Search results for: electronic health records

Authors: Jessy Rugeyo, William Donner

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This research delves into the resilience of Rwanda's public health infrastructure amidst natural disasters, a critical issue given that the Northern Province alone has witnessed no fewer than 1500 cases of disaster ranging from floods and landslides in the last five years, with more than 200 people killed and thousands of homes destroyed, according to MINEMA. In an era where climate change escalates the frequency and intensity of such disasters, fortifying the resilience of public health systems is paramount. This study offers a comprehensive analysis of the existing state of Rwanda's public health infrastructure and its ability to manage such crises. Employing a mix of literature review, case studies, and policy analysis, the study discerns key vulnerabilities and brings to light the intricacies of disaster management in Rwanda. Case studies centered around past natural disasters in Rwanda provide critical insights into the strengths and weaknesses of the existing disaster response mechanisms. A thorough critique of related disaster management and public health infrastructure policies reveals areas of commendable practice, along with gaps calling for policy enhancements. Findings guide the proposition of targeted strategies to bolster the resilience of Rwanda's public health infrastructure. This research serves as a significant contribution to the domains of disaster studies and public health, offering valuable insights for policymakers, public health and disaster management professionals in Rwanda and similar contexts. It presents actionable recommendations for improvement, underscoring the potential for enhancing Rwanda's disaster management capacity. By advocating for the strengthening of public health infrastructure resilience, the research highlights the potential for improved public health outcomes following natural disasters, thereby showcasing significant implications for public health and disaster management in the country, particularly in the face of a changing climate.

Keywords: public health infrastructure, disaster resilience, natural disaster, disaster management, emergency preparedness, health policy

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Authors: Reza Zarei

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The result of the present study is to determine the relation between spiritual intelligence and organizational health and job satisfaction among the female staff in Islamic Azad University of Marvdasht. The population of the study includes the female staff and the faculty of Islamic Azad University of Marvdasht. The method is correlational and the instrument in the research is three questionnaires namely the spiritual intelligence by (ISIS), Amraam and Dryer, organizational health by Fieldman and Job satisfaction questionnaire. In order to test the hypotheses we used interpretive statistics, Pearson and regression correlation coefficient. The findings show that there is a significant relation between the spiritual intelligence and organizational health among the female staff of this unit. In addition, the organizational health has a significant relation with the elements of self-consciousness and social skills and on the other hand, job satisfaction is in significant relation with the elements of self-consciousness, self-control, self-provocation, sympathy and social skills in the whole sample regardless of the participants' gender. Finally, the results of multiple regression and variance analysis showed that using the variables of the spiritual intelligence of the female staff could predict the organizational health and their job satisfaction.

Keywords: job satisfaction, spiritual intelligence, organizational health, Islamic Azad University

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Authors: Alexey P. Antropov, Alexander V. Ragutkin, Nicolay A. Yashtulov

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The original controlled technology for power active nanocomposite membrane-electrode assembly engineering on the basis of porous silicon is presented. The functional nanocomposites were studied by electron microscopy and cyclic voltammetry methods. The application possibility of the obtained nanocomposites as high performance renewable energy sources for micro-power electronic devices is demonstrated.

Keywords: cyclic voltammetry, electron microscopy, nanotechnology, platinum-palladium nanocomposites, porous silicon, power activity, renewable energy sources

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Authors: Shu-Lien Chou, Chung-Feng Liu

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Self-health management of chronic illnesses plays an important part in chronic illness treatments. However, various kinds of health information (health education materials) which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients’ use intention could be patients’ perceived Information overload regarding the health information. This study proposed an extended model of Theory of Planned Behavior, which integrating perceived information overload as another construct to explore patients’ use intention of the health information for self-health management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the health information. The cross-sectional study used a structured questionnaire for data collection, focusing on the chronic patients with coronary artery disease (CAD), who are the potential users of the health information, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the questionnaire respondents, and the Partial Least Squares (PLS) structural equation model to study the reliability and construct validity for testing our hypotheses. A total of 110 patients were enrolled in this study and 106 valid questionnaires were collected. The PLS analysis result indicates that the patients’ perceived information overload of health information contributes the most critical factor influencing the behavioral intention. Subjective norm and perceived behavioral control of TPB constructs had significant effects on patients’ intentions to use health information also, whereas the attitude construct did not. This study demonstrated a comprehensive framework, which extending perceived information overload into TPB model to predict patients’ behavioral intention of using heath information. We expect that the results of this study will provide useful insights for studying health information from the perspectives of academia, governments, and healthcare providers.

