Search results for: medical and social costs

Authors: Shaista Maseeh

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English Literature from the beginning itself has had psychological, social and environment concerns. Virgil, Shakespeare, John Milton, William Wordsworth to the most current Robert Hass have shown and proved their environmental and ecological interests as well as distress related to its loss. Pastoral literature is also one such genre that links literature with environment. Thanks to the contemporary literary theories that they successfully are relating Literature formally to the subjects other than written text. One of such literary theory is 'Ecocriticism.' It stands under the umbrella of the Economics term, Sustainable Development,' or it can also be understood as an ecological extension of it. Ecocriticism helps the reader to study the dynamic relation between literature and our degrading environment. It draws attention towards the ravaged condition of nature and animals, that how nature is exploited by human beings for their own benefit leaving nature at a repairable loss. For instance, deforestation is reducing the size of forest every year, injuring permanently flora, fauna and also the habitat of animals. This paper will study the ecological and environmental concerns in the latest novel by Pakistani British writer Kamila Shamsie, A God in every Stone (2014). The book is not only a literary masterpiece in elegant prose, but also a novel posing a lot of questions about 'nature and environment' in general and 'animals' in particular. It gives the glimpses of the interesting history of Temple of Zeus in Greece and Ancient Caria, and covers many episodes of history the Indian freedom struggle. In course of novel's narrative Kamila Shamsie poses disturbing question about environmental abuse, about how human beings are more 'beasts' than so call beasts, poor animals. She also glorifies the simplicity of past. The novel has enough instances to prove Shamsie's positive stand on saving the earth that is being more abused than used by human beings. This paper will provide an ecocritical approach to study A God in Every Stone (2014).

Keywords: animals, ecocriticism, environment, nature

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Authors: Chia Yu Chen, Shu Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Shu Jiuan Chen, Yen Ling Liu

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Aim: It remains undetermined that whether increased work stress may affect the job satisfaction and career loyalty among nursing staffs in the operating room. The long-term goal of this study is to lengthen the professional life of operating room nurses by attenuating the work stress and enhancing their contentment in work. Method: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in the southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses. Chi-square test was used to analyze the categorical data and Pearson correlation was used to analyze the association between two numerical datasets (SPSS version 20.0). Results: The response rate was 80% (80/100) and a total of 73 (73%) completed forms were eventually proceeded for analysis. The average scores for work stress and job satisfaction of the operating room nurses were 145.96±32.91 and 47.38±6.07, respectively. The correlation coefficients of work stress versus job satisfaction and organizational identity were (r=-0.338, p=0.003 and r=-0.354, p=0.002), respectively. There were more nurses who took rotating shift quitted works from the operating room than those who took only dayshift (2＝5.176, p<0.05). Nurses who reported of having lower job satisfaction were associated with significantly higher turnover intention (t=3.714, p< 0.01). Following multivariate regression analysis, rotating shift and low job satisfaction were identified as the two independent predictors of intention to quit from working in the operating room. Conclusion: Our study clearly demonstrates that increased work stress significantly attenuates job satisfaction and organizational identity. Rotating shift is associated with higher work stress, lower job satisfaction, and higher turnover intention, which is consistent with the previous surveys carried out in the department of medical technology. Therefore, improvement of working quality in the operating rooms is essential to increase the retain intention of the well-trained nursing staffs. Further investigation into types of work shifts and other strategies of attenuating stress in workplace is currently undertaken in order to improve the job satisfaction and to decrease turnover intention in the operating room.

Keywords: rotating shift, work stress, job satisfaction, turnover intention

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Authors: Adebisi David Alade

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In pre-colonial West Africa, the deadliness of the climate vis-a- vis malaria and other tropical diseases to Europeans turned the region into the “white man’s grave.” Thus, immediately after the partition of Africa in 1885, civilisatrice and mise en valeur not only became a pretext for the establishment of colonial rule; from a medical point of view, the control and possible eradication of disease in the continent emerged as one of the first concerns of the European colonizers. Though geared toward making Africa exploitable, historical evidence suggests that some colonial Water, Sanitation and Hygiene (WASH) policies and projects reduced certain tropical diseases in some West African communities. Exploring some of these disease control interventions by way of historical revisionism, this paper challenges the orthodox interpretation of colonial sanitation and public health measures in West Africa. This paper critiques the deployment of race and class as analytical tools for the study of colonial WASH projects, an exercise which often reduces the complexity and ambiguity of colonialism to the binary of colonizer and the colonized. Since West Africa presently ranks high among regions with Neglected Tropical Diseases (NTDs), it is imperative to decentre colonial racism and economic exploitation in African history in order to give room for Africans to see themselves in other ways. Far from resolving the problem of NTDs by fiat in the region, this study seeks to highlight important blind spots in African colonial history in an attempt to prevent post-colonial African leaders from throwing away the baby with the bath water. As scholars researching colonial sanitation and public health in the continent rarely examine its complex meaning and content, this paper submits that the outright demonization of colonial rule across space and time continues to build ideological wall between the present and the past which not only inhibit fruitful borrowing from colonial administration of West Africa, but also prevents a wide understanding of the challenges of WASH policies and projects in most West African states.

Keywords: colonial rule, disease control, neglected tropical diseases, WASH

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Authors: Tesfay Gidey, Emiru Birhane, Ashenafi Manaye, Hailemariam Kassa, Tesfay Atsbha, Negasi Solomon, Hadgu Hishe, Aklilu Negussie, Petr Madera, Jose G. Borges

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The globally endangered Dracaena ombet is one of the ten dragon multipurpose tree species in arid ecosystems. Anthropogenic and natural factors are now impacting the sustainability of the species. This study was conducted to prioritize criteria and alternative strategies for the conservation of the species using the analytical hierarchy process (AHP) model by involving all relevant stakeholders in the Desa'a dry Afromontane forest in northern Ethiopia. Information about the potential alternative strategies and the criteria for their evaluation was first collected from experts, personal experiences, and literature reviews. Afterward, they were validated using stakeholders' focus group discussions. Five candidate strategies with three evaluation criteria were considered for prioritization using the AHP techniques. The overall priority ranking value of the stakeholders showed that the ecological criterion was deemed as the most essential factor for the choice of alternative strategies, followed by the economic and social criteria. The minimum cut-off strategy, combining exclosures with the collection of only 5% of plant parts from the species, soil and water conservation, and silviculture interventions, was selected as the best alternative strategy for sustainable D. ombet conservation. The livelihood losses due to the selected strategy should be compensated by the collection of non-timber forest products, poultry farming, home gardens, rearing small ruminants, beekeeping, and agroforestry. This approach may be extended to study other dragon tree species and explore strategies for the conservation of other arid ecosystems.

