parameters. In the results, conditions of alternative and pulsed current and the samples were compared to each other with regards to microstructure and hardness.

Keywords: AZ31 magnesium alloy, microstructures, micro hardness TIG welding

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Authors: Junaid Bin Aamir, Ma Fanhua

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Methanol and hydrogen are the most suitable alternative fuel resources for the existing and future internal combustion engines. This paper experimentally examined the effects of hydrogen addition on the performance and emission characteristics of a spark-ignition engine fueled with methanol at part load conditions. The experiments were carried out for various engine speeds and loads. Hydrogen-rich syngas was used to enhance the performance of the test engine. It was formed by catalytic dissociation of methanol itself, and volumetric hydrogen fraction in syngas was about 67%. A certain amount of syngas dissociated from methanol was injected into the intake manifold in each engine cycle, and the low heating value (LHV) of hydrogen-rich syngas used was 4% of methanol in each cycle. Both the fuels were injected separately using port fuel injectors. The results showed that brake thermal efficiency of the engine was enhanced by 3-5% with hydrogen addition, while brake specific fuel consumption and exhaust gas temperature were reduced. There was a significant reduction (90-95%) in THC and (35-50%) in CO emissions at the exhaust. NOx emissions from hydrogen blended methanol increased slightly (10-15%), but they can be reduced by using lean fuel-air mixture to keep the cylinder temperature low.

Keywords: hydrogen, methanol, alternative fuel, emissions, spark ignition engines

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Authors: Stephen Verderber

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The World Health Organization (WHO) calls for research and development on ecologically sustainable, resilient structures capable of effectively responding to disaster events globally, in response to climate change, politically based diasporas, earthquakes, and other adverse events upending the rhythms of everyday life globally. By 2050, nearly 80% of the world’s population will reside in coastal zones, and this, coupled with the increasingly dire impacts of climate change, constitute a recipe for further chaos and disruption, and in light of these events, architects have yet to rise up to meet the challenge. In the arena of healthcare, rapidly deployable clinics and field hospitals can provide immediate assistance in medically underserved disaster strike zones. Transportable facilities offer multiple advantages over conventional, fixed-site hospitals, as lightweight, comparatively unencumbered alternatives. These attributes have been proven repeatedly in 20th century vehicular and tent-based structures deployed in frontline combat theaters and in prior natural disasters. Prefab transportable clinics and trauma centers recently responded adroitly to medical emergencies in the aftermath of the Haitian (2010) and Ecuadorian (2016) earthquakes, and in North American post-hurricane relief efforts (2017) while architects continue to be castigated by their engineer colleagues as chronically poor first responders. Architecturally based portable structures for healthcare currently include Redeployable Health Centers (RHCs), Redeployable Trauma Centers (RTCs), and Permanent Modular Installations (PMIs). Five tectonic variants within this typology have recently been operationalized in the field: 1. Vehicular-based Nomadics: Prefab modules installed on a truck chassis with interior compartments dropped in prior to final assembly. Alternately, a two-component apparatus is preferred, with a truck cab pulling a modular medical unit, with independent transiting component; 2. Tent and Pneumatic Systems: Tent/yurt precursors and inflatable systems lightweight and responsive to topographically challenging terrain and diverse climates; 3. Containerized Systems: The standard modular intermodal-shipping container affords structural strength, resiliency in difficult transiting conditions, and can be densely close-packed and these can be custom-built or hold flat-pack systems; 4. Flat-Packs and Pop-Up Systems: These kit-of-part assemblies are shipped in standardized or specially-designed ISO containers; and 5. Hybrid Systems: These consist of composite facilities representing a synthesis of mobile vehicular components and/or tent or shipping containers, fused with conventional or pneumatically activated tent systems. Hybrids are advantageous in many installation contexts from an aesthetic, fabrication, and transiting perspective. Advantages/disadvantages of various modular systems are comparatively examined, followed by presentation of a compendium of 80 evidence (research)-based planning and design considerations addressing site/context, transiting and commissioning, triage, decontamination/intake, diagnostic and treatment, facility tectonics, and administration/total environment. The benefits of offsite pre-manufactured fabrication are examined, as is anticipated growth in international demand for transportable healthcare facilities to meet the challenges posed by accelerating global climate change and global conflicts. This investigation into rapid response facilities for pre and post-disaster zones is drawn from a recent book by the author, the first on architecture on this topic (Innovations in Transportable Healthcare Architecture).

