Search results for: care gains

Authors: Liliana Gomez Cardona, Echo Parent-Racine, Joy Outerbridge, Arlene Laliberté, Outi Linnaranta

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Suicide rates among Inuit in Nunavik are six to eleven times larger than the Canadian average. The colonization, religious missions, residential schools as well as economic and political marginalization are factors that have challenged the well-being and mental health of these populations. In psychiatry, screening for mental illness is often done using questionnaires with which the patient is expected to respond how often he/she has certain symptoms. However, the Indigenous view of mental wellbeing may not fit well with this approach. Moreover, biomedical treatments do not always meet the needs of Indigenous peoples because they do not understand the culture and traditional healing methods that persist in many communities. Assess whether the questionnaires used to measure symptoms, commonly used in psychiatry are appropriate and culturally safe for the Inuit in Quebec. Identify the most appropriate tool to assess and promote wellbeing and follow the process necessary to improve its cultural sensitivity and safety for the Inuit population. Qualitative, collaborative, and participatory action research project which respects First Nations and Inuit protocols and the principles of ownership, control, access, and possession (OCAP). Data collection based on five focus groups with stakeholders working with these populations and members of Indigenous communities. Thematic analysis of the data collected and emerging through an advisory group that led a revision of the content, use, and cultural and conceptual relevance of the instruments. The questionnaires measuring psychiatric symptoms face significant limitations in the local indigenous context. We present the factors that make these tools not relevant among Inuit. Although the scale called Growth and Empowerment Measure (GEM) was originally developed among Indigenous in Australia, the Inuit in Quebec found that this tool comprehends critical aspects of their mental health and wellbeing more respectfully and accurately than questionnaires focused on measuring symptoms. We document the process of cultural adaptation of this tool which was supported by community members to create a culturally safe tool that helps in resilience and empowerment. The cultural adaptation of the GEM provides valuable information about the factors affecting wellbeing and contributes to mental health promotion. This process improves mental health services by giving health care providers useful information about the Inuit population and their clients. We believe that integrating this tool in interventions can help create a bridge to improve communication between the Indigenous cultural perspective of the patient and the biomedical view of health care providers. Further work is needed to confirm the clinical utility of this tool in psychological and psychiatric intervention along with social and community services.

Keywords: cultural adaptation, cultural safety, empowerment, Inuit, mental health, Nunavik, resiliency

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Authors: Sheetal Kumar Parwar, J. Deb Barma, A. Majumder

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Submerged arc welding is a very complex process. It is a very efficient and high performance welding process. In this present study an attempt have been done to reduce the welding distortion by increased amount of oxide flux through TiO2 in submerged arc welding process. Care has been taken to avoid the excessiveness of the adding agent for attainment of significant results. Data Envelopment Analysis (DEA) based BAT algorithm is used for the parametric optimization purpose in which DEA Data Envelopment Analysis is used to convert multi response parameters into a single response parameter. The present study also helps to know the effectiveness of the addition of TiO2 in active flux during submerged arc welding process.

Keywords: BAT algorithm, design of experiment, optimization, submerged arc welding

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Authors: Seydou Sinde

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The aims of this paper are to formulate mathematical expressions that can be used to estimate the standpipe pressure (SPP). The developed formulas take into account the main factors that, directly or indirectly, affect the behavior of SPP values. Fluid rheology and well hydraulics are some of these essential factors. Mud Plastic viscosity, yield point, flow power, consistency index, flow rate, drillstring, and annular geometries are represented by the frictional pressure (Pf), which is one of the input independent parameters and is calculated, in this paper, using Herschel-Bulkley rheological model. Other input independent parameters include the rate of penetration (ROP), applied load or weight on the bit (WOB), bit revolutions per minute (RPM), bit torque (TRQ), and hole inclination and direction coupled in the hole curvature or dogleg (DL). The technique of repeating parameters and Buckingham PI theorem are used to reduce the number of the input independent parameters into the dimensionless revolutions per minute (RPMd), the dimensionless torque (TRQd), and the dogleg, which is already in the dimensionless form of radians. Multivariable linear and polynomial regression technique using PTC Mathcad Prime 4.0 is used to analyze and determine the exact relationships between the dependent parameter, which is SPP, and the remaining three dimensionless groups. Three models proved sufficiently satisfactory to estimate the standpipe pressure: multivariable linear regression model 1 containing three regression coefficients for vertical wells; multivariable linear regression model 2 containing four regression coefficients for deviated wells; and multivariable polynomial quadratic regression model containing six regression coefficients for both vertical and deviated wells. Although that the linear regression model 2 (with four coefficients) is relatively more complex and contains an additional term over the linear regression model 1 (with three coefficients), the former did not really add significant improvements to the later except for some minor values. Thus, the effect of the hole curvature or dogleg is insignificant and can be omitted from the input independent parameters without significant losses of accuracy. The polynomial quadratic regression model is considered the most accurate model due to its relatively higher accuracy for most of the cases. Data of nine wells from the Middle East were used to run the developed models with satisfactory results provided by all of them, even if the multivariable polynomial quadratic regression model gave the best and most accurate results. Development of these models is useful not only to monitor and predict, with accuracy, the values of SPP but also to early control and check for the integrity of the well hydraulics as well as to take the corrective actions should any unexpected problems appear, such as pipe washouts, jet plugging, excessive mud losses, fluid gains, kicks, etc.

