Search results for: health effects

Authors: H. Apaza, L. Chévez, H. Loro

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Plastic and microplastic pollution in human food chain is a big problem for human health that requires more elaborated techniques that can identify their presences in different kinds of food. Hyperspectral imaging technique is an optical technique than can detect the presence of different elements in an image and can be used to detect plastics and microplastics in a scene. To do this statistical techniques are required that need to be evaluated and compared in order to find the more efficient ones. In this work, two problems related to the presence of plastics are addressed, the first is to detect and identify pieces of plastic immersed in almond seeds, and the second problem is to detect and quantify microplastic in almond flour. To do this we make use of the analysis hyperspectral images taken in the range of 900 to 1700 nm using 4 unmixing techniques of hyperspectral imaging which are: least squares unmixing (LSU), non-negatively constrained least squares unmixing (NCLSU), fully constrained least squares unmixing (FCLSU), and scaled constrained least squares unmixing (SCLSU). NCLSU, FCLSU, SCLSU techniques manage to find the region where the plastic is found and also manage to quantify the amount of microplastic contained in the almond flour. The SCLSU technique estimated a 13.03% abundance of microplastics and 86.97% of almond flour compared to 16.66% of microplastics and 83.33% abundance of almond flour prepared for the experiment. Results show the feasibility of applying near-infrared hyperspectral image analysis for the detection of plastic contaminants in food.

Keywords: food, plastic, microplastic, NIR hyperspectral imaging, unmixing

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Authors: Shirley S. Ho

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The advancement and development of social media have inadvertently brought about a new form of bullying – cyberbullying – that transcends across physical boundaries of space. Although extensive research has been conducted in the field of cyberbullying, most of these studies have taken an overwhelmingly empirical angle. Theories guiding cyberbullying research are few. Furthermore, very few studies have explored the association between parental mediation and cyberbullying, with majority of existing studies focusing on cyberbullying victimization rather than perpetration. Therefore, this present study investigates cyberbullying perpetration from a theoretical angle, with a focus on the Theory of Reasoned Action and the Parental Mediation Theory. More specifically, this study examines the direct effects of attitude, subjective norms, descriptive norms, injunctive norms and active mediation and restrictive mediation on cyberbullying perpetration on social media among children and adolescents in Singapore. Furthermore, the moderating role of age on the relationship between parental mediation and cyberbullying perpetration on social media are examined. A self-administered paper-and-pencil nationally-representative survey was conducted. Multi-stage cluster random sampling was used to ensure that schools from all the four (North, South, East, and West) regions of Singapore were equally represented in the sample used for the survey. In all 607 upper primary school children (i.e., Primary 4 to 6 students) and 782 secondary school adolescents participated in our survey. The total average response rates were 69.6% for student participation. An ordinary least squares hierarchical regression analysis was conducted to test the hypotheses and research questions. The results revealed that attitude and subjective norms were positively associated with cyberbullying perpetration on social media. Descriptive norms and injunctive norms were not found to be significantly associated with cyberbullying perpetration. The results also showed that both parental mediation strategies were negatively associated with cyberbullying perpetration on social media. Age was a significant moderator of both parental mediation strategies and cyberbullying perpetration. The negative relationship between active mediation and cyberbullying perpetration was found to be greater in the case of children than adolescents. Children who received high restrictive parental mediation were less likely to perform cyberbullying behaviors, while adolescents who received high restrictive parental mediation were more likely to be engaged in cyberbullying perpetration. The study reveals that parents should apply active mediation and restrictive mediation in different ways for children and adolescents when trying to prevent cyberbullying perpetration. The effectiveness of active parental mediation for reducing cyberbullying perpetration was more in the case of children than for adolescents. Younger children were found to be more likely to respond more positively toward restrictive parental mediation strategies, but in the case of adolescents, overly restrictive control was found to increase cyberbullying perpetration. Adolescents exhibited less cyberbullying behaviors when under low restrictive strategies. Findings highlight that the Theory of Reasoned Action and Parental Mediation Theory are promising frameworks to apply in the examination of cyberbullying perpetration. The findings that different parental mediation strategies had differing effectiveness, based on the children’s age, bring about several practical implications that may benefit educators and parents when addressing their children’s online risk.

Keywords: cyberbullying perpetration, theory of reasoned action, parental mediation, social media, Singapore

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Authors: Ali Mashayekh, Mahdiye Khorasani, Thomas Weyh

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The tendency to use the Battery-Electric vehicle (BEV) for the low and medium driving range or even high driving range has been growing more and more. As a result, higher safety, reliability, and durability of the battery pack as a component of electric vehicles, which has a great share of cost and weight of the final product, are the topics to be considered and investigated. Battery aging can be considered as the predominant factor regarding the reliability and durability of BEV. To better understand the aging process, offline battery characterization has been widely used, which is time-consuming and needs very expensive infrastructures. This paper presents the substitute method for the conventional battery characterization methods, which is based on battery Modular Multilevel Management (BM3). According to this Topology, the battery cells can be drained and charged concerning their capacity, which allows varying battery pack structures. Due to the integration of the power electronics, the output voltage of the battery pack is no longer fixed but can be dynamically adjusted in small steps. In other words, each cell can have three different states, namely series, parallel, and bypass in connection with the neighbor cells. With the help of MATLAB/Simulink and by using the BM3 modules, the battery string model is created. This model allows us to switch two cells with the different SoC as parallel, which results in the internal balancing of the cells. But if the parallel switching lasts just for a couple of ms, we can have a perturbation pulse which can stimulate the cells out of the relaxation phase. With the help of modeling the voltage response pulse of the battery, it would be possible to characterize the cell. The Online EIS method, which is discussed in this paper, can be a robust substitute for the conventional battery characterization methods.

Keywords: battery characterization, SoH estimation, RLS, BEV

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Authors: G. Bruno, A. Ciavarella, N. Linciano

