Search results for: social health

Authors: Mahmood Alsaadi, Alexei Lisitsa

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Nowadays, medical devices rely completely on software whether as whole software or as embedded software, therefore, the organization that develops medical device software can benefit from adopting agile practices. Using agile practices in healthcare software development industries would bring benefits such as producing a product of a high-quality with low cost and in short period. However, medical device software development companies faced challenges in adopting agile practices. These due to the gaps that exist between agile practices and the requirements of healthcare regulations such as documentation, traceability, and formality. This research paper will conduct a study to investigate the adoption rate of agile practice in medical device software development, and they will extract and outline the requirements of healthcare regulations such as Food and Drug Administration (FDA), Health Insurance Portability and Accountability Act (HIPAA), and Medical Device Directive (MDD) that affect directly or indirectly on software development life cycle. Moreover, this research paper will evaluate the suitability of using agile practices in healthcare industries by analyzing the most popular agile practices such as eXtream Programming (XP), Scrum, and Feature-Driven Development (FDD) from healthcare industry point of view and in comparison with the requirements of healthcare regulations. Finally, the authors propose an agile mixture model that consists of different practices from different agile methods. As result, the adoption rate of agile practices in healthcare industries still low and agile practices should enhance with regard to requirements of the healthcare regulations in order to be used in healthcare software development organizations. Therefore, the proposed agile mixture model may assist in minimizing the gaps existing between healthcare regulations and agile practices and increase the adoption rate in the healthcare industry. As this research paper part of the ongoing project, an evaluation of agile mixture model will be conducted in the near future.

Keywords: adoption of agile, agile gaps, agile mixture model, agile practices, healthcare regulations

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Authors: Levente Kovács, Fruzsina Luca Kézér, Ottó Szenci

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Prediction of the onset of calving and recognizing difficulties at calving has great importance in decreasing neonatal losses and reducing the risk of health problems in the early postpartum period. In this study, changes of rumination time, reticuloruminal pH and temperature were investigated in eutocic (EUT, n = 10) and dystocic (DYS, n = 8) dairy cows around parturition. Rumination time was continuously recorded using an acoustic biotelemetry system, whereas reticuloruminal pH and temperature were recorded using an indwelling and wireless data transmitting system. The recording period lasted from 3 d before calving until 7 days in milk. For the comparison of rumination time and reticuloruminal characteristics between groups, time to return to baseline (the time interval required to return to baseline from the delivery of the calf) and area under the curve (AUC, both for prepartum and postpartum periods) were calculated for each parameter. Rumination time decreased from baseline 28 h before calving both for EUT and DYS cows (P = 0.023 and P = 0.017, respectively). After 20 h before calving, it decreased onwards to reach 32.4 ± 2.3 and 13.2 ± 2.0 min/4 h between 8 and 4 h before delivery in EUT and DYS cows, respectively, and then it decreased below 10 and 5 min during the last 4 h before calving (P = 0.003 and P = 0.008, respectively). Until 12 h after delivery rumination time reached 42.6 ± 2.7 and 51.0 ± 3.1 min/4 h in DYS and EUT dams, respectively, however, AUC and time to return to baseline suggested lower rumination activity in DYS cows than in EUT dams for the 168-h postpartum observational period (P = 0.012 and P = 0.002, respectively). Reticuloruminal pH decreased from baseline 56 h before calving both for EUT and DYS cows (P = 0.012 and P = 0.016, respectively), but did not differ between groups before delivery. In DYS cows, reticuloruminal temperature decreased from baseline 32 h before calving by 0.23 ± 0.02 °C (P = 0.012), whereas in EUT cows such a decrease was found only 20 h before delivery (0.48 ± 0.05 °C, P < 0.01). AUC of reticuloruminal temperature calculated for the prepartum period was greater in EUT cows than in DYS cows (P = 0.042). During the first 4 h after calving, it decreased from 39.7 ± 0.1 to 39.00 ± 0.1 °C and from 39.8 ± 0.1 to 38.8 ± 0.1 °C in EUT and DYS cows, respectively (P < 0.01 for both groups) and reached baseline levels after 35.4 ± 3.4 and 37.8 ± 4.2 h after calving in EUT and DYS cows, respectively. Based on our results, continuous monitoring of changes in rumination time and reticuloruminal temperature seems to be promising in the early detection of cows with a higher risk of dystocia. Depressed postpartum rumination time of DYS cows highlights the importance of the monitoring of cows experiencing difficulties at calving.

Keywords: reticuloruminal pH, reticuloruminal temperature, rumination time, dairy cows, dystocia

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Authors: Melkamu A. Zeru, Aweke A. Mitiku, Endashaw Amuka

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Background: Under-five mortality is the likelihood that a baby will pass away before turning exactly 5 years old, represented as a percentage per 1,000 live births. Exploring the spatial distribution and identifying the temporal pattern is important to reducing under-five child mortality globally, including in Ethiopia. Thus, this study aimed to identify the risk factors of under-five mortality and the spatiotemporal variation in Ethiopian administrative zones. Method: This study used the 2000-2016 Ethiopian Demographic and Health Survey (EDHS) data, which were collected using a two-stage sampling method. A total of 43,029 (10,873 in 2000, 9,861 in 2005, 11,654 in 2011, and 10,641 in 2016) weighted sample under-five child mortality was used. The space-time dynamic model was employed to account for spatial and time effects in 65 administrative zones in Ethiopia. Results: From the result of a general nesting spatial-temporal dynamic model, there was a significant space-time interaction effect [γ = -0.1444, 95 % CI (-0.6680, -0.1355)] for under-five mortality. The increase in the percentages of mothers illiteracy [𝛽 = 0.4501, 95% CI (0.2442, 0.6559)], not vaccinated[𝛽= 0.7681, 95% CI (0.5683, 0.9678)], unimproved water[𝛽= 0.5801, CI (0.3793, 0.7808)] were increased death rates for under five children while increased percentage of contraceptive use [𝛽= -0.6609, 95% CI (-0.8636, -0.4582)] and ANC visit > 4 times [𝛽= -0.1585, 95% CI(-0.1812, -0.1357)] were contributed to the decreased under-five mortality rate at the zone in Ethiopia. Conclusions: Even though the mortality rate for children under five has decreased over time, still there is still higher in different zones of Ethiopia. There exists spatial and temporal variation in under-five mortality among zones. Therefore, it is very important to consider spatial neighbourhoods and temporal context when aiming to avoid under-five mortality.