Keywords: conservation strategies, analytical hierarchy process model, Desa'a forest, endangered species, Ethiopia, overexploitation

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Authors: Priya Nambisan, Lien B. Nguyen

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Women participate extensively in the healthcare field, professionally (as physicians, nurses, dietitians, etc.) as well as informally (as caregivers at home). This provides them with a better understanding of the health needs of people. Women are also in the forefront of using social media and other mobile health related apps. Further, many health mobile apps are specifically designed for women users. All of these indicate the potential for women to be successful entrepreneurs in healthcare, especially, in the area of mobile health app development. However, extant research in entrepreneurship has paid limited attention to women entrepreneurship in healthcare. The objective of this study is to determine the key factors that shape the intentions and actions of women entrepreneurs with regard to their entrepreneurial pursuits in the healthcare field. Specifically, the study advances several hypotheses that relate key variables such as personal skills and capabilities, experience, support from institutions and family, and perceptions regarding entrepreneurship to individual intentions and actions regarding entrepreneurship (specifically, in the area of mobile apps). The study research model will be validated using survey data collected from potential women entrepreneurs in the healthcare field – students in the area of health informatics and engineering. The questionnaire-based survey relates to woman respondents’ intention to become entrepreneurs in healthcare and the key factors (independent variables) that may facilitate or inhibit their entrepreneurial intentions and pursuits. The survey data collection is currently ongoing. We also plan to conduct semi-structured interviews with around 10-15 women entrepreneurs who are currently developing mobile apps to understand the key issues and challenges that they face in this area. This is an exploratory study and as such our goal is to combine the findings from the regression analysis of the survey data and that from the content analysis of the interview data to inform on future research on women entrepreneurship in healthcare. The study findings will hold important policy implications, specifically for the development of new programs and initiatives to promote women entrepreneurship, particularly in healthcare and technology areas.

Keywords: women entrepreneurship, healthcare, mobile apps, health apps

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Authors: T. Nishimura, K. Doi, H. Fujimoto, Y. Hoshikawa, T. Wada

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In Japan, it is expected that reasonable accommodation for persons with disabilities will progress further. In particular, there is an urgent need to enhance information support for visually impaired persons who have difficulty accessing information. Recently, tactile symbols have been attached to various surfaces, such as the content labels of containers and packaging of various everyday products. The advantage of tactile symbols is that they are useful for visually impaired persons who cannot read Braille. The method of displaying tactile symbols is prescribed by the International Organization for Standardization (ISO). However, the quantitative data on the shapes and dimensions of tactile symbols is insufficient. In this study, through an evaluation experiments, we examine the easy-to-distinguish shapes and dimensions of tactile symbols used for various applications, including the content labels on containers and packaging. Visually impaired persons participated in the experiments. They used tactile symbols on a daily basis. The details and processes of the experiments were orally explained to the participants prior to the experiments, and the informed consent of the participants was obtained. They were instructed to touch the test pieces of tactile symbols freely with both hands. These tactile symbols were selected because they were likely to be easily distinguishable symbols on the content labels of top surfaces of containers and packaging based on a hearing survey that involved employees of an organization of visually impaired and a social welfare corporation, as well as academic experts of support technology for visually impaired. The participants then answered questions related to ease of distinguishing of tactile symbols on a scale of 5 (where 1 corresponded to ‘difficult to distinguish’ and 5 corresponded to ‘easy to distinguish’). Hearing surveys were also performed in an oral free answer manner with the participants after the experiments. This study revealed the shapes and dimensions regarding easily distinguishable tactile symbols attached to containers and packaging. We expect that this knowledge contributes to improvement of the quality of life of visually impaired persons.

Keywords: visual impairment, accessible design, tactile symbol, containers and packaging

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Authors: Sophia Ming Lee Wen, Chao-Ching Kuo, Yu-Line Hu, Yu-Lung Ho, Chih-Cheng Huang, Yi-Hwa Lee

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Teaching and learning should involve social issues by which effectiveness and humanity is due consideration as a guideline for sharing and co-creating knowledge. A qualitative method was used after a pioneer study to confirm pre-service teachers’ awareness of open knowledge. There are 17 in-service teacher candidates sampling from 181 schools in Taiwan. Two questions are to resolve: a) How did teachers change their educational ideas, in particular, their attitudes to meet the needs of knowledge sharing and co-creativity; and b) How did they acknowledge the necessity of working out an appropriate way between the educational efficiency and the nature of education for high performance management. This interview investigated teachers’ attitude of sharing and co-creating knowledge. The results show two facts in Taiwan: A) Individuals who must be able to express themselves will be capable of taking part in an open learning environment; and B) Teachers must lead the direction to inspire high performance and improve students’ capacity via knowledge sharing and co-creating knowledge, according to the student-centered philosophy. Collected data from interviewing showed that the teachers were well aware of changing their teaching methods and make some improvements to balance the educational efficiency and the nature of education. Almost all teachers acknowledge that ICT is helpful to motivate learning enthusiasm. Further, teaching integrated with ICT saves teachers’ time and energy on teaching preparation and promoting effectiveness. Teachers are willing to co-create knowledge with students, though using information is not easy due to the lack of operating skills of the website and ICT. Some teachers are against to co-create knowledge in the informational background since they hold that is not feasible for there being a knowledge gap between teachers and students. Technology would easily mislead teachers and students to the goal of instrumental rationality, which makes pedagogy dysfunctional and inhumane; however, any high quality of teaching should take a dialectical balance between effectiveness and humanity.

