Search results for: social health insurance

Authors: Gülcan Taşkıran, Ayla Bayık Temel

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Background: Florence Nightingale, the modern founder of the nursing, is most famous for her role as a nurse. But not so much known about her contributions as a mathematician and statistician. Aim: In this conceptual article it is aimed to examine Florence Nightingale's statistics education, how she used her passion for statistics and applied statistical data in nursing care and her scientific contributions to statistical science. Design: Literature review method was used in the study. The databases of Istanbul University Library Search Engine, Turkish Medical Directory, Thesis Scanning Center of Higher Education Council, PubMed, Google Scholar, EBSCO Host, Web of Science were scanned to reach the studies. The keywords 'statistics' and 'Florence Nightingale' have been used in Turkish and English while being screened. As a result of the screening, totally 41 studies were examined from the national and international literature. Results: Florence Nightingale has interested in mathematics and statistics at her early ages and has received various training in these subjects. Lessons learned by Nightingale in a cultured family environment, her talent in mathematics and numbers, and her religious beliefs played a crucial role in the direction of the statistics. She was influenced by Quetelet's ideas in the formation of the statistical philosophy and received support from William Farr in her statistical studies. During the Crimean War, she applied statistical knowledge to nursing care, developed many statistical methods and graphics, so that she made revolutionary reforms in the health field. Conclusions: Nightingale's interest in statistics, her broad vision, the statistical ideas fused with religious beliefs, the innovative graphics she has developed and the extraordinary statistical projects that she carried out has been influential on the basis of her professional achievements. Florence Nightingale has also become a model for women in statistics. Today, using and teaching of statistics and research in nursing care practices and education programs continues with the light she gave.

Keywords: Crimean war, Florence Nightingale, nursing, statistics

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Authors: Misha Mirza

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In recent years, the definition of journalism in Pakistan has changed, so has the mindset of people and their approach towards a news story. For the audience, news has become more interesting than a drama or a film. This research thus provides an insight into Pakistan’s evolving media landscape. It tries not only to bring forth the outcomes of cross-platform cooperation among print and broadcast journalism but also gives an insight into the interactive data visualization techniques being used. The storytelling in journalism in Pakistan has evolved from depicting merely the truth to tweaking, fabricating and producing docu-dramas. It aims to look into how news is translated to a visual. Pakistan acquires a diverse cultural heritage and by engaging audience through media, this history translates into the storytelling platform today. The paper explains how journalists are thriving in a converging media environment and provides an analysis of the narratives in television talk shows today.’ Jack of all, master of none’ is being challenged by the journalists today. One has to be a quality information gatherer and an effective storyteller at the same time. Are journalists really looking more into what sells rather than what matters? Express Tribune is a very popular news platform among the youth. Not only is their newspaper more attractive than the competitors but also their style of narrative and interactive web stories lead to well-rounded news. Interviews are used as the basic methodology to get an insight into how data visualization is compassed. The quest for finding out the difference between visualization of information versus the visualization of knowledge has led the author to delve into the work of David McCandless in his book ‘Knowledge is beautiful’. Journalism in Pakistan has evolved from information to combining knowledge, infotainment and comedy. What is being criticized the most by the society most often becomes the breaking news. Circulation in today’s world is carried out in cultural and social networks. In recent times, we have come across many examples where people have gained overnight popularity by releasing songs with substandard lyrics or senseless videos perhaps because creativity has taken over information. This paper thus discusses the various platforms of convergence journalism from Pakistan’s perspective. The study concludes with proving how Pakistani pop culture Truck art is coexisting with all the platforms in convergent journalism. The changing media landscape thus challenges the basic rules of journalism. The slapstick humor and ‘jhatka’ in Pakistani talk shows has evolved from the Pakistani truck art poetry. Mobile journalism has taken over all the other mediums of journalism; however, the Pakistani culture coexists with the converging landscape.

Keywords: convergence journalism in Pakistan, data visualization, interactive narrative in Pakistani news, mobile journalism, Pakistan's truck art culture

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Authors: Weldeabrha Kiros Kidanemaryam, DepaTesfay Kelali Gidey, Yikaalo Welu Kidanemariam

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Dairy services are considered as sources of income, employment, nutrition and health for smallholder rural and urban farmers. The main objective of this study is to assess the interlinkage of dairy farms and small-scale dairy processing in Mekelle, Tigray. To achieve the stated objective, a descriptive research approach was employed where data was collected from 45 dairy farmers and 40 small-scale processors and analyzed by calculating the mean values and percentages. Findings show that the dairy business in the study area is characterized by a shortage of feed and water for the farm. The dairy farm is dominated by breeds of hybrid type, followed by the so called ‘begait’. Though the farms have access to medication and vaccination for the cattle, they fell short of hygiene practices, reliable shade for the cattle and separate space for the claves. The value chain at the milk production stage is characterized by a low production rate, selling raw milk without adding value and a very meager traditional processing practice. Furthermore, small-scale milk processors are characterized by collecting milk from farmers and producing cheese, butter, ghee and sour milk. They do not engage in modern milk processing like pasteurized milk, yogurt and table butter. Most small-scale milk processors are engaged in traditional production systems. Additionally, the milk consumption and marketing part of the chain is dominated by the informal market (channel), where market problems, lack of skill and technology, shortage of loans and weak policy support are being faced as the main challenges. Based on the findings, recommendations and future research areas are forwarded.

Keywords: value-chain, dairy, milk production, milk processing

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Authors: Siyabonga Kunene, Calvin Shipley

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Introduction: Despite health benefits that come with running, injuries are common with prevalence ranging between 18.2% and 92.4% worldwide. Differences in gait patterns between barefoot and shod running, can determine traits that could lead to running injuries. The aim was to assess and compare lower limb gait cycle patterns between barefoot and shod running among runners. Methods: An experimental same-subject study design was used. The study population consisted of male and female adult recreational runners who were injury free from a running club in Durban. A convenience sampling method was used and 14 participants were recruited. The study was conducted in the physiotherapy performance laboratory at the University of KwaZulu-Natal. A Woodway Desmo Treadmill and KinePro gait analysis system were used. Descriptive & inferential statistics were analysed using Microsoft Excel and Intercooled Stata. Results: Participants included a greater percentage of females (57.1%, n = 8) than males (42.9%, n = 6). The mean population age was 38.57. A significant difference (p < 0.0009) between barefoot cadence (177.9236steps/min) and shod cadence (171.9445steps/min) was observed. Right (0.261s) and left (0.257s) barefoot stand phase was shorter than right (0.273s) and left (0.270s) shod stand phase. Right barefoot swing phase exhibited less significant (0.420s) results when compared to right shod swing phase (0.427s), whereas left barefoot swing phase was quicker (0.416s) than left shod swing phase (0.432s). Significant differences between barefoot and shod stand (p < 0.009) and swing (p < 0.040) phase symmetry occurred. Conclusion: A considerable difference was found between barefoot and shod running gait cycle patterns among participants. This difference may play a role in prevention of running related injuries.

