Search results for: alternative health care

Authors: Hanen Filali, Mohamed Hachicha

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Treated grey water (TGW) reuse emerged as an alternative resource to meet the growing demand for water for agricultural irrigation and reduce the pressure on limited existing fresh water. However, this reuse needs adapted management in order to avoid environmental and health risks. In this work, the treatment of grey water (GW) was studied from a cyclic treatment system that we designed and implemented in the greenhouse of National Research Institute for Rural Engineering, Water and Forests (INRGREF). This system is composed of three levels for treatment (TGW 1, TGW 2, and TGW 3). Each level includes a sandy soil box. The use of grey water was moderated depending on the chemical and microbiological quality obtained. Different samples of soils and treated grey water were performed and analyzed for 14 irrigation cycles. TGW through cyclic treatment showed physicochemical parameters like pH, electrical conductivity (EC), chemical oxygen demand (COD), biological oxygen demand (BOD5) in the range of 7,35-7,91, 1,69-5,03 dS/m, 102,6-54,2 mgO2/l, and 31,33-15,74 mgO2/l, respectively. Results showed a reduction in the pollutant load with a significant effect on the three treatment levels; however, an increase in salinity was observed during all irrigation cycles. Microbiological results showed good grey water treatment with low health risk on irrigated soil. Treated water quality was below permissible Tunisian standards (NT106.03), and treated water is suitable for non-potable options.

Keywords: treated grey water, irrigation, cyclic treatment, soils, physico-chemical parameters, microbiological parameters

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Authors: Jayakant Singh, Enu Anand

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Background: Child marriage is widely prevalent in India. It is a form of gross human right violation that succumbs a child bride to be subservient to her husband within a marital relation. We investigated the relationship between age at marriage of women and her level of empowerment with physical violence experienced 12 months preceding the survey among young women aged 20-24 in two culturally distinct states- Bihar and Tamil Nadu of India. Methods: We used the information collected from 10514 young married women (20-24 years) at all India level, 373 in Bihar and 523 in Tamil Nadu from the third round of National Family Health Survey. Empowerment index was calculated using different parameters such as mobility, economic independence and decision making power of women using Principal Component Analysis method. Bivariate analysis was performed primarily using chi square for the test of significance. Logistic regression was carried out to assess the effect of age at marriage and empowerment on physical violence. Results: Lower level of women empowerment was significantly associated with physical violence in Tamil Nadu (OR=2.38, p<0.01) whereas child marriage (marriage before age 15) was associated with physical violence in Bihar (OR=3.27, p<0.001). The mean difference in age at marriage between those who experienced physical violence and those who did not experience varied by 7 months in Bihar and 10 months in Tamil Nadu. Conclusion: Culture specific intervention may be a key to reduction of violence against women as the results showed association of different factors contributing to physical violence in Bihar and Tamil Nadu. Marrying at an appropriate age perhaps is protective of abuse because it equips a woman to assert her rights effectively. It calls for an urgent consideration to curb both violence and child marriage with stricter involvement of family, civil society and the government. In the meanwhile physical violence may be recognized as a public health problem and integrate appropriate treatment to the victims within the health care institution.

Keywords: child marriage, empowerment, India, physical violence

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Authors: Junaid Bin Aamir, Ma Fanhua

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Methanol is one of the most suitable alternative fuels for replacing gasoline in present and future spark-ignited engines. However, for pure methanol engines, cold start problems and misfires are observed under certain operating conditions. Hydrogen provides a solution for such problems. This paper experimentally investigated the effect of hydrogen on the performance of a pure methanol SI-engine at city driving conditions (1500 rpm speed and 1.18 excess air ratio). Hydrogen was used as a part of methanol reformed syngas (67% hydrogen by volume). 4% by mass of the total methanol converted to hydrogen and other constituent gases, was used in each cycle. Port fuel injection was used to inject methanol and hydrogen-rich syngas into the 4-cylinder engine. The results indicated an increase in brake thermal efficiency up to 5% with the addition of hydrogen, a decrease in brake specific fuel consumption up to 200 g/kWh, and a decrease in exhaust gas temperature by 100°C for all mean effective pressures. Hydrogen addition also decreased harmful exhaust emissions significantly. There was a reduction in THC emissions up to 95% and CO emissions up to 50%. NOx emissions were slightly increased (up to 15%), but they can be reduced to zero by lean burn strategy.