Keywords: critical thinking, dialectic between effectiveness and humanity, open knowledge, pedagogy

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Authors: Tanya Keni

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Efforts to link culture and self, have been the focus, initially of Anthropology and later of Psychology in the first half of the 20th century. In doing so, cross-cultural researchers have endeavored to identify factors valuable for classifying cultures. One such central classification is that of individualism and collectivism which remains prominent. However, it overlooks certain other cultural dimensions that can be of interest and need attention. The current paper tries to move beyond this classic distinction, to cultures that are termed to be honor and dignity oriented. Both honor and dignity, refer to the worth of a person but bear different connotations and psychological consequences. While dignity is an independent concept of self-worth whose locus lies deep within the individual, honor is an interdependent concept that needs both personal as well as societal acknowledgment. This research takes an exploratory and qualitative approach to draw the individual, structural and contextual understanding of personal honor and dignity in broad cultures that are conceptualized as honor and dignity aimed. The aim is to understand the cultural influence on an individual’s self-worth, considering gender. 12 Focus group discussions were conducted across North India and Germany with four participants each. The research process was inspired by the approaches of social constructivism and critical realism. These discussions were transcribed and further analyzed using thematic analysis and the results have revealed differential themes for the concepts of honor and dignity. Certain dimensional similarities were also observed for both the cultural groups, however with differential usage of language. In particular, the North Indian group was seen using phrases that were oriented towards safeguarding against loss of honor or dignity. While the phrases of the German group were aligned towards worth-enhancement. The research also gives an illustration of how honor and dignity translate into behavioral practice that can exert an influence on important life decisions, especially about self and family for both males and females. In addition to these, the study also contributes to the literature on self-worth by developing the concept of ‘dignity’ for which there exists a dearth of research.

Keywords: culture, dignity, honor, self, self-worth

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Authors: Sally Kafelghazal

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Introduction: Arab Americans, who include immigrants, refugees, or U.S. born persons of Middle Eastern or North African descent, may experience significant difficulties during acculturation to Western society. Influential stressors include relocation, loss of social support, language barriers, and economic factors, all of which can impact mental health. There is limited research investigating the effects of acculturation on the mental health of the Arab American population. Objectives: The purpose of this study is to identify ways in which acculturation impacts the mental health of Arab Americans, specifically the development of depression and anxiety. Method: A literature search was conducted using PubMed and PsycArticles (ProQuest), utilizing the following search terms: “Arab Americans,” “Arabs,” “mental health,” “depression,” “anxiety,” “acculturation.” Thirty-nine articles were identified and of those, nine specifically investigated the relationship between acculturation and mental health in Arab Americans. Three of the nine focused exclusively on depression. Results: Several risk factors were identified that contribute to poor mental health associated with acculturation, which include immigrant or refugee status, facing discrimination, and religious ideology. Protective factors include greater levels of acculturation, being U.S. born, and greater heritage identity. Greater mental health disorders were identified in Arab Americans compared to normative samples, perhaps particularly depression; none of the articles specifically addressed anxiety. Conclusion: The current research findings support the potential association between the process of acculturation and greater levels of mental health disorders in Arab Americans. However, the diversity of the Arab American population makes it difficult to draw consistent conclusions. Further research needs to be conducted in order to assess which subgroups in the Arab American population are at highest risk for developing new or exacerbating existing mental health disorders in order to devise more effective interventions.

Keywords: arab americans, arabs, mental health, anxiety, depression, acculturation

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Authors: Yasser Aboel-Magd

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This research addresses the critical issue of accessibility for individuals with special needs and the broader implications of disability on one's ability to lead an independent and integrated life within society. It highlights the consequences of injury, illness, or disability not only on the physical level but also on psychological, social, educational, economic, and functional aspects of life. The study emphasizes the importance of inclusive design in urban spaces, reflecting on how a society's treatment of individuals with disabilities serves as a measure of its progress. The research delves into the challenges faced by people with special needs in the Kingdom, where, despite advancements in various sectors, there is a noticeable lack of accommodating public opportunities for this significant demographic. It argues for the necessity of a Saudi building code that considers the needs of a diverse population during the design phase. The paper discusses the role of urban space as a fundamental element in urban formation and its impact on the societal integration of individuals with special needs. The study explores a variety of inclusive design principles, ranging from physical features like ramps and tactile paving to digital and cognitive accessibility measures such as screen readers, closed captions, plain language, and visual aids. It also considers the impact of wayfinding and appropriate lighting design on the orientation and assistance of individuals within urban spaces at the lowest cost. The researchers connect inclusive design with sustainable practices, advocating for environments that are not only environmentally friendly but also adaptable and lasting. The paper concludes with the assertion that the integration of accessibility, universal design, and sustainability signifies a society's commitment to inclusivity and the empowerment of all individuals, paving the way for a future where everyone can participate fully and independently in society.

Keywords: accessibility, inclusive design, Saudi building code, disability inclusion, socioeconomic progress

