Search results for: catchment area of healthcare

Authors: Chitresh Kumar, Santanu Gupta

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The research work intends to understand the process of initiation, planning and development of capital-intensive urban area level infrastructure development in East Asian Cities (specific to Indian Cities). With the onset of emphasis on sustainable urban transport, self-financed urban local bodies, it has become of utmost important to identify infrastructure and projects on a priority basis, which provide optimal utility to the urban area. Through identification of Spatial, Demographic and Socio-Economic and Political Instability Parameters and their trends for the past 60 years at the urban area and state level, the paper attempts to identify the most suitable time period when initiation of the project would become economically and demographically viable for the city.

Keywords: urban planning, regional planning, mass transit, infrastructure development, spatial planning

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Authors: Merav Ben Natan, Heba Igbarin, Arwa Watted

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Introduction: The rising prevalence of autism spectrum disorders (ASD) has heightened the need to understand the challenges faced by children with ASD and their families in emergency departments (EDs). Children with ASD often experience additional health issues and heightened anxiety in the chaotic ED environment, which can impact their care and parental satisfaction. Purpose: This study aimed to examine factors identified by mothers as affecting their satisfaction with the care provided to their children in the ED, among mothers of children with ASD in comparison to mothers of children without ASD. Design and methods: In this correlational quantitative study, 128 Israeli mothers – 59 (46%) mothers of children with ASD and 69 (54%) of children without ASD - completed an online survey based on a Ministry of Health national survey of patient experience. Results: Mothers of children with ASD expressed lower satisfaction with the care provided. The difference was particularly evident concerning waiting times for examination of the child by nurses and physicians in the ED, whether the nurses were attentive and responsive to the mother's questions and concerns, whether the ED staff demonstrated coordination and cooperation with regard to medical care of the child, and whether work in the ED was conducted in an orderly and organized manner. The presence of communication difficulties in children predicted mothers' satisfaction with care. Conclusions: These findings suggest that certain needs of mothers and/or their children with ASD do not receive an appropriate response in the ED. Practice implications: It is important to raise the awareness of healthcare providers in EDs regarding the needs of children with ASD and their parents, especially children with communication difficulties. Strategies should be implemented to improve the experience of children with ASD and their parents in the ED.

Keywords: autism spectrum disorder, emergency department, parental satisfaction, healthcare challenges

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Authors: Busra Ekinci

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Urban heat island term becomes one of the most important problem in urban areas as a reflection of global warming in local scale last years. Many communities and governments are taking action to reduce heat island effects on urban areas where the half of the world's population live today. At this point, urban design turned out to be an important practice and research area for providing an environmentally sensitive urban development. In this study, mitigating strategies of urban heat island effects by urban design are investigated in Aksaray Square and surroundings in Istanbul. Aksaray is an important historical and commercial center of Istanbul, which has an increasing density due to be the node of urban transportation. Also, Istanbul Metropolitan Municipality prepared an urban design project to respond the needs of growing population in the area for 2018. The purpose of the study is emphasizing the importance of urban design objectives and strategies that are developed to reduce the heat island effects on urban areas. Depending on this, the urban heat island effect of the area was examined based on the albedo (reflectivity) parameter which is the most effective parameter in the formation of the heat island effect in urban areas. Albedo values were calculated by Albedo Viewer web application model that was developed by Energy and Environmental Engineering Department of Kyushu University in Japan. Albedo parameter had examined for the present situation and the planned situation with urban design project. The results show that, the current area has urban heat island potential. With the Aksaray Square Project, the heat island effect on the area can be reduced, but would not be completely prevented. Therefore, urban design strategies had been developed to reduce the island effect in addition to the urban design project of the area. This study proves that urban design objectives and strategies are quite effective to reduce the heat island effects, which negatively affect the social environment and quality of life in urban areas.

Keywords: Albedo, urban design, urban heat island, sustainable design

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Authors: Abegunde Linda, Adedeji Oluwatola

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It has become increasingly evident that large developments influence the climate within the immediate region and there are concerns that rising temperatures over developed areas could have negative impact and increase living discomfort within city boundaries. Temperature trends in Ibadan city have received minor attention, yet the area has experienced heavy urban expansion between 1972 and 2014. This research aims at examining the impact of landuse change on temperature knowing that the built environment absorbs and stores solar energy, the temperature in cities can be several degrees higher than in adjacent rural areas. This is known as the urban heat island (UHI) effect. The Landsat imagery were used to examine the landuse change for a time period of 42years (1972-2014) and Land surface temperature (LST) was obtained by converting the thermal band to a surface temperature map and zonal statistic analyses was further used to examine the relationship between landuse and temperature emission. The results showed that the settlement area increased by 200km2 while the area covered by vegetation also reduced to about 42.6% during the study period. The spatial and temporal trends of temperature are related to the gradual change in urban landcover and the settlement area has the highest emission of land surface temperature. This research provides useful insight into the temporal behavior of the Ibadan city.

