Search results for: healthcare facility

Authors: António J. R. Neves, Rui Garcia, Paulo Dias, Alina Trifan

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With the aging of the world population and the continuous growth in technology, service robots are more and more explored nowadays as alternatives to healthcare givers or personal assistants for the elderly or disabled people. Any service robot should be capable of interacting with the human companion, receive commands, navigate through the environment, either known or unknown, and recognize objects. This paper proposes an approach for object recognition based on the use of depth information and color images for a service robot. We present a study on two of the most used methods for object detection, where 3D data is used to detect the position of objects to classify that are found on horizontal surfaces. Since most of the objects of interest accessible for service robots are on these surfaces, the proposed 3D segmentation reduces the processing time and simplifies the scene for object recognition. The first approach for object recognition is based on color histograms, while the second is based on the use of the SIFT and SURF feature descriptors. We present comparative experimental results obtained with a real service robot.

Keywords: object detection, feature, descriptors, SIFT, SURF, depth images, service robots

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Authors: Rowen Naicker, Dhiren Allopi

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One of the major problems the Port of Durban is experiencing is addressing shallow spots aggravated by megaships that berth. In the recent years, the vessels that call at the Port have increased in size which calls for draughts that are much deeper. For this reason, these larger vessels can only berth under high tide to avoid the risk of running aground. In addition to this, the ships cannot sail in fully laden which does not make it feasible for ship owners. Further during the berthing materials are displaced from the seabed which result in shallow spots being developed. The permitted draft (under-keel allowance) for the Durban Container Terminal (DCT) is currently 12.2 m. Transnet National Ports Authority (TNPA) are currently investing in a dredging fleet worth almost two billion rand. One of the highlights of this investment would be the building of grab hopper dredger that would be dedicated to the Port by 2017. TNPA are trying various techniques to dissolve the reduction of draughts by implementing dredging maintenance projects but is this sufficient? The ideal resolution would be the deepening and widening of the berths. Plans for this project is in place, but the implementation process is a matter of urgency. The intention of this project will be to accommodate three big vessels rather than two which in turn will improve the turnaround time in the port. The berthing will then no longer depend on high tide to avoid ships running aground. The aim of this paper is to prove the implementation of deepening and widening of the Port of Durban is a matter of urgency. If the plan to deepen and widen the berths at DCT is delayed it will mean a loss of business for the South African economy. If larger vessels cannot be accommodated in the Port of Durban, it will bypass the busiest container handling facility in the Southern hemisphere. Shipping companies are compelled to use larger ships as opposed to smaller vessels to lower port and fuel costs. A delay in the expansion of DCT could also result in an escalation of costs.

Keywords: DCT, deepening, berth, port

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Authors: Gayatri Mahajan

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Modern Construction Technology (CT) includes a broad range of advanced techniques and practices that bound the recent developments in material technology, design methods, quantity surveying, facility management, services, structural analysis and design, and other management education. Adoption of recent digital transformation technology is the need of today to speed up the business and is also the basis of construction improvement. Incorporating and practicing the technologies such as cloud-based communication and collaboration solution, Mobile Apps and 5G,3D printing, BIM and Digital Twins, CAD / CAM, AR/ VR, Big Data, IoT, Wearables, Blockchain, Modular Construction, Offsite Manifesting, Prefabrication, Robotic, Drones and GPS controlled equipment expedite the progress in the Construction industry (CI). Resources used are journaled research articles, web/net surfing, books, thesis, reports/surveys, magazines, etc. The outline of the research organization for this study is framed at four distinct levels in context to conceptualization, resources, innovative and emerging trends in CI, and better methods for completion of the construction projects. The present study conducted during 2020-2022 reveals that implementing these technologies improves the level of standards, planning, security, well-being, sustainability, and economics too. Application uses, benefits, impact, advantages/disadvantages, limitations and challenges, and policies are dealt with to provide information to architects and builders for smooth completion of the project. Results explain that construction technology trends vary from 4 to 15 for CI, and eventually, it reaches 27 for Civil Engineering (CE). The perspective of the most recent innovations, trends, tools, challenges, and solutions is highly embraced in the field of construction. The incorporation of the above said technologies in the pandemic Covid -19 and post-pandemic might lead to a focus on finding out effective ways to adopt new-age technologies for CI.

