Search results for: family care team

Authors: Maryam Beiranvand, Sajad Yaghoubi

Abstract:

Background: Some microbes can colonize plants’ inner tissues without causing obvious damage and can even produce useful bioactive substances. In the present study, the diversity of the endophytic bacteria associated with medicinal plants from Iran was investigated by culturing techniques, molecular gene identification, as well as measuring them for antibacterial activity. Results: In the spring season from 2013 to 2014, 35 herb pharmacology samples were collected, sterilized, meshed, and then cultured on selective media culture. A total of 199 endophytic bacteria were successfully isolated from 35 tissue cultures of medical plants, and sixty-seven out of 199 bacterial isolates were subjected to identification by the 16S rRNA gene sequence analysis method. Based on the sequence similarity gene and phylogenetic analyses, these isolates were grouped into five classes, fourteen orders, seventeen families, twenty-one genera, and forty strains. The most abundant group of endophytic bacteria was actinobacterial, consisting of thirty-two (47%) out of 67 bacterial isolates. Ten (22.3%) out of 67 bacterial isolates remained unidentified and classified at the genus level. The signature of the 16S rRNA gene formed a distinct line in a phylogenetic tree showing that they might be new species of bacteria. One (5.2%) out of 67 bacterial isolates was still not well categorized. Forty-two out of 67 strains were candidates for antimicrobial activity tests. Nineteen (45%) out of 42 strains showed antimicrobial activity multidrug resistance (MDR); thirteen (68%) out of 19 strains were allocated to classes actinobacteria. Four (21%) out of 19 strains belonged to the Bacillaceae family, one (5.2%) out of 19 strains was the Paenibacillaceae family, and one (5.2%) out of 19 strains belonged to the Pseudomonadaceae family. The other twenty-three strains did not show inhibitory activities. Conclusions: Our research showed a high-level phylogenetic diversity and the intoxicating antibiotic activity of endophytic bacteria in the herb pharmacology of Iran.

Keywords: Antibacterial activity, endophytic bacteria, multidrug-resistant bacteria, whole genom sequencing

Procedia PDF Downloads 87

Authors: Fatima Faraz

Abstract:

BACKGROUND: While Artificial intelligence (AI) provides new opportunities across a wide variety of industries, healthcare is no exception. AI can lead to advancements in how the healthcare system functions and improves the quality of patient care. Developing countries like Pakistan are lagging in the implementation of AI-based solutions in healthcare. This demands increased knowledge and AI literacy among health care professionals. OBJECTIVES: To assess the level of awareness among medical students and faculty about AI in preparation for teaching AI basics and data science applications in clinical practice in an integrated medical curriculum. METHODS: An online 15-question semi-structured questionnaire, previously tested and validated, was delivered among participants through convenience sampling. The questionnaire composed of 3 parts: participant’s background knowledge, AI awareness, and attitudes toward AI applications in medicine. RESULTS: A total of 182 students and 39 faculty members from Rawalpindi Medical University, Pakistan, participated in the study. Only 26% of students and 46.2% of faculty members responded that they were aware of AI topics in clinical medicine. The major source of AI knowledge was social media (35.7%) for students and professional talks and colleagues (43.6%) for faculty members. 23.5% of participants answered that they personally had a basic understanding of AI. Students and faculty (60.1%) were interested in AI in patient care and teaching domain. These findings parallel similar published AI survey results. CONCLUSION: This survey concludes interest among students and faculty in AI developments and technology applications in healthcare. Further studies are required in order to correctly fit AI in the integrated modular curriculum of medical education.

