Search results for: primary health center

Authors: N. Dlamini, Mpumelelo G. Ndlela, Philisiwe Dlamini, Nicholus Kisyeri, Bhekizitha Sithole

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Accessing health services during the COVID-19 pandemic have exacerbated scarcity to routine medication. To ensure continuous accessibility to services, Eswatini launched Community Health Commodities Distribution (CHCD). Eligible Antiretroviral Therapy(ART) stable clients (VL<1,000) and patients on Non-Communicable Disease (NCD) medications were attended at community pick up points (PUP) based on distance between clients’ residence and the public health facility. Services provided includes ART and Pre-Exposure prophylaxis (PrEP) refills and NCD drug refills). The number of community PUP was 14% higher than health facility visits. Among all medications and commodities distributed between April and October 2020 at the PUP, 64% were HIV-related (HIV rapid test, HIVST, VL test, PrEP meds), and 36% were NCD related. The rapid roll out of CHCD during COVID-19 pandemic reduced the risk of COVID-19 transmission to clients as travel to health facilities was eliminated. It Additionally increased access to commodities during COVID-19-driven lockdown, decongested health facilities, integrated model of care, and increase service coverage. It was also noted that CHCD added different curative and HIV related services based on client specific needs and availability of the commodities.

Keywords: community health commodities distribution, pick up points, antiretroviral therapy, pre-exposure prophylaxis

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Authors: Eyob Seife, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew, Yohans Demis

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Developing countries continue to face preventable communicable diseases, such as vaccine-preventable diseases. The Expanded Programme on Immunization (EPI) was established by the World Health Organization in 1974 to control these diseases. Health data use is crucial in decision-making, but ensuring data quality remains challenging. The study aimed to assess the accuracy ratio, timeliness, and quality index of regular immunization programme data in the Birkod district of the Somali Region, Ethiopia. For poor data quality, technical, contextual, behavioral, and organizational factors are among contributors. The study used a quantitative cross-sectional design conducted in September 2022GC using WHO-recommended data quality self-assessment tools. The accuracy ratio and timeliness of reports on regular immunization programmes were assessed for two health centers and three health posts in the district for one fiscal year. Moreover, the quality index assessment was conducted at the district level and health facilities by trained assessors. The study found poor data quality in the accuracy ratio and timeliness of reports at all health units, which includes zeros. Overreporting was observed for most facilities, particularly at the health post level. Health centers showed a relatively better accuracy ratio than health posts. The quality index assessment revealed poor quality at all levels. The study recommends that responsible bodies at different levels improve data quality using various approaches, such as the capacitation of health professionals and strengthening the quality index components. The study highlighted the need for attention to data quality in general, specifically at the health post level, and improving the quality index at all levels, which is essential.

Keywords: Birkod District, data quality, quality index, regular immunization programme, Somali Region-Ethiopia

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Authors: Siwimol Phoomniyom, Pathom Karaipoom, Rossaphorn Kittyaowaman

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Background: C. trachomatis is the most common bacterial sexually transmitted infections. Although infection with C. trachomatis can be treated with antibiotic, it is frequently asymptomatic, especially in extragenital sites. Hence, if screening tests are not performed, undetected and untreated is a crucial problem for C. trachomatis infection, especially in Thailand, which is less well studied. We sought to assess the prevalence of C. trachomatis infection in multiple anatomical sites among patients attending Bangrak STIs Center. Methods: We examined laboratory results of all patients at baseline visit from 3 January 2018 to 27 December 2019. These results were tested by a validated in-house real time PCR specify for the cryptic plasmid gene of C. trachomatis. The prevalence of C. trachomatis was analyzed by anatomical sites, sexes, and ages. Urogenital samples were obtained from urethral swab of men and cervical swab of women. The median ages of the patients were 32 years (range 13-89 years). Chi-square test by IBM SPSS statistic version 20 was used to assess difference in the distribution of variables between groups. Results: Among 3,789 patients, the prevalence for C. trachomatis infection was the highest in rectal (16.1%), followed by urogenital (11.2%) and pharyngeal (3.5%) sites. Rectal and urogenital infection in men was higher than in women, with the highest prevalence of 16.6% in rectal site. Both rectal and urogenital sites also showed statistically significant differences between sexes (P<0.001). Meanwhile, pharyngeal C. trachomatis infection rate was higher in women than men. Interestingly, the chlamydia prevalence was the highest in age 13-19 years of all three sites (18.5%, urogenital; 17.7%, rectal; 6.5%, pharyngeal), with statistically significant difference between age groups (P<0.001). Total of 45 C. trachomatis infections, 20.0%, 51.1%, and 6.7% were isolated from urogenital, rectal, and pharyngeal sites. In total, 75.6%, 26.7%, and 80.0% of chlamydia infections would have been missed, if only urogenital, rectal, or pharyngeal screening was performed. Conclusions: The highest source of C. trachomatis infection was the rectal site. While, the highest prevalence in men was at rectal site, that in women was at urogenital site. The highest chlamydia prevalence was found in adolescent age group, indicating that the pediatric population was a high-risk group. This finding also elucidated that a high proportion of C. trachomatis infection would be missed, if only single anatomical site screening was performed, especially in extragenital sites. Hence, extragenital screening is also required for the extensive C. trachomatis detection.

