Search results for: cross-sectoral collaboration in health care

Authors: Teguh R. Hakim, Frenny F. F. Kairupan, Alberta M. Mantiri

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The face of the coastal city is generally the same as other cities face showing the dualistic, traditional and modern, rural and urbanity, planned and unplanned, slum and high quality. Manado city is located on the northern coastal areas of the island of Sulawesi, Indonesia. Manado city is located on the northern coastal areas of the island of Sulawesi, Indonesia. Urban environmental problems ever occurred in this city, which is the impact of dualistic urban. Overcrowding, inadequate infrastructure, and limited human resources become the main cause of untidiness the coastal settlements in Malalayang. This has an impact on the activities of social, economic, public health level in the environment of coastal City of Manado, Malalayang. This is becoming a serious problem which must be tackled jointly by the government, private parties, and the community. Community-based settlement environment setup, into one solution to realize the city's coastal settlements livable. As for this research aims to analyze the involvement of local communities in arrangements of the settlement. The participatory approach of the model used in this study. Its application is mainly at macro and meso-scale (region, city, and environment) or community architecture. Model participatory approach leads more operational research approach to find a solution/answer to the problems of settlement. The participatory approach is a model for research that involves researchers and society as an object at the same time the subject of research, which in the process in addition to researching also developed other forms of participation in the design and build together. The expected results of this study were able to provide education to the community about environmental and set up a livable settlement for the sake of improving the quality of life. The study also becomes inputs to the government in applying the pattern of development that will be implemented in the future.

Keywords: arrangements the coastal environment, community participation, urban environmental problems, livable settlement

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Authors: Maria Ashitko

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The Constitution of the Republic of Belarus is based on the principle of the unity of rights and obligations, including those of the child. The constitutional status of the child is aspecific system of constitutional elements established and guaranteed by the state through the current legislation and regulatory acts that ensure the special legal status of the child, his or her constitutional legal capacity, implementation of the principles of the constitutional and legal status of the child, constitutional rights of the child and their safeguards. Under the principles of the constitutional status of the child, we consider the general, normative, social-volitional rules of behavior established by the Constitution of the Republic of Belarus, laws and other regulatory acts that determine the content and social purpose of the legal status of the child. The constitutional and legal status of the child is characterized by the following special principles, which form a feature of the state legal system:1) Ensuring the interests of the child means providing for the child in accordance with his or her age, state of health, characteristics of development, life experience, family life, cultural traditions, ethnicity. 2) The principle of equal responsibility of both parents or their substitutes characterized by caring for the next generation as one of the priority tasks of the state and society, and all issues related to the implementation of children’s rights should be addressed at the constitutional level. 3) We would like to highlight such a special principle as the subprinciple of safeguards, which is the principle of ensuring the safety of the child. It is also worth noting that in legal studies, there is no relationship between safety and constitutional rights as general safeguards of individual rights and freedoms, and as special safeguards for the right to life. 4) The principle of justice is expressed by the fact that in modern conditions, the quality of life is determined not only by material wealth but also by the ability of the state to ensure the harmonization of social relations and social harmony on the basis of humanism and justice. Thus, the specificity of the constitutional status of the child is the age boundary between adulthood and minority; therefore, we propose to highlight the age characteristics of the child as an additional element. It is advisable to highlight such a special principle as the subprinciple of safeguards, which is the principle of ensuring the safety of the child.

Keywords: children’s rights, constitutional status, constitutional principles, constitutional rights

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Authors: Aly Kassem, Eman Sapet, Eman Abdelbaset, Hosam Mahmoud

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Objective: Hypertension is an important public health challenge being one of the most common worldwide disease-affecting human. Our aim is to study the clinical characteristics, therapeutic regimens, treatment compliance, and risk factors in a sector of of hypertensive patients at Sohag City. Subject and Methods: A cross sectional study; conducted in Sohag city; it involved 520 patients; males (45.7 %) and females (54.3 %). Their ages ranged between 35-85 years. BP measurements, BMI, blood glucose, Serum creatinine, urine analysis, serum Lipids, blood picture and ECG were done all the studied patients. Results: Hypertension presented more between non-smokers (72.55%), females (54.3%), educated patients (50.99%) and patients with low SES (54.9%). CAD presented in (51.63%) of patients, while laboratory investigations showed hyperglycaemia in (28.7%), anemia in (18.3%), high serum creatinine level in (8.49%) and proteinuria in (10.45%) of patient. Adequate BP control was achieved in (49.67%); older patients had lower adequacy of BP control in spite of the extensive use of multiple-drug therapy. Most hypertensive patients had more than one coexistent CV risk factor. Aging, being a female (54.3%), DM (32.3%), family history of hypertension (28.7%), family history of CAD (25.4%), and obesity (10%) were the common contributing risk factors. ACE-inhibitors were prescribed in (58.16%), Beta-blockers in (34.64%) of the patients. Monotherapy was prescribed for (41.17%) of the patients. (75.81%) of patients had regular use of their drug regimens. (49.67%) only of patients had their condition under control, the number of drugs was inversely related to BP control. Conclusion: Hypertensive patients in Sohag city had a profile of high CV risks, and poor blood pressure control particularly in the elderly. A multidisciplinary approach for routine clinical check-up, follow-up, physicians and patients training, prescribing simple once-daily regimens and encouraging life style modifications are recommended. Anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance.