Keywords: standpipe, pressure, hydraulics, nondimensionalization, parameters, regression

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Authors: Quinn Au, Amedeo Carmine, Tauheed Khan Mohd

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The Internet of Things (IoT) is emerging as a new development in information technology in recent years, with the potential to improve convenience and efficiency in life. Following the rise of IoT, the Social Internet of Things (SIoT) is another new development in which the benefits of connectivity and user-friendliness from social network services (SNS) are its main features. With the introduction of IoT, the world will be much more modernized, convenient, and industrialized. This paper will discuss the applications of IoT in different sectors such as healthcare services, education, and lifestyle. The privacy challenges that IoT still poses to user data will also be discussed. Finally, an empirical study to evaluate the number of active installed IoT connections in recent years demonstrates the increase in usage of IoT regardless of the privacy challenges. The study also examines some types of IoT devices that are being preferred in the market and predictions from researchers about IoT in the upcoming years.

Keywords: IoT, health care, robotics, social Internet of Things

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Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

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Authors: Rojan Dahal

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One Health refers to a collaborative effort between multiple disciplines - locally, nationally, and globally - to attain optimal health. Although there were unprecedented intersectoral alliances between the animal and human health sectors during the avian influenza outbreak, there are different views and perceptions concerning institutionalizing One Health in South Asia. It is likely a structural barrier between the relevant professionals working in different entities or ministries when it comes to collaborating on One Health actions regarding zoonotic diseases. Politicians and the public will likely need to invest large amounts of money, demonstrate political will, and understand how One Health works to overcome these barriers. One Health might be hard to invest in South Asian countries, where the benefits are based primarily on models and projections and where numerous issues related to development and health need urgent attention. The other potential barrier to enabling the One Health concept in responding to zoonotic diseases is a failure to represent One Health in zoonotic disease control and prevention measures in the national health policy, which is a critical component of institutionalizing the One Health concept. One Health cannot be institutionalized without acknowledging the linkages between animal, human, and environmental sectors in dealing with zoonotic diseases. Efforts have been made in the past to prepare a preparedness plan for One Health implementation, but little has been done to establish a policy environment to institutionalize One Health. It is often assumed that health policy refers specifically to medical care issues and health care services. When drafting, reviewing, and redrafting the policy, it is important to engage a wide range of stakeholders. One Health institutionalization may also be hindered by the interplay between One Health professionals and bureaucratic inertia in defining the priorities of diseases due to competing interests on limited budgets. There is a possibility that policymakers do not recognize the importance of veterinary professionals in preventing human diseases originating in animals. Compared to veterinary medicine, the human health sector has produced most of the investment and research outputs related to zoonotic diseases. The public health profession may consider itself superior to the veterinary profession. Zoonotic diseases might not be recognized as threats to human health, impeding integrated policies. The effort of One Health institutionalization remained only among the donor agencies and multi-sectoral organizations. There is a need for strong political will and state capacity to overcome the existing institutional, financial, and professional barriers for its effective implementation. There is a need to assess the structural challenges, policy challenges, and the attitude of the professional working in the multiple disciplines related to One Health. Limited research has been conducted to identify the reasons behind the barriers to institutionalizing the One Health concept in South Asia. Institutionalizing One Health in responding to zoonotic diseases breaks down silos and integrates animals, humans, and the environment.

