Search results for: rural hospitals

Authors: Cassi Henderson, Lucia Corsini, Shiv Kapila, Egle Augustaityte, Tsemaye Uwejamomere Zinzan Gurney, Aleyna Yildirim

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Plastic pollution is a major threat to human and planetary health. In Low- and Middle-Income Countries, plastic waste poses a major problem for marginalized populations who lack access to formal waste management systems. This study explores the potential for converting waste plastic into construction blocks. It is the first study to analyze the use of polyethylene terephthalate (PET) as a binder in plastic-sand bricks. Unlike previous studies of plastic sand-bricks, this research tests the properties of bricks that were made using a low-cost kiln technology that was co-designed with a rural, coastal community in Kenya.  The mechanical strength, resistance to fire and water absorption properties of the bricks are tested in this study. The findings show that the bricks meet structural standards for mechanical performance, fire resistance and water absorption. It was found that 30:70 PET to sand demonstrated the best overall performance.

Keywords: recycling, PET, plastic, sustainable construction, sustainable development

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Authors: Kidist Mesfin Nguse

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Ethiopia is the second most densely populated nation in Africa, and about 121 million people as the 2022 Ethiopia population live report recorded. In recent years, the Ethiopian government (GOE) has been gradually growing its road network. With 138,127 kilometers (85,825 miles) of all-weather roads as of the end of 2018–19, Ethiopia possessed just 39% of the nation's necessary road network and lacked a well-organized system. The Ethiopian urban population report recorded that about 21% of the population lives in urban areas, and the high population, coupled with growth in various infrastructures, has led to the migration of the workforce from rural areas to cities across the country. In main roads, the heterogeneous traffic flow with various operational features makes it more unfavorable, causing frequent congestion in the stretch of road. The Level of Service (LOS), a qualitative measure of traffic, is categorized based on the operating conditions in the traffic stream. Determining the capacity and LOS for this city is very crucial as this affects the planning and design of traffic systems and their operation, and the allocation of route selection for infrastructure building projects to provide for a considerably good level of service.

Keywords: capacity, level of service, traffic volume, free flow speed

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Authors: Nathen A. Spitz, Dennis Martin Kivlighan III, Arwa Aburizik

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Background and Purpose: Presently, there is a paucity of naturalistic studies that directly compare the effectiveness of psychotherapy versus concurrent psychotherapy and psychiatric care for the treatment of depression and anxiety in cancer patients. Informed by previous clinical trials examining the efficacy of concurrent approaches, this study sought to test the hypothesis that a combined approach would result in the greatest reduction of depression and anxiety symptoms. Methods: Data for this study consisted of 433 adult cancer patients, with 252 receiving only psychotherapy and 181 receiving concurrent psychotherapy and psychiatric care at the University of Iowa Hospitals and Clinics. Longitudinal PHQ9 and GAD7 data were analyzed between both groups using latent growth curve analyses. Results: After controlling for treatment length and provider effects, results indicated that concurrent care was more effective than psychotherapy alone for depressive symptoms (γ₁₂ = -0.12, p = .037). Specifically, the simple slope for concurrent care was -0.25 (p = .022), and the simple slope for psychotherapy alone was -0.13 (p = .006), suggesting that patients receiving concurrent care experienced a greater reduction in depressive symptoms compared to patients receiving psychotherapy alone. In contrast, there were no significant differences between psychotherapy alone and concurrent psychotherapy and psychiatric care in the reduction of anxious symptoms. Conclusions: Overall, as both psychotherapy and psychiatric care may address unique aspects of mental health conditions, in addition to potentially providing synergetic support to each other, a combinatorial approach to mental healthcare for cancer patients may improve outcomes.

Keywords: psychiatry, psychology, psycho-oncology, combined care, psychotherapy, behavioral psychology

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Authors: E. Kharaishvili

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The paper analyses the role of small farms in socio-economic development of agriculture in Georgia and evaluates modern concepts regarding the development of the farms of this size. The scale of farms in Georgia is studied and the major problems are revealed. Opportunities and directions of diversification are discussed from the point of increasing the share of Georgian grapes and wine both on domestic and international markets. It’s shown that the size of vineyard areas is directly reflected on the grape and wine production potential. Accordingly, vineyard area and grape production dynamics is discussed. Comparative analysis of small farms in Georgia and Italy is made and the major differences are identified. Diversification is evaluated based on cost-benefit analysis on the one hand and on the other hand, from the point of promoting economic activities, protecting nature and rural area development. The paper provides proofs for the outcomes of diversification. The key hindering factors for the development of small farms are identified and corresponding conclusions are made, based on which recommendations for diversification of the farms of this size are developed.