Keywords: disaster mitigation, rapid response healthcare architecture, offsite prefabrication

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Authors: Abdul-Ganiyu Fuseini, Bernice Redley, Helen Rawson, Lenore Lay, Debra Kerr

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Aim: The study aimed to develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospital admissions. Design: A three-phased mixed-method sequential exploratory design was used. Methods: Concept elicitation and generation of items for the scale was informed by older adults’ perspectives about dignity during acute hospitalization and a literature review. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. A cross-sectional survey design was conducted involving 270 hospitalized older adults for evaluation of construct and convergent validity, internal consistency reliability, and test–retest reliability of the scale. Analysis was performed using Statistical Package for the Social Sciences, version 25. Reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: We established the 15-item Hospitalized Older Adults’ Dignity Scale that has a 5-factor structure: Shared Decision-Making (3 items); Healthcare Professional-Patient Communication (3 items); Patient Autonomy (4 items); Patient Privacy (2 items); and Respectful Care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability, and good test-retest reliability were demonstrated. Conclusion: We established the Hospitalized Older Adults Dignity Scale as a valid and reliable scale to measure dignity for older adults during acute hospital admissions. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may provide information that informs the development of strategies to improve dignity-related care in the future. Impact: The development and validation of the Hospitalized Older Adults Dignity Scale will provide healthcare professionals with a feasible and reliable scale for measuring older adults’ dignity during acute hospitalization. Routine use of the scale may enable the capturing and incorporation of older patients’ perspectives about their healthcare experience and provide information that informs the development of strategies to improve dignity-related care in the future.

Keywords: dignity, older adults, hospitalisation, scale, patients, dignified care, acute care

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Authors: Traci A. Hefner

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Limited research exists on the readiness of emergency departments to respond to human trafficking (HT). The purpose of this qualitative case study was to improve the readiness of a Department of Emergency Medicine (ED), located in the southeast region of the United States, in identifying, assessing, and responding to trafficked individuals. The research objectives were to 1) provide an organizing framework to understand the ED’s readiness to respond to HT, using the Transtheoretical Model’s stages of change construct, 2) explain the readiness of the ED through a three-pronged contextual approach that included policies and procedures, patient data collection processes, and clinical practice methods, and 3) develop recommendations to respond to HT. Content analysis was used for document reviews and on-site observations, while thematic analysis identified themes of staff perceptions of the ED’s readiness in interviews of over 30 clinical and non-clinical healthcare professionals. Results demonstrated low levels of readiness to identify HT through the ED’s policies and procedures, data collection processes, and clinical practice methods. Clinical practice-related factors consisted of limited awareness of HT warning signs and low-levels of knowledge about community resources for possible HT referrals. Policy and practice recommendations to increase the ED’s readiness to respond to HT included: developing staff trainings across the ED system to enhance awareness of HT warning signs, incorporating HT into current policies and procedures for vulnerable patient populations as well as creating a HT protocol that addresses policies and procedures, screening tools, and community referrals.

Keywords: emergency medicine, human trafficking, organizational assessment, stages of change

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Authors: Sakchai Satienperakul, Manoch Thanomwat, Jutiporn Seedasama

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A paper based analytical devices (PADs) for the analysis of Fe (III) ion in natural water samples is developed, using reagent from guava leaf extract. The extraction is simply performed in deionized water pH 7, where tannin extract is obtained and used as an alternative natural reagent. The PADs are fabricated by ink-jet printing using alkenyl ketene dimer (AKD) wax. The quantitation of Fe (III) is carried out using reagent from guava leaf extract prepared in acetate buffer at the ratio of 1:1. A color change to gray-purple is observed by naked eye when dropping sample contained Fe (III) ion on PADs channel. The reflective absorption measurement is performed for creating a standard curve. The linear calibration range is observed over the concentration range of 2-10 mg L-1. Detection limited of Fe (III) is observed at 2 mg L-1. In its optimum form, the PADs is stable for up to 30 days under oxygen free conditions. The small dimensions, low volume requirement and alternative natural reagent make the proposed PADs attractive for on-site environmental monitoring and analysis.

Keywords: green chemical analysis, guava leaf extract, lab on a chip, paper based analytical device

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Authors: Espinosa-Garza G., Loera-Hernandez I., Antonyan N.

