Search results for: health risks

Authors: Ajay Kumar Yadav, Masum Paudel, Ritesh Chaudhary

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Background: Understanding the diagnosis and the treatment plan is very important for the patient which reflects the effectiveness of the patient care as well as counseling. Large groups of patients do not understand their emergency care plan or their discharge instructions. With only a little more than 2/3ʳᵈ of the adult population is literate and poorly distributed health service institutions in Nepal, exploring the current status of patient understanding of their diagnosis and treatment would help identify interventions to improve patient compliance with the provided care and the treatment outcomes. Objectives: This study was conducted to identify and describe the areas of patients’ understanding and confusion regarding emergency care and discharge instructions at the Emergency ward of B. P. Koirala Institute of Health Sciences teaching hospital, Dharan, Nepal. Methods: A cross-sectional study was conducted among 426 patients discharged from the emergency unit of BPKIHS. Cases who are leaving against medical advice absconded cases and those patients who came just for vaccination are excluded from the study. Patients’ understanding of the treatment plan and diagnosis was measured. Results: There were 60% men in this study. More than half of the participants reported not being able to read English. More than 90% of the respondents reported they could not read their prescription at all. While patient could point out their understanding of their diagnosis at discharge, most of them could not tell the names and the dosage of all the drugs prescribed to them at discharge. More than 95% of the patients could not tell the most common side effects of the drugs that they are prescribed. Conclusions: There is a need to further explore the factors influencing the understanding of the patients regarding their treatment plan. Interventions to understand the health literacy needs and ways to improve the health literacy of the patients are needed.

Keywords: discharge instruction, emergency ward, health literacy, treatment plan

Procedia PDF Downloads 128

Authors: Njoroge Margaret W., Johnson Deborah

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Gender-specific risk factors for common mental disorders that disproportionately affect women include but are not limited to gender-based violence, socioeconomic disadvantage, sociocultural factors and unrelenting responsibility for the care of others. The overall objective of this study was to assess mental health conditions and their risk factors among women in Garissa County, Kenya. The study adopted both quantitative and qualitative research designs. The study participants were 100 adult women and 20 key informants from different sectors in the region. Data was collected using DSM-5 (PCL-5) and Kessler Psychological Distress, interviews schedule and focus group discussions. Analysis of quantitative data was done using univariate analysis, while qualitative data was analyzed using thematic analysis. The results revealed that about 60% of women presented with moderate to severe psychological distress (PD), while 53% presented with PTSD. Additionally, women who have undergone female genital mutilation had higher PTSD and PD scores. They also presented with low self-esteem, depressive symptoms, sex anxiety, avoidance of reminders and intrusive memories of the event, especially those who developed fistula. The risk factors for poor mental health outcomes include lack of awareness/knowledge of mental health, retrogressive cultural practices (child marriage and female genital mutilation), as well as beliefs about the causes of mental disorders. The study also established that people with mental illness are neglected, abused and stigmatized. Preferred treatment approaches include prayers and the use of witch doctors and traditional healers. The study recommends gendered and culturally responsive interventions geared towards increasing community awareness and knowledge on mental health, reducing stigma and improving mental-health-seeking behaviors for women and girls in the region. Supported by the Ministry of Health, the approach should be spearheaded by trained community lay counselors.

Keywords: women, mental health conditions, cultural beliefs/practices, stigma, poverty, psychological distress, PTSD

Procedia PDF Downloads 33

Authors: Benedicta N. Nkeh-Chungag, Constance R. Sewani-Rusike, Isaac M. Malema, Daniel T. Goon, Oladele V. Adeniyi, Idowu A. Ajayi

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Background: Childhood and adolescent obesity is an important predictor of adult cardiometabolic diseases. Current data on age- and gender-specific cardiometabolic risk factors are lacking in the peri-urban Eastern Cape Province, South Africa. However, such information is important in designing innovative strategies to promote healthy living among children and adolescents. The purpose of this pilot study was to compare and determine the extent of cardiometabolic risk factors between samples of lean and overweight/obese adolescent population in a peri-urban township of South Africa. Methods: In this case-control study, age-matched, non-pregnant and non-lactating female adolescents consisting of equal number of cases (50 overweight/obese) and control (50 lean) participated in the study. Fasting venous blood samples were obtained for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (Trig), highly sensitive C-reactive protein (hsCRP) and blood sugar. Anthropometric measurements included weight, height, waist and hip circumferences. Body mass index was calculated. Blood pressure was measured; and metabolic syndrome was assessed using appropriate diagnostic criteria for children and adolescents. Results: Of the 76 participants with complete data, 12/38 of the overweight/obese and 1/38 of the lean group met the criteria for adolescent metabolic syndrome. All cardiometabolic risk factors were elevated in the overweight/obese group compared with the lean group: low HDL-C (RR = 2.21), elevated TC (RR = 1.23), elevated LDL-C (RR = 1.42), elevated Trig (RR = 1.73), and elevated hsCRP (RR = 1.9). There were significant atherosclerotic indices among the overweight/obese group compared with the lean group: TC/HDL and LDL/HDL (2.99±0.91 vs 2.63±0.48; p=0.016 and 1.73±0.61 vs 1.41±0.46; p= 0.014, respectively). Conclusion: There are multiple cardiometabolic risk factors among the overweight/obese female adolescent group compared with lean adolescent group in the study. Female adolescent who are overweight and obese have higher relative risks of developing cardiometabolic diseases compared with their lean counterparts in the peri-urban Mthatha, South Africa. School health programme focusing on promoting physical exercise, healthy eating and keeping appropriate weight are needed in the country.