Keywords: small farms, scale of farms, diversification, Georgia

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Authors: Enido Fabiano de Ramos, Ieda Kanashiro Makiya, Francisco I. Giocondo Cesar

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This study investigates the application of Digital Twins (DT) in Smart Hospital Environments (SHE), through a bibliometric study and literature review, including comparison with the principles of Industry 4.0. It aims to analyze the current state of the implementation of digital twins in clinical and non-clinical operations in healthcare settings, identifying trends and challenges, comparing these practices with Industry 4.0 concepts and technologies, in order to present a basic framework including stages and maturity levels. The bibliometric methodology will allow mapping the existing scientific production on the theme, while the literature review will synthesize and critically analyze the relevant studies, highlighting pertinent methodologies and results, additionally the comparison with Industry 4.0 will provide insights on how the principles of automation, interconnectivity and digitalization can be applied in healthcare environments/operations, aiming at improvements in operational efficiency and quality of care. The results of this study will contribute to a deeper understanding of the potential of Digital Twins in Smart Hospitals, in addition to the future potential from the effective integration of Industry 4.0 concepts in this specific environment, presented through the practical framework, after all, the urgent need for changes addressed in this article is undeniable, as well as all their value contribution to human sustainability, designed in SDG3 – Health and well-being: ensuring that all citizens have a healthy life and well-being, at all ages and in all situations. We know that the validity of these relationships will be constantly discussed, and technology can always change the rules of the game.

Keywords: digital twin, smart hospital, healthcare operations, industry 4.0, SDG3, technology

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Authors: Zhankun Wang, Timothy Makubuya

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The efficiency of public sports service of prefecture-level cities in Zhejiang from 2008 to 2012 was evaluated by applying the DEA method, then its influencing factors were also analyzed through Tobit model. Upon analysis, the results revealed the following; (i) the change in average efficiency of public sports service in Zhejiang present a smooth uptrend and at a relatively high level from 2008 to 2012 (ii) generally, the productivity of public sports service in Zhejiang improved from 2008 to 2012, the productivity efficiency varied greatly in different years, and the regional difference of production efficiency increased. (iii) The correlations for urbanization rate, aging rate, per capita GDP and the population density were significantly positive with the public sports service efficiency in Zhejiang, of which the most significant was the aging rate. However, the population density and per capita GDP had less impact on the efficiency of public sports service in Zhejiang. In addition, whether the efficiency of public sports services in different areas in Zhejiang reciprocates to overall benefits in public wellbeing in both rural and urban settings is still arguable.

Keywords: DEA model, public sports service, efficiency, Tobit model, Malmquist productivity index, Zhejiang

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Authors: Mahmood Salahi, Fatemeh Abbasi

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Increasing urbanization will be one of the defining features of the 21st century. This produces particular environmental challenges, but also creates opportunities for urban development that can contribute to broader goals of improving the quality of life for urban residents while achieving greater levels of global sustainability. Half of the world’s population already lives in urban areas, with a growing number of these people living in towns and cities in low and middle-income countries. As well as being a demographic phenomenon, urbanisation is intricately linked with economic, social and environmental transitions. The increasing proportion of the world’s population living in urban areas has been driven by the growing concentration of new investment and employment opportunities. In general, nations with the most rapid and sustained economic growth have urbanized most.2 Urban centres provide opportunities for a range of social and cultural activities, as well as being critical for innovations in science, technology and education. Indeed, urban areas are of critical importance for social and economic development: as the Cities Alliance recognizes, 'only sustained urban growth has the capacity to lift both rural and urban populations out of poverty'.

Keywords: environment, urban planning, management, urbanization

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Authors: Y. N. Shashidhara, B. S. Shakuntala

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Introduction: Nursing practice is undergoing tremendous changes and challenges. In order to meet social challenges and needs, nursing practice must be research based. Research is needed to evaluate the effectiveness of nursing treatment modalities, to determine the impact of nursing care on the health of the patients or to test the theory of nursing practice. Objective of the study to explore the attitude of staff nurses on Nursing research and its utilization Methodology: The descriptive study design was adopted and 300 staff nurses were selected by systematic random sampling technique from eight hospitals. The attitude on nursing research was assessed by validated and reliable self-administered attitude scale which consists of 40 items. Results: The overall attitude mean score 130.2 (SD 11.5) regarding attitude on Nursing research and its utilization. Some of the findings are the majority of staff nurses (51% agreed and 18.3% strongly agreed) that they have all the motivation to use research findings if they get support. Nearly 25.3 percent of staff nurses agreed and 10.7 percent strongly agreed that they do not have time to conduct research. The majority of staff nurses 53.7 percent agreed that research will help in updating Nursing profession. Nearly 32.6 percent of staff nurses agreed and 20.5 percent strongly agreed that being able to use will make them better nurses. About 45.3 percent and 17.3 percent agreed and strongly agreed that knowledge gained through experience is more useful than research. Most (40%) of nurses agreed that thy do not have the authority to change the patient care practice. The majority of staff nurses (45.7 percent agreed and 13 percent strongly agreed) feel the research will consume their personal time. Majority, 50 percent of staff nurses agreed and 16.7 percent strongly agreed that to conduct and utilize research findings requires financial support. Majority 50 percent of staff nurses agreed and 12 percent strongly agreed that physicians will cooperate and value nursing research findings. Majority 67.3 percent of staff nurses had moderate positive and 32.7 percent of staff nurses had highly positive attitude towards Nursing research and its utilization. Conclusion: With this study we understanding that, the staff nurses have positive attitude regarding nursing research. If the nurses are supported and motivated for research utilization we can improve the patient care.