Keywords: alternative fuels, hydrogen, methanol, performance, spark ignition engines

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Authors: Yuan-Jye Tseng, Jia-Shu Li

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To design a product with the given product requirement and design objective, there can be alternative ways to propose the detailed design specifications of the product. In the design modeling stage, alternative design cases with detailed specifications can be modeled to fulfill the product requirement and design objective. Therefore, in the design evaluation stage, it is required to perform an evaluation of the alternative design cases for deciding the final design. The purpose of this research is to develop a product evaluation model for evaluating the alternative design cases by integrated evaluating the criteria of functional design, Kansei design, and design for supply chain. The criteria in the functional design group include primary function, expansion function, improved function, and new function. The criteria in the Kansei group include geometric shape, dimension, surface finish, and layout. The criteria in the design for supply chain group include material, manufacturing process, assembly, and supply chain operation. From the point of view of value and cost, the criteria in the functional design group and Kansei design group represent the design value of the product. The criteria in the design for supply chain group represent the supply chain and manufacturing cost of the product. It is required to evaluate the design value and the supply chain cost to determine the final design. For the purpose of evaluating the criteria in the three criteria groups, a fuzzy analytic network process (FANP) method is presented to evaluate a weighted index by calculating the total relational values among the three groups. A method using the technique for order preference by similarity to ideal solution (TOPSIS) is used to compare and rank the design alternative cases according to the weighted index using the total relational values of the criteria. The final decision of a design case can be determined by using the ordered ranking. For example, the design case with the top ranking can be selected as the final design case. Based on the criteria in the evaluation, the design objective can be achieved with a combined and weighted effect of the design value and manufacturing cost. An example product is demonstrated and illustrated in the presentation. It shows that the design evaluation model is useful for integrated evaluation of functional design, Kansei design, and design for supply chain to determine the best design case and achieve the design objective.

Keywords: design for supply chain, design evaluation, functional design, Kansei design, fuzzy analytic network process, technique for order preference by similarity to ideal solution

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Authors: Jennifer Chen, Pei Y. Hsu, Yu W. Chen

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Groundwater resources play a vital role in regional water supply because over 1/3 of total demand is satisfied by groundwater resources. Because over-pumpage might cause environmental impact such as land subsidence, a sustainable management of groundwater resource is required. In this study, a blueprint of smart management for groundwater resource is proposed and planned. The framework of the smart management can be divided into two major parts, hardware and software parts. First, an internet of groundwater (IoG) which is inspired by the internet of thing (IoT) is proposed to observe the migration of groundwater usage and the associated response, groundwater levels. Second, algorithms based on data mining and signal analysis are proposed to achieve the goal of providing highly efficient management of groundwater. The entire blueprint is a 4-year plan and this year is the first year. We have finished the installation of 50 flow meters and 17 observation wells. An underground hydrological model is proposed to determine the associated drawdown caused by the measured pumpages. Besides, an alternative to the flow meter is also proposed to decrease the installation cost of IoG. An accelerometer and 3G remote transmission are proposed to detect the on and off of groundwater pumpage.

Keywords: groundwater management, internet of groundwater, underground hydrological model, alternative of flow meter

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Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen

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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.

Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure

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Authors: Amaal Almigal

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Technology has been argued to offer distinct advantages and benefits for teaching children with autism spectrum disorder (ASD) to communicate. One aspect of this technology is augmentative and alternative communication (AAC) systems such as picture exchange or speech generation devices. Whilst there has been significant progress in teaching these children to request their wants and needs with AAC, there remains a need for developing technologies that can really make a difference in teaching them to ask questions. iPad-based AAC can be effective for communication. However, the effectiveness of this type of AAC in teaching children to ask questions needs to be examined. Thus, in order to examine the effectiveness of iPad-based AAC in teaching children with ASD to ask questions, This research will test whether iPad leads to more learning than a traditional approach picture and text cards does. Two groups of children who use AAC will be taught to ask ‘What is it?’ questions. With the first group, low-tech AAC picture and text cards will be used, while an iPad-based AAC application called Proloquo2Go will be used with the second group. Interviews with teachers and parents will be conducted before and after the experiment. The children’s perspectives will also be considered. The initial outcomes of this research indicate that iPad can be an effective tool to help children with autism to ask questions.

