Search results for: general hospital

Authors: Atin Adhikari, Sushma Kurella, Pratik Banerjee, Nabanita Mukherjee, Yamini M. Chandana Gollapudi, Bushra Shah

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Different sharp instruments, drilling machines, and high speed rotary instruments are routinely used in dental clinics during dental cleaning. Therefore, these cleaning procedures release a lot of oral microorganisms including bacteria in clinic air and may cause significant occupational bioaerosol exposure risks for dentists, dental hygienists, patients, and dental clinic employees. Two major goals of this study were to quantify volumetric airborne concentrations of bacteria and to assess overall microbial activity in this type of occupational environment. The study was conducted in several dental clinics of southern Georgia and 15 dental cleaning procedures were targeted for sampling of airborne bacteria and testing of overall microbial activity in settled dusts over clinic floors. For air sampling, a Biostage viable cascade impactor was utilized, which comprises an inlet cone, precision-drilled 400-hole impactor stage, and a base that holds an agar plate (Tryptic soy agar). A high-flow Quick-Take-30 pump connected to this impactor pulls microorganisms in air at 28.3 L/min flow rate through the holes (jets) where they are collected on the agar surface for approx. five minutes. After sampling, agar plates containing the samples were placed in an ice chest with blue ice and plates were incubated at 30±2°C for 24 to 72 h. Colonies were counted and converted to airborne concentrations (CFU/m3) followed by positive hole corrections. Most abundant bacterial colonies (selected by visual screening) were identified by PCR amplicon sequencing of 16S rRNA genes. For understanding overall microbial activity in clinic floors and estimating a general cleanliness of the clinic surfaces during or after dental cleaning procedures, ATP levels were determined in swabbed dust samples collected from 10 cm2 floor surfaces. Concentration of ATP may indicate both the cell viability and the metabolic status of settled microorganisms in this situation. An ATP measuring kit was used, which utilized standard luciferin-luciferase fluorescence reaction and a luminometer, which quantified ATP levels as relative light units (RLU). Three air and dust samples were collected during each cleaning procedure (at the beginning, during cleaning, and immediately after the procedure was completed (n = 45). Concentrations at the beginning, during, and after dental cleaning procedures were 671±525, 917±1203, and 899±823 CFU/m3, respectively for airborne bacteria and 91±101, 243±129, and 139±77 RLU/sample, respectively for ATP levels. The concentrations of bacteria were significantly higher than typical indoor residential environments. Although an increasing trend for airborne bacteria was observed during cleaning, the data collected at three different time points were not significantly different (ANOVA: p = 0.38) probably due to high standard deviations of data. The ATP levels, however, demonstrated a significant difference (ANOVA: p <0.05) in this scenario indicating significant change in microbial activity on floor surfaces during dental cleaning. The most common bacterial genera identified were: Neisseria sp., Streptococcus sp., Chryseobacterium sp., Paenisporosarcina sp., and Vibrio sp. in terms of frequencies of occurrences, respectively. The study concluded that bacterial exposure in dental clinics could be a notable occupational biohazard, and appropriate respiratory protections for the employees are urgently needed.

Keywords: bioaerosols, hospital hygiene, indoor air quality, occupational biohazards

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Authors: Moumita Chanda, Md. Fazlul Karim Patwary

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Smoking is one of the most popular recreational drug use behaviors, and it contributes to birth defects, COPD, heart attacks, and erectile dysfunction. To completely eradicate this disease, it is imperative that it be identified and treated. Numerous smoking cessation programs have been created, and they demonstrate how beneficial it may be to help someone stop smoking at the ideal time. A tomography meter is an effective smoking detector. Other wearables, such as RF-based proximity sensors worn on the collar and wrist to detect when the hand is close to the mouth, have been proposed in the past, but they are not impervious to deceptive variables. In this study, we create a machine that can discriminate between smokers and non-smokers in real-time with high sensitivity and specificity by watching and collecting the human lung and analyzing the X-ray data using machine learning. If it has the highest accuracy, this machine could be utilized in a hospital, in the selection of candidates for the army or police, or in university entrance.

Keywords: CNN, smoker detection, non-smoker detection, OpenCV, artificial Intelligence, X-ray Image detection

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Authors: Dmitriy Chernov, Maria Karavassilis, Suhyoun Youn, Amna Izhar, Devasenan Devendra

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Introduction and Background: A well-structured and comprehensive departmental induction improves patient safety and job satisfaction amongst doctors. The aims of our Project were as follows: 1. Assess the perceived preparedness of junior doctors starting their rotation in Acute Medicine at Watford General Hospital. 2. Develop a supplemental Induction Guide and Pocket reference in the form of an iOS mobile application. 3. To collect feedback after implementing the mobile application following a trial period of 8 weeks with a small cohort of junior doctors. Materials and Methods: A questionnaire was distributed to all new junior trainees starting in the department of Acute Medicine to assess their experience of current induction. A mobile Induction application was developed and trialled over a period of 8 weeks, distributed in addition to the existing didactic induction session. After the trial period, the same questionnaire was distributed to assess improvement in induction experience. Analytics data were collected with users’ consent to gauge user engagement and identify areas of improvement of the application. A feedback survey about the app was also distributed. Results: A total of 32 doctors used the application during the 8-week trial period. The application was accessed 7259 times in total, with the average user spending a cumulative of 37 minutes 22 seconds on the app. The most used section was Clinical Guidelines, accessed 1490 times. The App Feedback survey revealed positive reviews: 100% of participants (n=15/15) responded that the app improved their overall induction experience compared to other placements; 93% (n=14/15) responded that the app improved overall efficiency in completing daily ward jobs compared to previous rotations; and 93% (n=14/15) responded that the app improved patient safety overall. In the Pre-App and Post-App Induction Surveys, participants reported: a 48% improvement in awareness of practical aspects of the job; a 26% improvement of awareness on locating pathways and clinical guidelines; a 40% reduction of feelings of overwhelmingness. Conclusions and recommendations: This study demonstrates the importance of technology in Medical Education and Clinical Induction. The mobile application average engagement time equates to over 20 cumulative hours of on-the-job training delivered to each user, within an 8-week period. The most used and referred to section was clinical guidelines. This shows that there is high demand for an accessible pocket guide for this type of material. This simple mobile application resulted in a significant improvement in feedback about induction in our Department of Acute Medicine, and will likely impact workplace satisfaction. Limitations of the application include: post-app surveys had a small number of participants; the app is currently only available for iPhone users; some useful sections are nested deep within the app, lacks deep search functionality across all sections; lacks real time user feedback; and requires regular review and updates. Future steps for the app include: developing a web app, with an admin dashboard to simplify uploading and editing content; a comprehensive search functionality; and a user feedback and peer ratings system.