Keywords: nurses, attitude, nursing research, research utilization

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Authors: Abel Kahuni

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Cooperative game theory (CGT) postulates that groups of players are crucial units of the decision-making and impose cooperative behaviour. Accordingly, cooperative games are regarded as competition between coalitions of players, rather than between individual players. However, the basic supposition in CGT is that the cooperative is formed by all players. One of the emerging questions in CGT is how to develop cooperatives and fairly allocate the payoff. Cooperative Game Theory (CGT) may provide a framework and insights into the ways small holder farmers in rural resettlements may develop competitive advantage through marketing cooperatives. This conceptual paper proposes a non-competition model for small holder farmers of homogenous agri-commodity under CGT conditions. This paper will also provide brief insights into to the theory of cooperative games in-order to generate an understanding of CGT, cooperative marketing gains and its application in small holder farming arrangements. Accordingly, the objective is to provide a basic introduction to this theory in connection with economic competitive theories in the context of small holder farmers. The key value proposition of CGT is the equitable and fair sharing of cooperative gains.

Keywords: game theory, cooperative game theory, cooperatives, competition

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Authors: Zubair Ahmad, Paolo Esposito

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The management of solid waste from its collection to disposal is a widespread issue all around the world. This is a stinging issue in the rural and urban areas of the developing and developed states of the world. The mismanagement in Pakistan in the context of solid waste is required to be recognized because it is not only affecting the health of the public but also affecting the health of the environment. Therefore, this study conducts qualitative research methodology and conducted interviews in Lahore, Karachi, Quetta, Peshawar and Islamabad’s solid waste management’s officials and waste pickers, for analyzing uses Grounded theory for the lens of thematic analysis to highlight how public value is being destroyed by the mismanagement of solid waste in Pakistan. This study critically examines the effects of corruption, mismanagement, lawlessness, lack of accountability, budgetary issues, and improper methods for the disposal of solid waste as the major factors that are destroying public value. Recognizing and addressing these factors is essential to improving the system of solid waste management in developing countries

Keywords: solid waste management, public value destruction, health, environment, accountability, grounded theory

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Authors: Recep Kesli, Gulsah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Pseudomonas aeruginosa (P. aeruginosa) is an important nosocomial pathogen which causes serious hospital infections and is resistant to many commonly used antibiotics. P. aeruginosa can develop resistance during therapy and also it is very resistant to disinfectant chemicals. It may be found in respiratory support devices in hospitals. In this study, the antibiotic resistance of P. aeruginosa strains isolated from bronchial aspiration samples was evaluated retrospectively. Methods: Between October 2013 and September 2015, a total of 318 P. aeruginosa were isolated from clinical samples obtained from various intensive care units and inpatient patients hospitalized at Afyon Kocatepe University, ANS Practice and Research Hospital. Isolated bacteria identified by using both the conventional methods and automated identification system-VITEK 2 (bioMerieux, Marcy l’etoile France). Antibacterial resistance tests were performed by using Kirby-Bauer disc (Oxoid, Hampshire, England) diffusion method following the recommendations of CLSI. Results: Antibiotic resistance rates of identified 318 P. aeruginosa strains were found as follows for tested antibiotics; 32 % amikacin, 42% gentamicin, 43% imipenem, 43% meropenem, 50% ciprofloxacin, 57% levofloxacin, 38% cefepime, 63% ceftazidime, and 85% piperacillin/tazobactam. Conclusion: Resistance profiles change according to years and provinces for P. aeruginosa, so these findings should be considered empirical treatment choices. In this study, the highest and lowest resistance rates found against piperacillin/tazobactam % 85, and amikacin %32.

Keywords: Pseudomonas aeruginosa, antibiotic resistance rates, intensive care unit, Pseudomonas spp.