Keywords: under-five children mortality, space-time dynamic, spatiotemporal, Ethiopia

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Masa Popovac, Philip Fine

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Information and Communication Technologies (ICTs) have altered our social environments, and young people in particular have immersed themselves in the digital age. Despite countless benefits, younger ICT users are being exposed to various online risks such as contact with strangers, viewing of risky content, sending or receiving sexually themed images or comments (i.e. ‘sexting’) as well as cyber bullying. Parents may not be fully aware of the online spaces their children inhabit and often struggle to implement effective mediation strategies. This quantitative study explored (i) three types of online risks (contact risks, content risks and conduct risks), (ii) cyber bullying victimization and perpetration, and (iii) parental mediation among a sample of 689 South African adolescents aged between 12-17 years. Survey data was also collected for 227 of their parents relating to their perceptions of their child’s online experiences. A comparison between adolescent behaviors and parental perceptions was examined on the three variables in the study. Findings reveal various online risk taking behaviors. In terms of contact risks, 56% of adolescents reported having contact with at least one online stranger, with many meeting these strangers in person. Content risks included exposure to harmful information such as websites promoting extreme diets or self-harm as well as inappropriate content: 84% of adolescents had seen violent content and 75% had seen sexual content online. Almost 60% of adolescents engaged in conduct risks such as sexting. Eight online victimization behaviors were examined in the study and 79% of adolescents had at least one of these negative experiences, with a third (34%) defining this experience as cyber bullying. A strong connection between victimization and perpetration was found, with 63% of adolescents being both a victim and perpetrator. Very little parental mediation of ICT use was reported. Inferential statistics revealed that parents consistently underestimated their child’s online risk taking behaviors as well as their cyber bullying victimization and perpetration. Parents also overestimated mediation strategies in the home. The generational gap in the knowledge and use of ICTs is a barrier to effective parental mediation and online safety, since many negative online experiences by adolescents go undetected and can continue for extended periods of time thereby exacerbating the potential psychological and emotional distress. The study highlights the importance of including parents in online safety efforts.

Keywords: cyber bullying, online risk behaviors, parental mediation, South Africa

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Authors: Zouhair Haddi, Stephane Delliaux, Jean-Francois Pons, Ismail Kechaf, Jean-Claude De Haro, Mustapha Ouladsine

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Atrial fibrillation (AF) has been considered as the most common cardiac arrhythmia, and a major public health burden associated with significant morbidity and mortality. Nowadays, telemedical approaches targeting cardiac outpatients situate AF among the most challenged medical issues. The automatic, early, and fast AF detection is still a major concern for the healthcare professional. Several algorithms based on univariate analysis have been developed to detect atrial fibrillation. However, the published results do not show satisfactory classification accuracy. This work was aimed at resolving this shortcoming by proposing multivariate data analysis methods for automatic AF detection. Four publicly-accessible sets of clinical data (AF Termination Challenge Database, MIT-BIH AF, Normal Sinus Rhythm RR Interval Database, and MIT-BIH Normal Sinus Rhythm Databases) were used for assessment. All time series were segmented in 1 min RR intervals window and then four specific features were calculated. Two pattern recognition methods, i.e., Principal Component Analysis (PCA) and Learning Vector Quantization (LVQ) neural network were used to develop classification models. PCA, as a feature reduction method, was employed to find important features to discriminate between AF and Normal Sinus Rhythm. Despite its very simple structure, the results show that the LVQ model performs better on the analyzed databases than do existing algorithms, with high sensitivity and specificity (99.19% and 99.39%, respectively). The proposed AF detection holds several interesting properties, and can be implemented with just a few arithmetical operations which make it a suitable choice for telecare applications.

Keywords: atrial fibrillation, multivariate data analysis, automatic detection, telemedicine

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Authors: E. M. Hoballah, M. Saber, A. Turky, N. Awad, A. M. Zaghloul

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Remediation of cultivated sewage soils in Egypt become an important aspect in last decade for having healthy crops and saving the human health. In this respect, a greenhouse experiment was conducted where contaminated sewage soil was treated with modified forms of 2% bentonite (T1), 2% kaolinite (T2), 1% bentonite+1% kaolinite (T3), 2% probentonite (T4), 2% prokaolinite (T5), 1% bentonite + 0.5% kaolinite + 0.5% rock phosphate (RP) (T6), 2% iron oxide (T7) and 1% iron oxide + 1% RP (T8). These materials were applied as remediative materials. Untreated soil was also used as a control. All soil samples were incubated for 2 months at 25°C at field capacity throughout the whole experiment. Carbon dioxide (CO2) efflux from both treated and untreated soils as a biomass indicator was measured through the incubation time and kinetic parameters of the best fitted models used to describe the phenomena were taken to evaluate the succession of sewaged soils remediation. The obtained results indicated that according to the kinetic parameters of used models, CO2 effluxes from remediated soils was significantly decreased compared to control treatment with variation in rate values according to type of remediation material applied. In addition, analyzed microbial biomass parameter showed that Ni and Zn were the most potential toxic elements (PTEs) that influenced the decreasing order of microbial activity in untreated soil. Meanwhile, Ni was the only influenced pollutant in treated soils. Although all applied materials significantly decreased the hazards of PTEs in treated soil, modified bentonite was the best treatment compared to other used materials. This work discussed different mechanisms taking place between applied materials and PTEs founded in the studied sewage soil.

Keywords: remediation, potential toxic elements, soil biomass, sewage

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Authors: G. Ghamrawi, Y. Abunnasr, M. Fawaz, S. Yazigi

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Coastal cities are constantly exposed to environmental degradation and economic regression fueled by rapid and uncontrolled urban growth as well as continuous resource depletion. This is the case of the City of Mina in Tripoli (Lebanon), where lack of awareness to preserve social, ecological, and historical assets, coupled with the increasing development pressures, are threatening the socioeconomic status of the city residents, the quality of life and accessibility to the coast. To address these challenges, a holistic coastal urban design and planning approach was developed to analyze the environmental, political, legal, and socioeconomic context of the city. This approach aims to investigate the potential of balancing urban development with the protection and enhancement of cultural, ecological, and environmental assets under an integrated coastal zone management approach (ICZM). The analysis of Mina's different sectors adopted several tools that include direct field observation, interviews with stakeholders, analysis of available data, historical maps, and previously proposed projects. The findings from the analysis were mapped and graphically represented, allowing the recognition of character zones that become the design intervention units. Consequently, the thesis proposes an urban, city-scale intervention that identifies 6 different character zones (the historical fishing port, Abdul Wahab island, the abandoned Port Said, Hammam el Makloub, the sand beach, and the new developable area) and proposes context-specific design interventions that capitalize on the main characteristics of each zone. Moreover, the intervention builds on the institutional framework of ICZM as well as other studies previously conducted for the coast and adopts nature-based solutions with hybrid systems for providing better environmental design solutions for developing the coast. This enables the realization of an all-inclusive, well-connected shoreline with easy and free access towards the sea; a developed shoreline with an active local economy, and an improved urban environment.

