Search results for: national one health platform

Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

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Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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Authors: Sophia Shi

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Acute kidney injury (AKI) is the sudden onset of kidney damage in which the kidneys cannot filter waste from the blood, requiring emergency hospitalization. AKI patient mortality rate is high in the ICU and is virtually impossible for doctors to predict because it is so unexpected. Currently, there is no hybrid model predicting AKI that takes advantage of two types of data. De-identified patient data from the MIMIC-III database and de-identified kidney images and corresponding patient records from the Beijing Hospital of the Ministry of Health were collected. Using data features including serum creatinine among others, two numeric models using MIMIC and Beijing Hospital data were built, and with the hospital ultrasounds, an image-only model was built. Convolutional neural networks (CNN) were used, VGG and Resnet for numeric data and Resnet for image data, and they were combined into a hybrid model by concatenating feature maps of both types of models to create a new input. This input enters another CNN block and then two fully connected layers, ending in a binary output after running through Softmax and additional code. The hybrid model successfully predicted AKI and the highest AUROC of the model was 0.953, achieving an accuracy of 90% and F1-score of 0.91. This model can be implemented into urgent clinical settings such as the ICU and aid doctors by assessing the risk of AKI shortly after the patient’s admission to the ICU, so that doctors can take preventative measures and diminish mortality risks and severe kidney damage.

Keywords: Acute kidney injury, Convolutional neural network, Hybrid deep learning, Patient record data, ResNet, Ultrasound kidney images, VGG

Procedia PDF Downloads 118

Authors: A. Lakshya

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The main aim of this paper is to interpret physical education for children from 5 to 18 years. Schools have the ability to promote positive mental health by developing physical education, which helps to build individual growth, goal setting, decision making, helps in muscular development, self-discipline, stresses relief, leadership qualities that can arise with new skills, prosocial behavior and problem-solving skills. But mostly the children at these early ages ought to hold the disorders as heart attack, diabetes and obesity disorders may increase in large number. The data of P.E has got a very least place, where children are with feeble minds and they acquired a state of inactiveness. Globally, 81% of adolescents aged 11-18 years were insufficiently physically active in the year 2016. Adolescent girls were less active than boys, with the percentage of 85% vs. 78% as well. A recent study of California schools found that students are sedentary most of the time during PE classes, with just four minutes of every half-hour spent in vigorous physical activity. Additionally, active PE time decreases with larger class sizes. Students in classes with more than forty-five students are half as active as students in smaller class sizes. The children in adolescence age they acquire more creative ideas hence they create new hairstyles, cooking styles and dressing styles. Instead, all the children are engaging themselves to TV (television) and video games. The development of physical quality not only improves students ’ physical fitness but is also conducive to the psychological development of the students. Physical education teaching should pay more attention to the training of physical quality in the future.

Keywords: physical education, prosocial behavior, leadership, goal setting

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Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: hypertension, north of Iran, dietary intake, weight

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Authors: Buket Metin

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Buildings cause a variety of loads on the environment due to activities performed at each stage of the building life cycle. Construction is the first stage that affects both the natural and built environments at different steps of the process, which can be defined as transportation of materials within the construction site, formation and preparation of materials on-site and the application of materials to realize the building subsystems. All of these steps require the use of technology, which varies based on the facilities that contractors and subcontractors have. Hence, environmental consequences of the construction process should be tackled by focusing on construction technology options used in every step of the process. This paper presents an environmental decision-making model for assessing on-site performances of subcontractors based on the construction technology options which they can supply. First, construction technologies, which constitute information, tools and methods, are classified. Then, environmental performance criteria are set forth related to resource consumption, ecosystem quality, and human health issues. Finally, the model is developed based on the relationships between the construction technology components and the environmental performance criteria. The Fuzzy Analytical Hierarchy Process (FAHP) method is used for weighting the environmental performance criteria according to environmental priorities of decision-maker(s), while the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method is used for ranking on-site environmental performances of subcontractors using quantitative data related to the construction technology components. Thus, the model aims to provide an insight to decision-maker(s) about the environmental consequences of the construction process and to provide an opportunity to improve the overall environmental performance of construction sites.

Keywords: construction process, construction technology, decision making, environmental performance, subcontractor

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Authors: Ayesha Aihetasham, Najma Arshad, Sobia Khan

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Damage causes by subterranean termites are of major concern today. Termites majorly treated with pesticides resulted in several problems related to health and environment. For this reason, plant-derived natural products specifically essential oils have been evaluated in order to control termites. The aim of the present study was to investigate the antitermitic potential of six essential oils on Heterotermes indicola subterranean termite. No-choice bioassay was used to assess the termiticidal action of essential oils. Further, gut from each set of treated termite group was extracted and analyzed for reduction in number of protozoa and bacteria by protozoal count method using haemocytometer and viable bacterial plate count (dilution method) respectively. In no-choice bioassay it was found that Foeniculum vulgare oil causes high degree of mortality 90 % average mortality at 10 mg oil concentration (10mg/0.42g weight of filter paper). Least mortality appeared to be due to Citrus sinensis oil (43.33 % average mortality at 10 mg/0.42g). The highest activity verified to be of Foeniculum vulgare followed by Eruca sativa, Trigonella foenum-graecum, Peganum harmala, Syzygium cumini and Citrus sinensis. The essential oil which caused maximum reduction in number of protozoa was P. harmala followed by T. foenum-graecum and E. sativa. In case of bacterial count E. sativa oil indicated maximum decrease in bacterial number (6.4×10⁹ CFU/ml). It is concluded that F. vulgare, E. sativa and P. harmala essential oils are highly effective against H. indicola termite and its gut microflora.