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To innovate, it is necessary to perform projects directed towards the search of improvement. The agricultural technique and the design of greenhouses have been studied by undergraduate engineering students from the Tecnológico de Monterrey using the campus areas. The purpose of this project was to incite students to create innovations and help rural populations of the state to solve one of the problems that they are dealing with nowadays. The main objective of the project was to search for an alternative technique that will allow the planting of the “chile piquín” plant, also known as Capsicum annuum, to grow quicker as it germinates. The “chile piquín” is one of the original crops of Mexico and forms the basis of the Mesoamerican cultures’ diet since the pre-hispanic era. To fulfill with today’s demand, it is required to implement new alternative methods to increase the “chile piquín’s” growth. The project lasted one semester with the participation of engineering students from multiple majors. The most important results from this academic experience were that, from the proposed goal, the students could analyze the needs of their town and were capable of introducing new and innovative ideas with the aim of resolving them. In the present article the pedagogic methodologies that allowed to carry out this project will be discussed.

Keywords: academic experience, chile piquín, engineering education, greenhouse design, innovation

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Authors: H. Majour, L. Djabri

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Many methods in the groundwater vulnerability have been developed in the world (methods like PRAST, DRIST, APRON/ARAA, PRASTCHIM, GOD). In this study, our choice dealt with two recent complementary methods using category mapping of index with weighting criteria (Point County Systems Model MSCP) namely the standard DRASTIC method and SI (Susceptibility Index). At present, these two methods are the most used for the mapping of the intrinsic vulnerability of groundwater. Two classes of groundwater vulnerability in the Biskra sandy aquifer were identified by the DRASTIC method (average and high) and the SI method (very high and high). Integrated analysis has revealed that the high class is predominant for the DRASTIC method whereas for that of SI the preponderance is for the very high class. Furthermore, we notice that the method SI estimates better the vulnerability for the pollution in nitrates, with a rate of 85 % between the concentrations in nitrates of groundwater and the various established classes of vulnerability, against 75 % for the DRASTIC method. By including the land use parameter, the SI method produced more realistic results.

Keywords: DRASTIC, SI, GIS, Biskra sandy aquifer, Algeria

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Authors: Zolani Metu

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The death of more than 140 psychiatric patients who were unethically deinstitutionalized from the Life Esidimeni hospital Johannesburg, in 2016, shined a light on South Africa’s failing public mental healthcare system. Compounded by insufficient research evidence on African deinstitutionalization, this necessitates inquiries into deinstitutionalized mental healthcare, reintegration and community-based mental healthcare within the South African context. This study employed a quantitative research approach which utilized a cross-sectional research design, to investigate experiences with the reintegration of institutionalized forensic mental health service users into communities in the Western Cape, South Africa. A convenience sample of 100 mental health care workers from different occupational and organizational backgrounds in the Western Cape was purposively selected using the Western Cape Health Directorate as a sampling frame. A self-administered questionnaire (SAQ) was used as the data collection instrument. The results of the study indicate that criminogenic factors such as substance use, history of violent behaviour, criminal history and disruptive social behaviour complicate the reintegration of forensic mental health service users into communities. The current extent of reintegration of forensic mental health service users was found to be 'poor' (46%; n= 46); and financial difficulties, criminogenic factors and limited Community-Based Care (CBC) facilities were identified as key barriers to the reintegration process. 56% of all job applications for forensic mental health service users were unsuccessful, and 53% of all applications for their admission into CBC facilities were declined. Although social support (informal) was found to be essential for successful reintegration, institutional support (formal) through assertive community treatment (35%; n= 35) and CBC facilities (21%) and the disability grant (DG=50%) was found to be more important for family coping and reintegration. Moreover, 72% of respondents had positive perceptions about the process of reintegration; no statistically significant relationship was found between years of experience and perceptions about reintegration (P-value = 0.062); and perceptions were not found to be a barrier to reintegration. No statistically significant relationship was found between years of working experience and understanding the legislative framework of deinstitutionalization (P-Value =.0.061). However, using a Chi-square test, a significant relationship (P-value = 0.021) was found between sex and understanding the legal framework involved in the process of reintegration. The study recommends a post-2020 deinstitutionalization agenda that factors-in criminogenic realities associated with forensic mental health service users, and affirms the strengthening of PHC and community based care systems as precedents of successful deinstitutionalization and reintegration of mental health service users.