Keywords: autism, communication, information, iPad, pictures, requesting

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Authors: Muhtasim Shafi Kader, Fizar Ahmed, Annesha Acharjee

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Machine learning and data mining are crucial in health care, as well as medical information and detection. Machine learning approaches are now being utilized to improve awareness of a variety of critical health issues, including diabetes detection, neuron cell tumor diagnosis, COVID 19 identification, and so on. Parkinson’s disease is basically a disease for our senior citizens in Bangladesh. Parkinson's Disease indications often seem progressive and get worst with time. People got affected trouble walking and communicating with the condition advances. Patients can also have psychological and social vagaries, nap problems, hopelessness, reminiscence loss, and weariness. Parkinson's disease can happen in both men and women. Though men are affected by the illness at a proportion that is around partial of them are women. In this research, we have to get out the accurate ML algorithm to find out the disease with a predictable dataset and the model of the following machine learning classifiers. Therefore, nine ML classifiers are secondhand to portion study to use machine learning approaches like as follows, Naive Bayes, Adaptive Boosting, Bagging Classifier, Decision Tree Classifier, Random Forest classifier, XBG Classifier, K Nearest Neighbor Classifier, Support Vector Machine Classifier, and Gradient Boosting Classifier are used.

Keywords: naive bayes, adaptive boosting, bagging classifier, decision tree classifier, random forest classifier, XBG classifier, k nearest neighbor classifier, support vector classifier, gradient boosting classifier

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Authors: Naci Büyükkaracığan, Murat Ahmet Ökmen

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Emerging demand for energy in developing countries rapid population growth and industrialization are causing a rapid increase, such as Turkey. Energy is an important and indispensable factor in the industry. At the same time, energy is one of the main indicators that reflect a country's economic and social development potential. There is a linear relationship between the energy consumption and social development, and in parallel this situation, it is seen that energy consumption increase with economic growth and prosperity. In recent year’s, energy sources consumption is increasingly continuing, because of population growth and economy in Turkey. 80% of the energy used in Turkey is supplied from abroad. At the same time, while almost all of the energy obtained from our country is met by hydropower. Alternatively, studies of determining and using potential renewable energy sources such as solar energy have been realized for recent years. In this study, first of all, the situation of energy sources was examined in Turkey. Information of reserve/capacity, production and consumption values of energy sources were emphasized. For this purpose, energy production and consumption, CO2 emission and electricity energy consumption of countries were investigated. Energy consumption and electricity energy consumption per capita were comparatively analyzed.

Keywords: energy potential, alternative energy sources, solar energy, Turkey

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Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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Authors: Lamia Bouzgarrou, Irtyah Merchaoui, Amira Omrane, Salma Kammoun, Amine Daafa, Neila Chaari