Keywords: anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance

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Authors: Jill Steel

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Introduction: Animal-assisted learning (AAL) interventions are increasing exponentially, yet a paucity of quality research in the field exists. The aim of this study was to evaluate how the promotion of emotional wellbeing, through AAL, in this case, a dog, may support children’s engagement with reading in a Primary 1 classroom. Research indicates that dogs can provide emotional support to children; by forming a trusting attachment with a non-critical ‘friend’ who confers unconditional positive regard on the child, confidence may be boosted and anxiety reduced. By promoting emotional wellbeing through interactions with the dog, it is hoped that children begin to associate reading with feelings of wellbeing, which then results in increased engagement with reading. Methodology: A review of the literature was conducted. The relationship between emotional wellbeing and learning was explored, followed by an examination of the literature relating to Animal-Assisted Therapy and AAL. Scottish educational policy and legislation were analysed to establish the extent to which AAL might be suitable for the Scottish pedagogical context. An empirical study was conducted in a mainstream Primary 1 classroom over a four-week period. An inclusive approach was adopted whereby all children that wanted to interact with the dog were given the opportunity to do so, and all 25 children subsequently chose to participate. Children were not withdrawn from the classroom. Primary methods included interviews, observations, and questionnaires. Three focus children were selected for closer study. Main Results: Results were remarkably close to previous research and literature. Children’s emotional wellbeing was boosted, and engagement in reading improved. Principal Conclusions and Implications for Field: It was concluded that AAL could support emotional wellbeing and, in turn, promote children’s engagement with reading. The main limitation of the study was its short-term nature, and a longer randomised controlled trial with a larger sample, currently being undertaken by the author, would provide a fuller answer to the research question. Barriers to AAL include health and safety concerns and steps to ensure the welfare of the dog.

Keywords: animal-assisted learning, emotional wellbeing, reading, reading to dogs

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Authors: Temosho Promise Chuene, T. Chitura

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Background: Foot and mouth disease is a real challenge in South Africa. The disease is a serious threat to the viability of livestock farming initiatives and affects local and international livestock trade. In Limpopo Province, the Kruger National Park and other game reserves are home to the African buffalo (Syncerus caffer), a notorious reservoir of the picornavirus, which causes foot and mouth disease. Out of the virus’s seven (7) distinct serotypes, Southern African Territories (SAT) 1, 2, and 3 are commonly endemic in South Africa. The broad objective of the study was to establish the trend of foot and mouth disease in Limpopo Province over a seven-year period (2014-2020), as well as the adoption and comprehensive reporting of the measures that are taken to contain disease outbreaks in the study area. Methods: The study used secondary data from the World Organization for Animal Health (WOAH) on reported cases of foot and mouth disease in South Africa. Descriptive analysis (frequencies and percentages) and Analysis of variance (ANOVA) were used to present and analyse the data. Result: The year 2020 had the highest prevalence of foot and mouth disease (3.72%), while 2016 had the lowest prevalence (0.05%). Serotype SAT 2 was the most endemic, followed by SAT 1. Findings from the study demonstrated the seasonal nature of foot and mouth disease in the study area, as most disease cases were reported in the summer seasons. Slaughter of diseased and at-risk animals was the only documented disease control strategy, and information was missing for some of the years. Conclusion: The study identified serious underreporting of the adopted control strategies following disease outbreaks. Adoption of comprehensive disease control strategies coupled with thorough reporting can help to reduce outbreaks of foot and mouth disease and prevent losses to the livestock farming sector of South Africa and Limpopo Province in particular.

Keywords: livestock farming, African buffalo, prevalence, serotype, slaughter

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Authors: Anjaly Joseph, Elezebeth Mathews

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Transportation and urban planning is the least recognised area for physical activity promotion in India, unlike developed regions. Identifying the preferred transportation modalities and factors associated with it is essential to address these lacunae. The objective of the study was to assess the prevalence of modes of transportation to work, and its correlates among working adults in Ernakulam District, Kerala. A cross sectional study was conducted among 350 working individuals in the age group of 18-60 years, selected through multi-staged stratified random sampling in Ernakulam district of Kerala. The inclusion criteria were working individuals 18-60 years, workplace at a distance of more than 1 km from the home and who worked five or more days a week. Pregnant women/women on maternity leave and drivers (taxi drivers, autorickshaw drivers, and lorry drivers) were excluded. An interview schedule was used to capture the modes of transportation namely, public, private and active transportation, socio demographic details, travel behaviour, anthropometric measurements and health status. Nearly two-thirds (64 percent) of them used private transportation to work, while active commuters were only 6.6 percent. The correlates identified for active commuting compared to other modes were low socio-economic status (OR=0.22, CI=0.5-0.85) and presence of a driving license (OR=4.95, CI= 1.59-15.45). The correlates identified for public transportation compared to private transportation were female gender (OR= 17.79, CI= 6.26-50.31), low income (OR=0.33, CI= 0.11-0.93), being unmarried (OR=5.19, CI=1.46-8.37), presence of no or only one private vehicle in the house (OR=4.23, CI=1.24-20.54) and presence of convenient public transportation facility to workplace (OR=3.97, CI= 1.66-9.47). The association between body mass index (BMI) and public transportation were explored and found that public transport users had lesser BMI than private commuters (OR=2.30, CI=1.23-4.29). Policies that encourage active and public transportation needs to be introduced such as discouraging private vehicle through taxes, introduction of convenient and safe public transportation facility, walking/cycling paths, and paid parking facility.

Keywords: active transportation, correlates, India, public transportation, transportation modes

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Authors: Hannah S. Elizabeth, D. Gnanasekaran, M. R. Manju Gowda, Antony George

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Phytoremediation a new technology of remediating the contaminated soil, water and air using plants and serves as a green technology with environmental friendly approach. The main aim of this technique is cleansing and detoxifying of organic compounds, organo-phosphorous pesticides, heavy metals like arsenic, iron, cadmium, gold, radioactive elements which cause teratogenic and life threatening diseases to mankind and animal kingdom when consume the food crops, vegetables, fruits, cerals, and millets obtained from the contaminated soil. Also, directly they may damage the genetic materials thereby alters the biosynthetic pathways of secondary metabolites and other phytoconstituents which may have different pharmacological activities which lead to lost their efficacy and potency as well. It would reflect in mutagenicity, drug resistance and affect other antagonistic properties of normal metabolism. Is the technology for real clean-up of contaminated soils and the contaminants which are potentially toxic. It reduces the risks produced by a contaminated soil by decreasing contaminants using plants as a source. The advantages are cost-effectiveness and less ecosystem disruption. Plants may also help to stabilize contaminants by accumulating and precipitating toxic trace elements in the roots. Organic pollutants can potentially be chemically degraded and ultimately mineralized into harmless biological compounds. Hence, the use of plants to revitalize contaminated sites is gaining more attention and preferred for its cost-effective when compared to other chemical methods. The introduction of harmful substances into the environment has been shown to have many adverse effects on human health, agricultural productivity, and natural ecosystems. Because the costs of growing a crop are minimal compared to those of soil removal and replacement, the use of plants to remediate hazardous soils is seen as having great promise.