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Authors: Saeed Abbas, Rahilla Tabassum, Haider Abbas, Babar Khan, Shahid Hussain, Muhammad Zafar Khan, Fazal Karim, Yawar Abbas, Rizwan Karim

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Human–carnivore conflict is considered to be a major conservation and rural livelihood concern because many carnivore species have been heavily victimized due to elevated conflict levels with communities. Like other snow leopard range countries, this situation prevails in Pakistan, where WWF is currently working under Asia High Mountain Project (AHMP) in Gilgit-Baltistan of Pakistan. To mitigate such conflicts requires a firm understanding of grazing and predation pattern including human-carnivore interaction. For this purpose we conducted a survey in Hoper valley (one of the AHMP project sites in Pakistan), during August, 2013 through a questionnaire based survey and unstructured interviews covering 647 households, permanently residing in the project area out of the total 900 households. The valley, spread over 409 km2 between 36°7'46" N and 74°49'2"E, at 2900m asl in Karakoram ranges is considered to be one of an important habitat of snow leopard and associated prey species such as Himalayan ibex. The valley is home of 8100 Brusho people (ancient tribe of Northern Pakistan) dependent on agro-pastoral livelihoods including farming and livestock rearing. The total number of livestock reported were (N=15,481) out of which 8346 (53.91%) were sheep, 3546 (22.91%) goats, 2193 (14.16%) cows, 903 (5.83%) yaks, 508 (3.28%) bulls, 28 (0.18%) donkeys, 27 (0.17%) zo/zomo (cross breed of yak and cow), and 4 (0.03%) horses. 83 percent respondent (n=542 households) confirmed loss of their livestock during the last one year July, 2012 to June, 2013 which account for 2246 (14.51%) animals. The major reason of livestock loss include predation by large carnivores such as snow leopards and wolf (1710, 76.14%) followed by diseases (536, 23.86%). Of the total predation cases snow leopard is suspected to kill 1478 animals (86.43%). Among livestock sheep were found to be the major prey of snow leopard (810, 55%) followed by goats (484, 32.7%) cows (151, 10.21%), yaks (15, 1.015%), zo/zomo (7, 0.5%) and donkey (1, 0.07%). The reason for the mass depredation of sheep and goats is that they tend to browse on twigs of bushes and graze on soft grass near cliffs. They are also considered to be very active as compared to other species in moving quickly and covering more grazing area. This makes them more vulnerable to snow leopard attack. The majority (1283, 75%) of livestock killed by predators occurred during the warm season (May-September) in alpine and sub-alpine pastures and remaining (427, 25%) occurred in the winter season near settlements in valley. It was evident from the recent study that Snow leopard kills outside the pen were (1351, 79.76%) as compared to inside pen (359, 20.24%). Assessing the economic loss of livestock predation we found that the total loss of livestock predation in the study area is equal to PKR 11,230,000 (USD 105,797), which is about PRK 17, 357 (USD 163.51) per household per year. Economic loss incurred by the locals due to predation is quite significant where the average cash income per household per year is PKR 85,000 (USD 800.75).

Keywords: carnivores, conflict, predation, livelihood, conservation, rural, snow leopard, livestock

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Authors: C. Matasane, C. Dwarika, R. Naidoo

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The mathematical analysis on radiation obtained and the development of the solar photovoltaic (PV) array groundwater pumping is needed in the rural areas of Thohoyandou, Limpopo Province for sizing and power performance subject to the climate conditions within the area. A simple methodology approach is developed for the directed coupled solar, controller and submersible ground water pump system. The system consists of a PV array, pump controller and submerged pump, battery backup and charger controller. For this reason, the theoretical solar radiation obtained for optimal predictions and system performance in order to achieve different design and operating parameters. Here the examination of the PV schematic module in a Direct Current (DC) application is used for obtainable maximum solar power energy for water pumping. In this paper, a simple efficient photovoltaic water pumping system is presented with its theoretical studies and mathematical modeling of photovoltaics (PV) system.

Keywords: renewable energy sources, solar groundwater pumping, theoretical and mathematical analysis of photovoltaic (PV) system, theoretical solar radiation

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Authors: Sushil Kumar Solanki, Rachna Khare

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Universal Design is a concept of built environment creation, where all people are facilitated to the maximum extent possible without using any type of specialized design. However, accessible design is a design process in which the needs of people with disabilities are specifically considered. Building standards on accessibility contains scoping and technical requirements for accessibility to sites, facilities, building and elements by individual with disability. India is also following its prescriptive types of various building standards for the creation of physical environment for people with disabilities. These building standards are based on western models instead of research based standards to serve Indian needs. These standards lack contextual connect when reflects in its application in the urban and rural environment. This study focuses on critical and comparative study of various international building standards and codes, with existing Indian accessibility standards to understand problems and prospects of concept of Universal Design building standards for India. The result of this study is an analysis of existing state of Indian building standard pertaining to accessibility and future need of performance based Universal Design concept.