Keywords: barefoot running, shod running, gait cycle pattern, same-subject study design

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Authors: Tomasz Kosicki

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The subject of the presentation will be the administrative and legal instruments of disciplining maintenance debtors adopted by the Polish legislator, the substantive legal bases of which were adopted in the Act of 7 September 2007 on assistance to persons entitled to maintenance (Journal of Laws of 2022, item 1205). These provisions are complemented by procedural regulations resulting from the Act of 14 June 1960 - Code of Administrative Procedure (Journal of Laws of 2021, item 735, as amended). The first part of the paper will focus on the administrative proceedings regarding the recognition of the debtor as evading maintenance obligations. The initiation of this procedure ex officio is preceded by a number of actions by public administration bodies, including Conducting a maintenance interview with the debtor, during which his health and professional situation and the reasons for non-payment of maintenance are determined, Professional activation in a situation where the lack of payment of maintenance results from the lack of employment. The reasons for initiating the above-mentioned administrative proceedings ex officio will be indicated, taking into account the current views of the judicial decisions. The second part of the paper will focus on the instrument of retaining the driving license of the debtor, who was previously found to be evading maintenance. The author points out that the detention of the driving license is one of the types of administrative sanctions of a very severe nature. Doubts of a constitutional nature will also be highlighted, as well as those concerning the effectiveness of this legal instrument and the protection of the debtor's rights. The thesis will be presented that the administrative procedure for the retention of a driving license does not fulfill its role and especially does not affect the collection of maintenance obligations from debtors. All the considerations will be based on the current and most representative views of the literature on the subject and the jurisprudence of Polish administrative courts.

Keywords: maintenance debtor, administrative proceedings, detention of driving license, administrative sanction, polish administrative law, public administration

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Authors: Chinumani Choudhury

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Heavy metal contamination is an alarming problem, which poses a serious risk to human health and the surrounding geology. Soils get contaminated with heavy metals due to the un-regularized industrial discharge of the toxic metal-rich effluents. Under such a condition, the remediation of the contaminated sites becomes imperative for a sustainable, safe, and healthy environment. Phytoextraction, which involves the removal of heavy metals from the soil through root absorption and uptake, is a viable remediation technique, which ensures extraction of the toxic inorganic compound available in the soil even at low concentrations. The soil present in the Silghat Region of Assam, India, is mostly contaminated with Zinc (Zn) and Lead (Pb), having concentrations as high as to cause a serious environmental problem if proper measures are not taken. In the present study, an extensive experimental study was carried out to understand the effectiveness of two commonly planted trees in Assam, namely, i) Indian Pennywort and ii) Fenugreek, in the removal of heavy metals from the contaminated soil. The basic characterization of the soil in the contaminated site of the Silghat region was performed and the field concentration of Zn and Pb was recorded. Various long-term laboratory pot tests were carried out by sowing the seeds of Indian Pennywort and Fenugreek in a soil, which was spiked, with a very high dosage of Zn and Pb. The tests were carried out for different concentration of a particular heavy metal and the individual effectiveness in the absorption of the heavy metal by the plants were studied. The concentration of the soil was monitored regularly to assess the rate of depletion and the simultaneous uptake of the heavy metal from the soil to the plant. The amount of heavy metal uptake by the plant was also quantified by analyzing the plant sample at the end of the testing period. Finally, the study throws light on the applicability of the studied plants in the field for effective remediation of the contaminated sites of Assam.

Keywords: phytoextraction, heavy-metals, Indian pennywort, fenugreek

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Authors: Norman Farb, Anirudh Kumar, Abdul Subhan, Pallavi Gupta, Jahnavi Mundluru, Abdul Subhan, Shankar Pathmakanthan

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Long term meditation practice is increasingly recognized for its health benefits. Among a diversity of contemplative traditions, Heartfulness meditation represents a quickly growing set of practices that is largely unstudied. Heartfulness is unique in that it is a meditation practice that focuses on the Heart. It helps individuals to connect to themselves and find inner peace while meditating. In order to deepen ones’ meditation on the heart, the element of Yogic Energy (‘pranahuti’) is used as an aid during meditation. The purpose of this study was to determine whether consistent EEG effects of Heartfulness meditation be observed in sixty experienced Heartfulness meditators, each of whom attended 6 testing sessions. In each session, participants performed three conditions: a set of cognitive tasks, Heartfulness guided relaxation, and Heartfulness Meditation. To measure EEG, the MUSE EEG head band (product of Interaxon Inc) was used. Participants during the cognitive portion were required to answer questions that tested their logical thinking (Cognitive Reflective Test) and creative thinking skills. (Random Associative Test) The order of condition was randomly counter balanced across six sessions. It was hypothesized that Heartfulness meditation would bring increased alpha (8-12Hz) brain activity during meditation and better cognitive task scores in sessions where the tasks followed meditation. Results show that cognitive task scores were higher after meditation in both CRT and RAT, suggesting stronger right brain and left brain activation. Heartfulness meditation produces a significant decrease in brain activity (as indexed by higher levels of alpha) during the early stages of meditation. As the meditation progressed deep meditative state (as indexed by higher levels of delta) were observed until the end of the condition. This lead to the conclusion that Heartfulness Meditation produces a state that is clearly distinguishable from effortful problem solving.

Keywords: heartfulness meditation, neuroplasticity, brain activity, relaxation response

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Authors: Mohammad Faheem, M. Tabish Rehman, Mohd Danishuddin, Asad U. Khan

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The worldwide dissemination of CTX-M type β-lactamases is a threat to human health. Previously, we have reported the spread of blaCTX-M-15 gene in different clinical strains of Enterobacteriaceae from the hospital settings of Aligarh in north India. In view of the varying resistance pattern against cephalosporins and other β-lactam antibiotics, we intended to understand the correlation between MICs and catalytic activity of CTX-M-15. In this study, steady-state kinetic parameters and MICs were determined on E. coli DH5α transformed with blaCTX-M-15 gene that was cloned from Enterobacter cloacae (EC-15) strain of clinical background. The effect of conventional β-lactamase inhibitors (clavulanic acid, sulbactam and tazobactam) on CTX-M-15 was also studied. We have found that tazobactam is the best among these inhibitors against CTX-M-15. The inhibition characteristic of tazobactam is defined by its very low IC50 value (6 nM), high affinity (Ki = 0.017 µM) and better acylation efficiency (k+2/K9 = 0.44 µM-1s-1). It forms an acyl-enzyme covalent complex, which is quite stable (k+3 = 0.0057 s-1). Since increasing resistance has been reported against conventional b-lactam antibiotic-inhibitor combinations, we aspire to design a non-b-lactam core containing b-lactamase inhibitor. For this, we screened ZINC database and performed molecular docking to identify a potential non-β-lactam based inhibitor (ZINC03787097). The MICs of cephalosporin antibiotics in combination with this inhibitor gave promising results. Steady-state kinetics and molecular docking studies showed that ZINC03787097 is a reversible inhibitor which binds non-covalently to the active site of the enzyme through hydrogen bonds and hydrophobic interactions. Though, it’s IC50 (180 nM) is much higher than tazobactam, it has good affinity for CTX-M-15 (Ki = 0.388 µM). This study concludes that ZINC03787097 compound can be used as seed molecule to design more efficient non-b-lactam containing b-lactamase inhibitor that could evade pre-existing bacterial resistance mechanisms.