Keywords: cost effective, eco-friendly, phytoremediation, secondary metabolites

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Authors: Lubna Azmi, Ila Shukla, Shyam Sundar Gupta, Padam Kant, Ch. V. Rao

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Gastric ulcer is a major global health threat, and it is the leading cause of stomach cancer death worldwide. Helicobacter pylori bacteriumis the most important etiologic factor for gastric ulcer. This infection is highly pervasive in South Asian developing countries, especially in India, Nepal, Srilanka etc. due to diversification in geographic area. Pathophysiology of gastric mucosal damage associated with non-invasive bacterium has not justified in detail, but it leads to change in histopathology, immunochemistry of the gastric and duodenal reason of host. The mechanism responsible for bacteria tissue tropism and mucosal damage in stomach variance during the disease is not clearly described and understood scientifically in treatment and control of pathogenic organisms. Polyphenols are secondary metabolites of plants and are generally involved in defense against aggression by pathogens. 2-(3,4-dihydroxyphenyl)-3,5,7-trihydroxychromen-4-one and 1-hydroxy-5,7-dimethoxy-2-naphthalene-carboxaldehyde are polyphenolic compound obtained from popular Indian medicinal plants ghavpatta (ArgeriaspeciosaLinn.f) andBael (Aeglemarmelos) have long been used in traditional Ayurvedic Indian medicine for various diseases. They have promising effects on ulcer, as detailed investigation has made in our laboratory. Therefore, the aim of present study is to explore membrane –dependent morphogenesis of H. pylori and associated apoptosis-mediated cell death. Based on this we analyzed immune gene expression in stomach of experimental animals with H. pylori, using quantitative reverse transcription polymerase chain reaction(q RT-PCR). This revealed rapid induction of prostaglandin, interferon I (INF-I), interferon II (INF-II) and INF-I associated genes in the infected animal. Ultrastructural changes associated with H. pylori will be taken for advanced studies. This investigation shows that the biomarkers eradicate H. pylori bacterium caused gastric ulcer which is a major risk factor for gastric cancer.

Keywords: gastric ulcer, Helicobacter pylori, immunochemistry, polyphenols

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Authors: Bouami Hind, Millot Patrick

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The implementation of automated devices in life-critical systems such as hospitals can bring a new set of challenges related to automation malfunctions. While automation has been identified as great leverage for the medication dispensing system’s security and efficiency, it also increases the complexity of the organization. In particular, the installation and operation stage of automated devices can be complex when malfunctions related to automated systems occur. This paper aims to document operators’ situation awareness about the malfunctions of automated drug delivery systems (ADCs) during their implementation through Saint Brieuc hospital’s feedback. Our evaluation approach has been deployed in Saint Brieuc hospital center’s pharmacy, which has been equipped with automated nominative drug dispensing systems since January of 2021. The analysis of Saint Brieuc hospital center pharmacy’s automation revealed numerous malfunctions related to the implementation of Automated Delivery Cabinets. It appears that the targeted performance is not reached in the first year of implementation in this case study. Also, errors have been collected in patients' automated treatments’ production such as lack of drugs in pill boxes or nominative carnets, excess of drugs, wrong location of the drug, drug blister damaged, non-compliant sachet, or ticket errors. Saint Brieuc hospital center’s pharmacy is doing a tremendous job of setting up and monitoring performance indicators from the beginning of automation and throughout ADC’s operation to control ADC’s malfunctions and meet the performance targeted by the hospital. Health professionals, including pharmacists, biomedical engineers and directors of work, technical services and safety, are heavily involved in an automation project. This study highlights the importance of the evaluation of ADCs’ performance throughout the implementation process and the hospital’s team involvement in automation supervision and management.

Keywords: life-critical systems, situation awareness, automated delivery cabinets, implementation, risks and malfunctions

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Authors: Young-Eun Jang, Mi-Hye Ma, Yemi Kim

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As the elderly population increases, the number of patients complaining of dry mouth is also increasing. Elderly people often use mouthwash to prevent periodontal disease. Mouthwash and saliva substitutes with low pH were reported to be able to cause enamel erosion. To the best of our knowledge, there have been no studies showing the effect of mouthwash on patients using saliva substitutes. Therefore, the purpose of this study was to evaluate the effect of the use of mouthwash in combination with saliva substitutes on tooth erosion using a quantitative light-induced fluorescence-digital (QLF-D) system. A total of 96 bovine specimens were embedded in putty blocks and randomly allocated to the following groups with n = 12 each: Group 1, application of mouthwash; Group 2, application of saliva substitutes; Group 3, application of saliva substitutes in combination with mouthwash; and control group, application of saline. The bovine samples were eroded using a demineralization solution and then saliva substitutes and mouthwash were applied according to the groups for 2 weeks. For saliva substitutes, three different products were used; Oasis (Oasis Consumer Health, Cleveland, OH, USA), Xeromia solution (Osstem Pharma Co., Seoul, Korea), and Drymund gel (Dong-A Pharma Co., Seoul, Korea). The pH values of the saliva substitutes were determined using a pH meter. Loss of enamel and root dentin was measured using the QLF-D system immediately after demineralization on the 3rd, 7th, and 14th days. The data were analyzed using repeated measures ANOVA followed by Tukey’s post hoc tests (p < 0.05). Mineral loss in enamel and root dentin was detected when mouthwash and saliva substitutes were used alone, respectively (p < 0.05). Also, when mouthwash was used with saliva substitutes, the mineral loss was observed in enamel and root dentin (p < 0.05). The use of Xeromia and Drymund gel increased mineral loss of enamel significantly compared to the use of Oasis (p < 0.05). However, when Drymund gel and Xeromia were used in combination with mouthwash, mineral loss of enamel was significantly reduced compared to when they were used alone (p < 0.05). The pH values of Drymund gel, Xeromia, Oasis, and mouthwash were 5.5, 5.52, 6.2, and 6.37, respectively. Based on these results, it can be concluded that the use of mouthwash with a higher pH value than that of saliva substitutes could help patients suffering from xerostomia avoid the risk of dental erosion.

