Search results for: primary health care

Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim

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Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.

Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure

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Authors: Vagolu S. Krishna, Shan Zheng, Estharla M. Rekha, Luke W. Guddat, Dharmarajan Sriram

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Tuberculosis (TB) remains a major threat to human health. This due to the fact that current drug treatments are less than optimal as well as the rising occurrence of multi drug-resistant and extensively drug-resistant strains of the etiological agent, Mycobacterium tuberculosis (Mt). Given the wide-spread significance of this disease, we have undertaken a design and evaluation program to discover new anti-TB drug leads. Here, our attention is focused on ketol-acid reductoisomerase (KARI), the second enzyme in the branched-chain amino acid biosynthesis pathway. Importantly, this enzyme is present in bacteria but not in humans, making it an attractive proposition for drug discovery. In the present work, we used high-throughput virtual screening to identify seventeen potential inhibitors of KARI using the Birla Institute of Technology and Science in-house database. Compounds were selected based on high docking scores, which were assigned as the result of favourable interactions between the compound and the active site of KARI. The Ki values for two leads, compounds 14 and 16 are 3.71 and 3.06 µM, respectively for Mt KARI. To assess the mode of binding, 100 ns molecular dynamics simulations for these two compounds in association with Mt KARI were performed and showed that the complex was stable with an average RMSD of less than 2.5 Å for all atoms. Compound 16 showed an MIC of 2.06 ± 0.91 µM and a 1.9 fold logarithmic reduction in the growth of Mt in an infected macrophage model. The two compounds exhibited low toxicity against murine macrophage RAW 264.7 cell lines. Thus, both compounds are promising candidates for development as an anti-TB drug leads.

Keywords: ketol-acid reductoisomerase, macrophage, molecular docking and dynamics, tuberculosis

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Authors: Kebede Gamo Sebehanie, Olu Emmanuel Femi, Alberto Velázquez Del Rosario, Abubeker Yimam Ali, Gudeta Jafo Muleta

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Water pollution is one of the most serious worldwide issues today. Among water pollution, heavy metals are becoming a concern to the environment and human health due to their non-biodegradability and bioaccumulation. In this study, a magnetite-cellulose nanocomposite derived from renewable resources is employed for hexavalent chromium elimination by adsorption. Magnetite nanoparticles were synthesized directly from iron ore using solvent extraction and co-precipitation technique. Cellulose nanofiber was extracted from sugarcane bagasse using the alkaline treatment and acid hydrolysis method. Before and after the adsorption process, the MNPs-CNF composites were evaluated using X-ray diffraction (XRD), Scanning electron microscope (SEM), Fourier transform infrared (FTIR), and Vibrator sample magnetometer (VSM), and Thermogravimetric analysis (TGA). The impacts of several parameters such as pH, contact time, initial pollutant concentration, and adsorbent dose on adsorption efficiency and capacity were examined. The kinetic and isotherm adsorption of Cr (VI) was also studied. The highest removal was obtained at pH 3, and it took 80 minutes to establish adsorption equilibrium. The Langmuir and Freundlich isotherm models were used, and the experimental data fit well with the Langmuir model, which has a maximum adsorption capacity of 8.27 mg/g. The kinetic study of the adsorption process using pseudo-first-order and pseudo-second-order equations revealed that the pseudo-second-order equation was more suited for representing the adsorption kinetic data. Based on the findings, pure MNPs and MNPs-CNF nanocomposites could be used as effective adsorbents for the removal of Cr (VI) from wastewater.

Keywords: magnetite-cellulose nanocomposite, hexavalent chromium, adsorption, sugarcane bagasse

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Authors: Hecson Christian, Joel Macwan

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Landfill site selection in an urban area is a critical issue in the planning process. With the growth of the urbanization, it has a mammoth impact on the economy, ecology, and environmental health of the region. Outsized amount of wastes are produced and the problem gets soared every day. Hence, selection of ideal site for sanitary landfill is a challenge for urban planners and solid waste managers. Disposal site is a function of many parameters. Among all, Geotechnical parameters are very vital as the same is related to surrounding open land. Moreover, the accessible safe and acceptable land is also scarce. Therefore, in this paper geotechnical parameters are used to develop a GIS model to identify an ideal location for landfill purpose. Metropolitan city of Surat is highly populated and fastest growing urban area in India. The research objectives are to conduct field experiments to collect data and to transfer the facts in GIS platform to evolve a model, to find ideal location. Planners’ preferences were obtained to use analytical hierarchical process (AHP) to find weights of each parameter. Integration of GIS and Multi-Criteria Decision Analysis (MCDA) techniques are applied to improve decision-making. It augments an environment for transformation and combination of geographical data and planners’ preferences. GIS performs deterministic overlay and buffer operations. MCDA methods evaluate alternatives based on the decision makers’ subjective values and priorities. Research results have shown many alternative locations. Economic analysis of selected site from actual operations point of view is not included in this research.

Keywords: GIS, AHP, MCDA, Geo-technical

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Authors: Leelavinothan Pari , Ayyasamy Rathinam

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Diabetes mellitus (DM) is a major and growing public health problem throughout the world. Pterocarpus marsupium (Roxb.) (Family: Fabaceae) is widely used as a traditional medicine to treat various diseases including diabetes. However, the molecular mechanism of Pterocarpus marsupium has not been investigated so far. Two fractions (2.5% and 5%) of extract from the medicinal plant, Pterocarpus marsupium (PME) were conducted in a dose dependent manner in streptozotocin (45 mg/kg b.w.) induced type 2 diabetic rats. Each fraction of PME was administered to diabetic rats intragastrically at a dose of 50, 100 and 200 mg/kg b.w for 45 days. The effective dose 200 mg/kg b.w of 5% fraction was more pronounced in reducing the levels of blood glucose (95.65 mg/dL) and glycosylated hemoglobin (HbA1c) (0.41 mg/g Hb), and increasing the plasma insulin (16.20 µU/mL) level. Moreover, PME (200 mg/kg b.w) significantly ameliorated lipid peroxidation products (thiobarbituric reactive substances, lipid hydroperoxides) enzymatic (superoxide dismutase, catalase and glutathione peroxidase) and non-enzymatic antioxidants (Vitamin C, Vitamin E and reduced glutathione) levels. The altered activities of the key enzymes of lipid metabolism along with the lipid profile in diabetic rats were significantly reverted to near normal levels by the administration of PME 5% 200 mg/kg b.w fraction. PME (200 mg/kg b.w) has the ability to reduce the inflammatory cytokines, such as TNF-α, IL-6 mRNA, as well as protein expression and apoptotic marker, such as caspase-3 enzyme in diabetic hepatic tissue. The above biochemical findings were also supported by histological studies such as improvement in pancreas and liver. Pterocarpus marsupium could effectively reduce the hyperglycemia, oxidative-stress, inflammation and hyperlipedimea in diabetic rats; hence it could be a useful drug in the management of diabetes without any side effects.