Keywords: bacterial count, essential oils, Heterotermes indicola, protozoal count

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Authors: Zahra Asgharpour, Eric Renteria, Sebastian De Boodt

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There is a growing trend towards personalization of medical care, as evidenced by the emphasis on outcomes based medicine, the latest developments in CT and MR imaging and personalized treatment in a variety of surgical disciplines. 3D Printing has been introduced and applied in the medical field since 2000. The first applications were in the field of dental implants and custom prosthetics. According to recent publications, 3D printing in the medical field has been used in a wide range of applications which can be organized into several categories including implants, prosthetics, anatomical models and tissue bioprinting. Some of these categories are still in their infancy stage of the concept of proof while others are in application phase such as the design and manufacturing of customized implants and prosthesis. The approach of 3D printing in this category has been successfully used in the health care sector to make both standard and complex implants within a reasonable amount of time. In this study, some of the clinical applications of 3D printing in design and manufacturing of a patient-specific hip implant would be explained. In cases where patients have complex bone geometries or are undergoing a complex revision on hip replacement, the traditional surgical methods are not efficient, and hence these patients require patient-specific approaches. There are major advantages in using this new technology for medical applications, however, in order to get this technology widely accepted in medical device industry, there is a need for gaining more acceptance from the medical device regulatory offices. This is a challenge that is moving onward and will help the technology find its way at the end as an accepted manufacturing method for medical device industry in an international scale. The discussion will conclude with some examples describing the future directions of 3D Medical Printing.

Keywords: CT/MRI, image processing, 3D printing, medical devices, patient specific implants

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Authors: Andrej Kocjan

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Introduction: Mobility has been shown to play an important role of health and quality of life among older adults. Falls, which are often related to decreased mobility, as well as to neuromuscular deficits, represent the most common injury among older adults. Fall risk has been shown to increase with reduced lower extremity flexibility. The aim of the paper is to assess the importance of flexibility training on joint range of motion and functional performance among elderly population. Methods: We performed literature research on PubMed and evaluated articles published until 2000. The articles found in the search strategy were also added. The population of interest included older adults (≥ 65 years of age). Results: Flexibility training programs still represent an important part of several rehabilitation programs. Static stretching and proprioceptive neuromuscular facilitation are the most frequently used techniques to improve the length of the muscle-tendon complex. Although the effectiveness of type of stretching seems to be related to age and gender, static stretching is a more appropriate technique to enhance shoulder, hip, and ankle range of motion in older adults. Stretching should be performed in multiple sets with holds of more than 60 seconds for a single muscle group. Conclusion: The literature suggests that flexibility training is an effective method to increase joint range of motion in older adults. In the light of increased functional outcome, activities such as strengthening, balance, and aerobic exercises should be incorporated into a training program for older people. Due to relatively little published literature, it is still not possible to prescribe detailed recommendations regarding flexibility training for older adults.

Keywords: elderly, exercise, flexibility, falls

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Authors: Dileep Kumar Verma, Sunil Kumar Lal

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Influenza still remains one of the most challenging diseases posing significant threat to public health causing seasonal epidemics and pandemics. Influenza A Virus (IAV) surface protein hemagglutinin is known to play an important role in viral attachment to the host sialic acid receptors and concentrate in lipid rafts for efficient viral fusion. Selective nature of Influenza A virus to utilize rafts micro-domain for efficient virus assembly and budding has been explored in depth. However, the detailed mechanism of IAV binding to host cell membrane and entry into the host remains elusive. In the present study we investigated the role of lipid rafts in early life cycle events of IAV. Role of host lipid rafts was studied using raft disruption method by extraction of cholesterol by Methyl-β-Cyclodextrin. Using GM1, a well-known lipid raft marker, we were able to observe co-localization of IAV on lipid rafts on the host cell membrane. This experiment suggests a direct involvement of lipid rafts in the initiation of the IAV life cycle. Upon disruption of lipid rafts by Methyl-b-cyclodextrin, we observed a significant reduction in IAV binding on the host cell surface indicating a significant decrease in virus attachment to coherent membrane rafts. Our results provide proof that host lipid rafts and their constituents play an important role in the adsorption of IAV. This study opens a new avenues in IAV virus-host interactions to combat infection at a very early steps of the viral lifecycle.

