Search results for: mobile health monitoring

Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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Authors: Abdulaziz Alakeel, Abdulrahman Alomair, Mohammed Fouda

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Introduction: Methotrexate (MTX) is an antimetabolite used to treat multiple conditions, including neoplastic diseases, severe psoriasis, and rheumatoid arthritis. Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The aim of this review is to evaluate the risk of skin cancer associated with the use of methotrexate and to suggest regulatory recommendations if required. Methodology: Signal Detection team at Saudi Food and Drug Authority (SFDA) performed a safety review using National Pharmacovigilance Center (NPC) database as well as the World Health Organization (WHO) VigiBase, alongside with literature screening to retrieve related information for assessing the causality between skin cancer and methotrexate. The search conducted in July 2020. Results: Four published articles support the association seen while searching in literature, a recent randomized control trial published in 2020 revealed a statistically significant increase in skin cancer among MTX users. Another study mentioned methotrexate increases the risk of non-melanoma skin cancer when used in combination with immunosuppressant and biologic agents. In addition, the incidence of melanoma for methotrexate users was 3-fold more than the general population in a cohort study of rheumatoid arthritis patients. The last article estimated the risk of cutaneous malignant melanoma (CMM) in a cohort study shows a statistically significant risk increase for CMM was observed in MTX exposed patients. The WHO database (VigiBase) searched for individual case safety reports (ICSRs) reported for “Skin Cancer” and 'Methotrexate' use, which yielded 121 ICSRs. The initial review revealed that 106 cases are insufficiently documented for proper medical assessment. However, the remaining fifteen cases have extensively evaluated by applying the WHO criteria of causality assessment. As a result, 30 percent of the cases showed that MTX could possibly cause skin cancer; five cases provide unlikely association and five un-assessable cases due to lack of information. The Saudi NPC database searched to retrieve any reported cases for the combined terms methotrexate/skin cancer; however, no local cases reported up to date. The data mining of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by the WHO Uppsala Monitoring Centre to measure the reporting ratio. Positive IC reflects higher statistical association, while negative values translated as a less statistical association, considering the null value equal to zero. Results showed that a combination of 'Methotrexate' and 'Skin cancer' observed more than expected when compared to other medications in the WHO database (IC value is 1.2). Conclusion: The weighted cumulative pieces of evidence identified from global cases, data mining, and published literature are sufficient to support a causal association between the risk of skin cancer and methotrexate. Therefore, health care professionals should be aware of this possible risk and may consider monitoring any signs or symptoms of skin cancer in patients treated with methotrexate.

Keywords: methotrexate, skin cancer, signal detection, pharmacovigilance

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Authors: Pangkaj Kumar Mahanta, Md. Rafizul Islam

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The rapid growth of the population causes a substantial amount of increase in household waste all over the world. Waste management is becoming one of the most challenging phenomena in the present day. The most environmentally friendly final disposal process of waste is sanitary landfilling, which is practiced in most developing countries. However, in Southeast Asia, most of the final disposal point is an open dump site. Due to the ignominy of proper management of waste and monitoring, the surrounding environment gets polluted more by the open dump site in comparison with a sanitary landfill. Khulna is 3rd largest metropolitan city in Bangladesh, having a population of around 1.5 million and producing approximately 450 tons per day of Municipal Solid Waste. The Municipal solid waste of Khulna city is disposed of in Rajbandh open dump site. The surrounding air is being polluted by the gas produced in the open dump site. Also, the open dump site produces leachate, which contains various heavy metals like Cadmium (Cd), Chromium (Cr), Lead (Pb), Manganese (Mn), Mercury (Hg), Strontium (Sr), etc. Leachate pollutes the soil as well as the groundwater of the open dump site and also the surrounding area through seepage. Moreover, during the rainy season, the surface water is polluted by leachate runoff. Also, the plastic waste flowing out from the open dump site through various drivers pollutes the nearby environment. The health risk assessment associated with heavy metals was carried out by computing the chronic daily intake (CDI), hazard quotient (HQ), and hazard index (HI) via different exposure pathways following the USEPA guidelines. For ecological risk, potential contamination index (Cp), Contamination factor (CF), contamination load index (PLI), numerical integrated contamination factor (NICF), enrichment factor (EF), ecological risk index (ER), and potential ecological risk index (PERI) were computed. The health risk and ecological risk assessment results reveal that some heavy metals possess strong health and ecological risk. In addition, the child faces higher harmful health risks from several heavy metals than the adult for all the exposure pathways and media. The conversion of an open dump site into a sanitary landfill and a proper management system can reduce the problems associated with an open dump site. In the sanitary landfill, the produced gas will be managed properly to save the surrounding atmosphere from being polluted. The seepage of leachate can be minimized by installing a compacted clay layer (CCL) as a baseline and leachate collection in a sanitary landfill to save the underlying soil layer and surrounding water bodies from leachate. Another important component of a sanitary landfill is the conversion of plastic waste to energy will minimize the plastic pollution in the landfill area and also the surrounding soil and water bodies. Also, in the sanitary landfill, the bio-waste can be used to make compost to reduce the volume of bio-waste and proper utilization of the landfill area.