Keywords: saliva substitute, mouthwash, tooth erosion, dry mouth

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Authors: P. Joshna, Souvik Kundu

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Detection of ultraviolet (UV) radiation is very important as it has exhibited a profound influence on humankind and other existences, including military equipment. In this work, a self-powered UV photodetector was reported based on oxides heterojunctions. The thin films of p-type nickel oxide (NiO) and n-type reduced graphene oxide (rGO) were used for the formation of p-n heterojunction. Low-Cost and low-temperature chemical synthesis was utilized to prepare the oxides, and the spin coating technique was employed to deposit those onto indium doped tin oxide (ITO) coated glass substrates. The top electrode platinum was deposited utilizing physical vapor evaporation technique. NiO offers strong UV absorption with high hole mobility, and rGO prevents the recombination rate by separating electrons out from the photogenerated carriers. Several structural characterizations such as x-ray diffraction, atomic force microscope, scanning electron microscope were used to study the materials crystallinity, microstructures, and surface roughness. On one side, the oxides were found to be polycrystalline in nature, and no secondary phases were present. On the other side, surface roughness was found to be low with no pit holes, which depicts the formation of high-quality oxides thin films. Whereas, x-ray photoelectron spectroscopy was employed to study the chemical compositions and oxidation structures. The electrical characterizations such as current-voltage and current response were also performed on the device to determine the responsivity, detectivity, and external quantum efficiency under dark and UV illumination. This p-n heterojunction device offered faster photoresponse and high on-off ratio under 365 nm UV light illumination of zero bias. The device based on the proposed architecture shows the efficacy of the oxides heterojunction for efficient UV photodetection under zero bias, which opens up a new path towards the development of self-powered photodetector for environment and health monitoring sector.

Keywords: chemical synthesis, oxides, photodetectors, spin coating

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Authors: Charlene Petersen, Herman Grobler, Karel Botha

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Restorative intervention with adolescents from a family violence context is a much needed resource given the limited access to mental health services in South Africa. In this research article the qualitative component which formed part of a mixed methods design of an overall research study, is discussed. A qualitative case study design was used. This article explores a psycho-education strategy, using a visual creative medium as a method for reconstructing identity in the context of family violence. The aim of this psycho-education strategy was to move away from interventions based on the biomedical model, but focused more on meaning-making about violent traumatic events adolescents have experienced, and to develop more positive, adaptive views about themselves in the present, and experience hope about the future. The research question that was asked was how the meaning, that adolescents from a specific community in South Africa give to family violence, contribute to defining their identity? Twelve participants were purposively selected for the study and included both male and female adolescents with ages ranging from 15 to 18 years from three secondary schools. The strategy was applied over five sessions with the intention to bring about awareness of different selves, identifying and naming the selves, and becoming aware of the configuration of identity that could lead to a redefined identity. The data were thematically and visually analyzed. Through the process of tailoring which forms the basis for reconstruction process, participants could identify the different selves, become aware of how they configure in the field. Through the process of tailoring the different self-parts, the sense of self became more self-cohesive and allowed the individual to become aware of the role of certain. Through identifying and naming the future self and resilient self the participants were able to accomplish some order and meaning in their lives. It provided them with a sense of predictability and an optimistic and hopefulness towards the future. The research findings indicated that this strategy can be used as a method for reconstructing identity in the context of family violence.

Keywords: identity, family violence, self-configuration, reconstructing identity, psycho-education strategy

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Authors: Kumaressan Ragunathan, Arisudhan Anantharachagan

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Gestational diabetes mellitus (GDM) is the subtype of diabetes that has been rapidly increasing in numbers in Australia. The annual percentage of GDM has increased more than 50 percent in the last decade. According to Diabetes Australia, more than five hundred thousand women in Australia will be diagnosed with GDM. Globally, the prevalence of GDM ranges from single-digit to more than 45%. The prevalence of GDM has increased significantly last five years after the introduction of new diagnostic criteria. Hence, we have decided to investigate the trend in GDM prevalence in a tertiary maternity unit at Western Australia and compare it to national prevalence. Data is derived from STORK Perinatal Database which has been used by Maternity services in Western Australia to populate information on pregnancy and labour. We have selected data from 2015 until 2020, which includes 17508 women. Among 17508 women, 3850 women were diagnosed with GDM. In 2015, we had a total of 2213 deliveries with 345 of them were complicated by GDM. GDM prevalence was 15.6% compared to the Australian national prevalence of 12%. In 2016, total deliveries increased to 2759 with 590 of were with GDM. GDM prevalence was 21.4% compared to the Australian national prevalence of 12%. In 2017, total deliveries further increased to 3049 with 675 with GDM. GDM prevalence was 22.1%, with an Australian national prevalence of 13%. In 2018, total deliveries continued to increase, with numbers reaching 3231 with 749 with GDM. GDM prevalence was 23.2%, with an Australian National prevalence of 14%. In 2019, total deliveries were 3110, with 712 complicated by GDM. GDM prevalence was 22.9%, with Australian national prevalence 14%. In 2020, total deliveries 3146 with 819 complicated by GDM. GDM prevalence increased to 26% and we were unable to compare this to national standard as national prevalence has not been released. Among 3890 women with GDM, 2482 (64%) of them required insulin. Apart from that, a total 1642(42%) from the GDM group were delivered via the Caesarean section. 2121 (55%) women with GDM required induction of labour. Overall, we demonstrated an increase in the prevalence of GDM in our unit from 2015 until 2020. Our prevalence is also higher compared to national prevalence. This could be contributed by the increasing number of obesity and in addition, our unit accepts referrals of women with a body mass index (BMI) of more than 40. Hence, further studies are required to look at other risk factors like ethnicity, socio-economic status, health literacy and age, which could contribute to this high prevalence.