Keywords: diabetes mellitus, streptozotocin, Pterocarpus marsupium, lipid peroxidation, Antioxidants, inflammatory cytokines

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Authors: Oyebade K. Oyedotun

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The cardiotocogram is a technical recording of the heartbeat rate and uterine contractions of a fetus during pregnancy. During pregnancy, several complications can occur to both the mother and the fetus; hence it is very crucial that medical experts are able to find technical means to check the healthiness of the mother and especially the fetus. It is very important that the fetus develops as expected in stages during the pregnancy period; however, the task of monitoring the health status of the fetus is not that which is easily achieved as the fetus is not wholly physically available to medical experts for inspection. Hence, doctors have to resort to some other tests that can give an indication of the status of the fetus. One of such diagnostic test is to obtain cardiotocograms of the fetus. From the analysis of the cardiotocograms, medical experts can determine the status of the fetus, and therefore necessary medical interventions. Generally, medical experts classify examined cardiotocograms into ‘normal’, ‘suspect’, or ‘pathological’. This work presents an artificial neural network based decision support system which can filter cardiotocograms data, producing the corresponding statuses of the fetuses. The capability of artificial neural network to explore the cardiotocogram data and learn features that distinguish one class from the others has been exploited in this research. In this research, feedforward and radial basis neural networks were trained on a publicly available database to classify the processed cardiotocogram data into one of the three classes: ‘normal’, ‘suspect’, or ‘pathological’. Classification accuracies of 87.8% and 89.2% were achieved during the test phase of the trained network for the feedforward and radial basis neural networks respectively. It is the hope that while the system described in this work may not be a complete replacement for a medical expert in fetus status evaluation, it can significantly reinforce the confidence in medical diagnosis reached by experts.

Keywords: decision support, cardiotocogram, classification, neural networks

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Authors: Gokcen Akyurek, Hulya Kayihan, Deniz Yuce, Selen Yilmaz

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The stigma towards mental illness is still very rooted in our society, despite the number of studies, campaigns, and anti-stigma programs developed in recent years. Stigma represents a serious obstacle to recovery and social integration for people who experience a mental illness, affecting directly their well-being and quality of life. It implies that these persons have to deal with many other barriers apart from the disease symptoms (1-5). Convergent, recent literature suggests that less positive attitudes by mental health professionals interfere with the self-determination and recovery process (4-10).The aim of this study was to translate the Attribution Questionnaire-27 (AQ-27) to the Turkish language (AQ-27-T), and to examine the reliability and validity of this new Turkish version. Cultural adaptation was implemented according to the internationally suggested method. To determine the understandability and appropriateness of this measure for the Turkish culture, a pretest was administered and the final form was generated. Then, 424 randomly chosen people took part in the study. Participant’s mean age was 36.9±12.7 years and %52 of them female. Cronbach's alpha and intra-class coefficients were used to estimate instrument reliability. The AQ-27-T was assessed again 14 days later for test retest reliability. The AQ-27-T demonstrated acceptable internal consistency, with a Cronbach's alpha of 0.88 for the total scale and ranging between 0.86 and 0.89 for the items. The test-retest reliability was good, with Pearson correlation coefficients of 0.79 for the total scale and ranging between 0.35 and 0.77 for the items (p<0.05). Correlation between subscales was moderate-good, with Pearson correlation coefficients of 0.18-0.88 (p<0.05). Fit indices of the model supported the factor structure and paths. The AQ-27-T is a reliable measure to assess stigmatizing attitudes in Turkish.

Keywords: attribution questionnaire, validity, reliability, stigma

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Authors: Wei Wen Yang, Emily Chia Yu Su

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Dengue fever is a mosquito-borne tropical infectious disease caused by the dengue virus. After infection, symptoms usually start from three to fourteen days. Dengue virus may cause a high fever and at least two of the following symptoms, severe headache, severe eye pain, joint pains, muscle or bone pain, vomiting, feature skin rash, and mild bleeding manifestation. In addition, recovery will take at least two to seven days. Dengue fever has rapidly spread in tropical and subtropical areas in recent years. Several phenomena around the world such as global warming, urbanization, and international travel are the main reasons in boosting the spread of dengue. In Taiwan, epidemics occur annually, especially during summer and fall seasons. On the other side, Singapore government also has announced the amounts number of dengue cases spreading in Singapore. As the serious epidemic of dengue fever outbreaks in Taiwan and Singapore, countries around the Asia-Pacific region are becoming high risks of susceptible to the outbreaks and local hub of spreading the virus. To improve public safety and public health issues, firstly, we are going to use Microsoft Excel and SAS EG to do data preprocessing. Secondly, using support vector machines and decision trees builds predict model, and analyzes the infectious cases between Taiwan and Singapore. By comparing different factors causing vector mosquito from model classification and regression, we can find similar spreading patterns where the disease occurred most frequently. The result can provide sufficient information to predict the future dengue infection outbreaks and control the diffusion of dengue fever among countries.

