Search results for: electronic health records (ehrs)

Authors: Chandralekha Ashangari, Amer Suleman

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Background and Purpose: The Postural Orthostatic Tachycardia Syndrome (POTS) affects primarily young women. POTS is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans, and millions more around the world. POTS is a form of orthostatic intolerance that is associated with many Gastrointestinal disturbances. The aim of this study is to determine the Gastrointestinal disturbances in Postural Orthostatic Tachycardia Syndrome (POTS) patients.2. Methods: 249 patients referred to our clinic from January to November with POTS. Reviewed the medical records of 249 POTS patients and gastrointestinal symptoms. Results: however out of 249 patients, 226 patients are female (90.76%; average age 32.69), 23 patients are male (9.24%; average age 27.91) Data analysis: Out of 249 patients 189 patients (76%) had vomiting or nausea, 150 patients (60%) had irritable bowel syndrome, 128 patients (51%) had bloating, 125 patients (50%) had constipation , 80 patients (32%) had abdominal pain, 56 patients (22%) had delayed gastric emptying, 24 patients (10%) had lactose intolerance, 8 patients (3%) had Gastroesophageal reflux disease, 5 patients (2%) had Iron deficiency anemia, 6 patients (2%) had Peptic ulcer disease, 4 patients (2%) had Celiac Disease. Conclusion: Patients with POTS have a very high prevalence of gastrointestinal symptoms however the majority of abnormalities appear to be motility related. Motility testing should be performed be performed in POTS patients. The diagnostic yield of endoscopic procedures appears to be low.

Keywords: gastrointestinal disturbances, Postural Orthostatic Tachycardia Syndrome (POTS), celiac disease, POTS patients

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Authors: Mulusew G. Jebena, David Lindstrom, Tefera Belachew, Craig Hadley, Carl Lachat, Patrick Kolsteren

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Background: The biological and psychosocial consequence of food insecurity on physical health and nutritional status has been reported. But, its effect on mental health during adolescence remains unexplored. Thus, the main aim of this analysis is to examine the mechanism by which food insecurity is linked to mental health among adolescents living in Jimma, Southwest Ethiopia. Methods: We used data from third round observation of Jimma Longitudinal Family and Youth Survey (JLFSY). A total of 1,521 adolescents included for the main analysis. Food insecurity was measured using 5-items scale and The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress. Structural equation modeling analysis was done using maximum likelihood estimation method. Model diagnostics test was reported. All p values were two tailed and P value ≤ 0.05 was used to determine statistical significance. Results: The prevalence of mental distress was 20.8%, 95% CI: (18.8, 22.9). After adjusted for covariates, the final model depicts food insecurity was associated with adolescent mental distress (β=.324). This analysis showed 94.1% of the effect of food insecurity on mental distress is direct. By contrast, 5.9% of the food insecurity effect is mediated by physical health. In addition, Self-rated health (β=.356), socioeconomic status (β=-.078) parental educational (β= .170), living in urban (β= .193) and female headed household (β=.205) were associated with adolescent mental distress. Conclusions: This finding highlights the direct effect of food insecurity on adolescent mental distress. Therefore, any intervention aimed to improve mental distress of adolescents should consider strategies to improve access to sufficient, safe, and nutritious food. Beside this, prevention of underlying factors such as psychosomatic health illness and improving socio economic status is also very critical. Furthermore longitudinal relationship of the long term effect of food insecurity on mental health should be investigated.

Keywords: adolescent, Ethiopia, food insecurity, mental health

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Authors: Wilai Masanga, Chirapha Tannanonta, Sangutid Thongsawad, Sasikarn Chamchod, Todsaporn Fuangrod

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The major factors of radiotherapy for head and neck (HN) cancers include patient’s anatomical changes and tumour shrinkage. These changes can significantly affect the planned dose distribution that causes the treatment plan deterioration. A measured transit EPID images compared to a predicted EPID images using gamma analysis has been clinically implemented to verify the dose accuracy as part of adaptive radiotherapy protocol. However, a global gamma analysis dose not sensitive to some critical organ changes as the entire treatment field is compared. The objective of this feasibility study is to evaluate the dosimetric response to patient anatomical changes during the treatment course in HN IMRT (Head and Neck Intensity-Modulated Radiation Therapy) using a novel comparison method; organ-of-interest gamma analysis. This method provides more sensitive to specific organ change detection. Random replanned 5 HN IMRT patients with causes of tumour shrinkage and patient weight loss that critically affect to the parotid size changes were selected and evaluated its transit dosimetry. A comprehensive physics-based model was used to generate a series of predicted transit EPID images for each gantry angle from original computed tomography (CT) and replan CT datasets. The patient structures; including left and right parotid, spinal cord, and planning target volume (PTV56) were projected to EPID level. The agreement between the transit images generated from original CT and replanned CT was quantified using gamma analysis with 3%, 3mm criteria. Moreover, only gamma pass-rate is calculated within each projected structure. The gamma pass-rate in right parotid and PTV56 between predicted transit of original CT and replan CT were 42.8%( ± 17.2%) and 54.7%( ± 21.5%). The gamma pass-rate for other projected organs were greater than 80%. Additionally, the results of organ-of-interest gamma analysis were compared with 3-dimensional cone-beam computed tomography (3D-CBCT) and the rational of replan by radiation oncologists. It showed that using only registration of 3D-CBCT to original CT does not provide the dosimetric impact of anatomical changes. Using transit EPID images with organ-of-interest gamma analysis can provide additional information for treatment plan suitability assessment.