Keywords: mobile app, doctor induction, medical education, acute medicine

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Authors: M. Bolacalı, Y. Öztürk, O. Yılmaz, M. Küçük, M. A. Karslı

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The aim of the study was to determine various body measurements from the birth to the 30-day age of Boer x Hair goats F1 crossbred kids and pure Hair goat kids raised in Van in Eastern Anatolia region, and reveal factors such as the effects of year, dame body weight, genotype, dame age, birth type and sex on this parameter. 49 kids born in 2012 and 76 kids born in 2014 were utilized in the study. In the statistical analysis of various body measurements data was performed using the General Lineer Model procedure in SPSS software. Duncan's multiple range test was used for multiple comparisons. Boer x Hair goats F1 crossbred kids and pure Hair goat kids from various body measurements cidago height, body length, chest length, chest depth, chest circumference, circumference of leg, cannon bone circumference, chest width were determinated in general respectively 29.90 and 27.88 cm; 29.49 and 27.93 cm; 17.28 and 16.68 cm; 13.34 and 12.82 cm; 31.74 and 29.85 cm; 28.43 and 23.95 cm; 5.41 and 5.15 cm; 8.71 and 7.63 cm at birth, respectively; 35.01 and 32.98 cm; 35.20 and 33.30 cm; 18.82 and 18.17 cm; 15.64 and 14.83 cm; 39.08 and 37.30 cm; 34.29 and 29.25 cm; 5.80 and 5.42 cm; 9.87 and 8.85 cm at 30 days age, respectively. Among factors affecting cidago height in this study, the effect of dame body weight and sex were not significant, but genotype, dame age and birth type were significant (P < 0,05 and P < 0,01) at birth; dame body weight effect of the cidago height was not significant, but the effect of genotype, birth type, of dame age and sex were significant (P < 0.05, P < 0.05 and P<0.001) at 30-day age. The effect of genotype and sex of body length were not significant, but dam age, dame body weight and birth type were significant (P < 0.05, P < 0.05 and P<0.001, respectively) at birth; the effect of sex to body length was not significant, but genotype, dame age, dame body weight and birth type were significant (P < 0.01, P < 0.05, P < 0.05 and P < 0.001, respectively) at 30-day age. While circumference of leg was insignificant the effect of dame age and sex, genotype, dame body weight and type of the birth were significant (P < 0.001, P < 0.05 and P < 0.001) at birth; the circumstance of leg at 30-day age was found to be important the effect of examined other factors except for sex (P < 0.05 and P < 0.001). The obtained results, when considered in terms of a variety of body sizes, from birth to 30-day age growth period, showed that the kids of Boer x Hair Goat F1 hybrids have higher values than the kids of Hair Goats.

Keywords: Boer x hair goat F1 crossbred, hair goat, body measurements, cidago height

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Authors: Anita Bajpai, Sarah Duan, Ashlee Erskine, Shehzein Khan, Raymond Kramer

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Introduction: This research focuses on exploring the beneficial effects if any, of Vitamin-D in reducing the need for supplemental oxygen among hospitalized COVID-19 patients. Two questions are investigated – Q1)Doeshaving a healthy level of baselineVitamin-D 25-OH (≥ 30ng/ml) help,andQ2) does administering Vitamin-D therapy after-the-factduring inpatient hospitalization help? Methods/Study Design: This is a comprehensive, retrospective, observational study of all inpatients at RUHS from March through December 2020 who tested positive for COVID-19 based on real-time reverse transcriptase–polymerase chain reaction assay of nasal and pharyngeal swabs and rapid assay antigen test. To address Q1, we looked atall N1=182 patients whose baseline plasma Vitamin-D 25-OH was known and who needed supplemental oxygen. Of this, a total of 121 patients had a healthy Vitamin-D level of ≥30 ng/mlwhile the remaining 61 patients had low or borderline (≤ 29.9ng/ml)level. Similarly, for Q2, we looked at a total of N2=893 patients who were given supplemental oxygen, of which713 were not given Vitamin-D and 180 were given Vitamin-D therapy. The numerical value of the maximum amount of oxygen flow rate(dependent variable) administered was recorded for each patient. The mean values and associated standard deviations for each group were calculated. Thesetwo sets of independent data served as the basis for independent, two-sample t-Test statistical analysis. To be accommodative of any reasonable benefitof Vitamin-D, ap-value of 0.10(α< 10%) was set as the cutoff point for statistical significance. Results: Given the large sample sizes, the calculated statistical power for both our studies exceeded the customary norm of 80% or better (β< 0.2). For Q1, the mean value for maximumoxygen flow rate for the group with healthybaseline level of Vitamin-D was 8.6 L/min vs.12.6L/min for those with low or borderline levels, yielding a p-value of 0.07 (p < 0.10) with the conclusion that those with a healthy level of baseline Vitamin-D needed statistically significant lower levels of supplemental oxygen. ForQ2, the mean value for a maximum oxygen flow rate for those not administered Vitamin-Dwas 12.5 L/min vs.12.8L/min for those given Vitamin-D, yielding a p-valueof 0.87 (p > 0.10). We thereforeconcludedthat there was no statistically significant difference in the use of oxygen therapy between those who were or were not administered Vitamin-D after-the-fact in the hospital. Discussion/Conclusion: We found that patients who had healthy levels of Vitamin-D at baseline needed statistically significant lower levels of supplemental oxygen. Vitamin-D is well documented, including in a recent article in the Lancet, for its anti-inflammatory role as an adjuvant in the regulation of cytokines and immune cells. Interestingly, we found no statistically significant advantage for giving Vitamin-D to hospitalized patients. It may be a case of “too little too late”. A randomized clinical trial reported in JAMA also did not find any reduction in hospital stay of patients given Vitamin-D. Such conclusions come with a caveat that any delayed marginal benefits may not have materialized promptly in the presence of a significant inflammatory condition. Since Vitamin-D is a low-cost, low-risk option, it may still be useful on an inpatient basis until more definitive findings are established.