Keywords: blue green infrastructure, coastal cities, hybrid solutions, integrated coastal zone management, sustainable development, urban planning

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Smita Nepal

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Despite being on the global education reform agenda for over two decades, interpretations and practices of inclusive education vary widely across the world. In Nepal, similar to many other developing countries, inclusive education is still an emerging concept and limited research is available to date in relation to how inclusive education is conceptualized and implemented here. Moreover, very little is known about how teachers who are at the frontline of providing inclusive education understand this concept and how well they are prepared to teach inclusively. This study addresses this research gap by investigating an overarching research question, ‘How prepared are Nepalese teachers to practice inclusive pedagogy?’ Different societies and cultures may have different interpretations of the concepts of diversity and inclusion. Acknowledging that such contextual differences influence how these issues are addressed, such as preparing teachers for providing inclusive education, this study has investigated the research questions using a sociocultural conceptual framework. A sequential mixed-method research design involved quantitative data from 203 survey responses collected in the first phase, followed by qualitative data in the second phase collected through semi-structured interviews with teachers. Descriptive analysis of the quantitative data and reflexive thematic analysis of the qualitative data revealed a narrow understanding of inclusive education in the participating Nepalese teachers with limited preparedness for implementing inclusive pedagogy. Their interpretation of inclusion substantially included the need for non-discrimination and the provision of equal opportunities. This interpretation was found to be influenced by the social context where a lack of a deep understanding of human diversity was reported, leading to discriminatory attitudes and practices. In addition, common norms established in society that experiencing privileges or disadvantages was normal for diverse groups of people appeared to have led to limited efforts to enhance teachers’ understanding of and preparedness for inclusive education. This study has significant implications, not only in the Nepalese context but globally, for reform in policies and practices and for strengthening the teacher education and professional development system to promote inclusion in education. In addition, the significance of this research lies in highlighting the importance of further context-specific research in this area to ensure inclusive education in a real sense by valuing socio-cultural differences.

Keywords: inclusive education, inclusive pedagogy, sociocultural context, teacher preparation

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Authors: Amr Amer

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Cheeses are among those high-protein-containing foodstuffs in which enzymatic and microbial activities cause the formation of biogenic amines from amino acids decarboxylation. The amount of biogenic amines in cheese may act as a useful indicator of the hygienic quality of the product. In other words, their presence in cheese is related to its spoilage and safety. Formation of biogenic amines during Ras cheese (Egyptian hard cheese) ripening was investigated for 4 months. Three batches of Ras cheese were manufactured using Egyptian traditional method. From each batch, Samples were collected at 1, 7, 15, 30, 60, 90 and 120 days after cheese manufacture. The concentrations of biogenic amines (Tyramine, Histamine, Cadaverine and Tryptamine) were analyzed by high performance liquid chromatography (HPLC). There was a significant increased (P<0.05) in Tyramine levels from 4.34± 0.07 mg|100g in the first day of storage till reached 88.77± 0.14 mg|100g at a 120-day of storage. Also, Histamine and Cadaverine levels had the same increased pattern of Tyramine reaching 64.94± 0.10 and 28.28± 0.08 mg|100g in a 120- day of storage, respectively. While, there was a fluctuation in the concentration of Tryptamine level during ripening period as it decreased from 3.24± 0.06 to 2.66± 0.11 mg|100g at 60-day of storage then reached 5.38±0.08 mg|100g in a 120- day of storage. Biogenic amines can be formed in cheese during production and storage: many variables, as pH, salt concentration, bacterial activity as well as moisture, storage temperature and ripening time, play a relevant role in their formation. Comparing the obtained results with the recommended standard by Food and Drug Administration "FDA" (2001), High levels of biogenic amines in various Ras cheeses consumed in Egypt exceeded the permissible value (10 mg%) which seemed to pose a threat to public health. In this study, presence of high concentrations of biogenic amines (Tyramine, Histamine, cadaverine and Tryptamine) in Egyptian Ras cheeses reflects the bad hygienic conditions under which they produced and stored. Accordingly, the levels of biogenic amines in different cheeses should be come in accordance with the safe permissible limit recommended by FDA to ensure human safety.

Keywords: Ras cheese, biogenic amines, tyramine, histamine, cadaverine

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Authors: Anjuri Srivastava, Akhouri Nishant Bhanu

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Soil is a natural material with a distinctive form. It is regarded to be a natural source of nutrients and minerals for plants. It meets many of our needs through the crops, trees, and inhabited places that have grown on or underneath it. Productive and rich soil plays a crucial role in both its wealth and well-being. If any external substance changes the soil's composition, it directly impacts the plant that was grown in that soil. If the soil is deficient in one or more essential components, fly ash can be utilized as fertilizer by incorporating it into the soil. This can also increase the porosity of the soil. Fly ash has a sufficient concentration of essential components to promote the growth of plants. The high concentration of elements in fly ash, including C, Na, K, Fe, and Zn, increases crop yields. Hazardous compounds harm plant life as soon as they get into the soil. The US Environmental Protection Agency and other regulatory agencies have found it as non-hazardous. By employing fly ash as a potential fertilizer supplement for degraded soils, the problem of disposing of solid waste can be partially handled. Fly ash's rapid growth can slow down mineralization because it contains a higher proportion of harmful heavy metals. The chemical characteristics, inclusion ratio, and composting process of fly ash have a significant impact on the fly ash compost’s potential to improve soil nutrition. Research institutions and regulatory agencies have been thoroughly investigating fly ash for a long time. Guard cells on plant leaves that accumulate fly ash trigger the regulatory system. Fly ash increases both chemical and physical damage at certain humidity levels. The lengthy sowing period is caused by the high levels of fly ash in the soil, which also slows down seedling germination and growth. For the sake of human health, it is crucial to consider the bioaccumulation of dangerous heavy metals and their necessary concentrations in plant tissues and soil.