Keywords: chronic patients, health information, information overload, theory of planned behavior

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Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

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Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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Authors: Eddy K. Mukadi

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The aim of this study was to provide contributing elements to improve the management of the asthma crisis in the intensive care unit of the General Reference Hospital of Kinshasa. This was a descriptive study of all patients in the intensive care unit presenting with the asthma attack during the period from February 5, 2013 to February 5, 2014. The main data were obtained from consultation registry and medical records. A total of 35 patients, 21 of whom were male (majority) compared to 14 female. Average age of patients was 46.48 plus or minus 16.98 with extremes ranging from 21-75 years. The clinic was dominated by dyspnea in 100% of cases, followed by rales with 91.4% of cases. In spite of the control of the crisis obtained after the treatment with B2 mimetic by inhalation was introduced A 91.5%; 88% corticosteroids; 80% oxygen, the therapeutic principle recommended for the management of asthma attacks was not respected in the majority of cases. This is why we suggest that improving the quality of care to be administered to patients will yield more adequate results.

Keywords: asthma crisis, intensive care, general hospital, Kinshasa

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Authors: M. Ezati Kooshki , H. Pourmohamad

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Leaf spring dampers are used for commercial vehicles and heavy tracks. The main function of this damper in these vehicles is protection against damage and providing comfort for drivers by creating suspension between road and vehicle. This paper presents a new device, circular leaf spring damper, which is frequently used on vehicles, aiming to gain seismic protection of structures. Finite element analyses were conducted on several one-story structures using finite element software (Abaqus, v6.10-1). The time history analysis was conducted on the records of Kobe (1995) and San Fernando (1971) ground motions to demonstrate the advantages of using leaf spring in structures as compared to simple bracing system. This paper also suggests extending the use of this damper in structures, considering its large control force despite high cycle fatigue properties and low prices.

Keywords: bracing system, finite element analysis, leaf spring, seismic protection, time history analysis

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Authors: Tony Cripps, Larry Kimber

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This paper will begin by briefly explaining how blockchain technology works. Then, after highlighting a few of the ways it promises to heavily impact all aspects of the digital landscape, the focus will shift to Blockchain in the field of education, with specific emphasis placed on practical applications in foreign language education. Blockchain is a decentralized Internet-based software application that guarantees truth in transactions. This means whenever two parties engage in a transaction using Blockchain, it is time-stamped, added to a block of other transactions, and then permanently attached to an unalterable ‘chain’ of blocks. The potential for developing applications with Blockchain is therefore immense, since software systems that ensure the impossibility of outside tampering are invaluable. Innovative ideas in every imaginable domain are presently being entertained and Blockchain in education is no exception. For instance, records kept within and between institutions of students’ grade performance, academic achievement and verification of assignment/course completion are just a few examples of how this new technology might potentially be used to revolutionize education. It is hoped that this paper will be of use to all educators interested in the application of technology in the field of education.

Keywords: blockchain, disruption, potential, technology

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Authors: Haslinda Nahazanan, Afshin Asadi, Zainuddin Md. Yusoff, Nik Nor Syahariati Nik Daud

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Mudrocks is considered as a problematic material due to their unexpected behaviour specifically when they are contacting with water or being exposed to the atmosphere. Many instability problems of cutting slopes were found lying on high slaking mudrocks. It has become one of the major concerns to geotechnical engineer as mudrocks cover up to 50% of sedimentary rocks in the geologic records. Mudrocks display properties between soils and rocks which can be very hard to understand. Therefore, this paper aims to review the definition, mineralogy, geo-chemistry, classification and engineering properties of mudrocks. As water has become one of the major factors that will rapidly change the behaviour of mudrocks, a review on the shear strength of mudrocks in Derbyshire has been made using a fully automated hydraulic stress path testing system under three states: dry, short-term inundated and long-term inundated. It can be seen that the strength of mudrocks has deteriorated as it condition changed from dry to short-term inundated and finally to long-term inundated.