Keywords: BIM, drones, GPS, mobile apps, 5G, modular construction, robotics, 3D printing

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Authors: Zenaida M. De Guzman, Davison T. Baldos, Gilberto T. Diano, Jeff Darren G. Valdez, Levelyn Mitos Tolentino, Gina B. Abrera, Ma. Lucia Cobar, Cristina Gragasin

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One of the factors affecting the quality of brown rice is the free fatty acid produced from surface lipids. It is the purpose of the study to determine the effect of gamma radiation, packaging materials and age and variety of paddy on the surface free fatty acid content using two different brown rice variety, namely, RC-160 and SL-7, packed in two different packaging materials, namely, regular polyethylene bag and Super bag irradiated at 0.5 and 1.0 kGy. Brown rice was produced from 2-week old (Lot 1) and two months old paddy (Lot 2) and irradiated at the Co-60 Multipurpose Irradiation Facility, PNRI. The surface Free Fatty Acid (FFA) content was obtained following the AOCS Official Method (1982) with some modifications. The experiment was laid out using Split-Plot Randomized Control Block Design. Analysis of variance (ANOVA) showed that the effects of variety, age of paddy and interactions of both were both significant. The surface FFA of SL-7 variety was found to be significantly higher than the RC-160 variety for all radiation doses. Likewise, Lot 2 was observed to have higher surface FFA than Lot 1 regardless of packaging material and radiation dose. It was observed that the surface FFA of both varieties packed in both packaging materials increased significantly up to the 2nd or 3rd month of storage and remains the same until the 5th month. On the other hand, radiation dose did not significantly affect the surface free fatty acid content for all storage/sampling time while the packaging material significantly interacts with the type of variety and radiation dose. Gamma radiation was proven to have no significant effect on the surface free fatty acid at 0.5 and 1.0 kGy and further analyses are needed to determine the action of gamma radiation to the activity of enzyme (lipase-induced and microbial) responsible for the production of other lipolytic products and the effect of gamma radiation on the integrity of the packaging materials.

Keywords: brown rice, free fatty acid, gamma radiation, polyethylene bag

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Authors: Merita Dauti, Edita Alili-Idrizi, Sihana Ahmeti –Lika, Ledjan Malaj

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The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people’s health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection.

Keywords: pharmaceutical waste, legal regulation, proper disposal, environment pollution

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Authors: M. Manohari, S. Priyadharshini, K. Bajeer Sulthan, R. Santhanam, S. Chandrasekaran, B. Venkatraman

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In-vivo monitoring facility at Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, caters to the monitoring of internal exposure of occupational radiation workers from various radioactive facilities of IGCAR. Internal exposure measurement is done using Na(Tl) based Scintillation detectors. Two types of whole-body counters, namely Shielded Chair Counter (SC) and Standing Whole-Body Monitor (SWBM), are being used. The shielded Chair is based on a NaI detector of 20.3 cm diameter and 10.15 cm thick. The chair of the system is shielded using lead shots of 10 cm lead equivalent and the detector with 8 cm lead bricks. Counting geometry is sitting geometry. Calibration is done using 95 percentile BOMAB phantom. The minimum Detectable Activity (MDA) for 137Cs for the 60s is 1150 Bq. Standing Wholebody monitor (SWBM) has two NaI(Tl) detectors of size 10.16 x 10.16 x 40.64 cm3 positioned serially, one over the other. It has a shielding thickness of 5cm lead equivalent. Counting is done in standup geometry. Calibration is done with the help of Ortec Phantom, having a uniform distribution of mixed radionuclides for the thyroid, thorax and pelvis. The efficiency of SWBM is 2.4 to 3.5 times higher than that of the shielded chair in the energy range of 279 to 1332 keV. MDA of 250 Bq for 137Cs can be achieved with a counting time of 60s. MDA for 131I in the thyroid was estimated as 100 Bq from the MDA of whole-body for one-day post intake. Standing whole body monitor is better in terms of efficiency, MDA and ease of positioning. In case of emergency situations, the optimal MDAs for in-vivo monitoring service are 1000 Bq for 137Cs and 100 Bq for 131I. Hence, SWBM is more suitable for the rapid screening of workers as well as the public in the case of an emergency. While a person reports for counting, there is a potential for external contamination. In SWBM, there is a feasibility to discriminate them as the subject can be counted in anterior or posterior geometry which is not possible in SC.