Keywords: dengue fever, Taiwan, Singapore, Aedes aegypti

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Authors: Akudo Ejelonu, Sarah Willig, J. Anthony Sauder, Heather Murphy, Frances Shofer

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Background: The high prevalence of diarrheal diseases in the village of Tzununá, Guatemala is linked to lack of sanitation facilities and handwashing practices. Diarrheal diseases are preventable and improved access to latrines, hygiene education and clean water may improve sanitation by reducing the spread of disease. Objective: Between May 2015-January 2017, the University of Pennsylvania Chapter of Engineers Without Border (PennEWB) and local partners designed an intervention to reduce diarrheal disease by building pour flush latrines in 50 individual households and providing education on the importance of handwashing practice. Design/Methods: Through convenient sampling, we surveyed 45 households to evaluate the community’s knowledge of diarrheal disease, handwashing practices, and maintenance of the latrines. Results: 92% of the study participants experienced decrease of new cases of diarrheal disease after receiving a latrine. Only 11% washed their hands after defecating in the latrine. There was gap in understanding the health outcome of latrine sanitation and handwashing education. The respondents did not connect the reduction of diarrheal disease with latrine use and maintenance. Instead, they associated their motivation for latrine use with aesthetics, proximity to their home, ease and comfort, and reduction of shame. We recommend that PennEWB adopt UNICEF or WHO education on hand washing practice. Conclusion: Social interaction and social pressure drove the household use of latrines. The latrines are being valued and cleaned. The education that the residents received did not target norms and behaviors. Latrines could be used to create a new social norm that supports behavioral change.

Keywords: diarrheal disease, latrine, open defecation, water, sanitation and hygiene

Procedia PDF Downloads 156

Authors: Piluntana Panpluem, Monticha Putsakum

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The objectives of this study were to investigate 1) consumers’ behaviors in buying organic products; and 2) the relationships between personal factors, cultural factors, social factors, psychological factors and marketing mix factors, and the behavior in buying organic products of consumers in the greater Bangkok metropolitan area. The sample group was 400 consumers at the age of 15 and older, who bought organic agricultural products from green markets and green shops in Bangkok, including its suburbs. The data were collected by using a questionnaire, which were analyzed by descriptive statistics and chi-square test. The results showed that the consumers bought 3 – 4 types of fresh vegetables with a total expenditure of less than 499 Baht each time. They purchased organic products mainly at a supermarket, 2 – 4 times per month, most frequently on Sundays, which took less than 30 minutes of shopping each time. The purpose of the purchase was for self-consuming. Gaining or retaining good health was the reason for the consumption of the products. Additionally, the first considered factor in the organic product selection was the quality. The decisions in purchasing the products were made directly by consumers, who were influenced mainly by advertising media on television. For the relationships among personal, cultural, social, psychological and marketing mix factors, and consumers’ behavior in buying organic products, the results showed the following: 1) personal factors, which were gender, age and educational level, were related to the behavior in terms of “What”, “Why”, and “Where” the consumers bought organic products (p<0.05); 2) cultural factors were related to “Why” the consumers bought organic products (p<0.05); 3) social factors were related to “Where” and “How” the consumers bought organic products (p<0.05); 4) psychological factors were related to “When” the consumers bought organic products (p<0.05). 5) For the marketing mix factors, “Product” was related to “Who participated” in buying, “What” and “Where” the consumers bought organic products (p<0.05), while “Price” was related to “What” and “When” the consumers bought organic products (p<0.05). “Place” was related to “What” and “How” the consumers bought organic products (p<0.05). Furthermore, “Promotion” was related to “What” and “Where” the consumers bought organic products (p<0.05).

Keywords: consumer behavior, organic products, Bangkok Metropolis and Vicinity

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Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa

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HIV/AIDS has been a long-term condition worldwide, which does not only affect physical health but also causes psychological and social challenges in people living with this condition. In Sub-Saharan countries, namely; Nigeria, Uganda, Zimbabwe and South Africa, people living with HIV/AIDS come across different challenges especially after one has disclosed his/her status. They experience stigma and discrimination, isolation, lack of accessing and receiving treatment, lack of support and experience psychological distress. By using the evidence-based systematic review as a form of methodology, journal articles, dissertations, internet, and books were explored. This paper seeks to describe the challenges faced by people living with HIV/AIDS after disclosure, which forms a critical component of HIV/AIDS prevention and treatment interventions. The disclosure process model is used to underpin the study. This theory allows one to understand when and why interpersonal and verbal self-disclosure is beneficial for individuals who live with concealable stigmatized identities such as HIV/AIDS. Literature findings advocate that both negative and positive results were noted after disclosing one’s HIV status and psychosocial well-being of the majority of people living with HIV/AIDS also get affected especially in societies which subscribe HIV/AIDS pandemic to witchcraft. As for the infected homosexuals, research indicates that they suffer in silence and to cover their emotional emptiness due to ostracism, they often report low- self-efficacy with regard to condom use and become susceptible to reinfections which further place their lives at heightened risk for low immune system. In this regard, this paper challenges the policies which protect the dignity of people living with HIV/AIDS and calls for unity and financial support in favour of psychoeducational programmes and support groups aimed at curbing discrimination.

Keywords: disclosure, discrimination, homosexuality, self-efficacy

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Authors: Soufiane Fal, Abderahim Aasfar, Ali Ouhssain, Hasnae Choukri, Abelaziz Smouni, Hicham El Arroussi

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Heavy metals contamination is a major environmental concern around the world. It has a harmful impact on plant productivity and poses a serious risk to humans and animals health. In the present study, the effect of Microalgae Crude Extract (MCE) on tomato growth and nutrients uptake exposed to 2 mM Pb2+ and Cd2+ was investigated. In results, 2 mM Pb2+ and Cd2+ showed a significant reduction of tomatobiomass and perturbation in nutrients absorption. Moreover, MCE application in tomato plant exposed to Pb2+ and Cd2+ showed a significant enhancement of biomass compared to tomato plants under Pb2+ and Cd2+. On the other hand, MCE application favoured heavy metals accumulation in root and inhibited their translocation to shoot as phytostabilisation mechanism. Tomato plants showed biochemical responses to Pb2+ and Cd2+ stress with elevation of scavenging enzymes and molecules such as POD, CAT, SOD, Proline, and polyphenols, etc. In addition, the treatment by MCE showed a significant reduction level of the majority of these parameters. Furthermore, the metabolomic analysis revealed a significant change in important metabolites. Pb2+ and Cd2+ showed decrease in SFA and increase of UFA, VLFA, alkanes, alkenes, sterols, which known accumulated as tolerance and resistance mechanism to heavy metal (H.M) stress. However, MCE treatment showed the inverse of these response to return tomato plants to normal state and enhanced tolerance and resistance to heavy metal stress. In the present study, we emphasized that MCE can alleviate H.M stress, enhance tomato plant growth nutrients absorption and improve biochemical responses.