Keywords: mudrocks, sedimentary rocks, inundation, shear strength

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Authors: Mohammad Ibrahim

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The study was conducted at Albasar international foundation ophthalmic hospitals in Sudan to study the burden and patterns of ophthalmic disorder in the sector. Review of the hospitals records revealed that the total number of patient examined in the hospitals and outreached camps conducted by the hospitals is 10,513,874, the total number of surgeries is 694,015 and the total number of pupils at school program is 230,382. The organization working with the highest management system and standards and quality result based planning. The study yielded that the ophthalmic problem in Sudan are of great percentage and the temporal blindness disorder are high since major cases and surgeries were Cataract (57.8%). Retinal problem (2.9%), Glaucoma (2.4%), Orbit and Occulo-plastic disorders (2.2%) other disorders are refractive errors, squint and strabismus, Corneal, Pediatrics and minor ophthalmic disorders.

Keywords: hospitals and outreach ophthalmic services, largest coverage of ophthalmic services, nonprofitable ophthalmic services, strong management system and standards

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Authors: Belayet Hossain, Laura Lamb

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The study investigates the importance of health and social capital in determining the labour force status of Canada’s Indigenous population using data from 2006 Aboriginal Peoples Survey. An instrumental variable ordered probit model has been specified and estimated. The study finds that health status and social capital are important in determining Indigenous peoples’ employment status along with other factors. The results of the study imply that human resource development initiatives of Indigenous Peoples need to be broadened by including health status and social capital. Poor health and low degree of inclusion of the Indigenous Peoples need to be addressed in order to improve employment status of Canada’s Indigenous Peoples.

Keywords: labour force, human capital, social capital, aboriginal people, Canada

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Authors: Elaine Wong

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This research protocol aims to explore and justify the need for nutrition and physical activity intervention to improve health outcomes among SME (Small Medium Enterprise) employees. It was found that the worksite is an ideal and convenient setting for employees to take charge of their health thru active participation in health programmes since they spent a great deal of time at their workplace. This study will examine the impact of both general or/and targeted health interventions in both SME and non-SME companies utilizing the Workplace Health Promotion (WHP) grant over a 12 months period and assessed the improvement in chronic health disease outcomes in Singapore. Random sampling of both non-SME and SME companies will be conducted to undergo health intervention and statistical packages such as Statistical Package for Social Science (SPSS) 25 will be used to examine the impact of both general and targeted interventions on employees who participate and those who do not participate in the intervention and their effects on blood glucose (BG), blood lipid, blood pressure (BP), body mass index (BMI), and body fat percentage. Using focus groups and interviews, the data results will be transcribed to investigate enablers and barriers to workplace health intervention revealed by employees and WHP coordinators that could explain the variation in the health screening results across the organisations. Dietary habits and physical activity levels of the employees participating and not participating in the intervention will be collected before and after intervention to assess any changes in their lifestyle practices. It makes economic sense to study the impact of these interventions on health screening outcomes across various organizations that are existing grant recipients to justify the sustainability of these programmes by the local government. Healthcare policy makers and employers can then tailor appropriate and relevant programmes to manage these escalating chronic health disease conditions which is integral to the competitiveness and productivity of the nation’s workforce.

Keywords: chronic diseases, health screening, nutrition and fitness intervention , workplace health

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Authors: P. Suchismita Behera, V. G. Sathe, A. K. Nigam, P. A. Bhobe