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Backgrounds: Currently, low back pain (LBP) is one of the most prevalent public health problems, which caused severe morbidity among a large portion of the adult population. It is also associated with heavy direct and indirect costs, in particular, related to absenteeism and early retirement. Health care workers are one of most occupational groups concerned by LBP, especially because of biomechanical and psycho-organizational risk factors. Our current study aims to investigate risk factors associated with chronic low back pain among Tunisian caregivers in university-hospitals. Methods: Cross-sectional study conducted over a period of 14 months, with a representative sample of caregivers, matched according to age, sex and work department, in two university-hospitals in Tunisia. Data collection included items related to socio-professional characteristics, the evaluation of the working capacity index (WAI), the occupational stress (Karazek job strain questionnaire); the quality of life (SF12), the musculoskeletal disorders Nordic questionnaire, and the examination of the spine flexibility (distance finger-ground, sit-stand maneuver and equilibrium test). Results: Totally, 293 caregivers were included with a mean age equal to 42.64 ± 11.65 years. A body mass index (BMI) exceeding 30, was noted in 20.82% of cases. Moreover, no regular physical activity was practiced in 51.9% of cases. In contrast, domestic activity equal or exceeding 20 hours per week, was reported by 38.22%. Job strain was noted in 19.79 % of cases and the work capacity was 'low' to 'average' among 27.64% of subjects. During the 12 months previous to the investigation, 65% of caregivers complained of LBP, with pain rated as 'severe' or 'extremely severe' in 54.4% of cases and with a frequency of discomfort exceeding one episode per week in 58.52% of cases. During physical examination, the mean distance finger-ground was 7.10 ± 7.5cm. Caregivers assigned to 'high workload' services had the highest prevalence of LBP (77.4%) compared to other categories of hospital services, with no statistically significant relationship (P = 0.125). LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p < 10⁻³). Moreover, the increase of the distance finger-ground was statistically associated with LBP (p = 0.05), advanced age (p < 10⁻³), professional seniority (p < 10⁻³) and the BMI ≥ 25 (p = 0.001). Furthermore, others physical tests of spine flexibility were underperformed among LBP suffering workers with a statistically significant difference (sit-stand maneuver (p = 0.03); equilibrium test (p = 0.01)). According to the multivariate analysis, only the domestic activity exceeding 20H/week, the degraded quality of physical life, and the presence of neck pain were significantly corelated to LBP. The final model explains 36.7% of the variability of this complaint. Conclusion: Our results highlighted the elevate prevalence of LBP among caregivers in Tunisian public hospital and identified both professional and individual predisposing factors. The preliminary analysis supports the necessity of a multidimensional approach to prevent this critical occupational and public health problem. The preventive strategy should be based both on the improvement of working conditions, and also on lifestyle modifications, and reinforcement of healthy behaviors in these active populations.

Keywords: health care workers, low back pain, prevention, risk factor

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Authors: Leong Tatt Loh, Ming Kun Yew, Ming Chian Yew, Lip Huat Saw, Jing Han Beh, Siong Kang Lim, Foo Wei Lee

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Oil palm shell (OPS) is the solid waste product from the palm oil sector of the agricultural industry and can be used as alternative coarse aggregates to substitute depleting conventional raw materials. This research aims to investigate the incorporation of various high-performance polypropylene (HPP) fibres with different geometry to enhance the mechanical properties and thermal conductivity of OPS lightweight concrete. The effect of different volume fractions (Vf) (0.05%, 0.10% and 0.15%) were studied for each fibre. The results reveal that the effectiveness of HPP fibres to increase the compressive strength at later ages was more pronounced than at early age. It is found that the use of HPP fibres reinforced OPS lightweight concrete (LWC) induced the advantageous of improving mechanical properties (compressive strength, flexural strength and splitting tensile strength) and thermal conductivity. Hence, this HPP fibres is a promising alternative solution to compensate lower mechanical properties as well as contribute to energy efficiency building material in the construction industry.

Keywords: oil palm shell, high performance polypropylene fibre, lightweight concrete, mechanical properties, thermal conductivity

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Authors: Sepali Guruge

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Background: There is an increase in interest among health care professionals and social workers in understanding how best to identify, mitigate, and prevent elder abuse. Purpose & method: Based on a recently completed scoping review of related literature, this paper will focus on the current state of knowledge on elder abuse interventions. Results: The results will be presented in light of the fact that limited literature exists on primary prevention of elder abuse. The existing literature on interventions to reduce or stop abuse will be critically examined in terms of their effectiveness. Particular attention will be paid to interventions such as relocation of older adults experiencing abuse, in-home assessments, empowerment and psycho-educational support for older adults. Conclusions: Overall, multi-stakeholder collaborative, community-based interventions should be designed to identify, mitigate, and prevent elder abuse.

Keywords: elder abuse, interventions, scoping review, prevention

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Authors: Bilge Demir, Ahmet Durgutlu, Mustafa Acarer

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In this study, the butt welding of the commercial AZ31 magnesium alloy sheets have been carried out by using Tungsten Inert Gas (TIG) welding process with alternative and pulsed current. Welded samples were examined with regards to hardness and microstructure. Despite some recent developments in welding of magnesium alloys, they have some problems such as porosity, hot cracking, oxide formation and so on. Samples of the welded parts have undergone metallographic and mechanical examination. Porosities and homogeneous micron grain oxides were rarely observed. Orientations of the weld microstructure in terms of heat transfer also were rarely observed and equiaxed grain morphology was dominant grain structure as in the base metal. As results, fusion zone and few locations of the HAZ of the welded samples have shown twin’s grains. Hot cracking was not observed for any samples. Weld bead geometry of the welded samples were evaluated as normal according to welding parameters. In the results, conditions of alternative and pulsed current and the samples were compared to each other with regards to microstructure and hardness.