Keywords: ecological risk, health risk, open dump site, sanitary landfill

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Authors: Sireen Irsheid, Stephanie Keeney Parks, Michael A. Lindsey

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The medical and mental health field have been organized as reactive systems to respond to symptoms of mental health problems and disability. This becomes problematic particularly for those harmed by structural violence and racism, typically pushing us in the direction of alleviating symptoms and personalizing structural problems. The current paper examines how we assess, diagnose, and treat mental health and disability challenges in clinical spaces. We provide the readers with some context to think about the problem of racism and mental health/disability, ways to deconstruct the problem through the lens of structural violence, and recommendations to critically engage in clinical assessments, diagnosis, and treatment for young people impacted by structural violence and racism.

Keywords: mental health, disability, race and ethnicity, structural violence, structural racism, young people

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Authors: Jaheon Gu, Wooyong Chung, Mijung Koo, Seonbok Lee, Gyoutae Park, Sangguk Ahn, Hiesik Kim, Jungil Park

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In this paper, we present a portable ammonia gas detector for performing the gas safety management efficiently. The display of the detector is separated from its body. The display module is received the data measured from the detector using ZigBee. The detector has a rechargeable li-ion battery which can be use for 11~12 hours, and a Bluetooth module for sending the data to the PC or the smart devices. The data are sent to the server and can access using the web browser or mobile application. The range of the detection concentration is 0~100ppm.

Keywords: ammonia, detector, gas, portable

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Authors: Yi Jen Wang, Yu Ju Chen

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Background: Heart rate variability (HRV) biofeedback can promote autonomic nervous function, sleep quality and reduce psychological stress. In HRV biofeedback training, it is hoped that through the guidance of machine video or audio, the patient can breathe slowly according to his own heart rate changes so that the heart and lungs can achieve resonance, thereby promoting the related effects of autonomic nerve function; while, it is also pointed out that if slow breathing of 6 times per minute can also guide the case to achieve the effect of cardiopulmonary resonance. However, there is no relevant research to explore the comparison of the effectiveness of cardiopulmonary resonance by using video or audio HRV biofeedback training and metronome-guided slow breathing. Purpose: To compare the promotion of autonomic nervous function performance between using HRV biofeedback and slow breathing guided by a metronome. Method: This research is a kind of experimental design with convenient sampling; the cases are randomly divided into the heart rate variability biofeedback training group and the slow breathing training group. The HRV biofeedback training group will conduct HRV biofeedback training in a four-week laboratory and use the home training device for autonomous training; while the slow breathing training group will conduct slow breathing training in the four-week laboratory using the mobile phone APP breathing metronome to guide the slow breathing training, and use the mobile phone APP for autonomous training at home. After two groups were enrolled and four weeks after the intervention, the autonomic nervous function-related performance was repeatedly measured. Using the chi-square test, student’s t-test and other statistical methods to analyze the results, and use p <0.05 as the basis for statistical significance. Results: A total of 27 subjects were included in the analysis. After four weeks of training, the HRV biofeedback training group showed significant improvement in the HRV indexes (SDNN, RMSSD, HF, TP) and sleep quality. Although the stress index also decreased, it did not reach statistical significance; the slow breathing training group was not statistically significant after four weeks of training, only sleep quality improved significantly, while the HRV indexes (SDNN, RMSSD, TP) all increased. Although HF and stress indexes decreased, they were not statistically significant. Comparing the difference between the two groups after training, it was found that the HF index improved significantly and reached statistical significance in the HRV biofeedback training group. Although the sleep quality of the two groups improved, it did not reach that level in a statistically significant difference. Conclusion: HRV biofeedback training is more effective in promoting autonomic nervous function than slow breathing training, but the effects of reducing stress and promoting sleep quality need to be explored after increasing the number of samples. The results of this study can provide a reference for clinical or community health promotion. In the future, it can also be further designed to integrate heart rate variability biological feedback training into the development of AI artificial intelligence wearable devices, which can make it more convenient for people to train independently and get effective feedback in time.

Keywords: autonomic nervous function, HRV biofeedback, heart rate variability, slow breathing

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Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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Authors: Doriane Micaela Andeme Bikoro, Samuel Fosso Wamba, Jean Robert Kala Kamdjoug

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Currently one of the leading fields in the market of technological innovation is digital health. In developed countries, this booming innovation is experiencing an exponential speed. We understand that in developed countries, e-health could also revolutionize the practice of medicine and therefore fill the many failures observed in medical care. Everything leads to believe that future technology is oriented towards the medical sector. The aim of this work is to explore at the same time the technological resources and the potential of health care based on new technologies; it is a case study in a rural area of Southern Cameroon. Among other things, we will make a census of the shortcomings and problems encountered, and we will propose various appropriate solutions. The work methodology used here is essentially qualitative. We used two qualitative data collection techniques, direct observation, and interviews. In fact, we spent two weeks in the field observing and conducting some semi-directive interviews with some of those responsible for these health structures. This study was conducted in three health facilities in the south of the country; including two health centers and a rural hospital. Many technological failures have been identified in the day-to-day management of these health facilities and especially in the administration of health care to patients. We note major problems such as the digital divide, the lack of qualified personnel, the state of isolation of this area. This is why various proposals are made to improve the health sector in Cameroon both technologically and medically.