Keywords: microalgae crude extract, heavy metal stress, nutrient uptake, metabolomic analysis, solanum lycopersicum (Tomato), phytostabilisation

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Authors: P. Acosta-Santamaría, A. Ibatá-Soto, A. López-Vásquez

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Organic compounds in wastewaters coming from textile and pharmaceutical industry generated multiple harmful effects on the environment and the human health. One of them is the methyl orange (MeO), an azoic dye considered to be a recalcitrant compound. The heterogeneous photocatalysis emerges as an alternative for treating this type of hazardous compounds, through the generation of OH radicals using radiation and a semiconductor oxide. According to the author’s knowledge, catalysts such as TiO₂ doped with metals show high efficiency in degrading MeO; however, this presents economic limitations on industrial scale. Black sand can be considered as a naturally doped catalyst because in its structure is common to find compounds such as titanium, iron and aluminum oxides, also elements such as zircon, cadmium, manganese, etc. This study reports the photocatalytic activity of the mineral black sand used as semiconductor in the discoloration of MeO by oxidation and reduction photocatalytic techniques. For this, magnetic composites from the mineral were prepared (RM, M1, M2 and NM) and their activity were tested through MeO discoloration while TiO₂ was used as reference. For the fractions, chemical, morphological and structural characterizations were performed using Scanning Electron Microscopy with Energy Dispersive X-Ray (SEM-EDX), X-Ray Diffraction (XRD) and X-Ray Fluorescence (XRF) analysis. M2 fraction showed higher MeO discoloration (93%) in oxidation conditions at pH 2 and it could be due to the presence of ferric oxides. However, the best result to reduction process was using M1 fraction (20%) at pH 2, which contains a higher titanium percentage. In the first process, hydrogen peroxide (H₂O₂) was used as electron donor agent. According to the results, black sand mineral can be used as natural semiconductor in photocatalytic process. It could be considered as a photocatalyst precursor in such processes, due to its low cost and easy access.

Keywords: black sand mineral, methyl orange, oxidation, photocatalysis, reduction

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Authors: Morlu Stevens, Bareki Batlokwa

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The use of treated wastewater is widely employed to compensate for the scarcity of safe and uncontaminated freshwater. However, the existence of toxic heavy metal ions in the wastewater pose a health hazard to animals and the environment, hence, the importance for an effective technique to tackle the challenge. A multi-templated ion imprinted sorbent (Fe,Ni,Cu-IIP) for the simultaneous removal of heavy metal ions from waste water was synthesised employing molecular imprinting technology (MIT) via thermal free radical bulk polymerization technique. Methacrylic acid (MAA) was employed as the functional monomer, and ethylene glycol dimethylacrylate (EGDMA) as cross-linking agent, azobisisobutyronitrile (AIBN) as the initiator, Fe, Ni, Cu ions as template ions, and 1,10-phenanthroline as the complexing agent. The template ions were exhaustively washed off the synthesized polymer by solvent extraction in several washing steps, while periodically increasing solvent (HCl) concentration from 1.0 M to 10.0 M. The physical and chemical properties of the sorbents were investigated using Fourier Transform Infrared Spectroscopy (FT-IR), X-ray Diffraction (XRD) and Atomic Force Microscopy (AFM) were employed. Optimization of operational parameters such as time, pH and sorbent dosage to evaluate the effectiveness of sorbents were investigated and found to be 15 min, 7.5 and 666.7 mg/L respectively. Selectivity of ion-imprinted polymers and competitive sorption studies between the template and similar ions were carried out and showed good selectivity towards the targeted metal ion by removing 90% - 98% of the templated ions as compared to 58% - 62% of similar ions. The sorbents were further applied for the selective removal of Fe, Ni and Cu from real wastewater samples and recoveries of 92.14 ± 0.16% - 106.09 ± 0.17% and linearities of R2 = 0.9993 - R2 = 0.9997 were achieved.

Keywords: ion imprinting, ion imprinted polymers, heavy metals, wastewater

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Authors: R. Barros, J. Azevedo, P. Padrão, M. Gregório, I. Pádua, C. Almeida, C. Rodrigues, P. Fontes, A. Coelho

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Recent evidence shows a positive association between nutritional literacy and healthy eating. Traditional nutrition education strategies for childhood obesity prevention have shown weak effect. The Nutriscience project aims to create and evaluate an innovative and multidisciplinary strategy for promoting effective and accessible nutritional information to children, their families, and educators. Nutriscience is a one-year prospective follow-up evaluation study including pre-school children (3-5 y), who attend national schools’ network (29). The project is structured around a web-based intervention, using an on-line interactive platform, and focus on increasing fruit and vegetable consumption, and reducing sugar and salt intake. The platform acts as a social network where educational materials, games, and nutritional challenges are proposed in a gamification approach that promotes family and community social ties. A nutrition Massive Online Open Course is developed for educators, and a national healthy culinary contest will be promoted on TV channel. A parental self-reported questionnaire assessing sociodemographic and nutritional literacy (knowledge, attitudes, skills) is administered (baseline and end of the intervention). We expect that results on nutritional literacy from the presented strategy intervention will give us important information about the best practices for health intervention with kindergarten families. This intervention program using a digital interactive platform could be an educational tool easily adapted and disseminated for childhood obesity prevention.