Keywords: soil, fly ash, plant, fertilizer, composts

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Authors: Beyene Daniel, Herbert Ntuli

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Agritourism in Eritrea is increasingly threatened by climate change, manifesting through rising temperatures, shifting rainfall patterns, and resource scarcity. This study employs quantitative methods to assess the economic and environmental impacts of climate change on agritourism, utilizing metrics such as annual income fluctuations, changes in visitor numbers, and energy consumption patterns. The methodology relies on secondary data sourced from the World Bank, government reports, and academic publications to analyze the economic viability of integrating solar energy into agritourism operations. Key variables include the Benefits from Renewable Energy (BRE), encompassing cost savings from reduced energy expenses and the monetized value of avoided greenhouse gas emissions. Using a net present value (NPV) framework, the research compares the impact of solar energy against traditional fossil fuel sources by evaluating the Value of Reduced Greenhouse Gas Emissions (CO2) and the Value of Health-Related Costs (VHRC) due to air pollution. The preliminary findings of this research are of utmost importance. They indicate that the adoption of solar energy can enhance energy independence by up to 40%, reduce operational costs by 25%, and stabilize agritourism activities in climate-sensitive regions. This research aims to provide actionable insights for policymakers and stakeholders, supporting the sustainable development of agritourism in Eritrea and contributing to broader climate adaptation strategies. By employing a comprehensive cost-benefit analysis, the study highlights the economic advantages and environmental benefits of transitioning to renewable energy in the face of climate change.

Keywords: climate change, renewable energy, resilience, cost-benefit analysis

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Authors: Malgorzata Sekulowicz, Krystyna Boron-Krupinska, Paulina Morga, Blazej Cieslik

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Burnout is highly prevalent in health care employees, especially in physicians. It significantly reduces the efficiency of these employees, which can have negative consequences for both physicians and patients. Resilience and mindfulness enhancing positive emotions, leading to sustainable development and personal commitment, can have a significant impact on burnout. Therefore, the aim of this study was to determine the relationship between burnout symptoms and mindfulness and resilience among physicians. The authors conducted a cross-sectional survey study among seventy-four polish physicians. Participants filled out the following psychometric tools: the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), Five Facet Mindfulness Questionnaire (FFMQ), Areas of Work-Life Survey (AWS), International Personality Item Pool (IPIP), the Resilience Assessment Scale (SPP-25) and the Mini-COPE Inventory. The relationship between burnout and resilience and mindfulness was assessed with path analysis. Analyzing the relationship between MBI-HSS components and mindfulness, a significant negative correlation of the FFMQ score with emotional exhaustion (-0.50, p < 0.05) and depersonalization (-0.43, p < 0.05) and a positive correlation with personal accomplishment (0.50, p < 0.05) was demonstrated. Analyzing resilience, a statistically significant relationship of SPP-25 with all tested components of MBI-HSS was demonstrated: emotional exhaustion (-0.54, p < 0.05), depersonalization (-0.31, p < 0.05) and personal accomplishment (0.35, p < 0.05). In the group of medical doctors, the higher the level of mindfulness and resilience, the lower the risk of burnout. Furthermore, the more frequently used active coping strategies (planning, acceptance), the lower the risk of burnout, while the use of passive, evasive strategies increases the risk of burnout. It may be worth considering implementing mindfulness intervention to effectively manage burnout symptoms in this group.

Keywords: burnout, medical doctors, mindfulness, physicians, resilience

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Authors: Zubair Ahmad

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The aim of this study is to analyze the risks factors and issues with waste management in developing nations as barriers. Depending on their content and categorization, wastes are managed differently. Waste management strategies differ for liquid, solid, and organic wastes. The final stage of trash disposal entails procedures like burning, interment, recycling, and treatment. Due to the rising creation of solid waste, the growing urban population has a magnified impact on the environment and public health. All regions, but especially informal urban neighborhoods, tribal villages, and official rural settlements have a protracted backlog in waste services. Another significant impediment seen in the developing world is a lack of education and awareness of effective waste-management practices. Unauthorized dumpsites pose a serious risk to the environment since they could contain dangerous elements like radioactive, infectious, and toxic waste. Wealthier individuals are more inclined to think that their actions will have an impact on environmental problems and to act to address them. Waste managers need to take action to make sure the public is given information that is consistent with what they currently know. The results of the data analysis conducted with the aid of the various methodologies discussed in the preceding chapter are presented in this chapter by the researcher. Descriptive analysis has been used in research to determine whether or not there are relationships between variables and to determine the importance of the variables. According to a survey, there are no efforts being made to lessen the odor that garbage dump sites emit (in terms of treating or recycling the material placed at dumpsite) This might be the case since respondents only commented on the waste management conditions in their immediate surroundings and may not have fully understood the steps taken to resolve this issue.

Keywords: risk factor of waste material, lack of awareness, developing countries struggles, waste management

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Authors: Pamela E. Mukaire

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Anemia and chronic energy deficiency are significant manifestations of poor nutritional health. Anaemia and nutritional status screening are practical ways for assessing the prevalence of iron deficiency anemia in the food insecure populations with large groups of childbearing women and children. The objective of the study was to assess anemia prevalence and other clinical manifestations of malnutrition among pairs of mothers and young children in rural Uganda. This community cross-sectional study used consecutive sampling to select 214 mothers and 214 children for the study. Data was generated using structured questionnaire, anthropometric measurements and on site analysis for anemia. Bivariable and multivariable analyses were used to assess the effect of different factors on anaemia. Of the 214 mothers, 54.2% were 25-34 years of age, 76.7% unmarried, 63% low income, and 55% had more than four children. Of the 214 children, 57% were female, 50% between 1 to 3 years of age and 35% under one year, and. Overall, 38% of the households had more 4 children under the age of 12. The prevalence of anemia was 48% for mothers and 72% for children; 20.6% of mothers had moderate to severe chronic energy deficiency, 39% had moderately-severe anaemia (10 to 7.1 g/dL). Among children, 53% had moderately-severe anaemia, and 18.2% had severe anaemia. Parity X2 =20, p < .037, number of children under 12 years living in a household X2 =10, p < .015, and child’s gender X2 =6.5, p < .038, had a significant relationship with maternal anaemia. There was a significant relationship between household income X2 =10, p < .005, marital status X2 =9, p < .011, owing a piece of land X2 =18, p < .000, owing home X2 =7, p < .036, and anaemia in children. The prevalence of anemia was high in both mothers and children. Income, marital status, owing a piece of land, owing home, number of children under age 12 in a household were associated with anaemia. Hence, efforts should be made for early diagnosis and management of anaemia deficiencies with special emphasis on those households with large number of children under age 12.