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The proportion of women in boardroom has traditionally been low around the world. Over the last decades, several jurisdictions opted for active intervention, which triggered a tangible progress in female representation. In Europe, many countries have implemented boardroom diversity policies in the form of legal quotas (Norway, Italy, France, Germany) or governance code amendments (United Kingdom, Finland). Policy actions rest, among other things, on the assumption that gender balanced boards result in improved corporate governance and performance. The investigation of the relationship between female boardroom representation and firm value is therefore key on policy grounds. The evidence gathered so far, however, has not produced conclusive results also because empirical studies on the impact of voluntary female board representation had to tackle with endogeneity, due to either differences in unobservable characteristics across firms that may affect their gender policies and governance choices, or potential reverse causality. In this paper, we study the relationship between the presence of female directors and corporate performance in Italy, where the Law 120/2011 envisaging mandatory quotas has introduced an exogenous shock in board composition which may enable to overcome reverse causality. Our sample comprises Italian firms listed on the Italian Stock Exchange and the members of their board of directors over the period 2008-2016. The study relies on two different databases, both drawn from CONSOB, referring respectively to directors and companies’ characteristics. On methodological grounds, information on directors is treated at the individual level, by matching each company with its directors every year. This allows identifying all time-invariant, possibly correlated, elements of latent heterogeneity that vary across firms and board members, such as the firm immaterial assets and the directors’ skills and commitment. Moreover, we estimate dynamic panel data specifications, so accommodating non-instantaneous adjustments of firm performance and gender diversity to institutional and economic changes. In all cases, robust inference is carried out taking into account the bidimensional clustering of observations over companies and over directors. The study shows the existence of a U-shaped impact of the percentage of women in the boardroom on profitability, as measured by Return On Equity (ROE) and Return On Assets. Female representation yields a positive impact when it exceeds a certain threshold, ranging between about 18% and 21% of the board members, depending on the specification. Given the average board size, i.e., around ten members over the time period considered, this would imply that a significant effect of gender diversity on corporate performance starts to emerge when at least two women hold a seat. This evidence supports the idea underpinning the critical mass theory, i.e., the hypothesis that women may influence.

Keywords: gender diversity, quotas, firms performance, corporate governance

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Authors: Yvette Nsabimana, Nadine Misago, Minani Methode

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Context: the issue of menstrual hygiene is an entry point for demonstrating the gender-specific nature of the needs of women and adolescent girls. Women and girls around the world face many challenges in managing their periods. They may be deprived of certain basic human rights, including those relating to education, work and health. This work describes the Knowledge, Attitudes and Practices of menstrual hygiene among adolescent girls from 12 to 19 years of Lake Tanganyika Secondary School. Method: This is a descriptive cross-sectional study among 384 adolescent girls from Lake Tanganyika secondary school over a period of 2 weeks from September 13 to September 27 and with a purely general objective of describing the Knowledge, Attitudes and Practices of menstrual hygiene in secondary schools. The study was conducted using a non-probability method and the sampling technique was for convenience. The data collection technique used was the survey by questionnaire and the exploitation of the documentary. The data collection tool used was the questionnaire. Microsoft Word 2013, Microsoft Excel 2.13 and EPI INFO7 software were used for this purpose. Results: We noticed that 55.47% of the participants knew that menstruation is a physiological process; 57.55% of the teenage girls surveyed get their information about menstrual hygiene from their mothers; 75.72% use sanitary napkins and 24.02% use fabrics as protective material; 35.16% of respondents have already lacked sanitary napkins since their menarche; 37.29% are absent from classes due to lack of sanitary napkins; 23.82% use soap and other products to wash.

Keywords: knowledge, attitudes, practices, menstrual hygiene

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Authors: M. Mathuthu, N. N. Gaxela, R. Y. Olobatoke

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A study was carried out to assess the heavy metal and radionuclide concentrations of water from the waste water treatment plant in Mafikeng Local Municipality to evaluate treatment efficiency. Ten water samples were collected from various stages of water treatment which included sewage delivered to the plant, the two treatment stages and the effluent and also the community. The samples were analyzed for heavy metal content using Inductive Coupled Plasma Mass Spectrometer. Gross α/β activity concentration in water samples was evaluated by Liquid Scintillation Counting whereas the concentration of individual radionuclides was measured by gamma spectroscopy. The results showed marked reduction in the levels of heavy metal concentration from 3 µg/L (As)–670 µg/L (Na) in sewage into the plant to 2 µg/L (As)–170 µg/L (Fe) in the effluent. Beta activity was not detected in water samples except in the in-coming sewage, the concentration of which was within reference limits. However, the gross α activity in all the water samples (7.7-8.02 Bq/L) exceeded the 0.1 Bq/L limit set by World Health Organization (WHO). Gamma spectroscopy analysis revealed very high concentrations of 235U and 226Ra in water samples, with the lowest concentrations (9.35 and 5.44 Bq/L respectively) in the in-coming sewage and highest concentrations (73.8 and 47 Bq/L respectively) in the community water suggesting contamination along water processing line. All the values were considerably higher than the limits of South Africa Target Water Quality Range and WHO. However, the estimated total doses of the two radionuclides for the analyzed water samples (10.62 - 45.40 µSv yr-1) were all well below the reference level of the committed effective dose of 100 µSv yr-1 recommended by WHO.

Keywords: gross α/β activity, heavy metals, radionuclides, 235U, 226Ra, water sample

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Authors: Nabil A. Albaser

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Background: There is a serious problem with adverse drug reactions (ADRs) everywhere, including Yemen. Since it helps with the detection, assessment, reporting and prevention of ADRs, pharmacovigilance (PV) is an essential part of the healthcare system. The unbiased reporting of ADRs remains the foundation of PV. Students majoring in healthcare should acquire the knowledge and skills necessary to conduct PV in a range of clinical settings. The primary objective of this study was to evaluate the understanding and attitudes of final-year Pharmacy, Nursing, and Midwifery students at Al-Razi University in Sana'a, Yemen, regarding PV and ADRs reporting. Methods: The study followed descriptive cross-sectional approach. A validated, self-administered questionnaire with three parts—demographic information, knowledge, and perceptions of Pharmacovigilance was online distributed to final-year Pharmacy, Nursing, and Midwifery students. The questionnaire was given to 175 students; 122 of them responded with a percentage (69.7%). Results: The majority of respondents were male (79.5%). More than the tow-third of the students, 68.9%, were beyond the age of 23. Although the majority of students, 80%, heard about the terms of ADRs and PV, but only 50% and 57.4% of the respondents, respectively, could define the both terms correctly. However, only 11.48 % of them, nevertheless, took a PV course. More than a half of them (56.6%) had a positive perceptions towards pharmacovigilance and ADR reporting and had a moderate degree of knowledge (68.9%). Conclusion: The study demonstrated that the participants lacked sufficient knowledge of pharmacovigilance and ADR reporting. They showed a moderate level of understanding of reporting ADRs as well as a favorable opinion of dealing with and reporting ADRs. Yemen's health care curriculum should include lessons on pharmacovigilance.