Keywords: ESBL, non-b-lactam-b-lactamase inhibitor, bioinformatics, biomedicine

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Authors: Mustapha Babatunde, Bassam Tawabini, Ole John Nielson

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Air dispersion (AD) models such as AERMOD are important tools for estimating the environmental impacts of air pollutant emissions into the atmosphere from anthropogenic sources. The outcome of these models is significantly linked to the climate condition like air temperature, which is expected to differ in the future due to the global warming phenomenon. With projections from scientific sources of impending changes to the future climate of Saudi Arabia, especially anticipated temperature rise, there is a potential direct impact on the dispersion patterns of air pollutants results from AD models. To our knowledge, no similar studies were carried out in Saudi Arabia to investigate such impact. Therefore, this research investigates the effects of climate temperature change on air quality in the Dammam Metropolitan area, Saudi Arabia, using AERMOD coupled with Station data using Sulphur dioxide (SO2) – as a model air pollutant. The research uses AERMOD model to predict the SO2 dispersion trends on the surrounding area. Emissions from five (5) industrial stacks, on twenty-eight (28) receptors in the study area were considered for the climate period (2010-2019) and future period of mid-century (2040-2060) under different scenarios of elevated temperature profiles (+1oC, + 3oC and + 5oC) across averaging time periods of 1hr, 4hr and 8hr. Results showed that levels of SO2 at the receiving sites under current and simulated future climactic condition fall within the allowable limit of WHO and KSA air quality standards. Results also revealed that the projected rise in temperature would only have mild increment on the SO2 concentration levels. The average increase of SO2 levels were 0.04%, 0.14%, and 0.23% due to the temperature increase of 1, 3, and 5 degrees respectively. In conclusion, the outcome of this work elucidates the degree of the effects of global warming and climate changes phenomena on air quality and can help the policymakers in their decision-making, given the significant health challenges associated with ambient air pollution in Saudi Arabia.

Keywords: air quality, sulphur dioxide, global warming, air dispersion model

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Authors: Kasipandi Muniyandi, Parimelazhagan Thangaraj

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Plants are important prospective wealth of a country, combination of local health care information about a specific plant together with data published by several groups of scientists, can help in deciding whether it should be considered acceptable for medicinal use. In the developed countries, too, plant-derived drugs may be of importance. The wide variety of ailments that are being treated with Plectranthus is an indication of the medicinal value of the genus. A number of species are not toxic and so may be taken orally, whilst others are used topically on the skin or as enemas. This study was designed to evaluate the different properties of Plectranthus stocksii and the aerial parts were collected and extracted with petroleum ether, chloroform, ethyl acetate, acetone and methanol by Soxhlet apparatus and finally macerated with hot water. The quantification assays revealed that, leaf methanol extract showed higher total phenolic (415.41 mg GAE/ g extract) and tannin (177.53 mg GAE/ g extract) contents whereas leaf ethyl acetate exhibited higher flavonoids (777.11 mg RE/ g extract) content. The antioxidant efficiency of the extracts was analyzed by various radical scavenging assays. Among the different antioxidant assays, leaf ethyl acetate extract showed higher free radical scavenging activities against DPPH (IC50 = 3.46 µg/mL), ABTS (27417.65 µM TE/ g extract), FRAP (152.17 mM Fe(II)E/ mg extract) NO• radical (21.46%) and Superoxide radical (IC50 = 24.16 µg/mL) assays. All the parts P. stocksii extracts showed significant protection against OH• induced DNA damage at 50 µg concentration. The HPLC analysis of leaf ethyl acetate extract revealed the presence of Quercetin (30.29 µg/mg of extract) was the major compound. Anticancer activity of leaf ethyl acetate extract showed better IC50 values were 48.87 and 36.08 µg/ mL against MCF-7 and Caco-2 respectively. From this study, P. stocksii can act as a potent antioxidant and cytotoxic antimicrobial agent. The scope for drug development from this plant is endless and there is undoubtedly a call for further research in pharmaceutical industries.

Keywords: antioxidant, cytotoxicity, phenolics, plectranthus stocksii

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Authors: Fiona Curran-Cournane

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Soil quality monitoring is a science-based soil management tool that assesses soil ecosystem health. A soil monitoring program in Auckland, New Zealand’s largest city, extends from 1995 to the present. The objective of this study was to firstly determine changes in soil parameters (basic soil properties and heavy metals) that were assessed from rural land in 1995-2000 and repeated in 2008-2012. The second objective was to determine differences in soil parameters across various land uses including native bush, rural (horticulture, pasture and plantation forestry) and urban land uses using soil data collected in more recent years (2009-2013). Across rural land, mean concentrations of Olsen P had significantly increased in the second sampling period and was identified as the indicator of most concern, followed by soil macroporosity, particularly for horticultural and pastoral land. Mean concentrations of Cd were also greatest for pastoral and horticultural land and a positive correlation existed between these two parameters, which highlights the importance of analysing basic soil parameters in conjunction with heavy metals. In contrast, mean concentrations of As, Cr, Pb, Ni and Zn were greatest for urban sites. Native bush sites had the lowest concentrations of heavy metals and were used to calculate a ‘pollution index’ (PI). The mean PI was classified as high (PI > 3) for Cd and Ni and moderate for Pb, Zn, Cr, Cu, As, and Hg, indicating high levels of heavy metal pollution across both rural and urban soils. From a land use perspective, the mean ‘integrated pollution index’ was highest for urban sites at 2.9 followed by pasture, horticulture and plantation forests at 2.7, 2.6, and 0.9, respectively. It is recommended that soil sampling continues over time because a longer spanning record will allow further identification of where soil problems exist and where resources need to be targeted in the future. Findings from this study will also inform policy and science direction in regional councils.