Keywords: landuse, LST, remote sensing, UHI

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Authors: Syedhossein Vakili

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According to the opinion of some experts, the world's two-spatialization means the establishment of a new virtual space and placing this new space next to the physical space. This dualization of space has left various effects, one of which is reducing the need for buildings and making the area of business premises economical through the use of virtual space instead of a part of physical space. In such a way that before the virtual space was known, a commercial or educational institution had to block a large part of its capital to acquire physical spaces and buildings in order to provide physical space and places needed for daily activities, but today, Thanks to the addition of the virtual space to the physical space, it has been possible to carry out its activities more widely in a limited environment with a minimum of physical space and drastically reduce costs. In order to understand the impact of virtual space on the reduction of physical space, the researcher used the official reports of the countries regarding the average area mentioned in the permits for the construction of commercial and educational units in the period from 2014 to 2023 and compared the average capital required for the absolute physical period with The period of two-spatialization of the world in the mentioned ten-year period, while using the analytical and comparative method, has proven that virtual space has greatly reduced the amount of investment of business owners to provide the required place for their activities by reducing the need for physical space. And economically, it has made commercial activities more profitable.

Keywords: two spatialization, building area, cyberspace, physical space, virtual place

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Authors: Vandana Maurya

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Positive psychological capital is the key contributor to the competitive advantage of the organizations. Moreover, work engagement and sense of humor are also positive notions and are able to facilitate positive workplace behaviour but the mechanism behind these relationships are not well understood. The purpose of this study was to examine the relationships among work engagement, sense of humor and outcome variables (organizational citizenship behaviour and ethical performance) as well as investigating how psychological capital (PsyCap) mediates the relationships between work engagement, sense of humor and the outcome variables among healthcare professionals. A cross-sectional survey was conducted on healthcare professionals (n= 240). Data were collected using questionnaires which includes Utrecht Work Engagement Scale (UWES), Multi-dimensional Sense of Humor Scale (MSHS), Psychological Capital Questionnaire (PCQ), Organizational Citizenship Behavior Questionnaire, and Ethical Performance Scale (EPS). The results of the regression analyses showed that work engagement and sense of humor both positively predicted the outcome variables. Mediation analysis reveals that psychological capital mediates the relationship between predictor and outcome variables. The study recommends that the framework presented in this study can be an important tool for managers to enhance their employees’ psychological capital by increasing their levels of work engagement and sense of humor. In turn, psychological capital could be a positive resource for employees to dealing more ethically and enhancing more positive workplace behaviour.

Keywords: ethical performance, humor, organizational citizenship behavior, PsyCap, work engagement

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Authors: Maher J. Tadros, Yaseen Ananbeh

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The study area is located in Ajluon Forest Reserve northern part of Jordan. It consists of Mediterranean hills dominated by open woodlands of oak and pistachio. The aims of the study were to investigate the positive and negative relationships between the locals and the protected area and how it can affect the long-term forest conservation. The main research objectives are to review the impact of establishing Ajloun Forest Reserve on nature conservation and on the livelihood level of local communities around the reserve. The Ajloun forest reserve plays a fundamental role in Ajloun area development. The existence of initiatives of nature conservation in the area supports various socio-economic activities around the reserve that contribute towards the development of local communities in Ajloun area. A part of this research was to conduct a survey to study the impact of Ajloun forest reserve on biodiversity composition. Also, studying the biodiversity content especially for vegetation to determine the economic impacts of Ajloun forest reserve on its surroundings was studied. In this study, several methods were used to fill the objectives including point-centered quarter method which involves selecting randomly 50 plots at the study site. The collected data from the field showed that the absolute density was (1031.24 plant per hectare). Density was recorded and found to be the highest for Quecus coccifera, and relative density of (73.7%), this was followed by Arbutus andrachne and relative density (7.1%), Pistacia palaestina and relative density (10.5%) and Crataegus azarulus (82.5 p/ha) and relative density (5.1%),

Keywords: composition, density, frequency, importance value, point-centered quarter, structure, tree cover

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Authors: Saira Mehnaz, Ali Jafar Abedi, Shazia Farooq Fazli, Sakeena Mushfiq, Zulfia Khan, M. Athar Ansari

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Introduction: Public health spending is a necessity in an underdeveloped country like India. The people are already suffering from poverty and that clubbed with out of pocket expenditure leads them to a very catastrophic situation, reducing the overall access to healthcare. Objectives: This study was designed to determine the usual source of medical care opted, the illness pattern, the expenditure incurred on illness and its source of procurement by the study population. It also intended to assess this expenditure as a determinant of access to health care. Methodology: Cities like Aligarh, which are classified as B grade cities in India are thought to be ripe sites for getting livelihood and hence are almost half filled with migrants living in urban slums. A cross sectional study was done to study the newer slum pockets. 3409 households with a population of 16,978 were studied with the help of pretested questionnaire; SPSS 20 was used for statistical analysis. Results and Conclusions: In our study, we found that almost all the households suffered from catastrophic health expenditure. The study population, which was already vulnerable owing to their low socio-economic and migrant status was further being forced with into poverty and indebtedness on account of expenditure on illness. This lead to a significant decrease in access to health. National health financing systems should be designed to protect households from financial catastrophe, by reducing out-of-pocket spending.