Keywords: re-plan, anatomical change, transit electronic portal imaging device, EPID, head, and neck

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Authors: Saeeda Batool, Ather Maqsood Ahmed

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This study investigates the impact of public healthcare facilities and socio-economic circumstances on the status of child health in Pakistan. The complete analysis is carried out in correspondence with fourth and sixth millennium development goals. Further, the health variables chosen are also inherited from targeted indicators of the mentioned goals (MDGs). Trends in the Human Opportunity Index (HOI) for both health inequalities and coverage are analyzed using the Pakistan Social and Living Standards Measurement (PLSM) data set for 2001-02 to 2012-13 at the national and provincial level. To reveal the relative importance of each circumstance in achieving the targeted values for child health, Shorrocks decomposition is applied on HOI. The annual point average growth rate of HOI is used to simulate the time period for the achievement of target set by MDGs and universal access also. The results indicate an improvement in HOI for a reduction in child mortality rates from 52.1% in 2001-02 to 67.3% in 2012-13, which confirms the availability of healthcare opportunities to a larger segment of society. Similarly, immunization against measles and other diseases such as Diphtheria, Polio, Bacillus Calmette-Guerin (BCG), and Hepatitis has also registered an improvement from 51.6% to 69.9% during the period of study at the national level. On a positive note, no gender disparity has been found for child health indicators and that health outcome is mostly affected by the parental and geographical features and availability of health infrastructure. However, the study finds that this achievement has been uneven across provinces. Pakistan is not only lagging behind in achieving its health goals, disappointingly with the current rate of health care provision, but it will take many additional years to achieve its targets.

Keywords: socio-economic circumstances, unmet MDGs, public healthcare services, child and infant mortality

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Authors: Xiaomin Zhong, Alexander Pate, Ya-Ting Yang, Ali Fahmi, Darren M. Ashcroft, Ben Goldacre, Brian Mackenna, Amir Mehrkar, Sebastian C. J. Bacon, Jon Massey, Louis Fisher, Peter Inglesby, Kieran Hand, Tjeerd van Staa, Victoria Palin

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Background: This study aimed to predict risks of potentially inappropriate antibiotic type and repeat prescribing and assess changes during COVID-19. Methods: With the approval of NHS England, we used the OpenSAFELY platform to access the TPP SystmOne electronic health record (EHR) system and selected patients prescribed antibiotics from 2019 to 2021. Multinomial logistic regression models predicted the patient’s probability of receiving an inappropriate antibiotic type or repeating the antibiotic course for each common infection. Findings: The population included 9.1 million patients with 29.2 million antibiotic prescriptions. 29.1% of prescriptions were identified as repeat prescribing. Those with same-day incident infection coded in the EHR had considerably lower rates of repeat prescribing (18.0%), and 8.6% had a potentially inappropriate type. No major changes in the rates of repeat antibiotic prescribing during COVID-19 were found. In the ten risk prediction models, good levels of calibration and moderate levels of discrimination were found. Important predictors included age, prior antibiotic prescribing, and region. Patients varied in their predicted risks. For sore throat, the range from 2.5 to 97.5th percentile was 2.7 to 23.5% (inappropriate type) and 6.0 to 27.2% (repeat prescription). For otitis externa, these numbers were 25.9 to 63.9% and 8.5 to 37.1%, respectively. Interpretation: Our study found no evidence of changes in the level of inappropriate or repeat antibiotic prescribing after the start of COVID-19. Repeat antibiotic prescribing was frequent and varied according to regional and patient characteristics. There is a need for treatment guidelines to be developed around antibiotic failure and clinicians provided with individualised patient information.