Keywords: Cameroon, capacities, census, digital health, qualitative method, rural area

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Authors: Andreas Kornmaaler Hansen, Carlos Gomez Cubero, Elizabeth Jochum

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The use of the arts in therapy and rehabilitation is well established, and there is growing recognition of the value of the arts for improving health and well-being across diverse populations. Combining arts with socially assistive robots is a relatively under-explored research area. This paper presents the results of a feasibility study conducted within an existing arts and health program to scope the possibility of combining visual arts with socially assistive robots to promote mental health and well-being. Using a participatory research design with participant-led perspectives, we present the results of our feasibility study with a collaborative drawing robot among an adult population with mild to severe mental illness. We identify key methodological challenges and advantages of working with participatory and human-centered approaches. Based on the results of three pilot workshops with participants and lay health workers, we outline suggestions for authentic engagement with real stakeholders toward the development of socially assistive robots in community health contexts. Working closely with a patient population at all levels of the research process is key for developing tools and interventions that center patient experience and priorities while minimizing the risks of alienating patients and communities.

Keywords: arts and health, visual art, health promotion, mental health, collaborative robots, creativity, socially assistive robots

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Authors: Amardass Dhami, Clare Samuelson

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Background: Sickle cell disease (SCD) is a complex, multisystem condition that significantly impacts patients' quality of life, characterized by acute illness episodes, progressive organ damage, and reduced life expectancy. In the UK, over 13,000 individuals are affected, with South Yorkshire having the fifth highest prevalence, including approximately 800 patients. Retinal complications in SCD can manifest as either proliferative or non-proliferative disease, with proliferative changes being more prevalent. These retinal issues can cause significant morbidity, including visual loss and increased care requirements, underscoring the need for regular monitoring. An integrated approach was applied to ensure timely interventions, ultimately enhancing patient outcomes and reduce ‘did not attend’ rates. Aim: To assess the factors which may influence attendance to Haematology and Ophthalmology Clinics with attention towards levels of deprivation towards non-attendance. Method : A retrospective study on 84 eligible patients, from the regional tertiary Centre for Sickle Cell Care (Sheffield Teaching Hospital) from 2017 to 2023. The study focused on the incidence of sickle cell eye disease, specifically examining the outcomes of patients who attended the combined haematology and ophthalmology clinics. Patients who did not attend either clinic were excluded from the analysis to ensure a clear understanding of the combined clinic's impact. This data was then compared with the United Kingdom’s Index of Multiple Deprivation (IMD) datasets to assess if inequalities of care affected this population. Results: The study concluded that the effectiveness of combining haematology and ophthalmology clinics was reduced following the intervention. The DNA rates increased to 40% for the haematology clinic. Additionally, a significant proportion of the cohort was classified as residing in areas of deprivation, suggesting a possible link between socioeconomic factors and non-attendance rates Conclusion: These findings underscore the challenges of integrating care for SCD patients, particularly in relation to socioeconomic barriers. Despite the intent to streamline care and improve patient outcomes, the increase in DNA rates points to the need for further investigation into the underlying causes of non-attendance. Addressing these issues, especially in deprived areas, could enhance the effectiveness of combined clinics and ensure that patients receive the necessary monitoring and interventions for their eye health and overall well-being. Future strategies may need to focus on improving accessibility, outreach, and support for patients to mitigate the impact of socioeconomic factors on healthcare attendance.

Keywords: south yorkshire, sickle cell anemia, deprivation, factors, haematology

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Authors: T. Holecki, J. Wozniak-Holecka, P. Romaniuk

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Due to the highly centralized model of financing health care in Poland, local self-government rarely undertook their own initiatives in the field of public health, particularly health promotion. However, since 2017 the possibility of applying for a subsidy to health policy programs has been allowed, with the additional resources to be retrieved from the National Health Fund, which is the dominant payer in the health system. The amount of subsidy depends on the number of inhabitants in a given unit and ranges about 40% of the total cost of the program. The aim of this paper is to assess the impact of newly implemented solutions in financing health policy on the management of public finances, as well as on the activity provided by local self-government in health promotion. An effort to estimate the amount of expenses that both local governments, and the National Health Fund, spent on local health policy programs while implementing the new solutions. The research method is the analysis of financial data obtained from the National Health Fund and from local government units, as well as reports published by the Agency for Health Technology Assessment and Pricing, which holds substantive control over the health policy programs, and releases permission for their implementation. The study was based on a comparative analysis of expenditures on the implementation of health programs in Poland in years 2010-2018. The presentation of the results includes the inclusion of average annual expenditures of local government units per 1 inhabitant, the total number of positively evaluated applications and the percentage share in total expenditures of local governments (16 voivodships areas). The most essential purpose is to determine whether the assumptions of the subsidy program are working correctly in practice, and what are the real effects of introducing legislative changes into local government levels in the context of public health tasks. The assumption of the study was that the use of a new motivation tool in the field of public management would result in multiplication of resources invested in the provision of health policy programs. Preliminary conclusions show that financial expenditures changed significantly after the introduction of public funding at the level of 40%, obtaining an increase in funding from own funds of local governments at the level of 80 to 90%.