Keywords: accessibility, building standard, built-environment, universal design

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Authors: J. Bravo, F. Cabrera Suárez, B. Vega, L. Román, M. Martel, F. Acosta

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Ciguatera fish poisoning (CFP) is the most common non-bacterial intoxication in the world caused by ingestion of fish with bio-accumulated ciguatoxins (CTXs). It is typical in tropical and subtropical areas, mainly affecting the Caribbean Sea, Polynesia and other areas in the Pacific and Indian Oceans. Interest in Europe by the CFP is increasing in recent years as more and more cases in European hospitals are appearing, usually by people who have consumed ciguatoxin imported fish or have travelled to areas of risk for this poisoning. Since 2004 a series of poisonings raised the question of a possible occurrence of ciguatoxin in Europe, especially in the area of Macaronesia in the East Atlantic temperate zone. Furthermore, some studies have identified the presence of Gambierdiscus spp. in waters surrounding the Canary Islands and Madeira, a toxic dinoflagellate related to this poisoning. The toxin accumulates and concentrates through the food chain and affects to the end of the chain, the human consumer. Fish were collected from the Canary Islands waters and the toxin has been extracted and purified by using acetone and liquid/liquid partition in order to eliminate the excess of fatty acids that may interfere with the detection of the toxin. The fish extracts were inoculated in Neuroblastoma (neuro-2a) cells. After 24-h cell viability was used as an endpoint for cytotoxic effects measurement. Since 2011 our laboratory is collecting data for species such Seriola spp., Epinephelus spp., Makaira spp., Pomatomus spp., Xiphias spp., and Acantocybium spp., from all islands and including the sports fishing and professional activities, we obtained a 8% of fish that have ciguatoxin in their muscle. With these results, we conclude that the island where fishing and fish size affects the probability of catching a fish with the ciguatoxin.

Keywords: Canary Islands, ciguatera fish poisoning, ciguatoxin, Europe

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Authors: Chinedu Ifedi Okeke

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The behavioural orientations of fathers, which resonate in the way they relate to members of their families and other community members, appear to have a variety of implications for the early development of children. In this paper, a conceptual map of fathers’ lifestyles is adopted to provide an interconnected network of father lifestyles. Empirical evidence from a qualitative case study of 25 Black fathers, who had been purposively selected from a suburb in one rural Eastern Cape municipality in South Africa, is reported in this paper. Semi-structured in-depth interviews were used to obtain data, which was analysed thematically. Findings identify and provide evidence of father lifestyles that are incongruent with the kind of parental behaviour needed to support the healthy early development of children. Findings suggest that these negative lifestyles appear to incapacitate fathers who fail to make a positive contribution to their children’s early development. To ensure that fathers make the expected contributions to their children’s early development, policies aimed at rehabilitating fathers who are involved in the negative lifestyles reported in this paper should be put in place.

Keywords: childhood development, fathering, fathers, intervention strategies, lifestyles, South Africa

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Authors: Benaissa Fatima, Alkama Rezak, Annesi-Maesano Isabella

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To assess the health impact of the air pollution on the population of Béjaia, we carried out a descriptive epidemiologic inquiry near the medical establishments of three areas. From the registers of hospital admissions, we collected data on the hospital mortality and admissions relating to the various cardiorespiratory pathologies generated by this type of pollution. In parallel, data on the automobile fleet of Bejaia and other measurements were exploited to show that the concentrations of the pollutants are strongly correlated with the concentration the urban traffic. This study revealed that the whole of the population is touched, but the sensitivity to pollution can show variations according to the age, the sex and the place of residence. So the under population of the town of Bejaia marked the most raised death and morbidity rates, followed that of Kherrata. Weak rates are recorded for under rural population of Feraoun. This approach enables us to conclude that the population of Béjaia could not escape the urban pollution generated by her old automobile fleet. To install a monitoring and measuring site of the air pollution in this city could provide a beneficial tool to protect its inhabitants by them informing on quality from the air that they breathe and measurements to follow to minimize the impacts on their health and by alerting the authorities during the critical situations.

Keywords: air, urban pollution, health, impacts

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: Bummo Ahn

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Palpation is widely used to measure soft tissue firmness or stiffness in the living condition in order to apply detection, diagnosis, and treatment of tumors, scar tissue, abnormal muscle tone, or muscle spasticity. Since these methods are subjective and depend on the proficiency level, it is concluded that there are other diagnoses depending on the condition of the experts and the results are not objective. The mechanical property obtained by using the elasticity of the tissue is important to calculate a predictive variable for monitoring abnormal tissues. If the mechanical load such as reaction force on the foot increases in the same region under the same conditions, the mechanical property of the tissue is changed. Therefore, objective diagnosis is possible not only for experts but also for patients using this quantitative information. Furthermore, the portable system also allows non-experts to easily diagnose at home, not in hospitals or institutions. In this paper, we introduce a portable palpation system that can be used to measure the mechanical properties of human tissue, which can be applied to monitor diabetic foot ulceration patients with measuring the mechanical property change of foot tissue. The system was designed to be smaller and portable in comparison with the conventional palpation systems. It is consists of the probe, the force sensor, linear actuator, micro control unit, the display module, battery, and housing. Using this system, we performed validation experiments by applying different palpations (3 and 5 mm) to soft tissue (silicone rubber) and measured reaction forces. In addition, we estimated the elastic moduli of the soft tissue against different palpations and compare the estimated elastic moduli that show similar value even if the palpation depths are different.