Keywords: minimum detectable activity, shielded chair, shielding thickness, standing whole body monitor

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Authors: Mohd Amran, Chan Yi Jing, Chong Chien Hwa

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Production of biogas from POME requires anaerobic digestion (AD), thus, anaerobic digester performance in biogas plants is crucial. As POME from different sources have varying characteristics due to different process flows in mills, there is no ideal treatment parameters for POME. Hence, different treatment plants alter different parameters in anaerobic digestion to achieve desired biogas production levels and to meet POME waste discharge limits. The objective of this study is to evaluate the performance of mesophilic anaerobic digestion in four different biogas plants in Malaysia. Aspects of POME pre-treatment efficiency, analysis of treated POME and AD’s bottom sludge characteristics, including several parameters like chemical oxygen demand (COD), biological oxygen demand (BOD), total solid (TS) removal in the effluent, pH and temperature changes, total biogas produced, the composition of biogas including methane (CH₄), carbon dioxide (CO₂), hydrogen sulfide (H₂S) and oxygen (O₂) were investigated. The effect of organic loading rate (OLR) and hydraulic retention time (HRT) on anaerobic digester performance is also evaluated. In pre-treatment, it is observed that BGP B has the lowest average outlet temperature of 40.41°C. All BGP shows a high-temperature fluctuation (36 to 49 0C) and good pH readings (minimum 6.7), leaving the pre-treatment facility before entering the AD.COD removal of POME is considered good, with an average of 78% and maximum removal of 85%. BGP C has the lowest average COD and TS content in treated POME, 13,313 mg/L, and 12,048 mg/L, respectively. However, it is observed that the treated POME leaving all ADs, still contains high-quality organic substances (COD between 12,000 to 19,000 mg/L) that might be able to digest further to produce more biogas. The biogas produced in all four BGPs varies due to different COD loads. BGP B has the highest amount of biogas produced, 378,874.7 Nm³/month, while BGP D has the lowest biogas production of 272,378.5 Nm³/month. Furthermore, the composition of biogas produced in all plants is well within literature values (CH4 between 55 to 65% and CO₂ between 32 to 36%).

Keywords: palm oil mill effluent, in-ground lagoon anaerobic digester, anaerobic digestion, biogas

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Authors: Gbone Akou Sophie

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Lome state in Togo is considered to have the highest HIV prevalence in Togo according to NAIIS 2023, with the prevalence of 5.5%, Female Sex Workers (FSW) are one of the most vulnerable population, and they are vital in HIV programming. They have the highest HIV prevalence compared to others such as HRM, PWID and Transgender in lome State, Togo. Evidence from Integrated Biological Behavioral Surveillance Survey shows increasing burden of HIV infection from 13.7% in 20018 to 17.2% in 2020 and now 22.9% in 2021 among Female Sex Workers (FSW). This shows their HIV prevalence has been rising over time. The vulnerability status of the FSW in the riverine areas of lome is heightened because of cultural and economic issues where there is exchange of sex for commodities with cross border traders as well as limited access to HIV prevention information. Methods:A cross sectional study which recruited 120 FSW from two Riverine LGAs of Agoe and Kpehenou LGA of Lome State using both snowballing and simple random sampling technique. While semi-structured questionnaire was used as an instrument for data collection among the 120 FSW respondents. Additional information was also elicited from 10 FSW key opinion leaders and community members through in-depth interviews (IDI). Results: 44(36%) of respondents were willing to receive regular HIV care and services as well as visit for STI check-ups at any service point. However, 47(40%) were willing to receive services at private facilities alone, 10 (8%) were willing to receive services at public facilities, 6 (5%) were willing to access services in their homes rather than in the health facility. 13 (11%) were also willing to have peers assist in getting HIV testing services. Conclusion: integrated differentiated model of care for HIV services helps improve HIV services uptake among FSW community especially in the hard- to reach riverine areas which will further lead to epidemic control. Also targeted HIV information should be designed to suit the learning needs of the hard-to reach communities like the riverine areas. More peer educators should be engaged to ensure information and other HIV services reach the riverine communities.

Keywords: female sex workers ( FSW), human immuno-deficiency virus(HIV), prevanlence, service delivery

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Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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Authors: Kristel Faye Tandog

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The State Owned Enterprise (SOE) or also called Public Enterprise (PE) has been playing a vital role in a country’s social and economic development. Following this idea, this study focused on the Factor Structures of Financial Performance of the Local Economic Enterprises (LEEs) namely: Food Court, Market, Slaughterhouse, and Terminal in Matalam, Cotabato. It aimed to determine the profile of the LEEs in terms of organizational structure, manner of creation, years in operation, source of initial operating requirements, annual operating budget, geographical location, and size or description of the facility. This study also included the different financial ratios of LEE that covered a five year period from Calendar Year 2009 to 2013. Primary data using survey questionnaire was administered to 468 respondents and secondary data were sourced out from the government archives and financial documents of the said LGU. There were 12 dominant factors identified namely: “management”, “enforcement of laws”, “strategic location”, “existence of non-formal competitors”, “proper maintenance”, “pricing”, “customer service”, “collection process”, “rentals and services”, “efficient use of resources”, “staffing”, and “timeliness and accuracy”. On the other hand, the financial performance of the LEE of Matalam, Cotabato using financial ratios needs reformatting. This denotes that refinement as to the following ratios: Cash Flow Indicator, Activity, Profitability and Growth is necessary. The cash flow indicator ratio showed difficulty in covering its debts in successive years. Likewise, the activity ratios showed that the LEE had not been effective in putting its investment at work. Moreover, profitability ratios revealed that it had operated in minimum capacity and had incurred net losses and thus, it had a weak profit performance. Furthermore, growth ratios showed that LEE had a declining growth trend particularly in net income.