Keywords: health care system, health policy programs, local self-governments, public health management

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Authors: Neetu Tyagi, Sumit Sharma

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The study illustrates the results of an integrated study done on Tangni landslide located on NH-58 at Chamoli, Uttarakhand. Geological, geo-morphological and geotechnical investigations were carried out to understand the mechanism of landslide and to plan further investigation and monitoring. At any rate, the movements were favored by continuous rainfall water infiltration from the zones where the phyllites/slates and Dolomites outcrop. The site investigations were carried out including the monitoring of landslide movements and of the water level fluctuations due to rainfall give us a better understanding of landslide dynamics that have been causing in time soil instability at Tangni landslide site. The Early Warning System (EWS) installed different types of sensors and all sensors were directly connected to data logger and raw data transfer to the Defence Terrain Research Laboratory (DTRL) server room with the help of File Transfer Protocol (FTP). The slip surfaces were found at depths ranging from 8 to 10 m from Geophysical survey and hence sensors were installed to the depth of 15m at various locations of landslide. Rainfall is the main triggering factor of landslide. In this study, the developed model of unsaturated soil slope stability is carried out. The analysis of sensors data available for one year, indicated the sliding surface of landslide at depth between 6 to 12m with total displacement up to 6cm per year recorded at the body of landslide. The aim of this study is to set the threshold and generate early warning. Local peoples already alert towards landslide, if they have any types of warning system.

Keywords: early warning system, file transfer protocol, geo-morphological, geotechnical, landslide

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Authors: Aderonke Oluseun Akinwumi, Olusola A. Komolaf

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This paper gives information about the wide array of challenges facing both the electric utilities and consumers in the distribution system in developing countries, using Obafemi Awolowo University, Ile-Ife Nigeria as a case study. It also proffers cost-effective solution through remote monitoring, diagnostic and operation of distribution networks without compromising the system reliability. As utilities move from manned and unintelligent networks to completely unmanned smart grids, switching activities at substations and feeders will be managed and controlled remotely by dedicated systems hence this design. The Substation Remote Diagnostic and Operation Solution (sRDOs) would remotely monitor the load on Medium Voltage (MV) and Low Voltage (LV) feeders as well as distribution transformers and allow the utility disconnect non-paying customers with absolutely no extra resource deployment and without interrupting supply to paying customers. The aftermath of the implementation of this design improved the lifetime of key distribution infrastructure by automatically isolating feeders during overload conditions and more importantly erring consumers. This increased the ratio of revenue generated on electricity bills to total network load.

Keywords: electric utility, consumers, remote monitoring, diagnostic, system reliability, manned and unintelligent networks, unmanned smart grids, switching activities, medium voltage, low voltage, distribution transformer

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Authors: Isabel Jones

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As adolescence is a formative time, experiences during adolescence often affect the rest of one’s life. Therefore, dating, specifically violence in dating, can have lasting effects on the rest of one’s life. In order to find sources, searches were conducted on PsycINFO, specifically EBSCO, and narrowed down under the criteria that the source contained information about adolescent dating violence rather than adult, and focused on causes, effects, or prevention methods. This literature review examines research regarding the effects and causes of TDV, and then what methods are effective in the prevention of TDV development. This will allow for a clear image of how these prevention methods are effective and why they are important. Effects of TDV extend beyond the physical, including psychological and sexual long-lasting effects. These are caused by a number of concepts, including learned behavior, inhibitory issues/substance abuse, and cultural factors. When both of these are taken into account, preventative measures such as school-based interventions, parental/adult monitoring, and the presence of positive family examples are more clear as to their effectiveness. This literature review may provide further awareness to this public health crisis and give the public a view of how adolescents are affected by TDV on their path from child to adult.

Keywords: adolescence, dating violence, risk factors, predictors, relationship

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

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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: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

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The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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Authors: Etienne Mfoumou, Mo Shamma, Martin Tango, Michael Locke

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Water literacy is essential for addressing emerging water management challenges in southwest Nova Scotia (SWNS), where growing concerns over water scarcity and sustainability have highlighted the need for improved educational frameworks. Current approaches often fail to fully represent the complexity of water systems, focusing narrowly on the water cycle while neglecting critical aspects such as groundwater infiltration and the interconnectedness of surface and subsurface water systems. To address these gaps, this paper proposes a comprehensive framework for water literacy that integrates the physical dimensions of water systems with key aspects of understanding, including processes, energy, scale, and human dependency. Moreover, a suggested tool to enhance this framework is a real-time hydrometric data map supported by a network of water level monitoring devices deployed across the province. These devices, particularly for monitoring dug wells, would provide critical data on groundwater levels and trends, offering stakeholders actionable insights into water availability and sustainability. This real-time data would facilitate deeper understanding and engagement with local water issues, complementing the educational framework and empowering stakeholders to make informed decisions. By integrating this tool, the proposed framework offers a practical, interdisciplinary approach to improving water literacy and promoting sustainable water management in SWNS.