Keywords: palpation probe, portable, diabetic foot ulceration, monitoring, mechanical property

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Authors: Dwi Purnomo, Anas Bunyamin, Fajar Susilo, Akbar Anugrah

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Beekeeping became a rural economic buffer, especially for people who lived by forest side to diversify their food or sell the honey and bee colony. Aside from the high price of honey and it’s derivative products, there is another revenue stream along beekeeping value chain that could be optimized by the people. There are five of nine honey bee species in the world, exist in Indonesia, such as Apis Cerana, Apis Dorsata, Apis Andreniformis, Apis Koschevnikovi, and Apis Nigrocincta. Indonesian farmer generally developed Apis Cerana and two other honey bees species, like Apis Mellifera and Trigona. This study tried to identify, how beekeeping business practices, challenges and opportunities in four beekeeping business in West Java through the value chain along the business. Data carried out by literature review, interview and focus group discussion with key actors in beekeeping business. There are six revenue stream in beekeeping business in West Java, such as brood hunter, beehives maker, agroforestry, agro-tourism, honey and derivatives products and bee acupuncture. This assesses conclude any criteria that should grasp for developing and sustaining beekeeping business in West Java.

Keywords: beekeeping business, business developing, value chain, West Java

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Authors: Addisu Tadesse Sahile, Tennyson Mgutshini

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Background: Periodontal disease is a common, complex, inflammatory disease characterized by the destruction of tooth-supporting soft and hard tissues of the periodontium and a major public health problem across developed and developing countries. Objectives: The study was aimed at assessing the prevalence of periodontal disease and associated factors among diabetes patients in Addis Ababa, Ethiopia, 2018. Methods: Institutional based cross-sectional study was conducted on 388 diabetes patients selected by systematic random sampling method from March to May 2018. The study was conducted at two conveniently selected public hospitals in Addis Ababa. Data were collected with pre-tested, structured and translated questionnaire then entered to SPSS version 23 software for analysis. Descriptive statistics as a summary, in line with chi-square and binary logistics regression to identify factors associated with periodontal disease, were applied. A 95% CI with a p-value less than 5% was used as a level of significance. Results: Ninety-one percent (n=353) of participants had periodontal disease while oral examination was done in six regions. While only 9% (n=35) of participants were free of periodontal disease. The number of tooth brushings per day, correct techniques of brushing, malocclusion, and fillings that are defective were associated with periodontal disease at p < 0.05. Conclusion and recommendation: A higher prevalence of periodontal disease among diabetes patient was observed. The frequency of tooth brushing, correct techniques of brushing, malocclusion and defective fillings were associated with periodontal disease. Emphasis has to be given to oral health of diabetes patients by every concerned body so as to control the current higher burden of periodontal disease in diabetes.

Keywords: periodontal disease, risk factors, diabetes mellitus, Addis Ababa

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Authors: Fouzia Mannan, Deepa Joshi

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Millions of Bangladeshis move from low-income agrarian villages to the country’s urban landscape with the hope to gain from the rapidly-growing middle-income urban, industrial future. However, the economic gains are mostly offset by new forms of extreme depravity, indignity, and inequality. Nonetheless, many scholars report unique gendered gains through migration - the rupture of traditional, entrenched inequalities by gender, providing women not only reliable incomes but also the opportunity to re-negotiate gendered roles, responsibilities and identities. In this study, we present the reflections of ten long-term urban migrant women in Dhaka city: of their gains, their losses as well as their aspirations for the future. Our findings show the incredibly high costs of a migration that is induced by desperate rural poverty. Further, we find that patriarchy persists - within the often 'kutcha' walls of urban low-income homes to the nature of so-called economic opportunities - in the constant intertwining of capitalism, globalization, and patriarchy. Caught in between, women have little choice but to cope with these new vulnerabilities by relying on the very norms and boundaries established by patriarchy and by recreating patriarchy to celebrate the (if) gains from displacement and migration.

Keywords: gender, internal migration, patriarchy, urbanization

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Authors: David Segun Adeniyi, Tongvwam P. J., Wekpe S., Owolagba F. E., Ofuche E., Samuels J. O., Okonkwo P.

