Search results for: healthcare ecosystem

Authors: Almaz Negash, Dessie Tibebe, Marye Mulugeta, Yezbie Kassa

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Large-scale textile industries use large amounts of toxic chemicals, which are very hazardous to human health and environmental sustainability. In this study, the removal of various dyes from effluents of textile industries using the electrocoagulation process was investigated. The studied dyes were Reactive Red 120 (RR-120), Basic Blue 3 (BB-3), and Basic Red 46 (BR-46), which were found in samples collected from effluents of three major textile factories in the Amhara region, Ethiopia. For maximum removal, the dye BB-3 required an acidic pH 3, RR120 basic pH 11, while BR-46 neutral pH 7 conditions. BB-3 required a longer treatment time of 80 min than BR46 and RR-120, which required 30 and 40 min, respectively. The best removal efficiency of 99.5%, 93.5%, and 96.3% was achieved for BR-46, BB-3, and RR-120, respectively, from synthetic wastewater containing 10 mg L1of each dye at an applied potential of 10 V. The method was applied to real textile wastewaters and 73.0 to 99.5% removal of the dyes was achieved, Indicating Electrocoagulation can be used as a simple, and reliable method for the treatment of real wastewater from textile industries. It is used as a potentially viable and inexpensive tool for the treatment of textile dyes. Analysis of the electrochemically generated sludge by X-ray Diffraction, Scanning Electron Microscope, and Fourier Transform Infrared Spectroscopy revealed the expected crystalline aluminum oxides (bayerite (Al(OH)3 diaspore (AlO(OH)) found in the sludge. The amorphous phase was also found in the floc. Textile industry owners should be aware of the impact of the discharge of effluents on the Ecosystem and should use the investigated electrocoagulation method for effluent treatment before discharging into the environment.

Keywords: electrocoagulation, aluminum electrodes, Basic Blue 3, Basic Red 46, Reactive Red 120, textile industry, wastewater

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Authors: Etaf Alkhlaifat

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This study drew conceptually on Communication Accommodation Theory to describe and analyze conversations between doctors and patients to examine the extent to which patients’ level of literacy represents one of the linguistic obstacles that may adversely influence the quality of healthcare services in Jordan. A thematic qualitative approach was employed to interpret the phenomena under study, which required direct observation and interviews with doctors (n=6) and patients (n=15) in natural Jordanian medical settings. This generated a comprehensive corpus of audio and videotaped data, which revealed that most doctors expressed dissatisfaction with patients’ ability to express themselves and comprehend them as a result of a lack of medical awareness and limited health education. The significance of this study rests on its detailed investigation of the impact of health literacy on patients’ health outcomes and while providing unique insights into how low health literacy could contribute to misunderstanding and potential ill-health.

Keywords: doctor-patient communication, health literacy, medical knowledge, communication accommodation theory, qualitative research

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Authors: Samir Chekchaki, ArifaBeddiar

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Nowadays, more and more species are introduced outside their natural range. If most of them remain difficult, some may adopt a much more dynamic behavior. Indeed, we have witnessed in recent decades, the development of high forests of Acacia mearnsii in El Kala National Park. Introduced indefinitely, this leguminous intended to make money (nitrogen supply for industrial plantations of Eucalyptus), became one of the most invasive and more costly in terms of forest management. It has crossed all barriers: it has acclimatized, naturalized and then expanded through diverse landscapes; entry into competition with native species such as cork oak and altered ecosystem functioning. Therefore, it is interesting to analyze this new threat by relying on plants as bio-indicator for assessing biodiversity at different scales. We have identified the species present in several plots distributed in a range of vegetation types subjected to different degrees of disturbance by using the braun-blanquet method. Fifty-six species have been recorded. They are distributed in 48 genera and 29 families. The analysis of the relative frequency of species correlated with relative abundance clearly shows that the Acacia mearnsii feels marginalized. The ecological analysis of this biological invasion shows that disruption of either natural or anthropogenic origin (fire, prolonged drought, cut) represent the factors that exacerbate invasion by opening invasion windows. The lifting of seeds of Acacia mearnsii lasting physical dormancy (and variable) is ensured by the thermal shock in relation to its heliophilous character.

Keywords: Acacia mearnsii De Wild, El Kala National park, fire, invasive, vegetation

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Authors: Hounyèmè Romuald, Mama Daouda, Argillier Christine

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The present study focused on the use of benthic macrofauna to define the reference state of an anthropized lagoon (Nokoué-Benin) from the responses of relevant metrics to proxies. The approach used is a combination of a joint species distribution model and Bayesian networks. The joint species distribution model was used to select the relevant metrics and generate posterior probabilities that were then converted into posterior response probabilities for each of the quality classes (pressure levels), which will constitute the conditional probability tables allowing the establishment of the probabilistic graph representing the different causal relationships between metrics and pressure proxies. For the definition of the reference thresholds, the predicted responses for low-pressure levels were read via probability density diagrams. Observations collected during high and low water periods spanning 03 consecutive years (2004-2006), sampling 33 macroinvertebrate taxa present at all seasons and sampling points, and measurements of 14 environmental parameters were used as application data. The study demonstrated reliable inferences, selection of 07 relevant metrics and definition of quality thresholds for each environmental parameter. The relevance of the metrics as well as the reference thresholds for ecological assessment despite the small sample size, suggests the potential for wider applicability of the approach for aquatic ecosystem monitoring and assessment programs in developing countries generally characterized by a lack of monitoring data.