Keywords: one health, institutionalization, South Asia, institutionalizations

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Authors: Pawan S. Nagda, Purnank S. Bhatt, Mit K. Shah

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Earing defect in drawing process is highly undesirable not only because it adds on an additional trimming operation but also because the uneven material flow demands extra care. The objective of this work is to study the earing problem in the Deep Drawing of circular cup and to optimize the blank shape to reduce the earing. A finite element model is developed for 3-D numerical simulation of cup forming process in ABAQUS. Extra-deep-drawing (EDD) steel sheet has been used for simulation. Properties and tool design parameters were used as input for simulation. Earing was observed in the simulated cup and it was measured at various angles with respect to rolling direction. To reduce the earing defect initial blank shape was modified with the help of anisotropy coefficient. Modified blanks showed notable reduction in earing.

Keywords: anisotropy, deep drawing, earing, finite element simulation

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Authors: Khaled M. Alhawiti

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This paper investigates the future of medicine and the use of Natural language processing. The importance of having correct clinical information available online is remarkable; improving patient care at affordable costs could be achieved using automated applications to use the online clinical information. The major challenge towards the retrieval of such vital information is to have it appropriately coded. Majority of the online patient reports are not found to be coded and not accessible as its recorded in natural language text. The use of Natural Language processing provides a feasible solution by retrieving and organizing clinical information, available in text and transforming clinical data that is available for use. Systems used in NLP are rather complex to construct, as they entail considerable knowledge, however significant development has been made. Newly formed NLP systems have been tested and have established performance that is promising and considered as practical clinical applications.

Keywords: clinical information, information retrieval, natural language processing, automated applications

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Authors: Godfrey Katende, Lillian Nakimera

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The process of caregiving may cause emotional distress in form of anxiety and depression among family carers of cancer patients. Little is known about the prevalence anxiety and depression among family carers of cancer patients in Uganda. This cross-sectional study aimed to determine the prevalence of anxiety and depression among family carers of cancer patients and related factors associated with abnormal levels of anxiety and depression. A total of 119 family carers from Uganda Cancer Institute (UCI) were assessed by the Hospital Anxiety and Depression Scale (HADS) standardized questionnaire. The prevalence of anxiety and depression among family carers was high (45% and 26 % respectively); (2) abnormal levels of anxiety (ALA) and depression (ALD) was significantly associated with being a relative carer. Incorporating evidence based psychological therapies targeting family carers into usual care of cancer patients is imperative.

Keywords: anxiety, cancer, carer, cross-sectional design, depression, Uganda

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Authors: M. Kamimukai, M. Bhattarai, B. B. Rana, K. Maeda, H. B. Kc, T. Kawano, M. Murai

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Most of the aged people older than 70 have difficulty in chewing and swallowing more or less. According to magnitude of this difficulty, gruel, “nanhan” (semi-soft rice) and ordinary cooked rice are served in general, particularly in sanatoriums and homes for old people in Japan. Nanhan is the name of a cooked rice used in Japan, having softness intermediate between gruel and ordinary cooked rice, which is boiled with intermediate amount of water between those of the latter two kinds of cooked rice. In the present study, nanhan was made in the rate of 240g of water to 100g of milled rice with an electric rice cooker. Murai developed a high amylose-content and high-yielding elite line ‘Murai 79’. Sensory eating-quality test was performed for nanhan and ordinary cooked rice of Murai 79 and the standard variety ‘Hinohikari’ which is a high eating-quality variety representative in southern Japan. Panelists (6 to 14 persons) scored each cooked rice in six items viz. taste, stickiness, hardness, flavor, external appearance and overall evaluation. Grading (-3 ~ +3) in each trait was performed, regarding the value of the standard variety Hinohikari as 0. Paddy rice produced in a farmer’s field in 2013 and 2014 and in an experimental field of Kochi University in 2015 and 2016 were used for the sensory test. According to results of the sensory eating-quality test for nanhan, Murai 79 is higher in overall evaluation than Hinohikari in the four years. The former was less sticky than the latter in the four years, but the former was statistically significantly harder than the latter throughout the four years. In external appearance, the former was significantly higher than the latter in the four years. In the taste, the former was significantly higher than the latter in 2014, but significant difference was not noticed between them in the other three years. There were no significant differences throughout the four years in flavor. Regarding amylose content, Murai 79 is higher by 3.7 and 5.7% than Hinohikari in 2015 and 2016, respectively. As for protein content, Murai 79 was higher than Hinohikari in 2015, but the former was lower than the latter in 2016. Consequently, the nanhan of Murai 79 was harder and less sticky, keeping the shape of grains as compared with that of Hinohikari, which may be due to its higher amylose content. Hence, the nanhan of Murai 79 may be recognized as grains more easily in a human mouth, which could make easier the continuous performance of mastication and deglutition particularly in aged persons. Regarding ordinary cooked rice, Murai 79 was similar to or higher in both overall evaluation and external appearance as compared with Hinohikari, despite its higher hardness and lower stickiness. Additionally, Murai 79 had brown-rice yield of 1.55 times as compared with Hinohikari, suggesting that it would enable to supply inexpensive rice for making nanhan with high quality particularly for aged people in Japan.