Keywords: heavy metals, pollution index, rural and urban land use, soil quality

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Authors: Emine Aydin, Duygu Gocmen

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In this study, pumpkin flours (PFs) were used to replace wheat flour in cookie formulation at three different levels (10%, 20% and 30% w/w). For this purpose PFs produced by two different applications (with or without metabisulfite pre-treatment) and then dried in freeze dryer. Control sample included no PFs. The total phenolic contents of the cookies supplemented with PFs were higher than that of control and gradually increased in total phenolic contents of cookies with increasing PF supplementation levels. Phenolic content makes also significant contribution on nutritional excellence of the developed cookies. Pre-treatment with metabisulfite (MS) had a positive effect on free, bound and total phenolics of cookies which are supplemented with various levels of MS-PF. This is due to a protective effect of metabisulfite pretreatment for phenolic compounds in the pumpkin flour. Phenolic antioxidants may act and absorb in a different way in humans and thus their antioxidant and health effects will be changed accordingly. In the present study phenolics’ bioavailability of cookies was investigated in order to assess PF as sources of accessible phenolics. The content of bioaccessible phenolics and phenolic bioaccessibility of cookies supplemented with PFs had higher than those of control sample. Cookies enriched with 30% MS-PF had the highest bioaccessible phenolics (597.86 mg GAE 100g-1) and phenolic bioaccessibility (41.71%). MS application in PF production caused a significant increase in phenolic bioaccessibility of cookies. According to all assay (ABTS, CUPRAC, FRAP and DPPH), antioxidant activities of cookies with PFs higher than that of control cookie. It was also observed that the cookies supplemented with MS-PF had significantly higher antioxidant activities than those of cookies including PF. In presented study, antioxidative bioaccessibilities of cookies were also determined. The cookies with PFs had significantly (p ≤ 0.05) higher antioxidative bioaccessibilities than control ones. Increasing PFs levels enhanced antioxidative bioaccessibilities of cookies. As a result, PFs addition improved the nutritional and functional properties of cookie by causing increase in antioxidant activity, total phenolic content, bioaccessible phenolics and phenolic bioaccessibilities.

Keywords: phenolic compounds, antioxidant activity, dietary fiber, pumpkin, freeze drying, cookie

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Authors: M. F. Mamabolo

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Mining activities are identified as the most significant source of heavy metal contamination in river basins, due to inadequate disposal of mining waste thus resulting in acid mine drainage. Waste materials generated from gold mining and processing have severe and widespread impacts on water resources. Therefore, a total of 30 water samples were collected from Fig Tree Creek, Kaapriver, Sheba mine stream & Sauid kaap river to investigate the impact of gold mines on the Kaap River system. Physicochemical parameters (pH, EC and TDS) were taken using a BANTE 900P portable water quality meter. The concentration of Fe, Cu, Co, and SO₄²⁻ in water samples were analysed using Inductively Coupled Plasma-Mass spectrophotometry (ICP-MS) at 0.01 mg/L. The results were compared to the regulatory guideline of the World Health Organization (WHO) and the South Africa National Standards (SANS). It was found that Fe, Cu and Co were below the guideline values while SO₄²⁻ detected in Sheba mine stream exceeded the 250 mg/L limit for both seasons, attributed by mine wastewater. SO₄²⁻ was higher in wet season due to high evaporation rates and greater interaction between rocks and water. The pH of all the streams was within the limit (≥5 to ≤9.7), however EC of the Sheba mine stream, Suid Kaap River & where the tributary connects with the Fig Tree Creek exceeded 1700 uS/m, due to dissolved material. The TDS of Sheba mine stream exceeded 1000 mg/L, attributed by high SO₄²⁻ concentration. While the tributary connecting to the Fig Tree Creek exceed the value due to pollution from household waste, runoff from agriculture etc. In conclusion, the water from all sampled streams were safe for consumption due to low concentrations of physicochemical parameters. However, elevated concentration of SO₄²⁻ should be monitored and managed to avoid water quality deterioration in the Kaap River system.

Keywords: Kaap river system, mines, heavy metals, sulphate

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Authors: Surachart Koyadun

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Currently, Plasmodium knowlesi malaria has spread to almost all countries in Southeast Asia. This research aimed to 1) describe the epidemiology of Plasmodium knowlesi malaria, 2) examine the clinical symptoms of P. knowlesi malaria patients 3) analyze the ecology, animal reservoir and entomology of P. knowlesi malaria. 4) summarize the diagnosis, blood parasites, and treatment of P. knowlesi malaria. The study design was a case report combined with retrospective descriptive survey research. A total of 34 study subjects were patients with a confirmed diagnosis of P. knowlesi malaria who received treatment at hospitals and vector-borne disease control units in Songkhla Province during 2021 – 2022. The results of the epidemiological study unveiled the majority of the samples were male, had a history of staying overnight in the forest before becoming sick, the source of the infection was in the forest, and the season during which they were sick was mostly summer. The average length of time from the onset of illness until receiving a blood test was 3.8 days. The average length of hospital stay was 4 days. Patients were treated with Chloroquine Phosphate, Primaquine, Artesunate, Quinine, and Dihydroartemisinin-piperaquine (40 mg DHA-320 mg PPQ). One death was seen in 34 P. knowlesi malaria patients. All remaining patients recovered and responded to treatment. All symptoms improved after drug administration. No treatment failures were found. Analyses of ecological, zoonotic and entomological data revealed an association between infected patients and forested, monkey-hosted and mosquito-transmitted areas. The recommendation from this study was that the Polymerase Chain Reaction (PCR) method should be used in conjunction with the Thick/Thin Film test and blood parasite test (Parasitaemia) for the specificity of the infection, accuracy of diagnosis, leading to treatment of disease in a timely manner and be effective in disease control.

Keywords: human malaria, Plasmodium knowlesi, zoonotic disease, diagnosis and treatment, epidemiology, ecology

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Authors: Ana Carolina Felizardo Da Silva

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People with disabilities are those who have limitations of a physical, mental, intellectual or sensory nature and who, therefore, should not be excluded or marginalized. In Brazil, the Brazilian Law for the Inclusion of People with Disabilities defines that people with disabilities have the right to culture, sport, tourism and leisure on an equal basis with other people. Sport for people with disabilities, in its genesis, had a character aimed at rehabilitating men and soldiers, that is, the male figure who returned wounded from war and needed care. By gaining practitioners, the marketing issue emerges and, successively, high performance, what we call Paralympic sport. We found that sport for people with disabilities was designed for men, corroborating the social idea that sport is a masculine and masculinizing environment. In this way, the inclusion of women with disabilities in sports becomes a double challenge because they are women and have a disability. From data collected from official documents of the International Paralympic Committee, it is found that the first report on the participation of women in the Paralympic Games was in 1948, in England, in Stoke Mandeville, a championship considered the firstborn of the games, later, became called the “Paralympic Games”. However, due to the lack of information, the return of the appearance of women participating in the Paralympics took place after long 40 years, in 1984, which demonstrates a large gap of records on the official website referring to women in the games. Despite the great challenge, the number of women has been growing substantially. When collecting data from participants of all 16 editions of the Paralympic Games, in its last edition, held in Tokyo, out of 4,400 competing athletes, 1,853 were women, which represents 42% of the total number of athletes. In this same edition, we had the largest delegation of Brazilian women, represented by 96 athletes out of a total of 260 Brazilian athletes. It is estimated that in the next edition, to be taken place in Paris in 2024, the participation of women will equal or surpass that of men. The certain invisibility of women participating in the Paralympic Games is noticed when we access the database of the Brazilian Paralympic Committee website. It is possible to identify all women medalists of a given edition. On the other side, participating female athletes who did not medal are not registered on the site. Regarding the participation of Brazilian women in the Paralympics, there was a considerable growth in the last two editions, in 2012 there were only 69 women participating, going to 102 in 2016 and 96 in 2021. The same happened in relation to the medalists, going from 8 Brazilians in 2012 to 33 in 2016 and 27 in 2021. In this sense, the present study, aims to analyze how Brazilian women participate in the Paralympics, giving visibility and voice to female athletes. Structured interviews are being carried out with the participants of the games, identifying the difficulties and potentialities of participating with athletes in the competition. The analysis will be carried out through Bardin’s content analysis.