Keywords: access to healthcare, catastrophic health expenditure, new urban slums, out of pocket expenditure

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Authors: Arsalan Jabbar, Wajiha Javed, Nelofer Mehboob, Zahid Memon

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Introduction: There are multiple social, individual and cultural factors that influence an individual’s decision to adopt family planning methods especially among non-users in patriarchal societies like Pakistan.Non-users, if targeted efficiently, can contribute significantly to country’s CPR. A research study showed that non-users if convinced to adopt lactational amenorrhea method can shift to long-term methods in future. Research shows that if non-users are targeted efficiently a 59% reduction in unintended pregnancies in Saharan Africa and South-Central and South-East Asia is anticipated. Methods: We did secondary data analysis on Pakistan Demographic Heath Survey (2012-13) dataset. Use of contraception (never-use/ever-use) was the outcome variable. At univariate level Chi-square/Fisher Exact test was used to assess relationship of baseline covariates with contraception use. Then variables to be incorporated in the model were checked for multi-collinearity, confounding, and interaction. Then binary logistic regression (with an urban-rural stratification) was done to find the relationship between contraception use and baseline demographic and social variables. Results: The multivariate analyses of the study showed that younger women (≤ 29 years) were more prone to be never users as compared to those who were > 30 years and this trend was seen in urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR 1.809, CI 1.421-2.303). While looking at regional variation, women from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as compared to other urban regions. Women in the rich wealth quintile were more never users and this was seen both in urban and rural localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162, CI .887-1.524)) even though these were not statistically significant. Women idealizing more children(> 4) are more never users as compared to those idealizing less children in both urban (AOR 1.854, CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916). Women who never lost a pregnancy were more inclined to be non-users in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar with only traditional or no method had more never users in rural areas (AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant. Women unaware of Lady Health Worker’s presence in their area were more never users especially in rural areas (AOR 1.276, CI 1.014-1.607). Women who did not visit any care provider were more never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR 7.832, CI 6.243-9.826)). Discussion/Conclusion: This study concluded that government, policy makers and private sector family planning programs should focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more children.). We need to make sure to cover catchment areas where there are less LHWs and less providers as ignorance to modern methods and never been visited by an LHW are important determinants of never use. This all is in sync with previous literate from similar developing countries.

Keywords: contraception, demographic and health survey, family planning, never users

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Authors: Augustine Osayande

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This research is on Major Gullies Erosion Sites and Volume of Soil Loss in Edo State, Nigeria. The primary objective was to identify notable gullies sites and quantify the volume of soil loss in the study area. Direct field observation and measurement of gullies dimensions was done with the help of research assistants using a measuring tape, Camera and 3percent accuracy Global Positioning System (GPS). The result revealed that notable gullies in the area have resulted in the loss of lives and properties, destruction of arable lands and wastage of large areas of usable lands. Gullies in Edo North have Mean Volume of Soil Loss of 614, 763.33 m³, followed by Edo South with 79,604.76 m³ and Edo Central is 46,242.98 m³ and as such an average of 1,772, 888.7m3 of soil is lost annually in the study area due to gully erosion problem. The danger of gully erosion in helpless regions like Edo State called for urgent remedies in order to arrest the further loss of soil, buildings and other properties.

Keywords: Edo, magnitude, gully, volume, soil, sloss

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Authors: Samuel Kehinde Okunade, Daniel Sunday Tolorunshagba

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Globally women are classified to be part of the vulnerable group in any environment. In a conflict-ridden environment, women being vulnerable often suffer the consequences as it relates to security and access to basic social services such as medical care. This is the situation in border communities in Nigeria where cross-border crimes are on the rife, thus, putting women at a disadvantaged position and, eventually, victims of such inimical activities. Border communities in the Saki/Iseyin area of Oyo state are a case in point where the lives of inhabitants are daily threatened most, especially women. In light of the above, this article examined the security situation of the Saki/Iseyin area of Oyo State with a view to ascertaining its status in terms of safety of lives and property. This paper also explored the experiences of women in the border communities within the area as it relates to their safety, the safety of their children, access to good health facilities in their immediate environment, and above all, how they have been able to cope or manage the situation. The qualitative research model was adopted utilizing a phenomenological case study approach. A Focused Group Discussion was conducted with 10 pregnant women and 10 mothers in Okerete and Abugudu communities while a Key Informant Interview was conducted with the women leaders in both communities of the Saki/Iseyin border area of Oyo State. The findings of the study revealed the poor state of basic infrastructure. So bad to a point that inhabitants of these communities no longer see themselves as Nigerians because they have been neglected by the government for too long. The only solution is for the government to embark on developmental projects within these communities so that they can live a good life just as those in the cities do. More importantly, this will increase the loyalty of these communities to the Nigeria state by defending and resisting all forms of cross-border criminal activities that go on along the porous borders.