Keywords: antibiotics, infection, COVID-19 pandemic, antibiotic stewardship, primary care

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Authors: Abdel-Aziz M. Mohamed, Nermeen Coutry

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Lead time is an important measure of supply chain performance. It impacts both customer satisfactions as well as the total cost of inventory. This paper presents the result of a study on the analysis of the customer order lead-time for a multinational company. In the study, the lead time was divided into three stages: order entry, order fulfillment, and order delivery. A sample of size 2,425 order lines from the company records were considered for this study. The sample data includes information regarding customer orders from the time of order entry until order delivery. Data regarding the lead time of each sage for different orders were also provided. Summary statistics on lead time data reveals that about 30% of the orders were delivered after the scheduled due date. The result of the multiple linear regression analysis technique revealed that component type, logistics parameter, order size and the customer type have significant impact on lead time. Data analysis on the stages of lead time indicates that stage 2 consumes over 50% of the lead time. Pareto analysis was made to study the reasons for the customer order delay in each of the 3 stages. Recommendation was given to resolve the problem.

Keywords: lead time reduction, customer satisfaction, service quality, statistical analysis

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Authors: Susanne Gustafsson

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Life-history research is an extraordinarily fruitful method to use for social analysis and gendered health analysis in particular. Its potential is illustrated through a case study drawn from a Swedish project. It reveals an old type of masculinity that faces difficulties when carrying out two sets of demands simultaneously, as a worker/manager and as a father/husband. The paper illuminates the historical transformation of masculinity and the consequences of this for health. We draw on the idea of the “changing faces of masculinity” to explore the dynamism and complexity of gendered health. An empirical case is used for its illustrative abilities. Jan, a middle-level manager and father employed in the energy sector in urban Sweden is the subject of this paper. Jan’s story is one of 32 semi-structured interviews included in an extended study focusing on well-being at work. The results reveal a face of masculinity conceived of in middle-level management as tacitly linked to the neoliberal doctrine. Over a couple of decades, the idea of “flexibility” was turned into a valuable characteristic that everyone was supposed to strive for. This resulted in increased workloads. Quite a few employees, and managers, in particular, find themselves working both day and night. This may explain why not having enough time to spend with children and family members is a recurring theme in the data. Can this way of doing be linked to masculinity and health? The first author’s research has revealed that the use of gender in health science is not sufficiently or critically questioned. This lack of critical questioning is a serious problem, especially since ways of doing gender affect health. We suggest that gender reproduction and gender transformation are interconnected, regardless of how they affect health. They are recognized as two sides of the same phenomenon, and minor movements in one direction or the other become crucial for understanding its relation to health. More or less, at the same time, as Jan’s masculinity was reproduced in response to workplace practices, Jan’s family position was transformed—not totally but by a degree or two, and these degrees became significant for the family’s health and well-being. By moving back and forth between varied events in Jan’s biographical history and his sociohistorical life span, it becomes possible to show that in a time of gender transformations, power relations can be renegotiated, leading to consequences for health.

Keywords: changing faces of masculinity, gendered health, life-history research method, subverter

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Authors: Haveesha Buddhdev

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The most important right for a human being in a society is the freedom of expression as stated by Article 18 and 19 of the Universal Declaration of Human rights pledged by member states of United Nations. Will it be fair to expect him/her to be of sound mental health if this right is taken away? Religion as a primary social institution controls many rights, freedoms and duties of people in a society. It does so by imposing certain values and beliefs on people which would either enhance quality of life or curb their freedom adversely thus affecting individual mental health. This paper aims to study the positive and negative role that religion plays in influencing one’s freedom of expression. This paper will focus on reviewing existing studies on the positive and negative impacts of religion on mental health. It will also contain data collected by the researcher about the impacts of religion on freedom of expression which will be obtained by surveying a sample of 30 adolescents and young adults. The researcher will use a Likert scale for these purpose, with response options ranging from strongly disagree to strongly agree and quantify it accordingly. Descriptive statistics would be used to analyse the data. Such research would help to identify possible problems faced by adolescents and young adults when it comes to religio-cultural ethos and also facilitate further researches to study the role that religion plays in mental health.

Keywords: cultural Ethos, freedom of expression, adolescent mental health, social science

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Authors: Adelaja O. Oriade

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The Nigerian hip-hop music genre, like the African American scene where it was adopted from, is riddled with musical lyrics that amplify and normalize hypermasculinity, homophobia, sexism, and objectification of women. Several factors are responsible for this anomaly; however, the greatest factor is the urge of hip-hop musicians to achieve the commercial success that is dependent on selling records and appealing to the established societal accepted norm for hip-hop music. Consequently, this paper presents a counter-narrative of this gender representation within the Nigerian hip-hop industry. This study analyzed the musical lyrics of the ‘Hypocrisy’ track on the 2019 album of famous Nigerian rapper, Falz the Bahd Guy; and argued that Falz in this album challenged the predominant ideas of hegemonic masculinity by singing in favor of LGBT people and women. Also, based on the success of this album, this paper argues that a hip-hop album can achieve commercial success without aligning with predominant hip-hop parameters of gender representation. The study recommends that future studies should evaluate the reactions of Nigerians to these gender presentations by Falz the Bahd guy.