Keywords: water education, water literacy, water management, water systems, Southwest Nova Scotia

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Authors: Divyanshi Singh

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Women’s right to have choices, sense of self-worth and their right to have access to opportunities have been a subject of serious concern. The health of women and their children in Indian society is adversely affected by the woman’s inferior status within households. The level of human development in society is a reflection of the better status of a woman, which has a clear impact on the usage of contraceptive methods and maternal health. The study is an attempt to assess the performance of Indian states on the parameters of levels of development and to see how the developmental trajectory is influencing the choice for contraception and maternal health. The objective of the paper is to study the relationship between usage of contraception, maternal health and levels of human development in Indian states. Data from NFHS-4th round, AHS (2012-13) and census 2011 is used. Three indicators of human development (effective literacy, infant mortality and gross district domestic product) have been taken. Maternal health for the study has been measured in MMR, IMR and pregnancy resulted in abortions, stillbirths and miscarriage. The multiple regression analysis has been done to analyze the relationship between them. The Developmental factor is found to be greatly influencing the choice of family planning and thus they both show strong relation with maternal health.

Keywords: human development, contraceptive usage, maternal health, effective literacy

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Authors: Mike Dee

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Urban public spaces are sutured with a range of surveillance and sensor technologies that claim to enable new forms of ‘data based citizen participation’, but also increase the tendency for ‘function-creep’, whereby vast amounts of data are gathered, stored and analysed in a broad application of urban surveillance. This kind of monitoring and capacity for surveillance connects with attempts by civic authorities to regulate, restrict, rebrand and reframe urban public spaces. A direct consequence of the increasingly security driven, policed, privatised and surveilled nature of public space is the exclusion or ‘unfavourable inclusion’ of those considered flawed and unwelcome in the ‘spectacular’ consumption spaces of many major urban centres. In the name of urban regeneration, programs of securitisation, ‘gentrification’ and ‘creative’ and ‘smart’ city initiatives refashion public space as sites of selective inclusion and exclusion. In this context of monitoring and control procedures, in particular, children and young people’s use of space in parks, neighbourhoods, shopping malls and streets is often viewed as a threat to the social order, requiring various forms of remedial action. This paper suggests that cities, places and spaces and those who seek to use them, can be resilient in working to maintain and extend democratic freedoms and processes enshrined in Marshall’s concept of citizenship, calling sensor and surveillance systems to account. Such accountability could better inform the implementation of public policy around the design, build and governance of public space and also understandings of urban citizenship in the sensor saturated urban environment.

Keywords: citizenship, public space, surveillance, young people

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Authors: Mari Jaakkola, Jasmiina Haverinen, Tiina Tolonen, Vesa Virtanen

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These process monitoring of biogas plant gives valuable information of the function of the process and help to maintain a stable process. The costs of basic monitoring are often much lower than the costs associated with re-establishing a biologically destabilised plant. Reactor acidification through reactor overload is one of the most common reasons for process deterioration in anaerobic digesters. This occurs because of a build-up of volatile fatty acids (VFAs) produced by acidogenic and acetogenic bacteria. VFAs cause pH values to decrease, and result in toxic conditions in the reactor. Ammonia ensures an adequate supply of nitrogen as a nutrient substance for anaerobic biomass and increases system's buffer capacity, counteracting acidification lead by VFA production. However, elevated ammonia concentration is detrimental to the process due to its toxic effect. VFAs are considered the most reliable analytes for process monitoring. To obtain accurate results, sample storage and transportation need to be carefully controlled. This may be a challenge for off-line laboratory analyses especially when the plant is located far away from the laboratory. The aim of this study was to investigate the correlation between fatty acids, ammonium, and bacteria in the anaerobic digestion samples obtained from an industrial biogas factory. The stability of the analytes was studied comparing the results of the on-site analyses performed in the factory site to the results of the samples stored at room temperature and -18°C (up to 30 days) after sampling. Samples were collected in the biogas plant consisting of three separate mesofilic AD reactors (4000 m³ each) where the main feedstock was swine slurry together with a complex mixture of agricultural plant and animal wastes. Individual VFAs, ammonium, and nutrients (K, Ca, Mg) were studied by capillary electrophoresis (CE). Longer chain fatty acids (oleic, hexadecanoic, and stearic acids) and bacterial profiles were studied by GC-MSD (Gas Chromatography-Mass Selective Detector) and 16S rDNA, respectively. On-site monitoring of the analytes was performed by CE. The main VFA in all samples was acetic acid. However, in one reactor sample elevated levels of several individual VFAs and long chain fatty acids were detected. Also bacterial profile of this sample differed from the profiles of other samples. Acetic acid decomposed fast when the sample was stored in a room temperature. All analytes were stable when stored in a freezer. Ammonium was stable even at a room temperature for the whole testing period. One reactor sample had higher concentration of VFAs and long chain fatty acids than other samples. CE was utilized successfully in the on-site analysis of separate VFAs and NH₄ in the biogas production site. Samples should be analysed in the sampling day if stored in RT or freezed for longer storage time. Fermentation reject can be stored (and transported) at ambient temperature at least for one month without loss of NH₄. This gives flexibility to the logistic solutions when reject is used as a fertilizer.