Keywords: chlamydia trachomatis, anatomical sites, sexes, ages

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Authors: Arpit Gite

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Purpose: We have evaluated the role of Total Neoadjuvant Therapy in patients with Locally Advanced Rectal cancer by giving Chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT) and, after that, the strategy of wait and watch. Methods: In this prospective case series, we evaluated the results of three locally advanced Rectal cancers, two cases Stage II (cT3N0) and one case Stage III ( cT4aN2). All three patients' growth was 4-6 cm from the anal verge. We have treated with Chemoradiotherapy to dose of 45Gy/25 Fractions to elective nodal regions (Inguinal node in anal canal Involvement)and Primary and mesorectum (Phase I) followed by 14.4Gy/8 Fractions to Primary and Mesorectum(Phase II) to a total dose of 59.4Gy/33 Fractions with concurrent chemotherapy Tab Capecitabine 825mg/m2 PO BD with Radiation therapy. After 6 weeks of completion of Chemoradiotherapy, advised six cycles of consolidative chemotherapy, CAPEOX regimen, Oxaliplatin 130mg/m2 on day 1 and Capecitabine 1000mg/m2 PO BD on days 1-14 repeated on a 21-day cycle for a total of six cycles. The primary endpoint is Disease-free survival (DFS); the secondary endpoint is adverse events related to chemoradiotherapy. Radiation toxicity is assessed by RTOG criteria, and chemotherapy toxicity is assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Results: After 6 weeks of completion of Chemoradiotherapy, we did PET-CT of all three patients; all three patients had a clinically complete response and we advised 6 cycles of consolidative chemotherapy. After completion of consolidative chemotherapy, again PET-CT and sigmoidoscopy, all three patients had complete response on PET-CT and no lesions on sigmoidoscopy and kept all three patients on wait and watch.2 patients had Grade 2 skin toxicities,1 patient had Grade 1 skin toxicity, .2 patients had Grade 2 lower GI toxicities, and 1 patient had Grade lower GI toxicity, both according to RTOG criteria. 3 patients had Grade 2 diarrhea due to capecitabine, and 1 patient had Grade 1 thrombocytopenia due to oxaliplatin assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Conclusion: Sphincter Preservation is possible with this regimen in those who don’t want to opt for surgery or in case of low-lying rectal cancer.

Keywords: locally advanced rectal cancer, sphincter preservation, chemoradiotherapy, consolidative chemotherapy

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Authors: Daniel Faraj, Arabella Raupach, Charlotte Hespe, Helen Wilcox, Kristie-Lee Anning

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Aim: International child sponsorship programs comprise a considerable proportion of global aid accessible to the general population. Team Philippines (TP), a healthcare and welfare initiative run in association with the University of Notre Dame Sydney since 2013, leads a holistic sponsorship program for thirty children from Calauan, Philippines. To date, empirical research has not been performed on the overall success and impact of the TP child sponsorship program. As such, this study aims to evaluate its effectiveness in improving pediatric outcomes. Methods: Study cohorts comprised thirty sponsored and twenty-nine age- and gender-matched non-sponsored children. Data were extracted from the TP Medical Director database and lifestyle questionnaires for July-November 2019. Outcome measures included anthropometry, markers of medical health, dental health, exercise, and diet. Statistical analyses were performed in SPSS. Results: Sponsorship resulted in fewer medical diagnoses and prescription medications, superior dental health, and improved diet. Further, sponsored children may show a clinically significant trend toward improved physical health. Sponsorship did not affect growth and development metrics or levels of physical activity. Conclusions: The TP child sponsorship program significantly impacts positive pediatric health outcomes in the Calauan community. The strength of the program lies in its holistic, sustainable, and community-based model, which is enabled by effective international child sponsorship. This study further supports the relationship between supporting early livelihood and improved health in the pediatric population.

Keywords: child health, public health, health status disparities, healthcare disparities, social determinants of health, morbidity, community health services, culturally competent care, medically underserved areas, population health management, Philippines

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Authors: Ayse Inel Manav, Saliha Bozdogan Yesilot, Pinar Yesil Demirci, Gursel Oztunc

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Introduction: This study was conducted with a view to evaluating cognitive function level, depression, and quality of life of elderly people living in a nursing home. Methods: This study, which is cross-sectional and descriptive in nature, was conducted in the Nursing and Rehabilitation Center for the Elderly in Adana/Turkey between 1st of May and 1st of August, 2016. The participants included 118 elderly people who were chosen using simple random sampling method. The data were collected using the Personal Information Form, the Standardized Mini Mental State Exam (SMMSE), the Geriatric Depression Scale (GDS), and the World Health Organization Quality of Life-OLD (WHOQOL-OLD) module. The data were analyzed using IBM SPSS Statistics 22 (IBM, SPSS, Turkey) program. Results: Of all the participants, 36,4% (n=43) were female, 63,6% (n=75) were male, and average age was 74,08 ± 8,23 years. The participants’ SMMSE mean score was found 20,37 ± 7,08, GDS mean score was 14,92 ± 4,29, and WHOQOL-OLD module mean score was 69,76 ± 11,54. There was a negative, significant relationship between SMMSE and GDS scores, a positive relationship between WHOQOL-OLD module total scores and a negative, significant relationship between GDS scores and WHOQOL-OLD module total scores. Discussıon and Conclusion: Results showed that more than half of the elderly people living in the nursing home experienced cognitive deterioration and depression; and cognitive state, depression, and quality of life were found to be significantly related to each other.