Keywords: hegemonic masculinity, hypermasculinity, LGBT, misogyny, sexism

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Authors: Susumu Fukita, Hiromi Kawasaki, Satoko Yamasaki, Kotomi Yamashita, Tomoko Iki

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The increase in the number of workers with mental health problems has become an issue. Many workers work in small- and medium-sized enterprises, which often support local employment and economy, especially in underpopulated mountainous areas. It is important for managers to take mental health measures for employees since there is no budget to hire health staff in small- and medium-sized enterprises. It is necessary to understand the manager's attitude toward the mental health of employees and to publicly support the manager in promoting mental health measures for employees. The purpose of this study was to study the awareness of managers of small- and medium-sized enterprises regarding the mental health of employees and to consider support for managers to take measures for the mental health of employees. Semi-structured interviews were conducted with six managers of small- and medium-sized enterprises in underpopulated mountainous areas in November 2019. Managers were asked about their awareness of the mental health of their employees. Qualitative descriptive analysis was used, and subcategories and categories were extracted. Four categories emerged. Regarding the mental health of employees, the managers acknowledged that if the appearance and behavior of the employees do not interfere with their lives, the manager judges that the employees’ mental health is normal. It was also found that the managers acknowledged that there is a comfortable working environment due to the characteristics of the underpopulated mountainous area. On the other hand, the managers acknowledged that employees are dissatisfied with salaries and management systems. In addition, it was found the manager acknowledged that some employees retire due to mental health problems. Although managers recognized that employees may be dissatisfied with salaries, they also recognized that there was a comfortable working environment due to the characteristics of the areas, with good interpersonal relationships. Economic challenges are difficult to solve in underpopulated mountainous areas. It is useful to consider measures that take advantage of the characteristics of the areas where it is easy to work because of good relations with each other, for example, to create a family-like workplace culture where managers and employees can engage in daily conversation. The managers judged that the employees were in good health if there was no interference with their lives. However, it is too late to take measures at the stage when it becomes an obstacle to life. Therefore, it is necessary to provide training for managers to learn observation techniques by which they quickly notice changes in the situation of employees and give appropriate responses; and to set up a contact point for managers to consult. Local governments should actively provide public support such as training for managers and establishing consultation desks to maintain valuable employment and local economics in underpopulated mountainous areas.

Keywords: employer, mental health, small- and medium- sized enterprises, underpopulated areas

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Authors: John Segars

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Built out of a real-world need to have better, more detailed, asset and infrastructure documentation, this project will lay out the case for using the database functionality of ArcGIS as a tool to track and maintain infrastructure location, status, maintenance and serviceability. Workflows and processes will be presented and detailed which may be applied to an organizations’ infrastructure needs that might allow them to make use of the robust tools which surround the ArcGIS platform. The end result is a value-added information system framework with a geographic component e.g., the spatial location of various I.T. assets, a detailed set of records which not only documents location but also captures the maintenance history for assets along with photographs and documentation of these various assets as attachments to the numerous feature class items. In addition to the asset location and documentation benefits, the staff will be able to log into the devices and pull SNMP (Simple Network Management Protocol) based query information from within the user interface. The entire collection of information may be displayed in ArcGIS, via a JavaScript based web application or via queries to the back-end database. The project is applicable to all organizations which maintain an IT infrastructure but specifically targets post-secondary educational institutions where access to ESRI resources is generally already available in house.

Keywords: ESRI, GIS, infrastructure, network documentation, PostgreSQL

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Authors: Seyoung Kim, Jeongmin Kim, Kwang Ryel Ryu

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A database that records average traffic speeds measured at five-minute intervals for all the links in the traffic network of a metropolitan city. While learning from this data the models that can predict future traffic speed would be beneficial for the applications such as the car navigation system, building predictive models for every link becomes a nontrivial job if the number of links in a given network is huge. An advantage of adopting k-nearest neighbor (k-NN) as predictive models is that it does not require any explicit model building. Instead, k-NN takes a long time to make a prediction because it needs to search for the k-nearest neighbors in the database at prediction time. In this paper, we investigate how much we can speed up k-NN in making traffic speed predictions by reducing the amount of data to be searched for without a significant sacrifice of prediction accuracy. The rationale behind this is that we had a better look at only the recent data because the traffic patterns not only repeat daily or weekly but also change over time. In our experiments, we build several different k-NN models employing different sets of features which are the current and past traffic speeds of the target link and the neighbor links in its up/down-stream. The performances of these models are compared by measuring the average prediction accuracy and the average time taken to make a prediction using various amounts of data.