Keywords: pressure proxies, bayesian inference, bioindicators, acadjas, functional traits

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Authors: Wan Nur'ashiqin Wan Mohamad, Zarina Othman, Mohd Azman Abas, Azizah Ya'acob, Rozmel Abdul Latiff

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Effective doctor-patient interaction is vital to both doctor and patient relationship. It is the cornerstone of good practice and an integral quality of a healthcare institution. This paper presented the hierarchy of the communication elements in doctor-patient interaction during medical consultations in a medical centre in Malaysia. This study adapted The Picker Patient Experience Questionnaire (2002) to obtain the information from patients. The questionnaire survey was responded by 100 patients between the ages of 20 and 50. Data collected were analysed using Rasch Measurement Model to yield the hierarchy of the communication elements in doctor-patient interaction. The findings showed that the three highest ranking on the doctor-patient interaction were doctor’s treatment, important information delivery and patient satisfaction of doctor’s responses. The results are valuable in developing the framework for communication ethics of doctors.

Keywords: communication elements, doctor-patient interaction, hierarchy, Rasch measurement model

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Authors: Adebayo A. Abimbola, Anifowose O. Joseph, Olanrewaju S. Taiwo

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Green building (GB) practices have the potential to save energy, save money, and improve the quality of human habitat. They can also contribute to water conservation, more efficient use of raw materials, and ecosystem health around the globe. The Intergovernmental Panel on Climate Change (IPCC) singled out the building sector as having the most cost-effective opportunities for reducing carbon emissions—in fact, many building-related opportunities are cost-neutral, or even cost-positive, to the building owner. These benefits have made green building practices the fastest-growing trend in the building industry, but they still represent only a fraction of new construction, and the enormous stock of existing buildings has barely been touched at all. To effectively deliver the kind of (GB) that can become a force for positive change at global, regional and local scales, all workforce sectors need new skills that are both technical and interpersonal in nature. A prominent bottleneck is seen to be education and training. This paper investigates the major gaps in current GB education and training offerings in Nigeria. A questionnaire survey was developed to capture the perception of construction professionals and academics in relevant professions regarding the significance of the identified gaps as it affects GB education and training. Based on Likert scale ranking, research result shows that perception of training in specific technical fields and financial benefits and evaluation are identified as the top gaps in GB training and education offerings. The paper concludes with suggestions and actions that can enhance capabilities of the GB workforce in Nigeria.

Keywords: education and training, gaps, green building, workforce

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Authors: John Peter Dacanay, Edison Ramos, Cristopher James Dicang

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Waste management is a global concern due to increasing waste production from changing consumption patterns and population growth. Proper waste disposal management is a critical aspect of public health and environmental protection. In the healthcare industry, medical waste is generated in large quantities, and if not disposed of properly, it poses a significant threat to human health and the environment. Efficient waste management conserves natural resources and prevents harm to human health, and implementing an effective waste management system can save human lives. The study aimed to assess the level of awareness and practices on waste disposal management, highlighting the understanding of proper disposal, potential hazards, and environmental implications among Medical Technology students. This would help to provide more recommendations for improving waste management practices in healthcare settings as well as for better waste management practices in educational institutions. From the collected data, a female of 21 years of age stands out among the respondents. With the frequency and percentage of medical technology students' knowledge of laboratory waste management being high, it indicates that all respondents demonstrated a solid understanding of proper disposal methods, regulations, risks, and handling procedures related to laboratory waste. That said, the findings emphasize the significance of education and awareness programs in equipping individuals involved in laboratory practices with the necessary knowledge to handle and dispose of hazardous and infectious waste properly. Most respondents demonstrate positive practices or are highly mannered in laboratory waste management, including proper segregation and disposal in designated containers. However, there are concerns about the occasional mixing of waste types, emphasizing the reiteration of proper waste segregation. Students show a strong commitment to using personal protective equipment and promptly cleaning up spills. Some students admit to improper disposal due to rushing, highlighting the importance of time management and safety prioritization. Overall, students follow protocols for hazardous waste disposal, indicating a responsible approach. The school's waste management system is perceived as adequate, but continuous assessment and improvement are necessary. Encouraging reporting of issues and concerns is crucial for ongoing improvement and risk mitigation. The analysis reveals a moderate positive relationship between the respondents' knowledge and practices regarding laboratory waste management. The statistically significant correlation with a p-value of 0.26 (p-value 0.05) suggests that individuals with higher levels of knowledge tend to exhibit better practices. These findings align with previous research emphasizing the pivotal role of knowledge in influencing individuals' behaviors and practices concerning laboratory waste management. When individuals possess a comprehensive understanding of proper procedures, regulations, and potential risks associated with laboratory waste, they are more inclined to adopt appropriate practices. Therefore, fostering knowledge through education and training is essential in promoting responsible and effective waste management in laboratory settings.