Keywords: depression, cognitive function level, quality of life

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Authors: Ajith Kumar S., Sankaran Namboothiri, Sankrish J., SarathKumar S., S. Anil Lal

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A numerical analysis of flow over a heated circular cylinder is done in this paper. The governing equations, Navier-Stokes, and energy equation within the Boussinesq approximation along with continuity equation are solved using hybrid FEM-FVM technique. The density gradient created due to the heating of the cylinder will induce buoyancy force, opposite to the direction of action of acceleration due to gravity, g. In the present work, the flow direction and the direction of buoyancy force are taken as same (vertical flow configuration), so that the buoyancy force accelerates the mean flow past the cylinder. The relative dominance of the buoyancy force over the inertia force is characterized by the Richardson number (Ri), which is one of the parameter that governs the flow dynamics and heat transfer in this analysis. It is well known that above a certain value of Reynolds number, Re (ratio of inertia force over the viscous forces), the unsteady Von Karman vortices can be seen shedding behind the cylinder. The shedding wake patterns could be seriously altered by heating/cooling the cylinder. The non-dimensional shedding frequency called the Strouhal number is found to be increasing as Ri increases. The aerodynamic force coefficients CL and CD are observed to change its value. In the present vertical configuration of flow over the cylinder, as Ri increases, shedding frequency gets increased and suddenly drops down to zero at a critical value of Richardson number. The unsteady vortices turn to steady standing recirculation bubbles behind the cylinder after this critical Richardson number. This phenomenon is well known in literature as "Breakdown of the Karman Vortex Street". It is interesting to see the flow structures on further increase in the Richardson number. On further heating of the cylinder surface, the size of the recirculation bubble decreases without loosing its symmetry about the horizontal axis passing through the center of the cylinder. The separation angle is found to be decreasing with Ri. Finally, we observed a second critical Richardson number, after which the the flow will be attached to the cylinder surface without any wake behind it. The flow structures will be symmetrical not only about the horizontal axis, but also with the vertical axis passing through the center of the cylinder. At this stage, there will be a "single plume" emanating from the rear stagnation point of the cylinder. We also observed the transition of the plume is a strong function of the Richardson number.

Keywords: drag reduction, flow over circular cylinder, flow control, mixed convection flow, vortex shedding, vortex breakdown

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Authors: Amaba, Marinela C., Espino, Gianne Ericka S. J. Valencia, Zeia Beatriz C.

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This study aims to determine the moderating role of attachment style on the relationship between psychological symptoms and well-being of mental health practitioners in rehabilitation centers that are accredited of the Department of Health in Pampanga. Using the data gathered from 46 mental health practitioners, multiple regression models were conducted to test the main and moderating effects of attachment styles. The findings show that all three psychological symptoms namely depression, anxiety, and stress have main effects on their general well-being on a negative direction. However, attachment style did not moderate the relationship between the psychological symptoms and general well-being. On one hand, results about the relationship of psychological symptoms and well-being are consistent to previous findings of other studies while on the other hand, results in moderation were contradicting.

Keywords: attachment style, psychological symptoms, well-being, mental health practitioners, rehabilitation centers

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Authors: Floyd Misheck Mwanza, Paul Boniface Majura

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The paper looked at highways/ roadside waste generation, disposal and the consequent environmental impacts. The dramatic increase in vehicular and paved roads in the recent past in Zambia, has given rise to the indiscriminate disposal of litter that now poses a threat to health and the environment. Primary data was generated by carrying out oral interviews and field observations for holistic and in–depth assessment of the environment and the secondary data was obtained from desk review method, information on effects of roadside wastes on environment were obtained from relevant literatures. The interviews were semi structured and a purposive sampling method was adopted and analyzed descriptively. The results of the findings showed that population growth and unplanned road expansion has exceeded the expected limit in recent time with resultant poor system of roadside wastes disposal. Roadside wastes which contain both biodegradable and non-biodegradable roadside wastes are disposed at the shoulders of major highways in temporary dumpsites and are never collected by a road development agency (RDA). There is no organized highway to highway or street to street collection of the wastes in Zambia by the key organization the RDA. The study revealed that roadside disposal of roadside wastes has serious impacts on the environment. Some of these impacts include physical nuisance of the wastes to the environment, the waste dumps also serve as hideouts for rodents and snakes which are dangerous. Waste are blown around by wind making the environment filthy, most of the wastes are also been washed by overland flow during heavy downpour to block drainage channels and subsequently lead to flooding of the environment. Most of the non- biodegradable wastes contain toxic chemicals which have serious implications on the environmental sustainability and human health. The paper therefore recommends that Government/ RDA should come up with proper orientation and environmental laws should be put in place for the general public and also to provide necessary facilities and arrange for better methods of collection of wastes.