Keywords: factor structures, financial performance, financial ratios, state owned enterprises

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Authors: Sastry Y. Kandukuri, Isak Andersen

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Despite recent advances in the manufacturing sector, quality issues remain a frequent occurrence, and can result in fatal accidents, equipment downtime, and loss of life. Adequate quality is of high importance in high-risk industries such as sea-going vessels and offshore installations in which third party quality assurance and product control play an important essential role in ensuring manufacturing quality of critical components. Classification societies play a vital role in mitigating risk in these industries by making sure that all the stakeholders i.e. manufacturers, builders, and end users are provided with adequate rules and standards that effectively ensures components produced at a high level of quality based on the area of application and risk of its failure. Quality issues have also been linked to the lack of competence or negligence of stakeholders in supply value chain. However, continued actions and regulatory reforms through modernization of rules and requirements has provided additional tools for purchasers and manufacturers to confront these issues. Included among these tools are updated ‘approval of manufacturer class programs’ aimed at developing and implementing a set of standardized manufacturing quality metrics for use by the manufacturer and verified by the classification society. The establishment and collection of manufacturing and testing requirements described in these programs could provide various stakeholders – from industry to vessel owners – with greater insight into the state of quality at a given manufacturing facility, and allow stakeholders to anticipate better and address quality issues while simultaneously reducing unnecessary failures that are costly to the industry. The publication introduces, explains and discusses critical manufacturing and testing requirements set in a leading class society’s approval of manufacturer regime and its rationale and some case studies.

Keywords: classification society, manufacturing, materials processing, materials testing, quality control

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Authors: Danielle Page

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Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This dissertation aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases.

Keywords: psychotraumatology, forensic psychology, PTSD, vietnam veterans

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Authors: Tosin Deborah Akanbi, Adeyemi Oluwaseun Adepoju, Hameed Olusegun Adebambo, Akinloye Fatai Lawal

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Building information modelling (BIM) is a process that starts with the development of a sequential 3D design and encourages data administration, organization, and visualization throughout the life span of a facility (drawings, construction, and supervision). The implementation of building information modelling has been slow in recent years, and this is due to some prominent barriers that hinder its adoption. In this regard, the study aims to examine the significant barriers that influence the adoption of building information modelling in the Lagos state construction industry. Data were gathered through a questionnaire survey with 332 construction professionals in the study area. Three online structured interviews were conducted to support and validate the findings of the quantitative analysis. The results revealed that interest (lack of awareness and understanding of BIM, absence of in-house BIM competent professionals, and unavailability of BIM competent professionals in the labour market), legal (lack of policies and regulations on copyright ownership and lack of enforcement from government agencies and industry leaderships) and professional (people’s inability or refusal to learn new technologies and processes, waste in time and human resource and lack of clarity of professional roles in BIM) barriers are the major barriers influencing the adoption of BIM. The results also revealed that six final themes were generated, namely: finance barriers, industry barriers, interest barriers, leadership barriers, legal barriers, and professional barriers. Thus, there is a need for policymakers to design and implement policies (regulatory, economic, and information) to promote financial schemes to support construction firms and professionals and to reduce financial barriers. It is also important for the government to lay down rules and regulations that must be enforced among the construction professionals and firms in the Lagos state construction industry.