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Authors: Yuliya Markava

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The laser in situ keratomileusis (LASIK) is widely common surgical procedure, which has become an alternative for patients who are not satisfied with the performance of other correction methods. A high level of patient satisfaction functional outcomes after refractive surgery confirms the high reliability and safety of LASIK and provides a significant improvement in the quality of life and social adaptation. Purpose: To perform clinical analysis of the results of correction made to the excimer laser system SCHWIND AMARIS 500E in patients with different types of refractive anomalies. Materials and Methods: This was a retrospective analysis of 1581 operations (812 patients): 413 males (50.86%) and 399 females (49.14%) at the age from 18 to 47 years with different types of ametropia. All operations were performed on excimer laser SCHWIND AMARIS 500E in the LASIK procedure. Formation of the corneal flap was made by mechanical microkeratome SCHWIND. Results: Analyzing the structure of refractive anomalies: The largest number of interventions accounted for myopia: 1505 eyes (95.2%), of which about a low myopia: 706 eyes (44.7%), moderate myopia: 562 eyes (35.5 %), high myopia: eyes 217 (13.7%) and supermyopia: 20 eyes (1.3%). Hyperopia was 0.7% (11 eyes), mixed astigmatism: 4.1% (65 eyes). The efficiency was 80% (in patients with supermyopia) to 91.6% and 95.4% (in groups with myopia low and moderate, respectively). Uncorrected visual acuity average values before and after laser operation was in groups: a low myopia 0.18 (up 0.05 to 0.31) and 0.80 (up 0.60 to 1.0); moderate myopia 0.08 (up 0.03 to 0.13) and 0.87 ( up 0.74 to 1.0); high myopia 0.05 (up 0.02 to 0.08) and 0.83 (up 0.66 to 1.0); supermyopia 0.03 (up 0.02 to 0.04) and 0.59 ( up 0.34 to 0.84); hyperopia 0.27 (up 0.16 to 0.38) and 0.57 (up 0.27 to 0.87); mixed astigmatism of 0.35 (up 0.19 to 0.51) and 0.69 (up 0.44 to 0.94). In all cases, after LASIK indicators uncorrected visual acuity significantly increased. Reoperation was 4.43%. Significance: Clinical results of refractive surgery at the excimer laser system SCHWIND AMARIS 500E in different ametropia correction is characterized by high efficiency.

Keywords: effectiveness of laser correction, LASIK, refractive anomalies, surgical treatment

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Authors: Seemab Safdar, Shazia Fatima, Ahmad Qureshy, M. Adnan Saeed, M. Faheem

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Background: Thyroid cancer has 586,000 cases per year worldwide, and this translates to 3% of all tumor diagnoses. 90% of the cases fall under differentiated thyroid carcinoma (DTC), which includes follicular thyroid cancer (FTC) and papillary thyroid cancer (PTC). During their illness, 10% of patients develop distant metastases, and two-thirds of them develop resistance to radioactive iodine (RAI) treatment. It has been shown that in some circumstances, like DTC with high TG levels and negative 131I whole-body scintigraphy (TENIS), [18F] FDG-PET-CT is an effective imaging technique. This study determines the role of [18F] FDG-PET-CT in the treatment of TENIS patients. Methods: 16 patients (n = 12 female; 4 males, age 45 ± 15 years) with histologically proven thyroid cancer (Differentiated and poorly differentiated) and high TG with negative iodine scans were included in this prospective study from January 2024 to June 2024. They underwent scanning in state-of-the-art (GE Discovery MI) [18F] FDG-PET-CT for re-staging or diagnostics of recurrent disease using a standardized protocol. All DTC subtypes and PDTC were included. The referring physicians completed standardized questionnaires both before and after PET-CT to prospectively determine the examination's effect on clinical decision-making. Patient outcomes were measured by analysis of medical records. Moreover, after PET-CT, a change in the pre-PET-CT planned therapies was documented in 32% of cases and additional invasive diagnostic procedures could be waived in 37.5 % of cases. TG levels under TSH stimulation were significantly higher in patients showing PET-CT metastases compared to patients without such findings (68.75%). Results: Without PET-CT, physicians referring to the doctors had not established a complete treatment plan for 45% of patients with thyroid carcinoma. 12/16 patients showed FDG avidity in cervical lymph nodes that were not Iodine avid previously, 2 patients had FDG avid disease in the lungs. In the process, PET-CT helped plan patient management and created a clear plan for treatment in 68.75% of patients. Conclusions: This study confirms that [18F] FDG-PET-CT used in a routine clinical setting has a very important impact on the management of patients with thyroid cancer when TG levels are persistently high in the presence of negative Iodine Scans by initiating treatments and replacing additional imaging and invasive tests.

Keywords: PET-CT, TENIS, role, FDG

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Authors: S. Pathak, R. Lazarus

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A 25-year-old male HIV patient (CD4 cells 20/µL and HIV viral load 14200000 copies/ml) with a past medical history of duodenal ulcer, pneumocystis carinii pneumonia, oesophageal candidiasis presented with fever and a seizure to hospital. The only recent travel had been a religious pilgrimage from Singapore to Malaysia 5 days prior; during the trip he sustained skin abrasions. The patient had recently started highly active antiretroviral therapy 2 months prior. Clinical examination was unremarkable other than a temperature of 38.8°C and perianal warts. Laboratory tests showed a leukocyte count 12.5x109 cells/L, haemoglobin 9.4 g/dL, normal biochemistry and a C-reactive protein 121 mg/L. CT head and MRI head were unremarkable and cerebrospinal fluid analysis performed after a delay (due to technical difficulties) of 11 days was unremarkable. Blood cultures (three sets) taken on admission showed Gram-negative rods in the anaerobic bottles only at the end of incubation with culture result confirmed by molecular sequencing showing Helicobacter cinaedi. The patient was treated empirically with ceftriaxone for seven days and this was converted to oral co-amoxiclav for a further seven days after the blood cultures became positive. A Transthoracic echocardiogram was unremarkable. The patient made a full recovery. Helicobacter cinaedi is a gram-negative anaerobic fastidious organism affecting patients with comorbidity. Infection may manifest as cellulitius, colitis or as in this case as bloodstream infection – the latter is often attributed to faeco-oral infection. Laboratory identification requires prolonged culture. Therapeutic options may be limited by resistance to macrolides and fluoroquinolones. The likely pathogen inoculation routes in the case described include gastrointestinal translocation due to proctitis at the site of perianal warts, or breach of the skin via abrasions occurring during the pilgrimage. Such organisms are increasing in prevalence as our patient population ages and patients have multiple comorbidities including HIV. It may be necessary in patients with unexplained fever to prolong incubation of sterile sites including blood in order to identify this unusual fastidious organism.