Keywords: adolescents, cardiometabolic risk factors, obesity, peri-urban South Africa

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Authors: Jonah Kenei, Elisha Opiyo

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Electronic health records, as a repository of patient information, is nowadays the most commonly used technology to record, store and review patient clinical records and perform other clinical tasks. However, the accurate identification and retrieval of relevant information from clinical records is a difficult task due to the unstructured nature of clinical documents, characterized in particular by a lack of clear structure. Therefore, medical practice is facing a challenge thanks to the rapid growth of health information in electronic health records (EHRs), mostly in narrative text form. As a result, it's becoming important to effectively manage the growing amount of data for a single patient. As a result, there is currently a requirement to visualize electronic health records (EHRs) in a way that aids physicians in clinical tasks and medical decision-making. Leveraging text visualization techniques to unstructured clinical narrative texts is a new area of research that aims to provide better information extraction and retrieval to support clinical decision support in scenarios where data generated continues to grow. Clinical datasets in electronic health records (EHR) offer a lot of potential for training accurate statistical models to classify facets of information which can then be used to improve patient care and outcomes. However, in many clinical note datasets, the unstructured nature of clinical texts is a common problem. This paper examines the very issue of getting raw clinical texts and mapping them into meaningful structures that can support healthcare professionals utilizing narrative texts. Our work is the result of a collaborative design process that was aided by empirical data collected through formal usability testing.

Keywords: classification, electronic health records, narrative texts, visualization

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Authors: Meng Sun, Bin Wei

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In the past decades, design-build has become a more popular project delivery system especially for the large scaled infrastructure project in North America. It provides a one-stop shopping system for the client therefore improves the efficiency of construction, and reduces the risks and overall cost for the clients. Compared to the project with traditional delivery method, design-build project requires contractor and designer to work together efficiently to deliver the best-value solutions through the construction process. How to facilitate a solid integration and efficient interaction between contractor and designer often affects the schedule, budget and quality of the construction therefore becomes a key factor to the success of a design-build project. This paper presents a concept of using modern mobile cloud technology to provide an integrated solution during the design-build construction. It uses mobile cloud architecture to provide a platform for real-time field progress, change request approval, job progress log, and project time entry with devices integration for field information and communications. The paper uses a real filed change notice as an example to demonstrate how mobile cloud technology applies in a design-build project and how it can improve the project efficiency.

Keywords: cloud, design-build, field change notice, mobile application

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Authors: Festus Adedoyin, Nana Mbeah Otoo, Sofia Meacham

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Hypertension is one of the main health issues in Ghana, where prevalence is higher in rural than in urban areas. This is due to the challenges rural areas have in accessing technology and healthcare services for hypertension control. This study's goal is to create a digital healthcare solution to alleviate this inequality. Through an analysis of current technology and problems, using the ring onion methodology, the study determined the needs for the intervention and evaluated healthcare disparities. An online application with teleconsultation capabilities, reminder mechanisms, and clinical decision support is part of the suggested solution. In outlying areas, mobile clinics in containers with the required equipment will be established. Heuristic evaluation and think-aloud sessions were used to assess the prototype's usability and navigational problems. This study highlights the need to develop digital health interventions to help manage hypertension in rural locations and decrease healthcare disparities. To develop and improve digital healthcare solutions for rural areas worldwide and in Ghana, this study might be used as a tool for future research.

Keywords: digital health, health inequalities, hypertension management, rural areas

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Authors: Elijah Acquah-Andoh

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The UK has had its fair share of the shale gas revolutionary waves blowing across the global oil and gas industry at present. Although, its exploitation is widely agreed to have been delayed, shale gas was looked upon favorably by the UK Parliament when they recognized it as genuine energy source and granted licenses to industry to search and extract the resource. This, although a significant progress by industry, there yet remains another test the UK fracking resource must pass in order to render shale gas extraction feasible – it must be economically extractible and sustainably so. Developing unconventional resources is much more expensive and risky, and for shale gas wells, producing in commercial volumes is conditional upon drilling horizontal wells and hydraulic fracturing, techniques which increase CAPEX. Meanwhile, investment in shale gas development projects is sensitive to gas price and technical and geological risks. Using a Two-Factor Model, the economics of the Bowland shale wells were analyzed and the operational conditions under which fracking is profitable in the UK was characterized. We find that there is a great degree of flexibility about Opex spending; hence Opex does not pose much threat to the fracking industry in the UK. However, we discover Bowland shale gas wells fail to add value at gas price of $8/ Mmbtu. A minimum gas price of $12/Mmbtu at Opex of no more than $2/ Mcf and no more than $14.95M Capex are required to create value within the present petroleum tax regime, in the UK fracking industry.