Keywords: biodegradable, disposal, environment, impacts

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Authors: Ignatio Madanhire, Charles Mbohwa

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Efficiency in manufacturing is critical in raising the value of exports so as to gainfully trade on the regional and international markets. There seems to be increasing popularity of continuous improvement strategies availed to manufacturing entities, but this research study established that there has not been a similar popularity accorded to the Six Sigma methodology. Thus this work was conducted to investigate the applicability, effectiveness, usefulness, application and suitability of the Six Sigma methodology as a competitiveness option for discrete manufacturing entity. Development of Six-sigma center in the country with continuous improvement information would go a long way in benefiting the entire industry

Keywords: discrete manufacturing, six-sigma, continuous improvement, efficiency, competitiveness

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Authors: Sally Kafelghazal

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Introduction: Arab Americans, who include immigrants, refugees, or U.S. born persons of Middle Eastern or North African descent, may experience significant difficulties during acculturation to Western society. Influential stressors include relocation, loss of social support, language barriers, and economic factors, all of which can impact mental health. There is limited research investigating the effects of acculturation on the mental health of the Arab American population. Objectives: The purpose of this study is to identify ways in which acculturation impacts the mental health of Arab Americans, specifically the development of depression and anxiety. Method: A literature search was conducted using PubMed and PsycArticles (ProQuest), utilizing the following search terms: “Arab Americans,” “Arabs,” “mental health,” “depression,” “anxiety,” “acculturation.” Thirty-nine articles were identified and of those, nine specifically investigated the relationship between acculturation and mental health in Arab Americans. Three of the nine focused exclusively on depression. Results: Several risk factors were identified that contribute to poor mental health associated with acculturation, which include immigrant or refugee status, facing discrimination, and religious ideology. Protective factors include greater levels of acculturation, being U.S. born, and greater heritage identity. Greater mental health disorders were identified in Arab Americans compared to normative samples, perhaps particularly depression; none of the articles specifically addressed anxiety. Conclusion: The current research findings support the potential association between the process of acculturation and greater levels of mental health disorders in Arab Americans. However, the diversity of the Arab American population makes it difficult to draw consistent conclusions. Further research needs to be conducted in order to assess which subgroups in the Arab American population are at highest risk for developing new or exacerbating existing mental health disorders in order to devise more effective interventions.

Keywords: arab americans, arabs, mental health, anxiety, depression, acculturation

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Authors: Janine Sommer, Mariana Daus, Mariana Simon, Maria Smith, Daniel Luna

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The technologies and communication advances contributed to new tools development which allows patients to have an active role in their own health. In the light of information needs and paradigms changes about health, the patient self-manages their care. This line of care focuses on patients; specific portals come up to people with particular requirements like pregnant women. Thinking of a portal design to this sector of the population, in September 2016 a survey was made to users with the objective to knowing and understanding information’s needs at the moment to use an application for pregnant. Also, prototypes of the portal´s features were designed to try and validate with users, using the methodology of human-centered design. Investigations have made possible the identification of needs of this population and develop a tool who try to satisfy, providing timely information for each part of pregnancy and allowing the patients to make a physical check and the follow up of pregnancy seeking advice from our obstetricians.

Keywords: electronic health record, health personal record, mobile applications, pregnant women

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Authors: Onyeke Paul Chuks

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Nigeria is ranked among the developing nations and a country with a low income per capita. The consequences of this economic situation have led to the low achievement records below UN benchmark especially in the area of basic education for her citizens. The country is, however, making relentless efforts at arresting the situation by making budgetary allocations to ensure the realization of Millennium Development Goal No. 2 which is achieving universal basic education, her distressed economy notwithstanding. Basic education which comprises primary and lower secondary education as well as pre-primary and/or adult literacy programs have suffered serious setbacks orchestrated by the dwindling of the nation’s economy. This category of education being the bedrock of all other levels of education is regarded as a priority by developing countries and also the focus of the Education for All Movement led by UNESCO. The introduction of child-friendly school model is one of the strategies designed by UNESCO to achieving this all important MDGs goal No. 2. Child-friendly education model is aimed at replacing the out-dated, mundane, regimented and officious school administrative model where the basic rights of school children are trampled upon with impunity and community participation in school activities is viewed as unnecessary interference by school managers. This paper ex-rayed the potential obstacles likely to impinge on the implementation of child-friendly school model in Nigeria especially from the angle of her distressed economy and the colossal effects of the corrupt practices bedeviling the nation. The paper as well outlines prospects for the successful implementation of the child-friendly school model in Nigeria.

Keywords: child-friendly school, distressed economy, model, Nigeria

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Authors: Suchada Wongsawat

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The objectives of this quasi-experiment were: 1) to compare pretest and posttest scores of the experimental group who were given health education on the “Fruit Diets for Elderly Patients with Type 2 Diabetes Mellitus”; and 2) to compare the posttest scores between experimental group and controlled group. The samples of this study were elderly patients with type 2 Diabetes Mellitus at Tambon Kanai Health Promoting Hospital, Thailand. The samples were randomly assigned to experimental and controlled groups, with 30 patients in each group. Statistics used in the data analysis included frequency, percentage, average, standard deviation, paired t-test and independent t-test. The study revealed that the patients in the experimental group had significantly higher posttest scores than the pretest scores in the health education at the .05 statistical level. The posttest scores of the experimental group in the health education were significantly higher than the controlled group at the .05 statistical level.