Keywords: waste disposal management, knowledge, attitude, practices

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Authors: Julie Furst-Bowe

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Over the past decade, there has been significant growth in online courses and programs at all levels of education in the United States. This study explores the growth of online and blended (or hybrid) programs offered by the sixteen technical colleges in the Wisconsin Technical College System (WTCS). The WTCS provides education and training programs to more than 300,000 students each year in career clusters including agriculture, business, energy, information technology, healthcare, human services, manufacturing, and transportation. These programs range from short-term training programs that may lead to a certificate to two-year programs that lead to an associate degree. Students vary in age from high school students who are exploring career interests to employees who are seeking to gain additional skills or enter a new career. Because there is currently a shortage of skilled workers in nearly all sectors in the state of Wisconsin, it is critical that the WTCS is providing fully educated and trained graduates to fill workforce needs in a timely manner. For this study, information on online and blended programs for the past five years was collected from the WTCS, including types of programs, course and program enrollments, course completion rates, program completion rates, time to completion and graduate employment rates. The results of this study indicate that the number of online and blended courses and programs is continuing to increase each year. Online and blended programs are most commonly found in the business, human services, and information technology areas, and they are less commonly found in agriculture, healthcare, manufacturing, and transportation programs. Overall, course and program completion rates were higher for blended programs when compared to fully online programs. Students preferred the blended programs over the fully online programs. Overall, graduates were placed into related jobs at a rate of approximately 90 percent, although there was some variation in graduate placement rates by programs and by colleges. Differences in graduate employment rate appeared to be based on geography and sector as employers did not distinguish between graduates who had completed their programs via traditional, blended or fully online instruction. Recommendations include further exploration as to the reasons that blended courses and programs appear to be more effective than fully online courses and programs. It is also recommended that those program areas that are not using blended or online delivery methods, including agriculture, health, manufacturing and transportation, explore the use of these methods to make their courses and programs more accessible to students, particularly working adults. In some instances, colleges were partnering with specific companies to ensure that groups of employees were completing online coursework leading to a certificate or a degree. Those partnerships are to be encouraged in order for the state to continue to improve the skills of its workforce. Finally, it is recommended that specific colleges specialize in the delivery of specific programs using online technology since it is not bound by geographic considerations. This approach would take advantage of the strengths of the individual colleges and avoid unnecessary duplication.

Keywords: career and technical education, online learning, skills shortage, technical colleges

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Authors: Gintarė Sauliutė, Gintaras Svecevičius

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Landfill leachates contain a number of persistent pollutants, including heavy metals. They have the ability to spread in ecosystems and accumulate in fish which most of them are classified as top-consumers of trophic chains. Fish are freely swimming organisms; but perhaps, due to their species-specific ecological and behavioral properties, they often prefer the most suitable biotopes and therefore, did not avoid harmful substances or environments. That is why it is necessary to evaluate the persistent pollutant dispersion in hydroecosystem using fish tissue metal concentration. In hydroecosystems of hybrid type (e.g. river-pond-river) the distance from the pollution source could be a perfect indicator of such a kind of metal distribution. The studies were carried out in the Kairiai landfill neighboring hybrid-type ecosystem which is located 5 km east of the Šiauliai City. Fish tissue (gills, liver, and muscle) metal concentration measurements were performed on two types of ecologically-different fishes according to their feeding characteristics: benthophagous (Gibel carp, roach) and predatory (Northern pike, perch). A number of mathematical models (linear, non-linear, using log and other transformations) have been applied in order to identify the most satisfactorily description of the interdependence between fish tissue metal concentration and the distance from the pollution source. However, the only one log-multiple regression model revealed the pattern that the distance from the pollution source is closely and positively correlated with metal concentration in all predatory fish tissues studied (gills, liver, and muscle).

Keywords: bioaccumulation in fish, heavy metals, hydroecosystem, landfill leachate, mathematical model

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Authors: Raymond Ezenweani, Jeffrey Ogbebor

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The menace of aquatic pollution has become increasingly of great concern and the effects of this pollution as a result of anthropogenic activities cannot be over emphasized. Phycoremediation is the application of algal remediation technology in the removal of harmful products from the environment. Harmful products also known as pollutants are usually introduced into the environment through variety of processes such as industrial discharge, agricultural runoff, flooding, and acid rain. This work has to do with the capability of algae in the efficient removal of different pollutants, ranging from hydrocarbons, eutrophication, agricultural chemicals and wastes, heavy metals, foul smell from septic tanks or dumps through different processes such as bioconversion, biosorption, bioabsorption and biodecomposition. Algae are capable of bioconversion of environmentally persistent compounds to degradable compounds and also capable of putting harmful bacteria growth into check in waste water remediation. Numerous algal organisms such as Nannochloropsis spp, Chlorella spp, Tetraselmis spp, Shpaerocystics spp, cyanobacteria and different macroalgae have been tested by different researchers in laboratory scale and shown to have 100% efficiency in environmental remediation. Algae as a result of their photosynthetic capacity are also efficient in air cleansing and management of global warming by sequestering carbon iv oxide in air and converting it into organic carbon, thereby making food available for the other organisms in the higher trophic level of the aquatic food chain. Algae play major role in the sustenance of the aquatic ecosystem by their virtue of being photosynthetic. They are the primary producers and their role in environmental sustainability is remarkable.