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Co-existence of long-range ferromagnetism and semi-conductivity with correlated behavior of structural, magnetic, optical and electrical properties in various sites doping at CdCr2Se4 makes it a most promising candidate for spin-based electronic applications and magnetic devices. It orders ferromagnetically below TC = 130 K with a direct band gap of ~ 1.5 eV. The magnetic ordering is believed to result from strong competition between the direct antiferromagnetic Cr-Cr spin couplings and the ferromagnetic Cr-Se-Cr exchange interactions. With an aim of understanding the influence of crystal structure on its magnetic properties without disturbing the magnetic site, we investigated four compositions with 3%, 5%, 7% and 10% of Sn-substitution at Cd-site. Partial substitution of Cd2+ (0.78Å) by small sized nonmagnetic ion, Sn4+ (0.55Å), is expected to bring about local lattice distortion as well as a change in electronic charge distribution. The structural disorder would affect the Cd/Sn – Se bonds thus affecting the Cr-Cr and Cr-Se-Cr bonds. Whereas, the charge imbalance created due to Sn4+ substitution at Cd2+ leads to the possibility of Cr mixed valence state. Our investigation of the local crystal structure using the EXAFS, Raman spectroscopy and magnetic properties using SQUID magnetometry of the Cd1-xSnxCr2Se4 series reflects this premise. All compositions maintain the Fd3m cubic symmetry with tetrahedral distribution of Sn at Cd-site, as confirmed by XRD analysis. Lattice parameters were determined from the Rietveld refinement technique of the XRD data and further confirmed from the EXAFS spectra recorded at Cr K-edge. Presence of five Raman-active phonon vibrational modes viz. (T2g (1), T2g (2), T2g (3), Eg, A1g) in the Raman spectra further confirms the crystal symmetry. Temperature dependence of the Raman data provides interesting insight to the spin– phonon coupling, known to dominate the magneto-capacitive properties in the parent compound. Below the magnetic ordering temperature, the longitudinal damping of Eg mode associated with Se-Cd/Sn-Se bending and T2g (2) mode associated to Cr-Se-Cr interaction, show interesting deviations with respect to increase in Sn substitution. Besides providing the estimate of TC, the magnetic measurements recorded as a function of field provide the values of total magnetic moment for all the studied compositions indicative of formation of multiple Cr valences.

Keywords: exchange interactions, EXAFS, ferromagnetism, Raman spectroscopy, spinel chalcogenides

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Authors: Salami Akeem Olanrewaju

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The transportation models or problems are primarily concerned with the optimal (best possible) way in which a product produced at different factories or plants (called supply origins) can be transported to a number of warehouses or customers (called demand destinations). The objective in a transportation problem is to fully satisfy the destination requirements within the operating production capacity constraints at the minimum possible cost. The objective of this study is to determine ways of minimizing transport cost in order to maximum profit. Data were gathered from the records of the Distribution Department of 7-Up Bottling Company Plc. Ilorin, Kwara State, Nigeria. The data were analyzed using SPSS (Statistical Package for Social Sciences) while applying the three methods of solving a transportation problem. The three methods produced the same results; therefore, any of the method can be adopted by the company in transporting its final products to the wholesale dealers in order to minimize total production cost.

Keywords: cost minimization, resources utilization, distribution system, allocation problem

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Authors: Luvindran Sugumaran, Mohd Nashrul Mohd Zubir, Kazi Md Salim Newaz, Tuan Zaharinie Tuan Zahari, Suazlan Mt Aznam, Aiman Mohd Halil

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With the fast growth of integrated circuits and the trend towards making electronic devices smaller, the heat dissipation load of electronic devices has continued to go over the limit. The high heat flux element would not only harm the operation and lifetime of the equipment but would also impede the performance upgrade brought about by the iteration of technological updates, which would have a direct negative impact on the economic and production cost benefits of rising industries. Hence, in high-tech industries like radar, information and communication, electromagnetic power, and aerospace, the development and implementation of effective heat dissipation technologies were urgently required. Pool boiling is favored over other cooling methods because of its capacity to dissipate a high heat flux at a low wall superheat without the usage of mechanical components. Enhancing the pool boiling performance by increasing the heat transfer coefficient via surface modification techniques has received a lot of attention. There are several surface modification methods feasible today, but the stability and durability of surface modification are the greatest priority. Thus, laser machining is an interesting choice for surface modification due to its low production cost, high scalability, and repeatability. In this study, different patterns of laser-processed copper surfaces are fabricated to investigate the nucleate pool boiling heat transfer performance of distilled water. The investigation showed that there is a significant enhancement in the pool boiling heat transfer performance of the laser-processed surface compared to the reference surface due to the notable increase in nucleation frequency and nucleation site density. It was discovered that the heat transfer coefficients increased when both the surface area ratio and the ratio of peak-to-valley height of the microstructure were raised. It is believed that the development of microstructures on the surface as a result of laser processing is the primary factor in the enhancement of heat transfer performance.