Keywords: fruit, health education, elderly, diabetes

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Authors: Mohammad Shahjahan, Md. Monoarul Haque

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In the research work information and data were collected from both types of sources, direct and indirect. Numerological, qualitative and participatory analysis methods have been followed. There were two principal sources of collecting information and data. Firstly, the data provided by the service recipients (300 nos. of women and children victims) in the Victim Support Centre and service providing policemen, executives and staffs (60 nos.). Secondly, data collected from Specialists, Criminologists and Sociologists involved in victim support services through Consultative Interview, KII, Case Study and FGD etc. The initial data collection has been completed with the help of questionnaires as per strategic variations and with the help of guidelines. It is to be noted that the main objective of this research was to determine whether services provided to the victims for their facilities, treatment/medication and rehabilitation by different government/non-government organizations was veritable at all. At the same time socio-economic background and demographic characteristics of the victims have also been revealed through this research. The results of the study show that although the number of victims has increased gradually due to socio-economic, political and cultural realities in Bangladesh, the number of victim support centers has not increased as expected. Awareness among the victims about the effectiveness of the 8 centers working in this regard is also not up to the mark. Two thirds of the victims coming to get service were not cognizant regarding the victim support services at all before getting the service. Most of those who have finally been able to come under the services of the Victim Support Center through various means, have received sheltering (15.5%), medical services (13.32%), counseling services (13.10%) and legal aid (12.66%). The opportunity to stay in security custody and psycho-physical services were also notable. Usually, women and children from relatively poor and marginalized families of the society come to victim support center for getting services. Among the women, young unmarried women are the biggest victims of crime. Again, women and children employed as domestic workers are more affected. A number of serious negative impacts fall on the lives of the victims. Being deprived of employment opportunities (26.62%), suffering from psycho-somatic disorder (20.27%), carrying sexually transmitted diseases (13.92%) are among them. It seems apparent to urgently enact distinct legislation, increase the number of Victim Support Centers, expand the area and purview of services and take initiative to increase public awareness and to create mass movement.

Keywords: crime, victim, support, Bangladesh

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Authors: Melaku Tsehay

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The Consortium of Christian Relief and Development Associations (CCRDA), and the CORE Group Polio Partners (CGPP) Secretariat have been working with Global Alliance for Vac-cines and Immunization (GAVI) to improve the immunization data quality in Afar and Somali Regional States. The main aim of this study was to compare the quality of immunization data before and after the above interventions in health facilities in the pastoralist communities in Ethiopia. To this end, a comparative-cross-sectional study was conducted on 51 health facilities. The baseline data was collected in May 2019, while the end line data in August 2021. The WHO data quality self-assessment tool (DQS) was used to collect data. A significant improvment was seen in the accuracy of the pentavalent vaccine (PT)1 (p = 0.012) data at the health posts (HP), while PT3 (p = 0.010), and Measles (p = 0.020) at the health centers (HC). Besides, a highly sig-nificant improvment was observed in the accuracy of tetanus toxoid (TT)2 data at HP (p < 0.001). The level of over- or under-reporting was found to be < 8%, at the HP, and < 10% at the HC for PT3. The data completeness was also increased from 72.09% to 88.89% at the HC. Nearly 74% of the health facilities timely reported their respective immunization data, which is much better than the baseline (7.1%) (p < 0.001). These findings may provide some hints for the policies and pro-grams targetting on improving immunization data qaulity in the pastoralist communities.

Keywords: data quality, immunization, verification factor, pastoralist region

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Authors: Chenxu Fang, Qikai Guan

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Riverside public space in mountainous cities has unique scenic resources and humanistic connotations and is an important place indispensable to the activities of urban residents. In recent years, with the continuous development of society and the expansion of the city, the public space along the riverside has been affected to a certain extent. Based on this, this study is based on the concept of health and safety through the study of riverfront space in the local section of Jialing River in Chongqing City; according to the actual use function of riverfront public space, the riverfront public space in mountainous cities is categorized into leisure and recreational riverfront space, ecological conservation waterfront space, and composite function waterfront space. Starting from the health and safety elements affecting the environment in the riverfront public space, the health and safety influencing factors of the riverfront public space are categorized into three major categories, namely, material, non-material, and social, and through the field research and questionnaire collection, combined with the analysis of the Likert scale, the important levels of the health and safety influencing factors of different types of the riverfront public space of the mountainous cities are clarified. We summarize the factors affecting the health and safety of mountainous riverside spaces, map their importance levels to the design of different types of riverside spaces, and put forward three representative paths for the governance of the safety and health of mountainous riverside public space.