Keywords: Algae , Pollutant, ., Phycoremediation, Aquatic, Sustainability

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Authors: Chimmoe Fomo Michelle Larissa

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The challenges of cybersecurity in Africa are increasingly significant as the continent undergoes rapid digital transformation. With the rise of internet connectivity, mobile phone usage, and digital financial services, Africa faces unique cybersecurity threats. The significance of this study lies in understanding these threats and the multifaceted challenges that hinder effective cybersecurity measures across the continent. The methodologies employed in this study include a comprehensive analysis of existing cybersecurity frameworks in various African countries, surveys of key stakeholders in the digital ecosystem, and case studies of cybersecurity incidents. These methodologies aim to provide a detailed understanding of the current cybersecurity landscape, identify gaps in existing policies, and evaluate the effectiveness of implemented security measures. Major findings of the study indicate that Africa faces numerous cybersecurity challenges, including inadequate regulatory frameworks, insufficient cybersecurity awareness, and a shortage of skilled professionals. Additionally, the prevalence of cybercrime, such as financial fraud, data breaches, and ransomware attacks, exacerbates the situation. The study also highlights the role of international cooperation and regional collaboration in addressing these challenges and improving overall cybersecurity resilience. In conclusion, addressing cybersecurity challenges in Africa requires a multifaceted approach that involves strengthening regulatory frameworks, enhancing public awareness, and investing in cybersecurity education and training. The study underscores the importance of regional and international collaboration in building a robust cybersecurity infrastructure capable of mitigating the risks associated with the continent's digital growth.

Keywords: Africa, cybersecurity, challenges, digital infrastructure, cybercrime

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Authors: Javed Mallick

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In metropolitan areas, rapid changes in land use and land cover (LULC) have ecological and environmental consequences. Saudi Arabia's cities have experienced tremendous urban growth since the 1990s, resulting in urban heat islands, groundwater depletion, air pollution, loss of ecosystem services, and so on. From 1990 to 2020, this study examines the variance and heterogeneity in land surface temperature (LST) caused by LULC changes in Abha-Khamis Mushyet, Saudi Arabia. LULC was mapped using the support vector machine (SVM). The mono-window algorithm was used to calculate the land surface temperature (LST). To identify LST clusters, the local indicator of spatial associations (LISA) model was applied to spatiotemporal LST maps. In addition, the parallel coordinate (PCP) method was used to investigate the relationship between LST clusters and urban biophysical variables as a proxy for LULC. According to LULC maps, urban areas increased by more than 330% between 1990 and 2018. Between 1990 and 2018, built-up areas had an 83.6% transitional probability. Furthermore, between 1990 and 2020, vegetation and agricultural land were converted into built-up areas at a rate of 17.9% and 21.8%, respectively. Uneven LULC changes in built-up areas result in more LST hotspots. LST hotspots were associated with high NDBI but not NDWI or NDVI. This study could assist policymakers in developing mitigation strategies for urban heat islands

Keywords: land use land cover mapping, land surface temperature, support vector machine, LISA model, parallel coordinate plot

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Authors: Jonathan D. Recchi

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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

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Authors: Helen Yetunde Omoboye, Adebukola Adenike Adedeji, Israel Funso Adeniyi

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This study of the biodiversity, community structure, and production capacity of the zooplankton community is an aspect of bio-monitoring of the aquatic ecosystem. Samples were selected horizontally and vertically from Esa-Odo Reservoir using improvised Meyer’s water sampler. Planktonic samples were collected at two months intervals for two years. Net and total plankton were sampled by filtration and sedimentation methods. Planktonic samples were preserved as 5% formalin and 1% Lugol’s solution. Measurement, enumeration, and scaled pictures of the recorded zooplankton were taken using a photomicrograph. The taxonomic composition of zooplankton biota was determined using identification keys. Eighty three (83) species of zooplankton recorded in this study belong to 4 groups: Rotifera, Cladocera, Copepoda, and Insecta. Rotifera was the most represented group (61.21%). Horizontally, 24 species with the highest mean abundance characterized the lacustrine; while 12 species and 10 species were unique to the transition and riverine zones, respectively. Vertically, most species had their mean abundance decreased from the surface to the bottom of the reservoir. A total of nine (9), two (2), and one (1) species were peculiar to the surface, bottom and mid-depth, respectively. Zooplankton was most abundant during the dry season. In conclusion, Esa-Odo Reservoir comprised highly diversified zooplankton fauna with great potential to support a rich aquatic community and fishery production. The reservoir can be classified as fairly clean based on the abundance of the rotifer group. However, the lake should be subjected to regular proper monitoring because of the presence of some pollution tolerant copepod species identified among the zooplankton fauna.