Keywords: gestational diabetes mellitus, prevalence, Western Australia, Australia

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Authors: Pelin Yilmaz, Gizemnur Yildiz Uysal, Elcin Demirhan, Belma Ozbek

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The edible fig plant, Ficus carica Linn, belongs to the Moraceae family, and the leaves are mainly considered agricultural waste after harvesting. It has been demonstrated in the literature that fig leaves contain appealing properties such as high vitamins, fiber, amino acids, organic acids, and phenolic or flavonoid content. The extraction of these valuable products has gained importance. Microwave-assisted extraction (MAE) is a method using microwave energy to heat the solvents, thereby transferring the bioactive compounds from the sample to the solvent. The main advantage of the MAE is the rapid extraction of bioactive compounds. In the present study, the MAE was applied to extract the bioactive compounds from Ficus carica L. leaves, and the effect of microwave power (180-900 W), extraction time (60-180 s), and solvent to sample amount (mL/g) (10-30) on the antioxidant property of the leaves. Then, the volatile organic component profile was determined at the specified extraction point. Additionally, antimicrobial studies were carried out to determine the minimum inhibitory concentration of the microwave-extracted leaves. As a result, according to the data obtained from the experimental studies, the highest antimicrobial properties were obtained under the process parameters such as 540 W, 180 s, and 20 mL/g concentration. The volatile organic compound profile showed that isobergapten, which belongs to the furanocoumarins family exhibiting anticancer, antioxidant, and antimicrobial activity besides promoting bone health, was the main compound. Acknowledgments: This work has been supported by Yildiz Technical University Scientific Research Projects Coordination Unit under project number FBA-2021-4409. The authors would like to acknowledge the financial support from Tubitak 1515 - Frontier R&D Laboratory Support Programme.

Keywords: Ficus carica Linn leaves, volatile organic component, GC-MS, microwave extraction, isobergapten, antimicrobial

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Authors: Maryam Zahmatkesh

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Middle managers form a significant occupational category in organisations. They undertake a vital role, as they sit between the operational and strategic roles. Traditionally they were acting as diplomat administrators, and were only in power to meet the demands of professionals. Following the introduction of internal market, in line with the principles of New Public Management, middle managers have been considered as change agents. More recently, in the debates of middle managers, there is emphasis on entrepreneurialism and enacting strategic role. It was assumed that granting autonomy to the local organisations and the inception of semi-autonomous hospitals (Foundation Trusts in England and Board of Trustees in Iran) would give managers more autonomy to act proactively and innovatively. This thesis explores the hospital middle managers’ perception of and responses to public management reforms (in particular, hospital autonomy) in England and Iran. In order to meet the aims of the thesis, research was undertaken within the interpretative paradigm, in line with social constructivism. Data were collected from interviews with forty-five middle managers, observational fieldwork and documentary analysis across four teaching university hospitals in England and Iran. The findings show the different ways middle managers’ autonomy is constrained in the two countries. In England, middle managers have financial and human recourses, but their autonomy is constrained by government policy and targets. In Iran, middle managers are less constrained by government policy and targets, but they do not have financial and human resources to exercise autonomy. Unbalanced autonomy causes tension and frustration for middle managers. According to neo-institutional theory, organisations are deeply embedded within social, political, economic and normative settings that exert isomorphic and internal population-level pressures to conform to existing and established modes of operation. Health systems which are seeking to devolve autonomy to middle managers must appreciate the multidimensional nature of the autonomy, as well as the wider environment that organisations are embedded, if they are about to improve the performance of managers and their organisations.

Keywords: autonomy, healthcare organisations, middle managers, new public management

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Authors: Rima Almalla

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The purpose of the research project in Geography is to evaluate the applicability of urban green infrastructure approach in Finnish climate. The key focus will be on the operation and efficiency of green infrastructure on urban stormwater management. Green infrastructure approach refers to the employment of sufficient green covers as a modern and smart environmental solution to improve the quality of urban environments. Green infrastructure provides a wide variety of micro-scale ecosystem services, such as stormwater runoff management, regulation of extreme air temperatures, reduction of energy consumption, plus a variety of social benefits and human health and wellbeing. However, the cold climate of Finland with seasonal ground frost, snow cover and relatively short growing season bring about questions of whether green infrastructure works as efficiently as expected. To tackle this question, green infrastructure solutions will be studied and analyzed with manifold methods: stakeholder perspectives regarding existing and planned GI solutions will be collected by web based questionnaires, semi structured interviews and group discussions, and analyzed in both qualitative and quantitative methods. Targeted empirical field campaigns will be conducted on selected sites. A systematic literature review with global perspective will support the analyses. The findings will be collected, compiled and analyzed using geographic information systems (GIS). The findings of the research will improve our understanding of the functioning of green infrastructure in the Finnish environment in urban stormwater management, as a landscape element for citizens’ wellbeing, and in climate change mitigation and adaptation. The acquired information will be shared with stakeholders in interactive co-design workshops. As green covers have great demand and potential globally, the conclusions will have relevance in other cool climate regions and may support Finnish business in green infrastructure sector.

Keywords: climate change adaptation, climate change, green infrastructure, stormwater

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Authors: Sahar Fahmy Mehanna

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Wild fisheries and aquaculture offer excellent opportunities to decrease hunger and improve nutrition, relieve poverty, create economic growth and guarantee healthier use of natural resources. Employment in fisheries and aquaculture has grown continuously quicker than in the agriculture sector, providing up to 55 million jobs worldwide. Fisheries and aquaculture supplied Egypt with 2.1 million tons of fish in 2021, mostly used as food for people. Fish production in Egypt has grown dramatically in the last three decades, where fish production increased from about 346 thousand tons in 1990 to up to 2.1 million tons in 2021. In contrast to natural resources, which increased by only 30% in the period from 1990 to 2021, aquaculture production increased by 2502% during the same period. The majority of wild fisheries production in Egypt arises from coastal areas, where pollution is one of the main challenges severely affected both the productivity and quality of fish stocks. Our marine resources are at the risk of irreversible loss to habitats, ecological functions, and biodiversity because of overfishing, pollution, destructive fishing methods, climatic changes, unsustainable coastal area development and the competing demands from different industrial uses and human activities. Illegal, Unreported and Unregulated (IUU) Fishing continues to be a big challenge to achieve sustainable fisheries. Furthermore, poor governance, management and practices are a further challenge. Reducing overfishing, stimulating responsible and sustainable fisheries management, applying aquaculture new and friendly practices and conserving the marine environment health are among the government’s best opportunities to provide highly nutritious food to the increasing population in Egypt. The present presentation will discuss the fishery regulations in the Egyptian marine fisheries that taken to maintain, protect and promote the different Egyptian marine environments and to what extent these regulations were effective.