Keywords: security, women, Saki/Iseyin border area, cross-border criminalities, basic infrastructure

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Authors: Loonibha Manandhar, Rajendra Bhandari, Kumud Raj Kafle

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Nepal’s Terai region is a part of the Ganges river basin which is one of the most disaster-prone areas of the world, with recurrent monsoon flooding causing millions in damage and the death and displacement of hundreds of people and households every year. The vulnerability of human settlements to natural disasters such as floods is increasing, and mapping changes in land use practices and hydro-geological parameters is essential in developing resilient communities and strong disaster management policies. The objective of this study was to develop a flood hazard zonation map of Orai Khola watershed and map the decadal land use/land cover dynamics of the watershed. The watershed area was delineated using SRTM DEM, and LANDSAT images were classified into five land use classes (forest, grassland, sediment and bare land, settlement area and cropland, and water body) using pixel-based semi-automated supervised maximum likelihood classification. Decadal changes in each class were then quantified using spatial modelling. Flood hazard mapping was performed by assigning weights to factors slope, rainfall distribution, distance from the river and land use/land cover on the basis of their estimated influence in causing flood hazard and performing weighed overlay analysis to identify areas that are highly vulnerable. The forest and grassland coverage increased by 11.53 km² (3.8%) and 1.43 km² (0.47%) from 1996 to 2016. The sediment and bare land areas decreased by 12.45 km² (4.12%) from 1996 to 2016 whereas settlement and cropland areas showed a consistent increase to 14.22 km² (4.7%). Waterbody coverage also increased to 0.3 km² (0.09%) from 1996-2016. 1.27% (3.65 km²) of total watershed area was categorized into very low hazard zone, 20.94% (60.31 km²) area into low hazard zone, 37.59% (108.3 km²) area into moderate hazard zone, 29.25% (84.27 km²) area into high hazard zone and 31 villages which comprised 10.95% (31.55 km²) were categorized into high hazard zone area.

Keywords: flood hazard, land use/land cover, Orai river, supervised maximum likelihood classification, weighed overlay analysis

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Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

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Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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Authors: Gikunda Aloise, Mjema Saida, Barasa Herbert, Wanyungu John, Kimani Maureen

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Background: Community Health Workforce (CHW) is health care providers at the community level (Level 1) and serves as a bridge between the community and the formal healthcare system. This human resource has enormous potential to extend healthcare services and ensures that the vulnerable, marginalized, and hard-to-reach populations have access to quality healthcare services at the community and primary health facility levels. However, these cadres are neither recognized, remunerated, nor in most instances, registered in a master list. Management and supervision of CHWs is not easy if their individual demographics, training capacity and incentives is not well documented through a centralized registry. Description: In February 2022, Amref supported the Kenya Ministry of Health in developing a community health workforce database called Community Health Workers Master List Registry (CHWML), which is hosted in Kenya Health Information System (KHIS) tracker. CHW registration exercise was through a sensitization meeting conducted by the County Community Health Focal Person for the Sub-County Community Health Focal Person and Community Health Assistants who uploaded information on individual demographics, training undertaken and incentives received by CHVs. Care was taken to ensure compliance with Kenyan laws on the availability and use of personal data as prescribed by the Data Protection Act, 2019 (DPA). Results and lessons learnt: By June 2022, 80,825 CHWs had been registered in the system; 78,174 (96%) CHVs and 2,636 (4%) CHAs. 25,235 (31%) are male, 55,505 (68%) are female & 85 (1%) are transgender. 39,979. (49%) had secondary education and 2500 (3%) had no formal education. Only 27 641 (34%) received a monthly stipend. 68,436 CHVs (85%) had undergone basic training. However, there is a need to validate the data to align with the current situation in the counties. Conclusions/Next steps: The use of CHWML will unlock opportunities for building more resilient and sustainable health systems and inform financial planning, resource allocation, capacity development, and quality service delivery. The MOH will update the CHWML guidelines in adherence to the data protection act which will inform standard procedures for maintaining, updating the registry and integrate Community Health Workforce registry with the HRH system.