Keywords: adverse drug reaction reporting, pharmacovigilance, yemen, knowlegde

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Authors: M. Ottenbrite, G. Yilmaz, J. Devenish, M. Kang, H. Dan, M. Lin, C. Lau, C. Carrillo, K. Bessonov, J. Nash, E. Topp, J. Guan

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Consumption of food contaminated by antibiotic-resistant (AR) bacteria may lead to the transmission of AR genes in the gut microbiota and cause AR bacterial infection, a significant public health concern. However, information is limited on if and how background microbes from the food matrix (food microbes) may influence resistance transmission. Thus, we assessed the colonization of a β-lactam resistant Salmonella Heidelberg strain (donor) and a β-lactam susceptible S. Typhimurium strain (recipient) and the transfer of the resistance genes in the mouse gut in the presence or absence of food microbes that were derived from washing freshly-harvested carrots. Mice were pre-treated with streptomycin and then inoculated with both donor and recipient bacteria or recipient only. Fecal shedding of the donor, recipient, and transconjugant bacteria was enumerated using selective culture techniques. Transfer of AR genes was confirmed by whole genome sequencing. Gut microbial composition was determined by 16s rRNA amplicon sequencing. Significantly lower numbers of donors and recipients were shed from mice that were inoculated with food microbes compared to those without food microbe inoculation. S. Typhimurium transconjugants were only recovered from mice without inoculation of food microbes. A significantly higher survival rate was in mice with vs. without inoculation of food microbes. The results suggest that the food microbes may compete with both the donor and recipient Salmonella, limit their growth and reduce transmission of the β-lactam resistance gene in the mouse gut.

Keywords: antibiotic resistance, gene transfer, gut microbiota, Salmonella infection

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Authors: Sahabeh Safarpour, Khiruddin Abdullah, Hwee San Lim, Mohsen Dadras

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Air pollution is a growing problem arising from domestic heating, high density of vehicle traffic, electricity production, and expanding commercial and industrial activities, all increasing in parallel with urban population. Monitoring and forecasting of air quality parameters are important due to health impact. One widely available metric of aerosol abundance is the aerosol optical depth (AOD). The AOD is the integrated light extinction coefficient over a vertical atmospheric column of unit cross section, which represents the extent to which the aerosols in that vertical profile prevent the transmission of light by absorption or scattering. Seasonal aerosol optical depth (AOD) values at 550 nm derived from the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor onboard NASA’s Terra satellites, for the 10 years period of 2000-2010 were used to test 7 different spatial interpolation methods in the present study. The accuracy of estimations was assessed through visual analysis as well as independent validation based on basic statistics, such as root mean square error (RMSE) and correlation coefficient. Based on the RMSE and R values of predictions made using measured values from 2000 to 2010, Radial Basis Functions (RBFs) yielded the best results for spring, summer, and winter and ordinary kriging yielded the best results for fall.

Keywords: aerosol optical depth, MODIS, spatial interpolation techniques, Radial Basis Functions

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Authors: Atefeh Esmailnejad, Mohammad Abbaszadeh Hasiri

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Coxiella burnetii is a gram-negative obligatory intracellular bacterium that causes Q fever, a significant zoonotic disease. Sheep, cattle, and goats are the most commonly reported reservoirs for the bacteria, but infected cats and dogs have also been implicated in the transmission of the disease to human. The aim of present study was to investigate the presence of antibodies against Coxiella burnetii among companion dogs in Fars province, South of Iran. A total of 181 blood samples were collected from asymptomatic dogs, mostly referred to Veterinary Hospital of Shiraz University for regular vaccination. The IgG antibody detection against Coxiella burnetii was made by indirect Enzyme-linked Immunosorbent Assay (ELISA), employing phase I and II Coxiella burnetii antigens. A logistic regression model was developed to analyze multiple risk factors associated with seropositivity. An overall seropositivity of 7.7% (n=14) was observed. Prevalence was significantly higher in adult dogs above five years (18.18 %) compared with dogs between 1 and five years (7.86 %) and less than one year (6.17%) (P=0.043). Prevalence was also higher in male dogs (11.21 %) than in female (2.7 %) (P=0.035). There were no significant differences in the prevalence of positive cases and breed, type of housing, type of food and exposure to other farm animals (P>0.05). The results of this study showed the presence of Coxiella burnetii infection among the companion dogs population in Fars province. To our knowledge, this is the first study regarding Q fever in dogs carried out in Iran. In areas like Iran, where human cases of Q fever are not common or remain unreported, the public health implications of Q fever seroprevalence in dogs are quite significant.

Keywords: Coxiella burnetii, dog, Iran, Q fever

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Authors: Roberto de Lieto Vollaro, Emanuele de Lieto Vollaro, Gianluca Coltrinari

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The building sector is responsible, in many industrialized countries, for about 40% of the total energy requirements, so it seems necessary to devote some efforts in this area in order to achieve a significant reduction of energy consumption and of greenhouse gases emissions. The paper presents a study aiming at providing a design methodology able to identify the best configuration of the system building/plant, from a technical, economic and environmentally point of view. Normally, the classical approach involves a building's energy loads analysis under steady state conditions, and subsequent selection of measures aimed at improving the energy performance, based on previous experience made by architects and engineers in the design team. Instead, the proposed approach uses a sequence of two well known scientifically validated calculation methods (TRNSYS and RETScreen), that allow quite a detailed feasibility analysis. To assess the validity of the calculation model, an existing, historical building in Central Italy, that will be the object of restoration and preservative redevelopment, was selected as a case-study. The building is made of a basement and three floors, with a total floor area of about 3,000 square meters. The first step has been the determination of the heating and cooling energy loads of the building in a dynamic regime by means of TRNSYS, which allows to simulate the real energy needs of the building in function of its use. Traditional methodologies, based as they are on steady-state conditions, cannot faithfully reproduce the effects of varying climatic conditions and of inertial properties of the structure. With TRNSYS it is possible to obtain quite accurate and reliable results, that allow to identify effective combinations building-HVAC system. The second step has consisted of using output data obtained with TRNSYS as input to the calculation model RETScreen, which enables to compare different system configurations from the energy, environmental and financial point of view, with an analysis of investment, and operation and maintenance costs, so allowing to determine the economic benefit of possible interventions. The classical methodology often leads to the choice of conventional plant systems, while RETScreen provides a financial-economic assessment for innovative energy systems and low environmental impact. Computational analysis can help in the design phase, particularly in the case of complex structures with centralized plant systems, by comparing the data returned by the calculation model RETScreen for different design options. For example, the analysis performed on the building, taken as a case study, found that the most suitable plant solution, taking into account technical, economic and environmental aspects, is the one based on a CCHP system (Combined Cooling, Heating, and Power) using an internal combustion engine.