Keywords: forensic mental health, deinstitutionalization, reintegration, mental health service users

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Authors: Farramae Francisco, Rhoda Mae Simora, Sharon Nunal

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Deproteination and demineralization efficiencies of shrimp waste using two Lactobacillus species treated with different carbohydrate sources for chitin production, its chemical conversion to chitosan and the quality of chitin and chitosan produced were determined. Using 5% glucose and 5% cassava starch as carbohydrate sources, pH slightly increased from the initial pH of 6.0 to 6.8 and 7.2, respectively after 24 h and maintained their pH at 6.7 to 7.3 throughout the treatment period. Demineralization (%) in 5 % glucose and 5 % cassava was highest during the first day of treatment which was 82% and 83%, respectively. Deproteination (%) was highest in 5% cassava starch on the 3rd day of treatment at 84.4%. The obtained chitin from 5% cassava and 5% glucose had a residual ash and protein below 1% and solubility of 59% and 44.3%, respectively. Chitosan produced from 5% cassava and 5% glucose had protein content below 0.05%; residual ash was 1.1% and 0.8%, respectively. Chitosan solubility and degree of deacetylation were 56% and 33% in 5% glucose and 48% and 29% in 5% cassava, respectively. The advantage this alternative technology offers over that of chemical extraction is large reduction in chemicals needed thus less effluent production and generation of a protein-rich liquor, although the demineralization process should be improved to achieve greater degree of deacetylation.

Keywords: alternative carbon source, bioprocessing, lactic acid bacteria, waste utilization

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Authors: Corbel Camille, Le Cerf Flora, Capriz Françoise, Vaillant-Ciszewicz Anne-Julie, Breaud Jean, Guerin Olivier, Corveleyn Xavier

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Background: The medical environment can generate stressful and anxiety-provoking situations for patients, particularly during painful care procedures for the older population. These stressful environments have deleterious effects on the quality of care and can even put the patient at risk and set the care team up for failure. The search for a solution is, therefore, imperative. The development of new technologies, such as virtual reality (VR), seems to be an answer to this problem. Objectives: The objective of this study is to compare the effects of virtual reality on pain and anxiety when caring for older hospitalized people with the effects of usual care. More precisely, different individual factors (age, cognitive level, individual preferences, etc.) and different virtual reality universes (personalized or non-personalized) are studied to understand the role of these factors in reducing pain and anxiety during care procedures. The aim of this study is to improve the quality of life of patients and caregivers in their work environment. Method: This mono-centered, randomized, controlled study was conducted from September 2023 to September 2024 on 120 participants recruited from the geriatric departments of the Cimiez Hospital, Nice, France. Participants are randomized into three groups: a control group, a personalized VR group and a non-personalized VR group. Each participant is followed during a painful care session. Data are collected before, during and after the care, using measures of pain (Algoplus and numerical scale) and anxiety (Hospital anxiety scale and numerical scale). Physiological assessments with an oximeter are also performed to collect both heart and respiratory rate measurements. The implementation of the care will be assessed among healthcare providers to evaluate its effects on the difficulty and fatigue associated with the care. Additionally, a questionnaire (System Usability Scale) will be administered at the conclusion of the study to determine the willingness of healthcare providers to integrate VR into their daily care practices. Result: The preliminary results indicate significant effects on anxiety (p=.001) and pain (p=<.001) following the VR intervention during care, as compared to the control group. Conclusion: The preliminary results suggest that VRI appears to be a suitable and effective method for reducing anxiety and pain among older hospitalized individuals compared with standard care. Finally, the experiences of healthcare professionals involved will also be considered to assess the impact of these interventions on working conditions and patient support.

Keywords: anxiety, care, pain, older adults, virtual reality

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Authors: Natia Kvachakidze

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Translating fiction is a complicated and multidimensional issue. However, studying and analyzing literary translations is not less challenging. This becomes even more complex due to the existence of several alternative translations of one and the same literary work. However, this also makes the research process more interesting at the same time. The aim of the given work is to distinguish major obstacles and challenges translators come across while working on Ernest Hemingway’s short fiction, as well as to analyze certain peculiarities and characteristic features of some existing Georgian translations of the writer’s work (especially in the context of various alternative versions of some well-known short stories). Consequently, the focus is on studying how close these translations come to the form and the context of the original text in order to see if the linguistic and stylistic characteristics of the original author are preserved. Moreover, it is interesting not only to study the relevance of each translation to the original text but also to present a comparative analysis of some major peculiarities of the given translations, which are naturally characterized by certain strengths and weaknesses. The latter is at times inevitable, but in certain cases, there is room for improvement. The given work also attempts to humbly suggest certain ways of possible improvements of some translation inadequacies, as this can provide even more opportunities for deeper and detailed studies in the future.