Keywords: heat transfer coefficient, laser processing, micro structured surface, pool boiling

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Authors: Andriana E. Tran, Anna Chur-Hansen

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Sexual health is an important aspect of overall wellbeing. This study aimed to explore the sexual health experiences of men aged 50 years and over from the perspective of health care professional participants who were specializing in sexual health care and who consulted with older men. A total of ten interviews were conducted. Eleven themes were identified regarding men’s experiences with sexual health care as reported by participants. 1) Biologically focused: older male clients focus largely on the biological aspect of their sexual health without consideration of other factors which might affect their functioning. 2) Psychological concerns: there is an interaction between mental and sexual health but older male clients do not necessarily see this. 3) Medicalization of sexual functioning: advances in medicine that aid with erectile difficulties which consequently mean that older men tend to favor a medical solution to their sexual concerns. 4) Masculine identity: sexual health concerns are linked to older male clients’ sense of masculinity. 5) Penile functionality: most concerns that older male clients have center on their penile functionality. 6) Relationships: many male clients seek sexual help as they believe it improves relationships. Conversely, having supportive partners may mean older male clients focus less on the physicality of sex. 7) Grief and loss: men experience grief and loss – the loss of their sexual functioning, grief from loss of a long-term partner, and loss of intimacy and privacy when moving from independent living to residential care. 8) Social stigma: older male clients experience stigma around aging sexuality and sex in general. 9) Help-seeking behavior: older male clients will usually seek mechanistic solution for biological sexual concerns, such as medication used for penile dysfunction. 10) Dismissed by health care professionals: many older male clients seek specialist sexual health care without the knowledge of their doctors as they feel dismissed due to lack of expertise, lack of time, and the doctor’s personal attitudes and characteristics. Finally, 11) Lack of resources: there is a distinct lack of resources and training to understand sexuality for healthy older men. These findings may inform future research, professional training, public health campaigns and policies for sexual health in older men.

Keywords: ageing, biopsychosocial model, men's health, sexual health

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Authors: Helena Baffoe

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The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance use, empirical evidence, logistic regression

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Authors: Sisira Edirippulige

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Background: Digital health education and training (DHET) is imperative for preparing current and future clinicians to work competently in digitally enabled environments. Despite rapid integration of digital health in modern health services, systematic education and training opportunities for health workers is still lacking. Objectives: This study aimed to investigate healthcare professionals’ perspectives and expectations regarding the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Methods: A qualitative study design with semi-structured individual interviews was employed. A purposive sample method was adopted to collect relevant information from the health workers. Inductive thematic analysis was used to analyse data. Interviews were audio-recorded and transcribed verbatim. Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed when we reported this study. Results: Two themes emerged while analysing the data: (1) what to teach in DHET and (2) how to teach DHET. Overall, healthcare professionals agreed that DHET is important for preparing current and future clinicians for working competently in digitally enabled environments. Knowledge relating to what is digital health, types of digital health, use of technology and human factors in digital health were considered as important to be taught in DHET. Skills relating to digital health consultations, clinical information system management and remote monitoring were considered important to be taught. Blended learning which combined e-learning and classroom-based teaching, simulation sessions and clinical rotations were suggested by healthcare professionals as optimal approaches to deliver the above-mentioned content. Conclusions: This study is the first of its kind to investigate health professionals’ perspectives and expectations relating to the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Healthcare workers are keen to acquire relevant knowledge, skills and competencies related to digital health. Different modes of education delivery is of interest to fit in with busy schedule of health workers.

Keywords: digital health, telehealth, telemedicine, education, curriculum

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Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

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Authors: P. Singh, S. Mittal

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Stability of slope in Chamoli Distt. near River Alaknanda in Uttarakhand is essential to safeguard the infrastructure of the slope where a dam is proposed to be built near this slope. Every year the areas near the slope have been facing severe landslides (small or big) due to intensive precipitation inflicting substantial damages as per Geological Survey of India records. The stability analysis of the slope under static and pseudo static conditions are presented in this study by using FEM software PHASE2. As per the earthquake zonation map of India, the slope is found in zone V, and hence, pseudo static stability of slope has been performed considering pseudo static analysis. For analysing the slope Mohr-Coulomb shear strength criteria is adopted for soil material and self-drilling anchors are modelled as bolts with parameters like modulus of elasticity, diameter of anchors and peak pull-out resistance of the anchors with the soil present there. The slope is found to be unstable under pseudo static conditions with computed factor of safety= 0.93. Stability is provided to the slope by using Self Drilling Anchors (SDA) which gives factor of safety= 1.15 under pseudo static condition.