Keywords: childhood obesity, educational tool, nutritional literacy, web-based intervention

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Authors: Nasir Ullah

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Marketing strategies are important factors in the success of a company. Local pharmaceutical companies in Pakistan face several issues, such as low-level budgets, lack of skilled human resources, and challenges to competing with multinational competitors that have negative impacts on their success. However, still there exist local companies with great levels of success in the pharmaceutical sector. This study aims to evaluate the marketing strategies of successful local companies in the pharmaceutical sector of Khyber Pakhtunkhwa, Pakistan. The study employed a constructivist approach to know about successful strategies of the marketing managers that worked well. For this purpose, in-depth interviews were conducted with marketing managers of four pharmaceutical companies which were deemed as successful on the basis of their annual target achievements. Thematic analysis was conducted using Nvivo to devise major themes from the collected data. Four major themes or successful strategies were identified. These are i) share in the profit to marketing and sales staff, ii) invitation to the doctors for participation in free medical camps and health awareness seminars, iv) incentives for the Doctors and retailers, v) utilization of traditional capital (local social relationships) by the marketing officers. The study concludes that profit share to the employees, valuing doctors through their involvement and utilization of traditional capital are the successful marketing strategies of the successful pharmaceutical companies in the Pakhtun society of Pakistan. The study suggests hiring local staff that can utilize their traditional capital to influence doctors' decisions regarding the prescription of their medicine to the patients. The study also suggests profit share or increased bonuses to the marketing and sales staff as a measure of success.

Keywords: successful marketing strategies, pharmaceutical industry, traditional social capital, local companies

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Authors: Vedat Kurt, Tansel Koyunoglu, Gamze Kurt, Ozgen Aras

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Low back pain is one of the most common health problem in public. Common symptoms that can be associated with low back pain include; pain, functional disability, gait disturbances. The aim of the study was to investigate the differences between disability scores and gait parameters in subjects with low back pain. Sixty participants are included in our study, (35 men, 25 women, mean age: 37.65±10.02 years). Demographic characteristics of participants were recorded. Pain (visual analog scale) and disability level (Oswestry Disability Index(ODI)) were evaluated. Gait parameters were measured with Zebris-FDM-2 platform. Independent samples t-test was used to analyse the differences between subjects with under 40 points (n=31, mean age:35.8±11.3) and above 40 points (n=29, mean age:39.6±8.1) of ODI scores. Significant level in statistical analysis was accepted as 0.05. There was no significant difference between the ODI scores and groups’ ages. Statistically significant differences were found in step width between subjects with under 40 points of ODI and above 40 points of ODI score(p < 0.05). But there were non-significant differences with other gait parameters (p > 0.05). The differences between gait parameters and pain scores were not statistically significant (p > 0.05). Researchers generally agree that individuals with LBP walk slower and take shorter steps and have asymmetric step lengths when compared with than their age-matched pain-free counterparts. Also perceived general disability may have moderate correlation with walking performance. In the current study, the patients classified as minimal/moderate and severe disability level by using ODI scores. As a result, a patient with LBP who have higher disability level tends to increase support surface. On the other hand, we did not find any relation between pain intensity and gait parameters. It may be caused by the classification system of pain scores. Additional research is needed to investigate the effects of functionality level and pain intensity on gait in subjects with low back pain under different classification types.

Keywords: functionality, low back pain, gait, pain

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Authors: Ragi Poyyara, V. Vivek, Ashish Khaparde

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The Product Development Process (PDP) in the technology group plays a very important role in the launch of any product. While a manufacturing process encourages the use of certain measures to reduce Health, Safety and Environmental (HSE) risks on the shop floor, the PDP concentrates on the use of Geometric Dimensioning and Tolerancing (GD&T) to develop a flawless design. Furthermore, PDP distributes and coordinates activities between different departments such as marketing, purchasing, and manufacturing. However, it is seldom realized that PDP makes a significant contribution to developing a product that reduces HSE risks by encouraging the Technology group to use effective GD&T. The GD&T is a precise communication tool that uses a set of symbols, rules, and definitions to mathematically define parts to be manufactured. It is a quality assurance method widely used in the oil and gas sector. Traditionally it is used to ensure the interchangeability of a part without affecting its form, fit, and function. Parts that do not meet these requirements are rejected during quality audits. This paper discusses how the Technology group integrates this quality assurance tool into the PDP and how the tool plays a major role in helping the HSE department in its goal towards eliminating HSE incidents. The PDP involves a thorough risk assessment and establishes a method to address those risks during the design stage. An illustration shows how GD&T helped reduce safety risks by ergonomically improving assembling operations. A brief discussion explains how tolerances provided on a part help prevent finger injury. This tool has equipped Technology to produce fixtures, which are used daily in operations as well as manufacturing. By applying GD&T to create good fits, HSE risks are mitigated for operating personnel. Both customers and service providers benefit from reduced safety risks.

Keywords: HSE risks, product development process, geometric dimensioning and tolerances, mechanical engineering

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Authors: C. G. Shashi Kumar, G. Arun Maiya, H. Manjunath Hande, K. V. Rajagopal

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Background: Diabetes mellitus (DM) is a metabolic disorder with involvement of neurovascular and muscular system. Studies have documented that the gait parameter is altered in type 2 diabetes mellitus with peripheral neuropathy. However, there is a dearth of literature regarding the gait characteristics in type 2 diabetes mellitus (T2DM) without peripheral neuropathy. Therefore, the present study is focused on identifying gait changes in early type 2 diabetes mellitus without peripheral neuropathy. Objective: To analyze the gait characteristics in Type 2 diabetes mellitus without peripheral neuropathy. Methods: After obtaining ethical clearance from Institutional Ethical Committee (IEC), 36 T2DM without peripheral neuropathy and 32 matched healthy subjects were recruited. Gait characteristics (step duration, gait cycle length, gait cycle duration, stride duration, step length, double stance duration) of all the subjects were analyzed using Windtrack dynamic foot scanner. Data were analyzed using Independent‘t’ test to find the difference between the groups (step duration, gait cycle length, gait cycle duration) and Mann-Whitney test was used to analyze the step length and double stance duration to find difference between the groups. Level of significance was kept at P<0.05. Results: Result analysis showed significant decrease in step duration, gait cycle length, gait cycle duration, step length, double stance duration in T2DM subjects as compared to healthy subjects. We also observed a mean increase in stride duration in T2DM subjects compared to healthy subjects.