Keywords: medical education, data science, artificial intelligence, curriculum

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Authors: Kimberly Otieno

Abstract:

The Nairobi Hospital plays a pivotal role in healthcare provision in East and Central Africa, yet it faces challenges in providing accessible dialysis care. This paper explores strategic interventions to enhance dialysis care, improve access, and streamline health information management, with the aim of fostering an integrated and patient-centered healthcare system in our region. Challenges at The Nairobi Hospital: The Nairobi Hospital currently grapples with insufficient dialysis machines, which results in extended turnaround times. This issue stems from both staffing bottlenecks and infrastructural limitations, given our growing demand for renal care services. Our paper-based record-keeping system and fragmented flow of information downstream hinder the hospital’s ability to manage health data effectively. There is also a need for investment in expanding the Nairobi Hospital dialysis facilities to far-reaching communities. Setting up satellite clinics that are closer to people who live in areas far from the main hospital will ensure better access to underserved areas. Community Outreach and Education: Implementing education programs on kidney health within local communities is vital for early detection and prevention. Collaborating with local leaders and organizations can establish a proactive approach to renal health hence reducing the demand for acute dialysis interventions. We can amplify this effort by expanding The Nairobi Hospital’s corporate social responsibility outreach program with weekend engagement activities such as walks, awareness classes and fund drives. Enhancing Efficiency in Dialysis Care: Demand for dialysis services continues to rise due to an aging Kenyan population and the increasing prevalence of chronic kidney disease (CKD). Present at this year's International Nursing Conference are a diverse group of caregivers from around the world who can share with us their process optimization strategies, patient engagement techniques, and resource utilization efficiencies to catapult The Nairobi Hospital to the 21st century and beyond. Plans are underway to offer ongoing education opportunities to keep staff updated on best practices and emerging technologies, in addition to utilizing patient feedback mechanisms to identify areas for improvement and enhance satisfaction. Staff empowerment and suggestion boxes address the Nairobi Hospital’s organizational challenges. Current financial constraints may limit a leapfrog in technology integration, such as the acquisition of new dialysis machines and an investment in predictive analytics to forecast patient needs and optimize resource allocation. Streamlining Health Information Management: Fully embracing a shift to 100% electronic health records (EHRs) is a transformative step toward efficient health information management. Shared information promotes a holistic understanding of patients’ medical history, minimizing redundancies and enhancing overall care quality. To manage the transition to community-based care and EHRs effectively, a phased implementation approach is recommended. Conclusion: By strategically enhancing dialysis care access and streamlining health information management, the Nairobi Hospital can strengthen its position as a leading healthcare institution in both East and Central Africa. This comprehensive approach aligns with the hospital’s commitment to providing high-quality, accessible, and patient-centered care in an evolving landscape of healthcare delivery.

Keywords: Africa, urology, dialysis, healthcare

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Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

Abstract:

Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

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Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

Abstract:

Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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Authors: Ibrahim Alsendid, Rob Sturman, Benjamin Sharp

Abstract:

In this paper, we consider a family of 2-dimensional nonlinear area-preserving transformations on the torus. A single parameter η varies between 0 and 1, taking the transformation from a hyperbolic toral automorphism to the “Cerbelli-Giona” map, a system known to exhibit multifractal properties. Here we study the multifractal properties of the family of maps. We apply a box-counting method by defining a grid of boxes Bi(δ), where i is the index and δ is the size of the boxes, to quantify the distribution of stable and unstable manifolds of the map. When the parameter is in the range 0.51< η <0.58 and 0.68< η <1 the map is ergodic; i.e., the unstable and stable manifolds eventually cover the whole torus, although not in a uniform distribution. For accurate numerical results, we require correspondingly accurate construction of the stable and unstable manifolds. Here we use the piecewise linearity of the map to achieve this, by computing the endpoints of line segments that define the global stable and unstable manifolds. This allows the generalized fractal dimension Dq, and spectrum of dimensions f(α), to be computed with accuracy. Finally, the intersection of the unstable and stable manifold of the map will be investigated and compared with the distribution of periodic points of the system.

Keywords: Discrete-time dynamical systems, Fractal geometry, Multifractal behaviour of the Perturbed map, Multifractal of Dynamical systems

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Authors: Maryam Beiranvand, Sajad Yaghoubi

Abstract:

Background: Some microbes can colonize plants’ inner tissues without causing obvious damage and can even produce useful bioactive substances. In the present study, the diversity of the endophytic bacteria associated with medicinal plants from Iran was investigated by culturing techniques, molecular gene identification, as well as measuring them for antibacterial activity. Results: In the spring season from 2013 to 2014, 35 herb pharmacology samples were collected, sterilized, meshed, and then cultured on selective media culture. A total of 199 endophytic bacteria were successfully isolated from 35 tissue cultures of medical plants, and sixty-seven out of 199 bacterial isolates were subjected to identification by the 16S rRNA gene sequence analysis method. Based on the sequence similarity gene and phylogenetic analyses, these isolates were grouped into five classes, fourteen orders, seventeen families, twenty-one genera, and forty strains. The most abundant group of endophytic bacteria was actinobacterial, consisting of thirty-two (47%) out of 67 bacterial isolates. Ten (22.3%) out of 67 bacterial isolates remained unidentified and classified at the genus level. The signature of the 16S rRNA gene formed a distinct line in a phylogenetic tree showing that they might be new species of bacteria. One (5.2%) out of 67 bacterial isolates was still not well categorized. Forty-two out of 67 strains were candidates for antimicrobial activity tests. Nineteen (45%) out of 42 strains showed antimicrobial activity multidrug-resistance (MDR); thirteen (68%) out of 19 strains were allocated to classes actinobacteria. Four (21%) out of 19 strains belonged to the Bacillaceae family, one (5.2%) out of 19 strains was the Paenibacillaceae family, and one (5.2%) out of 19 strains belonged to the Pseudomonadaceae family. The other twenty-three strains did not show inhibitory activities. Conclusions: Our research showed a high-level phylogenetic diversity and the intoxicating antibiotic activity of endophytic bacteria in the herb pharmacology of Iran.

Keywords: medical plant, endophytic bacteria, antimicrobial activity, whole genome sequencing analysis

Procedia PDF Downloads 126

Authors: M. A. N. Rasanjalee Perera

Abstract:

The world is facing several problems due to increasing elderly population. In Sri Lanka, along with the complexity of the modern society and structural and functional changes of the family, “caring for elders” seems as an emerging social problem. This situation may intensify as the county is moving into a middle income society. Seeking higher education and related career opportunities, and urban living in modern housing are new trends, through which several problems are generated. Among many issues related with elders, “lack of accessible and appropriate facilities in their houses as well as public buildings” can be identified as a major problem. This study argues that welfare facilities provided for the elderly people, particularly in the home environment, in the country are not adequate. Modern housing features such as bathrooms, pantries, lobbies, and leisure areas etc. are questionable as to whether they match with elders’ physical and mental needs. Consequently, elders have to face domestic accidents and many other difficulties within their living environments. Records of hospitals in the country also proved this fact. Therefore, this study tries to identify how far modern houses are suited with elders’ needs. The study further questioned whether “aging” is a considerable matter when people are buying, planning and renovating houses. A randomly selected sample of 50 houses were observed and 50 persons were interviewed around the Maharagama urban area in Colombo district to obtain primary data, while relevant secondary data and information were used to have a depth analysis. The study clearly found that none of the houses included to the sample are considering elders’ needs in planning, renovating, or arranging the home. Instead, most of the families were giving priority to the rich and elegant appearance and modern facilities of the houses. Particularly, to the bathrooms, pantry, large setting areas, balcony, parking slots for two vehicles, ad parapet walls with roller-gates are the main concerns. A significant factor found here is that even though, many children of the aged are in middle age and reaching their older years at present, they do not plan their future living within a safe and comfortable home, despite that they are hoping to spent the latter part of their lives in the their current homes. This fact highlights that not only the other responsible parts of the society, but also those who are reaching their older ages are ignoring the problems of the aged. At the same time, it was found that more than 80% of old parents do not like to stay at their children’s homes as the living environments in such modern homes are not familiar or convenient for them. Due to this context, the aged in Sri Lanka may have to be alone in their own homes due to current trend of society of migrating to urban living in modern houses. At the same time, current urban families who live in modern houses may have to face adding accessible facilities in their home environment, as current modern housing facilities may not be appropriate them for a better life in their latter part of life.