Keywords: fastidious, Helicobacter cinaedi, HIV, immunocompromised

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Authors: Monika Ksiezopolska-Gocalska, Pawel Albrycht, Robert Holyst

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Surface Enhanced Raman Spectroscopy (SERS) is a technique used to analyze very low concentrations of substances in solutions, even in aqueous solutions - which is its advantage over IR. This technique can be used in the pharmacy (to check the purity of products); forensics (whether at a crime scene there were any illegal substances); or medicine (serving as a medical test) and lots more. Due to the high potential of this technique, its increasing popularity in analytical laboratories, and simultaneously - the absence of appropriate platforms enhancing the SERS signal (crucial to observe the Raman effect at low analyte concentration in solutions (1 ppm)), we decided to invent our own SERS platforms. As an enhancing layer, we have chosen gold and silver nanoparticles, because these two have the best SERS properties, and each has an affinity for the other kind of particles, which increases the range of research capabilities. The next step was to commercialize them, which resulted in the creation of the company ‘SERSitive.eu’ focusing on production of highly sensitive (Ef = 10⁵ – 10⁶), homogeneous and reproducible (70 - 80%) substrates. SERStive SERS substrates are made using the electrodeposition of silver or silver-gold nanoparticles technique. Thanks to a very detailed analysis of data based on studies optimizing such parameters as deposition time, temperature of the reaction solution, applied potential, used reducer, or reagent concentrations using a standardized compound - p-mercaptobenzoic acid (PMBA) at a concentration of 10⁻⁶ M, we have developed a high-performance process for depositing precious metal nanoparticles on the surface of ITO glass. In order to check a quality of the SERSitive platforms, we examined the wide range of the chemical compounds and the biological substances. Apart from analytes that have great affinity to the metal surfaces (e.g. PMBA) we obtained very good results for those fitting less the SERS measurements. Successfully we received intensive, and what’s more important - very repetitive spectra for; amino acids (phenyloalanine, 10⁻³ M), drugs (amphetamine, 10⁻⁴ M), designer drugs (cathinone derivatives, 10⁻³ M), medicines and ending with bacteria (Listeria, Salmonella, Escherichia coli) and fungi.

Keywords: nanoparticles, Raman spectroscopy, SERS, SERS applications, SERS substrates, SERSitive

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Authors: Ayda Youssef, Tarek Rafaat, Iman zaky

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Purpose: Langerhans’ cell histiocytosis (LCH) is not uncommon pathology that implies aberrant proliferation of a specific dendritic (Langerhans) cell. These atypical but mature cells of monoclonal origin can infiltrate many sites of the body and may occur as localized lesions or as widespread systemic disease. Liver is one of the uncommon sites of affection. The twofold objective of this study is to illustrate the radiological presentation of this disease, and to compare these results with previously reported series. Methods and Materials: Between 2007 and 2012, 150 patients with biopsy-proven LCH were treated in our hospital, a paediatric cancer tertiary care center. A retrospective review of radiographic images and reports was performed. There were 33 patients with liver affection are stratified. All patients underwent imaging studies, mostly US and CT. A chart review was performed to obtain demographic, clinical and radiological data. They were analyzed and compared to other published series. Results: Retrospective assessment of 150 patients with LCH was performed, among them 33 patients were identified who had liver involvement. All these patients developed multisystemic disease; They were 12 females and 21 males with (n= 32), seven of them had marked hepatomegaly. Diffuse hypodense liver parenchyma was encountered in five cases, the periportal location has a certain predilection in cases of focal affection where three cases has a hypodense periportal soft tissue sheets, one of them associated with dilated biliary radicals, only one case has multiple focal lesions unrelated to portal tracts. On follow up of the patients, two cases show abnormal morphology of liver with bossy outline. Conclusion: LCH is a not infrequent disease. A high-index suspicion should be raised in the context of diagnosis of liver affection. A biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality. Liver histiocytosis are not disease specific features but should be interpreted in conjunction with the clinical history and the results of biopsy. Clinical Relevance/Application: Radiologist should be aware of different patterns of hepatobiliary histiocytosis, Thus early diagnosis and proper management of patient can be conducted.

Keywords: langerhans’ cell histiocytosis, liver, medical and health sciences, radiology

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Authors: Folasade R. Sulaiman

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Pupils’ health and nutrition are basically important to their schooling. The preponderance of avoidable deaths among children in Africa (WHO, 2000) may not be unconnected with the nutritional and health education status of families and communities that have their children as school clients. This study adopted a descriptive survey design focusing on the assessment of the level of nutritional and health education of families and community members in the rural riverine areas of Ogun State. Two research questions were raised. The Nutritional and Health Education of Families and Communities Inventory (NHEFCI) was used to collect data from 250 rural child-bearing aged women, and 0.73 test-retest reliability coefficient was established to determine the strength of the instrument. Data collected were analysed using descriptive statistics of frequency counts, percentages and mean in accordance with research questions raised in the study. The findings revealed amongst others: that 65% of the respondents had low level of nutritional and health education among the families and community members; while 72% had low level of awareness of the possible influence of nutritional and health education on the learning outcomes of the children. Based on the findings, it was recommended among others that government should intensify efforts on sensitization, mass literacy campaign etc.; also improve upon the already existing School Feeding Programme in Nigerian primary schools to provide at least one balanced diet for children while in school; community health workers, social workers, Non-Governmental Organizations (NGO) should collaborate with international Organizations like UNICEF, UNESCO, WHO etc. to organize sensitization programmes for members of the rural riverine communities on the importance of meeting the health and nutritional needs of their children in order to attain their educational potentials.