Keywords: lipid raft, adsorption, cholesterol, methyl-β-cyclodextrin, GM1

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Authors: Muzamil Mahmood, Afshan Naseem, Muhammad Zeeshan Mirza, Yasir Ahmad, Masood Raza

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The purpose of this research is to analyze how aviation maintenance workers’ characteristics and work demand affect their development of work-related musculoskeletal disorders (WMSDs). Guided by literature on task characteristics, work demand, and WMSDs, data is collected from 128 aviation maintenance workers of private and public airlines. Data is then analyzed through descriptive and inferential statistics. It is found that task characteristics have a significant positive effect on WMSDs and an increase in tasks performed by aviation maintenance workers leads to increase in WMSDs. Work demand did not have a significant effect on WMSDs. The task characteristics of aviation maintenance workers moderates the relationship between their work demand and WMSDs. This reveals that task characteristics of aviation maintenance workers enhance the effect of work demand on WMSDs. The task characteristics of aviation maintenance workers are challenging and unpredictable. Subsequently, WMSDs are prevalent among aviation maintenance workers. The work demand of aviation maintenance workers does not influence their development of WMSDs. Pakistan Civil Aviation Authority should minimize the intensity of tasks assigned to aviation maintenance workers by introducing work dynamisms such as task sharing, job rotation, and probably teleworking to enhance flexibility. Human Resource and Recruitment Department need to consider the ability and fitness levels of potential aviation maintenance workers during recruitment. In addition, regular physical activities and ergonomic policies should be put in place by the management of the Pakistan Civil Aviation Authority to reduce the incidences of WMSDs.

Keywords: work related musculoskeletal disorders, ergonomics, occupational health and safety, human factors

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Authors: Vladyslav Povoroznyuk, Tetiana Orlуk, Nataliia Dzerovych

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Introduction: Back pain is an extremely common health care problem worldwide. Many studies show a link between an obesity and risk of lower back pain. The aim is to study correlation and peculiarities of vertebral pain in women of different age depending on their anthropometric indicators. Materials: 1886 women aged 25-89 years were examined. The patients were divided into groups according to age (25-44, 45-59, 60-74, 75-89 years old) and body mass index (BMI: to 18.4 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-30 kg/m2 (overweight) and more than 30.1 kg/m2 (obese). Methods: The presence and intensity of pain was evaluated in the thoracic and lumbar spine using a visual analogue scale (VAS). BMI is calculated by the standard formula based on body weight and height measurements. Statistical analysis was performed using parametric and nonparametric methods. Significant changes were considered as p <0.05. Results: The intensity of pain in the thoracic spine was significantly higher in the underweight women in the age groups of 25-44 years (p = 0.04) and 60-74 years (p=0.005). The intensity of pain in the lumbar spine was significantly higher in the women of 45-59 years (p = 0.001) and 60-74 years (p = 0.0003) with obesity. In the women of 45-74 years BMI was significantly positively correlated with the level of pain in the lumbar spine. Obesity significantly increases the relative risk of pain in the lumbar region (RR=0.07 (95% CI: 1.03-1.12; p=0.002)), while underweight significantly increases the risk of pain in the thoracic region (RR=1.21 (95% CI: 1.00-1.46; p=0.05)). Conclusion: In women, vertebral pain syndrome may be related to the anthropometric characteristics (e.g., BMI). Underweight may indirectly influence the development of pain in the thoracic spine and increase the risk of pain in this part by 1.21 times. Obesity influences the development of pain in the lumbar spine increasing the risk by 1.07 times.

Keywords: body mass index, age, pain in thoracic and lumbar spine, women

Procedia PDF Downloads 356

Authors: Aziz Rezapour, Abdosaleh Jafari, Marziye Hadian, Elaheh Mazaheri

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Introduction: Cardiac rehabilitation is an accurate educational and sporting program designed to help heart patients to increase their physical activities and reduce the risk factors that make their health worse and help to a healthier lifestyle so that they can return to their families and society with a better spirit. The aim of this study was to examine the cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases. Methods: In the present review study, published articles related to cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases within the time interval between 2004 and 2019 were searched using electronic databases. The methodological quality of the structure of articles was examined by Drummond’s standard checklist. Results: The results of reviewing studies showed that most of the studies related to the economic evaluation of cardiac rehabilitation programs in patients with cardiovascular disease were flawed in Drummond’s criteria, and only one study adhered to Drummond’s criteria. The results of the present study indicated use of cardiac rehabilitation programs in patients with cardiovascular disease was cost-effective. Conclusion: The results of this review study showed that although the results of the studies were different in terms of a number of aspects, such as the study perspective, the time horizons, and the costs of rehabilitation programs, they achieved a similar conclusion, they concluded that the use of cardiac rehabilitation programs in patients with cardiovascular diseases, leading to higher quality-adjusted life years (QALYs) and lower costs.