Keywords: energy, system, building, cooling, electrical

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Authors: Prabu Duplex

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Due to stringent emission regulation targets, large-scale transition to renewable energy sources is a global challenge, and wind power plays a significant role in the solution vector. This scenario has led to the construction of offshore wind farms, and several wind farms are planned in the shallow waters where the marine habitat exists. It raises concerns over impacts of underwater noise on marine species, for example bridge constructions in the ocean straits. Dangerous to aquatic life, the environmental organisations say, the bridge would be devastating, since ocean straits are important place of transit for marine mammals. One of the highest concentrations of biodiversity in the world is concentrated these areas. The investigation of ship noise and piling noise that may happen during bridge construction and in operation is therefore vital. Once the source levels are known the receiver levels can be modelled. With this objective this work investigates the key requirement of the software that can model transmission loss in high frequencies that may occur during construction or operation phases. Most propagation models are 2D solutions, calculating the propagation loss along a transect, which does not include horizontal refraction, reflection or diffraction. In many cases, such models provide sufficient accuracy and can provide three-dimensional maps by combining, through interpolation, several two-dimensional (distance and depth) transects. However, in some instances the use of 2D models may not be sufficient to accurately model the sound propagation. A possible example includes a scenario where an island or land mass is situated between the source and receiver. The 2D model will result in a shadow behind the land mass where the modelled transects intersect the land mass. Diffraction will occur causing bending of the sound around the land mass. In such cases, it may be necessary to use a 3D model, which accounts for horizontal diffraction to accurately represent the sound field. Other scenarios where 2D models may not provide sufficient accuracy may be environments characterised by a strong up-sloping or down sloping seabed, such as propagation around continental shelves. In line with these objectives by means of a case study, this work addresses the importance of 3D interactions in underwater acoustics. The methodology used in this study can also be used for other 3D underwater sound propagation studies. This work assumes special significance given the increasing interest in using underwater acoustic modeling for environmental impacts assessments. Future work also includes inter-model comparison in shallow water environments considering more physical processes known to influence sound propagation, such as scattering from the sea surface. Passive acoustic monitoring of the underwater soundscape with distributed hydrophone arrays is also suggested to investigate the 3D propagation effects as discussed in this article.

Keywords: underwater acoustics, naval, maritime, cetaceans

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Authors: Mauro Masili, Fernanda O. Duarte, Liliane Ventura

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Ultraviolet (UV) radiation is electromagnetic waves from 100 – 400 nm wavelength. The World Health Organization and the International Commission on Non-Ionizing Radiation Protection (ICNIRP) recommend guidelines on the exposure of the eyes to UV radiation because it is correlated to ophthalmic diseases. Those exposure limits for an 8-h period are 1) UV radiant exposure should not exceed 30 J/m2 when irradiance is spectrally weighted using an actinic action spectrum; 2) unweighted radiant exposure in the UV-A spectral region 315 – 400 nm should not exceed 10 kJ/m2. Sunglasses play an important role in preventing eye injuries related to Sun exposure. We have calculated the direct and diffuse solar UV irradiance in a geometry that refers to an individual wearing a sunglass, in which the solar rays strike on a vertical surface. The diffuse rays are those scattered from the atmosphere and from the local environment. The calculations used the open-source SMARTS2 spectral model, in which we assumed a clear sky condition, aside from information about site location, date, time, ozone column, aerosols, and turbidity. In addition, we measured the spectral transmittance of a typical sunglasses lens and the global solar irradiance was weighted with the spectral transmittance profile of the lens. The radiant exposure incident on the eye’s surface was calculated in the UV and UV-A ranges following the ICNIRP’s recommendations for each day of the year. The tested lens failed the UV-A safe limit, while the UV limit failed to comply with this limit after the aging process. Hence, the ICNIRP safe limits should be considered in the standards to increase the protection against UV radiation on the eye.

Keywords: ICNIRP safe limits, ISO-12312-1, sunglasses, ultraviolet radiation

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Authors: Kalpana Adhikari, Mandip Subedi, Keshab Sharma, Indra P. Acharya

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The Gorkha Nepal earthquake of moment magnitude (Mw) 7.8 struck the central region of Nepal on April 25, 2015 with the epicenter about 77 km northwest of Kathmandu Valley . Peak ground acceleration observed during the earthquake was 0.18g. This motion induced several geotechnical effects such as landslides, foundation failures liquefaction, lateral spreading and settlement, and local amplification. An aftershock of moment magnitude (Mw) 7.3 hit northeast of Kathmandu on May 12 after 17 days of main shock caused additional damages. Kathmandu is the largest city in Nepal, have a population over four million. As the Kathmandu Valley deposits are composed mainly of sand, silt and clay layers with a shallow ground water table, liquefaction is highly anticipated. Extensive liquefaction was also observed in Kathmandu Valley during the 1934 Nepal-Bihar earthquake. Field investigations were carried out in Kathmandu Valley immediately after Mw 7.8, April 25 main shock and Mw 7.3, May 12 aftershock. Geotechnical investigation of both liquefied and non-liquefied sites were conducted after the earthquake. This paper presents observations of liquefaction and liquefaction induced damage, and the liquefaction potential assessment based on Standard Penetration Tests (SPT) for liquefied and non-liquefied sites. SPT based semi-empirical approach has been used for evaluating liquefaction potential of the soil and Liquefaction Potential Index (LPI) has been used to determine liquefaction probability. Recorded ground motions from the event are presented. Geological aspect of Kathmandu Valley and local site effect on the occurrence of liquefaction is described briefly. Observed liquefaction case studies are described briefly. Typically, these are sand boils formed by freshly ejected sand forced out of over-pressurized sub-strata. At most site, sand was ejected to agricultural fields forming deposits that varied from millimetres to a few centimeters thick. Liquefaction-induced damage to structures in these areas was not significant except buildings on some places tilted slightly. Boiled soils at liquefied sites were collected and the particle size distributions of ejected soils were analyzed. SPT blow counts and the soil profiles at ten liquefied and non-liquefied sites were obtained. The factors of safety against liquefaction with depth and liquefaction potential index of the ten sites were estimated and compared with observed liquefaction after 2015 Gorkha earthquake. The liquefaction potential indices obtained from the analysis were found to be consistent with the field observation. The field observations along with results from liquefaction assessment were compared with the existing liquefaction hazard map. It was found that the existing hazard maps are unrepresentative and underestimate the liquefaction susceptibility in Kathmandu Valley. The lessons learned from the liquefaction during this earthquake are also summarized in this paper. Some recommendations are also made to the seismic liquefaction mitigation in the Kathmandu Valley.

Keywords: factor of safety, geotechnical investigation, liquefaction, Nepal earthquake