Keywords: COVID-19, vitamin-D, supplemental oxygen, vitamin-D in primary care

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Authors: Mikel Niño, Roberto V. Zicari, Todor Ivanov, Kim Hee, Naveed Mushtaq, Marten Rosselli, Concha Sánchez-Ocaña, Karsten Tolle, José Miguel Blanco, Arantza Illarramendi, Jörg Besier, Harry Underwood

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One of the application fields for data analysis techniques and technologies gaining momentum is the area of social good or “common good”, covering cases related to humanitarian crises, global health care, or ecology and environmental issues, among others. The promotion of data-driven projects in this field aims at increasing the efficacy and efficiency of social initiatives, improving the way these actions help humanity in general and people in need in particular. This application field, however, poses its own barriers and challenges when developing data-driven projects, lagging behind in comparison with other scenarios. These challenges derive from aspects such as the scope and scale of the social issue to solve, cultural and political barriers, the skills of main stakeholders and the technological resources available, the motivation to be engaged in such projects, or the ethical and legal issues related to sensitive data. This paper analyzes the application of data projects in the field of social good, reviewing its current state and noteworthy initiatives, and presenting a framework covering the key aspects to analyze in such projects. The goal is to provide guidelines to understand the main challenges and opportunities for this type of data project, as well as identifying the main differential issues compared to “classical” data projects in general. A case study is presented on the initial steps and stakeholder analysis of a data project for the inclusion of refugees in the city of Frankfurt, Germany, in order to empirically confront the framework with a real example.

Keywords: data-driven projects, humanitarian operations, personal and sensitive data, social good, stakeholders analysis

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Authors: Alice Sanwald, Thomas Schober

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We analyze mortality and follow-up costs of heart attack patients using administrative data from Austria (2002-2011). As treatment intensity in a hospital largely depends on whether it has a catheterization laboratory, we focus on the effects of patients' initial admission to these specialized hospitals. To account for the nonrandom selection of patients into hospitals, we exploit individuals' place of residence as a source of exogenous variation in an instrumental variable framework. We find that the initial admission to specialized hospitals increases patients' survival chances substantially. The effect on 3-year mortality is -9.5 percentage points. A separation of the sample into subgroups shows the strongest effects in relative terms for patients below the age of 65. We do not find significant effects on longterm inpatient costs and find only marginal increases in outpatient costs.

Keywords: acute myocardial infarction, mortality, costs, instrumental variables, heart attack

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Authors: Sergei Kosarev

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Wrong treatment tactics for hand and wrist sport-related injuries can lead to the inability to play sports in the future. It is especially important for professional athletes. The members of the Russian Olympic Team are treated in our hospital -Federal Clinical Research Center (Moscow). For their treatment, we use minimally invasive methods such as wrist arthroscopy and also orthobiologics procedures. In 2022 we had cases with scaphoid fracture and TFCC injuries. In all the cases, we were using the arthroscopy technic for treatment. The scaphoid fracture was fixed by K-wires with free bone grafting. For TFCC injures we used transossal sutures. Rehabilitation started the next day after surgery. Rehabilitation included hand therapy and physiotherapy. All athletes returned to the sport after 8-12 weeks after surgery. One of them had pain in the wrist after 12 weeks after surgery, not more than 4 point VAS. Pain syndrome was blocked after 2 PRP injections in the ulnar side of the wrist.

Keywords: sport trauma, wrist arthroscopy, wrist pain, scaphoid fracture

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Authors: Grace Omowunmi Soyebi

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A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved, this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, computing, data, innovation

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Authors: Shamill Amedot Udonwa, Phyllis S. Y. Chong, Lim S. L. Julia, Wee-Joo Chng

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In this paper, we investigated how PRL-3 expression in H929 and U266 cells affects the efficacy of drug treatment. H929 and U266 cells were treated with Bortezomib (BTZ) of different concentrations, and it was observed that H929 cells were resistant to BTZ, while U266 cells were not viable. Investigations into how BTZ targets these cells were conducted, and it was observed that BTZ affects the PARP-Caspase3 pathway as well as PRL-3-Leo1 pathways. These pathways regulate cell proliferation and cell cycle, respectively. Hence, we are able to show the mechanism of how BTZ affects cells and also the role PRL-3 plays on downstream oncogenes such as cyclin-D1 and c-MYC. More importantly, this investigation into PRL-3 in BTZ resistance will be highly applicable in the future as the first clinical trials of PRL-3 antibody (PRL3-zumab) are ongoing at the National University Hospital, Singapore (NUHS). This would mean that understanding the mechanism of resistance through PRL-3, which has yet to be studied, will demonstrate the potential of PRL-3 in developing novel strategies to improve the treatment of MM.