Keywords: anaerobic digestion, capillary electrophoresis, ammonium, bacteria

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Authors: Sohail Bawani, Kausar S. Khan, Rozina Karmaliani, Shehnaz Mir

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Action research (AR) is one of the types of health systems research (HSR), and participatory action research (PAR) is known for being effective in health systems strengthening (HSS). The current literature on PAR for HSS cites numerous examples and case studies that led to improve health services; build child health information system; increase knowledge and awareness of people about health problems, and identify pathways for institutional and policy change by engaging people in research. But examples of marginalized communities being agents of change in health governance are not common in health systems research (HSR). This approach to PAR is at the heart of Paolo Freire’s Social Transformation Theory and Critical Consciousness building, which was used to design a community-based PAR study in the Northern/mountainous areas of Pakistan. The purpose of the study was to understand the place and role of marginalized communities in strengthening existing health governance structure (health facility and village health committees and health boards) by taking marginalized communities as partners. Community meetings were carried out to identify who is living at the social, political, cultural and economic margins in 40 different villages. Participatory reflection and analysis (PRA) tools were used during the meeting to facilitate identification. Focus group discussions were conducted with marginalized groups using PRA tools and family ethnographies with marginalized families identified through group discussions. Findings of the study revealed that for the marginalized health systems constitute more than just delivery of health services, but it also embraces social determinants that surround systems and its governance. The paper argues that from Frerian perspective people’s participation should not only be limited to knowledge generation. People must be seen active users of the knowledge that they generate for achieving better health outcomes that they want to achieve in the time to come. PAR provides a pathway to the marginalized in playing a role in health governance. The study dissemination planned shall engage the marginalized in a dialogue with service providers so that together a role for the marginalized can be outlined.

Keywords: participatory action research, health systems, marginalized, health services

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Authors: G. Sandhya Devi, G. Suvarna Kumar, S. Chandini

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This research work aims to develop a system that will analyze and identify students who indulge in malpractices/suspicious activities during the course of an academic offline examination. Automated Video Surveillance provides an optimal solution which helps in monitoring the students and identifying the malpractice event immediately. This work is organized into three modules. The first module deals with performing an impersonation check using a PCA-based face recognition method which is done by cross checking his profile with the database. The presence or absence of the student is even determined in this module by implementing an image registration technique wherein a grid is formed by considering all the images registered using the frontal camera at the determined positions. Second, detecting such facial malpractices in which a student gets involved in conversation with another, trying to obtain unauthorized information etc., based on the threshold range evaluated by considering his/her mouth state whether open or closed. The third module deals with identification of unauthorized material or gadgets used in the examination hall by training the positive samples of the object through various stages. Here, a top view camera feed is analyzed to detect the suspicious activities. The system automatically alerts the administration when any suspicious activities are identified, thereby reducing the error rate caused due to manual monitoring. This work is an improvement over our previous work published in identifying suspicious activities done by examinees in an offline examination.

Keywords: impersonation, image registration, incrimination, object detection, threshold evaluation

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Authors: Marsha R. Lawrence

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Introduction: In February and March of 2020, many Black Americans in Albany, Georgia, were impacted by COVID-19 compared to the rest of the country. Due to misinformation and distrust in the community, citizens were not able to make good health decisions regarding COVID-19. The city of Albany applied for a grant with the Department of Health and Human Services, specifically the Office of Minority Health and it was approved. The city of Albany partnered with Albany State University to administer the grant and implementation ensued. Method: An eleven-page electronic and paper cross-sectional survey was given to participants. Albany State University recruited community partners like health care organizations and faith-based organizations to reach the citizens of Albany, Georgia. These partners reached participants through creative community activities to educate participants about COVID-19 and provide incentives to receive a vaccine. Data collection is still in progress because activities are ongoing. Anticipated Results: By December 2023, we anticipate results of the number of participants who accepted vaccines based on participants who stated providers checked their understanding, participants who were satisfied with communication regarding COVID-19 health information about the vaccine, and participants who were involved in decisions regarding the COVID-19 vaccine. Conclusion: Health communication is a subsection of health literacy. At this point, approximately 4000 individuals have received information and education about COVID-19 in the Albany area. We expect building trusting relationships played an important part in the increase in knowledge and vaccination in Albany, Georgia.

Keywords: health literacy, health communication, vaccination, COVID-19

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Authors: Tadewos Awugchew Wudineh