Keywords: egypt, marine fisheries, fishery regulations, fisheries management, Marine ecosystem conservation

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Authors: Andra Vidyarini

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Adolescence is a transition period in which various changes occur, both biologically, intellectually and psychosocially. Changes in adolescents, one of which is a change in food consumption patterns that make adolescents vulnerable to nutritional problems that can affect their growth and health in the future. Nutritional problems in adolescents have increased from year to year and one of the causes is the low diversity and quality of consumption. The diversity and quality of consumption can be seen through the Individual Dietary Diversity Score and the Healthy Eating Index. Currently, in Indonesia, data on the diversity and quality of food consumption, especially among adolescents, are still scarce. In general, the purpose of this study is to describe the diversity and quality of adolescent food consumption and the relationship between the diversity and quality of food consumption with nutritional status. This study is a cross-sectional study by looking at the diversity and quality of consumption of adolescents aged 15-17 years. The total number of subjects in this study amounted to 70 teenagers. This research was conducted online via a google form. Data analysis in this study was univariate and bivariate. The results showed that the diversity of the subject's food consumption was in the diverse and very diverse category with an average of 6. However, the quality was still not good, whereas it was still in the bad and moderate categories with an average of 12.93. The nutritional status of the majority of the subjects was in the normal category and overweight to obese. The implementation of blended learning where there are still limited face-to-face meetings at school can be the reason why teenagers' food consumption is more diverse than when they are face-to-face schools. In addition, changes in people's diet during the pandemic also influenced the results of the study. The change in pattern is a change in eating habits to three times a day with menu choices ranging from rice, meat, fish, bean and vegetables. Analysis of the relationship between the diversity and quality of food consumption shows that the diversity of consumption has a significant relationship with the quality of food consumption with a p-value of 0.002 (p<0.05). Meanwhile, the diversity and quality of food consumption have no significant relationship with nutritional status, with p values 0.777 and 0.251 (>0.05), respectively. This shows that the diversity of food consumption is directly proportional to the quality of consumption, where if you have a variety of food consumption, the quality or in terms of portions and weight are also sufficient in accordance with the recommendations of PGRS.

Keywords: healthy eating index (HEI), food diversity, quality of consumption, adolescent

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Authors: Ilyes Athimni, Mouna Bouzazi, Mongi Boulehmi, Ahmed Ferchichi

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The principles of good governance, universal values, and digitization are among the tools to fight corruption and improve the quality of service delivery. In recent years, these tools have become one of the most controversial topics in the field of education and a concern of many international organizations and institutions against the problem of corruption. Corruption in the education sector, particularly in higher education, has negative impacts on the quality of education systems and on the quality of administrative or educational services. Currently, the health crisis due to the spread of the COVID-19 pandemic reveals the difficulties encountered by education systems in most countries of the world. Due to the poor governance of these systems, many educational institutions were unable to continue working remotely. To respond to these problems encountered by most education systems in many countries of the world, our initiative is to propose a methodology to reinvent education systems based on global values and digital technologies. This methodology includes a work strategy for educational institutions, whether in the provision of administrative services or in the teaching method, based on information and communication technologies (ICTs), intelligence artificial, and intelligent agents. In addition, we will propose a supervisory law that will be implemented and monitored by intelligent agents to improve accountability, transparency, and accountability in educational institutions. On the other hand, we will implement and evaluate a field experience by applying the proposed methodology in the operation of an educational institution and comparing it to the traditional methodology through the results of teaching an educational program. With these specifications, we can reinvent quality education systems. We also expect the results of our proposal to play an important role at local, regional, and international levels in motivating governments of countries around the world to change their university governance policies.

Keywords: artificial intelligence, corruption in education, distance learning, education systems, ICTs, intelligent agents, good governance

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Authors: Layaly Ayoub, Mariana Ribeiro

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Introduction: Breast cancer is currently considered the leading cause of cancer-related deaths among women in Brazil. Mastectomy, essential in this treatment, often necessitates subsequent breast reconstruction to restore physical appearance and aid in the emotional and psychological recovery of patients. The choice between immediate or delayed reconstruction is influenced by factors such as the type and stage of cancer, as well as the patient's overall health. The decision between autologous breast reconstruction or implant-based reconstruction requires a detailed analysis of individual conditions and needs. Objectives: This study analyzes the techniques and indications used in post-mastectomy breast reconstruction. Methodology: Literature review conducted in the PubMed and SciELO databases, focusing on articles that met the inclusion and exclusion criteria and descriptors. Results: After mastectomy, breast reconstruction is commonly performed. It is necessary to determine the type of technique to be used in each case depending on the specific characteristics of each patient. The tissue expander technique is indicated for patients with sufficient skin and tissue post-mastectomy, who do not require additional radiotherapy, and who opt for a less complex surgery with a shorter recovery time. This procedure promotes the gradual expansion of soft tissues where the definitive implant will be placed. Both temporary and permanent expanders offer flexibility, allowing for adjustment in the expander size until the desired volume is reached, enabling the skin and tissues to adapt to the breast implant area. Conversely, autologous reconstruction is indicated for patients who will undergo radiotherapy, have insufficient tissue, and prefer a more natural solution. This technique uses the transverse rectus abdominis muscle (TRAM) flap, the latissimus dorsi muscle flap, the gluteal flap, and local muscle flaps to shape a new breast, potentially combined with a breast implant. Conclusion: In this context, it is essential to conduct a thorough evaluation regarding the technique to be applied, as both have their benefits and challenges.