Keywords: FEM, pseudo static, self-drilling anchors, slope stability

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Authors: N. Ben Si Ali, N. Benalia, N. Zerzouri

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Many electronic drivers for the induction motor control are based on sensorless technologies. Speed and torque control is usually attained by application of a speed or position sensor which requires the additional mounting space, reduce the reliability and increase the cost. This paper seeks to analyze dynamical performances and sensitivity to motor parameter changes of reactive power based technique used in sensorless control of induction motors. Validity of theoretical results is verified by simulation.

Keywords: adaptive observers, model reference adaptive system, RP-based estimator, sensorless control, stability analysis

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Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

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Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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Authors: Ardak Myrzabekova

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Sentinel epidemiological surveillance (SES) of severe acute respiratory infections (SARI) was introduced in the Republic of Kazakhstan in 2008. The purpose of this study was to analyze SES of flu among SARI patients in the Republic of Kazakhstan during last two flu seasons. Comparative analysis was conducted of SARI morbidity during 40 – 23 weeks of 2014/2015 (season 2014) and 2015/2016 (season 2015) in online base (http:\\ses.dec.kz). In the database during season 2014 were 1,398 SARI patients and 1,985 patients during season 2015. Individual data (clinical, epidemiological and laboratory) of SARI cases were collected based on the questionnaire and were put into the flu electronic system. The studied population was residents of the Republic of Kazakhstan who addressed for medical help in 24 sentinel in-patient clinics in 9 sentinel regions of the country. Swabs from nose and throat were taken for laboratory testing from SARI patients who met the standard case definition. The samples were examined in virology labs of sentinel regions using PCR and 'AmpliSens' test systems made in Russia. The first positive results for flu during season 2014 were obtained on 48 week, during season 2015 – on 46 week. The increase of the number of hospitalized SARI patients was observed during 42 week of 2015 – 01 week of 2016, and during 03 - 06 weeks of 2016, with fluctuating SARI incidence rate from 171 to 444 per 1,000 hospitalized. The highest SARI incidence rate during season 2014 were observed during 01 - 03 weeks of 2015: from 389 to 466 per 1,000 hospitalized. Patients admitted to the ICU during season 2015 were 3.0% (60) SARI patients, compared to 2.7% (38) in 2014 (p=0.3), obtaining oxygen therapy 1.0% (21) compared to 0.3% (5), accordingly, (р=0.009); with shortness of breath 74.8% (1,486) compared to 72.6% (1,015), (р=0.07); with impairment of consciousness 1.0% (21) compared to 0.6% (9), (р=0.11); with muscle pain 19.3% (384) compared to 13.6% (191), (р < 0.001); with joint pain 13.3% (265) compared to 9.3% (131), (p < 0.001). During season 2015 the prevailing subtype of flu А was А/Н1N1-09, it was observed mainly in the age group 30-64: 32.5% (169/520). During season 2014 flu А/Н3N2 was observed mainly in the age group 15-29: 43.6% (106/243). Among children under 14 flu А/Н1N1-09 during season 2015 was 37.3% (194/520), during season 2014 flu А/Н3N2 – 34.9% (85/243). Earlier beginning of the flu season was noted in 2015-2016 and a longer period of hospitalization of SARI patients, with high SARI morbidity rates, unlike season 2014-2015. Season 2015-2016 was characterized by prevailing circulation of virus of flu А/Н1N1-09, mainly in the age group 30-64, and also among children under 14. During season 2014-2015 the virus circulating in the country was А/Н3N2, which was observed mainly in the age group 15-29 and among children under 14.