Keywords: anemia, maternal-child, nutrition, rural population

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Authors: Yavuz Arat, Ugur Tuztasi, Mehmet Uysal

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Anatolia has been the host of many civilizations and a site where architectural structures of many cultural layers were interpreted. Most significantly the Turks who settled in Central Asia brought their architectural dynamics and cultural accumulation to Anatolia after the 12th century. The tomb structures first observed in Central Asia under the influence of Islamic faith and Turkish cultural heritage has blossomed under Great Seljuk Empire and with the Anatolian Seljuk Empire these tombs changed both in size and form with rich and beautiful samples from Ahlat to Sivas to Kayseri and Konya. This tomb tradition which started during 13th century has continued during the Ottoman Empire period with some alterations of form and evolved into the rarely observed mausoleum type tombs. The Ottoman tradition of building tombs inside mosque gardens and their forms present the clues of an important burial tradition. However this understanding was abandoned in 20th century Turkey. This tradition was abandoned with regard to legal regulations and health conditions. This study investigates the vestiges of this tradition and its spatial reflections over a sample. The present sample is representative of a tradition that started in 1970s and the case of building tombs inside mosque gardens will be illustrated over the tomb of Hacı Kemal Onsun and his wife which is located in Konya, the capital of the Anatolian Seljuks. The building process of this tomb will be evaluated with regard to burial traditions and architectural stylization.

Keywords: tomb, language of architectural form, Anatolian Seljuk tombs, Ottoman tombs

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Authors: Andreas Aceranti, Simonetta Vernocchi, Marco Colorato, Daniel Zaccariello

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Our study explores the usefulness of implementing facial expression recognition capabilities and using the Facial Action Coding System (FACS) in contexts where the other person is wearing a mask. In the communication process, the subjects use a plurality of distinct and autonomous reporting systems. Among them, the system of mimicking facial movements is worthy of attention. Basic emotion theorists have identified the existence of specific and universal patterns of facial expressions related to seven basic emotions -anger, disgust, contempt, fear, sadness, surprise, and happiness- that would distinguish one emotion from another. However, due to the COVID-19 pandemic, we have come up against the problem of having the lower half of the face covered and, therefore, not investigable due to the masks. Facial-emotional behavior is a good starting point for understanding: (1) the affective state (such as emotions), (2) cognitive activity (perplexity, concentration, boredom), (3) temperament and personality traits (hostility, sociability, shyness), (4) psychopathology (such as diagnostic information relevant to depression, mania, schizophrenia, and less severe disorders), (5) psychopathological processes that occur during social interactions patient and analyst. There are numerous methods to measure facial movements resulting from the action of muscles, see for example, the measurement of visible facial actions using coding systems (non-intrusive systems that require the presence of an observer who encodes and categorizes behaviors) and the measurement of electrical "discharges" of contracting muscles (facial electromyography; EMG). However, the measuring system invented by Ekman and Friesen (2002) - "Facial Action Coding System - FACS" is the most comprehensive, complete, and versatile. Our study, carried out on about 1,500 subjects over three years of work, allowed us to highlight how the movements of the hands and upper part of the face change depending on whether the subject wears a mask or not. We have been able to identify specific alterations to the subjects’ hand movement patterns and their upper face expressions while wearing masks compared to when not wearing them. We believe that finding correlations between how body language changes when our facial expressions are impaired can provide a better understanding of the link between the face and body non-verbal language.

Keywords: facial action coding system, COVID-19, masks, facial analysis

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Authors: Ram Sharan Mehta, Dina Khanal, Pushpa Parajuli, Gayanand Mandal, Bijaya Bartuala

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Background: Cardiovascular disease (CVD) is the leading cause of death worldwide. Adequate awareness of risk factors of CVD is the first step towards effective preventive strategies to combat the CVD burden in diabetes patients.This study aims to assess the awareness on risk factors of CVD among patients with diabetes mellitus attending diabetic clinic of BPKIHS and to find the association between awareness with their selected socio demographic variables. Methods and Material: A descriptive cross sectional study was conducted among 112 patients with diabetes in diabetic clinic of BPKIHS. Convenient sampling technique was used for data collection over duration of one month using interview schedule by HDFQ II tool. Data were analyzed by using descriptive and inferential statistics. (Chi square). Results: The mean age of respondents was 55.4±12.13 years. That mean HDFQ score was 14.31± 5.08. Only 33% of the respondents had adequate level of awareness whereas majority of the respondents (67%) had inadequate level of awareness. Majority of the respondent (83.9%) were aware about smoking, (78.6%) physical activity, (75%) increasing age, (75.9%) high blood pressure, (71.4%) overweight respectively. Whereas most of the respondents were not aware of high cholesterol, fatty diet, preventive strategies and association of diabetes with CVD. Awareness was statistically significant with (p=0.043) educational status, (p=0.025) monthly income, (p=0.05) residence, (p=0.006) CVD information received and (p=0.022) co morbid condition as a heart disease. Conclusion: The findings of this study concluded most of the respondents had an inadequate level of awareness on risk factors of CVD. So Effective education and appropriate preventive strategies of CVD are indeed important to reduce CVD burden in diabetes patients.