Keywords: aging population, elderly care, home environment, housing facilities

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Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Degenerative disc disease is a process of premature and accelerated deterioration of the intervertebral disc; it is of multifactorial origin and is responsible for chronic low back pain. Objectives: Determine an epidemiological profile of patients with painful lumbar degenerative disc disease. Patients and methods: We performed a prospective study of 104 patients operated on for degenerative painful lumbar disc disease over a period of 25 months. The parameters analyzed were: age, sex, Body Mass Index (BMI), comorbidities, family history of low back pain, and difficulty with professional activity. Results: The average age was 43.3 years, with a clear predominance of men: 72 men for 32 women, the average BMI was 26.80Kg / m2, and 63.5% of the patients were overweight. The occurrence of disc degeneration in pathological conditions was noted in 14.4% of cases. The notion of familial low back pain was found in 49% of cases. The majority of patients perform more or less arduous work (51%) in the cases. Conclusion: In our series, degenerative painful lumbar disc disease predominates in the male subject, active obese who performs more or less painful work, in whom we find a family history of low back pain.

Keywords: degenerative disc disease, low back pain, body mass index, disque intervertebrale

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Authors: Sunil Gaikwad

Abstract:

Gender discrimination is a very prevalent and much used word in the legal parlance. , The more socially, culturally, economically and educationally backward the community, the more gender discrimination is seen there. Gender discrimination is a worldwide Phenomena. In India it was more prevalent, due to illiteracy, bad social and religious customs. in Indian family system male child is considered as inheritor of the family clan, support for parents in their old age and girls as the property of others and unnecessary load on parents and on property as the dowry has to be give at her marriage as also some festivals like Raksha Bandhan and Bhau Teej during Deepawali (wherein having brother is compulsory)insist on having a male child in the family, hence most couples try to give birth only to male child at the cost of female child, hence the female feticide was going on a large scale due to which, sex ratio had considerably decreased creating problem for geeting groom for bride groom thereby putting question mark on family system. To redo the damage done to the society due to the female feticide Government of India has enacted various Laws and introduced various welfare schemes for the upliftment of girl child and also launched countrywide awareness campaign to create awareness among people about the importance of girl child and punitive laws for infanticide which is now bearing fruits but still cases of female feticide are coming fore. There is an urgent need to go to the roots of the problem and to find practicable and effective legal and social measures to overcome this issue, and the purpose of this research paper is the same. The research paper discusses in detail the reasons and superstitions that are responsible for the gender discriminations and comes out with effective measures including necessary and effective changes in the existing Laws, effective awareness campaign against religious superstitions for gender equality. For this research paper doctrinal research methodology is used to drive the research to its logical conclusion, for which various primary and secondary sources literature has been perused and studied. It is worth noting that while working on the paper suggestions and recommendations and conclusions have been drawn where it is suggested and concluded that there is an urgent need to re think about the festivals which encourages gender discriminations, to sensitize and create ample of awareness among people by effectively utilizing Radio, Television, Social Media folk arts, public shows and to make existing laws more effective and strict implementation for the purpose and zero tolerance for female feticide.

Keywords: awareness, effective laws, female foeticide, festivals, superstitions

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Authors: Laura M. F. Bertens

Abstract:

The houses we inhabit are important containers of memory. As homes, they take on meaning for those who live inside, and memories of family life become intimately tied up with rooms, windows, and gardens. Each new family creates a new layer of meaning, resulting in a palimpsest of family memory. These houses function quite literally as memory palaces, as a walk through a childhood home will show; each room conjures up images of past events. Over time, these personal memories become woven together with the cultural memory of countries and generations. The importance of the home is a central theme in art, and several contemporary artists have a special interest in the relationship between memory and the home. This paper analyses three case studies in order to get a deeper understanding of the ways in which the home functions and feels like a memory palace, both on an individual and on a collective, cultural level. Close reading of the artworks is performed on the theoretical intersection between Art History and Cultural Memory Studies. The first case study concerns works from the exhibition Mnemosyne by the artist duo Anne and Patrick Poirier. These works combine interests in architecture, archaeology, and psychology. Models of cities and fantastical architectural designs resemble physical structures (such as the brain), architectural metaphors used in representing the concept of memory (such as the memory palace), and archaeological remains, essential to our shared cultural memories. Secondly, works by Do Ho Suh will help us understand the relationship between the home and memory on a far more personal level; outlines of rooms from his former homes, made of colourful, transparent fabric and combined into new structures, provide an insight into the way these spaces retain individual memories. The spaces have been emptied out, and only the husks remain. Although the remnants of walls, light switches, doors, electricity outlets, etc. are standard, mass-produced elements found in many homes and devoid of inherent meaning, together they remind us of the emotional significance attached to the muscle memory of spaces we once inhabited. The third case study concerns an exhibition in a house put up for sale on the Dutch real estate website Funda. The house was built in 1933 by a Jewish family fleeing from Germany, and the father and son were later deported and killed. The artists Anne van As and CA Wertheim have used the history and memories of the house as a starting point for an exhibition called (T)huis, a combination of the Dutch words for home and house. This case study illustrates the way houses become containers of memories; each new family ‘resets’ the meaning of a house, but traces of earlier memories remain. The exhibition allows us to explore the transition of individual memories into shared cultural memory, in this case of WWII. Taken together, the analyses provide a deeper understanding of different facets of the relationship between the home and memory, both individual and collective, and the ways in which art can represent these.