Keywords: economic evaluation, systematic review, cardiac rehabilitation, Drummond’s checklist

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Authors: Aleksandr Medvedev, Zakhar Slukovsii

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Waterbodies, which are located either within urban areas or nearby towns, permanently undergo anthropogenic load. The extent of the load can be determined via investigations of chemical composition of both water and sediments. Lakes, as a rule, are considered as a landscape depressions, hence they are capable of natural material accumulating, which has been delivered from the catchment area through rivers as well as temporary flows. As a result, lacustrine sediments (especially closed-basin lakes sediments) are considered as perfect archives, which are served for reconstructing past sedimentation process, assessment of the modern contamination level, and prognostication of possible ways of changing in the future. The purposes of the survey are to define a heavy metals content in lake sediments cores, which were retrieved from four urban lakes located in the southern part of Karelia Republic, and to ascertain the main sources of heavy metals input to these waterbodies. It is really crucial to be aware of heavy metals content in environment, because chemical composition of a landscape may have a significant effect on living organisms and people’s health. Sediment columns were sampled in a field with 2-cm intervals by a gravitational corer called «Limnos». The sediment samples were analyzed by inductively coupled plasma spectrometry (ICP MS) for 8 chemical elements (Pb, Cd, Zn, Cr, Ni, Cu, Mn, V). The highest concentrations of trace elements were established in the upper and middle layers of the cores. It has also been ascertained that the extent of contamination mostly depends on a remoteness of a lake from various pollution sources and features of the sources.

Keywords: bottom sediments, environmental pollution, heavy metals, lakes

Procedia PDF Downloads 132

Authors: Avi Shrivastava

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Title 42, an emergency health decree, has forced the federal authorities to turn away asylum seekers and all other border crossers since last year. When Title 42 was first deployed in immigration detention centers, where many migrants are held when they arrive at the U.S.-Mexico border, the Trump administration embraced it as a strategy. Expulsions Policy and New Border Challenges will be examined in regard to Title 42 concerns. Humanitarian measures for refugees arriving at the US-Mexico border are the focus of this article. To a large extent, this article addresses the implications of the United States' use of Title 42 in expelling refugees and the possible ramifications of doing away with it. A secondary data collecting strategy was used to gather the information for this study, allowing researchers to examine a large number of previously collected data sets. Information about Title 42 may be found in a variety of places, such as scholarly publications, newspapers, books, and the internet. The inquiry employed qualitative and explanatory research approaches. The claim that 1.7 million individuals were forced to leave the country as a result of it was withdrawn. Since CBP and ICE were limited in their ability to process deportees, it employed a very random patchwork technique in selecting the expelled individuals. As a consequence, repeat offenders, particularly those who were single, got a reduced punishment. The government will be compelled to focus on long-overdue but vital border enhancements if expulsions are halted. Title 42 provisions may help expedite the processing of asylum and other types of humanitarian relief. The government is prepared for an increase in arrivals, but ending the program would lead to a return to arrival levels seen during the Title 42 period.

Keywords: migrants, refugees, title 42, medical, trump administration

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Authors: Cangir Uyarlar, E. Eren Gultepe, I. Sadi Cetingul, Ismail Bayram

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This study was conducted to investigate the effect of humic acid (Potassium Humate) at different levels on rations on the effects of both maternal and offspring health, metabolic parameters and immunity levels in transition dairy cows. For this purpose, 50 Holstein dairy cows divided 5 trial groups. Experimental groups were designed as follows: A) Control (0% Humas); B) 0.5 Humas (0,5% in concentrated diet); C) 1 Humas (1% in concentrated diet), D) 1,5 Humas (1,5% in concentrated diet), E) 2 Humas (2% in concentrated diet), respectively. The study lasted from the first day of the dry period to postpartum 30th day. Diets were prepared as isocaloric and isonitrogenic. In the experiment, the day on which the animals gave birth was accepted as ‘0 (zero)’ and blood was taken from tail vein (v. coccygea) at -60, -53, -46, -39, -32, -25, -18, -11, -4, 0, ; Colostrum samples were taken on days 0, 1 and 2; Blood samples were taken on days 0, 1, 2, 15 and 30 from the juguler vein (v. jugularis) of the new born calves. Total blood leukocyte, Lymphocyte, Monocyte, granulocytes, Hemoglobin, Hematocrit, MCV, MCH, MWC, RDW, PLT, MPV, PDW, PCT, NEFA, BHBA, Glucose, Total Cholesterol , Triglyceride, LDL, HDL, VLDL, ALT, AST, ALP, GGT and Total IgG levels and colostrum IgG levels were determined in this experiment. The results suggest that although the supplementation of humic acid at 2% level adversely affected to production parameters, the addition of humic acid (potassium humate) to the concentrate mix during the dry period (particularly 0.5 and 1% levels) may provide an increasing on mother and the offspring immunity, some improving on serum metabolism parameters and enhancing the milk production.