Keywords: cardiovascular disease, awareness, diabetes patients, risk

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Authors: Mahin Pourmorad Naseri

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Myths have been an inseparable aspect of man’s life in all nations and cultures across the world over time; however, it seems that the form and use of myths in the poetry of the 20th century have gained a new meaning and purpose. Among the poets of the time, T. S. Eliot in English and Mahdi Akhavan Sales in Persian are the two mostly referred to in this regard. In this paper, the pattern of heroic journey as the main theme in the poetry of Akhavan and Eliot will be reviewed, compared, and contrasted. Attempts have been made to find out how the myth of the hero’s journey has been reflected in the century’s well-known poetry and if myth allusions in these poems confirm or reject Campbell’s claim that mythology can be an appropriate psychological cure for man’s loneliness in today’s life. T. S. Eliot (1888-1965), the English poet, essayist, playwright, publisher, and critic, is mostly known for his modernist poetry and the extensive allusions to mythologies and world literary masterpieces. At the same time, Mahdi Akhavan Sales (1929-1990) Iranian poet, one of the pioneers of modern Persian poetry, is also most well-known for his epic poetic style (Khorasani Style) and also his high amount of allusions to myths, especially Zoroastrian mythology, and his myth-making technique. Although their greatly different cultural background may cause the similarities in their poetic style and themes not to attract attention, at first sight, reading the poems closely through the light of the 20th century’s life context and literary movements reveal interesting similarities in the way they understand and apply myth in their poetry. The present paper reviews the theme of the hero’s journey in Akhavan’s Chavooshi and Eliot’s “Journey of the Magi” from the perspective of Campbell’s notion of mono-myth or the pattern of mythic hero’s journey. The poems will be reviewed in search of the steps of the inward journey the heroes make, the goals they pursue, and how successful they are in achieving the goals. The findings of the study reveal that while the difference in the social context of the poets makes the small differences in the stages of the journey, both journeys end in a gloomy atmosphere for the disappointedly isolated hero who is finally left alone in the godless and materialistic world of 20th century. It is also evident that both poets meant to fulfill their responsibility of reviving mythology in writing the poems.

Keywords: myth, Akhavan, Eliot, poetry, hero's journey

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Authors: Geetha Baskaran, Andrzej Barjiela, Rong Qu

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Motivation: Nurse scheduling is a complex combinatorial optimization problem. It is also known as NP-hard. It needs an efficient re-scheduling to minimize some trade-off of the measures of violation by reducing selected constraints to soft constraints with measurements of their violations. Problem Statement: In this paper, we extend our novel approach to solve the nurse scheduling problem by transforming it through Information Granulation. Approach: This approach satisfies the rules of a typical hospital environment based on a standard benchmark problem. Generating good work schedules has a great influence on nurses' working conditions which are strongly related to the level of a quality health care. Domain transformation that combines the strengths of operation research and artificial intelligence was proposed for the solution of the problem. Compared to conventional methods, our approach involves judicious grouping (information granulation) of shifts types’ that transforms the original problem into a smaller solution domain. Later these schedules from the smaller problem domain are converted back into the original problem domain by taking into account the constraints that could not be represented in the smaller domain. An Integer Programming (IP) package is used to solve the transformed scheduling problem by expending the branch and bound algorithm. We have used the GNU Octave for Windows to solve this problem. Results: The scheduling problem has been solved in the proposed formalism resulting in a high quality schedule. Conclusion: Domain transformation represents departure from a conventional one-shift-at-a-time scheduling approach. It offers an advantage of efficient and easily understandable solutions as well as offering deterministic reproducibility of the results. We note, however, that it does not guarantee the global optimum.

Keywords: domain transformation, nurse scheduling, information granulation, artificial intelligence, simulation

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Authors: Yara Mohamed Taha, Mohamed Ali El Desouky, Heba Kamal Abdel Hakim, Maha Hanafy Mahmoud

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Hepatotoxicity due to drugs and toxic chemicals constitutes a crucial health problem nowadays. Medicinal plants are widely used recently for protecting against many liver disorders and inflammatory conditions. This study aims to evaluate hepatoprotective impact of green tea extract (GTE), rosemary extract (RE) and rosmarinic acid (RA) against hepatotoxins; ferric nitrilotriacetate (Fe-NTA) and diethylnitrosamine (DEN) in rats. Five groups of male Wistar rats were included; one control negative, while the other groups were treated intraperitoneally with DEN as 160 mg.kg-1 b.w. on 15th day and Fe-NTA as 5 mg.kg-1 b.w. on 33rd day. One of them was control positive. The other three groups were pre-administered with daily protective oral doses of either 200 mg.kg-1 b.w. of RE or 1 g.kg- 1 b.w. of GTE or 50 mg.kg-1 b.w. of RA two weeks prior to DEN exposure and continued till the end of the experimental period. The obtained data revealed a highly significant increase of MDA, 8-OHdG, DNA damage percent, a significant depletion of GSH and elevated Gr-1 protein expression in hepatocytes with liver tissue histopathological changes of rats exposed to DEN+Fe-NTA. Pre-administration of protective doses of RE, GTE and RA to DEN+Fe-NTA treated rats could normalize the altered biochemical, histopathological and immunohistochemical parameters. In conclusion, RE, GTE and RA showed a hepatoprotective effect against liver toxicity induced by DEN+Fe-NTA, with the best antioxidant and anti-inflammatory impact were for RA and GTE. Therefore, the current study declared that rosemary, green tea and products enriched with rosmarinic acid should be involved daily in diet of people who are exposed to chemicals and environmental toxins to protect themselves from hepatotoxicity.

Keywords: hepatotoxicity, diethylnitrosamine and ferric nitrilotriacetate, rosemary extract (RE), green tea extract (GTE), rosmarinic acid (RA)

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Authors: Dawa Wangmo

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The anti-religious campaigns of the Soviet Union in the 1930s eradicated Kalmyk Buddhism from the public sphere. Following Perestroika, the Kalmyks retained a sense of being essentially Buddhist people. Nevertheless, since the collapse of the Soviet Communist regime, Kalmykia has been going through vigorous ethnic and cultural revitalization. The new Kalmyk government is reviving the religion with the building of Buddhist temples and the attempted training of Kalymk monks. Kalmykia, officially an autonomous republic within the Federation of Russia, is situated in the European part of Russia in the steppe region bordering the Caspian Sea in its southeast. According to the 2010 census, the Kalmyks, a people of Mongolian origin, constitute over 57 percent of the Republic’s population of less than 290000. Russians living in Kalmykia comprise around 30 percent, the remainder being various Slavic and Asian groups. Since the Kalmyks historically adhere to Buddhism, Kalmykia is often described in tourist brochures and proudly by the Kalmyks themselves as one of the three “traditional Buddhist republics” of Russia and “the only Buddhist region” in Europe. According to traditional Kalmyk Gelug Buddhism, monasticism is the central aspect; hence monastic Tibetans from India have been invited to the Republic to help revive Buddhism and their Buddhist identity in Russia as a whole. However, for the young post-soviets, the monastic way of life is proving too alien, and the subsequent labeling by these monks of ‘surviving’ Kalmyk Buddhist practices as superstitious, mistaken, or corrupt is an initial step in the purification of alternate views, leading to religious reform. This sentiment is also felt by younger Kalmyks who do not find sense in surviving Buddhism but believe more in the philosophical approach of Buddhism taught by the visiting Buddhist teachers at Dharma centers. By discussing this post-soviet shift in local notions of religious efficacy, an attempt will be made to shed light on how the social movements of both reform and revival arise as a collusion between contemporary Tibetan and Kalmyk views on the nature of true Buddhism. This work explores aspects of religious innovation that have developed since the early 1990s in the process of reconstitution of ethnic and religious identity in Kalmykia, a Republic in the southwest of Russia. Any attempts to study the history of Buddhism in Kalmykia would surely mean studying the “History of the most northern Dharma community in the World.”