Keywords: paralympics, sport for people with disabilities, woman, woman in sport

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Authors: Tambe Daniel Atem

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Background: Clinical Research is an organized research on human beings intended to provide adequate information on the drug use as a therapeutic agent on its safety and efficacy. The significance of the study is to educate the global health and life science graduates in Clinical Research in depth to perform better as it involves testing drugs on human beings. Objectives: to provide an overall understanding of the scientific approach to the evaluation of new and existing medical interventions and to apply ethical and regulatory principles appropriate to any individual research. Methodology: It is based on – Primary data analysis and Secondary data analysis. Primary data analysis: means the collection of data from journals, the internet, and other online sources. Secondary data analysis: a survey was conducted with a questionnaire to interview the Clinical Research Professionals to understand the need of training to perform clinical trials globally. The questionnaire consisted details of the professionals working with the expertise. It also included the areas of clinical research which needed intense training before entering into hardcore clinical research domain. Results: The Clinical Trials market worldwide worth over USD 26 billion and the industry has employed an estimated 2,10,000 people in the US and over 70,000 in the U.K, and they form one-third of the total research and development staff. There are more than 2,50,000 vacant positions globally with salary variations in the regions for a Clinical Research Coordinator. R&D cost on new drug development is estimated at US$ 70-85 billion. The cost of doing clinical trials for a new drug is US$ 200-250 million. Due to an increase trained Clinical Research Professionals India has emerged as a global hub for clinical research. The Global Clinical Trial outsourcing opportunity in India in the pharmaceutical industry increased to more than $2 billion in 2014 due to increased outsourcing from U.S and Europe to India. Conclusion: Assessment of training need is recommended for newer Clinical Research Professionals and trial sites, especially prior the conduct of larger confirmatory clinical trials.

Keywords: clinical research, clinical trials, clinical research professionals

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Authors: Wafa Al Jabri

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Sickle cell disease (SCD) is a genetic blood disorder that is characterized by a severe painful crisis. SCD among children requires long term dependencies and high caregiving demands that increase the overall family burdens. It is, therefore, essential to examine, support, and promote the well-being of families of children with SCD. Although there has been considerable progress in the international research on family quality of life (FQOL) in recent years; however, research in this field is relatively recent and diverse. Oman is a country in which family quality of life has definitely been under-researched. Therefore, the purpose of the study is to describe the FQOL in families of children with SCD in Oman. The study will also examine the relationships between child, mother, and family-related factors that may influence the overall FQOL. Theoretical Framework: The study is guided by the unified theory of family quality of life to help in understanding the concept of FQOL and the factors that shape it. Method:A convenience sample of 98 mothers of children with SCD will be recruited from the pediatric hematology clinic at Sultan Qaboos University Hospital in Oman to participate in this descriptive, cross sectional, correlational study. Data will be obtained using a self-administered questionnaire that includes child and mother socio-demographic data, questions about the number of visits and admissions to health care facilities for vaso- occlusive crises (VOCs), the Perceived Stress Scale-10, and the Beachcenter-FQOL scale. Anticipated Results: It is expected to find an association among frequency of VOCs, mother’s perceived stress level, and FQOL in families of children with SCD in Oman. Family type, socio-economic status, and number of SCD children in the family are also expected to influence the overall FQOL. Conclusion: The findings of the study might be pivotal in designing and implementing tailored family-based interventions to improve families’ wellbeing.

Keywords: family quality of life, sickle cell disaes, children, family well-being

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Authors: Kanika Naresh Singh, Uday Shankar

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Background: Human behaviours are influenced by drives. Sexual drive is one of them. Education regarding sexual behaviour plays a great role in shaping one’s attitude towards it. These days after attaining the age of puberty, adolescents are confused and feel shy to talk about it. In order to get information, they refer to various types of sources and these sources play a greater role in spreading awareness in the mass adolescent population. Sometimes it also leads to the building of myths and misconceptions. Due to increasing incidences of HIV/AIDS, RTIs/STIs and teenage pregnancies, there is a rising need to impart sex education. Aim: The aim of this research was to study the level of sexual awareness among the youth of Bihar and also study their sexual behaviour and sources of influence. It also aims to study the correlation between sexual awareness, behaviour and sources of sexual knowledge among youth in Bihar. Methods: The sample size for the project was 50 youth consisting of both boys and girls, in between the age group of 18 to 23 years from urban and semi-urban areas. The purposive sampling method was used in the research. The tools used were the Sexual Awareness Questionnaire and Sexual Behavior and Sources of Influence (SBSI) scale. The sexual Awareness Questionnaire was developed by Snell, having 35 items. A socio-demographic data sheet was also used. Results: The youth had poor sexual awareness. Internet and Friends were found to be the major source for gathering information. The youth of Bihar were less inclined towards resolving their doubts with their parents. There was a positive correlation between sexual awareness, behaviour and sources of knowledge. Conclusion: The youth of Bihar has poor sexual knowledge. Internet and Friends are major sources of information. Sex Education should be promoted as suggested by various institutions like World Health Organization United Nations. Psychiatrists and psychologists have a key leadership role in introducing these potentially emotionally challenging issues to the youth with consideration of psychosocial and cultural factors.