Keywords: humic acid, dairy cow, calf, immunity

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Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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Authors: A. Abdullah, N. Faghih Mirzaei, S. Hany Haron

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Neighbourhood environment walkability on reported physical activity (PA) levels of students of Universiti Sains Malaysia (USM) in Malaysia. Compared with previous generations, today’s young people spend less time playing outdoors and have lower participation rates in PA. Research suggests that negative perceptions of neighbourhood walkability may be a potential barrier to adolescents’ PA. The sample consisted of 200 USM students (to 24 years old) who live outside of the main campus and engage in PA in sport halls and sport fields of USM. The data were analysed using the t-test, binary logistic regression, and discriminant analysis techniques. The present study found that youth PA was affected by neighbourhood environment walkability factors, including neighbourhood infrastructures, neighbourhood safety (crime), and recreation facilities, as well as street characteristics and neighbourhood design variables such as facades of sidewalks, roadside trees, green spaces, and aesthetics. The finding also illustrated that active students were influenced by street connectivity, neighbourhood infrastructures, recreation facilities, facades of sidewalks, and aesthetics, whereas students in the less active group were affected by access to destinations, neighbourhood safety (crime), and roadside trees and green spaces for their PAs. These results report which factors of built environments have more effect on youth PA and they message to the public to create more awareness about the benefits of PA on youth health.

Keywords: fear of crime, neighbourhood built environment, physical activities, street characteristics design

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Authors: Saima Batool, Saima Rafique

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Background and Objective: Pandemics like COVID-19 adversely affect children’s behavior and psychological development by disrupting routine life activities. Children of healthcare workers are exposed additionally due to the fear of parental exposure to the virus. The objective of this study was to assess the perception of frontline healthcare workers (HCWs) regarding the psychological impact of the COVID-19 pandemic on their children. We also sought to identify the difference in the psychological impact on children of male and female healthcare workers. Methods: A survey questionnaire was developed comprising 10 questions about the perception of HCWs regarding the psychological impact of COVID-19 on their children. It was distributed both online and face-to-face among 150 healthcare professionals working in training and non-training posts in 4 public and 5 nongovernment hospitals in Pakistan. The mean and standard deviation were calculated for each survey item using Statistical Package for the Social Sciences 26.0. Results: The response rate was 71.3%, and the majority (64.2%) of the healthcare professionals were ≥30 years of age. Ninety-two HCWs (85.98%) either agreed or strongly agreed that parental separation from their kids for long hours during the pandemic had a negative psychological impact on their children. There was a significant difference in the perceived psychological impact of COVID-19 on the children of male and female HCWs, with a mean survey score of 2.29 ± 1.82 and 1.69 ± 0.79, respectively (t = 2.29, p-value = 0.024). Conclusion: Children of healthcare workers experience more stress and anxiety because of long duty hours and working in high-risk settings. Continuous psychological support and counseling services may be adopted formally to prevent unforeseen adverse events or any long-term negative impact on their physical and mental health.

Keywords: healthcare workers, pandemic, COVID-19, anxiety, psychological

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Authors: Ayse Inel Manav, Saliha Bozdogan Yesilot, Pinar Yesil Demirci, Gursel Oztunc

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Introduction: This study was conducted with a view to evaluating cognitive function level, depression, and quality of life of elderly people living in a nursing home. Methods: This study, which is cross-sectional and descriptive in nature, was conducted in the Nursing and Rehabilitation Center for the Elderly in Adana/Turkey between 1st of May and 1st of August, 2016. The participants included 118 elderly people who were chosen using simple random sampling method. The data were collected using the Personal Information Form, the Standardized Mini Mental State Exam (SMMSE), the Geriatric Depression Scale (GDS), and the World Health Organization Quality of Life-OLD (WHOQOL-OLD) module. The data were analyzed using IBM SPSS Statistics 22 (IBM, SPSS, Turkey) program. Results: Of all the participants, 36,4% (n=43) were female, 63,6% (n=75) were male, and average age was 74,08 ± 8,23 years. The participants’ SMMSE mean score was found 20,37 ± 7,08, GDS mean score was 14,92 ± 4,29, and WHOQOL-OLD module mean score was 69,76 ± 11,54. There was a negative, significant relationship between SMMSE and GDS scores, a positive relationship between WHOQOL-OLD module total scores and a negative, significant relationship between GDS scores and WHOQOL-OLD module total scores. Discussıon and Conclusion: Results showed that more than half of the elderly people living in the nursing home experienced cognitive deterioration and depression; and cognitive state, depression, and quality of life were found to be significantly related to each other.

Keywords: depression, cognitive function level, quality of life

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Authors: Ashwini Bhosale, Yogesh Patil

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Urban areas are extremely complicated environmental settings, where health and well-being of an individual and population are governed by a large number of bio-physical, socio-economical, and inclusive aspects. Although poverty and slums are the prime issues under UN-HABITAT agenda of environmental sustainability, slums, the inevitable part of urban environment, have not accounted for inclusive city planning. Developing nations, where about 60 % of world slum population resides, are increasingly under pressure to uplift the urban poor, particularly slum dwellers. From a point of advantage, these new slum redevelopment projects have succeeded in providing legitimized and more permanent and stable shelter for the low income people, as well as individualized sanitation and water supply. However, they unfortunately follow the “one type fits all" approach and exhibit no response to the climatic design needs on Mumbai. The thesis focuses on the study of environmental perspectives in the context of Daylight, natural ventilation and social aspects in the design process of Slum-Rehabilitation schemes (SRS) – case of Mumbai. It attempts to investigate into Indian approaches about SRS and concludes upon strategies to be incorporated in SRS to improve the overall SRS environment. The main objectives of this work have been to identify and study the spatial configuration and possibilities of daylight and natural ventilation in Slum Rehabilitated buildings. The performance of the proposed method was evaluated by comparison with the daylight luminance simulated by lighting software, namely ECOTECT, and with measurements under real skies whereas for the ventilation study purpose, software named FLOW DESIGN was used.