Keywords: health and safety, mountain city, riverfront public space, spatial governance, Chongqing Jialing River

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Authors: Awatif Habeeb Al-Shamare

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The number of social media users amongst special education teachers and parents of children with Down Syndrome (DS) is increasing annually. This is also the case in the Kingdom of Saudi Arabia (KSA). However, according to the best of the author’s knowledge, there are no qualitative studies which testify to the true nature of the interaction between teachers and parents when using social media, nor the role of social media in supporting and assisting parents and teachers with regards to the children’s educational needs in KSA. Therefore, this ongoing study aims to identify the role of social media in supporting parents and teachers of DS students, with a special emphasis on early intervention services in KSA. By bridging the knowledge gap on social media and special education in KSA and presenting socially relevant and applied information on the topic, this research provides a theoretical and practical base for the establishment of appropriate and effective programmes between the ministries of Information and Special Education in particular. A qualitative approach was selected because it was the most suitable approach for exploring the participants’ experiences, which could not be determined through scientific tests. Interviewing, chosen as the research instrument, allowed the researcher to obtain a detailed understanding of the topic linked to the study objectives. Initially, a pilot study was conducted at the Daycare Center in May 2016. Its aim was to examine and refine the methodology and assess whether the questions were understood with the potential for re-drafting them, if necessary. The main study consists of five teachers and five mothers with experience of using social media and with links to the Daycare Center. Thematic Analysis has been chosen for analysing the findings because it is a flexible method that allows themes to emerge from the data. Results of the current study are still in the initial stages, but the preliminary findings are as follows: (1) social media is an important tool in encouraging parents and teachers to access the necessary information and knowledge about, and experience in, early intervention services; (2) it acts as a support network for the parents; (3) it helps raise awareness about DS and the need for early intervention; (4) it can be used to put pressure on the government for an expansion in early intervention services, and finally (5) its use can be problematic in that parents and teachers face some difficulties and challenges when using the different platforms. It can be concluded that social media plays a significant role in the lives of teachers and parents with special needs children in KSA.

Keywords: down syndrome, early intervention services, social media, support parents and teachers

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Authors: Shivani Kuttuva, James Sampson, Timothy Simmons, Vinayak Thattaruparambil, Holly Burton, Peter Coyne

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Anogenital mammary-like glands were established to be embryological remnants of breast tissue due to failed resolution of the ectodermal mammary ridge. However, recent studies are now considering this to represent normal constituents of the anogenital area with histological resemblance to the orthotopic breast tissue with multiple benign and malignant lesions arising from it. The incidence of the above has been predominant in females in the vulval region. Due to the paucity of cases reported in men, this poses a diagnostic and therapeutic challenge resulting in a delay in treatment and, thereby, poor outcomes. Our patient presented to the dermatology clinic with an itchy, purplish lesion in the peri-anal region which, on punch biopsy, was diagnosed to be Extra-mammary Paget’s disease and taken up for Wide local excision. Immunochemically, staining was positive for HER2, ER and Cytokeratin 7, keeping with the presence of actual breast tissue with no primary breast carcinoma. Due to the invasive nature of the disease, he required Abdominoperineal resection with flap reconstruction. Despite complete surgical clearance and adjuvant radiotherapy, the disease progressed to adjacent inguinal and obturator lymph nodes with origin resembling anogenital type mammary glands but histology negative for hormonal receptors of the breast.

Keywords: anogenital mammary-like glands, abdominoperineal resection, ectopic breast tissue, ectopic male breast carcinoma, peri-anal skin lesion

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Authors: Arezoo Fallahi

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Introduction: Exposure to second-hand smoke is an important global health problem and threatens the health of people, especially children and women. The aim of this study was to determine the effect of education based on the Health Belief Model on preventive behaviors of exposure to secondhand smoke in women. Materials and Methods: This experimental study was performed in 2023in Sanandaj, west of Iran. Seventy-four people were selected by simple random sampling and divided into an intervention group (37 people) and a control group (37 people). Data collection tools included demographic characteristics and a second-hand smoke exposure questionnaire based on the Health Beliefs Model. The training in the intervention group was conducted in three one-hour sessions in the comprehensive health service centers in the form of lectures, pamphlets, and group discussions. Data were analyzed using SPSS software version 21 and statistical tests such as correlation, paired t-test, and independent t-test. Results: The intervention and control groups were homogeneous before education. They were similar in terms of mean scores of the Health Belief Model. However, after an educational intervention, some of the scores increased, including the mean perceived sensitivity score (from 17.62±2.86 to 19.75±1.23), perceived severity score (28.40±4.45 to 31.64±2), perceived benefits score (27.27±4.89 to 31.94±2.17), practice score (32.64±4.68 to 36.91±2.32) perceived barriers from 26.62±5.16 to 31.29±3.34, guide for external action (from 17.70±3.99 to 22/89 ±1.67), guide for internal action from (16.59±2.95 to 1.03±18.75), and self-efficacy (from 19.83 ±3.99 to 23.37±1.43) (P <0.05). Conclusion: The educational intervention designed based on the Health Belief Model in women was effective in performing preventive behaviors against exposure to secondhand smoke.