Keywords: sexual awareness, sexual behavior, sources of influence, youths, Bihar, India

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Authors: Hasanzade Nazenin, Hasanova Naila

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According to the WHO, osteoporosis is one of the most important health problems in the world and occupies the 4th place in its importance after cardiovascular pathology, oncological diseases and diabetes mellitus. The significance of osteoporosis is determined by its prevalence among the population, the severity of the course, the cause of death, disability, reduced quality of life, high economic costs for prevention and treatment. Osteoporosis is a systemic skeletal disease characterized by a decrease in bone mass and a violation of the structure of bone tissue, leading to an increase in bone fragility and the risk of fractures. Osteoporosis is manifested by low-traumatic fractures. Due to the complexity of the recovery process, the treatment of osteoporotic fractures is one of the important problems of modern traumatology. Diagnostic markers are needed to monitor the recovery period. Human cartilage glycoprotein -39, which has been studied so far in inflammatory processes in the bones, may allow the development of the correct treatment regimen, reflecting the level of metabolic processes in the bone tissue. The study was performed to examine the dynamics of human cartilage glycoprotein-39 (HCgp39) in the blood serum during osteoporosis and fracture healing. The material of the study is formed by the examination results of 68 people aged 38-83. Group I - control group consisted of 14 practically healthy people, group II - 14 patients with osteoporosis, group III - 15 patients with non-osteoporotic fractures, group IV - 25 patients with osteoporotic fractures. In groups, they were analyzed by enzyme-linked immunosorbent assay 3 times during the first month. As a result, in the first month of the recovery period, no significant difference was observed in the HCgp39 dynamics for groups II and IV (p> 0.05). However, there was a significant reduction in group III (p <0.05). As no osteoporotic changes were observed in this patient group, bone healing was rapid and it was possible to monitor the dynamics of HCgp39 changes within 1 month. Patients with osteoporosis and other bone fractures in the process of complete recovery need to study HCgp39 more as a diagnostic indicator.

Keywords: osteoporosis, osteoporotic fractures, human cartilage glycoprotein, HCgp39

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Authors: Sudha Summarwar, Sudesh Agarwal, Deepali Lall, Nalini Kataria, Jyotsana Pandey

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Assessment of antioxidant status is an effective tool to appraise the presence of oxidative stress. A combination of assays can be used to evaluate the antioxidant status like serum catalase (CAT), superoxide dismutase (SOD) and monoamine oxidase (MAO). In human medicine pregnancy is known to be associated with oxidative stress. Oxidative stress produces harmful effects to the developing foetus. Several metabolic changes occur in the maternal body to meet the demand of energy of developing foetus. Due to these changes susceptibility of maternal body increases to oxidative stress. There is paucity of research work on this aspect in nondescript goats. Therefore, the present study was intended to appraise the oxidative stress in pregnant and non-pregnant non-descript goat. Blood samples were collected for serum separation in otherwise healthy pregnant and non-pregnant nondescript goats. Mean values of serum CAT, SOD and MAO were found on a higher side (p≤0.05) with serum SOD values showing a rise of 2.5 times higher than the control healthy value. Correlations among all the three parameters were found to be highly significant (p≤0.01) especially greatest in youngest group of pregnant animals. Illustration of result enlightened the veracity of bumped up production of free radicals in pregnant animals. Technical savoir-faire of oxidative stress supervision is essential for upholding of health status of foetus. The upshot of present study undoubtedly implied the development of oxidative stress in pregnant goats on the basis of altered antioxidant status. These findings conclude that initially the oxidative stress due to pregnancy is critically combated by the intricate defensive mechanism of natural antioxidant system of the body. It appears that this imbalance between oxidant and antioxidant must be checked in time to prevent cellular damage by regularly appraising the antioxidant status through laboratory methods.

Keywords: antioxidant, oxidative stress, pregnancy, serum catalase

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Authors: J. Hakula

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Discussion on euthanasia is a continuous process. Euthanasia is defined as 'deliberately ending a patient's life by administering life-ending drugs at the patient's explicit request'. With few exceptions, worldwide in most countries human societies have not been able to agree on some fundamental issues concerning ultimate decisions of life and death. Outranking methods in voting oriented social choice theory and multicriteria decision-making (MCDM) can be applied to issues in medical ethics. There is a wide range of voting methods, and using different methods the same group of voters can end up with different outcomes. In the MCDM context, decision alternatives can be substituted for candidates, and criteria for voters. The view chosen here is that of a single decision-maker. Initially, three alternatives and three criteria are chosen. Pairwise and basic positional voting rules - plurality, anti-plurality and the Borda count - are applied. In the MCDM solution, criteria are put weights by giving them the more 'votes'; the more important the decision-maker ranks them. A hypothetical example on evaluating properties of euthanasia consists of three alternatives A, B, and C, which are ranked according to three criteria - the patient’s willingness to cooperate, general action orientation (active/passive), and cost-effectiveness - the criteria having weights 7, 5, and 4, respectively. Using the plurality rule and the weights given to criteria, A is the best alternative, B and C thereafter. In pairwise comparisons, both B and C defeat A with weight scores 7 to 9. On the other hand, B is defeated by C with weights 11 to 5. Thus, C (i.e. the so-called Condorcet winner) defeats both A and B. The best alternative using the plurality principle is not necessarily the best in the pairwise sense, the conflict remaining unsolved with or without additional weights. Positional rules are sensitive to variations in alternative sets. In the example above, the plurality rule gives the rank ABC. If we leave out C, the plurality ranking between A and B results in BA. Withdrawing B or A the ranking is CA and CB, respectively. In pairwise comparisons an analogous problem emerges when the number of criteria is varied. Cyclic preferences may lead to a total tie, and no (rational) choice between the alternatives can be made. In conclusion, the choice of the best commitment to re-evaluate euthanasia, with criteria left unchanged, depends entirely on the evaluation method used. The right strategies matter, too. Future studies might concern the problem of an abstention - a situation where voters do not vote - and still their best candidate may win. Or vice versa, actively giving the ballot to their first rank choice might lead to a total loss. In MCDM terms, a decision might occur where some central criteria are not actively involved in the best choice made.

Keywords: medical ethics, euthanasia, voting methods, multicriteria decision-making

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Authors: Zafer Sakka, Husain Al-Khaiat