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Authors: Tri Nguyen

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Background: Female sex workers (FSWs) are at heightened risk of sexually transmitted infections (STIs) and HIV. The purpose of the research is to study FSWs socio-demographic and behavioral characteristics and their HIV/STIs prevalence in Ba Ria – Vung Tau, Vietnam. Methods: A cross-sectional survey of 420 direct and indirect FSWs between January and May, 2014 from 2 cities and 6 districts in Ba Ria – Vung Tau were collected using sampling methods. FSWs were interviewed using the structured questionnaire and biological samples were tested for syphilis, gonorrhoea, chlamydia and HIV in the study. A database was constructed and entered using Epidata 3.1 software and analyzed using the SPSS 20.0 statistical package. Results: A total of 420 FSWs participated in the survey, with a median age of 27 years within a range of 18 – 43 years. Education levels were low with 33.1% only completing all seven major indicators. The median age of first sexual intercourse of the FSWs was 18 years. Most (88.8%) of the FSWs had oral sex. A high proportion (82.4 %) of the FSWs had consumed alcohol. Among them, 51.2% of the FSWs have had sex after drunk. Of the 177 FSWs have reported that they have had sex after drunk, almost half of direct FSWs have had unprotected sex. Among the 420 FSWs who participated in the survey, 2.6 % (11/420) were found to be HIV positive. There was a difference in HIV prevalence among direct and indirect FSWs (4.8 % and 1.2%, p= 0,022). Nearly 7 percent of the FSWs were infected with Syphilis. Similarly, the percentage (7.9 %) of the FSWs was found with Gonorrhoea and a doubly higher percentage (16.4%) of them was suffering from Chlamydia. On the aggregate, the percentage of FSWs with any one of the STIs (Gonorrhoea or Chlamydia) was highest 21.4 %. Conclusions: FSWs in Ba Ria – Vung Tau, Vietnam are highly vulnerable to STIs and need to enhance the existing STIs treatment and intervention programs in order to reduce the risk of HIV infections. HIV/STIs health education and a 100% condom use program should be implemented, and sex industry should be regulated by law.

Keywords: sex workers, female sex workers, HIV, STIs

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Authors: Phan Minh Trang, Joacim Rocklöv, Kim Bao Giang, Gunnar Kullgren, Maria Nilsson

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There are recent studies from high income countries reporting an association between heat waves and hospital admissions for mental health disorders. It is not previously studied if such relations exist in sub-tropical and tropical low- and middle-income countries. In this study from Vietnam, the assumption was that hospital admissions for mental disorders may be triggered, or exacerbated, by heat exposure and heat waves. A database from Hanoi Mental Hospital with mental disorders diagnosed by the International Classification of Diseases 10, spanning over five years, was used to estimate the heatwave-related impacts on admissions for mental disorders. The relationship was analysed by a Negative Binomial regression model accounting for year, month, and days of week. The focus of the study was heat-wave events with periods of three or seven consecutive days above the threshold of 35oC daily maximum temperature. The preliminary study results indicated that heat-waves increased the risks for hospital admission for mental disorders (F00-79) from heat-waves of three and seven days with relative risks (RRs) of 1.16 (1.01–1.33) and 1.42 (1.02–1.99) respectively, when compared with non-heat-wave periods. Heatwave-related admissions for mental disorders increased statistically significantly among men, among residents in rural communities and in elderly. Moreover, cases for organic mental disorders including symptomatic illnesses (F0-9) and mental retardation (F70-79) raised in high risks during heat waves. The findings are novel studying a sub-tropical middle-income city, facing rapid urbanisation and epidemiological and demographic transitions.

Keywords: mental disorders, admissions for F0-9 or F70-79, maximum temperature, heat waves

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Authors: Bartosz Osiecki, Jane Liu

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Pollutants emitted from forest fires such as PM₂.₅ and carbon monoxide (CO) have been found to impact the air quality of distant regions through long-range transport. PM₂.₅ is of particular concern due to its transport capacity and implications for human respiratory and cardiovascular health. As such, significant increases in PM₂.₅ concentrations have been exhibited in urban areas downwind of fire sources. This study seeks to expand on this literature by evaluating the impacts of long-range forest fire emission transport on air quality in Toronto, Ontario, as a means of evaluating the vulnerability of this major urban center to distant fire events. In order to draw correlations between the fire event and air pollution episode in Toronto, MODIS fire count data and HYPLSIT trajectories are used to assess the date, location, and severity of the fire and track the trajectory of emissions (respectively). Forward and back-trajectories are run, terminating at the West Toronto air monitoring station. PM₂.₅ and CO concentrations in Toronto during September 2017 are found to be significantly elevated, which is likely attributable to the fire activity. Other sites in Ontario including Toronto (East, North, Downtown), Mississauga, Brampton, and Hamilton (Downtown) exhibit similar peaks in PM₂.₅ concentrations. This work sheds light on the non-local, natural factors influencing air quality in urban areas. This is especially important in the context of climate change which is expected to exacerbate intense forest fire events in the future.

Keywords: air quality, forest fires, PM₂.₅, Toronto

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Authors: Stephen Verderber

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The World Health Organization (WHO) calls for research and development on ecologically sustainable, resilient structures capable of effectively responding to disaster events globally, in response to climate change, politically based diasporas, earthquakes, and other adverse events upending the rhythms of everyday life globally. By 2050, nearly 80% of the world’s population will reside in coastal zones, and this, coupled with the increasingly dire impacts of climate change, constitute a recipe for further chaos and disruption, and in light of these events, architects have yet to rise up to meet the challenge. In the arena of healthcare, rapidly deployable clinics and field hospitals can provide immediate assistance in medically underserved disaster strike zones. Transportable facilities offer multiple advantages over conventional, fixed-site hospitals, as lightweight, comparatively unencumbered alternatives. These attributes have been proven repeatedly in 20th century vehicular and tent-based structures deployed in frontline combat theaters and in prior natural disasters. Prefab transportable clinics and trauma centers recently responded adroitly to medical emergencies in the aftermath of the Haitian (2010) and Ecuadorian (2016) earthquakes, and in North American post-hurricane relief efforts (2017) while architects continue to be castigated by their engineer colleagues as chronically poor first responders. Architecturally based portable structures for healthcare currently include Redeployable Health Centers (RHCs), Redeployable Trauma Centers (RTCs), and Permanent Modular Installations (PMIs). Five tectonic variants within this typology have recently been operationalized in the field: 1. Vehicular-based Nomadics: Prefab modules installed on a truck chassis with interior compartments dropped in prior to final assembly. Alternately, a two-component apparatus is preferred, with a truck cab pulling a modular medical unit, with independent transiting component; 2. Tent and Pneumatic Systems: Tent/yurt precursors and inflatable systems lightweight and responsive to topographically challenging terrain and diverse climates; 3. Containerized Systems: The standard modular intermodal-shipping container affords structural strength, resiliency in difficult transiting conditions, and can be densely close-packed and these can be custom-built or hold flat-pack systems; 4. Flat-Packs and Pop-Up Systems: These kit-of-part assemblies are shipped in standardized or specially-designed ISO containers; and 5. Hybrid Systems: These consist of composite facilities representing a synthesis of mobile vehicular components and/or tent or shipping containers, fused with conventional or pneumatically activated tent systems. Hybrids are advantageous in many installation contexts from an aesthetic, fabrication, and transiting perspective. Advantages/disadvantages of various modular systems are comparatively examined, followed by presentation of a compendium of 80 evidence (research)-based planning and design considerations addressing site/context, transiting and commissioning, triage, decontamination/intake, diagnostic and treatment, facility tectonics, and administration/total environment. The benefits of offsite pre-manufactured fabrication are examined, as is anticipated growth in international demand for transportable healthcare facilities to meet the challenges posed by accelerating global climate change and global conflicts. This investigation into rapid response facilities for pre and post-disaster zones is drawn from a recent book by the author, the first on architecture on this topic (Innovations in Transportable Healthcare Architecture).