Keywords: women, health behaviour, smoke, belive

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Authors: Chanada Aonsri, Wichai Eungpinichpong

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Stereotypical behavior is one of the learning and social skills development problems that affect children with autism. Previous studies found that traditional Thai massage (TTM) could reduce stereotypical behaviors in autistic children. However, the effects of TTM delivered by the parents of autistic children have not been explored. This pilot study investigated the effects of TTM by parents on stereotypical behaviors in children with autism. A one-group pretest-posttest design was applied for 15 children, aged 4-16 years, with their parents' permissions. They participated in the study at the Special Education program of the Special Education Center of Khon Kaen University, Thailand. After being trained in a specialized TTM for children, the parents delivered 50-minute TTM to children once a day, twice a week for eight weeks. The severity of autism and autistic behaviors were measured using the Childhood Autism Rating Scale (CARS), and the Autism Treatment Evaluation Checklist (ATEC), respectively. The functions of autonomic nervous systems were measured using Heart Rate Variability (HRV) to indicated physical and mental disorders such as stress. The data at baseline and the 8th week were analyzed using either an independent t-test or Wilcoxon signed-rank test. The study found that 16 sessions of TTM significantly improved measured data for autism in all children including the CARS (p<0.001), ATEC, speech/language/communication (p<0.001), sociability (p<0.001), sensory/cognitive awareness (p<0.001), health/physical/behavior (p < 0.001), and HRV (p<0.001). The results indicated that TTM performed by parents could be useful as an adjunct therapy for autistic children as it can reduce stereotypical behaviors and stress.

Keywords: traditional Thai massage, stereotypical behaviors, Autistic children, parent

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Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

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Authors: Sevgi Balkan-Sahin

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The Justice and Development Party (AKP) government has included nuclear power as a major component of Turkey’s new energy strategy by promoting it as the only alternative for Turkey to diversify energy resources, trigger economic growth, and boost competitiveness of the country. The effective promotion of such a framing has created a hegemonic discourse around nuclear energy in Turkey. However, fiercely opposing the nuclear initiative of the government, the Turkish anti-nuclear platform (ANP) composed of more than 50 civil society groups has challenged the hegemonic discourse of the AKP government by presenting nuclear energy as dangerous for human health, human rights, and the protection of environment. Based on an engagement between Gramscian perspective and Laclau and Mouffe’s discourse theory, this paper considers the discourses of the Turkish anti-nuclear platform and its associated activities as a counter-hegemonic strategy to change the ‘common sense’ on nuclear energy in Turkey. Analyzing the data from interviews with the representatives of the anti-nuclear platform coupled with primary sources, such as Parliamentary Records and official statements by civil society organizations, the paper highlights how the anti-nuclear platform exercises power through counter-hegemonic discourses in terms of the delegitimization of nuclear energy in Turkey.

Keywords: counter-hegemony, discourse, nuclear energy, Turkey

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Authors: Cecilia Sosa, Fernanda Figueroa, Leonardo Calzada

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Biosphere reserves (BR) are considered as the main strategy for biodiversity and ecosystems conservation. Mexican BR are mainly inhabited by rural communities who strongly depend on forests and their resources. Even though the dual objective of conservation and development has been sought in BR, land cover change is a common process in these areas, while most rural communities are highly marginalized, partly as a result of restrictions imposed by conservation to the access and use of resources. Achieving ecosystems conservation and social development face serious challenges. Factors such as financial support for development projects (public/private), environmental conditions, infrastructure and regional economic conditions might influence both land use change and wellbeing. Examining the temporal trends of conservation and development in BR is central for the evaluation of outcomes for these conservation strategies. In this study, we analyzed changes in primary vegetation cover (as a proxy for conservation) and the index of marginalization (as a proxy for development) in Mexican BR (2000-2015); we also explore the influence of various factors affecting these trends, such as conservation-development projects financial support (public or private), geographical distribution in ecoregions (as a proxy for shared environmental conditions) and in economic zones (as a proxy for regional economic conditions). We developed a spatial analysis at the municipal scale (2,458 municipalities nationwide) in ArcGIS, to obtain road densities, geographical distribution in ecoregions and economic zones, the financial support received, and the percent of municipality area under protection by protected areas and, particularly, by BR. Those municipalities with less than 25% of area under protection were regarded as part of the protected area. We obtained marginalization indexes for all municipalities and, using MODIS in Google Earth Engine, the number of pixels covered by primary vegetation. We used a linear mixed model in RStudio for the analysis. We found a positive correlation between the marginalization index and the percent of primary vegetation cover per year (r=0.49-0.5); i.e., municipalities with higher marginalization also show higher percent of primary vegetation cover. Also, those municipalities with higher area under protection have more development projects (r=0.46) and some environmental conditions were relevant for percent of vegetation cover. Time, economic zones and marginalization index were all important. Time was particularly, in 2005, when both marginalization and deforestation decreased. Road densities and financial support for conservation-development projects were irrelevant as factors in the general correlation. Marginalization is still being affected by the conservation strategies applied in BR, even though that this management category considers both conservation and development of local communities as its objectives. Our results suggest that roads densities and support for conservation-development projects have not been a factor of poverty alleviation. As better conservation is being attained in the most impoverished areas, we face the dilemma of how to improve wellbeing in rural communities under conservation, since current strategies have not been able to leave behind the conservation-development contraposition.