Keywords: big data, k-NN, machine learning, traffic speed prediction

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Authors: Jeremiah L. Chukwuneke, Obiora E. Anisiji, Chinonso H. Achebe, Paul C. Okolie

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This paper developed a mathematical model of a commercial biogas plant for urban area clean energy requirement. It identified biodegradable waste materials like domestic/city refuse as economically viable alternative source of energy. The mathematical formulation of the proposed gas plant follows the fundamental principles of thermodynamics, and further analyses were accomplished to develop an algorithm for evaluating the plant performance preferably in terms of daily production capacity. In addition, the capacity of the plant is equally estimated for a given cycle of operation and presented in time histories. A nominal 1500 m3 power gas plant was studied characteristically and its performance efficiency evaluated. It was observed that the rate of bio gas production is essentially a function of the reactor temperature, pH, substrate concentration, rate of degradation of the biomass, and the accumulation of matter in the system due to bacteria growth. The results of this study conform to a very large extent with reported empirical data of some existing plant and further model validations were conducted in line with classical records found in literature.

Keywords: energy and mass conservation, specific growth rate, thermophilic bacteria, temperature, rate of bio gas production

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Authors: Jun Young Moon, Hyeonggeon Lee, Jong Tae Kim

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In this paper, we present Cortex-M3 based virtual platform which can virtualize wearable hardware platform and evaluate hardware performance. Cortex-M3 is very popular microcontroller in wearable devices, hardware sensors and display devices. This platform can be used to implement software layer for specific hardware architecture. By using the proposed platform the software development process can be parallelized with hardware development process. We present internal mechanism to implement the proposed virtual platform and describe how to use the proposed platform to develop software by using case study which is low cost wearable device that uses Cortex-M3.

Keywords: electronic system level design, software development, virtual platform, wearable device

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Authors: Wenmin Qu

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A capacitance level sensor with a segmented film electrode and a thin-film volume flow sensor with an innovative by-pass sleeve is presented as industrial products for the application in a harsh environment. The working principle of such sensors is well known; however, the traditional sensors show some limitations for certain industrial measurements. The two sensors presented in this paper overcome this limitation and enlarge the application spectrum. The problem is analyzed, and the solution is given. The emphasis of the paper is on developing the problem-solving concepts and the realization of the corresponding measuring circuits. These should give advice and encouragement, how we can still develop electronic measuring products in an almost saturated market.

Keywords: by-pass sleeve, charge transfer circuit, fixed ΔT circuit, harsh environment, industrial application, segmented electrode

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Authors: Kopila Shrestha

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Adolescent sexual reproductive health is one of the most important issues in the world. Reproductive ability is taking place at an earlier age and adolescents are indulging in risk taking behaviors day by day. A descriptive cross-sectional study was conducted in Kathmandu valley to assess the knowledge regarding sexual and reproductive health among adolescent. Total of 200 respondents were selected through non-probability convenient sampling technique. Self-administered written questionnaires using semi-structured questions were used. The collected data were analyzed by using descriptive statistics such as frequency, percentage, mean, standard deviation and inferential statistics such as Chi-square test. The findings revealed that most of the respondents had adequate knowledge regarding transmission and protection of HIV/AIDs and STIs but still some respondents had a misconception regarding it. Few respondents had knowledge regarding legal age for marriage and the minimum age for first child bearing. The statistical analysis revealed that the total mean knowledge score with standard deviation was 45.02±8.674. Nearly half of the respondents (49.5%) had a moderate level of knowledge, followed by an inadequate level of knowledge 29.5% and adequate level of knowledge 21.0% regarding sexual and reproductive health. There was significant association of level of knowledge with area of residence (p-value .002) but no association with age (p-value .067), sex (p-value .999), religion (p-value .082) and ethnicity (p-value .114). Nearly half of the participants possess some knowledge about sexual and reproductive health but still effective educational intervention is required in higher secondary school to encourage more sensible and healthy behaviour.

Keywords: adolescents, higher secondary school, knowledge, sexual and reproductive health

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Authors: Koushik Roy, Sourav Gur, Sudib K. Mishra

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Evidence of pulse type features in near-fault ground motions has raised serious concern to the structural engineering community, in view of their possible implications on the behavior of structures located on the fault regions. Studies in the recent past explore the effects of pulse type ground motion on the special structures, such as transmission towers in view of their high flexibility. Identically, long period sloshing of liquid in the storage tanks under dynamic loading might increase their failure vulnerability under near-fault pulses. Therefore, the behavior of the elevated liquid storage tank is taken up in this study. Simple lumped mass model is considered, with the bilinear force-deformation hysteresis behavior. Set of near-fault seismic ground acceleration time histories are adopted for this purpose, along with the far-field records for comparison. It has been demonstrated that pulse type motions lead to significant increase of the responses; in particular, sloshing of the fluid mass could be as high as 5 times, then the far field counterpart. For identical storage capacity, slender tanks are found to be more vulnerable than the broad ones.