Keywords: AZ31 magnesium alloy, microstructures, micro hardness TIG welding

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Authors: Valentina Zhang

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While facial expression is a complex and individualized behavior, all facial emotion recognition (FER) systems known to us rely on a single facial representation and are trained on universal data. We conjecture that: (i) different facial representations can provide different, sometimes complementing views of emotions; (ii) when employed collectively in a discussion group setting, they enable more accurate emotion reading which is highly desirable in autism care and other applications context sensitive to errors. In this paper, we first study FER using pixel-based DL vs semantics-based DL in the context of deepfake videos. Our experiment indicates that while the semantics-trained model performs better with articulated facial feature changes, the pixel-trained model outperforms on subtle or rare facial expressions. Armed with these findings, we have constructed an adaptive FER system learning from both types of models for dyadic or small interacting groups and further leveraging the synthesized group emotions as the ground truth for individualized FER training. Using a collection of group conversation videos, we demonstrate that FER accuracy and personalization can benefit from such an approach.

Keywords: neurodivergence care, facial emotion recognition, deep learning, ground truth for supervised learning

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Authors: Junaid Bin Aamir, Ma Fanhua

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Methanol and hydrogen are the most suitable alternative fuel resources for the existing and future internal combustion engines. This paper experimentally examined the effects of hydrogen addition on the performance and emission characteristics of a spark-ignition engine fueled with methanol at part load conditions. The experiments were carried out for various engine speeds and loads. Hydrogen-rich syngas was used to enhance the performance of the test engine. It was formed by catalytic dissociation of methanol itself, and volumetric hydrogen fraction in syngas was about 67%. A certain amount of syngas dissociated from methanol was injected into the intake manifold in each engine cycle, and the low heating value (LHV) of hydrogen-rich syngas used was 4% of methanol in each cycle. Both the fuels were injected separately using port fuel injectors. The results showed that brake thermal efficiency of the engine was enhanced by 3-5% with hydrogen addition, while brake specific fuel consumption and exhaust gas temperature were reduced. There was a significant reduction (90-95%) in THC and (35-50%) in CO emissions at the exhaust. NOx emissions from hydrogen blended methanol increased slightly (10-15%), but they can be reduced by using lean fuel-air mixture to keep the cylinder temperature low.

Keywords: hydrogen, methanol, alternative fuel, emissions, spark ignition engines

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Authors: Francesco Colcerasa, Fabio Pisani

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We contribute to the subjective well-being literature testing the relationship between life satisfaction and inequality of opportunity in health, measured through the Human Opportunity Index calculated at the national level using individual socio-economic data from the cross-country European Social Survey sample. We compute several indexes of opportunity inequality in health, each obtained according to a different combination of circumstances (gender, immigrant status, parents’ education). We find a robust and significant relationship where life satisfaction is higher in correspondence with low levels of health opportunity inequality. The result is twofold. On the one hand, the importance of the well-being of other types of inequality than income inequality emerges. On the other hand, the socioeconomic roots of inequality in health are investigated, suggesting that circumstances at birth have a role in future well-being. Several rationales for the nexus between life satisfaction and inequality of opportunity in health are possible, which we investigate by splitting the sample. Among others, we find a prominent role of pro-social preferences – formalized as interest towards own offspring (which can be interpreted as intergenerational justice) – as a mediating factor of the relationship.

Keywords: Inequality of opportunity, subjective wellbeing, health, health inequality, inequality of opportunity in health

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Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

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Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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Authors: Sakchai Satienperakul, Manoch Thanomwat, Jutiporn Seedasama

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A paper based analytical devices (PADs) for the analysis of Fe (III) ion in natural water samples is developed, using reagent from guava leaf extract. The extraction is simply performed in deionized water pH 7, where tannin extract is obtained and used as an alternative natural reagent. The PADs are fabricated by ink-jet printing using alkenyl ketene dimer (AKD) wax. The quantitation of Fe (III) is carried out using reagent from guava leaf extract prepared in acetate buffer at the ratio of 1:1. A color change to gray-purple is observed by naked eye when dropping sample contained Fe (III) ion on PADs channel. The reflective absorption measurement is performed for creating a standard curve. The linear calibration range is observed over the concentration range of 2-10 mg L-1. Detection limited of Fe (III) is observed at 2 mg L-1. In its optimum form, the PADs is stable for up to 30 days under oxygen free conditions. The small dimensions, low volume requirement and alternative natural reagent make the proposed PADs attractive for on-site environmental monitoring and analysis.