Keywords: Kalmykia, Tibetan Buddhism, reform, revival, identity

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Authors: Jana Soler Libran

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The primary aim of this paper is to analyze the relationship between power and knowledge suggested in Michel Foucault's theory. Taking into consideration the role of power in knowledge production, the goal is to evaluate to what extent genealogy can be presented as a practical method for epistemic resistance. To do so, the methodology used consists of a revision of Foucault’s literature concerning the topic discussed. In this sense, conceptual analysis is applied in order to understand the effect of the double dimension of power on knowledge production. In its negative dimension, power is conceived as an organ of repression, vetoing certain instances of knowledge considered deceitful. In opposition, in its positive dimension, power works as an organ of the production of truth by means of institutionalized discourses. This double declination of power leads to the first main findings of the present analysis: no truth or knowledge can lie outside power’s action, and power is constituted through accepted forms of knowledge. To second these statements, Foucaultian discourse formations are evaluated, presenting external exclusion procedures as paradigmatic practices to demonstrate how power creates and shapes the validity of certain epistemes. Thus, taking into consideration power’s mechanisms to produce and reproduce institutionalized truths, this paper accounts for the Foucaultian praxis of genealogy as a method to reveal power’s intention, instruments, and effects in the production of knowledge. In this sense, it is suggested to consider genealogy as a practice which, firstly, reveals what instances of knowledge are subjugated to power and, secondly, promotes aforementioned peripherical discourses as a form of epistemic resistance. In order to counterbalance these main theses, objections to Foucault’s work from Nancy Fraser, Linda Nicholson, Charles Taylor, Richard Rorty, Alvin Goldman, or Karen Barad are discussed. In essence, the understanding of the Foucaultian relationship between power and knowledge is essential to analyze how contemporary discourses are produced by both traditional institutions and new forms of institutionalized power, such as mass media or social networks. Therefore, Michel Foucault's practice of genealogy is relevant, not only for its philosophical contribution as a method to uncover the effects of power in knowledge production but also because it constitutes a valuable theoretical framework for political theory and sociological studies concerning the formation of societies and individuals in the contemporary world.

Keywords: epistemic resistance, Foucault’s genealogy, knowledge, power, truth

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Authors: Kurt Maxwell Kusterer, Sylvain Mignot, Annick Vignes

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To our best knowledge YouTube is the largest video hosting platform in the world. A high number of creators, viewers, subscribers and commentators act in this specific eco-system which generates huge sums of money. Views, subscribers, and comments help to increase the popularity of content creators. The most popular creators are sponsored by brands and participate in marketing campaigns. For a few of them, this becomes a financially rewarding profession. This is made possible through the YouTube Partner Program, which shares revenue among creators based on their popularity. We believe that the role of comments in increasing the popularity is to be emphasized. In what follows, YouTube is considered as a bilateral network between the videos and the commentators. Analyzing a detailed data set focused on French YouTubers, we consider each comment as a link between a commentator and a video. Our research question asks what are the predominant features of a video which give it the highest probability to be commented on. Following on from this question, how can we use these features to predict the action of the agent in commenting one video instead of another, considering the characteristics of the commentators, videos, topics, channels, and recommendations. We expect to see that the videos of more popular channels generate higher viewer engagement and thus are more frequently commented. The interest lies in discovering features which have not classically been considered as markers for popularity on the platform. A quick view of our data set shows that 96% of the commentators comment only once on a certain video. Thus, we study a non-weighted bipartite network between commentators and videos built on the sub-sample of 96% of unique comments. A link exists between two nodes when a commentator makes a comment on a video. We run an Exponential Random Graph Model (ERGM) approach to evaluate which characteristics influence the probability of commenting a video. The creation of a link will be explained in terms of common video features, such as duration, quality, number of likes, number of views, etc. Our data is relevant for the period of 2020-2021 and focuses on the French YouTube environment. From this set of 391 588 videos, we extract the channels which can be monetized according to YouTube regulations (channels with at least 1000 subscribers and more than 4000 hours of viewing time during the last twelve months).In the end, we have a data set of 128 462 videos which consist of 4093 channels. Based on these videos, we have a data set of 1 032 771 unique commentators, with a mean of 2 comments per a commentator, a minimum of 1 comment each, and a maximum of 584 comments.

Keywords: YouTube, social networks, economics, consumer behaviour

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Authors: Matthew Conner, Leah Plocharczyk

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This study examines the role of academic libraries in support of the intellectually disabled (ID) in post-secondary education. With the growing public awareness of the ID, there has been recognition of their need for post-secondary educational opportunities. This was an unforeseen result for a population that has been associated with elementary levels of education, yet the reasons are compelling. After aging out of the school system, the ID need and deserve educational and social support as much as anyone. Moreover, the commitment to diversity in higher education rings hollow if this group is excluded. Yet, challenges remain to integrating the ID into a college curriculum. This presentation focuses on the role of academic libraries. Neglecting this vital resource for the support of the ID is not to be thought of, yet the library’s contribution is not clear. Library collections presume reading ability and libraries already struggle to meet their traditional goals with the resources available. This presentation examines how academic libraries can support post-secondary ID. For context, the presentation first examines the state of post-secondary education for the ID with an analysis of data on the United States compiled by the ThinkCollege! Project. Geographic Information Systems (GIS) and statistical analysis will show regional and methodological trends in post-secondary support of the ID which currently lack any significant involvement by college libraries. Then, the presentation analyzes a case study of a book club at the Florida Atlantic University (FAU) libraries which has run for several years. Issues such as the selection of books, effective pedagogies, and evaluation procedures will be examined. The study has found that the instruction pedagogies used by libraries can be extended through concepts of Universal Learning Design (ULD) to effectively engage the ID. In particular, student-centered, participatory methodologies that accommodate different learning styles have proven to be especially useful. The choice of text is complex and determined not only by reading ability but familiarity of subject and features of the ID’s developmental trajectory. The selection of text is not only a necessity but also promises to give insight into the ID. Assessment remains a complex and unresolved subject, but the voluntary, sustained, and enthusiastic attendance of the ID is an undeniable indicator. The study finds that, through the traditional library vehicle of the book club, academic libraries can support ID students through training in both reading and socialization, two major goals of their post-secondary education.