Keywords: capex, economical, investment, profitability, shale gas development, sustainable

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Authors: Halkiopoulos Constantinos, Koutsopoulou Ioanna, Gkintoni Evgenia, Antonopoulou Hera

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Immunization appears to be an essential part of health care service in times of pandemics such as covid-19 and aims not only to protect the health of the population but also the health and sustainability of the economies of the countries affected. It is reported that more than 3.44 billion doses have been administered so far, which accounts for 45 doses for 100 people. Vaccination programs in various countries have been promoted and accepted by people differently and therefore they proceeded in different ways and speed; most countries directing them towards people with vulnerable chronic or recent health statuses. Large scale restriction measures or lockdown, personal protection measures such as masks and gloves and a decrease in leisure and sports activities were also implemented around the world as part of the protection health strategies against the covid-19 pandemic. This research aims to present an analysis based on variations on people’s attitudes towards vaccination based on demographic, social and epidemiological characteristics, and health status on the one hand and perception of health, health satisfaction, pain, and quality of life on the other hand. 1500 Greek e-consumers participated in the research, mainly through social media who took part in an online-based survey voluntarily. The questionnaires included demographic, social and medical characteristics of the participants, and questions asking people’s willingness to be vaccinated and their opinion on whether there should be a vaccine against covid-19. Other stressor factors were also reported in the questionnaires and participants’ loss of someone close due to covid-19, or staying at home quarantine due to being infected from covid-19. WHOQUOL-BREF and GLOBAL PSYCHOTRAUMA SCREEN- GPS were used with kind permission from WHO and from the International Society for Traumatic Stress Studies in this study. Attitudes towards vaccination varied significantly related to aging, level of education, health status and consumer behavior. Health professionals’ attitudes also varied in relation to age, level of education, profession, health status and consumer needs. Vaccines have been the most common technological aid of human civilization so far in the fight against viruses. The results of this study can be used for health managers and digital marketers of pharmaceutical companies and also other staff involved in vaccination programs and for designing health policy immunization strategies during pandemics in order to achieve positive attitudes towards vaccination and larger populations being vaccinated in shorter periods of time after the break out of pandemic. Health staff needs to be trained, aided and supervised to go through with vaccination programs and to be protected through vaccination programs themselves. Feedback in each country’s vaccination program, short backs, deficiencies and delays should be addressed and worked out.

Keywords: consumer behavior, cognitive models, vaccination policy, pandemic, Covid-19, Greece

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Authors: Sreejith Jayachandran, Mojtaba Ghods, Morteza Mohammadzaheri

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The modern busy world is running behind new embedded technologies based on computers and software; meanwhile, some people forget to do their health condition and regular medical check-ups. Some of them postpone medical check-ups due to a lack of time and convenience, while others skip these regular evaluations and medical examinations due to huge medical bills and hospital expenses. Engineers and medical experts have come together to give birth to a new device in the telemonitoring system capable of monitoring, checking, and evaluating the health status of the human body remotely through the internet for the needs of all kinds of people. The remote health monitoring device is a microcontroller-based embedded unit. Various types of sensors in this device are connected to the human body, and with the help of an Arduino UNO board, the required analogue data is collected from the sensors. The microcontroller on the Arduino board processes the analogue data collected in this way into digital data and transfers that information to the cloud, and stores it there, and the processed digital data is instantly displayed through the LCD attached to the machine. By accessing the cloud storage with a username and password, the concerned person’s health care teams/doctors and other health staff can collect this data for the assessment and follow-up of that patient. Besides that, the family members/guardians can use and evaluate this data for awareness of the patient's current health status. Moreover, the system is connected to a Global Positioning System (GPS) module. In emergencies, the concerned team can position the patient or the person with this device. The setup continuously evaluates and transfers the data to the cloud, and also the user can prefix a normal value range for the evaluation. For example, the blood pressure normal value is universally prefixed between 80/120 mmHg. Similarly, the RHMS is also allowed to fix the range of values referred to as normal coefficients. This IoT-based miniature system (11×10×10) cm³ with a low weight of 500 gr only consumes 10 mW. This smart monitoring system is manufactured with 100 GBP, which can be used not only for health systems, it can be used for numerous other uses including aerospace and transportation sections.