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Due to social and economic considerations, owners all over the world desire to keep and use existing structures, including aging ones. However, these structures, especially those that are dear, need accurate condition assessment, and proper safety evaluation. More than half of the budget spent on construction activities in developed countries is related to the repair and maintenance of these reinforced concrete (R/C) structures. Also, periodical evaluation and assessment of relatively old concrete structures are vital and imperative. If the evaluation and assessment of structural components of a particular aging R/C structure reveal that repairs are essential for these components, these repairs should not be delayed. Delaying the repairs has the potential of losing serviceability of the whole structure and/or causing total failure and collapse of the structure. In addition, if repairs are delayed, the cost of maintenance will skyrocket as well. It can also be concluded from the above that the assessment of existing needs to receive more consideration and thought from the structural engineering societies and professionals. Ten major existing structures in Kuwait city that were constructed in the 1970s were assessed for structural reliability and integrity. Numerous concrete samples were extracted from the structural systems of the investigated buildings. This paper presents the results of the compressive strength tests that were conducted on the extracted cores. The results are compared for the buildings’ columns and beams elements and compared with the design strengths. The collected data were statistically analyzed. The average compressive strengths of the concrete cores that were extracted from the ten buildings had a large variation. The lowest average compressive strength for one of the buildings was 158 kg/cm². This building was deemed unsafe and economically unfeasible to be repaired; accordingly, it was demolished. The other buildings had an average compressive strengths fall in the range 215-317 kg/cm². Poor construction practices were the main cause for the strengths. Although most of the drawings and information for these buildings were lost during the invasion of Kuwait in 1990, however, information gathered indicated that the design strengths of the beams and columns for most of these buildings were in the range of 280-400 kg/cm². Following the study, measures were taken to rehabilitate the buildings for safety. The mean compressive strength for all cores taken from beams and columns of the ten buildings was 256.7 kg/cm². The values range was 139 to 394 kg/cm². For columns, the mean was 250.4 kg/cm², and the values ranged from 137 to 394 kg/cm². However, the mean compressive strength for the beams was higher than that of columns. It was 285.9 kg/cm², and the range was 181 to 383 kg/cm². In addition to the concrete cores that were extracted from the ten buildings, the 28-day compressive strengths of more than 24,660 concrete cubes were collected from a major ready-mixed concrete supplier in Kuwait. The data represented four different grades of ready-mix concrete (250, 300, 350, and 400 kg/cm²) manufactured between the year 2003 and 2018. The average concrete compressive strength for the different concrete grades (250, 300, 350 and 400 kg/cm²) was found to be 318, 382, 453 and 504 kg/cm², respectively, and the coefficients of variations were found to be 0.138, 0.140, 0.157 and 0.131, respectively.

Keywords: concrete compressive strength, concrete structures, existing building, statistical analysis.

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Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

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Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

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Authors: Ram Sharan Mehta, Gayanandra Malla, Anita Gurung, Anu Aryal, Divya Labh, Hricha Neupane

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Objectives: Lack of resuscitation skills of nurses and doctors in basic life support (BLS) and advanced life support (ALS) has been identified as a contributing factor to poor outcomes of cardiac arrest victims. The objective of this study was to examine retention of life support measures (BLS/ALS) knowledge and skills of nurses following education intervention programme. Materials and Methods: Pre-experimental research design was used to conduct the study among the nurses working in medical units of B.P Koirala Institute of Health Sciences, where CPR is very commonly performed. Using convenient sampling technique total of 20 nurses agreed to participate and give consent were included in the study. The theoretical, demonstration and re-demonstration were arranged involving the trained doctors and nurses during the three hours educational session. Post-test was carried out after two week of education intervention programme. The 2010 BLS & ALS guidelines were used as guide for the study contents. The collected data were analyzed using SPSS-15 software. Results: It was found that there is significant increase in knowledge after education intervention in the components of life support measures (BLS/ALS) i.e. ratio of chest compression to ventilation in BLS (P=0.001), correct sequence of CPR (p <0.001), rate of chest compression in ALS (P=0.001), the depth of chest compression in adult CPR (p<0.001), and position of chest compression in CPR (P=0.016). Nurses were well appreciated the programme and request to continue in future for all the nurses. Conclusions: At recent BLS/ALS courses (2010), a significant number of nurses remain without any such training. Action is needed to ensure all nurses receive BLS training and practice this skill regularly in order to retain their knowledge.

Keywords: pre-experimental, basic and advance life support, nurses, sampling technique

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Authors: Morena Paulisic, Marli Gonan Bozac

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Business organization and management in theory are typically presented as gender- neutral. Although in practice female contribution to corporation is not questionable, gender diversity in top management of corporation is and that especially in emerging countries like Croatia. This paper brings insights into obstacles and problems which should be overcome. Furthermore, gives an introspective view on the most important promotion and motivation factors of powerful female CEOs in Croatia. The goal was to clarify perception and performance of female CEOs that contributed to their success and to determine mutual characteristics of women in corporate entrepreneurship regarding the motivation. For our study we used survey instrument that was developed for this research. The research methods used were: table research, field research, generalization method, comparative method, and statistical method (descriptive statistics and Pearson’s Chi-square test). Some result showed us that today even more women in corporations are not likely to accept more engagement at work if it harms their families (2003 – 31.9% in 2013 – 33.8%) although their main motivating factor is still interested job (2003 – 95.8%; in 2013-100%). It is also significant that 78.8 % of Croatian top managers (2013) think that women managers in Croatia are insufficiently spoken and written about, and that the reasons for this are that: (1) the society underestimates their ability (37.9%); (2) women underestimate themselves (22.4%); (3) the society still mainly focuses on male managers (20.7%) and (4) women managers avoid interviews and appearing on front pages (19%). The environment still “blocks” the natural course of advancement of women managers in organisations (entrepreneurship in general) and the main obstacle is that women must always or almost always be more capable than men in order to succeed (96.6%). Based on survey results on longitudinal research conducted in 2003 (return rate 30,8%) and 2013 (return rate 29,2%) in Croatia we expand understanding of determination indicators of corporate female entrepreneurship. Theoretically in practice gender structure at the management level (executive management, management board and supervisory board) throw years (2011- 2014) have positive score but still women remain significantly underrepresented at those positions. Findings from different sources have shown that diversity at the top of corporations’ correlates with better performance. In this paper, we have contributed to research on gender in corporate entrepreneurship by offering experiences from successful female CEOs and explanation why in social responsible society women with their characteristics can support needed changes and construct different way forward for corporations. Based on research result we can conclude that in future underrepresentation of female in corporate entrepreneurship should be overcome.

Keywords: Croatia, female entrepreneurship, glass ceiling, motivation

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Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

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A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

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Authors: Jonathan Turner, Julie Doyle, Laura O’Philbin, Dympna O’Sullivan

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People living with dementia should be at the centre of decision-making regarding goals for daily living. These goals include basic activities (dressing, hygiene, and mobility), advanced activities (finances, transportation, and shopping), and meaningful activities that promote well-being (pastimes and intellectual pursuits). However, there is limited involvement of people living with dementia in the design of technology to support their goals. A project is described that is co-designing intelligent computer-based support for, and with, people affected by dementia and their carers. The technology will support self-management, empower participation in shared decision-making with carers and help people living with dementia remain healthy and independent in their homes for longer. It includes information from the patient’s care plan, which documents medications, contacts, and the patient's wishes on end-of-life care. Importantly for this work, the plan can outline activities that should be maintained or worked towards, such as exercise or social contact. The authors discuss how to integrate care goal information from such a care plan with data collected from passive sensors in the patient’s home in order to deliver individualized planning and interventions for persons with dementia. A number of scientific challenges are addressed: First, to co-design with dementia patients and their carers computerized support for shared decision-making about their care while allowing the patient to share the care plan. Second, to develop a new and open monitoring framework with which to configure sensor technologies to collect data about whether goals and actions specified for a person in their care plan are being achieved. This is developed top-down by associating care quality types and metrics elicited from the co-design activities with types of data that can be collected within the home, from passive and active sensors, and from the patient’s feedback collected through a simple co-designed interface. These activities and data will be mapped to appropriate sensors and technological infrastructure with which to collect the data. Third, the application of machine learning models to analyze data collected via the sensing devices in order to investigate whether and to what extent activities outlined via the care plan are being achieved. The models will capture longitudinal data to track disease progression over time; as the disease progresses and captured data show that activities outlined in the care plan are not being achieved, the care plan may recommend alternative activities. Disease progression may also require care changes, and a data-driven approach can capture changes in a condition more quickly and allow care plans to evolve and be updated.