Keywords: zooplankton, spatial, temporal, abundance, biodiversity, reservoir

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Authors: Anirban Sengupta

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The recruitment industry plays a critical role in connecting employers with talent. While there are many big recruitment firms and big organizations can also afford to have their own recruitment teams, small recruitment agencies form an essential part of the ecosystem serving a vast majority of small and medium sized clients. These clients utilize the services of the recruitment agencies to be able to scale their operations. However, there are significant organizational challenges that a small recruitment agency faces to build a sustainable and growing business. This case study explores the organizational challenges faced by a small recruitment agency in South India in an increasingly competitive landscape. Through this paper, the authors hope to understand, analyze and share the challenges faced by this firm and suggest a systematic approach to address the challenges. The study uses both qualitative and quantitative data collected from the agency’s management and employees based on the year 2024. The findings reveal that the agency struggles with limited resources, unpredictable clients, and a lack of scalable processes and systems, which impacts not only the business outcomes but also key areas like employee performance management, compensation and benefits, and employee well-being. Based on these insights, the study proposes several strategies for overcoming these challenges, such as implementing scalable systems and processes. This research contributes to the understanding of the specific obstacles faced by small recruitment agencies in regional contexts and offers actionable recommendations for improving their organizational health, which may, in turn, positively impact their competitiveness.

Keywords: recruitment, organizational challenges, performance management, recruitment technology

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Authors: Mohammad Tahir Yousafzai, Rubina Qasim

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We assessed Hepatitis B vaccination and its determinants among health care workers (HCW) in Northwest Pakistan. HCWs from both public and private clinics were interviewed about hepatitis B vaccination, socio-demographic, hepatitis B virus transmission modes, disease threat and benefits of vaccination. Logistic regression was performed. Hepatitis B vaccination was 40% (Qualified Physicians: 86% and non-qualified Dispensers:16%). Being Qualified Physician (Adj. OR 26.6; 95%CI 9.3-73.2), Non-qualified Physician (Adj.OR 1.9; 95%CI 0.8-4.6), qualified Dispensers (Adj. OR 3.6; 95%CI 1.3-9.5) compared to non-qualified Dispensers, working in public clinics (Adj. OR 2.5; 95%CI 1.1-5.7) compared to private, perceived disease threat after exposure to blood and body fluids (Adj. OR 1.1; 95%CI 1.1-1.2) and perceived benefits of vaccination (Adj. OR 1.1; 95%CI 1.1-1.2) were significant predictors of hepatitis B vaccination. Improved perception of disease threat and benefits of vaccination and qualification of HCWs are associated with hepatitis B vaccination.

Keywords: Hepatitis B vaccine, immunization, healthcare workers, primary health

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Authors: Ralph Lugon, Randolf Ramseyer

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The beauty and quality of the natural heritage can be appreciated in different ways by different users, but the delicate balance of the environment in a nature reserve must be respected. The case of the territorial anchorage of the Grangettes natural reserve gives an interesting insight into the users' perception of the environmental constraints and standards of tourist activities. The nature reserve was once conceived as a sanctuary of natural heritage, a place where flora and fauna could flourish with minimal human interference. However, over time and with the transition to modernity, the values and meanings of the reserve have changed for visitors and the people living in the surrounding area. Today, The Grangettes nature reserve is a place of relaxation for urban dwellers with limited knowledge of nature and a lack of awareness of conservation issues. As a result, the reserve is now threatened by the negative impacts of human activities and mass tourism on its environment. Les Grangettes is a nature reserve that faces the challenge of preserving biodiversity while managing tourist flows. Ways must be found to accommodate new types of visitors from towns and cities who are looking for new activities, quality services and facilities, as well as aesthetic inspiration. To ensure the long-term conservation of the area, the flow of tourists must be carefully controlled. Through a dual qualitative-quantitative approach in 2021-22, this paper explores new visitor trends, changes in the reserve, and potential consequences for other stakeholders in the ecosystem. The purpose of this research is to assess users' perceptions of environmental constraints and standards on tourist activities in a nature reserve.

Keywords: outdoor recreation, nature-based tourism, over tourism, protected area, user's perceptions

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Authors: Nasir Mustafa

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One of the prerequisites required for an efficient diagnosis in a medical practice is to have a strong command of both functional and clinical anatomy. In this study, we introduce a new collaborative approach to the effective teaching of the knee and hip joints. In the present teaching model, anatomists, orthopedists and physical therapists present the anatomy of the hip and knee joints in small groups. Courses for the hip and knee joints were scheduled during the early stages of the medical curriculum. Students of nursing and physical therapy were grouped together to sensitize to the importance of a collaborative effort. The study results clearly demonstrate that nursing students and physical therapy students appreciated this teaching approach. The collaborative approach further proved to be a suitable method to teach both functional and clinical anatomy of the hip and knee joints. Aside from this training, a collaborative approach between medical students and physical therapy students was also successful for a healthcare organization.