Keywords: BIM barriers, BIM adoption characteristics, construction industry, Lagos State Nigeria

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Authors: Ian Walmsley

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The aim of this paper is to explore the influence of time and temporality on the experience of coming off heroin in prison. The presentation draws on qualitative data collected during a small-scale pilot study of the role of self-care in the process of coming off drugs in prison. Time and temporality emerged as a key theme in the interview transcripts. Drug dependent prisoners experience of time in prison has not been recognized in the research literature. Instead, the literature on prison time typically views prisoners as a homogenous group or tends to focus on the influence of aging and gender on prison time. Furthermore, there is a tendency in the literature on prison drug treatment and recovery to conceptualize drug dependent prisoners as passive recipients of prison healthcare, rather than active agents. In building on these gaps, this paper argues that drug dependent prisoners experience multiple temporalities which involve an interaction between the body-times of the drug dependent prisoner and the economy of time in prison. One consequence of this interaction is the feeling that they are doing, at this point in their prison sentence, double prison time. The second part of the argument is that time and temporality were a means through which they governed their withdrawing bodies. In addition, this paper will comment on the challenges of prison research in England.

Keywords: heroin withdrawal, time and temporality, prison, body

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Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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Authors: James Pietris

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Glaucoma is a collection of irreversible optic neuropathies which, if left untreated, lead to severe visual field loss. These diseases are a leading cause of blindness across the globe and are estimated to affect approximately 80 million people, particularly women and people of Asian descent.1This represents a major burden on healthcare systems worldwide. Recently, there has been increasing interest in the potential of nicotinamide (vitamin B3) as a novel option in the management of glaucoma. This review aims to analyse the currently available literature to determine whether there is evidence of an association between nicotinamide adenine dinucleotide (NAD+) and glaucomatous optic neuropathy and whether nicotinamide has the potential to prevent or reverse these effects. The literature showed a strong connection between reduced NAD+ levels and retinal ganglion cell dysfunction through multiple different studies. There is also evidence of the positive effect of nicotinamide supplementation on retinal ganglion cell function in models of mouse glaucoma and in a study involving humans. Based on the literature findings, a recommendation has been made that more research into the efficacy, appropriate dosing, and potential side effects of nicotinamide supplementation is needed before it can be definitively determined whether it is appropriate for widespread prophylactic and therapeutic use against glaucoma in humans.

Keywords: glaucoma, nicotinamide, vitamin B3, optic neuropathy

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Jessie Fazel, Kristen Smith

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Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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Authors: H. Saikouk, D. Laux, Emmanuel Le Clézio, B. Lacroix, K. Audic, R. Largenton, E. Federici, G. Despaux

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Pressurized Water Reactor (PWR) fuel rods are made of ceramic pellets (e.g. UO2 or (U,Pu) O2) assembled in a zirconium cladding tube. By design, an initial gap exists between these two elements. During irradiation, they both undergo transformations leading progressively to the closure of this gap. A local and non destructive examination of the pellet/cladding interface could constitute a useful help to identify the zones where the two materials are in contact, particularly at high burnups when a strong chemical bonding occurs under nominal operating conditions in PWR fuel rods. The evolution of the pellet/cladding bonding during irradiation is also an area of interest. In this context, the Institute of Electronic and Systems (IES- UMR CNRS 5214), in collaboration with the Alternative Energies and Atomic Energy Commission (CEA), is developing a high frequency acoustic microscope adapted to the control and imaging of the pellet/cladding interface with high resolution. Because the geometrical, chemical and mechanical nature of the contact interface is neither axially nor radially homogeneous, 2D images of this interface need to be acquired via this ultrasonic system with a highly performing processing signal and by means of controlled displacement of the sample rod along both its axis and its circumference. Modeling the multi-layer system (water, cladding, fuel etc.) is necessary in this present study and aims to take into account all the parameters that have an influence on the resolution of the acquired images. The first prototype of this microscope and the first results of the visualization of the inner face of the cladding will be presented in a poster in order to highlight the potentials of the system, whose final objective is to be introduced in the existing bench MEGAFOX dedicated to the non-destructive examination of irradiated fuel rods at LECA-STAR facility in CEA-Cadarache.

Keywords: high-frequency acoustic microscopy, multi-layer model, non-destructive testing, nuclear fuel rod, pellet/cladding interface, signal processing

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Authors: Caroline Smith, Professor Debi Bhattacharya, Sion Scott