Keywords: community health registry, community health volunteers (CHVs), community health workers masters list (CHWML), data protection act

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Authors: Gavin J. Baxter, Mark H. Stansfield

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This paper reviews the internal use of blogs and their potential effectiveness as organisational learning tools. Prior to and since the emergence of the concept of ‘Enterprise 2.0’ there still remains a lack of empirical evidence associated with how organisations are applying social media tools and whether they are effective towards supporting organisational learning. Surprisingly, blogs, one of the more traditional social media tools, still remains under-researched in the context of ‘Enterprise 2.0’ and organisational learning. The aim of this paper is to identify the theoretical linkage between blogs and organisational learning in addition to reviewing prior research on organisational blogging with a view towards exploring why this area remains under-researched and identifying what needs to be done to try and move the area forward. Through a review of the literature, one of the principal findings of this paper is that organisational blogs, dependent on their use, do have a mutual compatibility with the interpretivist aspect of organisational learning. This paper further advocates that further empirical work in this subject area is required to substantiate this theoretical assumption.

Keywords: Enterprise 2.0, blogs, organisational learning, social media tools

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Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

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Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

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Authors: Victoria Tobi Dada, Emmanuel Dada

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Culture trees are notable agricultural system in the tropical region of the world because of its great contribution to the economy of this region. Plantation agriculture such as oil palm, cocoa, cashew and rubber are the dominant agricultural trees in the tropical countries with the at least mean annual rainfall of 1500mm and 280c temperature. The study examines the review developmental trend in the common tropical culture trees. The study shows that global area of land occupied by rubber plantation increased from 9464276 hectares to 11739333 hectares between year 2010 and 2017, while oil palm cultivated land area increased from 1851278 in 2010 hectares to 2042718 hectares in 2013 across 35 countries. Global cashew plantation cultivation are dominated by West Africa with 44.8%, South-Eastern Asia with 32.9% and Sothern Asia with 13.8%, while the remaining 8.5% of the cultivated land area were distributed among six other tropical countries of the world. Cocoa cultivation and production globally are dominated by five West African countries, Indonesia and Brazil. The study revealed that notable tropical culture trees have not study together to determine their spatial distribution.

Keywords: culture trees, tropical region, cultivated area, spatial distribution

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Authors: Zhende Hou, Fan Yang, Guoli Zhang

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Dielectric elastomer is a promising class of Electroactive polymers which can deform in response to an applied electric field. Comparing general smart material, the Dielectric elastomer is more compliance and can achieve higher energy density, which can be for diverse applications such as actuators, artificial muscles, soft robotics, and energy harvesters. The coupling of the Electroactive polymers and the electric field is that the elastomer is sandwiched between two compliant electrodes and when the electrodes are subjected to a voltage, the positive and negative charges on the two electrodes compress the polymer, so that the polymer reduces in thickness and expands in area. However, the pre-stretched dielectric elastomer film not only can achieve large electric-field induced deformation but also is prone to wrinkling, under the interaction of its own strain energy and the applied electric field energy. For a uniaxially pre-stretched dielectric elastomer film, the electrode area is an important parameter to the electric-field induced deformation and may also be a key factor affecting the film wrinkling. To determine and quantify the effect experimentally, VHB 9473 tapes were employed and compliant electrodes with different areas were pant on each of them. The tape was first tensed to a uniaxial stretch of 8. Then a DC voltage was applied to the electrodes and increased gradually until wrinkling occurred in the film. Then, the critical wrinkling voltages of the film with different electrode areas were obtained, and the wrinkle wavelengths were obtained simultaneously for analyzing the wrinkling characteristics. Experimental results indicate when the electrode area is smaller the wrinkling voltage is higher, and with the increases of electrode area, the wrinkling voltage decreases rapidly until a specific area. Beyond that, the wrinkling voltage becomes larger gradually with the increases of the area. While the wrinkle wavelength decreases gradually with the increase of voltage monotonically. That is, the relation between the critical wrinkling voltage and the electrode areas is U-shaped. Analysis believes that the film wrinkling is a kind of local effect, the interaction and the energy transfer between electrode region and non-electrode region have great influence on wrinkling. In the experiment, very thin copper wires are used as the electrode leads that just contact with the electrodes, which can avoid the stiffness of the leads affecting the wrinkling.

Keywords: elastomers, uniaxial stretch, electrode area, wrinkling

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Authors: Andrés I. Ávila, Patricia Aros, César San Martín, Elizabeth Kehr, Yovana Leal

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Planning models for fresh products is a very useful tool for improving the net profits. To get an efficient supply chain model, several functions should be considered to get a complete simulation of several operational units. We consider a linear programming model to help farmers to decide if it is convenient to choose what area should be planted for three kinds of export fruits considering their future investment. We consider area, investment, water, productivity minimal unit, and harvest restrictions to develop a monthly based model to compute the average income in five years. Also, conditions on the field as area, water availability, and initial investment are required. Using the Chilean costs and dollar-peso exchange rate, we can simulate several scenarios to understand the possible risks associated to this market. Also, this tool help to support decisions for government and individual farmers.