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Background: Pediatrics HIV viral suppression remains a major challenge across Africa. In this study, we sought to establish the relationship between AMP and sustained plasma HIV viremia among a population of pediatric clients on Antiretroviral Therapy (ART). We also seek to determine the prevalence of AMP among the study population. Methods: 180 pediatrics clients on ART at four (4) Comprehensive Hospitals in Jos, Nigeria, participated in this study between the months of October to December 2022. The mean age of the study participants was 13 years. Venous blood was drawn from the participants after consent was sought, and ethical approval was obtained from the Plateau State Specialist Hospital (PSSH) Research and Ethics Committee. All samples were screened for AMP using the CareStart® HRP2 Malaria kit. The Absolute and % CD4 values of the clients were obtained using the BD Presto® CD4 Analyzer. The separated plasma samples were assayed for HIV viral load using the Roche Cobas C4800® system. Obtained data were analyzed using simple descriptive statistics. Results: From the 180 participants in this study, 12.8% (23) have AMP. 90.6% (163) were virally suppressed (<1000 copies/ml), while 9.4% (17) were virally unsuppressed (>1000 copies/ml). 11.7% (19/163) of the virally suppressed population have AMP, with mean absolute and % CD4 values of 648 and 31%, respectively. The virally suppressed population without AMP has mean absolute and % CD4 values of 719 and 32%, respectively. 24% (4/17) of the virally unsuppressed population have AMP, with mean absolute and % CD4 values of 514 and 26%, respectively. The virally unsuppressed population without AMP has mean absolute and % CD4 values of 292 and 16%, respectively. Conclusion: Our study shows that there is a high prevalence of AMP among the study populations (11.7% and 24%, respectively). The high prevalence of AMP among the virally unsuppressed with mean absolute and % CD4 values of 514 and 26% alludes to the fact that malaria co-infection with HIV fosters a dysregulated immune complex response which favors an increased HIV plasma viremia. We thus recommend the routine use of Malaria IPT in pediatric HIV clients.

Keywords: pediatrics, HIV, Malaria, viral suppression

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods: A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results: Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions: A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

Keywords: partograph, knowledge, utilization, obstetric care givers, public health institutions

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Authors: Isaac Ali Kwasu, Aje Tokan

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The research was set to design a manually pedal operated water pump to aid water flow technology for irrigation activities for rural farmers. The development was carried out first by a prototype design to guide the fabrication. All items needed for the fabrication were used for the final product. The machine is operated manually by pedaling. This engages all the parts of the machine into active motion. Energy is generated and transfer finally to the pumping unit which is wired with plastic pipes. The pumping unit which is wired with PVC pipes, both linked to the water source and the reservoir respectively. The (rpm) revolution per minute of the machine is approximated at 3130 depending on the pedaling speed of the user. The machine does not have gear arrangement yet can give high (rpm) for effective performance. The pumping performance of the machine is 125 liters in one minute and can sustain small scale irrigation farming activities and to supplement water management system to sustain crop growth.

Keywords: pump, development, manual, flywheel, sprocket, pulley, machine, v belt, chain, hub, pipe, steel, mechanism, irrigation, prototype, fabrication

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Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

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Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29)，the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

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Authors: Sanoj Sahu, Ramakar Jha

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Odisha (India) is in need of reliable, cost-effective power generation. A prolonged electricity crisis and increasing power demand have left over thousands of citizens without access to electricity, and much of the population suffers from sporadic outages. The purpose of this project is to build a methodology to evaluate small hydropower potential, which can be used to alleviate the Odisha’s energy problem among rural communities. This project has three major tasks: the design of a simple SHEP for a single location along a river in the Odisha; the development of water flow prediction equations through a linear regression analysis; and the design of an ArcGIS toolset to estimate the flow duration curves (FDCs) at locations where data do not exist. An explanation of the inputs to the tool, as well has how it produces a suitable output for SHEP evaluation will be presented. The paper also gives an explanation of hydroelectric power generation in the Odisha, SHEPs, and the technical and practical aspects of hydroelectric power. Till now, based on topographical and rainfall analysis we have located hundreds of sites. Further work on more number of site location and accuracy of location is to be done.