Keywords: Anne and Patrick Poirier, cultural memory, Do Ho Suh, home, memory palace

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Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown

Abstract:

Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.

Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

Abstract:

Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Sakineh Abbasi Bourondaragh

Abstract:

The aim of this research is effectiveness of integrative behavioral couples therapy on the communication patterns of couples applying for divorce. We selected (N=20) reports from Tabriz Family Judicial Complex (FJC) of couples which have conflict in their marital relationships. All of reports were released during 2012. First, they were randomly divided into two experimental and control groups and all the couples were given pre-test. They participated in twelve therapy sessions. Then the experimental group was exposed to an experimental intervention, but the control group was not received experimental intervention. The subjects were treated. At the end of treatment, a post-test was performed about subjects (each of two groups).The results showed that integrative behavioral couple therapy could increase and improve communication patterns. The findings also showed that integrative behavioral couples therapy had increased mutual constructive pattern and decreased demand/withdraw pattern and mutual avoidance pattern of CPQ sub-scale. Steady change indicator showed that the difference is clinically meaningful.

Keywords: integrative behavioral couple therapy, communication patterns, cognitive sciences, Family Judicial Complex

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Authors: Azman Ramlie, Vivian Foo Jing Wen

Abstract:

As the advancement of technology has tremendously changed the way people communicate with each other, it has opened up opportunities for interracial relationships. Interracial relationship is also known as intercultural or interethnic relationships. This research topic aims to study on students’ perceptions toward interracial relationship in terms of their level of acceptance and approval. In addition, the study also focuses on determining and ranking the factors that affects students’ perceptions towards interracial relationship. This study also targets to determine the differences in students’ perceptions from business and communication major. This study uses a sample of university students from Sunway University, particularly on students in business and communication major. The study was conducted through online survey questionnaires. Results revealed that students’ level of acceptance towards interracial relationship was high. In addition, results also further indicated that family members’ support was one of the most important factors in influencing students’ perception towards interracial relationship. No diverse differences of perceptions among students in business and communication major towards interracial relationship were shown in the findings. Most of the result showed that both majors turned out to have similar perceptions towards interracial relationship. It can be said that the students’ perception towards interracial relationship did not differ from which major the students was in but their family background that would shape their perceptions.

Keywords: interracial relationship, racial, relationship, perceptions

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Authors: Bo Ram Choi, Ji Su Kim, Juyeon Cho, Hyukjin Lee

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Food contaminated by bacteria (E.coli), causes food poisoning, which occurs to many patients worldwide annually. We have introduced an application of rolling circle amplification (RCA) as a versatile biosensor and developed a diagnostic platform composed of capillary tube and microbeads for rapid and easy detection of Escherichia coli (E. coli). When specific mRNA of E.coli is extracted from cell lysis, rolling circle amplification (RCA) of DNA template can be achieved and can be visualized by beads aggregation in capillary tube. In contrast, if there is no bacterial pathogen in sample, no beads aggregation can be seen. This assay is possible to detect visually target gene without specific equipment. It is likely to the development of a genetic kit for point of care testing (POCT) that can detect target gene using microbeads.