Keywords: disaster mitigation, rapid response healthcare architecture, offsite prefabrication

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Authors: Navid Kaboudi, Ali Shayanfar

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Introduction: Feeding infants with safe milk from the beginning of their life is an important issue. Drugs which are used by mothers can affect the composition of milk in a way that is not only unsuitable, but also toxic for infants. Consuming permeable drugs during that sensitive period by mother could lead to serious side effects to the infant. Due to the ethical restrictions of drug testing on humans, especially women, during their lactation period, computational approaches based on structural parameters could be useful. The aim of this study is to develop mechanistic models to predict the M/P ratio of drugs during breastfeeding period based on their structural descriptors. Methods: Two hundred and nine different chemicals with their M/P ratio were used in this study. All drugs were categorized into two groups based on their M/P value as Malone classification: 1: Drugs with M/P>1, which are considered as high risk 2: Drugs with M/P>1, which are considered as low risk Thirty eight chemical descriptors were calculated by ACD/labs 6.00 and Data warrior software in order to assess the penetration during breastfeeding period. Later on, four specific models based on the number of hydrogen bond acceptors, polar surface area, total surface area, and number of acidic oxygen were established for the prediction. The mentioned descriptors can predict the penetration with an acceptable accuracy. For the remaining compounds (N= 147, 158, 160, and 174 for models 1 to 4, respectively) of each model binary regression with SPSS 21 was done in order to give us a model to predict the penetration ratio of compounds. Only structural descriptors with p-value<0.1 remained in the final model. Results and discussion: Four different models based on the number of hydrogen bond acceptors, polar surface area, and total surface area were obtained in order to predict the penetration of drugs into human milk during breastfeeding period About 3-4% of milk consists of lipids, and the amount of lipid after parturition increases. Lipid soluble drugs diffuse alongside with fats from plasma to mammary glands. lipophilicity plays a vital role in predicting the penetration class of drugs during lactation period. It was shown in the logistic regression models that compounds with number of hydrogen bond acceptors, PSA and TSA above 5, 90 and 25 respectively, are less permeable to milk because they are less soluble in the amount of fats in milk. The pH of milk is acidic and due to that, basic compounds tend to be concentrated in milk than plasma while acidic compounds may consist lower concentrations in milk than plasma. Conclusion: In this study, we developed four regression-based models to predict the penetration class of drugs during the lactation period. The obtained models can lead to a higher speed in drug development process, saving energy, and costs. Milk/plasma ratio assessment of drugs requires multiple steps of animal testing, which has its own ethical issues. QSAR modeling could help scientist to reduce the amount of animal testing, and our models are also eligible to do that.

Keywords: logistic regression, breastfeeding, descriptors, penetration

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Authors: Soundarya Lahari Vedula

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Dalit women make up a significant portion of the Indian population. However, they are victims of age old discrimination. This paper presents a brief background of the Indian caste system which is a hierarchical division placing Dalits at the lowest rank. Dalits are forced to perform menial and harsh tasks. They often face social ostracism. The situation of Dalit women is of unique significance as they face triple discrimination due to their caste, gender, and class. Dalit women are strictly withheld by the rigid boundaries of the caste system. They are discriminated at every stage of their life and are denied access to public places, education and healthcare facilities among others. They face the worst forms of sexual violence. In spite of legislations and international conventions in place, their plight is not adequately addressed. This paper discusses, in brief, the legal mechanism in place to prohibit untouchability. Furthermore, this paper details on the specific human rights violations faced by Dalit women in the social, economic and political spheres. The violations range from discrimination in public places, denial of education and health services, sexual exploitation and barriers to political representation. Finally, this paper identifies certain lacunae in the existing Indian statutes and broadens on the measures to be taken to improve the situation of Dalit women. This paper offers some recommendations to address the plight of Dalit women such as amendments to the existing statutes, effective implementation of legal mechanisms and a more meaningful interpretation of the international conventions.

Keywords: Dalit, caste, class, discrimination, equality

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Authors: Nikita Pasricha, Karen Smith, Simone Marshall, Vincent DePaul, Jessica Trier

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Understanding that physical activity in rehabilitation programs shapes outcomes in acquired brain injury (ABI) populations is not a new concept. However, there is a void in understanding the physical activity patterns of inpatients in ABI rehabilitation, the trajectory of physical activity recovery, and factors that contribute to the recovery of physical activity over the initial months post-ABI. The purpose of this study was to determine if physical activity patterns vary in people with recent ABI in inpatient rehabilitation. The study also investigated differences in physical activity patterns in ABI patients compared to age-related healthy participants. Results revealed that ABI patients spent approximately 6.7 times longer per day in sedentary postures than in active positions. In comparison, the control group spent only 2.8 times longer in sedentary postures compared to active positions. Patients with ABI took significantly fewer steps than age-matched health control participants. Within the ABI population, patients took 0.78 times fewer steps on weekends compared to weekdays. Participants with greater mobility limitations had a greater difference in WD to WE steps taken. Potential reasons could be from no structured weekend rehabilitation programs, lower availability of staff, or varying schedules. Given that the rehabilitation program is only structured on weekdays, further research to investigate the benefits of structured physical activities like group walking programs on weekends for ABI patients in inpatient rehabilitation programs is warranted.

Keywords: brain, ABI, TBI, rehabilitation

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Authors: Min Wei

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The green hotel provides the products/services consistent with the full utilization of resources, protecting the ecological environment conducive to customers’ requirements and health. In order to better develop the green hospitality industry, this paper applies the game theory to analyze the intrinsic relationship and balanced interests among the stakeholders including government, hotels, and tourists during green hospitality development. Based on the hypothesis in game theory, this paper tries to construct a linkage mechanism in stakeholders, by which a theoretical basis for the interests’ balance can be realized. By using game theory and constructing a game model including tourists, hotels and government, this paper analyzes the relationship of the various stakeholders involved in the green hospitality development, and subsequently proposes the development model of green hospitality industry. On the one hand, this paper applies game theory to construct a green hotel development model and provides a theoretical basis for the interest balance of stakeholders based on theoretical perspective. On the other hand, the current development of green hospitality industry is still in initial phase, and the outcome of this research tries to guide tourists to form a green awareness and to establish the concept of green consumption for hotel development, so that green hotel products/services are provided. In addition, this paper provides a basis for decision making in the relevant government departments so that the interests of all stakeholders are promoted and cooperative game between stakeholders is established, for which the sustainable development of green hotels is achieved. The findings indicate that the process of achieving green hospitality industry development is to maximize the whole interests of stakeholders.