Keywords: care goals, decision-making, dementia, self-care, sensors

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Authors: Fangjing Zhou, Wen Chen, Brian J. Hall, Yu Wang, Carl Latkin, Li Ling, Joseph D. Tucker

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Background: Economic and social reforms designed to open China to the world has been successful, but also appear to have rapidly laid the foundation for the reemergence of STIs since 1980s. Changes in sexual behaviors, relationships, and norms among Chinese contributed to the STIs epidemic. As the massive population moved during the last 30 years, early coital debut, multiple sexual partnerships, and unprotected sex have increased within the general population. Our objectives were to assess associations between residences location, sexual risk behaviors and sexually transmitted infections (STIs) among adults living in Guangzhou, China. Methods: Stratified cluster sampling followed a two-step process was used to select populations aged 18-59 years in Guangzhou, China. Spatial methods including Geographic Information Systems (GIS) were utilized to identify 1400 coordinates with latitude and longitude. Face-to-face household interviews were conducted to collect self-report data on sexual risk behaviors and diagnosed STIs. Kulldorff’s spatial scan statistic was implemented to identify and detect spatial distribution and clusters of sexual risk behaviors and STIs. The presence and location of statistically significant clusters were mapped in the study areas using ArcGIS software. Results: In this study, 1215 of 1400 households attempted surveys, with 368 refusals, resulting in a sample of 751 completed surveys. The prevalence of self-reported sexual risk behaviors was between 5.1% and 50.0%. The self-reported lifetime prevalence of diagnosed STIs was 7.06%. Anal intercourse clustered in an area located along the border within the rural-urban continuum (p=0.001). High rate clusters for alcohol or other drugs using before sex (p=0.008) and migrants who lived in Guangzhou less than one year (p=0.007) overlapped this cluster. Excess cases for sex without a condom (p=0.031) overlapped the cluster for college students (p<0.001). Conclusions: Short-term migrants and college students reported greater sexual risk behaviors. Programs to increase safer sex within these communities to reduce the risk of STIs are warranted in Guangzhou. Spatial analysis identified geographical clusters of sexual risk behaviors, which is critical for optimizing surveillance and targeting control measures for these locations in the future.

Keywords: cluster analysis, migrant, sexual risk behaviors, spatial distribution

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Authors: Rabea Sefrin, Christian Glock, Juergen Schnell

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The preservation of existing structures is of great economic interest because it contributes to higher sustainability and resource conservation. In the case of existing buildings, in addition to repair and maintenance, modernization or reconstruction works often take place in the course of adjustments or changes in use. Since the structural framework and the associated load level are usually changed in the course of the structural measures, the stability of the structure must be verified in accordance with the currently valid regulations. The concrete compressive strength of the existing structures concrete and the derived mechanical parameters are of central importance for the recalculation and verification. However, the compressive strength of the existing concrete is usually set comparatively low and thus underestimated. The reasons for this are too small numbers, and large scatter of material properties of the drill cores, which are used for the experimental determination of the design value of the compressive strength. Within a structural component, the load is usually transferred over the area with higher stiffness and consequently with higher compressive strength. Therefore, existing strength variations within a component only play a subordinate role due to rearrangement effects. This paper deals with the experimental and numerical determination of such rearrangement effects in order to calculate the concrete compressive strength of existing structures more realistic and economical. The influence of individual parameters such as the specimen geometry (prism or cylinder) or the coefficient of variation of the concrete compressive strength is analyzed in experimental small-part tests. The coefficients of variation commonly used in practice are adjusted by dividing the test specimens into several layers consisting of different concretes, which are monolithically connected to each other. From each combination, a sufficient number of the test specimen is produced and tested to enable evaluation on a statistical basis. Based on the experimental tests, FE simulations are carried out to validate the test results. In the frame of a subsequent parameter study, a large number of combinations is considered, which had not been investigated in the experimental tests yet. Thus, the influence of individual parameters on the size and characteristic of the rearrangement effect is determined and described more detailed. Based on the parameter study and the experimental results, a calculation model for a more realistic determination of the in situ concrete compressive strength is developed and presented. By considering rearrangement effects in concrete during recalculation, a higher number of existing structures can be maintained without structural measures. The preservation of existing structures is not only decisive from an economic, sustainable, and resource-saving point of view but also represents an added value for cultural and social aspects.

Keywords: existing structures, in-situ concrete compressive strength, rearrangement effects, recalculation

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Authors: Charles St. Geste, Michael Neumann, Catherine Twohig

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Our primary aim is to examine farmer-centered participatory action learning as a tool to improve agricultural production, build resilience to climate shocks and, more broadly, advance community-driven solutions for sustainable development in rural communities across Haiti. For over six years, sixty plus farmers from Deslandes, Haiti, organized in three traditional work groups called konbits, have designed and tested low-input agroecology techniques as part of the Konbit Vanyan Kapab Pwoje Agroekoloji. The project utilizes a participatory action learning approach, emphasizing social inclusion, building on local knowledge, experiential learning, active farmer participation in trial design and evaluation, and cross-community sharing. Mixed methods were used to evaluate changes in knowledge and adoption of agroecology techniques, confidence in advancing agroecology locally, and innovation among Konbit Vanyan Kapab farmers. While skill and knowledge in application of agroecology techniques varied among individual farmers, a majority of farmers successfully adopted techniques outside of the trial farms. The use of agroecology techniques on trial and individual farms has doubled crop production in many cases. Farm income has also increased, and farmers report less damage to crops and property caused by extreme weather events. Furthermore, participatory action strategies have led to greater local self-determination and greater capacity for sustainable community development. With increased self-confidence and the knowledge and skills acquired from participating in the project, farmers prioritized sharing their successful techniques with other farmers and have developed a farmer-to-farmer training program that incorporates participatory action learning. Using adult education methods, farmers, trained as agroecology educators, are currently providing training in sustainable farming practices to farmers from five villages in three departments across Haiti. Konbit Vanyan Kapab farmers have also begun testing production of value-added food products, including a dried soup mix and tea. Key factors for success include: opportunities for farmers to actively participate in all phases of the project, group diversity, resources for application of agroecology techniques, focus on group processes and overcoming local barriers to inclusive decision-making.

Keywords: agroecology, participatory action learning, rural Haiti, sustainable community development

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