Keywords: hip and knee joint anatomy, collaborative, Anatomy teaching, Nursing students, Physiotherapy students

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Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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Authors: A. Alrasheed, I. Connerton

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Daily provision of high quality food and hygiene to patients is a challenging goal of the healthcare. In Saudi Arabia, matters related to food safety and hygiene are regulated by the Ministry of Health (MOH) and the Saudi Food and Drugs Authority (SFDA). The purpose of this research is to discuss the food safety management inconsistencies and flaws, in particular the ones related to Hazard Analysis and Critical Control Points (HACCP) in Riyadh’s MOH hospitals. As required by law, written HACCP regulations must be implemented, and food handlers need to receive the training accordingly. However, in Saudi hospitals, this is not a requirement, and the food handlers do not need to hold training certificates in food safety or HACCP. Nowadays, the matter of food safety and hygiene have become increasingly important since the decision makers want to align these regulations with the majority of the world and to implement HACCP fully and for this purpose, the SFDA was established. 

Keywords: food safety, patients, hospitals, HACCP, Saudi Arabia

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Authors: Zhiqiang Yan, Chen Fan, Beicheng Xia

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Urban lakes play an invaluable role in urban water systems such as flood control, landscape, entertainment, and energy utilization, and have suffered from severe eutrophication over the past few years. To investigate the ecological response of main aquatic species and system stability to chlorine interference in shallow urban lakes, a mini system dynamic model, based on the competition and predation of main aquatic species and TP circulation, was developed. The main species of submerged macrophyte, phytoplankton, zooplankton, benthos and TP in water and sediment were simulated as variables in the model with the interference of chlorine which effect function was attenuation equation. The model was validated by the data which was investigated in the Lotus Lake in Guangzhou from October 1, 2015 to January 31, 2016. Furthermore, the eco-exergy was used to analyze the change in complexity of the shallow urban lake. The results showed the correlation coefficient between observed and simulated values of all components presented significant. Chlorine showed a significant inhibitory effect on Microcystis aeruginosa，Rachionus plicatilis, Diaphanosoma brachyurum Liévin and Mesocyclops leuckarti (Claus).The outbreak of Spiroggra spp. inhibited the growth of Vallisneria natans (Lour.) Hara, caused a gradual decrease of eco-exergy, reflecting the breakdown of ecosystem internal equilibria. It was concluded that the study gives important insight into using chlorine to achieve eutrophication control and understand mechanism process.

Keywords: system dynamic model, urban lake, chlorine, eco-exergy

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Authors: Buket Metin

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

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

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Authors: Julius Lenaerts, Ahmed Elsaadawy, Mohammed Bashir

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Background Sedated and paralyzed patients have an impaired blink reflex leading to ophthalmic complications such as conjunctivitis, epithelial defects, bacterial keratitis, and more. These are entirely preventable complications through regular eye care. Methods Patients at level 3 or above (intubated/paralyzed) care in the Intensive Care Unit (ICU) were reviewed between February and April. Data was pulled from Metavision and adherence was compared to Royal College of Ophthalmology (RCOphth) recommendations[4]. Using a multi-pronged approach through posters, individual teaching sessions and faculty teaching, we aimed to educate staff about eye care in the ICU. Patients were reaudited in the period July to August. Results Out of 40 patients, only 23% were assessed for eye care needs on admission compared to 77% after teaching; eye care was only delivered 59% of the time it was due, compared to 61%; 2.5% of patients had eyedrops prescribed compared to 41%. This shows an overall increase in meeting RCOphth standards. Key messages Eye care is an overlooked aspect of patient care in the ICU, associated with avoidable ocular complications. Healthcare staff need further rigorous education on the provision and importance of eye care to reduce avoidable complications.

Keywords: ICU, eye care, risk, QIP

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Authors: Vedant Janapaty

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Estuaries are wetlands where fresh water from streams mixes with salt water from the sea. Also known as “kidneys of our planet”- they are extremely productive environments that filter pollutants, absorb floods from sea level rise, and shelter a unique ecosystem. However, eutrophication and loss of native species are ailing our wetlands. There is a lack of uniform data collection and sparse research on correlations between satellite data and in situ measurements. Remote sensing (RS) has shown great promise in environmental monitoring. This project attempts to use satellite data and correlate metrics with in situ observations collected at five estuaries. Images for satellite data were processed to calculate 7 bands (SIs) using Python. Average SI values were calculated per month for 23 years. Publicly available data from 6 sites at ELK was used to obtain 10 parameters (OPs). Average OP values were calculated per month for 23 years. Linear correlations between the 7 SIs and 10 OPs were made and found to be inadequate (correlation = 1 to 64%). Fourier transform analysis on 7 SIs was performed. Dominant frequencies and amplitudes were extracted for 7 SIs, and a machine learning(ML) model was trained, validated, and tested for 10 OPs. Better correlations were observed between SIs and OPs, with certain time delays (0, 3, 4, 6 month delay), and ML was again performed. The OPs saw improved R² values in the range of 0.2 to 0.93. This approach can be used to get periodic analyses of overall wetland health with satellite indices. It proves that remote sensing can be used to develop correlations with critical parameters that measure eutrophication in situ data and can be used by practitioners to easily monitor wetland health.