Keywords: type 2 diabetes mellitus, dynamic foot scan, gait characteristics, medical and health sciences

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Authors: John E. Muñoz, Jose F. Lopez, David S. Lopez

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Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that affects 1 out of 5 Colombian children, converting into a real public health problem in the country. Conventional treatments such as medication and neuropsychological therapy have been proved to be insufficient in order to decrease high incidence levels of ADHD in the principal Colombian cities. This work demonstrates a design and development of a videogame that uses a brain computer interface not only to serve as an input device but also as a tool to monitor neurophysiologic signal. The video game named “The Harvest Challenge” puts a cultural scene of a Colombian coffee grower in its context, where a player can use his/her avatar in three mini games created in order to reinforce four fundamental aspects: i) waiting ability, ii) planning ability, iii) ability to follow instructions and iv) ability to achieve objectives. The details of this collaborative designing process of the multimedia tool according to the exact clinic necessities and the description of interaction proposals are presented through the mental stages of attention and relaxation. The final videogame is presented as a tool for sustained attention training in children with ADHD using as an action mechanism the neuromodulation of Beta and Theta waves through an electrode located in the central part of the front lobe of the brain. The processing of an electroencephalographic signal is produced automatically inside the videogame allowing to generate a report of the theta/beta ratio evolution - a biological marker, which has been demonstrated to be a sufficient measure to discriminate of children with deficit and without.

Keywords: BCI, neuromodulation, ADHD, videogame, neurofeedback, theta/beta ratio

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Authors: Aanshika Puri, Sakshi Mehrotra

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Technology has always been a double edged sword. The constant rut of updating oneself to a better and newer version is the new norm. ‘Being Online’ is the latest addition to one’s everyday routine. Availability of various social online platforms being served on a platter topped with easy and cheap access to the internet makes it simple and doable for people of all social backgrounds. Interestingly, in India, a recent development is the line of demarcation between people from varied backgrounds, doing the vanishing act. One finds everybody on at least one, if not more, social platforms in a desire to stay connected. For instance, this ranges from sending a ‘WhatsApp’ message to a vegetable vendor for ordering your daily needs to vendors and small entrepreneurs. Even a rickshaw puller now has access to a mobile phone, an internet connection and apps/ platforms to stay connected. Recent observations show the extent to which everyone is hooked on to their mobile phones/ tabs/ laptops/ etc. Young mothers use them to distract their children and keep them busy while they finish the task at hand. Exposure to this part of the technology at such a tender age requires responsible and careful handling. Talking of adolescents, their self- image depends on their online social image to a large extent. There is a desire to be liked and accepted by the peer group at all times. Cyber-bullying is a by-product of the 24/7 availability of these resources. There is enough research-based evidence to prove the psychosocial and emotional impact on the development and well-being of the victim. The present paper attempts to understand the dynamics of cyber bullying vis-à-vis the developmental and mental health issues faced by the bully.

Keywords: Developmental Psychology, Empathy & Resilience Based Interventions, Mental Well-Being of Cyber Bully, Positive Psychology

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Authors: Seema Ahlawat, Parul Saxena, Malik Zainul Abdin

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Malaria is a major health problem in many developing countries. The parasite responsible for the vast majority of fatal malaria infections is Plasmodium falciparum. Unfortunately, most Plasmodium strains including P. falciparum have become resistant to most of the antimalarials including chloroquine, mefloquine, etc. To combat this problem, WHO has recommended the use of artemisinin and its derivatives in artemisinin based combination therapy (ACT). Due to its current use in artemisinin based-combination therapy (ACT), its global demand is increasing continuously. But, the relatively low yield of artemisinin in A. annua L. plants and unavailability of economically viable synthetic protocols are the major bottlenecks for its commercial production and clinical use. Chemical synthesis of artemisinin is also very complex and uneconomical. The hairy root system, using the Agrobacterium rhizogenes LBA 9402 strain to enhance the production of artemisinin in A. annua L., is developed in our laboratory. The transgenic nature of hairy root lines and the copy number of trans gene (rol B) were confirmed using PCR and Southern Blot analyses, respectively. The effect of different concentrations of Piriformospora indica on artemisinin production in hairy root cultures were evaluated. 3% P. indica has resulted 1.97 times increase in artemisinin production in comparison to control cultures. The effects of P. indica on artemisinin production was positively correlated with regulatory genes of MVA, MEP and artemisinin biosynthetic pathways, viz. hmgr, ads, cyp71av1, aldh1, dxs, dxr and dbr2 in hairy root cultures of A. annua L. Mass scale cultivation of A. annua L. hairy roots by plant tissue culture technology may be an alternative route for production of artemisinin. A comprehensive investigation of the hairy root system of A. annua L. would help in developing a viable process for the production of artemisinin. The efficiency of the scaling up systems still needs optimization before industrial exploitation becomes viable.

Keywords: A. annua L., artemisinin, hairy root cultures, malaria

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Authors: Maryam Karimi, Rouzbeh Nazari

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Introduction: Understanding thermal distribution in the micro-urban climate has now been necessary for urban planners or designers due to the impact of complex micro-scale features of Urban Heat Island (UHI) on the built environment and public health. Hence, understanding the interrelation between urban components and thermal pattern can assist planners in the proper addition of vegetation to build-environment, which can minimize the UHI impact. To characterize the need for urban green infrastructure (UGI) through better urban planning, this study proposes the use of RayMan model to measure the impact of air quality and increased temperature based on urban morphology in the selected metropolitan cities. This project will measure the impact of build environment for urban and regional planning using human biometeorological evaluations (Tmrt). Methods: We utilized the RayMan model to estimate the Tmrt in an urban environment incorporating location and height of buildings and trees as a supplemental tool in urban planning and street design. The estimated Tmrt value will be compared with existing surface and air temperature data to find the actual temperature felt by pedestrians. Results: Our current results suggest a strong relationship between sky-view factor (SVF) and increased surface temperature in megacities based on current urban morphology. Conclusion: This study will help with Quantifying the impacts of the built environment and surface properties on surrounding temperature, identifying priority urban neighborhoods by analyzing Tmrt and air quality data at the pedestrian level, and characterizing the need for urban green infrastructure cooling potential.