Keywords: indications, post-mastectomy, breast reconstruction, techniques

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Authors: Deepak Nathiya1, Ramesh Roop Rai, Pratima Singh1, Preeti Raj1, Supriya Suman, Balvir Singh Tomar

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Background: Sarcopenia is a catabolic state in liver cirrhosis (LC), accelerated with a breakdown of skeletal muscle to release amino acids which adversely affects survival, health-related quality of life, and response to any underlying disease. The primary objective of the study was to investigate the long-term effect of branched-chain amino acids (BCAA) supplementations on parameters associated with improved prognosis in sarcopenic patients with LC, as well as to evaluate its impact on cirrhotic-related events. Methods: We carried out a 24 week, single-center, randomized, open-label, controlled, two cohort parallel-group intervention trial comparing the efficacy of BCAA against lactoalbumin (L-ALB) on 106 sarcopenic liver cirrhotics. The BCAA (intervention) group was treated with 7.2 g BCAA per whereas, the lactoalbumin group was also given 6.3 g of L-Albumin. The primary outcome was to assess the impact of BCAA on parameters of sarcopenia: muscle mass, muscle strength, and physical performance. The secondary outcomes were to study combined survival and maintenance of liver function changes in laboratory and clinical markers in the duration of six months. Results: Treatment with BCAA leads to significant improvement in sarcopenic parameters: muscle strength, muscle function, and muscle mass. The total cirrhotic-related complications and cumulative event-free survival occurred fewer in the BCAA group than in the L-ALB group. Prognostic markers also improved significantly in the study. Conclusion: The current clinical trial demonstrated that long-term BCAAs supplementation improved sarcopenia and prognostic markers in patients with advanced liver cirrhosis.

Keywords: sarcopenia, liver cirrhosis, BCAA, quality of life

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Authors: Adamu Muhammed Tukur

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Pulp and paper industry is one of the fastest growing industries due to an increased demand in paper products. For it to satisfy this ever increasing demand, it adopts new technological innovations some of which are proved to affect our environment negatively. Global consumption of paper has increased by 400% in the last four decades and this suggests that more research is required to assess the impact of industrial effluents to our environment and public health. Paper products are generally biodegradable, however, the processes involved in its production which involve the use of mainly bleaching agents and other non-biodegradable substances pose serious problem to the environment. There are more than 250 chemicals released in paper mill waste and some are xenobiotics. Different methods such as physical and chemical methods can be adopted for the remediation of the effluents but are proved to be costly and not safe to the environment. On the other hand, biological method is shown to be less costly and environmentally friendly. Microorganisms and their enzymes have shown a promising future for bioremediation of effluents related to paper mill. Many studies prove that one of the major pollutants in the paper mill effluent is phenol especially its chlorinated derivatives. Pentachlorophenol is extremely hazardous to living cells and therefore need to be removed from the environment. Microorganisms including bacteria and fungi have the potential to degrade phenolic compounds e.g. Bacillus stearothermiphilus, Pseudomonas putida, Coricus versicolor, Sphingomonas chlorophenolica, Fusarium sp, Bacillus subtilis and P. aeroginosa. Enzymes used for the degradation include phenol hydrooxylase, polyphenoloxylase, laccase, peroxidase among others. Lignin is another important pollutant and is resistant to microbial degradation but it has been proved that certain bacteria and fungi like can degrade it. Among the fungi white-rot fungi like Fomes lividus and Trametes vesicolor are the most important bioremediators. This review focused on use of microorganism to reduce or eradicate pollutants released from the paper industry. It can serve as a review for further research to be conducted especially in the field of Biotechnology.

Keywords: bioremediation, pulp and paper, pentachlorophenol, environment

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Authors: Pooja Kumari, Anandkumar Tengli

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Aurora kinase enzyme, a protein on overexpression, leads to metastasis and is extremely important for women’s health in terms of prevention or treatment. While creating a targeted technique, the aim of the work is to design purine molecules that inhibit in aurora kinase enzyme and helps to suppress breast cancer. Purine molecules attached to an amino acid in DNA block protein synthesis or halt the replication and metastasis caused by the aurora kinase enzyme. Various protein related to the overexpression of aurora protein was docked with purine molecule using Biovia Drug Discovery, the perpetual software. Various parameters like X-ray crystallographic structure, presence of ligand, Ramachandran plot, resolution, etc., were taken into consideration for selecting the target protein. A higher negative binding scored molecule has been taken for simulation studies. According to the available research and computational analyses, purine compounds may be powerful enough to demonstrate a greater affinity for the aurora target. Despite being clinically effective now, purines were originally meant to fight breast cancer by inhibiting the aurora kinase enzyme. In in-silico studies, it is observed that purine compounds have a moderate to high potency compared to other molecules, and our research into the literature revealed that purine molecules have a lower risk of side effects. The research involves the design, synthesis, and identification of active purine molecules against breast cancer. Purines are structurally similar to the normal metabolites of adenine and guanine; hence interfere/compete with protein synthesis and suppress the abnormal proliferation of cells/tissues. As a result, purine target metastasis cells and stop the growth of kinase; purine derivatives bind with DNA and aurora protein which may stop the growth of protein or inhibits replication and stop metastasis of overexpressed aurora kinase enzyme.

Keywords: aurora kinases, in silico studies, medicinal chemistry, combination therapies, chronic cancer, clinical translation

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Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

Abstract:

Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

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Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

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Authors: Dawit Assefa, Kassaye Tekie, Gebrie Alebachew, Degefu Beyene, Bikila Alemu, Naji Mohammed, Asnakech Agegnehu, Seble Tsehay, Geremew Tasew

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Background: Implementation of a Laboratory Quality Management System (LQMS) is critical to ensure accurate, reliable, and efficient laboratory testing of antimicrobial resistance (AMR). However, limited LQMS implementation and progress toward accreditation in the AMR surveillance laboratory testing setting exist in Ethiopia. By addressing non-conformances (NCs) and working towards accreditation, microbiology laboratories can improve the quality of their services, increase staff competence, and contribute to mitigate the spread of AMR. Methods: Using standard ISO 15189 horizontal and vertical assessment checklists, certified assessors identified NCs at Hawassa and Jimma Hospital microbiology laboratories. The Ethiopian Public Health Institute AMR mentors and IDDS staff prioritized closing the NCs through the implementation of an intensified mentorship program that included ISO 15189 orientation training, resource allocation, and action plan development. Results: For the two facilities to clear their NCs, an intensified mentorship approach was adopted by providing ISO 15189 orientation training, provision of buffer reagents, controls, standards, and axillary equipment, and facilitating equipment maintenance and calibration. Method verification and competency assessment were also conducted along with the implementation of standard operating procedures and recommended corrective actions. This approach enhanced the laboratory's readiness for accreditation. After addressing their NCs, the two laboratories applied to Ethiopian Accreditation Services for ISO 15189 accreditation. Conclusions: Clearing NCs through the implementation of intensified mentorship was crucial in preparing the two laboratories for accreditation and improving quality laboratory test results. This approach can guide other microbiology laboratories’ accreditation attainment efforts.