Keywords: green hospitality, game theory, stakeholders, development model

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Authors: Norihiro Kato, Yuriko Takayama

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Some gram-negative bacteria enable the simultaneous activation of gene expression involved in N-acylhomoserine lactone (AHL) dependent cell-to-cell communication system. Such regulatory system for the bacterial group behavior is termed as quorum sensing (QS) because a diffusible AHL signal can accumulate around the cell during the increase of the cell density and trigger activation of the sequential QS process. By blocking the QS, the expression of diverse genes related to infection, antibiotic production, and biofilm formation is inhibited. Conditioning of QS by regulation of the DNA-receptor-AHL interaction is a potential target for enhancing host defenses against pathogenicity. We focused on engineered application of transcriptional regulator SpnR produced in opportunistic human pathogen Serratia marcescens. The SpnR can interact with AHL signals at an N-terminal domain and also with a promoter region of a QS target gene at a C-terminal domain. As the initial process of the QS activation, the SpnR forms a complex with the AHL to enhance the expression of pig cluster; the SpnR normally acts as an activator for the expression of the QS-dependent gene. In this research, we attempt to artificially control QS by changing the role of SpnR. The QS-dependent prodigiosin production is expected to inhibit by externally added SpnR in the culture broth of AS-1 strain because the AHL concentration was kept below the threshold by AHL-SpnR complex formation. Maltose-binding protein (MBP)-tagged SpnR (MBP-SpnR) was overexpressed in Escherichia coli and purified using an affinity chromatography equipped with an amylose resin column. The specific interaction between AHL and MBP-SpnR was demonstrated by quartz crystal microbalance (QCM) sensor. AHL with amino end-group was coupled with COOH-terminated self-assembled monolayer prepared on a gold electrode of 27-MHz quartz crystal sensor using water-soluble carbodiimide. After the injection of MBP-SpnR into a cup-type sensor cell filled with the buffer solution, time course of resonant frequency change (ΔFs) was determined. A decrease of ΔFs clearly showed the uptake of MBP-SpnR onto the AHL-immobilized electrode. Furthermore, no binding affinity was observed after the heat-inactivation of MBP-SpnR at 80ºC. These results suggest that MBP-SpnR possesses a specific affinity for AHL. MBP-SpnR was added to the culture medium as an AHL trap to study inhibitory effects on intracellularly accumulated prodigiosin. With approximately 2 µM MBP-SpnR, the amount of prodigiosin induced was half that of the control without any additives. In conclusion, the function of SpnR could be switched by adding it to the cell culture. Exogenously added MBP-SpnR possesses high affinity for AHL derived from cells and acts as an inhibitor of AHL-mediated QS.

Keywords: intracellular signaling, microbial biotechnology, quorum sensing, transcriptional regulator

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Authors: Olufemi Samuel Shola, Oladapo Adenike Adesola

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Inadequate dietary intake has increased the susceptibility of under five children to malnutrition and infections. This study, therefore, assessed the feeding practices of children of 0-23 months of age among mothers in urban areas of Akure, Ondo State, Nigeria. Simple random sampling technique was used to select four hundred (400) mothers out of 710 mothers from 7 primary health care centres in Akure metropolis for the study. Data were collected using modified WHO 2003 Questionnaire on child feeding practices. Data were analyzed using descriptive statistics, while chi-square was used to determine the association between variables. Results showed that 52.0% of the children were males, with 47.5% in the 6-8 months age group. More than half (57.0%) of the mothers were between the ages of 20-29 years, and 45.0% had secondary education. Majority (94.3%) of the mothers breastfed their children in the last 24 hours preceding the survey. The feeding practices history of mothers showed that 28.0% and 53.7% of the mothers initiated breastfeeding less than 30 minutes and between 30 minutes to 1 hour after delivery, respectively. Also, 52.0% of mothers practiced exclusive breastfeeding for six months, while 26.2% breastfed from 6 months up to 2 years of age. Dietary diversity of the children age 6-23 months revealed that 68.7% of the children attained the minimum dietary diversity by consuming 4 or more food groups in the last 24 hours. There was a significant association (P < 0.05) between mothers’ education (n=180), occupation(n=41) and dietary diversity (n= 150) and meal frequency (n=209). Therefore, the study concluded that the duration of breastfeeding and time of introduction of complementary food did not meet WHO recommended guidelines. There is urgent need to launching more programmes.

Keywords: breastfeeding, mothers, child feeding, urban areas, ondo state, nigeria

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Authors: Yung-Feng Yen, I-an Jen, Yi-Ming Arthur Chen

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The molecular mimicry between human immunodeficiency virus (HIV) protein and red blood cell (RBC) antigens could induce the production of anti-RBC autoantibodies. However, the association between HIV infection and subsequent development of autoimmune hemolytic anemia (AIHA) remains unclear. This nationwide population-based cohort study aimed to determine the association between incident AIHA and HIV in Taiwan. From 2000–2012, we identified adult people living with HIV/AIDS (PLWHA) from the Taiwan centers for disease control HIV Surveillance System. HIV-infected individuals were defined by positive HIV-1 western blot. Age- and sex-matched controls without HIV infection were selected from the Taiwan National Health Insurance Research Database for comparison. All patients were followed until Dec. 31, 2012, and observed for occurrence of AIHA. Of 171,468 subjects (19,052 PLWHA, 152,416 controls), 30 (0.02%) had incident AIHA during a mean follow-up of 5.45 years, including 23 (0.12%) PLWHA and 7 (0.01%) controls. After adjusting for potential confounders, HIV infection was found to be an independent risk factor of incident AIHA (adjusted hazard ratio [AHR], 20.9; 95% confidence interval [CI], 8.34-52.3). Moreover, PLWHA receiving HAART were more likely to develop AIHA than those not receiving HAART (AHR, 10.8; 95% CI, 2.90-40.1). Additionally, the risk of AIHA was significantly increased in those taking efavirenz (AHR, 3.15; 95% CI, 1.18-8.43) or atazanavir (AHR, 6.58; 95% CI, 1.88-22.9) component of the HAART. In conclusion, HIV infection is an independent risk factor for incident AIHA. Clinicians need to be aware of the higher risk of AIHA in PLWHA.