Keywords: small hydropower, ArcGIS, rainfall analysis, Odisha’s energy problem

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Authors: Priyanka Kumari

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Menstrual hygiene is an important aspect in the life of young girls. Menstrual Hygiene Management (MHM) is defined as ‘Women and adolescent girls using a clean material to absorb or collect menstrual blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required and having access to facilities to dispose of used menstrual management materials. This paper aims to investigate the prevalence of hygienic menstrual practices and socio-demographic correlates of hygienic menstrual practices among women aged 15-24 in India. Data from the 2015–2016 National Family Health Survey–4 for 244,500 menstruating women aged 15–24 were used. The methods have been categorized into two, women who use sanitary napkins, locally prepared napkins and tampons considered as a hygienic method and those who use cloth, any other method and nothing used at all during menstruation considered as an unhygienic method. Women’s age, year of schooling, religion, place of residence, caste/tribe, marital status, wealth index, type of toilet facility used, region, the structure of the house and exposure to mass media are taken as an independent variables. Bivariate analysis was carried out with selected background characteristics to analyze the socio-economic and demographic factors associated with the use of hygienic methods during menstruation. The odds for the use of the hygienic method were computed by employing binary logistic regression. Almost 60% of the women use cloth as an absorbent during menstruation to prevent blood stains from becoming evident. The hygienic method, which includes the use of locally prepared napkins, sanitary napkins and tampons, is 16.27%, 41.8% and 2.4%. The proportion of women who used hygienic methods to prevent blood stains from becoming evident was 57.58%. Multivariate analyses reveal that education of women, wealth and marital status are found to be the most important positive factors of hygienic menstrual practices. The structure of the house and exposure to mass media also have a positive impact on the use of menstrual hygiene practices. In contrast, women residing in rural areas belonging to scheduled tribes are less likely to use hygienic methods during their menstruation. Geographical regions are also statistically significant with the use of hygienic methods during menstruation. This study reveals that menstrual hygiene is not satisfactory among a large proportion of adolescent girls. They need more education about menstrual hygiene. A variety of factors affect menstrual behaviors; amongst these, the most influential is economic status, educational status and residential status, whether urban or rural. It is essential to design a mechanism to address and access healthy menstrual knowledge. It is important to encourage policies and quality standards that promote safe and affordable options and dynamic markets for menstrual products. Materials that are culturally acceptable, contextually available and affordable. Promotion of sustainable, environmentally friendly menstrual products and their disposal as it is a very important aspect of sustainable development goals. We also need to educate the girls about the services which are provided by the government, like a free supply of sanitary napkins to overcome reproductive tract infections. Awareness regarding the need for information on healthy menstrual practices is very important. It is essential to design a mechanism to address and access healthy menstrual practices. Emphasis should be given to the education of young girls about the importance of maintaining hygiene during menstruation to prevent the risk of reproductive tract infections.

Keywords: adolescent, menstruation, menstrual hygiene management, menstrual hygiene

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Authors: Cornelius Ehlers, Lisa Harmatiuk, Sharon Rowland, Michelle Shafers

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The objective of the Street Connect program is to provide client-centered care for the homeless population within the City of Red Deer. The program aims to provide an extended continuum of care (addiction, mental health, and physical health) for high acuity homeless individuals who are not connected to a service provider and/or community service agency. Street Connect includes both primary and secondary streams of service: Overall, Street Connect has demonstrated its ability to support vulnerable populations within the City of Red Deer, specifically those who are homeless and seeking addiction, mental health, and medical assistance. The results from the data extract and chart audit reflect the complexity and vulnerability of the clients enrolled in the Street Connect program. The clients were predominantly male, with an average age of 41 years. The majority did not have a permanent address, and 65% did not have employment. Substance abuse/addiction issues were common, combined with a history of psychiatric diagnoses and previous mental health hospitalizations. The most utilized drugs were street drugs such as methamphetamine, fentanyl, and other opioids.

Keywords: client-centred care, homelessness, mental health, rural

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Authors: Abeer Mohammed, Nevein Mustafa Elashery, Mona Hassan Abdel Aal, Ereny Wilson Nagib

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The Aim of the current study is to investigate nutrition role in the management of psychiatric disorders. Research Design: A quasi- experimental research design was utilized for this study. Setting The study was conducted at outpatient clinic at Institute of Psychiatry affiliated to Ain Shams University hospitals, using a convenient sample of 50 psychiatric patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. Tools: data were collected through; first, an interview questionnaire covering socio-demographic characteristics, second, nutrition assessment tools Third, nutrition risk assessment. Fourth, nutrition management program Results showed that there were highly statistically significant improvements in modified nutritional supplements for patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders' patients after conducting the nutrition management program. Regarding psychiatric patients’ knowledge about healthy food, healthy nutritional habits, and patients’ awareness & readiness for change, there were highly statistically significant improvements. Concerning signs and symptoms of psychiatric disorders, there were highly statistically significant improvements for depression, schizophrenia, bipolar disorders, and obsessive-compulsive patients after conducting the management program. In conclusion, the nutrition management program was effective in improving symptoms associated with, depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. The study recommended that nurses should have more contribution in counseling psychiatric patients, and their families about healthy diet and healthy habits. Further research should recommend studying the effectiveness of herbs on enhancing mental health for psychiatric patients.

Keywords: nutrition, role, management, psychiatric disorders

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