Keywords: mixed integer problem, fresh fruit production, support decision model, agricultural and biosystems engineering

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Authors: Lalita Panchal, Zulfiya Sheikh

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Fluoride is essential for teeth and bones development not only for human beings but also for animals. But excess intake of fluoride causes harmful effects on health. Fluorosis is a worldwide health hazard and India is also one of the endemic countries. Udaipur district of Rajasthan is also prone to fluorosis and superphosphate industries are aggravating fluoride toxicity in this area. Grazing fields for animals in the close vicinity of the industries, fodder and water are fluoride contaminated. Fluoride toxicity in the form of dental fluorosis was observed in domestic animals, inhabiting industrial area near Udaipur, where superphosphate fertilizer plants are functioning and releasing fluoride and fumes and effluents into the surroundings. These fumes and gases directly affect the vegetation of grazing field, thus allowing entry of fluoride into the food chain. A survey was conducted in this area to assess the severity of fluorosis, in 2015-16. It was a house to house survey and animal owners were asked for their fodder and water supply. Anterior teeth of the animal were observed. Domestic animals exhibited mild to severe signs of dental fluorosis. Teeth showed deep brown staining, patches, lines and abrasions. Even immature animals were affected badly. Most of the domestic animals were affected, but goats of this area showed chronic symptoms of fluorosis. Due to abrasion of teeth and paining teeth their chewing or grazing capacity and appetite reduced. Eventually, it reduced the life span of animals and increased the mortality rate.

Keywords: domestic animals, fluoride toxicity, industrial fluorosis, superphosphate fertilizers

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Authors: Abd El-Aziz Khairy Abd El-Aal, Yuji Yagi, Heba Kamal

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In this study, an integrated multi-channel analysis of Surface Waves (MASW) technique is applied to explore the geotechnical parameters of subsurface layers at the Zafarana wind farm. Moreover, a seismic hazard procedure based on the extended deterministic technique is used to estimate the seismic hazard load for the investigated area. The study area includes many active fault systems along the Gulf of Suez that cause many moderate and large earthquakes. Overall, the seismic activity of the area has recently become better understood following the use of new waveform inversion methods and software to develop accurate focal mechanism solutions for recent recorded earthquakes around the studied area. These earthquakes resulted in major stress-drops in the Eastern desert and the Gulf of Suez area. These findings have helped to reshape the understanding of the seismotectonic environment of the Gulf of Suez area, which is a perplexing tectonic domain. Based on the collected new information and data, this study uses an extended deterministic approach to re-examine the seismic hazard for the Gulf of Suez region, particularly the wind turbine towers at Zafarana Wind Farm and its vicinity. Alternate seismic source and magnitude-frequency relationships were combined with various indigenous attenuation relationships, adapted within a logic tree formulation, to quantify and project the regional exposure on a set of hazard maps. We select two desired exceedance probabilities (10 and 20%) that any of the applied scenarios may exceed the largest median ground acceleration. The ground motion was calculated at 50th, 84th percentile levels.

Keywords: MASW, seismic hazard, wind turbine towers, Zafarana wind farm

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Authors: M. Kumral, A. Abdelnasser, M. Budakoglu, M. Karaman, D. K. Yildirim, Z. Doner, A. Bostanci

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The Paraga area is located at the extreme eastern part of Nakhchivan district at the boundary with Armenia. The field study is situated at Ordubad region placed in 9 km from Paraga village and stays at 2300-2800 m height over sea level. It lies within a region of low-grade metamorphic porphyritic volcanic and plutonic rocks. The detailed field studies revealed that this area composed mainly of metagabbro-diorite intrusive rocks with porphyritic character emplaced into meta-andesitic rocks. This complex is later intruded by unmapped olivine gabbroic rocks. The Cu-Mo-(Au) mineralization at Paraga deposit is vein-type mineralization that is essentially related to quartz veins stockwork which cut the dioritic rocks and concentrated at the eastern and northeastern parts of the area with different directions N80W, N25W, N70E and N45E. Also, this mineralization is associated with two shearing zones directed N75W and N15E. The host porphyritic rocks were affected by intense sulfidation, carbonatization, sericitization and silicification with pervasive hematitic alterations accompanied with mineralized quartz veins and quartz-carbonate veins. Sulfide minerals which are chalcopyrite, pyrite, arsenopyrite and sphalerite occurred in two cases either inside these mineralized quartz veins or disseminated in the highly altered rocks as well as molybdenite and also at the peripheries between the altered host rock and veins. Gold found as inclusion disseminated in arsenopyrite and pyrite as well as in their cracks.