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Health and safety issues have always been a major problem and concern in the building construction industry. The health and safety regulations are stated to eliminate the potential hazards and to reduce the consequential risks. However, the importance of the regulations seems to be overlooked in building construction sites of Hawassa City. Accordingly, many companies don’t follow the regulations as construction workers are more likely to be injured and killed by construction accident than any other type of employment. This paper aimed to identify factors that affect the implementation of construction health and safety regulations, their effects and mitigation measures in building construction project sites of Hawassa City. To reach this objective, a review of literature as well as the Ethiopian construction health and safety regulations have been undertaken. Mainly a five-point Likert scale questionnaire was distributed, and statistical analysis was used to summarize, interpret the data, and to find the significances of the responses. In addition, interviews were carried out. Accordingly, the findings indicate that the top factors which affect the implementation of CHS regulations are, availability and development of a clear health and safety policy, health and safety inspections by top management, conducting health and safety training and orientation, provision of healthy and safe working environment and employment of trained safety officers. The study revealed that implementation or non-implementation of CHS regulations have effects on the worker’s productivity, job satisfaction, rate of accidents, and cost greatly. Thus, the suggestion to minimize the impact on worker’s job performance are, developing of a clear health and safety policy, management commitment towards implementation of health and safety regulations, health and safety education and training and conducting regular health and safety inspections. It was concluded from the study that good implementation of health and safety regulations are the results from administrative and management commitment which calls for more attention to be paid to improve the implementation of CHS regulations in building construction sites of Hawassa City.

Keywords: construction health and safety regulations, effects, factors, mitigation

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Authors: Fathima M. A., Milu Maria Anto

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Aim: The current study aims to explore the understanding about Mental Health and the likelihood to seek help for mental health problems among adolescents in the state of Kerala (India). Method: A cross sectional exploratory design was used. Samples were selected using convenience sampling. Ninety nine high school and higher secondary school students who had enrolled in the program “Responsible Adolescents (READ)” organized by MKMS Education from Kerala participated in this study. The data for the present study was collected using google forms prior to the commencement of the READ programme. Open-ended questions were used to explore the understanding of participants about mental health, mental health problems, causes of mental health problems and the role of mental health professionals. The likelihood to seek help (from friends, parents, teachers and mental health professionals) for mental health problems was assessed using a visual analogue scale. Further open-ended questions were used to identify what changes in teachers and parents will make them feel more comfortable to approach them when they need help. Content analysis was used to identify themes and coded data was further analyzed using correlation. Results: The results show that students have a fair idea about what Mental Health is. Even though the majority is familiar with the names of mental health disorders, relatively fewer students identify it as irregularity in mental functions such as thoughts, emotions and behaviors. The students tend to attribute symptoms of mental health problems as the cause of mental health problems. Very few students have the understanding that biological variations and adverse childhood experiences are primary causes for the development of mental health problems. Less than half of the students were aware of the role of psychiatrists and psychologists in mental health treatment. The students were more likely to seek help from parents and friends during distress. They had a medium inclination to seek help from mental health professionals and showed even lower likelihood to seek help from teachers. The majority of the students responded that they would be more comfortable approaching teachers if they were more open-minded and approachable as well as non-judgmental and non-dismissive. Conclusion: Findings show that there is inadequate awareness among adolescents about mental health problems and their causes. There is a lack of understanding about the roles of two main mental health professionals which can pose a big hurdle in accessing adequate help from the appropriate professional at the right time. The low likelihood to seek help from teachers for mental health problems is very concerning. The major barriers reported by the students in seeking help from teachers were the judgmental and dismissive approach. The findings throw light on the current level of awareness about mental health and mental health help-seeking, which can be utilized in framing mental health awareness programs for students as well as teachers.

Keywords: Mental Health Awareness, Adolescent Mental Health, Help Seeking Behavior, School Mental Health

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Authors: Michel Mikhail

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Introduction: Values, which are the guiding principles and beliefs of our lives, have an influence on one’s psychological health. This study aims to investigate how Schwartz’s four higher-order values (conservation, openness to change, self-transcendence, and self-enhancement) and religious values influence psychological health among the Arab population. Methods: A total of 1,023 respondents from nine Arab countries aged 18 to 71 filled out an online survey with measures of the following constructs: Schwartz’s four higher-order values (Portrait Value Questionnaire-21), religious values (Sahin’s Index of Islamic Moral Values), and general psychological health (General Health Questionnaire-28). Results: Two models of multiple regression were conducted to investigate the relationships between values and psychological health. Higher conservation, self-enhancement, and religious values were significantly associated with better psychological health, with conservation losing significance after adding religious values to the model. All of Schwartz’s four values were found to have a significant relationship with religious values. More self-enhancement and conservation values were associated with higher identification of religious values, and the opposite was true for the other two values. Conclusion: The findings challenged existing assumptions that conservation values relate negatively to psychological health. This finding could be explained by the congruence of conservation values and the Arab culture. The most powerful relationships were those of self-enhancement and religious values, both of which were positively associated with psychological health. As such, therapists should be aware to reconsider biases against religious or conservation values and rather pay attention to their potential positive influence over one’s psychological health.

Keywords: counseling psychology, counseling and cultural values, counseling and religious values, psychotherapy and Arab values

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Authors: Sabri Sulaiman, Siti Hajar Abu Bakar Ah, Haris Abd Wahab

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Street children is a global phenomenon and declared as a social problem by social researcher and scholars across the world. The insecure street environment exposes street children into various risk factors. One of them is the health and psychological problem. The objective of this study is to assess the health problem and psychological wellbeing of street children in Kuala Lumpur, Malaysia. The cross-sectional study involved 303 street children in Chow Kit, Kuala Lumpur. The study confirmed that the majority (95.7%) of street children who participated in the study have a health problem. The findings also demonstrated that the majority of them have issues related to their psychological wellbeing. The inputs from this study are instrumental for the suggestion of specific intervention to improve the health and psychology wellbeing of street children in Malaysia. Agencies which are responsible for the street children well-being can utilise the inputs to framing and improving the social care programmes for the children.