Keywords: non-conformance clearance, intensified mentorship, accreditation, ISO 15189

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Authors: Neslihan Ozsoy Taskiran, Miray Dayioglu, Belgin Gunbey, Banu Yucel, Cigdem Takma, Unal Karik, Tugce Olgun, Levent Aydin

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A greater wax moth (Galleria mellonella L.), which is one of the most important pests after Varroa, plays a role in the transportation of many pathogens into the hive as well as damage to the honeycombs, and beekeepers suffer economically. Due to the risk that some of the methods against this pest may cause residue in bee products, and it can be harmful to the health of people who consume these products. Therefore, the most appropriate, most economical, and effective method should be applied in the moth control. For this purpose, in the first phase of the project (2017-2018), planned to be 2-stage in the Aegean Agricultural Research Institute in 2017-2020, the honeycombs, certified with good agricultural practice, were kept in a favorable condition for moths. Later, applications (Sulfur - B401 - Walnut (Leaf & Smoker) - lavender essential oil (1cc & 2cc & 3cc & 4cc) - laurel essential oil (1cc & 2cc & 3cc & 4cc) - control) were applied to the honeycombs with moths. In 2017, the B401 group had the highest wax moth damage area, and the group with the lowest wax moth damage area was determined as lavender 1cc; In 2018, the highest wax moth damage area was found in the walnut smoker group, while the lowest wax moth damage area was found in sulfur, walnut leaves, laurel 1cc - 2cc - 4cc, lavender 1cc - 2cc - 3cc - 4cc and control groups. In addition, sulfur residue amount (mean 128,18 mg/kg) in honeycomb was measured in the sulfur-treated group. Phase 1 of the project was completed, and the most important sub-groups among walnut (leaf) - lavender (1cc) and laurel (4cc) groups were identified. Accordingly, it is planned to carry out these treatments ((sulfur - B401 - walnut (leaf) - lavender (1cc) and laurel (4cc)) on honeycombs with do not contain moths, and later, it is planned to examine the effects of the treatment on the offspring area and honey yield by giving these honeycombs to the hives, in the 2nd stage of the project (2019-2020).

Keywords: honey bee, lavender essential oil, laurel essential oil, walnut, wax moth

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Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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Authors: Chigozie Azunna, Botes Lucius

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Child homelessness remains a significant challenge in South Africa in the upcoming decade. Despite children making up a substantial portion of South Africa's population, the issue of child homelessness continues to pose a socio-economic crisis with diverse impacts. Achieving the UN 2050 Agenda for Sustainable Development Goals (SDGs), especially in terms of equality and non-discrimination, requires an effective approach to curb child homelessness. Addressing this issue will positively influence the economic trajectory of South Africa's evolving demographic landscape. This research uses content analysis through an extensive review of current literature on child homelessness in South Africa. Findings indicate alignment between national policies and international agendas in tackling child homelessness in South Africa. However, the following statistics depict the ongoing challenge: In metropolitan areas, homelessness stands at 74.1%, whereas non-metro regions account for 25.9%. The City of Tshwane has the highest number of homeless individuals at 18.1%, followed by the City of Johannesburg at 15.6%, while Nelson Mandela Bay Metropolitan has the lowest at 2.7%. Despite existing national policy frameworks, child homelessness persists. The lack of accurate data, compounded by issues such as economic challenges, the lingering impacts of the COVID-19 pandemic, poverty, the HIV/AIDS epidemic, and gaps in policy implementation, has exacerbated the problem. The consequences are dire, affecting children’s physical and emotional health, education, and future opportunities. The study recommends reinforcing actionable policies to address child homelessness effectively. Bridging the urban-rural divide and establishing intra-community networks are crucial for tackling this issue comprehensively. This includes addressing multifaceted challenges such as access to education, disease susceptibility, and the overall vulnerability of homeless children.

Keywords: South Africa, child, homeless, SDGs, COVID, urban, rural

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Authors: Carolyn Scott, Rachel Nugent

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The agricultural industry in Ireland and worldwide is one of the most dangerous occupations with respect to occupational health and safety accidents and fatalities. Many accident causation models have been developed in safety research to understand the underlying and contributory factors that lead to the occurrence of an accident. Due to the uniqueness of the agricultural sector, current accident causation theories cannot be applied. This paper presents an accident causation model named the Irish Farm Accident Causation Model (IFACM) which has been specifically tailored to the needs of Irish farms. The IFACM is a theoretical and practical model of accident causation that arranges the causal factors into a graphic representation of originating, shaping, and contributory factors that lead to accidents when unsafe acts and conditions are created that are not rectified by control measures. Causes of farm accidents were assimilated by means of a thorough literature review and were collated to form a graphical representation of the underlying causes of a farm accident. The IFACM was validated retrospectively through case study analysis and peer review. Participants in the case study (n=10) identified causes that led to a farm accident in which they were involved. A root cause analysis was conducted to understand the contributory factors surrounding the farm accident, traced back to the ‘root cause’. Experts relevant to farm safety accident causation in the agricultural industry have peer reviewed the IFACM. The accident causation process is complex. Accident prevention requires a comprehensive understanding of this complex process because to prevent the occurrence of accidents, the causes of accidents must be known. There is little research on the key causes and contributory factors of unsafe behaviours and accidents on Irish farms. The focus of this research is to gain a deep understanding of the causality of accidents on Irish farms. The results suggest that the IFACM framework is helpful for the analysis of the causes of accidents within the agricultural industry in Ireland. The research also suggests that there may be international applicability if further research is carried out. Furthermore, significant learning can be obtained from considering the underlying causes of accidents.

Keywords: farm safety, farm accidents, accident causation, root cause analysis

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