Keywords: drug resistance, hematology, multiple myeloma, oncogene

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Authors: Lamia Bouzgarrou, Amira Omrane, Leila Mrabet, Taoufik Khalfallah

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Background and aims: School accidents are one of the leading causes of morbidity and mortality among pupils and students. Indeed, they may induce an elevated number of lost school days, heavy emotional and physical disabilities, and financial costs on the victims and their families. This study aims to evaluate the annual incidence of school accidents in the central Tunisian governorate of Mahdia and to identify the epidemiological profile of victims and risk factors of these accidents. Methods: A retrospective study was conducted over the period of 5 school years, focusing on school accidents that occurred in public educational institutions (primary, basic, secondary and university) in the governorate of Mahdia (area = 2 966 km² and number of inhabitants in 2014 = 410 812). All accidents declared near the only official insurance of this type of injuries (MASU: Mutual School and University Accidents), and initially taken in charge at the University Hospital of Mahdia were included. Data was collected from the MASU reporting forms and the medical records of emergency and other specialized hospital departments. Results: With 3248 identified victims, the annual incidence of school accidents was equal to 0.69 per 100 pupils and students per year. The average age of victims was 14.51 ± 0.059 years and the sex ratio was 1.58. Pupils aged between 12 and 15 years, were concerned by 46.7% of the identified accidents. The practice of sports was the most relevant circumstances of these accidents (76.2 %). In 56.58 % of cases, falls were the leading mechanism. Bruises and fractures were the most frequent lesions (32.43 % and 30.51 %). Serious school accidents were noted in 28% of cases with hospitalization in 2.27 % of them. The average lost school days, was 12.23±1.73 days. Accidents occurring during sports or leisure activities were significantly more serious (p= 0.021). Furthermore, the frequency of hospitalization was significantly higher among boys (2.81% vs. 1.43%; p= 0.035), students ≤11 years (p= 0.008), and following crush trauma (p= 0.000). In addition, the surgical interventions were statistically more frequent among male victims (p=0.00), accidents occurring during physical education sessions (p=0.000); those associated to falls (p=0.000) and to crushes mechanisms (p=0.002), and injuries affecting lower limbs (p=0.000). Following this Multi-varied analysis concluded that the severity of school accident is correlated to the activity practiced during the trauma and the geographical location of the school. Conclusion: Children and adolescents are one of the most vulnerable groups against incidents with the risk of permanent disability, mainly related to the perturbation of the growth process and physiological limitations. Our five-year study, objectified a real elevate incidence of school accident among children and adolescents, with a considerable rate of severe injuries. In any community, the promotion of adolescents and children’s health is an important indicator of the public health level. Thus, it’s important to develop a multidisciplinary prevention strategy of school accident, based on safety and security rules and adapted to the specificity of our context.

Keywords: children and adolescents, children health, injuries and disability, school accident

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Authors: Launcelot.McGrath

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A comprehensive understanding of physiological data is a vital aid to the anaesthesiologist in monitoring and maintaining the well-being of a patient undergoing surgery. Biosignal analysis is one of the most important topics that researchers have tried to develop over the last century to understand numerous human diseases. Understanding which biological signals are most important during anaesthesia is critically important. It is important that the anaesthesiologist understand both the signals themselves and the limitations introduced by the processes of acquisition. In this article, we provide an overview of different types of biological signals as well as the mechanisms applied to acquire them.

Keywords: general biosignals, anaesthesia, biological, electroencephalogram

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Authors: Safeer Hussain Khan

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In this paper, we prove a strong convergence result using a recently introduced iterative process with contractive-like operators. This improves and generalizes corresponding results in the literature in two ways: the iterative process is faster, operators are more general. In the end, we indicate that the results can also be proved with the iterative process with error terms.

Keywords: contractive-like operator, iterative process, fixed point, strong convergence

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Authors: Sanjaya Humagain, Rajendra Koju

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Background: Rheumatic heart disease (RHD) is the most common cardiovascular disease in children and young adults. Though declined and almost non-existent in developed nations, RHD is still one of the leading cause for premature death and disability in developing countries. Prevalence of RHD is high in both rural as well as urban area of Nepal. Present study is designed to look at the pattern of valvular involvement and demographic features in RHD. Methods: 326 patients indicated for inj. Benzathine penicillin were selected and echocardiograph performed to see the pattern of vavular involvement. Data analysis was done using SPSS 17. Result: The most common type of lesion was mixed type with mitral valve involvement. MR was the most common isolated lesion. MS was more commonly seen in females whereas AS was more common in males. Secondary prophylaxis was more common than primary prophylaxis. Conclusion: RHD still being a major problem and a preventable disease so extensive screening program is required to identify them early and prevent the complication.