Keywords: urban environment, slum-rehabilitation, daylight, natural-ventilation, architectural consequences

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: Zsanett Bahor, Cristina Nunes-Fonseca, Gillian L. Currie, Emily S. Sena, Lindsay D.G. Thomson, Malcolm R. Macleod

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Psychosis is ranked as the third most disabling medical condition in the world by the World Health Organization. Despite a substantial amount of research in recent years, available treatments are not universally effective and have a wide range of adverse side effects. Since many clinical drug candidates are identified through in vivo modelling, a deeper understanding of these models, and their strengths and limitations, might help us understand reasons for difficulties in psychosis drug development. To provide an unbiased summary of the preclinical psychosis literature we performed a systematic electronic search of PubMed for publications modelling a psychotic disorder in vivo, identifying 14,721 relevant studies. Double screening of 11,000 publications from this dataset so far established 2403 animal studies of psychosis, with the most common model being schizophrenia (95%). 61% of these models are induced using pharmacological agents. For all the models only 56% of publications test a therapeutic treatment. We propose a systematic review of these studies to assess the prevalence of reporting of measures to reduce risk of bias, and a meta-analysis to assess the internal and external validity of these animal models. Our findings are likely to be relevant to future preclinical studies of psychosis as this generation of strong empirical evidence has the potential to identify weaknesses, areas for improvement and make suggestions on refinement of experimental design. Such a detailed understanding of the data which inform what we think we know will help improve the current attrition rate between bench and bedside in psychosis research.

Keywords: animal models, psychosis, systematic review, schizophrenia

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Authors: Ibrahim Iddrisu, Joseph Ayariga, Junhuan Xu, Ayomide Adebanjo, Boakai K. Robertson, Michelle Samuel-Foo, Olufemi Ajayi

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The rise of antimicrobial resistance is a global public health crisis that threatens the effective control and prevention of infections. Due to the emergence of pan drug-resistant bacteria, most antibiotics have lost their efficacy. Bacteriophages or their components are known to target bacterial cell walls, cell membranes, and lipopolysaccharides (LPS) and hydrolyze them. Bacteriophages, being the natural predators of pathogenic bacteria, are inevitably categorized as ‘human friends’, thus fulfilling the adage that ‘the enemy of my enemy is my friend’. Leveraging on their lethal capabilities against pathogenic bacteria, researchers are searching for more ways to overcome the current antibiotic resistance challenge. In this study, we expressed and purified epsilon 34 phage tail spike protein (E34 TSP) from the E34 TSP gene, then assessed the ability of this bacteriophage protein in the killing of two CBD-resistant strains of Salmonella spp. We also assessed the ability of the tail spike protein to cause bacteria membrane disruption and dehydrogenase depletion. We observed that the combined treatment of CBD-resistant strains of Salmonella with CBD and E34 TSP showed poor killing ability, whereas the mono treatment with E34 TSP showed considerably higher killing efficiency. This study demonstrates that the inhibition of the bacteria by E34 TSP was due in part to membrane disruption and dehydrogenase inactivation by the protein. The results of this work provide an interesting background to highlight the crucial role phage proteins such as E34 TSP could play in pathogenic bacterial control.

Keywords: cannabidiol, resistance, Salmonella, antimicrobials, phages

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Authors: Chanchai Wimon, Polin Muangngam, Thannapat Nimsumram, Chanin Prombutra, Prasert Aengchuan, Perawat Boonpuek

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Cleaning water containers is essential for drinking water production to prevent contamination and residual chemicals from washing liquid. Water distribution divisions in Thailand are facing a critical problem with residual contamination in 15-liter drinking water containers due to dust and residual chemicals (TDS value > 200) after normal washing. A thorough washing process is required before filling the purified water into each container. Unfortunately, the washing procedure and frequency do not align with the work instructions provided by the health department. The measured Total Dissolved Solids (TDS) value of the remaining water was found to range between 195–202, exceeding the standard TDS for excellent drinking water (50-190 ppm). This research uses the design of experiment technique in statistics to improve the washing process and reduce such contamination. Statistical data from our survey of the cleaning process is collected to identify affecting factors. Washing time and water volume are varied to test the efficiency of the washing process in reducing residual sediment in the water. The result indicates that cleaning the 15-liter container with 2 liters of tap water mixed with 15 milliliters of dishwashing liquid for 3.12 minutes per container is optimal, as the resulting TDS reduces to 189.75, falling within the standard value for good drinking water. This study result would benefit the drinking water industry in implementing a statistically evaluated cleaning procedure without conducting multiple trials, thus saving takt time and production costs.