Keywords: academic libraries, intellectual disability, literacy, post-secondary education

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Authors: Ozcan Yavas, Berrak Erol Nalbur, Sermin Gunarslan

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A materiality matrix is a tool that organizations use to prioritize their activities and adapt to the increasing sustainability requirements in recent years. For the materiality index to move from business models to the sustainability business model stage, it must be done with all partners in the raw material, supply, production, product, and end-of-life product stages. Within the scope of this study, the Materiality Matrix was used to transform the business model into a sustainability business model and to create a sustainability roadmap in a factory producing electric buses. This matrix determines the necessary roadmap for all stakeholders to participate in the process, especially in sectors that produce sustainable products, such as the electric vehicle sector, and to act together with the cradle-to-cradle approach of sustainability roadmaps. Global Reporting Initiative analysis was used in the study conducted with 1150 stakeholders within the scope of the study, and 43 questions were asked to the stakeholders under the main headings of 'Legal Compliance Level,' 'Environmental Strategies,' 'Risk Management Activities,' 'Impact of Sustainability Activities on Products and Services,' 'Corporate Culture,' 'Responsible and Profitable Business Model Practices' and 'Achievements in Leading the Sector' and Economic, Governance, Environment, Social and Other. The results of the study aimed to include five 1st priority issues and four 2nd priority issues in the sustainability strategies of the organization in the short and medium term. When the studies carried out in the short term are evaluated in terms of Sustainability and Environmental Risk Management, it is seen that the studies are still limited to the level of legal legislation (60%) and individual studies in line with the strategies (20%). At the same time, the stakeholders expect the company to integrate sustainability activities into its business model within five years (35%) and to carry out projects to become the first company that comes to mind with its success leading the sector (20%). Another result obtained within the study's scope is identifying barriers to implementation. It is seen that the most critical obstacles identified by stakeholders with climate change and environmental impacts are financial deficiency and lack of infrastructure in the dissemination of sustainable products. These studies are critical for transitioning to sustainable business models for the electric vehicle sector to achieve the EU Green Deal and CBAM targets.

Keywords: sustainability business model, materiality matrix, electricity bus, carbon neutrality, sustainability management

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Authors: Soumita Banerjee

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The State of West Bengal is mostly watered by innumerable rivers, and they are different in nature in both the northern and the southern part of the state. The southern part of West Bengal is mainly drained with the river Bhagirathi-Hooghly, and its major distributaries and tributaries have divided this major river basin into many subparts like the Ichamati-Bidyadhari, Pagla-Bansloi, Mayurakshi-Babla, Ajay, Damodar, Kangsabati Sub-basin to name a few. These rivers basically drain the Districts of Bankura, Burdwan, Hooghly, Nadia and Purulia, Birbhum, Midnapore, Murshidabad, North 24-Parganas, Kolkata, Howrah and South 24-Parganas. West Bengal has a huge number of flood-prone blocks in the southern part of the state of West Bengal, the responsible factors for flood situation are the shape and size of the catchment area, its steep gradient starting from plateau to flat terrain, the river bank erosion and its siltation, tidal condition especially in the lower Ganga Basin and very low maintenance of the embankments which are mostly used as communication links. Along with these factors, DVC (Damodar Valley Corporation) plays an important role in the generation (with the release of water) and controlling the flood situation. This year the whole Gangetic West Bengal is being flooded due to high intensity and long duration rainfall, and the release of water from the Durgapur Barrage As most of the rivers are interstate in nature at times floods also take place with release of water from the dams of the neighbouring states like Jharkhand. Other than Embankments, there is no such structural measures for combatting flood in West Bengal. This paper tries to analyse the reasons behind the flood situation this year especially with the help of climatic data collected from the Indian Metrological Department, flood related data from the Irrigation and Waterways Department, West Bengal and GPM (General Precipitation Measurement) data for rainfall analysis. Based on the threshold value derived from the calculation of the past available flood data, it is possible to predict the flood events which may occur in the near future and with the help of social media it can be spread out within a very short span of time to aware the mass. On a larger or a governmental scale, heightening the settlements situated on the either banks of the river can yield a better result than building up embankments.

Keywords: dam failure, embankments, flood, rainfall

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Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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Authors: Venuste Kayinamura, V. Iyamuremye, A. Ngirabakunzi

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Anti-retroviral therapy (ART) for HIV patient can cause a deficiency in glucose metabolism by promoting insulin resistance, glucose intolerance, and diabetes, diabetes mellitus keep increasing among HIV-infected patients worldwide but there is limited data on levels of blood glucose and its relationship with antiretroviral drugs (ARVs) and HIV-infection worldwide, particularly in Rwanda. A convenient sampling strategy was used in this study and it involved 323 HIV patients (n=323). Patients who are HIV positive under ARVs were involved in this study. The patient’s blood glucose was analyzed using an automated machine or glucometer (COBAS C 311). Data were analyzed using Microsoft Excel and SPSS V. 20.0 and presented in percentages. The highest diabetes mellitus prevalence was 93.33 % in people aged >40 years while the lowest diabetes mellitus prevalence was 6.67% in people aged between 21-and 40 years. The P-value was (0.021). Thus, there is a significant association between age and diabetes occurrence. The highest diabetes mellitus prevalence was 28.2% in patients under ART treatment for more than 10 years, 16.7% were <5years while 20% of patients were on ART treatment between 5-10 years. The P-value here is (0.03), thus the incidence of diabetes is associated with long-term ART use in HIV-infected patients. This study assessed the prevalence of diabetes among HIV-infected patients under ARVs attending the University Teaching Hospital of Butare (CHUB), it shows that the prevalence of diabetes is high in HIV-infected patients under ARTs. This study found no significant relationship between gender and diabetes mellitus growth. Therefore, regular assessment of diabetes mellitus especially among HIV-infected patients under ARVs is highly recommended to control other health issues caused by diabetes mellitus.

Keywords: anti-retroviral, diabetes mellitus, antiretroviral therapy, human immune deficiency virus

Procedia PDF Downloads 113