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Introduction: Oropharyngeal Dysphagia (OD) effects around 15% of older people, however it is often unrecognised and under diagnosed until they are hospitalised. There is a need for primary care healthcare practitioners (HCPs) to assume a proactive role in identifying and managing OD to prevent adverse outcomes such as aspiration pneumonia. Understanding the determinants of primary care HCPs undertaking this new behaviour provides the intervention targets for addressing. This realist review, underpinned by the Theoretical Domains Framework (TDF), aims to synthesise relevant literature and develop programme theories to understand what interventions work, how they work and under what circumstances to facilitate HCPs to prevent harm from OD. Combining realist methodology with behavioural science will permit conceptualisation of intervention components as theoretical behavioural constructs, thus informing the design of a future behaviour change intervention. Furthermore, through the TDF’s linkage to a taxonomy of behaviour change techniques, we will identify corresponding behaviour change techniques to include in this intervention. Methods & analysis: We are following the five steps for undertaking a realist review: 1) clarify the scope 2) Literature search 3) appraise and extract data 4) evidence synthesis 5) evaluation. We have searched Medline, Google scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We are obtaining additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature is being screened, evaluated and synthesised in Excel and Nvivo. We will appraise evidence in relation to its relevance and rigour. Data will be extracted and synthesised according to its relation to Initial programme theories (IPTs). IPTs were constructed after the preliminary literature search, informed by the TDF and with input from a stakeholder group of patient and public involvement advisors, general practitioners, speech and language therapists, geriatricians and pharmacists. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards to report study results. Results: In this ongoing review our search has identified 1417 manuscripts with approximately 20% progressing to full text screening. We inductively generated 10 IPTs that hypothesise practitioners require: the knowledge to spot the signs and symptoms of OD; the skills to provide initial advice and support; and access to resources in their working environment to support them conducting these new behaviours. We mapped the 10 IPTs to 8 TDF domains and then generated a further 12 IPTs deductively using domain definitions to fulfil the remaining 6 TDF domains. Deductively generated IPTs broadened our thinking to consider domains such as ‘Emotion,’ ‘Optimism’ and ‘Social Influence’, e.g. If practitioners perceive that patients, carers and relatives expect initial advice and support, then they will be more likely to provide this, because they will feel obligated to do so. After prioritisation with stakeholders using a modified nominal group technique approach, a maximum of 10 IPTs will progress to test against the literature.

Keywords: behaviour change, deglutition disorders, primary healthcare, realist review

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Authors: Abdullah Alenezi, Mane Alsudrawi, Rafat Misak

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Kuwait is faced with a potentially wide and harmful range of both natural and anthropogenic hazardous events such as dust storms, floods, fires, nuclear accidents, earthquakes, oil spills, tsunamis and other disasters. For Kuwait can be highly vulnerable to these complex environmental risks, an up-to-date and in-depth understanding of their typology, genesis, and impact on the Kuwaiti society is needed. Adequate anticipation and management of environmental crises further require a comprehensive system of decision support to the benefit of decision makers to further bridge the gap between (technical) risk understanding and public action. For that purpose, the Kuwait Institute for Scientific Research (KISR), intends to establish a decision support center for management of the environmental crisis in Kuwait. The center will support policy makers, stakeholders and national committees with technical information that helps them efficiently and effectively assess, monitor to manage environmental disasters using decision support tools. These tools will build on state of the art quantification and visualization techniques, such as remote sensing information, Geographical Information Systems (GIS), simulation and prediction models, early warning systems, etc. The center is conceived as a central facility which will be designed, operated and managed by KISR in coordination with national authorities and decision makers of the country. Our vision is that by 2035 the center will be recognized as a leading national source of scientific advice on national risk management in Kuwait and build unity of effort among Kuwaiti’s institutions, government agencies, public and private organizations through provision and sharing of information. The project team now focuses on capacity building through upgrading some KISR facilities manpower development, build strong collaboration with international alliance.

Keywords: decision support, environment, hazard, Kuwait

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Authors: John Olav Bjornestad, Bjorn Tore Johansen

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The number of people suffering from mental illnesses is increasing, and such illness is currently one of the major causes of disability and poor health. The reason for this is most likely a lack of physical activity. The purpose of this study was to discover if physical activity was an effective mode of treatment for psychiatric patients at an out-patient treatment facility. The study included an exploration of whether or not patients having physical activity included as an integral part of their treatment (to a greater degree than do patients who are physically inactive) would achieve 1) an improvement in their physical condition 2) a reduction in symptomatic pressure and 3) an increase in their health-related quality of life. The intervention period lasted a total of 12 weeks. The training group completed a minimum of 2 training sessions per week with an intensity of 60-75% of maximum heart rate. The participants’ health-related quality of life (SF-36), symptomatic pressure (SCL-90-R) and physical condition (UKK-walking test) were measured before and after intervention. Twenty participants were pre-tested, and out of this initial group, nine patients completed the intervention program and participated thereafter in post-testing. The results showed that participants on average improved their physical condition, reduced their symptomatic pressure and increased their health-related quality of life over the course of the intervention period. The training group experienced significant changes in their symptomatic pressure (the anxiety dimension) and health-related quality of life (the mental health dimension) from the pre-testing stage to the post-testing one. Furthermore, there was a significant connection between symptomatic pressure and health-related quality of life. The patients who were admitted to the psychiatric out-patient clinic were in a physical condition that was significantly poorer than that of persons of the same age in the remainder of the population. Experiences from the study and the relatively large defection from it demonstrate that there is a great need for close follow-up of psychiatric patients’ physical activity levels when physical activity and lifestyle changes are included as part of their treatment program.