Keywords: green chemical analysis, guava leaf extract, lab on a chip, paper based analytical device

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Authors: Espinosa-Garza G., Loera-Hernandez I., Antonyan N.

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To innovate, it is necessary to perform projects directed towards the search of improvement. The agricultural technique and the design of greenhouses have been studied by undergraduate engineering students from the Tecnológico de Monterrey using the campus areas. The purpose of this project was to incite students to create innovations and help rural populations of the state to solve one of the problems that they are dealing with nowadays. The main objective of the project was to search for an alternative technique that will allow the planting of the “chile piquín” plant, also known as Capsicum annuum, to grow quicker as it germinates. The “chile piquín” is one of the original crops of Mexico and forms the basis of the Mesoamerican cultures’ diet since the pre-hispanic era. To fulfill with today’s demand, it is required to implement new alternative methods to increase the “chile piquín’s” growth. The project lasted one semester with the participation of engineering students from multiple majors. The most important results from this academic experience were that, from the proposed goal, the students could analyze the needs of their town and were capable of introducing new and innovative ideas with the aim of resolving them. In the present article the pedagogic methodologies that allowed to carry out this project will be discussed.

Keywords: academic experience, chile piquín, engineering education, greenhouse design, innovation

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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Authors: Kinga Topolska, Agnieszka Filipiak-Florkiewicz, Adam Florkiewicz, Daria Chechelska, Iwona Cieślik, Ewa Cieślik

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Food choice is a complex human behaviour, that is influenced by many interrelating factors. It is important to understand what consumers really want to eat. Nowadays, the growing popularity of frozen desserts is observed. Among them, sorbets are of the special interest. They are made primarily of fruit juice or fruit purée, water and sugar. A questionnaire study was done to evaluate the consumer preferences towards sorbets. A hundred respondents were included in the study. The respondents answered the questions concerning, inter alia, on the favourite taste of sorbets, additional ingredients (pieces of fruits, nuts etc.), the reason for choosing the product and also the opinion about potential purchasing or not the new product. Women, more frequently than men, indicated strawberry sorbet or the product on the basis of citrus fruits as a favourite one. In turn, 14% of men chose the apple taste. Pieces of chocolate were chosen by most of respondents. Men, more often than women, regarded raisins, alcohol and nuts as the most desirable additional ingredients of sorbets. The candied fruits and spices were indicated more frequently by women. Most of respondents indicated the taste as the major reason for sorbet buying. In turn, for 20% women the most important determinant was the care for their figure. It was observed that more than a half of women regarded sorbets as healthier than traditional ice creams. Answering the question: 'If you had the opportunity to try a new sorbet, containing the ingredient with proven healthy properties, would you buy it?', significantly more men than women answered 'yes, because I like novelty'. Meanwhile, for 14% respondents (independently of gender) it would be only a publicity stunt. Knowing what the consumers desire in selecting a product, is a very important information to design and offer them a new one. Sorbets could be an interesting alternative to ice creams.

Keywords: consumer, preferences, sorbets, questionnaire study

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Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

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Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

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Authors: K. P. Farsana

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Belief in supernatural causation of mental illnesses and resort to religious and faith healing as the method of intervention still continue in many parts of the world. The proposed study intended to find out the belief and causation on health and illness and utilization of religious and faith healing, its implications, and associated socio-cultural and religious factors among Mappila Muslims of Malabar, Kerala, a southern state of India.Thangals are the endogamous community in Kerala, of Yemeni heritage who claim direct descent from the Prophet Mohammed’s family. Because of their sacrosanct status, many Thangal works as religious healers in Malabar, Northern Kerala. Using the case of one Thangal healer as an illustration of the many religious healers in Kerala who engage in the healing practices, it is intended, in this paper to illustrate the religious and ritual healing practices among Mappila Muslims of Malabar. It was found that the majority of the Mappila Muslims believed in supernatural causation on illness, and majority of them consulted religious and faith healers for various health problems before seeking professional help, and a considerable proportion continued to believe in the healing efficiency of the religious and faith healing. A significant proportion of the population found religious and faith healing practices are supportive and more acceptable within the community. Religion and belief system play an important role in the heath seeking behavior of a person.