Keywords: rolling circle amplification (RCA), Escherichia coli (E. coli), point of care testing (POCT), beads aggregation, capillary tube

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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Authors: Mehravar Javid, Stacey Dershewitz, Shohreh Hashemighoochani, Artin Yousefi

Abstract:

One of the most common reasons for destroying relationships is infidelity. This study was conducted to understand children's experience of infidelity in Iran. In this qualitative research, the interpretive phenomenological approach and theoretical (purposive) sampling method were used, and the data was saturated by conducting semi-structured interviews with eight offspring of families affected by infidelity. All interviews were audio recorded and analyzed on paper after implementation. Acceptability and homogeneity of data were confirmed by different methods. Eight main themes were identified from the participants' statements: description of the family atmosphere, lack of security and distrust, emotional reactions, behavioral reactions, worry about the future, financial problems, mother's physical-psychological state, and mother's coping strategies and offspring's proposed solutions. The children's experiences showed that in addition to causing irreparable harm to the wife, infidelity affected the whole family and caused the children to suffer crucial consequences such as emotional, behavioral, educational, and economic consequences and mistrust.

Keywords: consequences and hurt, infidelity, offspring, phenomenology, qualitative research

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Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

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Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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Authors: Doctor Akanle Florence Foluso

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Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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Authors: Anela Lupuwana

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The main objective of this paper is to develop an ethnobotanical survey that documents medicinal plants used to treat diarrhea among infants in the Eastern Cape province of South Africa. In South Africa’s pluralistic healthcare system, medicinal plants are an integral part of healing and treating an array of diseases. This is also the case in rural areas of South Africa, where healthcare facilities are hard to access. There is a lack of literature on the use of medicinal plants to cure ailments common to children, and this paper fills this gap. A total of 18 participants were interviewed using semi-structured interviews. A purposive approach was used to sample the study cohorts. A total of 28 medicinal plants representing 19 different families were recorded, with the family Asteraceae (11%) having the most medicinal plants. The remaining plants (82%) were distributed equally among the following families: Rubiaceae, Canellaceae, Aloaceae, Rutaceae, Thymeleaceae, Myrinaceae, Olinaceae, Iradeceae, Zingiberaceae, Capparaceae, Aizoaceae, Fabaceae, Geraniaceae, Cornaceae, Monimiaceae, Talinaceae, Chrysobalanaceae, and Icacinaceae. Oral administration was the most common mode of administration, with 82% of plants taken orally. Healing was proven to be holistic; it was more than just treating physical ailments as such; infants were protected from evil spirits that made them vulnerable to illnesses. There was also evidence of the assimilation of Dutch medicine and animal products into traditional healing methods. In order to mitigate the prevalence of disease and illness in South Africa, I recommend that diversity in healing practices should be acknowledged and appreciated.

Keywords: infants, traditional healers, primary care givers, traditional medicine

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Authors: Pei Yi Lin

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Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.

Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model

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Authors: Isabel Gouveia

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Antimicrobial textile materials may significantly reduce the risk of infections and because they are able to absorb substances from the skin and release therapeutic compounds to the skin, they can also find applications as complementary therapy of skin-diseases as part of standard management. Although functional textiles may be a promising area in skin disease/injury management, as part of standard management, few offer complementary treatment even though they are well known to reduce scratching and aiding emollient absorption, reducing infection, and alleviating pruritus. The reason for this may rely on the low quality of supporting evidence and negative effect that antimicrobial agents may exert on skin microbiome, as for example additional irritation of the vulnerable skin, and by causing resistant bacteria. Several antimicrobial agents have been tested in textiles: quaternary ammonium compounds, silver, polyhexamethylene-biguanides and triclosan have been used, with success. They have powerful bactericidal activity but the majority have a reduce spectrum of microbial inhibition and may cause skin irritation, ecotoxicity and bacteria resistance. Furthermore, the rising flow of strains resistant to last-resort antibiotics rekindles interest in alternative strategies. In this regard, new functional textiles incorporating highly specific antimicrobial agents towards pathogenic bacteria, are required. Recent research has been conducted on naturally occurring antimicrobials as novel alternatives to antibiotics. Conscious of this need our team firstly reported new approaches using L-cysteine and antimicrobial peptides (AMP). Briefly, we were able to develop different immobilization processes towards 6 Log Reduction against bacteria such as S. aureus and K. pneumoniae. Therefore, here we present several innovative antimicrobial textiles incorporating AMP and L-Cysteine which may open new avenues for the medical textiles market and biomaterials in general. Team references will be discussed as an overview and for comparison purposes in terms of potential therapeutic applications.