Keywords: porphyry Cu-Mo-(Au), Paraga area, Nakhchivan, Azerbaijan, paragenesis, hyrothermal alteration

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Authors: Arvind Kumar

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The city of Kanpur is located in the terrestrial plain area on the bank of the river Ganges and is the second largest city in the state of Uttar Pradesh. The city generates approximately 1400-1600 tons per day of MSW. Kanpur has been known as a major point and non-points-based pollution hotspot for the river Ganges. The city has a major industrial hub, probably the largest in the state, catering to the manufacturing and recycling of plastic and other dry waste streams. There are 4 to 5 major drains flowing across the city, which receive a significant quantity of waste leakage, which subsequently adds to the Ganges flow and is carried to the Bay of Bengal. A river-to-sea flow approach has been established to account for leaked waste into urban drains, leading to the build-up of marine litter. Throughout its journey, the river accumulates plastic – macro, meso, and micro, from various sources and transports it towards the sea. The Ganges network forms the second-largest plastic-polluting catchment in the world, with over 0.12 million tonnes of plastic discharged into marine ecosystems per year and is among 14 continental rivers into which over a quarter of global waste is discarded 3.150 Kilo tons of plastic waste is generated in Kanpur, out of which 10%-13% of plastic is leaked into the local drains and water flow systems. With the Support of Kanpur Municipal Corporation, 1TPD capacity MRF for drain waste management was established at Krishna Nagar, Kanpur & A German startup- Plastic Fisher, was identified for providing a solution to capture the drain waste and achieve its recycling in a sustainable manner with a circular economy approach. The team at Plastic Fisher conducted joint surveys and identified locations on 3 drains at Kanpur using GIS maps developed during the survey. It suggested putting floating 'Boom Barriers' across the drains with a low-cost material, which reduced their cost to only 2000 INR per barrier. The project was built upon the self-sustaining financial model. The project includes activities where a cost-efficient model is developed and adopted for a socially self-inclusive model. The project has recommended the use of low-cost floating boom barriers for capturing waste from drains. This involves a one-time time cost and has no operational cost. Manpower is engaged in fishing and capturing immobilized waste, whose salaries are paid by the Plastic Fisher. The captured material is sun-dried and transported to the designated place, where the shed and power connection, which act as MRF, are provided by the city Municipal corporation. Material aggregation, baling, and transportation costs to end-users are borne by Plastic Fisher as well.

Keywords: Kanpur, marine environment, drain waste management, plastic fisher

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Authors: Ashley L. Freeman, Jessica D. Watkins

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TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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Authors: Pratyashi Phukan, Ranjan Saikia

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Morphometry incorporates quantitative study of the area ,altitude,volume, slope profiles of a land and drainage basin characteristics of the area concerned.Fluvial geomorphology includes the consideration of linear,areal and relief aspects of a fluvially originated drainage basin. The linear aspect deals with the hierarchical orders of streams, numbers, and lenghts of stream segments and various relationship among them.The areal aspect includes the analysis of basin perimeters,basin shape, basin area, and related morphometric laws. The relief aspect incorporates besides hypsometric, climographic and altimetric analysis,the study of absolute and relative reliefs, relief ratios, average slope, etc. In this paper we have analysed the relationship among stream velocity, channel shape,sediment load,channel width,channel depth, etc.

Keywords: morphometry, hydraulic geometry, Umtrew river, Meghalaya

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Authors: Simone Rondelli, Damiano Rondelli, Bishesh Poudyal, Juan Jose Cabrera-Lazarini

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One of the main obstacles for Social Entrepreneurship is to find a business model that is financially sustainable. In other words, the captured value generates enough cash flow to ensure business continuity and reinvestment for growth. Providing Health Services in poor countries for the uninsured population affected by a high-cost chronical disease is not the exception for this challenge. As a prime example, cancer has become a high impact on a global disease not only because of the high morbidity but also of the financial impact on both the patient family and health services in underdeveloped countries. Therefore, it is relevant to find a Social Entrepreneurship Model that provides affordable treatment for this disease while maintaining healthy finances not only for the patient but also for the organization providing the treatment. Using the methodology of Constructive Research, this paper applied a Positive Theory and four business models of Social Entrepreneurship to a case of a Private Foundation model whose mission is to address the challenge previously described. It was found that the Foundation analyzed, in this case, is organized as an Embedded Business Model and complies with the four propositions of the Positive Theory considered. It is recommended for this Private Foundation to explore implementing the Integrated Business Model to ensure more robust sustainability in the long term. It evolves as a scalable model that can attract investors interested in contributing to expanding this initiative globally.

Keywords: affordable treatment, global healthcare, social entrepreneurship theory, sustainable business model

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Authors: Jahede Tekeykhah, Seyed Mohsen Hossini, Gholamali Jalali

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Industrial and traffic activities cause large amounts of heavy metals enter into the atmosphere and the use of plant species can be effective in assessing and reducing air pollution by metals. This study aimed to investigate the adsorption level of heavy metals in leaves of Fraxinus rotundifolia, Robinia, Platanus orientalis, Platycladus orientalis and Pinus eldarica trees in Abidar forest park. For this purpose, samples leaves of the trees were prepared from the contaminated and control areas in each region in 3 stations with 3 replicates in mid-August and finally 90 samples were sent to the laboratory. Then, the concentrations of heavy metals were measured by graphite furnace. To do this, factorial experiment based on a completely randomized design with two factors of location on two levels (contaminated area and control area) and the factor of species on five levels (Fraxinus rotundifolia, Robinia, Platanus orientalis, Platycladus orientalis and Pinus eldarica) with three replications was used. The analysis of collected data was performed by SPSS software and Duncan's multiple range test was used to compare the means. The results showed that the accumulation of all metals in the leaves of most species in the infected area with a significant difference at 95% level was higher than the control area. In the contaminated area, with a significant difference at 5% level, the highest accumulations of metals were observed as the following: lead, cadmium, zinc and manganese in Platanus orientalis, nickel in Fraxinus rotundifolia and copper in Platycladus orientalis.