Keywords: embedded technology, telemonitoring system, microcontroller, Arduino UNO, cloud storage, global positioning system, remote health monitoring system, alert system

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Authors: Carla Nardelli, Jérome Holtzmann, Céline Baeyens, Catherine Bortolon

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Background. Emotion regulation (ER) is a process associated with difficulties in mental health. Given its transdiagnostic features, its improvement could facilitate the recovery of various psychological issues. A limit of current studies is the lack of knowledge regarding whether available interventionsimprove ER flexibility (i.e., the ability to implement ER strategies in line with contextual demands), even though this capacity has been associated with better mental health and well-being. Therefore, the aim of the study is to test the efficacy of a 9-weeks ER group program (the Affect Regulation Training-ART), using the most appropriate measures (i.e., experience sampling method) in a student population. Plus, the goal of the study is to explore the potential mediative role of ER flexibility on mental health improvement. Method. This Randomized Controlled Trial will comparethe ER program group to an active control group (a relaxation program) in 100 participants. To test the mediative role of ER flexibility on mental health, daily measures will be used before, during, and after the interventions to evaluate the extent to which participants are flexible in their ER. Expected outcomes. Using multilevel analyses, we expect an improvement in anxious-depressive symptomatology for both groups. However, we expect the ART group to improve specifically on ER flexibility ability and the last to be a mediative variable on mental health. Conclusion. This study will enhance knowledge on interventions for students and the impact of interventions on ER flexibility. Also, this research will improve knowledge on ecological measures for assessing the effect of interventions. Overall, this project represents new opportunities to improve ER skills to improve mental health in undergraduate students.

Keywords: emotion regulation flexibility, experience sampling method, psychological intervention, emotion regulation skills

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Authors: Tiberiu Socaciu, Tudor Colomeischi, Eugenia Iancu

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Business failure affects in various proportions shareholders, managers, lenders (banks), suppliers, customers, the financial community, government and society as a whole. In the era in which we have telecommunications networks, exists an interdependence of markets, the effect of a failure of a company is relatively instant. To effectively manage risk exposure is thus require sophisticated support systems, supported by analytical tools to measure, monitor, manage and control operational risks that may arise. As we know, bankruptcy is a phenomenon that managers do not want no matter what stage of life is the company they direct / lead. In the analysis made by us, by the nature of economic models that are reviewed (Altman, Conan-Holder etc.), estimating the risk of bankruptcy of a company corresponds to some extent with its own business cycle tracing of the company. Various models for predicting bankruptcy take into account direct / indirect aspects such as market position, company growth trend, competition structure, characteristics and customer retention, organization and distribution, location etc. From the perspective of our research we will now review the economic models known in theory and practice for estimating the risk of bankruptcy; such models are based on indicators drawn from major accounting firms.

Keywords: Anglo-Saxon models, continental models, national models, statistical models

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Authors: Niya Chen, Jennifer Chan

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In the financial market, risk management helps to minimize potential loss and maximize profit. There are two ways to assess risks; the first way is to calculate the risk directly based on the volatility. The most common risk measurements are Value at Risk (VaR), sharp ratio, and beta. Alternatively, we could look at the quantile of the return to assess the risk. Popular return models such as GARCH and stochastic volatility (SV) focus on modeling the mean of the return distribution via capturing the volatility dynamics; however, the quantile/expectile method will give us an idea of the distribution with the extreme return value. It will allow us to forecast VaR using return which is direct information. The advantage of using these non-parametric methods is that it is not bounded by the distribution assumptions from the parametric method. But the difference between them is that expectile uses a second-order loss function while quantile regression uses a first-order loss function. We consider several quantile functions, different volatility measures, and estimates from some volatility models. To estimate the expectile of the model, we use Realized Conditional Autoregressive Expectile (CARE) model with the bayesian method to achieve this. We would like to see if our proposed models outperform existing models in cryptocurrency, and we will test it by using Bitcoin mainly as well as Ethereum.

Keywords: expectile, CARE Model, CARR Model, quantile, cryptocurrency, Value at Risk

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Authors: Kristina Thorell

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Food security has been one of the most important policy issues on the global arena after the Second World War. The overall aim of this presentation is to describe preconditions for a sustainable food supply from a spatial perspective. Special attention is paid to the differences between advanced and less advanced economies around the world. The theoretical framework is based upon models which are explaining complex systems of factors that affect the preconditions for agricultural productions. In additions to this, theories about how population and environmental pollution change through different stages of societal development are explained. The results are based upon data of agricultural practices, population growth, hunger and nutrition levels from different countries around the world. The analysis shows that factors which affect preconditions for agricultural production are dynamic. Factors which support the food security in the near future are a decreasing population growth, technological development and innovation but the environmental crisis is associated to high risks. It is, therefore, important to develop environmental policies and improved methods for organic farming. A final conclusion is that the spatial pattern is clear; the food supply is sufficient within advanced economies but rather complicated in development countries.