Keywords: Antimicrobials, Antimicrobial Textiles, Biomedical Textiles, Biomimetic surface functionalization

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Authors: Zeeshan Hamid, Asher Ramish

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The purpose of this paper is to focus on security and safety issues facing by pharmaceutical industry globally when counterfeit drugs are in question. Hence, there is an intense need to secure and authenticate pharmaceutical products in the emerging counterfeit product market. This paper will elaborate the application of radio frequency identification (RFID) in pharmaceutical industry and to identify its key benefits for patient’s care. The benefits are: help to co-ordinate the stream of supplies, accuracy in chains of supplies, maintaining trustworthy information, to manage the operations in appropriate and timely manners and finally deliver the genuine drug to patient. It is discussed that how RFID supported supply chain information sharing (SCIS) helps to combat against counterfeit drugs. And a solution how to tag pharmaceutical products; since, some products prevent RFID implementation in this industry. In this paper, a proposed model for pharma industry distribution suggested to combat against the counterfeit drugs when they are in supply chain.

Keywords: supply chain, RFID, pharmaceutical industry, counterfeit drugs, patients care

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Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia

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Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.

Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders

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Authors: Mojeed A. Oladele

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The original zoning system in Louisville promoted social segregation among groups and remained a tool for social exclusion that strengthened preexisting inequalities. The current residential zoning system in Louisville is predominantly single-family residential housing. Of the 75% of total land allocated for residential purposes, 55% comprises single-family housing, constituting one form of development and ruminant problems of social segregation within the city. The zoning reform initiative birthed the spatial improvement and development of additional middle housing as a more generic and inclusive housing form. The paper investigates the basis of zoning reform relative to the interconnectedness amongst the discursive objects of analysis and the extensiveness as a strategic tool of structural adjustment. Qualitative methodological assessment generated by collective planning professionals reflects the effectiveness of the new zoning design in strengthening the socio-spatial interactions within the city. The zoning reform is currently at the early stage of implementation and requires more professional/public inputs and constant iterative processes for a more promising urban planning outcome.

Keywords: zoning reform, viability, urban inequality, housing affordability, Louisville

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Authors: O. A. Al-Mashaqbeh, A. M. Ghrair, D. Alsafadi, S. S. Dalahmeh, S. L. Bartelt-Hunt, D. D. Snow

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Grab samples were collected in the summer to characterize selected pharmaceuticals and personal care products (PPCPs) in the influent of two wastewater treatment plants (WWTPs) in Jordan. Liquid chromatography tandem mass spectrometry (LC–MS/MS) was utilized to determine the concentrations of 18 compounds of PPCPs. Among all of the PPCPs analyzed, eight compounds were detected in the influent samples (1,7-dimethylxanthine, acetaminophen, caffeine, carbamazepine, cotinine, morphine, sulfamethoxazole and trimethoprim). However, five compounds (amphetamine, cimetidine, diphenhydramine, methylenedioxyamphetamine (MDA) and sulfachloropyridazine) were not detected in collected samples (below the detection limits <0.005 µg/l). Moreover, the results indicated that the highest concentration levels detected in collected samples were caffeine, acetaminophen, 1,7-dimethylxanthine, cotinine and carbamazepine at concentration of 182.5 µg/L, 28.7 µg/l, 7.47 µg/l, 4.67 µg/l and 1.54 µg/L, respectively. In general, most of compounds concentrations measured in wastewater in Jordan are within the range for wastewater previously reported in India wastewater except caffeine.