Keywords: far-field motion, hysteresis, liquid storage tank, near fault earthquake, sloshing

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Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Ji-Wook Mauk, Yu-Suk Kim, Hyung-Joon Kim

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This study carried out comparative seismic performance of reinforced concrete frames infilled by masonry walls with different heights. Partial and fully infilled RC frames were modeled for the research objectives and the analysis model for a bare reinforced concrete frame was established for comparison. Non-linear static analyses for the studied frames were performed to investigate their structural behavior under extreme loading conditions and to find out their collapse mechanism. It was observed from analysis results that the strengths of the partial infilled RC frames are increased and their ductility is reduced, as infilled masonry walls are higher. Especially, Reinforced concrete frames with a higher partial infilled masonry wall would experience shear failures. Non-linear dynamic analyses using 10 earthquake records show that the bare and fully infilled reinforced concrete frames present stable collapse mechanism while the reinforced concrete frames with a partially infilled masonry wall collapse in more brittle manner due to short-column effects.

Keywords: fully infilled RC frame, partially infilled RC frame, masonry wall, short-column effect

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Authors: Salwa Obeisat

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Obesity had become a global issue and a major public health concern, because of its impact on the public health. Obstetric and midwifery evidences reported that maternal obesity an important issue, because of its associated complications like obstructed labors, infections, and hemorrhage. People who are obese are often stigmatized and blamed for their weight. Health care providers are not immune to obesity-related prejudice, and the literature features several examples of their negative attitudes towards obese patients. In Jordan, few studies were conducted to investigate obesity prevalence rate and its associated factors. The purposes of this study were to assess the health care providers' attitudes toward overweight and obese women during the childbirth in the North of Jordan and to investigate the relationships between health care providers' socio-demographic characteristics and their attitudes. A descriptive, cross-sectional design was utilized. A convenient sample was consisted of 95 midwives, 30 nurses and 62 obstetricians, who were working in the labor rooms. A self-administered questionnaire consisted of three sections: demographical data, Arabic version of Fat Phobia Scale (FPS), and Arabic version of Nurses' Attitudes toward Obesity and Obese Patients Scale (NATOOPS). Results: The study findings revealed that the majority of Jordanian health care providers held negative attitudes toward overweight and obese women during childbirth. Midwives held less negative attitudes than did obstetricians and nurses. The majority of participants were perceived the overweight and obese pregnant women during childbirth as overate people, shapeless, slow and unattractive. Age, specialty, education and years of experience were found to be associated with health care providers’ attitudes. The Conclusion: Health care providers negative attitudes toward overweight and obese pregnant women are a cause for concern. Therefore, maternal obesity was needed to be more adequately addressed in basic education courses, and in the continuing professional education classes of practicing health care providers.

Keywords: attitudes, obesity, prevalence rate, nurses, midwives, obstetrician, childbirth

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Authors: Saba Harati, Nasrin Arian Parsa

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The current research was an attempt to investigate the effect of resilience on mental health and life satisfaction. In one Cross Sectional research, 287 (173 females and 114 males) students of Tehran University were participated their average age was 23.17 years old (SD=4.9). The instruments used for assessing the research variables included: Cutter and Davidson resilience scale (CD-RISC), the short form of the depression-anxiety-stress scale, and life satisfaction scale. The data analysis was done in the form of structural equation model. The results of Simultaneous Hierarchical Multiple Regression Analysis indicated that there was a significant mediating role of the negative emotions (depression, anxiety, and stress), in the relationship between the family resilience (p < 0.001) and satisfaction with life (p < 0.001). Resilience results in life satisfaction by reducing the emotional problems (or increasing the mental health level). The effect of the resilience variable on life satisfaction was indirect.

Keywords: resilience, negative emotion, mental health, life satisfaction

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

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

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

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Authors: William Coburn, Dylan Hauchard, Amel Naouali

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Background: The nature of the HIV epidemic in Puerto Rico (PR) is less understood than in the continental U.S. There is evidence to suggest that there are differences in health care access based on geographical location, such that rural areas are less underserved and have less immediate access to HIV prevention resources. Methods: The current study consists of a cross-sectional online survey of self-reporting HIV-negative sexual minority men (SMM) residing in PR. Results: In this sample, there were no differences between urban and rural-based services for SMM. However, more than half of the sample reported that they have never disclosed their gender identity and sexual practices to a physician. Conclusion: HIV is a significant public health concern affecting Latinos/Hispanics in the U.S. Findings in this paper can have implications for HIV prevention services in PR specifically, as few studies have directly focused on the impact of HIV and health care services in PR outside of the continental U.S.