Keywords: Hemingway, short fiction, translation, Georgian

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Authors: Tzen-Ying Ling

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Recently, the resilience of dwellings in urban areas has been deliberated, as to accommodate the growing demand for changing the demography and rapid urbanization. The need to incorporate sustainability and cleaner production thinking have intensified to mitigate climate risks and satisfy the demand for housing. The modular thinking satisfies both the pressing call for fast-tracked housing stocks; while meeting the goal of more sustainable production. In the other side, the importance of the dwelling as a podium for well-being and social connectedness are sought to explore the key human/environment design thinking for the modular system in dwelling. We argue the best practice incorporates the concept of systemic components thinking. The fieldwork reported in this paper illustrates the process of the case study in a modular dwelling unit prototype development; focusing on the systemic frame system design process and adjustment recommendation hereafter. Using a case study method, the study identified that: (1) inclusive human dimensional factoring through systemic design thinking results in affordable implementations possibilities. (2) The environmental dimension encourages the place-based solution suited for the locality and the increasing demand for dwelling in the urban system. (3) Prototype design consideration avails module system component as dwelling construction alternative. (4) Building code often acts as an inhibitor for such dwelling units by the restriction in lot sizes and units placement. The demand for fast-track dwelling construction and cleaner production decisively outweighs the code inhibition; we further underscored the sustainability implication of the alternative prototype as the core of this study. The research suggests that modular thinking results in a resilient solution suited for the locality and the increasing demand for dwelling in the urban system.

Keywords: system prototype, urban resilience, human/environment dimension, modular thinking, dwelling alternative

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Authors: Nadeem Yousuf Khan

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This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.

Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology

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Authors: Mahla Azimi

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Introduction: Post-bladder catheter infection is a common and significant healthcare-associated infection that affects individuals with indwelling urinary catheters. These infections can lead to various complications, including urinary tract infections (UTIs), bacteremia, sepsis, and increased morbidity and mortality rates. This article aims to provide a comprehensive review of post-bladder catheter infections, including their causes, risk factors, clinical presentation, diagnosis, treatment options, and preventive measures. Causes and Risk Factors: Post-bladder catheter infections primarily occur due to the colonization of microorganisms on the surface of the urinary catheter. The most common pathogens involved are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species. Several risk factors contribute to the development of these infections, such as prolonged catheterization duration, improper insertion technique, poor hygiene practices during catheter care, compromised immune system function in patients with underlying conditions or immunosuppressive therapy. Clinical Presentation: Patients with post-bladder catheter infections may present with symptoms such as fever, chills, malaise, suprapubic pain or tenderness, and cloudy or foul-smelling urine. In severe cases or when left untreated for an extended period of time, patients may develop more severe symptoms like hematuria or signs of systemic infection. Diagnosis: The diagnosis of post-bladder catheter infection involves a combination of clinical evaluation and laboratory investigations. Urinalysis is crucial in identifying pyuria (presence of white blood cells) and bacteriuria (presence of bacteria). A urine culture is performed to identify the causative organism(s) and determine its antibiotic susceptibility profile. Treatment Options: Prompt initiation of appropriate antibiotic therapy is essential in managing post-bladder catheter infections. Empirical treatment should cover common pathogens until culture results are available. The choice of antibiotics should be guided by local antibiogram data to ensure optimal therapy. In some cases, catheter removal may be necessary, especially if the infection is recurrent or associated with severe complications. Preventive Measures: Prevention plays a vital role in reducing the incidence of post-bladder catheter infections. Strategies include proper hand hygiene, aseptic technique during catheter insertion and care, regular catheter maintenance, and timely removal of unnecessary catheters. Healthcare professionals should also promote patient education regarding self-care practices and signs of infection. Conclusion: Post-bladder catheter infections are a significant healthcare concern that can lead to severe complications and increased healthcare costs. Early recognition, appropriate diagnosis, and prompt treatment are crucial in managing these infections effectively. Implementing preventive measures can significantly reduce the incidence of post-bladder catheter infections and improve patient outcomes. Further research is needed to explore novel strategies for prevention and management in this field.