Keywords: design of experiment, drinking water purification, quality management, production process reliability

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Authors: Rigas Dimakopoulos, Marianna Papadopoulou, Roser Pons

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Background: Participation in family, recreational activities and self-care is an integral part of health. It is also the main outcome of rehabilitation services for children and adolescents with motor disabilities. There are currently no tools in Greek to assess participation in young children. Purpose: To culturally adapt and validate the Greek version of the Child Engagement in Daily Living (CEDL). Method: The CEDL was cross-culturally translated into Greek using forward-backward translation, review by the expert committee, pretest application and final review. Internal consistency was evaluated using the Cronbach alpha and test-retest reliability using the intra-class correlation coefficient (ICC). Parents of children aged 18 months to 5 years and with motor disabilities were recruited. Participants completed the CEDL and the children’s gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Results: Eighty-three children were included, GMFCS I-V. Mean ± standard deviation of the CEDL domains “frequency of participation” “enjoyment of participation” and “self-care” were 58.4±14.0, 3.8±1.0 and 49.9±24, respectively. Internal consistency of all domains was high; Cronbach alpha for “frequency of participation” was 0.83, for “enjoyment of participation” was 0.76 and for “self-care” was 0.92. Test-retest reliability (ICC) was excellent for the “self-care” (0.95) and good for “frequency of participation” and “enjoyment of participation” domains (0.90 and 0.88, respectively). Conclusion: The Greek CEDL has good reliability. It can be used to evaluate participation in Greek young children with motor disabilities GMFCS levels I-V.

Keywords: participation, child, disabilities, child engagement in daily living

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Authors: Mbanzulu Kennedy, Zanga Josue, Wumba Roger

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Malaria and schistosomiasis remain life-threatening public health problems in sub-Saharan Africa. The infection pattern related to age indicates that preschool and school-age children are at the highest risk of malaria and schistosomiasis. Both parasitic infections, separately or combined, may have negative impacts on the haemoglobin concentration levels. The existing data revealed that artemisinin derivatives commonly used to cure malaria present also in antischistosomal activities. The current study investigated the impact of Artesunate-Amodiaquine (AS-AQ) on schistosomiasis when administered to treat malaria in rural area of Lemfu, DRC. A prospective longitudinal study including 171 coinfected children screened for anaemia, Schistosoma mansoni, and Plasmodium falciparum infections. The egg reduction rate and haemoglobin concentration were assessed four weeks after the treatment with AS-AQ, of all coinfected children of this series. One hundred and twenty-five (74.4%) out of 168 coinfected children treated and present during the assessment were found stool negative for S. mansoni eggs. Out of 43 (25.6%) children who remained positives, 37 (22%) showed a partial reduction of eggs amount, and no reduction was noted in 3.6% of coinfected. The mean of haemoglobin concentration and the prevalence of anaemia were, respectively, 10.74±1.5g/dl , 11.2±1.3g/dl, and 64.8%, 51.8%, respectively, before and after treatment, p<0.001. The AS-AQ commonly used against Plasmodium allowed curing S. mansoni in coinfected children and increasing the Hb level. For the future, the randomized and multicentric clinical trials are needed for a better understanding of the effectiveness of AS-AQ against Schistosoma spp. The trial registration number was 3487183.

Keywords: paludisme, schistosomiase, as-aq, enfants lemfu

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Authors: Anissa Mary Thomas Thattil, Nancy Angeline Gnanaselvam, B. Ramakrishna Goud

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Faecal sludge management (FSM) is an unorganized sector, and in India, there is an absence of regulations regarding the collection, transport, treatment, and disposal of faecal sludge. FSM has a high degree of occupational hazards that need to be thoroughly understood in order to shape effective solutions. On-field observations of five FSM operations were conducted in Anekal Taluk of southern Karnataka. All five of the FSM operations were privately owned and snowball method of sampling was employed. Two types of FS operations observed were: mechanical emptying involving direct human contact with faecal sludge and mechanical emptying without direct human contact with faecal sludge. Each operation was manned by 3-4 faecal sludge operators (FSOs). None of the observed FSOs used personal protective equipment. According to the WHO semi-quantitative risk assessment, the very high risk occupational hazards identified were dermal contact with faecal sludge, inhalation of toxic gases, and social stigma. The high risk hazards identified were trips and falls, injuries, ergonomic hazards, substance abuse, and mental health problems. In all five FSM operations, the collected faecal sludge was discharged untreated onto abandoned land. FSM in India is fraught with occupational and environmental hazards which need to be urgently addressed. This includes formalizing the institution of FSM, contextualized behaviour change communication, capacity building of local bodies, awareness programmes among agriculturists and FSOs, and designation of sites for the safe harnessing of faecal sludge as soil nutrient.