Keywords: nutritional and health education, learning capacities, school-age children, universal basic education, rural riverine areas

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Authors: Recep Keşli, Hayriye Tokay, Cengiz Demir, İsmail Ceyhan

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Objective: In many countries, tuberculosis (TB) is still one of the most important diseases. Tuberculosis is among top 10 causes of death worldwide. The early diagnosis of active tuberculosis still depends on the presence of acid resistant bacilli (ARB) in stained smears. In this study, we aimed to investigate the diagnostic performances of Erlich Ziehl Neelsen (EZN), Kinyoun and two different fluorescent stains. Methods: The specimens were obtained from the patients who applied to Chest Diseases Departments of Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, and Afyon Kocatepe University, ANS Research and Practice Hospital. The study was carried out in the Medical Microbiology Laboratory, School of Medicine, Afyon Kocatepe University. All the non-sterile specimens were homogenized and decontaminated according to the EUCAST instructions. Samples were inoculated onto the Löwenstein-Jensen agars (bio-Merieux Marcy l'Etoile, France) and then incubated at 37˚C, for 40 days. Four smears were prepared from each specimen. Slides were stained with commercial EZN (BD, Sparks, USA), Kinyoun (SALUBRIS Istanbul, Turkey), Auramine (SALUBRIS Istanbul, Turkey) and Rhodamine (SALUBRIS Istanbul, Turkey) kit. While EZN and Kinyoun stainings were examined by light microscope, Auramine and Rhodamine slides were examined by fluorescence microscopy. Results: A total of 158 respiratory system samples (sputum, broncho alveolar lavage fluid…etc) were enrolled into the study. A hundred and two of the samples that processed were found as culture positive. The sensitivity, specificity, positive predictive, and negative predictive values were detected as 100%, 67.5%, 73.5%, and 100% for EZN, 100%, 70.9%, 77.4%, and 100% for Kinyoun, 100%,77.8%, 84.3%, 100% for Auramine, and 100%, 80% , 86.3%, and 100% for Rhodamine respectively. Conclusions: According to our study auramine and rhodamine staining methods showed the best diagnostic performance among the four investigated staining methods. In conclusion, the fluorochrome staining method may be accepted as the most reliable, rapid and useful method for diagnosis of the mycobacterial infections truly.

Keywords: acid resistant bacilli (ARB), auramine, Ehrlich-Ziehl-Neelsen (EZN), Kinyoun, Rhodamine

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Authors: Asrat M.Belachew, Tiago Pereira, Institute of Mathematics, Computer Sciences, Avenida Trabalhador São Carlense, 400, São Carlos, 13566-590, Brazil

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Infectious diseases are among the most prominent threats to human beings. They cause morbidity and mortality to an individual and collapse the social, economic, and political systems of the whole world collectively. Mathematical models are fundamental tools and provide a comprehensive understanding of how infectious diseases spread and designing the control strategy to mitigate infectious diseases from the host population. Modeling the spread of infectious diseases using a compartmental model of inhomogeneous populations is good in terms of complexity. However, in the real world, there is a situation that accounts for heterogeneity, such as ages, locations, and contact patterns of the population which are ignored in a homogeneous setting. In this work, we study how classical an SEIR infectious disease spreading of the compartmental model can be extended by incorporating the mobility of population between heterogeneous cities during an outbreak of infectious disease. We have formulated an SEIR multi-cities epidemic spreading model using a system of 4k ordinary differential equations to describe the disease transmission dynamics in k-cities during the day and night. We have shownthat the model is epidemiologically (i.e., variables have biological interpretation) and mathematically (i.e., a unique bounded solution exists all the time) well-posed. We constructed the next-generation matrix (NGM) for the model and calculated the basic reproduction number R0for SEIR-epidemic spreading model with cities mobility. R0of the disease depends on the spectral radius mobility operator, and it is a threshold between asymptotic stability of the disease-free equilibrium and disease persistence. Using the eigenvalue perturbation theorem, we showed that sending a fraction of the population between cities decreases the reproduction number of diseases in interconnected cities. As a result, disease transmissiondecreases in the population.

Keywords: SEIR-model, mathematical model, city mobility, epidemic spreading

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Authors: Novita Linda Akbar, Elmeida Effendy, Mustafa M. Amin

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Background: The most common of psychotic disorders is schizophrenia. Vitamin D is made from sunlight, and in the skin from UVB radiation from sunlight. If people with Vitamin D deficiency is common severe mental illness such as schizophrenia.Schizophrenia is a chronic mental illness characterised by positive symptoms and negatives symptoms, such as hallucinations and delusions, flat affect and lack of motivation we can found. In patients with Schizophrenia maybe have several environmental risk factors for schizophrenia, such as season of birth, latitude, and climate has been linked to vitamin D deficiency. There is also relationship between the risk of schizophrenia and latitude, and with an increased incidence rate of schizophrenia seen at a higher latitude. Methods: This study was an analytical study, conducted in BLUD RS Jiwa Propinsi Sumatera Utara and RSUD Deli Serdang, the period in May 2016 and ended in June 2016 with a sample of the study 60 sample (20 patients live in the Highland and Lowland, 20 healthy controls). Inclusion criteria were schizophrenic patients both men and women, aged between 18 to 60 years old, acute phase no agitation or abstinence antipsychotic drugs for two weeks, live in the Highland and Lowland, and willing to participate this study. Exclusion criteria were history of other psychotic disorders, comorbidities with other common medical condition, a history of substance abuse. Sample inspection for serum vitamin D using ELFA method. Statistical analysis using numeric comparative T-independent test. Results: The results showed that average levels of vitamin D for a group of subjects living in areas of high land was 227.6 ng / mL with a standard deviation of 86.78 ng / mL, the lowest levels of vitamin D is 138 ng / mL and the highest 482 ng / mL. In the group of subjects who settled in the low lands seem mean vitamin D levels higher than the mountainous area with an average 237.8 ng / mL with a standard deviation of 100.16 ng / mL. Vitamin D levels are lowest and the highest 138-585 ng / mL. Conclusion and Suggestion: The results of the analysis using the Mann Whitney test showed that there were no significant differences between the mean for the levels of vitamin D based on residence subject with a value of p = 0.652.