Keywords: acute rheumatic fever, RHD, MS, MR, AS, AR, Inj benzathine penicillin

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Authors: M. Marín-Ferrer, M. A. Hernández, T. Tollefsen, S. Vanzo, E. Nweke, P. V. Tognoli, M. De Cort

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Under the terms of Article 36 of the Euratom Treaty, European Union Member States (MSs) shall periodically communicate to the European Commission (EC) information on environmental radioactivity levels. Compilations of the information received have been published by the EC as a series of reports beginning in the early 1960s. The environmental radioactivity results received from the MSs have been introduced into the Radioactivity Environmental Monitoring database (REMdb) of the Institute for Transuranium Elements of the EC Joint Research Centre (JRC) sited in Ispra (Italy) as part of its Directorate General for Energy (DG ENER) support programme. The REMdb brings to the scientific community dealing with environmental radioactivity topics endless of research opportunities to exploit the near 200 millions of records received from MSs containing information of radioactivity levels in milk, water, air and mixed diet. The REM action was created shortly after Chernobyl crisis to support the EC in its responsibilities in providing qualified information to the European Parliament and the MSs on the levels of radioactive contamination of the various compartments of the environment (air, water, soil). Hence, the main line of REM’s activities concerns the improvement of procedures for the collection of environmental radioactivity concentrations for routine and emergency conditions, as well as making this information available to the general public. In this way, REM ensures the availability of tools for the inter-communication and access of users from the Member States and the other European countries to this information. Specific attention is given to further integrate the new MSs with the existing information exchange systems and to assist Candidate Countries in fulfilling these obligations in view of their membership of the EU. Article 36 of the EURATOM treaty requires the competent authorities of each MS to provide regularly the environmental radioactivity monitoring data resulting from their Article 35 obligations to the EC in order to keep EC informed on the levels of radioactivity in the environment (air, water, milk and mixed diet) which could affect population. The REMdb has mainly two objectives: to keep a historical record of the radiological accidents for further scientific study, and to collect the environmental radioactivity data gathered through the national environmental monitoring programs of the MSs to prepare the comprehensive annual monitoring reports (MR). The JRC continues his activity of collecting, assembling, analyzing and providing this information to public and MSs even during emergency situations. In addition, there is a growing concern with the general public about the radioactivity levels in the terrestrial and marine environment, as well about the potential risk of future nuclear accidents. To this context, a clear and transparent communication with the public is needed. EURDEP (European Radiological Data Exchange Platform) is both a standard format for radiological data and a network for the exchange of automatic monitoring data. The latest release of the format is version 2.0, which is in use since the beginning of 2002.

Keywords: environmental radioactivity, Euratom, monitoring report, REMdb

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Authors: Anzal Abbas Jaffari, Wajiha Javed, Naseem Salahuddin

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Rationale: Rabies, a vaccine preventable disease, continues to be a critical public health issue as it kills around 2000-5000 people annually in Pakistan. Along with the disease spread among animals, the dog population remains a victim of brutal culling practices by the local authorities, which adversely affects ecosystem (sinking of poison in the soil – affecting vegetation & contaminating water) and the disease spread. The dog population has been exponentially rising primarily because a lack of a consolidated nationwide Animal Birth Control program and awareness among the local communities in general and children in particular. This is reflected in Pakistan’s low SARE score - 1.5, which makes the country trails behind other developing countries like Bangladesh (2.5) and Philippines (3.5).According to an estimate, the province of Sindh alone is home to almost 2.5 million dogs. The clustering of dogs in Peri-Urban areas and inner cities localities leads to an increase of reported dog bite cases in these areas specifically. Objective: Rabies Free Pakistan (RFP), which is a joint venture of Getz Pharma Private Limited and Indus Hospital & Health Network (IHHN); it was established in 2018 to eliminate Rabies from Pakistan by 2030 using the One Health Approach. Methodology: The RFP team is actively working on advocacy and policy front with both the Federal & Provincial government to ensure that all stakeholders currently involved in dog culling in Pakistan have a paradigm shift towards humane methods of vaccination and ABC. Along with the federal government, RFP aims to declare Rabies as a notifiable disease. Whereas RFP closely works with the provincial government of Sindh to initiate a province wide Rabies Control Program.RFP program follows international standards and WHO approved protocols for this program in Pakistan.RFP team has achieved various milestones in the fight against Rabies after successfully scaling up project operations and has vaccinated more than 30,000 dogs and neutered around 7,000 dogs since 2018. Recommendations: Effective implementation of Rabies program (MDV and ABC) requires a concentrated effort to address a variety of structural and policy challenges. This essentially demands a massive shift in the attitude of individuals towards rabies. The two most significant challenges in implementing a standard policy at the structural level are lack of institutional capacity, shortage of vaccine, and absence of inter-departmental coordination among major stakeholders: federal government, provincial ministry of health, livestock, and local bodies (including local councils). The lack of capacity in health care workers to treat dog bite cases emerges as a critical challenge at the clinical level. Conclusion: Pakistan can learn from the successful international models of Sri Lanka and Mexico as they adopted the One Health Approach to eliminate rabies like RFP. The WHO advised One Health approach provides the policymakers with an interactive and cross-sectoral guide, which involves all the essential elements of the eco system (including animals, humans, and other components).

Keywords: animal birth control, dog population, mass dog vaccination, one health, rabies elimination

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Authors: Pooja Balasubramanian, Ghida Karbala

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Unfair treatment at the workplace encourages workers to adjust their behavior in order to restore fairness and align monetary returns to costs. This adjustment of behavior, however, may differ depending on the reference group considered to evaluate equity. In this aspect two main questions are to be considered: How do workers respond to unfair treatment at the workplace? And how does this response change depending on the identity of the reference group? To answer the above research questions, this paper utilizes data from a randomized field experiment conducted in Kolkata, India where student assistants were hired to help in a data entry task. Recruited workers were working in a team of two and were offered a fixed wage per hour. Workers were randomly assigned to one of the following treatment groups: A control group not subjected (1) to wage cuts (2) A general wage cut (3) A unilateral wage cut in reference to colleagues with similar social identity (4) A unilateral wage cut in reference to colleagues with a different social identity, where social identity is defined in terms of gender. Results show a significant decrease in the quantity and quality of work following a general wage cut. A more severe drop in productivity was presented by men in the case of unilateral wage cut, while women experiencing unilateral wage cuts didn’t exhibit a similar behavior regardless of the gender of the team member. To the contrary, women matched with a male colleague and experiencing unilateral wage cut show a slight increase in productivity, a result that contributes to the discussion regarding the paradox of the 'content female worker'. These findings highlight the necessity of a better understanding of the social comparison processes prevailing at the workplace, given the major role they play in determining the level of productivity supplied.