Keywords: health-related quality, mental health, physical activity, physical condition

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Authors: Ahmet Kurklu, Abdussamed Sarp, Gokmen Arikan, Akin Eren, Arif Ulu, Ferit Cakir

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Our natural resources are diminishing day by day with the needs of the growing world population. There is a danger that these resources will be depleted if they are not used in a controlled manner. As a result of the rapid increase in the consumption of limited natural resources, one of the issues where studies have gained importance is recycling. Many countries have carried out various research and development activities on recycling and reuse to prevent wastage of resources. For sustainable and healthy living, the limited amount of raw material resources in nature should be consumed consciously, and the necessary awareness should be given for recycling activities. One of the sectors where the consumption of raw materials is high is the construction sector. With the changing consumption habits of the evolving technology in the construction sector, the need to use special concrete along with the normal concrete has arisen. With the increasing need for specialty concretes, polymer concrete, which was discovered in the early 1900s, has evolved to the present day. Polymer concretes are special concretes with high strength, water impermeability, resistance to chemical action, and low surface roughness. Thanks to these properties, they find wide applications in many fields such as swimming pools, drainage systems, repair works. In the study, the effect of using recycled aggregates instead of natural aggregates in the production of polymer concrete on the performance of polymer concrete is investigated. In the experiments conducted for this purpose, the use of natural aggregate is reduced at certain rates, and instead, recycled aggregate is added at the same rate. The recycled aggregate to be used in the study is obtained from the polymer concrete drainage channel production facility of Mert Casting Co., Istanbul, Turkey. In order to clearly observe the effect of recycled materials on the product in the study, the other components (resin, hardener, accelerator, and additive) are kept constant in the concrete mix. In the study, fresh and hardened concrete tests are to be carried out on the mixes to be prepared.

Keywords: concrete, mechanical properties, polymer concrete, recycle aggregate

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Authors: A. Bertašienė

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Energy harvesting from any structure makes a challenge. Different structure of air/wind flows in industrial, environmental and residential applications emerge the real flow investigation in detail. Many of the application fields are hardly achievable to the detailed description due to the lack of up-to-date statistical data analysis. In situ measurements aim crucial investments thus the simulation methods come to implement structural analysis of the flows. Different configurations of testing environment give an overview how important is the simple structure of field in limited area on efficiency of the system operation and the energy output. Several configurations of modeled working sections in air flow test facility was implemented in CFD ANSYS environment to compare experimentally and numerically air flow development stages and forms that make effects on efficiency of devices and processes. Effective form and amount of these flows under different geometry cases define the manner of instruments/devices that measure fluid flow parameters for effective operation of any system and emission flows to define. Different fluid flow regimes were examined to show the impact of fluctuations on the development of the whole volume of the flow in specific environment. The obtained results rise the discussion on how these simulated flow fields are similar to real application ones. Experimental results have some discrepancies from simulation ones due to the models implemented to fluid flow analysis in initial stage, not developed one and due to the difficulties of models to cover transitional regimes. Recommendations are essential for energy harvesting systems in both, indoor and outdoor cases. Further investigations aim to be shifted to experimental analysis of flow under laboratory conditions using state-of-the-art techniques as flow visualization tool and later on to in situ situations that is complicated, cost and time consuming study.