Keywords: food security, agricultural geography, demography, advanced economies, population growth, agricultural practices

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Authors: Saleh Alzahrani, Halim Boussabaine

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The Public Private Partnership (PPP) contracts are produced taking into account the reason that the configuration, development, operation, and financing of an open undertaking is to be recompensed to a private gathering inside a solitary contractual structure. PPP venture dangers are ordinarily connected with the improvement and development of another resource and in addition its operation for a considerable length of time. Without a doubt, the most genuine outcomes of dangers amid the development period are value and time overwhelms. These occasions are amongst the most extensively utilized situations as a part of worth for cash investigation dangers. The wellsprings of danger change over the life cycle of a PPP venture. In customary acquirement, the general population segment ordinarily needs to cover all value trouble from these dangers. At any rate there is bounty confirmation to recommend that cost pain is a standard in a percentage of the tasks that are conveyed under customary obtainment. This paper means to research the effect of endogenous dangers on expense overwhelm in KSA PPP ventures. The paper displays a brief writing survey on PPP danger evaluating systems, and after that presents an affiliation model between danger occasions and expense invade in KSA. The paper finishes up with considerations for future examination.

Keywords: PPP, risk pricing, impact of risk, Endogenous risks

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Authors: A. Sainvil, J. Mallela, L. M. Pereira

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Adolescents and young adults (AYA) diagnosed with cancer are tasked with managing their health through treatment, a time when reliance on and independence from parents may change in unexpected ways. Resilience allows patients to cope and manage their own health through treatment, promoting motivation and a healthier lifestyle. The film acts as a source of reflection through the cancer journey, which may have an impact on how patients cope. The current research investigated relationships between resilient linguistic qualities of the video narratives and attitudes toward personal health management. N=24 patients diagnosed between ages 11-18 were recruited. First, participants provided demographic information, then made a video testimonial about their cancer experience. After filming, participants then completed a questionnaire on the perceived benefits for themselves and others for making the video. Videos were transcribed and analyzed for thematic content via codebook and for linguistic qualities, indicating resilience with the use of the Linguistic Inquiry and Word Count Analysis Program (LIWC). Linear regressions were then calculated to explore relationships between resilient qualities, thematic content, and participants’ perceptions of their medical team and willingness to care for themselves. Participants who spoke with greater narrator connectedness were more likely to change their view of their medical team (β=.628 p=.034). When a participant believed that providers were likely to view their video, they were marginally more likely to want to take better care of themselves (β=.367, p=.078). Participants who spoke in depth about their health reported higher intention to take better care of themselves (β=.785, p=.033). AYAs with cancer who showcased certain resilient qualities within their narrative were more likely to consider taking better care of themselves. Additionally, the more patients reflected on their health, the more they wanted to take better care of themselves. These relationships were stronger when a patient believed that a provider would watch their video. Study findings highlight the utility of film in uncovering aspects of resilience and coping that may lead to healthier behaviors in AYAs with cancer.

Keywords: adolescents, cancer, resilience, health management

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Authors: Nenashev Yaroslav, Russkin Oleg

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The mixing process is one of the most important and critical stages in many industrial sectors, such as chemistry, pharmaceuticals, and the food industry. When designing equipment with mixing impellers, technology developers often encounter working environments with complex physical properties and rheology. In such cases, the use of computational fluid dynamics tools is an excellent solution to mitigate risks and ensure the stable operation of the equipment. The research focuses on one of the designed reactors with mixing impellers intended for polymer synthesis. The study describes an approach to modeling reactors of similar configurations, taking into account the complex properties of the mixed liquids using the computational fluid dynamics (CFD) method. To achieve this goal, a complex 3D model was created, accurately replicating the functionality of chemical equipment. The model allows for the assessment of the hydrodynamic behavior of the reaction mixture inside the reactor, consideration of heat release due to the reaction, and the heat exchange between the reaction mixture and the cooling medium. The results indicate that the choice of the type and size of the mixing device significantly affects the efficiency of the mixing process inside the chemical reactor.

Keywords: CFD, mixing, blending, chemical reactor, non-Newton liquids, polymers

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Authors: Theodorus Holtzhausen

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With a growing number of professionals in healthcare moving freely between countries and also in general a more mobile global workforce, awareness of cultural differences have become more urgent for health care workers to apply proper care. There is a slowly emerging trend in health care due to globalisation that may create a more uniform cultural base for administering healthcare, but it is still very vulnerable to being hijacked and misdirected by major commercial interests. Veterinary clinics and medical clinics promoting alternative remedies lacking evidence based support and simultaneously practicing medicine as a science have become more common. Such ‘holistic’ clinics see these remedies more as a belief system causing no harm with minimal impact but with added financial benefit to the facility. With the inarguable acceptance and realisation of the interconnection between evolutionary aspects of cognition, knowledge and culture as a global but vulnerable cognition-gaining process affecting us all, we can see the enormous responsibility we carry. Such a responsibility for creating global well-being calling for an universally applicable ethic. Such an ethic with the potential of having significant impact on our cognition gaining process.