Keywords: estuary, remote sensing, machine learning, Fourier transform

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Authors: Aina Barcelona, Carolyn Oldham, Jordi Colomer, Teresa Serra

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The loss of seagrass meadows worldwide is being tackled by formulating coastal restoration strategies. Seagrass loss results in a network of vegetated patches which are barely interconnected, and consequently, the ecological services they provide may be highly compromised. Hence, there is a need to optimize coastal management efforts in order to implement successful restoration strategies, not only through modifying the architecture of the canopies but also by gathering together information on the hydrodynamic conditions of the seabeds. To obtain information on the hydrodynamics within the patches of vegetation, this study deals with the scale analysis of the minimum lengths of patch management strategies that can be effectively used on. To this aim, a set of laboratory experiments were conducted in a laboratory flume where the plant densities, patch lengths, and hydrodynamic conditions were varied to discern the vegetated patch lengths that can provide optimal ecosystem services for canopy development. Two possible patch behaviours based on the turbulent kinetic energy (TKE) production were determined: one where plants do not interact with the flow and the other where plants interact with waves and produce TKE. Furthermore, this study determines the minimum patch lengths that can provide successful management restoration. A canopy will produce TKE, depending on its density, the length of the vegetated patch, and the wave velocities. Therefore, a vegetated patch will produce plant-wave interaction under high wave velocities when it presents large lengths and high canopy densities.

Keywords: seagrass, minimum patch size, turbulent kinetic energy, oscillatory flow

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Authors: Oum Elkhir Mahmoudi, Nebiha Ben Haj Ali

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Micropaleontological, sedimentological and statistical studies were carried out on the late Paleocene-early Eocene succession of Sra Ouertaine and Dyr El Kef in Northern open phosphatic Basin of Tunisia. Based on the abundance and stratigraphic distribution of planktic foraminiferal species, five planktic zones have been recognized from the base to the top of the phosphatic layers. The El Acarinina sibaiyaensis Zone, the E2 Pseudohastigerina wilcoxensis Zone, the E3 Morozovella marginodentata Zone, the E4 Morozovella formosa Zones and the E5 Morozovella subbotinae Zone. The placement of Paleocene-Eocene boundary (PETM) is just below the base of the phosphatic interval. The ETM-2 event may be detectable in the analyzed biotic record of Sra Ouertaine. Based on benthic assemblages, abundances, cluster and multivariate statistical analyses, two biofacies were recognized for each section. The recognized ecozones are typical of warm and shallow water inner neritic setting (dominance of epifaunal fauna Anomalinoides, Dentalina and Cibicidoides associated with Frondicularia phosphatica, Trochamminoides globigeriniformis and Eponides elevatus). The paleoenvironment is eutrophic (presence of several bolivinitids and verneuilinids). For the Dyr El Kef section and P5 and E2 of Sra Ouertaine section, our records indicate that paleoenvironment is influenced by coastal upwelling without oxygen-deficiency, the paleodepth is estimated to be around 50 m. The paleoecosystem is diversified and balanced with a general tendency to stressed condition. While the upper part of Sra Ouertaine section is more eutrophic, influenced by coastal upwelling with oxygen-deficiency, the paleodepth is estimated to be less than 50 m and the ecosystem is unsettled.

Keywords: Tunisia, Sra ouertaine Dyr el kef, early Eocene, foraminifera, chronostratigraphy, paleoecology, paleoenvironment

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Authors: Alaa Abdellatif, Gabrièle Breda