Keywords: fluid flow, initial region, tube coefficient, distinct shape

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Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the country. The elevated death and disease among ex-slaves were attributable to the unavailability of healthcare. To address the paucity of healthcare services, the College, an institution with the mission of educating minority professionals and serving the under served population, was established in 1876. This study was designed to assess if the College has accomplished its mission of serving under served communities and contributed to the elimination of health disparities in the United States. The study objective was to quantify the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities, which, in turn, was significantly associated with a health professional shortage score partly designated by the U.S. Department of Health and Human Services. Various statistical methods were used to analyze the alumni data in years 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates into the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t test was performed to detect the significant mean differences for clustering and criterion variables between Disadvantaged and Non-disadvantaged Communities, which confirms the “content” validity of cluster analysis model. Chi-square test was used to assess if the proportion of cluster groups (Disadvantaged vs Non-disadvantaged Communities) were consistent with that of practicing specialties (primary care vs. non-primary care). Finally, the partial least squares (PLS) path model was constructed to explore the “construct” validity of analytics model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving disadvantaged community. The social ecological theory along with statistical models mentioned was used to establish the relationship between medical and dental graduates (primary care professionals serving disadvantaged communities) and their social environments (socioeconomic status, adverse health outcome, health professional shortage score). Based on social ecological framework, it was hypothesized that the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities could be quantified. Also, primary care professionals serving disadvantaged communities related to a health professional shortage score can be measured. Adverse health outcome (adult obesity rate, age-adjusted premature mortality rate, and percent of people diagnosed with diabetes) could be affected by the latent variable, namely socioeconomic status (unemployment rate, poverty rate, percent of children who were in free lunch programs, and percent of uninsured adults). The study results indicated that approximately 83% (3,192/3,864) of the College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. In addition, the PLS path modeling demonstrated that primary care professionals serving disadvantaged community was significantly associated with socioeconomic status and adverse health outcome (p < .001). In summary, the majority of medical and dental graduates from the College provide primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcomes, which demonstrate that the College has fulfilled its mission.

Keywords: disadvantaged community, K-means cluster analysis, PLS path modeling, primary care

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Authors: Norhanim Nordin, Rosnah Shamsudin, Azrina Azlan, Mohammad Effendy Ya’acob

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An environmental friendly approach for disposal of voluminous durian husk waste could be implemented by substituting them into various valuable commodities, such as healthcare and biofuel products. Thus, the study of composition value in each segment of durian husk was very crucial to determine the suitable proportions of nutrients that need to be added and mixed in the product. A total of 12 ‘Durian Kampung’ fruits from Sg Ruan, Pahang were selected and each fruit husk was divided into four segments and labelled as P-L (thin neck area of white inner husk), P-B (thick bottom area of white inner husk), H (green and thorny outer husk) and W (whole combination of P-B and H). Four experiments have been carried out to determine the dry matter, moisture, ash and crude fibre content. The results show that the H segment has the highest dry matter content (30.47%), while the P-B segment has the highest percentage in moisture (81.83%) and ash (6.95%) content. It was calculated that the ash content of the P-B segment has a higher rate of moisture level which causes the ash content to increase about 2.89% from the P-L segment. These data have proven that each segment of durian husk has a significant difference in terms of composition value, which might be useful information to fully utilize every part of the durian husk in the future.

Keywords: durian husk, crude fibre content, dry matter content, moisture content

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Authors: Jonathan A. Akinwale, Ibukun J. Agotola

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There is a need to rethink how technology is being disseminated to end users in order to ensure wide adoption and utilisation. Aflasafe bio-control was developed to combat aflatoxin in maize to ensure food safety for the end users. This study was designed to assess how the pull mechanism is enhancing the utilisation of this proven technology among maize farmers in Oyo State, Nigeria. The study determines the awareness of farmers on Aflasafe, sources of purchase of Aflasafe, incentives towards the usage of Aflasafe, constraints to farmers’ utilisation and factors influencing farmers’ utilisation of Aflasafe bio-control measures. Respondents were selected using a multi-stage sampling procedure. Data were collected from respondents through interview schedule and analyzed using descriptive statistics (means, frequencies, and percentages) and inferential statistics (Pearson Product Moment Correlation and regression analysis). The result showed that 89% of the farmers indicated implementers as the outlet for the purchase of Aflasafe. Also, premium payment and provision of technical assistance were the highly ranked incentives to the utilisation of Aflasafe among the farmers. The study also revealed that the major constraints face by respondents were low access to credit facility, inadequate sources of purchase, and lack of storage facilities. A little above half (54%) of the farmers were found to have fully utilized Aflasafe in maize production. Pearson Product Moment Correlation (PPMC) analysis revealed that there was a significant correlation between incentives and utilisation of Aflasafe (r-value=0.274; p ≤ 0.01). The result of the regression analysis indicated maize production experience (β=0.572), output (β=0.531), years of formal education (β=0.404) and household size (β=0.391) as the leading factors influencing farmers utilisation of Aflasafe bio-control in maize production. The study, therefore, recommends that governments and non-governmental organisations should be interested in making Aflasafe available to the maize farmers either through loan provision or price subsidy.

Keywords: Aflasafe bio-control, maize production, production incentives, pull mechanism, utilisation

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Authors: R. Schweighoffer, N. Nagy, E. Reeves, B. Liebig

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Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.

Keywords: collaboration, healthcare networks, palliative care, Switzerland

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