Keywords: built environment, urban planning, urban cooling, extreme heat

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Authors: Nargiza Nuralieva

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The study delves into assessing the influence of mindfulness and mental resilience training on the cognitive performance and stress management of pilots. Employing a meticulous literature search across databases such as Medline and Google Scholar, the study used specific keywords to target a wide array of studies. Inclusion criteria were stringent, focusing on peer-reviewed studies in English that utilized designs like randomized controlled trials, with a specific interest in interventions related to mindfulness or mental resilience training for pilots and measured outcomes pertaining to cognitive performance and stress management. The initial literature search identified a pool of 123 articles, with subsequent screening resulting in the exclusion of 77 based on title and abstract. The remaining 54 articles underwent a more rigorous full-text screening, leading to the exclusion of 41. Additionally, five studies were selected from the World Health Organization's clinical trials database. A total of 11 articles from meta-analyses were retained for examination, underscoring the study's dedication to a meticulous and robust inclusion process. The interventions varied widely, incorporating mixed approaches, Cognitive behavioral Therapy (CBT)-based, and mindfulness-based techniques. The analysis uncovered positive effects across these interventions. Specifically, mixed interventions demonstrated a Standardized Mean Difference (SMD) of 0.54, CBT-based interventions showed an SMD of 0.29, and mindfulness-based interventions exhibited an SMD of 0.43. Long-term effects at a 6-month follow-up suggested sustained impacts for both mindfulness-based (SMD: 0.63) and CBT-based interventions (SMD: 0.73), albeit with notable heterogeneity.

Keywords: mindfulness, mental resilience, pilots, cognitive performance, stress management

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Authors: Ali Taheri Mirghaed, Sara Ahani, Ashkan Zargar, Seyyed Morteza Hoseini

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Diseases are the major challenges in intensive aquaculture that cause significant annual losses. Antibiotic-therapy is a common way to control bacterial disease in fish, and oxytetracycline (OTC) is the only oral antibiotic in aquaculture approved FDA. OTC has been found to have negative effects on fish, such as oxidative stress and immune-suppression, thus, it is necessary to mitigate such effects. Medicinal herbs have various benefits on fish, including antioxidant, immunostimulant, and anti-microbial effects. Therefore, we hypothesized if dietary ginger meal (GM) interacts with dietary OTC by monitoring plasma protein fractions in rainbow trout. The study was conducted as a 2 × 2 factorial design, including diets containing 0 and 1% GM and 0 and 1.66 % OTC (corresponding to 100 mg/kg fish biomass per day). After ten days treating the fish (60 g individual weight) with these feeds, blood samples were taken from al treatments (n =3). Plasma was separated by centrifugation, and protein fractions were determined by electrophoresis. The results showed that OTC and GM had interaction effects on total protein (P<0.001), albumin (P<0.001), alpha-1 fraction (P=0.010), alpha-2 fraction (P=0.001), beta-2 fraction (P=0.014), and gamma fraction (P<0.001). Beta-1 fraction was significantly (P=0.030) affected by dietary GM. GM decreased plasma total protein, albumin, and beta-2 but increased beta-1 fraction. OTC significantly decreased total protein (P<0.001), albumin (P=0.001), alpha-2 fraction (P<0.001), beta-2 fraction (P=0.004), and gamma fraction (P<0.001) but had no significant effects on alpha-1 and beta-1 fractions. Dietary GM inhibited/suppressed the effects of dietary OTC on the plasma total protein and protein fractions. In conclusion, adding 1% GM to diet can mitigate the negative effects of dietary OTC on plasma proteins. Thus, GM may boost health of rainbow trout during the period of medication with OTC.

Keywords: ginger, plasma protein electrophoresis, dietary additive, rainbow trout

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Authors: Man Wai Leung, Margaret O’Donoghue, Lorna K. P. Suen

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Personal and household hygiene measures are important to prevent upper respiratory tract infections (URTIs) and other infectious diseases, including coronavirus disease 2019 (COVID-19). An online survey recruited 414 eligible parents in Hong Kong to study their hygiene knowledge, attitudes, and practices (KAP) in the prevention of URTIs among their children. The average knowledge score was high (10.2/12.0), but some misconceptions were identified. The majority of participants agreed that good personal hygiene (93.5%) and good environmental hygiene (92.8%) can prevent URTIs. The average score for hand hygiene practices was high (3.78/4.00), but only 56.8% of parents always perform hand hygiene before touching their mouth, nose, or eyes. For environmental hygiene, only some household items were disinfected with disinfectants (69.8%: door handles, 60.4%: toilet seats, 42.8%: floor, 24.2%: dining chairs, 20.5%: dining tables). Higher knowledge score was associated with parents having a tertiary educational level or above, working as healthcare professionals, living at private residential flat or staff quarter, and having a household income of $70,000 or above. Hand hygiene practices varied significantly with parents’ age and income. During the 5th wave of the COVID-19 epidemic, misconceptions about hygiene knowledge were found among parents. Health promotion programs should target parents, especially those who are in old age, obtain lower educational levels, live in public housing, or have a lower income. Hand hygiene moments and proper use of disinfectants could be one of the targeted educational topics.

Keywords: hygiene, upper respiratory tract infection, parents, children, COVID-19

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Authors: Luo Guidong, Song Hang, Jim Song, Virginia Martin Torrejon

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Due to their excellent properties, polymer packaging foams have become increasingly essential in our current lifestyles. They are cost-effective and lightweight, with excellent mechanical and thermal insulation properties. However, they constitute a major environmental and health concern due to litter generation, ocean pollution, and microplastic contamination of the food chain. In recent years, considerable efforts have been made to develop more sustainable alternatives to conventional polymer packaging foams. As a result, biobased and compostable foams are increasingly becoming commercially available, such as starch-based loose-fill or PLA trays. However, there is still a need for bulk manufacturing of bio-foams planks for packaging applications as a viable alternative to their fossil fuel counterparts (i.e., polystyrene, polyethylene, and polyurethane). Gelatin is a promising biopolymer for packaging applications due to its biodegradability, availability, and biocompatibility, but its mechanical properties are poor compared to conventional plastics. However, as widely reported for other biopolymers, such as starch, the mechanical properties of gelatin-based bioplastics can be enhanced by formulation optimization, such as the incorporation of fibres from different crops, such as bamboo. This research aimed to produce gelatin-bamboo fibre foams by mechanical foaming and to study the effect of fibre content on the foams' properties and structure. As a result, foams with virtually no shrinkage, low density (<40 kg/m³), low thermal conductivity (<0.044 W/m•K), and mechanical properties comparable to conventional plastics were produced. Further work should focus on developing formulations suitable for the packaging of water-sensitive products and processing optimization, especially the reduction of the drying time.