Keywords: latitude, schizophrenia, Vitamin D, Sumatera Utara

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Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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Authors: Debora C. Mendes, Matthias Eckert, Claudia S. Moço, Helio Martins, Jean-Pierre Gonçalves, Miguel Oliveira, Jose P. Da Silva

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Disposal of construction and demolition waste (C&DW) in embankments in the periphery of cities causes both environmental and social problems. To achieve the management of C&DW, a detailed analysis of the properties of these materials should be done. In this work we report a comparative study of the physical, chemical and environmental properties of natural and C&DW aggregates from 25 different origins. Assays were performed according to European Standards. Analysis of heavy metals and organic compounds, namely polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs), were performed. Finally, properties of concrete prepared with C&DW aggregates are reported. Physical analyses of C&DW aggregates indicated lower quality properties than natural aggregates, particularly for concrete preparation and unbound layers of road pavements. Chemical properties showed that most samples (80%) meet the values required by European regulations for concrete and unbound layers of road pavements. Analyses of heavy metals Cd, Cr, Cu, Pb, Ni, Mo and Zn in the C&DW leachates showed levels below the limits established by the Council Decision of 19 December 2002. Identification and quantification of PCBs and PAHs indicated that few samples shows the presence of these compounds. The measured levels of PCBs and PAHs are also below the limits. Other compounds identified in the C&DW leachates include phthalates and diphenylmethanol. The characterized C&DW aggregates show lower quality properties than natural aggregates but most samples showed to be environmentally safe. A continuous monitoring of the presence of heavy metals and organic compounds should be made to trial safe C&DW aggregates. C&DW aggregates provide a good economic and environmental alternative to natural aggregates.

Keywords: concrete preparation, construction and demolition waste, heavy metals, organic pollutants

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Authors: Getahun Nigusie

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: To assess incidence and predictors of mortality among HIV positive children on ART in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, Ethiopia

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Authors: Yavuz Erdoğan, Hidayet Çiftçi

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Cyberbullying, a phenomenon among adolescents, is defined as actions that use information and communication technologies such as social media to support deliberate, repeated, and hostile behaviour by an individual or group. With the advancement in communication and information technology, cyberbullying has expanded its boundaries among students in schools. Thus, parents, psychologists, educators, and lawmakers must become aware of the potential risks of this phenomenon. In the light of these perspectives, this study aims to investigate the relationships between cyberbullying perception and Facebook attitudes of Turkish students. A survey method was used for the study and the data were collected by “Cyberbullying Perception Scale”, “Facebook Attitude Scale” and “Personal Information Form”. For this purpose, study has been conducted during 2014-2015 academic year, with a total of 748 students with 493 male (%65.9) and 255 female (%34.1) from randomly selected high schools. In the analysis of data Pearson correlation and multiple regression analysis, multivariate analysis of variance (MANOVA) and Scheffe post hoc test has been used. At the end of the study, the results displayed a negative correlation between Turkish students’ Facebook attitudes and cyberbullying perception (r=-.210; p<0.05). In order to identify the predictors of students’ cyberbullying perception, multiple regression analysis was used. As a result, significant relations were detected between cyberbullying perception and independent variables (F=5.102; p<0.05). Independent variables together explain 11.0% of the total variance in cyberbullying scores. The variables that significantly predict the students’ cyberbullying perception are Facebook attitudes (t=-5.875; p<0.05), and gender (t=3.035; p<0.05). In order to calculate the effects of independent variables on students’ Facebook attitudes and cyberbullying perception MANOVA was conducted. The results of the MANOVA indicate that the Facebook attitudes and cyberbullying perception were significantly differed according to students’ gender, age, educational attainment of the mother, educational attainment of the father, income of the family and daily usage of internet.

Keywords: facebook, cyberbullying, attitude, internet usage

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Authors: Ni Tang, Jinping Zhang

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An effective and sustainable volunteer team is needed to create a more available blood supply system. In order to promote the sustainable development of blood donation in Zhejiang Province, China, a “three-exemption” policy was proposed in 2014: blood donors who received the National Award for unpaid blood donation may government-invested and funded parks, scenic spots and other places for free, visit non-profit medical institutions for free outpatient fees, and be exempted from urban public transportation fees. As the policy has been in place for seven years, this study evaluated the effectiveness of the policy by comparing the increasing rate of blood donation in Hangzhou (capital city of Zhejiang) before and after the policy using the intermittent time series analysis. The blood donation in Anhui, a Province near Zhejiang, was also compared as a negative control. Blood donation data from 2012 to 2018 were obtained from the donation center's official websites. The increasing rate of blood donation volume since 2012 in Hangzhou is 34.37 units/month, and after 2014, the increasing rate additionally increases 71.69 (p=0.1442), which indicating a statistically non-significant change after the policy. While as a negative control, in Anhui, the increasing rate of blood donation volume since 2012 is -163.3 unit/month, and the increasing rate additionally increases 167.2 (p=5.63e-07) after 2014. The result shows that the three-exemption policy had a certain level of impact on encouraging volunteers to donate blood, but the effect was not substantial. One possible reason for the ineffectiveness of the policy might be a lack of public awareness of the policy. On the other hand, this policy mainly waived unnecessary life expenses, such as fares and scenic entrance fees, and requires a certain number of blood donations, registration procedures, and blood donation certificates. Perhaps, reducing life-related expenses such as oil, water and electricity, could better attract people to participate in blood donation. This current study on the three-exemption policy provides a new direction for promoting people's blood donation. Incentive policies may require greater publicity and incentives. In order to better ensure the operation of the blood donation system, other policies, especially incentive policies, should be further explored.

Keywords: blood donation, policy, Zhejiang, unpaid blood donation, three-exemption policy

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Authors: Wei Qu, Cassandra Agius, Nikki Varvazovsky, Angela Meade

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The goals of the case study are to address the importance of early diagnosis of osmotic demyelination syndrome (ODS) and to analyse the types, duration, and intensities of the rehabilitation program to promote neurological and functional recovery. It can be associated with biphasic course of disease and severe neurological and neuropsychiatric symptoms. Although a few treatment modalities, such as plasmapheresis, immunoglobulin therapy, steroid, and thyrotrophin-releasing hormone, have been suggested, there is no effective treatment for ODS. The overall prognosis of established ODS is generally poor. A high proportion of patients have a severe permanent disability, which has led to social, economic, and emotional burdens to carers and societies. In this case, a 69-year-old retired pensioner with chronic alcoholism was admitted to the hospital with a reduced level of consciousness and tonic-clonic seizure. He had severe hyponatraemia (serum sodium 118 mmol/L) and hypokalemia (serum potassium 2.8 mmol/L). He was treated with anticonvulsants, 150ml 3% hypertonic saline over one hour, and 40 mmol potassium chloride over one hour, and his sodium was increased by 11 mmol/L in the first 24 hours. However, he had worsened neurological symptoms with quadriplegia, dysphagia, anarthria, and confusion, and the radiological features suggested the diagnosis of ODS. He had minimal neurological recovery during the first four weeks of hospital admission. He was treated with seven weeks of a multi-disciplinary intensive rehabilitation program. On discharge, he had made a significant cognitive and functional recovery and could mobilize independently without a walking aid. In conclusion, ODS can still occur despite correcting sodium following the current clinical guidelines. Patients with severe neurological deficits in the context of osmotic demyelination syndrome would benefit from intensive rehabilitation to facilitate their functional improvement and to promote their quality of life.