Keywords: flu, electronic system, sentinel epidemiological surveillance, severe acute respiratory infections

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Authors: Maria Luisa T. Uayan

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The global need for qualified nurses to take care of the clients with various health needs is an incessant occurrence that persistently cause migration of nurses from developing to developed countries. The pull-push theory of migration greatly affects health care delivery systems of sending countries which is the same way affects nursing management. The exodus of nurses prepared to provide the much needed leadership at the bedside leaves the country in clusters giving health care institutions limited time to develop the next front-line managers that will assure quality patient care. This paper focuses on the extent and consequences of the massive recurring migration phenomena that is felt ONLY IN THE PHILIPPINE health care arena. It deals with the causes, problems, and effects of the cyclical loss of competent Filipina nurses in terms of emigration. Also, it will highlights the difficulties confronted by nursing service departments and health care teams when more experienced nurses set out for the “greener pastures” and patients are placed under the care of novice nurses. Fundamentally, it will emphasize the impact of suffering the loss of competent nurse managers in the Philippine health care institutions and provide contemporary recommendations on how to responsd accordingly to this very timely issue.

Keywords: Migration, Nurse Manager, Philippines

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Authors: Pranav Gunhal., Krish Jhurani

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This study tackles the significant computational challenge of predicting excited state dynamics in organic photovoltaic (OPV) materials—a pivotal factor in the performance of solar energy solutions. Time-dependent density functional theory (TDDFT), though effective, is computationally prohibitive for larger and more complex molecules. As a solution, the research explores the application of transformer neural networks, a type of artificial intelligence (AI) model known for its superior performance in natural language processing, to predict excited state dynamics in OPV materials. The methodology involves a two-fold process. First, the transformer model is trained on an extensive dataset comprising over 10,000 TDDFT calculations of excited state dynamics from a diverse set of OPV materials. Each training example includes a molecular structure and the corresponding TDDFT-calculated excited state lifetimes and key electronic transitions. Second, the trained model is tested on a separate set of molecules, and its predictions are rigorously compared to independent TDDFT calculations. The results indicate a remarkable degree of predictive accuracy. Specifically, for a test set of 1,000 OPV materials, the transformer model predicted excited state lifetimes with a mean absolute error of 0.15 picoseconds, a negligible deviation from TDDFT-calculated values. The model also correctly identified key electronic transitions contributing to the excited state dynamics in 92% of the test cases, signifying a substantial concordance with the results obtained via conventional quantum chemistry calculations. The practical integration of the transformer model with existing quantum chemistry software was also realized, demonstrating its potential as a powerful tool in the arsenal of materials scientists and chemists. The implementation of this AI model is estimated to reduce the computational cost of predicting excited state dynamics by two orders of magnitude compared to conventional TDDFT calculations. The successful utilization of transformer neural networks to accurately predict excited state dynamics provides an efficient computational pathway for the accelerated discovery and design of new OPV materials, potentially catalyzing advancements in the realm of sustainable energy solutions.

Keywords: transformer neural networks, organic photovoltaic materials, excited state dynamics, time-dependent density functional theory, predictive modeling

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Authors: Hussein Lujuo Mohamed

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Introduction: Public health has always been influenced by climate and weather. Changes in climate and climate variability, particularly changes in weather extremes affect the environment that provides people with clean air, food, water, shelter, and security. Tanzania is not an exception to the threats of climate change. The health sector is mostly affected due to emergence and proliferation of infectious diseases, thereby affecting health of the population and thus impacting achievement of sustainable development goals. Methodology: A desk review on documented issues pertaining to climate change and health in Tanzania was done using Google search engine. Keywords included climate change, link, health, climate initiatives. In cases where information was not available, documents from Ministry of Health, Vice Presidents Office-Environment, Local Government Authority, Ministry of Water, WHO, research, and training institutions were reviewed. Some of the reviewed documents from these institutions include policy brief papers, fieldwork activity reports, training manuals, and guidelines. Results: Six main climate resilience activities were identified in Tanzania. These were development and implementation of climate resilient water safety plans guidelines both for rural and urban water authorities, capacity building of rural and urban water authorities on implementation of climate-resilient water safety plans, and capacity strengthening of local environmental health practitioners on mainstreaming climate change and health into comprehensive council health plans. Others were vulnerability and adaptation assessment for the health sector, mainstreaming climate change in the National Health Policy, and development of risk communication strategy on climate. In addition information, education, and communication materials on climate change and to create awareness were developed aiming to sensitize and create awareness among communities on climate change issues and its effect on public health. Conclusion: Proper implementation of these interventions will help the country become resilient to many impacts of climate change in the health sector and become a good example for other least developed countries.