Keywords: street children, health status, psychology wellbeing, homeless

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Authors: Ayodeji Adebayo, Tolulope Soyannwo, Oluwakemi A. Sigbeku

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Intimate Partner Violence (IPV) is a significant public health problem with adverse health consequences. There is increasing evidence of association of IPV with mental health problems. Understanding the association between IPV and mental health status of women of reproductive aged group in the rural communities in Nigeria can provide information to improve maternal health status. Therefore, this study was conducted to examine the relationship between experience of IPV and mental health status of women of reproductive aged group in a rural community in Southwest Nigeria. A community based cross-sectional survey was conducted using a cluster sampling technique to select 283 non-pregnant women of reproductive age group (15-49 years Mental health was assessed based on respondents’ experience of any symptoms of depression, anxiety and/or low self-esteem. IPV was assessed over a period of 12 months and the forms of IPV assessed were emotional, physical and sexual. An interviewer administered questionnaire was used to collect information on experience of IPV, reproductive history and factors influencing mental health. Data was analyzed using descriptive statistics, Chi-square and multivariate logistic regression at 5% level of significance. The mean age of respondents was 26.1± 7.8 with 57.1% aged 15-24years. More than half (58.0%) were married. Overall, 60.7% of respondents had mental health problems while 84.8% experienced all categories of violence. The pattern of IPV includes physical violence (10.7%), emotional violence (82.7%) and sexual violence (20.8%). Women who experienced sexual violence by a partner are most likely to suffer from all mental issues. Also, gynaecological morbidities are associated with increasing risk of mental health problems. The research demonstrates an urgent need for mental health policies to recognize the relationship between intimate partner violence, gynaecological morbidities and mental health problems in women in Nigeria.

Keywords: intimate partner violence, mental health, reproductive age group, women

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Authors: S. M. Moustafa, A. Ezzat, Y. S. Taha, G. H. Hassib, S. Hamada

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After the occurrence of 14, Nov, 1981 earthquake (M = 5.3), on Kalabska fault, south of Egypt, seismic stations distributed in and around the Kalabsha area, in order to monitoring, recording and studying the seismic activity in the area. In addition of that, from 1989 a number of piezometer wells drilled in the same area, distribed on at the both side of the active faults area and in different water bearing formations, in order to measuring the groundwater parameters (level, temperature, ph, and conductivity) to monitoring the relationship between those parameters and the seismic activity at Kalabsha area. The behavior of groundwater due to seismic activity over the world studied by several scientists i.e. H. Wakita (1979) on Izu-Oshima earthquake (M= 7.0) at Japan, M. E. Contadakis & G.asteriadis (1972), and Evans (1966), they found an anomalies on groundwater measurements prior, co, and post the occurrence of bigger earthquakes, referring to the probability of precursory evidence of impending earthquakes. In Kalabsha area south of Egypt, this study has been done using recorded seismic data, and the measurements of underground water parameters. same phenomena of anomalies founded on groundwater measurements pre, co. and post the occurrence of earthquakes with magnitude bigger than 3, and no systematic regularity exists for epicenter distance, duration of anomalies or time lag between anomalies appear and occurrence of events. Also the results found present strong relation between the groundwater in the upper unconfined aquifer Nubian Sandstone formation, and Kalabsha seismic activity, otherwise no relation between the seismic activities in the area with the deep groundwater in the lower confined aquifer Sandstone.

Keywords: seismicity, groundwater, Aswan, Egypt

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Authors: Sidi M. A. Ghaly, Mohammad O. Khan, Mohammed Shalaby, Khaled A. Al-Snaie

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Electrical capacitance tomography (ECT) is a valuable, non-invasive technique used to monitor multiphase flow processes, especially within industrial pipelines. This study focuses on the design, testing, and performance comparison of ECT sensors configured with 8, 12, and 16 electrodes, aiming to evaluate their effectiveness in imaging accuracy, resolution, and sensitivity. Each sensor configuration was designed to capture the spatial permittivity distribution within a pipeline cross-section, enabling visualization of phase distribution and flow characteristics such as oil and water interactions. The sensor designs were implemented and tested in closed pipes to assess their response to varying flow regimes. Capacitance data collected from each electrode configuration were reconstructed into cross-sectional images, enabling a comparison of image resolution, noise levels, and computational demands. Results indicate that the 16-electrode configuration yields higher image resolution and sensitivity to phase boundaries compared to the 8- and 12-electrode setups, making it more suitable for complex flow visualization. However, the 8 and 12-electrode sensors demonstrated advantages in processing speed and lower computational requirements. This comparative analysis provides critical insights into optimizing ECT sensor design based on specific industrial requirements, from high-resolution imaging to real-time monitoring needs.

Keywords: capacitance tomography, modeling, simulation, electrode, permittivity, fluid dynamics, imaging sensitivity measurement

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