Keywords: airborne, tree species, heavy metals, absorption, Abidar Forest Park

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Authors: Ahmed Abdelghany, Bernard Uguen, Christophe Moy, Dominique Lemur

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The Internet of Things (IoT) is developed to ensure monitoring and connectivity within different applications. Thus, it is critical to study the channel propagation characteristics in Low Power Wide Area Network (LPWAN), especially Long Range Wide Area Network (LoRaWAN). In this paper, an in-depth investigation of the reciprocity between the uplink and downlink Channel State Information (CSI) is done by performing an outdoor measurement campaign in the area of Campus Beaulieu in Rennes. At each different location, the CSI reciprocity is quantified using the Pearson Correlation Coefficient (PCC) which shows a very high linear correlation between the uplink and downlink CSI. This reciprocity feature could be utilized for the physical layer security between the node and the gateway. On the other hand, most of the CSI shapes from different locations are highly uncorrelated from each other. Hence, it can be anticipated that this could achieve significant localization gain by utilizing the frequency hopping in the LoRa systems by getting access to a wider band.

Keywords: IoT, LPWAN, LoRa, effective signal power, onsite measurement

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Authors: Yu-Cheng Chen, Tzu-Ping Lin, Feng-Yi Lin, Chih-Yu Chen

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Due to the urban heat island effect caused by highly development of city, the heat stress increased in recent year rapidly. Resulting in a sharp raise of the energy used in urban area. The heat stress during summer time exacerbated the usage of air conditioning and electric equipment, which caused more energy consumption and anthropogenic heat. Therefore, an accurate and simple method to measure energy used in urban area can be helpful for the architectures and urban planners to develop better energy efficiency goals. This research applies the combination of airborne LiDAR data and thermal imager to provide an innovate method to estimate energy consumption. Owing to the high resolution of remote sensing data, the accurate current volume and total floor area and the surface temperature of building derived from LiDAR and thermal imager can be herein obtained to predict energy used. In the estimate process, the LiDAR data will be divided into four type of land cover which including building, road, vegetation, and other obstacles. In this study, the points belong to building were selected to overlay with the land use information; therefore, the energy consumption can be estimated precisely with the real value of total floor area and energy use index for different use of building. After validating with the real energy used data from the government, the result shows the higher building in high development area like commercial district will present in higher energy consumption, caused by the large quantity of total floor area and more anthropogenic heat. Furthermore, because of the surface temperature can be warm up by electric equipment used, this study also applies the thermal image of building to find the hot spots of energy used and make the estimation method more complete.

Keywords: urban heat island, urban planning, LiDAR, thermal imager, energy consumption

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Authors: Nabil A. Albaser

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Background: There is a serious problem with adverse drug reactions (ADRs) everywhere, including Yemen. Since it helps with the detection, assessment, reporting and prevention of ADRs, pharmacovigilance (PV) is an essential part of the healthcare system. The unbiased reporting of ADRs remains the foundation of PV. Students majoring in healthcare should acquire the knowledge and skills necessary to conduct PV in a range of clinical settings. The primary objective of this study was to evaluate the understanding and attitudes of final-year Pharmacy, Nursing, and Midwifery students at Al-Razi University in Sana'a, Yemen, regarding PV and ADRs reporting. Methods: The study followed descriptive cross-sectional approach. A validated, self-administered questionnaire with three parts—demographic information, knowledge, and perceptions of Pharmacovigilance was online distributed to final-year Pharmacy, Nursing, and Midwifery students. The questionnaire was given to 175 students; 122 of them responded with a percentage (69.7%). Results: The majority of respondents were male (79.5%). More than the tow-third of the students, 68.9%, were beyond the age of 23. Although the majority of students, 80%, heard about the terms of ADRs and PV, but only 50% and 57.4% of the respondents, respectively, could define the both terms correctly. However, only 11.48 % of them, nevertheless, took a PV course. More than a half of them (56.6%) had a positive perceptions towards pharmacovigilance and ADR reporting and had a moderate degree of knowledge (68.9%). Conclusion: The study demonstrated that the participants lacked sufficient knowledge of pharmacovigilance and ADR reporting. They showed a moderate level of understanding of reporting ADRs as well as a favorable opinion of dealing with and reporting ADRs. Yemen's health care curriculum should include lessons on pharmacovigilance.

Keywords: adverse drug reaction reporting, pharmacovigilance, yemen, knowlegde

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