Keywords: religious and faith healing, mental illness, Mappila Muslims, Malabar

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Authors: Farramae Francisco, Rhoda Mae Simora, Sharon Nunal

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Deproteination and demineralization efficiencies of shrimp waste using two Lactobacillus species treated with different carbohydrate sources for chitin production, its chemical conversion to chitosan and the quality of chitin and chitosan produced were determined. Using 5% glucose and 5% cassava starch as carbohydrate sources, pH slightly increased from the initial pH of 6.0 to 6.8 and 7.2, respectively after 24 h and maintained their pH at 6.7 to 7.3 throughout the treatment period. Demineralization (%) in 5 % glucose and 5 % cassava was highest during the first day of treatment which was 82% and 83%, respectively. Deproteination (%) was highest in 5% cassava starch on the 3rd day of treatment at 84.4%. The obtained chitin from 5% cassava and 5% glucose had a residual ash and protein below 1% and solubility of 59% and 44.3%, respectively. Chitosan produced from 5% cassava and 5% glucose had protein content below 0.05%; residual ash was 1.1% and 0.8%, respectively. Chitosan solubility and degree of deacetylation were 56% and 33% in 5% glucose and 48% and 29% in 5% cassava, respectively. The advantage this alternative technology offers over that of chemical extraction is large reduction in chemicals needed thus less effluent production and generation of a protein-rich liquor, although the demineralization process should be improved to achieve greater degree of deacetylation.

Keywords: alternative carbon source, bioprocessing, lactic acid bacteria, waste utilization

Procedia PDF Downloads 473

Authors: Luljeta Gashi, Naser Ramadani, Zana Deva, Dafina Gexha-Bunjaku

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The official HIV/AIDS data in Kosovo are based on HIV case reporting from health-care services, the blood transfusion system and Voluntary Counselling and Testing centres. Between 1986 and 2014, are reported 95 HIV and AIDS cases, of which 49 were AIDS, 46 HIV and 40 deaths. The majority (69%) of cases were men, age group 25 to 34 (37%) and route of transmission is: heterosexual (90%), MSM (7%), vertical transmission (2%) and IDU (1%). Based on existing data and the UNAIDS classification system, Kosovo is currently still categorised as having a low-level HIV epidemic. Even though with a low HIV prevalence, Kosovo faces a number of threatening factors, including increased number of drug users, a stigmatized and discriminated MSM community, high percentage of youth among general population (57% of the population under the age of 25), with changing social norms and especially the sexual ones. Methods: Data collection was done using self administered structured questionnaires amongst 249 high school students. Data were analysed using the Statistical Package for Social Sciences (SPSS). Results: The findings revealed that 68% of students know that HIV transmission can be reduced by having sex with only one uninfected partner who has no other partners, 94% know that the risk of getting HIV can be reduced by using a condom every time they have sex, 68% know that a person cannot get HIV from mosquito bites, 81% know that they cannot get HIV by sharing food with someone who is infected and 46% know that a healthy looking person can have HIV. Conclusions: Seventy one percent of high school students correctly identify ways of preventing the sexual transmission of HIV and who reject the major misconceptions about HIV transmission. The findings of the study indicate a need for more health education and promotion.