Keywords: deforestation, local development, marginalization, protected areas

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Authors: Suruchi Shukla, Shantanu Prakash, Amita Jain

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Introduction: Arboviral diseases are one of the most common causes of viral hemorrhagic fever (VHF). Of which, Dengue and Chikungunya pose a significant health problem in India. Arbovirus has a tendency to cross the territories and emerge in the new region. Considering the above issues, in the current study active surveillance was conducted among viral hemorrhagic fever (VHF) cases reported from Uttar Pradesh (UP), India. We studied the arboviral etiology of VHF; mainly Dengue, Chikungunya, and ZIKA. Methods: Clinical samples of 465 suspected VHF cases referred to tertiary care referral center of UP, India were enrolled in the study during a period from 15th May 2016 to 9th March 2018. Serum specimens were collected and analyzed for the presence of Dengue, Chikungunya, and ZIKA either by serology and/or by molecular assays. Results: Of all tested, 165 (35.4%) cases were positive for either Dengue or Chikungunya. Dengue (21.2%) was found to be the most prevalent, followed by Chikungunya, (6.6%). None of the cases tested positive for ZIKA virus. Serum samples of 35 (7.5%) cases were positive for both Dengue and Chikungunya. DEN-2 serotype was the most predominant serotype. Phylogenetic and sequence analysis of DEN-2 strains showed 100% clustering with the Cosmopolitan genotype strain. Bleeding from several sites, jaundice, abdominal pain, arthralgia, haemoconcentration, and thrombocytopenia were significantly higher in dengue hemorrhagic cases. However, the rash was significantly more common in Chikungunya patients. Most of the Dengue and Chikungunya positive cases (Age group 6-40 years) were seen in post monsoon season (September to November). Conclusion: Only one-third of total VHF cases are positive for either Dengue/Chikungunya or both. This necessitates the screening of other etiologies capable of causing hemorrhagic manifestations.

Keywords: viral hemorrhagic fever, dengue, chikungunya, zika, India

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Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari

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Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.

Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers

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Authors: Alexander Hendricks, Sean Nevin, Clayton Wikoff, Melissa Dougherty, Jacob Orlita, Rafiqul Noorani

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Knee orthotics play an important role in aiding in the recovery of those with knee injuries, especially athletes. However, structural knee orthotics is often very expensive, ranging between $300 and $800. The primary reason for this project was to answer the question: can 3D printed orthotics represent a viable and cost-effective alternative to present structural knee orthotics? The primary objective for this research project was to design a knee orthotic for athletes with knee injuries for a low-cost under $100 and evaluate its effectiveness. The initial design for the orthotic was done in SolidWorks, a computer-aided design (CAD) software available at Loyola Marymount University. After this design was completed, finite element analysis (FEA) was utilized to understand how normal stresses placed upon the knee affected the orthotic. The knee orthotic was then adjusted and redesigned to meet a specified factor-of-safety of 3.25 based on the data gathered during FEA and literature sources. Once the FEA was completed and the orthotic was redesigned based from the data gathered, the next step was to move on to 3D-printing the first design of the knee brace. Subsequently, physical therapy movement trials were used to evaluate physical performance. Using the data from these movement trials, the CAD design of the brace was refined to accommodate the design requirements. The final goal of this research means to explore the possibility of replacing high-cost, outsourced knee orthotics with a readily available low-cost alternative.

Keywords: 3D printing, knee orthotics, finite element analysis, design for additive manufacturing

Procedia PDF Downloads 181

Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and novel data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. To the best of our knowledge, this is the first work to apply modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

Procedia PDF Downloads 134

Authors: Fatima Zohra Belghait, Nawal Cheikh, Oscar Palacios, Ramon Barnadas, Pau Bayon

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Metalloporphyrin and its derivatives play an important role in different scientific areas due to its tetradentate vacant site in the center that is suitable for metal coordination. Metalosomes (MTS) are supramolecular aggregates (similar to liposomes) generated by the self-assembly of compounds similar to phospholipids (with a polar and a hydrophobic part), but incorporating, as part of their membrane, molecules that contain bound metals. The aim of our work is to synthesise metalosomes containing catioinc amphiphilic porphyrin and their complexes with Fe and Cu to study their therapeutical applications. All synthesized compounds were confirmed with Dynamic Light Scattering; elemental analysis, Ultraviolet–visible spectroscopy

Keywords: metalloporphyrin, amphiphilique porphyrin, metalosomes, supramolecular

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Authors: Farhat Nigar

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Social stress is stress which arises from one's relationships with others and from the social environment. When a person finds that they are not capable of coping with a situation, stress arises. Sanitation workers faces a lot of discrimination from the society which leads to stress and have severe impact on their mental health. Sanitation workers face lot of work pressure which sometimes leads to mental health problems, but there is lack of proper data of sanitation workers dealing with mental health problems which is a big obstacle before evolving policies for the welfare of sewage and septic tank workers which needs attention. The objective of the study is to find out the effect of social stress on the mental health of sanitation workers and to explore the scope of social work in coping with mental health problems of workers. This descriptive and analytical study was conducted on 100 sanitation workers of Aligarh city through convenience sampling. Data were collected from respondents by schedule and interview method. Most of the respondents said that they don’t enjoy equal status in society and at the workplace as well which leads to stress. Many of them said that social stress leads to poor performance in the workplace. Some of the workers feel depressed when their work is not appreciated and recognized in society. Majority of respondents has stress in financial and employment-related difficulties. Thus it can be said that social stress has several impacts on mental health which leads to poor performance, lack of confidence, and motivation which sometimes leads to depression. Social work can play a very important and challenging role in overcoming these difficulties by providing education, motivation and guiding them and by making them aware of their rights and duties.

Keywords: discrimination, health, stress, sanitation workers

Procedia PDF Downloads 148