Keywords: HIV, Puerto Rico, infectious diseases , public health

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Authors: Nicolas Lopez-Villalobos, Dorian J. Garrick, Hugh T. Blair

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Many dairy goat farmers of New Zealand milk herds of mixed breed does. Simultaneous evaluation of sires and does across breed is required to select the best animals for breeding on a common basis. Across-breed estimated breeding values (EBV) and estimated producing values for 208-day lactation yields of milk (MY), fat (FY), protein (PY) and somatic cell score (SCS; LOG2(SCC) of Saanen, Nubian, Alpine, Toggenburg and crossbred dairy goats from 75 herds were estimated using a test day model. Evaluations were based on 248,734 herd-test records representing 125,374 lactations from 65,514 does sired by 930 sires over 9 generations. Averages of MY, FY and PY were 642 kg, 21.6 kg and 19.8 kg, respectively. Average SCC and SCS were 936,518 cells/ml milk and 9.12. Pure-bred Saanen does out-produced other breeds in MY, FY and PY. Average EBV for MY, FY and PY compared to a Saanen base were Nubian -98 kg, 0.1 kg and -1.2 kg; Alpine -64 kg, -1.0 kg and -1.7 kg; and Toggenburg -42 kg, -1.0 kg and -0.5 kg. First-cross heterosis estimates were 29 kg MY, 1.1 kg FY and 1.2 kg PY. Average EBV for SCS compared to a Saanen base were Nubian 0.041, Alpine -0.083 and Toggenburg 0.094. Heterosis for SCS was 0.03. Breeding values are combined with respective economic values to calculate an economic index used for ranking sires and does to reflect farm profit.

Keywords: breed effects, dairy goats, milk traits, test-day model

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Authors: V. S. Binu, Amitha Puranik, Sintomon Mathew, Sebin Thomas

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Globally, women are more vulnerable to various forms of crimes than males. The crimes that are directed specifically towards women are classified as crime against women. Crime against women in India is observed to increase year after year and according to the National Crime Records Bureau (NCRB) report, in 2014 there was an increase of 9.2% cases of crime against women compared to the previous year. The violence in a population depends on socio-demographic factors, unemployment, poverty, number of police officials etc. There are very few studies that explored to identify hotspots of various types of crime against women in India. Hotspots are geographical regions where the number of observed cases is more than the expected number for that region. It is important to identify the hotspots of crime against women in India in order to control and prevent violence against women in that region. The goal of this study is to identify the hotspots of crime against women in India using spatial data analysis techniques. For the present study, we used the district level data of various types of crime against women in India in the year 2011 published by NCRB and the 2011 Census population in each of these districts. The study used spatial scan statistic to identify the hotspots using SaTScan software.

Keywords: crime, hotspots, India, Satscan, Women

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Authors: Surupa Shaw, Debjyoti Banerjee

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Enhancing heat transfer in compact volumes is a challenge when constrained by cost issues, especially those associated with requirements for minimizing pumping power consumption. This is particularly acute for electronic chip cooling applications. Technological advancements in microelectronics have led to development of chip architectures that involve increased power consumption. As a consequence packaging, technologies are saddled with needs for higher rates of power dissipation in smaller form factors. The increasing circuit density, higher heat flux values for dissipation and the significant decrease in the size of the electronic devices are posing thermal management challenges that need to be addressed with a better design of the cooling system. Maximizing surface area for heat exchanging surfaces (e.g., extended surfaces or “fins”) can enable dissipation of higher levels of heat flux. Fractal structures have been shown to maximize surface area in compact volumes. Self-replicating structures at multiple length scales are called “Fractals” (i.e., objects with fractional dimensions; unlike regular geometric objects, such as spheres or cubes whose volumes and surface area values scale as integer values of the length scale dimensions). Fractal structures are expected to provide an appropriate technology solution to meet these challenges for enhanced heat transfer in the microelectronic devices by maximizing surface area available for heat exchanging fluids within compact volumes. In this study, the effect of different fractal micro-channel architectures and flow structures on the enhancement of transport phenomena in heat exchangers is explored by parametric variation of fractal dimension. This study proposes a model that would enable cost-effective solutions for thermal-fluid transport for energy applications. The objective of this study is to ascertain the sensitivity of various parameters (such as heat flux and pressure gradient as well as pumping power) to variation in fractal dimension. The role of the fractal parameters will be instrumental in establishing the most effective design for the optimum cooling of microelectronic devices. This can help establish the requirement of minimal pumping power for enhancement of heat transfer during cooling. Results obtained in this study show that the proposed models for fractal architectures of microchannels significantly enhanced heat transfer due to augmentation of surface area in the branching networks of varying length-scales.

Keywords: fractals, microelectronics, constructal theory, heat transfer enhancement, pumping power enhancement

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Authors: Gokhan Kilic, Pelin Celik

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Structural health monitoring (SHM) is widely used in evaluating the state and health of membrane structures. In the past, in order to collect data and send it to a data collection unit on membrane structures, wire sensors had to be put as part of the SHM process. However, this study recommends using wireless sensors instead of traditional wire ones to construct an economical, useful, and easy-to-install membrane structure health monitoring system. Every wireless sensor uses a software translation program that is connected to the monitoring server. Operational neural networks (ONNs) have recently been developed to solve the shortcomings of convolutional neural networks (CNNs), such as the network's resemblance to the linear neuron model. The results of using ONNs for monitoring to evaluate the structural health of a membrane are presented in this work.