Keywords: post-bladder catheter infection, urinary tract infection, bacteriuria, indwelling urinary catheters, prevention

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Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

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Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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Authors: Sajjad Esmaeili, Robert Krause, Lukas Gerlich, Alireza Mohammadian Kia, Benjamin Uhlig

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This investigation aims to develop the feasible and qualitative process parameters for the thin films fabrication into ultra-large through-silicon-vias (TSVs) as vertical interconnections. The focus of the study is on TSV metallization and its challenges employing new materials for the purpose of rapid signal propagation in the microsystems technology. Cobalt metal-organic chemical vapor deposition (Co-MOCVD) process enables manufacturing an adhesive and excellent conformal ultra-thin film all the way through TSVs in comparison with the conventional non-conformal physical vapor deposition (PVD) process of copper (Cu) seed layer. Therefore, this process provides a Cu seed-free layer which is capable of direct Cu electrochemical deposition (Cu-ECD) on top of it. The main challenge of this metallization module is to achieve the proper alternative seed layer with less roughness, sheet resistance and granular organic contamination (e.g. carbon) which intensify the Co corrosion under the influence of Cu electrolyte.

Keywords: Cobalt MOCVD, direct Cu electrochemical deposition (ECD), metallization technology, through-silicon-via (TSV)

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Authors: Sanat Kumar, Rahul Kumar Tiwari

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At this time when society is becoming increasingly aware of the declining reserves of fossil, it has become apparent that biodiesel is destined to make a substantial contribution to the future energy demands of the domestic and industrial economies. In this regard, the significance of biodiesel is technically and commercially viable alternative to fossil-diesel. There are different potential feed stocks for biodiesel production. This paper analyses the performance, combustion and emission characteristics of biodiesel from different feed stocks. Biodiesel fuel is considered as offering many benefits like reduction of greenhouse gas emissions and many harmful pollutants (PM, HC, CO etc.). This paper critically reviews the effect of injection timing on combustion and emission characteristics. An attempt has been carried out to discuss the effect of biodiesel in terms of combustion, emission and performance based up on composition and properties. The results of the study show that different chemical composition leads to variation in its combustion, performance and emission characteristics. Biodiesel produced from different aspired feed stocks reduces the pollutant emission and resistive to oxidation but exhibit poor atomization. As a conclusion many research needs to be carried out to understand the relationship between the types of biodiesel feed stock, performance conclusion and emission.

Keywords: atomization, biodiesel, greenhouse gas, oxidation

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Authors: Azna Zuberi

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Biofilm is a sessile bacterial accretion in which bacteria adapts different physiological and morphological behavior from planktonic form. It is the root cause of about 80% microbial infections in human. Among them, E. coli biofilms are most prevalent in medical devices associated nosocomial infections. The objective of this study was to inhibit biofilm formation by targeting LuxS gene, involved in quorum sensing using CRISPRi. luxS is a synthase, involved in the synthesis of Autoinducer-2(AI-2), which in turn guides the initial stage of biofilm formation. To implement CRISPRi system, we have synthesized complementary sgRNA to target gene sequence and co-expressed with dCas9. Suppression of luxS was confirmed through qRT-PCR. The effect of luxS gene on biofilm inhibition was studied through crystal violet assay, XTT reduction assay and scanning electron microscopy. We conclude that CRISPRi system could be a potential strategy to inhibit bacterial biofilm through mechanism base approach.

Keywords: biofilm, CRISPRi, luxS, microbial

Procedia PDF Downloads 181

Authors: A. Altomi, A. Alhebshi, M. Rasm, B. Osman

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This study explored the application of chitin nanocrystals (ChiNCs), derived from a renewable and environmentally friendly material, as stabilizers for oil-in-water (O/W) emulsions. O/W emulsions are commonly used in various applications but are prone to instability and degradation over time. Instability can occur due to factors such as flocculation, coalescence, and gravitational separation, including creaming and sedimentation, either independently or simultaneously. To produce ChiNCs, chitin powder underwent acid hydrolysis. Transmission electron microscopy (TEM) analysis revealed that ChiNCs exhibited a needle-like morphology, with lengths ranging from 200 to 800 nm and widths ranging from 20 to 80 nm. The surface charge of ChiNCs was negative at pH values above 7 and positive at pH values below 7. The rheological properties of O/W emulsions stabilized by ChiNCs were compared to those stabilized by synthetic surfactants, namely Tween 80 and CTAB. The emulsions stabilized by ChiNCs demonstrated higher yield stress and lower shear viscosity compared to those stabilized by synthetic surfactants. This indicates that ChiNC-stabilized emulsions are more stable and less prone to breakdown. Based on these findings, ChiNCs show promise as an alternative to synthetic surfactants for stabilizing O/W emulsions.

Keywords: chitin nanocrystals, colloidal pickering, emulsion rheology, oil-in-water, synthetic surfactant

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