Keywords: Kosovo, KPAR, HIV, high school

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Authors: Alongkorn Pekalee, Rossarin Gray

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Various determinants associated with older health include socio-demographic factors and health-promoting behaviors but lack in scholars recommended what factors associated with health status in specific sub-groups of older adults. The current study aims to explore the health-promoting behaviors and to examine and compare the associations of these factors with self-rated health status among three older age cohorts in Thai traditional context. Methods: This study is based on the Survey of Older Persons in Thailand (SOPT), in 2017, conducted by the National Statistical Office (NSO) of Thailand. Participants were classified into three groups by using the Thai contextual recommendation: youngest-old cohort (60-69), old-old cohort (70-79) and oldest old cohort (80 or older). Health promoting behaviors are the behaviors which associated with the health status of older adults include alcohol consumption, smoking, diet, and physical activity. Health status was defined as a subjective measurement by using self-rated health, a simple measure of general health. The socio-demographic factors, health-promoting behaviors, and health status were explained and summarized by descriptive statistics. The binary logistic regression was performed to analyze the data and evaluate the associations between independent and dependent variables. Results: Increase of age contributes to a higher proportion of health-promoting behaviors. All variables were associated with self-reported health status as good health among three older age cohorts statistically significant (p-value = 0.000). However, the influence of income sufficiency on health status is more notable, especially in older adults who aged 60-69 and 70-79. The influence of dietary and physical activity on health status became greater as age increased. Conclusion: the results suggest that income sufficiency should be noted in a plan to promote healthy aging, and co-residence should be more concerned especially in the oldest old cohort. Moreover, the interventions or policies to promote older health behaviors like diet and physical activity should be emphasized in the oldest old cohort more than others.

Keywords: health-promoting behaviors, older adults, self- rated health, Thailand

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Authors: Srikanth Pandurangi, Basheer Mohammed, Nezar Al Sayegh

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In order to meet the increasing demand for housing care for Kuwaiti citizens, the government authorities in Kuwait are undertaking a series of projects in the form of new large cities, outside the current urban area. Al Mutlaa City located to the north-west of the Kuwait Metropolitan Area is one such project out of the 15 planned new cities. The city accommodates a wide variety of residential developments, employment opportunities, commercial, recreational, health care and institutional uses. This paper examines the application of comprehensive transportation demand modeling works undertaken in VISUM platform to understand the future intracity and intercity travel distribution patterns in Kuwait. The scope of models developed varied in levels of detail: strategic model update, sub-area models representing future demand of Al Mutlaa City, sub-area models built to estimate the demand in the residential neighborhoods of the city. This paper aims at offering model update framework that facilitates easy integration between sub-area models and strategic national models for unified traffic forecasts. This paper presents the transportation demand modeling results utilized in informing the planning of multi-modal transportation system for Al Mutlaa City. This paper also presents the household survey data collection efforts undertaken using GPS devices (first time in Kuwait) and notebook computer based digital survey forms for interviewing representative sample of citizens and residents. The survey results formed the basis of estimating trip generation rates and trip distribution coefficients used in the strategic base year model calibration and validation process.

Keywords: innovative methods in transportation data collection, integrated public transportation system, traffic forecasts, transportation modeling, travel behavior

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Authors: E. Xavier, B. Nandita

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Rohingyas are an ethnic and religious minority that resides in the Rakhine State of Myanmar. Post the military coup in 1962, Rohingyas have not been recognized as one of the ethnic tribes of Burma under the legislation. They have lost citizenship, education, health care rights, and instantly became illegal immigrants. While the historicization of this conflict is crucial, this paper wants to humanize the Rohingya population’s embodiment of violence on three different levels – individual, social, and political. In addition, the study focuses on their liminal existence in refugee camps in Bangladesh and in other parts of the world, such as Malaysia and the United States of America. A multi-medium study, it includes first-hand interviews with the Rohingya community in Wisconsin and Chicago, second-hand interviews from documentaries and past ethnographies from scholars to draw meaningful conclusions about their experience as a community. In the end, it focuses on the group of Rohingyas who have managed to resettle in another country and their transitioning experience. Rohingyas embody violence on their individual, social, and political bodies in different ways. Along with rape, murder, and physical harm, the community also encounters sexually transmitted infections, post-traumatic stress disorder symptoms, and poor mental health. On a social level, they encounter heightened gender discrimination, work industry shifting, and immense, shared emotional pain. As for their political body, the news media and journalism industry uses their bodies for purposes that benefit both parties and flirts with a tone of sensationalism in their reporting. In addition, the Rohingya community fluctuates with the concept of nationality, patriotism, citizenship, and refugee when they think about the future. This study provides a framework that future aid or health programs can use to determine the type of community need and its significance in the Rohingya community.

Keywords: embodiment, liminal, refugee, Rohingya

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