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Background. Advanced therapy medicinal products (ATMPs) are innovative therapies that mainly target orphan diseases and high unmet medical needs. ATMP includes gene therapy medicinal products (GTMP), somatic cell therapy medicinal products (CTMP), and tissue-engineered therapies (TEP). Since legislation opened the way in 2007, 25 ATMPs have been approved in the EU, which is about the same amount as the U.S. Food and Drug Administration. However, not all of the ATMPs that have been approved have successfully reached the market and retained their approval. Objectives. We aim to understand all the factors limiting the market access to very promising therapies in a systemic approach, to be able to overcome these problems, in the future, with scientific, regulatory and commercial innovations. Further to recent reviews that focus either on specific countries, products, or dimensions, we will address all the challenges faced by ATMP development today. Methodology. We used mixed methods and a multi-level approach for data collection. First, we performed an updated academic literature review on ATMP development and their scientific and market access challenges (papers published between 2018 and April 2023). Second, we analyzed industry feedback from cell and gene therapy webinars and white papers published by providers and pharmaceutical industries. Finally, we established a comparative analysis of the regulatory guidelines published by EMA and the FDA for ATMP approval. Results: The main challenges in bringing these therapies to market are the high development costs. Developing ATMPs is expensive due to the need for specialized manufacturing processes. Furthermore, the regulatory pathways for ATMPs are often complex and can vary between countries, making it challenging to obtain approval and ensure compliance with different regulations. As a result of the high costs associated with ATMPs, challenges in obtaining reimbursement from healthcare payers lead to limited patient access to these treatments. ATMPs are often developed for orphan diseases, which means that the patient population is limited for clinical trials which can make it challenging to demonstrate their safety and efficacy. In addition, the complex manufacturing processes required for ATMPs can make it challenging to scale up production to meet demand, which can limit their availability and increase costs. Finally, ATMPs face safety and efficacy challenges: dangerous adverse events of these therapies like toxicity related to the use of viral vectors or cell therapy, starting material and donor-related aspects. Conclusion. As a result of our mixed method analysis, we found that ATMPs face a number of challenges in their development, regulatory approval, and commercialization and that addressing these challenges requires collaboration between industry, regulators, healthcare providers, and patient groups. This first analysis will help us to address, for each challenge, proper and innovative solution(s) in order to increase the number of ATMPs approved and reach the patients

Keywords: advanced therapy medicinal products (ATMPs), product development, market access, innovation

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Authors: Elaine Wong Yee-Sing, Liaw Wee Tong

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Rapid transformations in demographic and socioeconomic shifts are leading to a growing global demand for health and beauty products and services that demands holistic concepts of well-being. In addition, technological breakthroughs such as internet of things make it convenient and offer innovative solutions for well-being and engage consumers to track their own health conditions and fitness goals. This 'new health economy' encompasses three key concepts: well-being, well-conditioned and well-shaped; which are shaped by wellness segments and goals that influence purchasing decisions of consumers. The research protocol aims to examine the feasibility, challenges, and capabilities in provision for each customer with an ecosystem, or platform, that organizes data and insights to create an individual health and fitness, nutrition, and beauty profile. Convenience sampling of 100 consumers residing in private housing within five major districts in Singapore will be selected to participate in the study. Statistical Package for Social Science 25 will be used to conduct descriptive statistics for quantitative data while qualitative data results using focus interviews, will be translated and transcribed to identify improvements in provision of these services. Rising income in emerging global markets is fuelling the demand for these general wellbeing products and services. Combined with technological advances, it is imperative to understand how these highly personalized services with integrated technology can be designed better to support consumer preferences; provide greater flexibility and high-quality service, and generate better health awareness among consumers.

Keywords: beauty, consumers, health, technology, wellness

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Authors: Paveenapat Nithitantiwat, Kwanjai Pataipakaipet

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The purpose of this research was to study the happiness level of nursing students, Boromarajonani College of nursing, Ratchaburi, Thailand. A purposive sampling of 652 first to four-year nursing students was used. This research is descriptive research. The instruments were questionnaires that developed by the researcher. It included the demographic data and nursing student’s perception about healthcare, safety, life security, family, proud of oneself, education and activities, dormitories and environment in college, and how to improve their happiness. Frequencies, percentage, mean, and T-test is used to analysis the data. The results of the research have shown that family and moral value was an important thing in nursing student’s life. In addition, the mean of the happiness level was a high level. The first year nursing students had the higher mean score of the happiness level than the fourth year, second year, and the third year, respectively. Therefore, nursing students would realize that the important things in their life are family and Buddhism’s teaching. In addition, dharma is guideline how to be both academic achievements and successful in life.

Keywords: happiness, nursing students, nursing students’ perceptions, bachelor program

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Authors: Taurai T. Chikotie, Bruce W. Watson

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The manifestation of ‘new’ infectious diseases and the re-emergence of ‘old’ infectious diseases now present global problems and Southern Africa has not been spared from such calamity. Although having an organized public health system, countries in this region have failed to leverage on the proliferation in use of Information and Communication Technologies to promote effective disease surveillance. Objective: The objective of this study was to critically review and analyse the crucial variables to consider in the development and implementation of electronic disease surveillance systems in public health within the context of Southern Africa. Methodology: A critical review of literature published in English using, Google Scholar, EBSCOHOST, Science Direct, databases from the Centre for Disease Control (CDC and articles from the World Health Organisation (WHO) was undertaken. Manual reference and grey literature searches were also conducted. Results: Little has been done towards harnessing the potential of information technologies towards disease surveillance and this has been due to several challenges that include, lack of funding, lack of health informatics experts, poor supporting infrastructure, an unstable socio-political and socio-economic ecosystem in the region and archaic policies towards integration of information technologies in public health governance. Conclusion: The Southern African region stands to achieve better health outcomes if they adopt the use of e-disease surveillance systems in public health. However, the dynamics and complexities of the socio-economic, socio-political and technical variables would need addressing to ensure the successful development and implementation of e-disease surveillance systems in the region.

Keywords: critical review, disease surveillance, public health informatics, Southern Africa

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