Keywords: faecal sludge, faecal sludge management, FSM, occupational hazards, sanitation

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Authors: Preeyarach Whisetkhan, Malai Taweechotipatr, Ulisa Pachekrepapol

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Elevated level of blood cholesterol or hypercholesterolemia may lead to atherosclerosis and poses a major risk for cardiovascular diseases. Probiotics play a crucial role in human health, and probiotic bacteria that possesses bile salt hydrolase (BSH) activity can be used to lower cholesterol level of the host. The aim of this study was to investigate whether lactic acid bacteria (LAB) isolated from traditional Thai fermented foods were able to exhibit bile salt hydrolase activity and their use in fermented milk. A total of 28 isolates were tested for BSH activity by plate method on MRS agar supplemented with 0.5% sodium salt of taurodeoxycholic acid and incubated at 37°C for 48 h under anaerobic condition. The results showed that FN1-1 and FN23-3 isolates possessed strong BSH activity. FN1-1 and FN23-3 isolates were then identified for phenotype, biochemical characteristics, and genotype (16S rRNA sequencing). FN1-1 isolate showed 99.92% similarity to Lactobacillus pentosus DSM 20314(T), while FN23-3 isolate showed 99.94% similarity to Enterococcus faecium CGMCC1.2136 (T). Lactobacillus pentosus FN1-1 and Enterococcus faecium FN23-3 were tolerant of pH 3-4 and 0.3 and 0.8% bile. Bacterial count and pH of milk fermented with Lactobacillus pentosus FN1-1 at 37°C and 43°C were investigated. The results revealed that Lactobacillus pentosus FN1-1 was able to grow in milk, which led to decrease in pH level. Fermentation at 37°C resulted in faster growth rate than at 43 °C. Lactobacillus pentosus FN1-1 was a candidate probiotic to be used in fermented milk products to reduce the risk of high-cholesterol diseases.

Keywords: probiotics, lactic acid bacteria, bile salt hydrolase, cholesterol

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Authors: Sujatha Shanmugasundaram

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Background: It has been since one year that COVID-19 has emerged into the world. Since then, healthcare professionals facing a great challenge in to fight against this deadly virus. According to World Health Organization (WHO) 2021, it is estimated that more than 131 million confirmed cases and 2million deaths around the world due to this pandemic. Nurses are the frontline workers who play a major role in safeguarding the lives of the people in acute care settings. Evidence suggests that there are numbers of research have been carried out on nurses' and healthcare provider’s experiences during the pandemic. But, unfortunately, there are no or little evidence available on Muslim nurse’s perspective. Hence, this research will investigate the experiences of Muslim nurses working in an acute care setting during the pandemic. Purpose: The purpose of the study is to explore the experiences of Muslim nurses working in an acute setting during the COVID-19 pandemic. Research Methods: A qualitative research approach will be utilized for the study. Semi-structured interview schedule will be used to collect the data. Face to face interviews will be conducted. All interviews will be conducted in Arabic, and it will be audio recorded. Verbatim will be noted. Muslim nurses working in an acute setting will be included in the study. Convenient sampling technique will be used to recruit the participants. Ethical approval will be obtained from the study sites. Strauss and Corbin's thematic analysis will be used to analyze the data. Conclusion: Considering that nurses are the frontline workers, they have a significant role in dealing with this COVID-19. It is a great challenge for the nurses working in an acute care setting. Thus, this study will bring out significant findings that will impact the nursing practice.

Keywords: acute care, COVID-19, experiences, muslim nurses

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Authors: Arun Perumbilavil Anand

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In the recent years, Kerala is witnessing a large inflow of migrants from different parts of the country. Though initially, the migrants were largely from the districts of Tamil Nadu and mostly of seasonal nature, but at a later period, the state started getting migrants from the far-off states like UP, Assam, Bengal, etc. Higher wages for unskilled labour, large opportunities for employment, the reluctance on the part of Kerala workers to do menial and hard physical work, and the shortage of local labour, paradoxically despite the high unemployment rate in the state, led to the massive influx of migrant labourers. This study takes a multi-dimensional overview of migrant labour in Kerala by encompassing factors such as channels of migration, nature of employment contracts entered into and the corresponding wages and benefits obtained by them. The study also analysed the circumstances that led to the large influx of migrants from different states of India. It further makes an attempt to examine the varying dimensions of living and working environment, and also the health conditions of migrants. The study is based on the empirical findings obtained as a result of the primary interviews conducted with migrants in the districts of Palakkad, Malappuram, and Ernakulam. The study concludes by noting that Kerala will inevitably have to depend on migrant labour and is likely to experience heavy in-migration of labour in future, provided that if the existing socioeconomic and demographic situations persist. Since, this is inevitable, the best way before the state is to prepare well in advance to receive and accommodate such migrant labour to lead a comfortable life in a hassle free environment, so that it would definitely play a vital role in further strengthening and sustaining the growth trajectory of not only Kerala’s economy but also the states of origin.

Keywords: Kerala, labour, migration, migrant workers

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