Keywords: wireless sensor network, non-destructive testing, operational neural networks, membrane structures, dynamic monitoring

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Authors: M. Prasanth, V. Nithin, R. Keerthana, S.Kalyani

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In the current scenario, the steering system in automobiles is such that the motion from the steering wheel is transferred to driving wheel by mechanical linkages. In this paper, we propose a method to design a steering mechanism using servomotors to turn the wheels instead of linkages. In this method, a steering angle sensor senses the turn angle of the steering wheel and its output is processed by an electronical control module. Then the ECM compares the angle value to that of a standard value from a look-up database. Then it gives the appropriate input power and the turning duration to the motors. Correspondingly, the motors turn the wheels by means of bevel gears welded to both the motor output shafts and the wheel hubs. Thus, the wheels are turned without the complicated framework of linkages, reducing the driver’s effort and fatigue considerably.

Keywords: electronic control unit, linkage-less steering, servomotors, E-Mo Steer

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Authors: Sonal Tuljaram Kame

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Growth and development is based on proper diet. A balanced diet contains all the nutrients in required quantum. Although physical growth is completed by young adulthood, the body tissues remain in a dynamic state with catabolism slightly exceeding anabolism, resulting in a net decrease in the number of cells. After the years of adolescence which cause upheavals in the life of the person, the individual struggle to emerge as an adult who know who he is and what his goals are. During this period nutrients are needed for maintaining the health and energy is required for physical functions and physical activities. The nutritional requirement in young adulthood differs from other periods of life. Iron is needed for haemoglobin synthesis and necessitates by the considerable examination of blood volume. Young adult girls need to ensure adequate intake of iron as they loose 0.5 mg/day by way of menstruation. This is complete awareness about nutritional and health on the other side there is widespread ignorance about nutrition and health among young adult girls. The young adult girls who are aware about nutrition and health seem to be very conscious about nutritional intake and health. Figure consciousness and fear of obesity leads to self imposed intake of nutrients. It may result in various health problems. The study was planned to investigate nutrient intake, find relation between nutritional intake, clinical examination score and health status of young adult girls. The present study is based on the data collected from 120 young adult girls studying in four different competitive exams coaching academies in Akola city of Maharashtra. It was found that nutritional intake of these young adult girls was below the recommended level, nutritional knowledge level and nutritional intake are associated attributes, calories, calcium and protein intake is positively correlated with clinical examination and health status. It was concluded that well planned nutritional counseling for the young adult girls can help prevent nutritional deficiency diseases and disorders which may lead to anaemic condition in young adult girls. Girls need to be educated on intake of iron and vitamin B12.

Keywords: nutritional intake, health status, young adult girls, correlation studies

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Authors: Khanday Pervaiz Ahmad

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It was in 19th century when the Indian educated class started to reform their socio-religious set up as an imperative to respond to the challenges put forward by the colonial empire. The colonial discourse on India from the very beginning was gendered, as the colonized society was feminized and its ‘effeminate’ character, as opposed to ‘colonial masculinity’ was held to be a justification for its loss of independence. The ‘women health figure’ is prominently in these gender discourses. The women’s health received a much place in the colonial discourse. Lack of health consciousness, illiteracy, and belief in myths, rituals and superstitions were deemed the main factors taken as an indicator of miserable condition of Indian women’s health. As the low position of women caused shame to the natives, reforming the condition of women, its health occupied a major place in their intellectual as well as activist engagements. Magazines (journals) for women began to appear in various Indian languages in the mid to late 19th century with Bengal leading the front. These sources (Magazines) like Harm, Tehzib un Niswan, Saheli, Khatoon etc. are essential for the study of the emergence of an ideology of respectable domesticity in Indian Muslim upper middle class. Similarly for the study of development of Women’s health consciousness, women’s magazines are very essential. These earliest women Urdu magazines were first started by men, and then followed by the women’s own magazines. Various health issues, like pregnancy, child-rearing, menstruation, midwives training, Pardah, and health etc. were discussed at a time when it was impossible to discuss them in public sphere. These women magazines were brave pioneers, expanding the frontiers of women’s roles, and consciousness at a time when those frontiers were severely limited. This paper will try to focus on how women responded to the question of colonial discourse about their bodies. How health consciousness developed among Indian Muslim women and in what way it contributed in the development of feminist consciousness in South Asian Muslim Women community.

Keywords: Ashraf class, khatoon, haram women, feminism

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