Keywords: veterinary health care, ethics, wellbeing, veterinary clinics

Procedia PDF Downloads 631

Authors: Diksha Sapkota, Kathleen Baird, Amornrat Saito, Debra Anderson

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Background: Violence during pregnancy is global public health problem incurring huge amount of social, economic and human costs. It is of particular concern as it affects health of mother, neonates and also disrupt family functioning. Mental illness is one of its commonest consequences affecting both mother and baby and likely to be chronic if left unattended. Past decade has seen advances in knowledge about different forms of violence, its health impacts and intervention/s helping to confront the violence. However, limited range and lack of consistency in measurable outcomes undermine overall effect of interventions, and available evidence are largely slanted towards high-income countries. Despite recognition of integrating screening and counselling for abused pregnant women in health settings, there is a dearth of evidence on its effectiveness from developing countries limiting its applicability and feasibility. This study intends to summarise the high-quality evidence on intimate partner violence interventions in reducing violence and improving mental health and implement the promising intervention in our context. Methods: Quantitative systematic review will be done using PRISMA statement and based on its finding; randomised controlled intervention will be carried out. The study will be conducted among women attending ANC clinic of Dhulikhel Hospital, Nepal. Being the pilot study, samples just adequate to draw the inferences i.e. not less than 30 in each arm will be taken. Phenomological approach will be used to explore the strengths and weaknesses of tested intervention and recommendations for better planning in future. Conclusion: This study intends to provide concrete evidence on what works best in our context and will assist policymakers, programme planners, donors in informed decision making.

Keywords: intimate partner violence/prevention and control, mental health, Nepal, pregnant

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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: David Armany, Matthew Allaway, Preet Gosal, Senarath Edirimanne

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A potentially devastating complication of routine laparoscopic cholecystectomy includes iatrogenic bile duct injuries, which represent a stable incidence rate of 0.3% over the past three decades. Whilst related to several relative risks such as surgeon experience and patient factors (older age, male sex), misinterpretation of biliary tree anatomy remains the most common cause, accounting for 80% of iatrogenic Common Bile Duct injuries. Whilst extremely rare, a duplicate common bile duct anomaly remains a potential variation to encounter during biliary surgery, with 30 recognised cases in the worldwide literature, of which type Vb accounts for 4. We report the case of a rare type Vb variation encountered during intra-operative laparoscopic cholecystectomy and confirmed on cholangiogram. To our knowledge, this is the first documented Type Vb case encountered in an Australian population. Given these anomalies are asymptomatic and can perpetuate iatrogenic common bile duct injuries, awareness of all subtypes is crucial. Irrevocably, preoperative Magnetic Resonance Cholangiopancreatography can help recognise these anomalies before the operating theatre; however, their widespread adoption is limited by expensive and availability.

Keywords: duplicated common bile duct, type Vb, cholecystitis, MRCP, cholangiogram, iatrogenic CBD

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Authors: Moslem Hossain, Mukesh Kumar, K. C. Das

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Background: Household headship is the crucial decision-maker as well as the economic provider of the household. In Indian society, household heads occupied by men from the pre-colonial period. This study attempt to examine the changes in household headship in India. Methods: The study used univariate and multivariate analysis to examine the trends and patterns of different characteristics of the household head using the various rounds of national family health survey data. Results: The female household head is gradually increasing; on the other hand, the male-dominant is decreasing over the four national family and health surveys. The mean age of the household head is higher in rural areas than urban India. Only ten percentage of Households are higher educated, and 83 percent of the male household head has a low standard of living. The mean family size of the household has a decreasing trend in both the urban and rural areas during the study period. Conclusions: The result indicates that women's autonomy is increasing and leading to inclusive growth, which introduced in the eleven five year plan, especially focuses on the woman and young people in the country.

Keywords: household head, national family health survey, mean age, mean family size

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Authors: Rancy Chepchirchir Kosgey, John Olukuru

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This study examines the impact of introduction of futures trading on the spot price volatility in the commodity market. The paper considers the United States of America, South Africa and Ethiopian economies. Three commodities i.e. coffee, maize and wheat from New York Merchantile Exchange, South African Futures Exchange and Ethiopian Commodity Exchange are analyzed. ARCH LM test is used to check for heteroskedasticity and GARCH and EGARCH are used to check for the behavior of volatility between the pre- and post-futures periods. For all the three economies, the results indicate presence of the ARCH effect in the log returns. For conditional and unconditional variances; spot price volatility for coffee has decreased after futures trading in all the economies and the EGARCH has also shown reduction in persistence of volatility in the post-futures period in the three economies; while that of maize has reduced for the Ethiopian economy while there has been an increase in both the US and South African economies. For wheat, the conditional variance has been found to rise in the post-futures period in all the three economies.