Keywords: biobased and compostable foam, sustainable packaging, natural polymer hydrogel, cold chain packaging

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Authors: Foluke Abimbola

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There are two separate groups of a recognised body of human rights. These are known as Civil and Political Rights, and Economic and Social Rights. There is however an impression that civil and political rights are enforceable in courts while socio-economic rights are not. Nigeria is an example of one of such countries whose constitution has social, economic and cultural rights’ provisions as well as civil and political rights. However, the socio-economic rights provided in the Nigerian constitution are not justiciable or are unenforceable in a court of law. On the other hand, a comparative examination of the socio-economic right provisions in the South African constitution and judgments of the constitutional court of South Africa reveals that socio-economic rights may be enforceable. This position may ensure the protection of the socio-economic rights of the poor and vulnerable groups. These rights include the rights to food, adequate shelter, health, and education. Moreover, the African Charter on Human and Peoples’ Rights (African Charter) which incorporates similar socio-economic right provisions, has been recognized as a domestic law in Nigeria and its provisions are enforceable by the domestic courts by virtue of the African Charter on Human and People’s Rights (Ratification and Enforcement) Act Cap A9 Laws of the Federation of Nigeria 2004. It is not only a regional treaty signed and adopted by Nigeria but has been passed into law by the National Assembly and can be enforced like any other local law. This paper will propose that in view of the provisions of the African Charter and mechanisms for implementation as well as other international conventions and national constitutional provisions on human rights, domestic courts may be able to assess state responsibilities in the light of socio-economic rights. Cases decided by South African courts and other jurisdictions will be discussed in order to lend weight to the notion that socio-economic rights can be enforced in jurisdictions such as Nigeria even though the constitution provides otherwise.

Keywords: african charter, constitutional court of south africa, nigerian constitution, socio-economic rights, south african constitution

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Authors: Alyaa Abdlwahab

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Cutaneous leishmaniasis represents a serious health problem in Syria; this problem has become noticeably aggravated after the civil war in the country. Leishmania tropica parasite is the main cause of cutaneous leishmaniasis in Syria. In order to control the disease, we need an effective vaccine against leishmania parasite. DNA vaccination remains one of the favorable approaches that have been used to face cutaneous leishmaniasis. Ribosomal protein S4 is responsible for important roles in Leishmania parasite life. DNA vaccine based on S4 gene has been used against infections by many species of Leishmania parasite but leishmania tropica parasite, so this gene represents a good candidate for DNA vaccine construction. After proving the existence of ribosomal protein S4 gene in a Syrian strain of Leishmania tropica (LCED Syrian 01), sequencing it and cloning it into pCI plasmid, BALB/C mice were inoculated with pCI-S4 DNA vaccine. The immune response was determined by monitoring the lesion progression in inoculated BALB/C mice for six weeks after challenging mice with Leishmania tropica (LCED Syrian 01) parasites. IL-12, IFN-γ, and IL-4 were quantified in draining lymph nodes (DLNa) of the immunized BALB/C mice by using the RT-qPCR technique. The parasite burden was calculated in the final week for the footpad lesion and the DLNs of the mice. This study proved the existence and the expression of the ribosomal protein S4 gene in Leishmania tropica (LCED Syrian 01) promastigotes. The sequence of ribosomal protein cDNA S4 gene was determined and published in Genbank; the gene size was 822 bp. Expression was also demonstrated at the level of cDNA. Also, this study revealed that pCI-S4 DNA vaccine induces TH1\TH2 response in immunized mice; this response prevents partially developing a dermal lesion of Leishmania.

Keywords: ribosomal protein S4, DNA vaccine, Leishmania tropica, BALB\c

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Authors: Afshin Azari, Farzad Peiravian, Nazila Yousefi

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Introduction: Community pharmacies have been always played an important role in public health. Therefore, having a decent service provided by these pharmacies is of paramount importance for the healthcare system. The issue of pharmacy ownership and its possible impact on the quality of services and amount of violations has been argued for many years, and there are different opinions around this debate. Since, so far, no scientific research has been performed to investigate this issue in Iran, this study aimed to examine the differences between these two types of pharmacies ownership in terms of violations and service quality. Method: This study investigates the impact of two different kinds of pharmacy ownership (pharmacists and non-pharmacist’s ownership) on the pharmacies’ amount of violations and services quality. Pharmacies’ amount of violations was examined using “pharmacy inspection reports” between September 2018 and September 2019, in their distinguishable categories: minor, major and critical violations. Then, service quality was examined using a questionnaire from the perspective of pharmacy customers. Results: Considering violations, there was no evidence to prove a significant relationship between critical violations and major violations with the type of pharmacy ownership. However, in minor violations, the average of violations was higher in pharmacies owned by pharmacists in comparison to their non-pharmacist owned counterparts. Regarding service quality, the results showed that there is no significant relationship between the quality of service and the type of pharmacy ownership. Discussion and Conclusion: In this study, no significant relationship was found between the amount of violations and the type of pharmacy ownership. This could indicate that the pharmacy ownership would not influence the rate of violations. Considering that more inspections have been carried out in non-pharmacist owned pharmacies, it can be concluded that these pharmacies are more under control, and in fact, this monitoring has reduced violations in these pharmacies. The quality of services in the two types of pharmacies were not significantly different from each other, and this shows that non-pharmacist-owned pharmacies also try to maintain the desired level of service in competition with their competitors.

Keywords: pharmacy ownership, quality of service, violation, community pharmacy

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