Keywords: effort supply, fairness, reference groups, social comparison

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Authors: Guram Esakia, Giorgi Goguadze

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The following paper is written due to overview the concept of R2P, this new dimension in International Relations field. Paper contains the general description of previously mentioned concept, its advantages and disadvantages. We also compare each other R2P and“humanitarian intervention“, trying to make clear division between these two approaches in conflict solution. There is also discussed R2P in real action, successful one in Libya and yet failed in Syria. Essay doesn’t claim to be the part of scientific chain and is based only on personal subjection as well on information gathered from various scholars and UN resolutions.

Keywords: the concept of R2P, humanitarian intervention, Libya, Syria

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Authors: T. Marinaci, C. Venuleo

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Different conceptualizations of disease affect patient care. This study aims to address this gap. It explores how health professionals conceptualize gambling problem, addiction and the goals of recovery process. In-depth, semi-structured, open-ended interviews were conducted with Italian psychologists, psychiatrists, general practitioners, and support staff (N= 114), working within health centres for the treatment of addiction (public health services or therapeutic communities) or medical offices. A Lexical Correspondence Analysis (LCA) was applied to the verbatim transcripts. LCA allowed to identify two main factorial dimensions, which organize similarity and dissimilarity in the discourses of the interviewed. The first dimension labelled 'Models of relationship with the problem', concerns two different models of relationship with the health problem: one related to the request for help and the process of taking charge and the other related to the identification of the psychopathology underlying the disorder. The second dimension, labelled 'Organisers of the intervention' reflects the dialectic between two ways to address the problem. On the one hand, they are the gambling dynamics and its immediate life-consequences to organize the intervention (whatever the request of the user is); on the other hand, they are the procedures and the tools which characterize the health service to organize the way the professionals deal with the user’ s problem (whatever it is and despite the specify of the user’s request). The results highlight how, despite the differences, the respondents share a central assumption: understanding gambling problem implies the reference to the gambler’s identity, more than, for instance, to the relational, social, cultural or political context where the gambler lives. A passive stance is attributed to the user, who does not play any role in the definition of the goal of the intervention. The results will be discussed to highlight the relationship between professional models and users’ ways to understand and deal with the problems related to gambling.

Keywords: cultural models, health professionals, intervention models, problem gambling

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Authors: Mirza Waseem Abbas, Syed Danish Raza

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For many countries agriculture is still the major force driving the economy and a critically important socioeconomic sector, despite exceptional industrial development across the globe. In countries like Pakistan, this sector is considered the backbone of the economy, and most of the economic decision making revolves around agricultural outputs and data. Timely and accurate facts and figures about this vital sector hold immense significance and have serious implications for the long-term development of the economy. Therefore, any significant improvements in the statistics and other forms of data regarding agriculture sector are considered important by all policymakers. This is especially true for decision making for the betterment of crops and the agriculture sector in general. Provincial and federal agricultural departments collect data for all cash and non-cash crops and the sector, in general, every year. Traditional data collection for such a large sector i.e. agriculture, being time-consuming, prone to human error and labor-intensive, is slowly but gradually being replaced by remote sensing techniques. For this study, remotely sensed data were used for change detection (machine learning, supervised & unsupervised classification) to assess the increase or decrease in area under agriculture over the last fifteen years due to urbanization. Detailed Landsat Images for the selected agricultural districts were acquired for the year 2000 and compared to images of the same area acquired for the year 2016. Observed differences validated through detailed analysis of the areas show that there was a considerable decrease in vegetation during the last fifteen years in four major agricultural districts of the Punjab province due to urbanization (housing societies).

Keywords: change detection, area estimation, machine learning, urbanization, remote sensing

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Authors: Ashleigh Medina

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Chronic conditions account for the majority of total health care spending both in the United States and globally. Encouraging self-management to improve chronic conditions, which in turn could decrease the strain placed on hospitals, requires resources to address the patient’s social concerns in addition to their medical concerns. Transitional care has been identified as a possible bridge between acutely managing conditions at the hospital to chronically managing conditions in a community setting. The aim of this integrative review was to examine the impact of transitional care on self-management outcomes of chronic conditions in un/underinsured populations. Both transitional care, by assisting with resources such as funding sources for healthcare and medications or identifying a healthcare provider for continued care, and self-management, by increasing responsibility for one’s care through goal setting and taking action, can impact health outcomes while providing health care cost-savings.

Keywords: chronic conditions, self-management, transitional care, uninsured

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Authors: Driss Kettani

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In this paper, we shed light on “Digital Divide 2.0,” which we see as COVID-19’s Version of the Digital Divide! We believe that “Fighting” against Digital Divide 2.0 necessitates for a Country to be seriously advanced in the Global Digital Transformation that is, naturally, a complex, delicate, costly and long-term Process. We build an argument supporting our assumption and, from there, we present the foundations of a computational framework to guide and streamline Digital Transformation at all levels.