Keywords: pharmaceuticals, personal care products, wastewater, Jordan

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Authors: María-Dolores Olvera-Lobo, Bryan John Robinson, Juncal Gutierrez-Artacho

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Graduates are equipped with a wide range of generic competencies which complement solid curricular competencies and facilitate their access to the labour market in diverse fields and careers. However, some generic competencies such as instrumental, personal and systemic competencies related to teamwork and interpersonal communication skills, decision-making and organization skills are seldom taught explicitly and even less often assessed. In this context, translator training has embraced a broad range of competencies specified in the undergraduate program currently taught at universities and opens up the learning experience to cover areas often ignored due to the difficulties inherent in both teaching and assessment. In practice, translator training combines two well-established approaches to teaching/learning: project-based learning and genuinely cooperative – or merely collaborative – learning. Our professional approach to translator training is a model focused on and adapted to the teleworking context of professional translation and presented through the medium of blended e-learning. Teamwork-related competencies are extremely relevant, and they require explicit and implicit teaching so that graduates can be confident about their capacity to make their way in professional contexts. In order to highlight the importance of teamwork and intra-team relationships beyond the classroom, we aim to raise awareness of teamwork processes so as to empower translation students in managing their interaction and ensure that they gain valuable pre-professional experience. With these objectives, at the University of Granada (Spain) we have developed a range of classroom activities and assessment tools. The results of their application are summarized in this study.

Keywords: blended learning, collaborative teamwork, cross-curricular competencies, higher education, intra-team relationships, students’ perceptions, translator training

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Authors: Kiana Taghikhan, Shamim Sherafat, Mostafa Taheri

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Although many people with autism spectrum disorder around the world face many problems and challenges, their conditions may unintentionally affect the lives of the people around them. In this research the experiences of siblings of autistic children have been investigated in both the public and private spheres of their lives. "Private sphere" includes the experiences of research participants in socializing with relatives and family, assignments and responsibilities, as well as how they spend their leisure time and lifestyle. The "public sphere" includes the experience of their presence in society, such as university, or workplace and any outdoor activities that could have been affected by their sibling’s disorder. The present research has been done using the qualitative research method and in-depth interview technique with siblings of autistic children. The sample population is 15 individuals who participated in the research theoretically and purposefully. Based on the findings, the private and social experiences of these individuals is very different compared to peers who do not have siblings with autism disorder in the family. The difference is to such an extent that causes them to separate and distance themselves from other members of the society, and depending on their special conditions, it can affect their goals and life opportunities such as job, marriage, having children, etc.

Keywords: autism spectrum disorder, siblings, private sphere, public sphere

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Authors: Zena F. Mushtaq, Iqbal M. Abbas

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Background: Diabetes mellitus during pregnancy is one of the major medical and social problems with increasing prevalence in last decades and may lead to more vulnerable to dental problems and increased risk for periodontal diseases. Objectives: To assess oral hygiene behaviors among pregnant women with diabetes who attended primary health care centers and find out the relationship between oral hygiene behaviors and studied variables. Methodology: A cross sectional design was conducted from 7 July to 30 September 2014 on non probability (convenient sample) of 150 pregnant women with diabetes was selected from twelve Primary Health Care Centers at Baghdad city. Questionnaire format is tool for data collection which had designed and consisted of three main parts including: socio demographic, reproductive characteristics and items of oral hygiene behaviors among pregnant women with diabetes. Reliability of the questionnaire was determined through internal consistency of correlation coefficient (R= 0.940) and validity of content was determined through reviewing it by (12) experts in different specialties and was determined through pilot study. Descriptive and inferential statistics were used to analyze collected data. Result: Result of study revealed that (35.3%) of study sample was (35-39) years old with mean and SD is (X & SD = 33.57 ± 5.54) years, and (34.7%) of the study sample was graduated from primary school and less, half of the study sample was government employment and self employed, (42.7%) of the study sample had moderate socioeconomic status, the highest percentage (70.0%) of the study sample was nonsmokers, The result indicates that oral hygiene behaviors have moderate mean score in all items. There are no statistical significant association between oral hygiene domain and studied variables. Conclusions: All items related to health behavior concerning oral hygiene is in moderate mean of score, which may expose pregnant women with diabetes to high risk of periodontal diseases. Recommendations: Dental care provider should perform a dental examination at least every three months for each pregnant woman with diabetes, explanation of the effect of DM on periodontal health, oral hygiene instruction, oral prophylaxis, professional cleaning and treatment of periodontal diseases(scaling and root planing) when needed.

Keywords: diabetes, health behavior, pregnant women, oral hygiene

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