Keywords: derivatives, futures exchange, agricultural commodities, spot price volatility

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Authors: Muhammad Badar Habib, Muhammad Shakir, Asif Ali, Muhammad Zia ul Haq

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Purpose of the research is to examine the university teachers’ health and physical activities regarding their academic competencies. Major objectives of this piece research were (a) to identify health problems of teachers at university level that affects academic competencies of university teachers and (b) to evaluate educational betterment through physical balance. This research is descriptive in nature and questionnaire was used as source of collecting data. Population of the present research comprises teachers, professors and professionals teaching in the universities of Pakistan. 580 university teachers were selected as a population of the study. Random sampling technique was used to identify recipients. Data was feed and filter in Ms-Excel. In the light of the analysis of the study following findings were drawn out. This study found that the university teachers in Pakistan do not adopt proper physical exercise program. They were less interested to burn their extra calories and face diseases such as cramping, contraction of the muscles, diabetics and stomach diseases. This study recommends that seminars/workshops may be held by University establishment; to develop overall awareness among the teachers.

Keywords: evaluating effects of health and physical maintenance, academic competencies, university teachers, Pakistan

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Authors: D. Szinay, O. Perski, A. Jones, T. Chadborn, J. Brown, F. Naughton

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Background: The uptake of health and wellbeing smartphone apps is largely influenced by popularity indicators (e.g., rankings), rather than evidence-based content. Rapid disengagement is common. This study aims to explore how and why potential users 1) select and 2) engage with such apps, and 3) how increased engagement could be promoted. Methods: Semi-structured interviews and a think-aloud approach were used to allow participants to verbalise their thoughts whilst searching for a health or wellbeing app online, followed by a guided search in the UK National Health Service (NHS) 'Apps Library' and Public Health England’s (PHE) 'One You' website. Recruitment took place between June and August 2019. Adults interested in using an app for behaviour change were recruited through social media. Data were analysed using the framework approach. The analysis is both inductive and deductive, with the coding framework being informed by the Theoretical Domains Framework. The results are further mapped onto the COM-B (Capability, Opportunity, Motivation - Behaviour) model. The study protocol is registered on the Open Science Framework (https://osf.io/jrkd3/). Results: The following targets were identified as playing a key role in increasing the uptake of and engagement with health and wellbeing apps: 1) psychological capability (e.g., reduced cognitive load); 2) physical opportunity (e.g., low financial cost); 3) social opportunity (e.g., embedded social media); 4) automatic motivation (e.g., positive feedback). Participants believed that the promotion of evidence-based apps on NHS-related websites could be enhanced through active promotion on social media, adverts on the internet, and in general practitioner practices. Future Implications: These results can inform the development of interventions aiming to promote the uptake of and engagement with evidence-based health and wellbeing apps, a priority within the UK NHS Long Term Plan ('digital first'). The targets identified across the COM-B domains could help organisations that provide platforms for such apps to increase impact through better selection of apps.

Keywords: behaviour change, COM-B model, digital health, mhealth

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Authors: Laila Habiballah, Ahmad Tubaishat

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Background: with the development of information and communication technology, using the internet as a source to obtain health information is increasing. Nursing students as future health care providers should have the skills of locating, evaluating and using online health information. This will enable them to help their patients and families to make informed decisions. Aim: this study has a two-fold aim. The first is to assess the eHealth literacy among nursing students in Jordan. The second aim is to explore the factors that have an effect on the eHealth literacy. Methods: this is a descriptive cross-sectional survey that conducted in two universities in Jordan; public and private one. A number of 541 students from both universities were completed the eHEALS scale, which is an instrument designed to measure the eHealth literacy. Some additional personal and demographical variable were collected to explore its effect on eHealth literacy. Results: Students have a high perceived level of e-Health literacy (M=3.62, SD=0.58). They are aware of the available online health resources, know how to search, locate, and use these resources. But, they do not have the skills to evaluate these resources and cannot differentiate between the high and low-quality resources. The results showed as well that type of university, type of students' admission, academic level, students' skills of using the internet, and the perception of usefulness and importance of internet have an effect on the eHealth literacy. While the age, gender, GPA, and the frequency of using the internet was no significant factors. Conclusion: This study represents a baseline reference for the eHealth literacy in Jordan. Students have some skills of eHealth literacy and other skills need to be improved. Nursing educators and administrators should integrate and incorporate the skills of eHealth literacy in the curriculum.

Keywords: eHealth, literacy, nursing, students, Jordan

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Authors: Kenneth Christie

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Syria and Iraq are Arabian nightmares at the local, the regional and global levels in terms of human security and the protection of the vulnerable. Wracked by civil war, ethnic and political violence in the last 5 years in the case of Syria and 13 years in the case of Iraq, the body count now is staggering; the humanitarian crisis continues and there appears no end to this. A crisis that has claimed the lives of 200,000 people so far in Syria, sparked a humanitarian catastrophe fuelled violent Islamic extremism and exposed serious splits in the international community who appear to have no consensus. The international community’s failure to act is simply another sign of the desperate situation which has developed over conflicts that appears unsolvable in the immediate future and may be intractable in the long range. Three things are really at stake I’m going to argue in these continuing crises and how it will affect the human security dimensions of the conflict. Firstly, the protection of vulnerable individuals and civilians in the war, 2ndly, the dire consequences for regional instability as a result and thirdly the risks for minority and ethnic identities who are caught up in this, within and across these volatile borders. This paper will examine these elements and the consequences of the conflict in terms of human security, migration and development.