Keywords: osmotic demyelination syndrome, hyponatremia, central pontine and extrapontine myelinolysis, rehabilitation

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Authors: Ndeye Tiguida Sarr, Onur Akpinar

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The tourism industry, being the sector that includes all the activities related to the organization and satisfaction of tourists during their trip, also has a very important role in the national economy of the host country. In order to measure the stakes of tourism on the economy, microeconomic and macroeconomic factors are elements of analysis. While microeconomics is limited to an individual perspective, macroeconomics extends to a global perspective and treats the economy as a whole by focusing on social and economic actors in general. It is in this context that this study focuses on macroeconomic variables in order to determine the factors that influence the financial performance of tourism firms in Turkey, which is one of the world's major destinations. The aim of the study is to demonstrate the relationship between macroeconomic variables and the financial performance of tourism firms. Data from 2011 to 2020 are collected, from a sample of 16 companies that represent the tourism sector in Borsa Istanbul. Tobin’s Q ratio, Market to Book ratio, Return on Invested Capital, and Return on Assets as the financial performance indicators were dependent variables of the study. Gross Domestic Products, Inflation, Interest Rates, and Unemployment as macroeconomic indicators were independent variables. Again, Size, Liquidity, Leverage, and Age were control variables of the study. According to the results, value indicators, which are Tobin’s Q ratio and Market to Book ratio, have a statistically significant relationship with Inflation, Interest Rates, and Unemployment. A negative relationship is found between value indicators and Interest rates and a positive relationship between value indicators and Unemployment and Inflation. On the other hand, there is no significant relationship between profit indicators (Return on Invested Capital and Return on Assets) and macroeconomic variables. Accordingly, Interest rates negatively affect the financial performance of tourism firms and stand out as a factor that decreases the value.

Keywords: financial performance, macroeconomic variables, panel data, Tobin Q

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Authors: Indrani Chattopadhyaya

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This paper seeks to examine how identity – a cultural self-image of a group of people develops – how they live, they think, they celebrate and express their world view through language, gesture, symbols, and rituals. 'Culture' is a way of life and 'identity' is assertion of that cultural self-image practiced by the group. The way in which peoples live varies from time to time and from place to place. This variation is important for their identity. Archaeologists have classified these patterns of spacial variations as 'archaeological culture.' These cultures are identified 'self-consciously' with a particular social group indicating ethnicity. The ethnic identity as archaeological cultures also legitimizes the claims of modern groups to territory. In prehistoric research problems of ethnicity and multiculturalism, stylistic attributes significantly reflect both group membership and individuality. In India, anthropologists feel that though tribes have suffered relative isolation through history, they have remained an integral part of Indian civilization. The term 'tribe' calls for substitution with a more meaningful name with an indigenous flavour 'Adivasi' (original inhabitants of the land).While studying prehistoric rock paintings from central India - Sonbhadra (Uttar Pradesh) and Bhimbetka (Madhya Pradesh), one is struck by the similarity between stylistic attributes of painted motifs in the prehistoric rock shelters and the present day indigenous art of Kol and Bhil tribes in the area, who have not seen these prehistoric rock paintings, yet are carrying on with the tradition of painting and decorating their houses in the same way. They worship concretionary sandstone blocks with triangular laminae as Goddess, Devi, Shakti. This practice is going on since Upper Palaeolithic period confirmed by archaeological excavation. The past is legitimizing the role of the present groups by allowing them to trace their roots from earlier times.

Keywords: ethnic identity, hermeneutics, semiotics, Adivasi

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Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: Mimoza Canga, Irene Malagnino, Ruzhdie Qafmolla, Vergjini Mulo, Gresa Baboci, Vito Antonio Malagnino

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Background: Dental caries represents the most widespread pathology in childhood. The prevalence of dental caries varies with age, gender, socio economic status, geographical location, nutrition habits, and oral hygiene. Objective: The objective of the present longitudinal study is to show clearly the prevalence of dental caries in the children of age 6 and 7 years old in Vlore, Albania, in a two year time period with controls done every 6 months. Materials and methods: The present study was conducted on 530 children, with a controlled sample for a time period of 24 months from September 2019- September 2021. The children in the study had different economic and social backgrounds. The teeth controls were done by the dentists who work at the hospital of the city. The present study was conducted in accordance with Helsinki declaration. Permissions were obtained in written form, which allowed us to perform the observations. Parents had the right to withdraw their children at any time. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: The data of the present study showed that the age group of 6 years old had 139 or 52.3% of the children with dental caries and 127 or 47.7% of them had no dental caries, while at the age of 7 there were 184 or 69.7% of the children with dental caries problems in the permanent molars and 80 or 30.3% of them had no dental caries. In the present study, it was observed that there is a statistically significant association between age group and presence of caries. Children 7 years old had higher presence of dental caries (χ2 = 16.934 (df 1) p-value < 0.001). According to the present research, there is a statistically significant correlation between period of time and the presence of dental caries. Furthermore, in the actual research, it was established that in the time 18-24 months, the prevalence of dental caries was high (χ2=15,318 (df 1) p-value = 0.004). Conclusion: According to the results of the present study performed in Albania in a two year time period with controls done every 6 months, it is proved that the prevalence of dental caries was 17.4 percent higher among children 7 years old in comparison with the children 6 years old.

Keywords: age, children, dental caries, permanent molars

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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