Keywords: climate, change, Tanzania, health

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Authors: Elena Samarsky

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According to German national records and willingness to migrate surveys, emigration is much more attractive for better educated citizens employed in white-collar positions, with academics displaying the highest migration rate. The case study of academic migration from Germany is furthermore intriguing due to the country's financial power, competitive labour market and relatively good life-standards, working conditions and high wage rates. Investigation of such mobility challenges traditional economic view on migration, as it raises the question of why people chose to leave their highly-industrialized countries known for their high life-standards, stable political scene and prosperous economy. Within the regional domain, examining mobility of Germans contributes to the ongoing debate over the extent of influence of the EU mobility principle on migration decision. The latter is of particular interest, as it may shed the light on the extent to which it frames individual migration path, defines motivations and colours the experiences of migration action itself. The paper is based on the analysis of the migration decisions obtained through in-depth interviews with German academics employed in the UK. These retrospective interviews were conducted with German academies across selected universities in the UK, employed in a variety of academic fields, and different career stages. Interviews provide a detailed description of what motivated people to search for a post in another country, which attributes of such job are needed to be satisfied in order to facilitate migration, as well as general information on particularities of an academic career and institutions involved. In the course of the project, it became evident that although securing financial stability was non-negotiable factor in migration (e.g., work contract singed before relocation) non-pecuniary motivations played significant role as well. Migration narratives of this group - the highly skilled, whose human capital is transferable, and whose expertise is positively evaluated by countries, is mainly characterised by search for personal development and career advancement, rather than a direct increase in their income. Such records are also consistent in showing that in case of academics, scientific freedom and independence are the main attributes of a perfect job and are a substantial motivator. On the micro level, migration is rather depicted as an opportunistic action addressed in terms of voluntary and rather imposed decision. However, on the macro level, findings allow suggesting that such opportunities are rather an outcome embedded in the peculiarities of academia and its historical and structural developments. This, in turn, contributes significantly to emergence of a scene in which migration action takes place. The paper suggest further comparative research on the intersection of the macro and micro level, and in particular how both national academic institutions and the EU mobility principle shape migration of academics. In light of continuous attempts to make the European labour market more mobile and attractive such findings ought to have direct implications on policy.

Keywords: migration, EU, academics, highly skilled labour

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Authors: Mohamad Reza Khodabakhsh

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Physical activity is important because it affects the stress and mental health of the elderly. The purpose of this research is to examine the relationship between the physical activity of the elderly and stress and mental health. The current research is correlational research, and the studied population includes all the elderly who are engaged in sports in the parks of Mashhad city in 2021. The whole community consists of 200 people. Sampling was done by the headcount method. The tool used in this research is a questionnaire. The physical activity questionnaire is Likert. General GHQ is based on the self-report method. The study method is correlation type to find the relationship between predictor and predicted variables, and the multiple regression method was used for the relationships between the sub-components. And the results showed that physical activity has the effect of reducing the stress of the elderly and improving their mental health. In general, the results of this research indicate the confirmation of the research hypotheses.

Keywords: relationship, physical activity, stress, mental health, elderly

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Authors: Hamnah Nisar

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As food is something which is particularly important for survival, in fact, it improves the quality of life and promotes health. Quality food is a key to a healthy life. Consumption of food depends on the knowledge we have regarding the nutrients it contains. Moreover, the awareness and knowledge about something is an initial stage for its improvement. We cannot work on anything unless we have knowledge about it. The pros and cons, effects, causes, dos, and don'ts, especially for an important things like food, are a necessity to learn. That is why my research would be all about analyzing what difference awareness makes on people and how making people more aware about a certain thing can help them improve their lifestyles and bring a positive change for them. The research would be done through questionnaires and interviews among two classes, one would be the upper class and the other would-be lower class. Because the upper class can easily access learning facilities and can know about the new things than the lower class. The questions would be related to what kind of food do they consume, what health issues they face, or what health issues are common among their regions. The results of the research would be helpful to know firstly the effects of awareness and education regarding food on health, how a basic thing like knowledge can have a significant effect on health and can be the cause of several diseases.

Keywords: nutrition, awareness, quality food, knowledge

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