Keywords: human security, migration, Syria and Iraq, conflict and development

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Authors: Anders Thorsén, Behrooz Sangchoolie, Peter Folkesson, Ted Strandberg

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As more parts of the power grid become connected to the internet, the risk of cyberattacks increases. To identify the cybersecurity threats and subsequently reduce vulnerabilities, the common practice is to carry out a cybersecurity risk assessment. For safety classified systems and products, there is also a need for safety risk assessments in addition to the cybersecurity risk assessment in order to identify and reduce safety risks. These two risk assessments are usually done separately, but since cybersecurity and functional safety are often related, a more comprehensive method covering both aspects is needed. Some work addressing this has been done for specific domains like the automotive domain, but more general methods suitable for, e.g., intelligent distributed grids, are still missing. One such method from the automotive domain is the Security-Aware Hazard Analysis and Risk Assessment (SAHARA) method that combines safety and cybersecurity risk assessments. This paper presents an approach where the SAHARA method has been modified in order to be more suitable for larger distributed systems. The adapted SAHARA method has a more general risk assessment approach than the original SAHARA. The proposed method has been successfully applied on two use cases of an intelligent distributed grid.

Keywords: intelligent distribution grids, threat analysis, risk assessment, safety, cybersecurity

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Authors: Ahmed Mohamed Nasr, Waseim Ragab Azzam, Nada Osama Ramadan

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Contaminated soil can weaken the stability of buildings and infrastructure, posing serious risks to their structural integrity. Therefore, this study aims to understand how oil contamination affects the torsion behavior of model steel piles at different soil densities. This research is crucial for evaluating the structural integrity and stability of piles in oil-contaminated environments. Clean sand samples and heavy motor oil were mixed in amounts ranging from 0 to 6% of the soil's dry weight. The mixture was thoroughly mixed to ensure uniform distribution of the oil throughout the sandy soil for simulating the field conditions. In these investigations, the relative densities (Dr), pile slenderness ratio (Lp/Dp), oil content (O.C%), and contaminated sand layer thickness (LC) were all different. Also, the paper presents an analysis of piles that are loaded both vertically and torsionally. The findings demonstrated that the pre-applied torsion load led to a decrease in the vertical bearing ability of the pile. Also, at Dr = 80%, the ultimate vertical load under combined load at constant torsional load T = (1/3Tu, 2/3Tu, and Tu) in the cases of (Lc/Lp) = 0.5 and (Lp/Dp) =13.3 was found to be reduced by (1.48, 2.78, and 4.15%) less than piles under independent vertical load, respectively so it is crucial to consider the torsion load during pile design.

Keywords: torsion-vertical load, oil-contaminated sand, twist angle, steel pile

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Authors: Dana Weimann Saks

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This study aimed to examine the use of the internet as a source of health-related information (HRI), as well as the change in attitudes following the online search for HRI. The current study sample included 88 participants, randomly divided into two experimental groups. One was given the name of an unfamiliar disease and told to search for information about it using various search engines, and the second was given a text about the disease from a credible scientific source. The study findings show a large percentage of participants used the internet as a source of HRI. Likewise, no differences were found in the extent to which the internet was used as a source of HRI when demographics were compared. Those who searched for the HRI on the internet had more negative opinions and believed symptoms of the disease were worse than the average opinion among those who obtained the information about the disease from a credible scientific source. The Internet clearly influences the participants’ beliefs, regardless of demographic differences.

Keywords: health-related information, internet, young adults, HRI

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Authors: Jaqueline Nichi, Leila Da Costa Ferreira, Fabiana Barbi Seleguim, Gabriela Marques Di Giulio, Mariana Barbieri

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The transport sector is responsible for approximately 55% of global greenhouse gas (GHG) emissions, in addition to pollution and other negative externalities, such as road accidents and congestion, that impact the routine of those who live in large cities. The objective of this article is to discuss the application and use of distinct mobility technologies such as climate adaptation and mitigation measures in the context of smart cities in the Global South. The documentary analysis is associated with 22 semi structured interviews with managers who work with mobility technologies in the public and private sectors and in civil society organizations to explore solutions in multilevel governance for smart and low-carbon mobility based on the case study from the city of São Paulo, Brazil. The hypothesis that innovation and technology to mitigate and adapt to climate impacts are not yet sufficient to make mobility more sustainable has been confirmed. The results indicate four relevant aspects for advancing a climate agenda in smart cities: integrated planning, coproduction of knowledge, experiments in governance, and new means of financing to guarantee the sustainable sociotechnical transition of the sector.

Keywords: urban mobility, climate change, smart cities, multilevel governance

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