Keywords: digital divide 2.0, digital transformation, ICTs for development, computational outcomes assessment

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Authors: Shogo Kato, Daisuke Okamoto, Satoko Tsuru, Yoshinori Iizuka, Ryoko Shimono

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Healthcare safety has been perceived important. It is essential to prevent troubles in healthcare processes for healthcare safety. Trouble prevention is based on trouble prediction using accumulated knowledge on processes, troubles, and countermeasures. However, information on troubles has not been accumulated in hospitals in the appropriate structure, and it has not been utilized effectively to prevent troubles. In the previous study, though a detailed knowledge acquisition process for trouble prediction was proposed, the knowledgebase for countermeasures was not involved. In this paper, we aim to propose the structure of the knowledgebase for countermeasures in the knowledge acquisition process for trouble prediction in healthcare process. We first design the structure of countermeasures and propose the knowledge representation form on countermeasures. Then, we evaluate the validity of the proposal, by applying it into an actual hospital.

Keywords: trouble prevention, knowledge structure, structured knowledge, reusable knowledge

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Authors: Arvan Prakash Ankitha, Madasamy Arockiasamy

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The increasing demand for adopting pile foundations in bridgeshas pointed towardsthe need to constantly improve the existing analytical techniques for better understanding of the behavior of such foundation systems. This study presents a simplistic approach using the energy-based method to assess the displacement responses of piles subjected to general loading conditions: Axial Load, Lateral Load, and a Bending Moment. The governing differential equations and the boundary conditions for a bridge pile embedded in multi-layered soil strata subjected to the general loading conditions are obtained using the Hamilton’s principle employing variational principles and minimization of energies. The soil non-linearity has been incorporated through simple constitutive relationships that account for degradation of soil moduli with increasing strain values.A simple power law based on published literature is used where the soil is assumed to be nonlinear-elastic and perfectly plastic. A Tresca yield surface is assumed to develop the soil stiffness variation with different strain levels that defines the non-linearity of the soil strata. This numerical technique has been applied to a pile foundation in a two - layered soil strata for a pier supporting the bridge and solved using the software MATLAB R2019a. The analysis yields the bridge pile displacements at any depth along the length of the pile. The results of the analysis are in good agreement with the published field data and the three-dimensional finite element analysis results performed using the software ANSYS 2019R3. The methodology can be extended to study the response of the multi-strata soil supporting group piles underneath the bridge piers.

Keywords: pile foundations, deep foundations, multilayer soil strata, energy based method

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Authors: David Ming Liu, Benjamin Hirsch, Bashir Aden

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Syndromic surveillance is to detect or predict disease outbreaks through the analysis of medical sources of data. Using social media data like tweets to do syndromic surveillance becomes more and more popular with the aid of open platform to collect data and the advantage of microblogging text and mobile geographic location features. In this paper, a Syndromic Surveillance Framework is presented with machine learning kernel using tweets data analytics. Influenza and the three cities Abu Dhabi, Al Ain and Dubai of United Arabic Emirates are used as the test disease and trial areas. Hospital cases data provided by the Health Authority of Abu Dhabi (HAAD) are used for the correlation purpose. In our model, Latent Dirichlet allocation (LDA) engine is adapted to do supervised learning classification and N-Fold cross validation confusion matrix are given as the simulation results with overall system recall 85.595% performance achieved.

Keywords: Syndromic surveillance, Tweets, Machine Learning, data mining, Latent Dirichlet allocation (LDA), Influenza

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Authors: A. Alrasheed, I. Connerton

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Providing patients with safe meals on a daily basis is one of the challenges in the healthcare sector. In Saudi Arabia matters related to food safety and hygiene have been the heart of the Ministry of Health (MOH) and Saudi Food and Drugs Authority (SFDA). The aim of this study is to examine the causes of inadequate implementation of food safety management systems such as HACCP in Riyadh’s MOH hospitals. By the law, food safety must be managed using a documented, HACCP based approach, and food handlers must be appropriately trained in food safety. Food handlers in Saudi Arabia are not required to provide a certificate or attend a food handling training course even in healthcare sectors. Since food safety and hygiene issues are of increasing importance for Saudi Arabian health decision makers, the SFDA has been established to apply food hygiene requirements in all food operations. It should be pointed out that the implications of food outbreaks on the whole society may potentially go beyond individual health impacts but also impact on the Nation’s health and bring about economic repercussions.

Keywords: food safety, patient, hospital, HACCP

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Authors: Amel Chenafa, Sihem Boulenouar, Linda Aoued, Imane Sediri, Ismahan Djebbar, Mohamed Adil Selka

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Introduction: The specialties intended for adults are often inadequate marketed for pediatric use, such as for a galenic form or in the dosage. For an industrial, development of a pediatric drug is confronted to various problems. So, the hospital pharmacies have to respond to adaptation needs of pharmaceutical forms for pediatric use. The objective of our work is to develop an oral form of prednisone for pediatric use since no adapted form to children is commercialized. Materials and Methods: Therefore an extemporaneous syrup of prednisone was prepared at the concentration of 0,5mg/ml from 5mg tablets and stored in amber glass bottles. Organoleptic and microbiological stability was studied in two temperatures: 5°C and 25°C, and evaluated at D0, D15, and D30. Results: No organoleptic changes have been detected on the syrup conserved at 25 and 5°C. The results show that there is no presence of bacteria, yeasts, and molds in the syrups stored at both temperatures during the analysis period. Conclusion: Sheltered from light, the developed syrup of prednisone remained stable at room temperature and/or refrigerator for 30 days.