Keywords: autoimmune disease , hemolytic anemia, HIV, highly active antiretroviral treatment

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Authors: Natalia Politaeva, Iuliia Smiatskaia, Iuliia Bazarnova, Iryna Atamaniuk, Kerstin Kuchta

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Nowadays, the progressive decrease of primary natural resources and ongoing upward trend in terms of energy demand, have resulted in development of new generation technological processes which are focused on step-wise production and residues utilization. Thus, microalgae-based 3^rd generation bioeconomy is considered one of the most promising approaches that allow production of value-added products and sophisticated utilization of residues biomass. In comparison to conventional biomass, microalgae can be cultivated in wide range of conditions without compromising food and feed production, and thus, addressing issues associated with negative social and environmental impacts. However, one of the most challenging tasks is to undergo seasonal variations and to achieve optimal growing conditions for indoor closed systems that can cover further demand for material and energetic utilization of microalgae. For instance, outdoor cultivation in St. Petersburg (Russia) is only suitable within rather narrow time frame (from mid-May to mid-September). At earlier and later periods, insufficient sunlight and heat for the growth of microalgae were detected. On the other hand, without additional physical effects, the biomass increment in summer is 3-5 times per week, depending on the solar radiation and the ambient temperature. In order to increase biomass production, scientists from all over the world have proposed various technical solutions for cultivators and have been studying the influence of various physical factors affecting biomass growth namely: magnetic field, radiation impact, and electric field, etc. In this paper, the influence of infrared radiation (IR) and fluorescent light on the growth rate of microalgae Chlorella sorokiniana has been studied. The cultivation of Chlorella sorokiniana was carried out in 500 ml cylindrical glass vessels, which were constantly aerated. To accelerate the cultivation process, the mixture was stirred for 15 minutes at 500 rpm following 120 minutes of rest time. At the same time, the metabolic needs in nutrients were provided by the addition of micro- and macro-nutrients in the microalgae growing medium. Lighting was provided by fluorescent lamps with the intensity of 2500 ± 300 lx. The influence of IR was determined using IR lamps with a voltage of 220 V, power of 250 W, in order to achieve the intensity of 13 600 ± 500 lx. The obtained results show that under the influence of fluorescent lamps along with the combined effect of active aeration and variable mixing, the biomass increment on the 2^nd day was three times, and on the 7^th day, it was eight-fold. The growth rate of microalgae under the influence of IR radiation was lower and has reached 22.6·10⁶ cells·mL^-1. However, application of IR lamps for the biomass growth allows maintaining the optimal temperature of microalgae suspension at approximately 25-28°C, which might especially be beneficial during the cold season in extreme climate zones.

Keywords: biomass, fluorescent lamp, infrared radiation, microalgae

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Authors: Aneta Nitsch-Osuch, Katarzyna Zycinska, Ewa Gyrczuk, Agnieszka Topczewska-Cabanek, Kazimierz Wardyn

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Introduction: Influenza is an important clinical and epidemiological problem and should be considered as a possible nosocomial infection. The aim of the study was to determine the influenza vaccine coverage rates among Polish nurses and to find out drivers and barriers for influenza vaccination among this group of health care workers (HCWs). Material and methods: The self- fulfilled survey with 26 questions about the knowledge, perception, and influenza coverage rates was distributed among 461 nurses. Results: Only 15% of nurses were vaccinated against influenza in the consecutive seasons. The majority (75%) of the regularly vaccinated nurses were ambulatory careworkers. The difference between the number of vaccinated hospitals and ambulatory care nurses was statistically significant (p < 0.05). The main motivating factors for an influenza vaccination were: a fear of the illness and its complications (97%) and a free of charge vaccine available at the workplace (87%). Ambulatory care nurses more often declared that they were vaccinated mainly to protect themselves while hospital care nurses more often declared the will to protect their patients, these differences in the perception and attitudes to an influenza vaccination among hospital and ambulatory care nurses were statistically significant (p < 0.05). The main barriers for an influenza vaccination among the nursing staff were: a lack of reimbursement of the vaccine (95%), a lack of insufficient knowledge about the effectiveness, and safety of the influenza vaccine (54%). The ambulatory care nurses more often found influenza vaccination as the ethical duty compared to hospital care nurses (p < 0.05). Conclusions: The influenza vaccine coverage rates among the Polish nurses are low and must be improved in the future. More educational activities dedicated to HCWs may result in the increased awareness of influenza vaccination benefits for both medical professionals and patients.

Keywords: influenza, vaccination, nurses, ambulatory careworkers

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Authors: Nicholas Agyepong, Paul Gyan

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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Nicole Brown

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This study considers the illness experience of fibromyalgia patients by using identity boxes. The results improve health care professionals' understanding of patient experiences. Additionally, the concept of the identity boxes may offer a practical solution for helping patients accept the diagnosis of fibromyalgia. Fibromyalgia research traditionally refers to pain experiences and relies on questionnaires, surveys, interviews and some narrative analysis. However, due to the variability in symptoms, symptom levels, and locations, these methods may not be best suited to provide an insight into the patient experience. On the other hand, lengthy interview processes are not easily accessible for sufferers of fibromyalgia. In addition to timelines and diary extracts, this study uses identity boxes as its main data collection method. Participants are asked to find items in response to specific questions and to arrange them in their box. The objects represent the patients' experiences holistically. Participants provide photographs of their identity box at each stage of the process and explain their chosen items. The photographs of the identity boxes and the patients' explanations of their objects and their boxes are subjected to interpretative phenomenological analysis. Despite the unique forms of the completed boxes, common experiences are described: the need for comfort, the role of spirituality and the impact of fibromyalgia on everyday life, that it plays a significant role but those patients are determined not to let it rule their lives. The work with the identity boxes has shown beneficial impact due to the reflective nature involved in the tasks. Further investigations will be needed to identify the long-term impact of identity work using such boxes.

Keywords: biographical disruption, fibromyalgia, illness experience, illness narrative

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Authors: Barbara Erjauz, Juliane Eichhorn

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Background and Purpose: The world´s population is rapidly aging, wherefore the World Health Organization (WHO) is dealing with concepts of Age-Friendly-Communities and criteria to define them. Also in Germany, we can find an aging population and a large amount of seniors is living in rural areas. Those regions are defined by unique social and environmental characteristics, which can enhance or decrease age-friendliness. To identify and work with these characteristics, we are in need of appropriate assessment instruments. To the author’s best knowledge until now, no instrument could be identified as suitable and scientifically proven for the German speaking area. The aim of the study was to identify an assessment instrument to measure the age-friendliness of rural communities and its psychometric testing regarding the content validity. Methods: A literature search was carried out to identify instruments related to concepts of Age-Friendly-Communities. According to the German situation, an instrument was chosen and modified based on a Delphi-study. In this context, the content validity was investigated by calculating the Content Validity Index (CVI). Results: An instrument consisting of 86 items based on WHO indicators and the German situation in rural areas was created. 43 items (50%) had a Content Validity Index for Items (I-CVI) of 1,00, 37 items (43%) had an I-CVI of >0,78 and > 1.00, and 6 items had an I-CVI of >0,78. The value of the Content Validity Index for Scales, averaging calculation method (S-CVI/Ave) for the entire scale was 0,91. Conclusions: The results indicate a good content validity and it can be concluded that the created instrument represents the phenomenon of age-friendliness in rural areas. Nevertheless, further psychometric testing related to reliability, validity and responsiveness is recommended.

Keywords: assessment, age-friendly, rural, psychometric testing

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