Keywords: extemporaneous syrup, pediatric drug, prednisone, stability

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Authors: Ameer Alalwan

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Summary: The aim of this research is to identify trends of municipal council member in practicing his administrative control, decision-making, and counsultive role on municipalities' main municipal activities in the kingdom of Saudi Arabia. This research is conducted after the implementation of the new municipal system resolution no. (M\61) in 1435 in the work of municipal councils for the third session. To achieve the goal of this research, a questionnaire has been designed to obtain the opinion of municipal councils on this matter. This questionnaire has been tested for reliability and validity. The results of this research show that in general performance of municipal council is moderate after the implementation of the new municipal system resolution no. (M\61) in 1435 in the work of municipal councils for the third session. Also, extend that municipal council member practice his roles on the main municipality activities is moderate and weak. In addition, results show that municipal council member practice big role in decision-making, and moderate role in administrative control, and weaker role in giving opinion on municipality main issues. Furthermore, the results show that there is a significant difference between municipal council member's responses by the change of their Personal characteristics. Educated and appointed municipal council members practicing their role more than others do. In addition, municipal council presidents, and vice presidents, and in regional and sub-regional municipalities practice their role more than others do. Finally, this research in general recommened that muincialty council member must be empowered, so that he can practice his role on muicipality main activities. In addition, research suggest, granting municipal council member the authority, resources needed, training and appointment of qualified members, so that they will be able to practice their roles. Furthermore, this research suggest for the time being maintain certain percent of municipal council's appointed until this experience mature in the kingdom.

Keywords: municipal council, municipal council member, municipality, decision-making role

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Authors: Pierre Mintom, Armel Assiene Agamou, Leslie Toukem, William Dakam, Christine Fernande Nyangono Biyegue

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Context: Hyperuricemia, the presence of high levels of uric acid in the blood, is a known precursor to the development of gout. Recent studies have suggested a strong association between hyperuricemia and disorders of lipoprotein metabolism, specifically hypercholesterolemia. Understanding the factors associated with these conditions in gout patients is essential for effective treatment and management. Research Aim: The objective of this study was to determine the prevalence of hyperuricemia, hypercholesterolemia, and the double burden of hyperuricemia-hypercholesterolemia in the gouty population. Additionally, the study aimed to identify the factors associated with these conditions. Methodology: The study utilized a database from a survey of 150 gouty patients recruited at the Laquintinie Hospital in Douala between August 2017 and February 2018. The database contained information on anthropometric parameters, biochemical markers, and the food and drugs consumed by the patients. Hyperuricemia and hypercholesterolemia were defined based on specific serum uric acid and total cholesterol thresholds, and the double burden was defined as the co-occurrence of hyperuricemia and hypercholesterolemia. Findings: The study found that the prevalence rates for hyperuricemia, hypercholesterolemia, and the double burden were 61.3%, 76%, and 50.7% respectively. Factors associated with these conditions included hypertriglyceridemia, atherogenicity index TC/HDL ratio, atherogenicity index LDL/HDL ratio, family history, and the consumption of specific foods and drinks. Theoretical Importance: The study highlights the strong association between hyperuricemia and dyslipidemia, providing important insights for guiding treatment strategies in gout patients. Additionally, it emphasizes the significance of nutritional education in managing these metabolic disorders, suggesting the need to address eating habits in gout patients. Data Collection and Analysis Procedures: Data was collected through surveys and medical records of gouty patients. Information on anthropometric parameters, biochemical markers, and dietary habits was recorded. Prevalence rates and associated factors were determined through statistical analysis, employing odds ratios to assess the risks. Question Addressed: The study aimed to address the prevalence rates and associated factors of hyperuricemia, hypercholesterolemia, and the double burden in gouty patients. It sought to understand the relationships between these conditions and determine their implications for treatment and nutritional education. Conclusion: Findings show that it’s exists an association between hyperuricemia and hypercholesterolemia in gout patients, thus creating a double burden. The findings underscore the importance of considering family history and eating habits in addressing the double burden of hyperuricemia-hypercholesterolemia. This study provides valuable insights for guiding treatment approaches and emphasizes the need for nutritional education in gout patients. This study specifically focussed on the sick population. A case–control study between gouty and non-gouty populations would be interesting to better compare and explain the results observed.

Keywords: gout, hyperuricemia, hypercholesterolemia, double burden

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Authors: Kiran Bala

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Health, education and employment opportunities available for a common citizen reflect the development status of a country. Health of an individual affects the growth of a country in every aspect. According to a study by WHO, India is estimated to lose more than $237 billion of its GDP over the period 2006-15 on account of premature death and morbidity from Non-communicable diseases alone. Each year 37 million people fall below poverty line due to high expenditure on health services they have to incur. Falling sick puts a double burden on them in terms of loss of income and expenditure on health care which pushes them further into debt and poverty. Adding to the gravity of situation, public spending on health in India has itself declined after liberalization from 1.3% of GDP in 1990 to 0.9% in 1999. The Approach Paper of the Government of India to the Twelfth Five Year Plan indicated that health expenditure alone as a per cent of GDP was about 1.4 per cent (B.E.) in 2011-12. It also mentioned that if one included expenditure on rural water supply and sanitation, the figure would be about 1.8 per cent. Given the abysmally low level of priority accorded to health in Indian economic policy, it becomes rather important to study the representation of health in the Indian public sphere. To this end, this study examines the prioritization of health in the public policy agenda of the national/regional political parties as evidenced in their election manifestos at a time when the nation is poised to go for the General Elections. The paper also focuses attention on the prioritization of health in the public perception as evidenced in their reasons for their preferences for a particular party or individual contestant. To arrive at the reasons for the priority level accorded by the political actors and the citizens, the study uses Focus groups of health policy makers, media persons, medical practitioners and voters. Collected data will be analysed in the theoretical framework of spiral of silence and agenda setting theory.

Keywords: health, election manifestos, public perception, policies

Procedia PDF Downloads 358