Keywords: high-amylose content, high-yielding rice line, nanhan, nursing care food, sensory eating quality test

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Authors: Mahmoud I. Syam, Osama K. El-Hafy

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With lack of student motivation, there will be a little or no real learning in the class and this directly effects student achievement and test scores. Some students are naturally motivated to learn, but many students are not motivated, they do care little about learning and need their instructors to motivate them. Thus, motivating students is part of the instructor’s job. It’s a tough task to motivate students and make them have more attention and enthusiasm. As a part of this research, a questionnaire has been distributed among a sample of 155 students out of 1502 students from Foundation Program at Qatar University. The questionnaire helped us to determine some methods to motivate the students and encourage them to study such as variety of teaching activities, encouraging students to participate during the lectures, creating intense competition between the students, using instructional technology, not using grades as a threat and respecting the students and treating them in a good manner. Accordingly, some hypotheses are tested and some recommendations are presented.

Keywords: learning, motivating, student, teacher, testing hypotheses

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Authors: Rattakorn Poonsuph

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Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: Eugenia Jilinguirian

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In the healthcare industry, data mining is essential since it transforms the field by collecting useful data from large datasets. Data mining is the process of applying advanced analytical methods to large patient records and medical histories in order to identify patterns, correlations, and trends. Healthcare professionals can improve diagnosis accuracy, uncover hidden linkages, and predict disease outcomes by carefully examining these statistics. Additionally, data mining supports personalized medicine by personalizing treatment according to the unique attributes of each patient. This proactive strategy helps allocate resources more efficiently, enhances patient care, and streamlines operations. However, to effectively apply data mining, however, and ensure the use of private healthcare information, issues like data privacy and security must be carefully considered. Data mining continues to be vital for searching for more effective, efficient, and individualized healthcare solutions as technology evolves.

Keywords: data mining, healthcare, big data, individualised healthcare, healthcare solutions, database

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Authors: Maria Cristina B. Cabanag, Elijinese Marie S. Culangen

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Pregnancy is a period in a woman's life wherein the body may undergo different physiological changes. These changes can be attributed to the interplay of hormones in the body but can mask a more sinister type of disease such as malignancy on rare occasions. Colorectal cancer (CRC) in pregnancy is an epidemiologically rare disease worldwide. To our knowledge, no available studies were reported in the Philippines at the time of this writing, posing a dilemma for its appropriate diagnosis and management. Signs and symptoms of colorectal malignancy may camouflage a normal pregnancy and, when overlooked, impedes an appropriate approach. This case of a 38-year-old elderly primigravid who presented with hematochezia on her 25th week of gestation. She was diagnosed with rectal adenocarcinoma later in pregnancy which warranted a predicament regarding her appropriate care and management. This paper explores the repertoire of the different diagnostic and treatment approaches to colorectal cancer in the second trimester of pregnancy, with the least possible maternal and fetal hazards.

Keywords: cancer in pregnancy, chemotherapy in pregnancy, colorectal cancer, hematochezia in pregnancy

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Authors: Tuisem Shimrah

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One general agreement on climate change is that its causes may be local but the effects are global. Indigenous people are subscribed to “low-carbon” traditional ways of life and as such they have contributed little to causes of climate change. On the contrary they are the most adversely affected by climate change due to their dependence on surrounding rich biological wealth as a source of their livelihood, health care, entertainment and cultural activities This paper deals with the results of the investigation of various adaptation strategies adopted to combat climate change by traditional community. The result shows effective ways of application of traditional knowledge and wisdom applied by Tangkhul traditional community at local and community level in remote areas in Northeast India. Four adaptation measures are being presented in this paper.

Keywords: adaptation, climate change, Northeast India, Tangkhul, traditional community

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Authors: Eva Laryea, Clement Yeboah Authors

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A pretest-posttest within subjects, experimental design was employed to examine the effects of a computerized basic statistics learning game on achievement and statistics-related anxiety of students enrolled in introductory graduate statistics course. Participants (N = 34) were graduate students in a variety of programs at state-funded research university in the Southeast United States. We analyzed pre-test posttest differences using paired samples t-tests for achievement and for statistics anxiety. The results of the t-test for knowledge in statistics were found to be statistically significant indicating significant mean gains for statistical knowledge as a function of the game-based intervention. Likewise, the results of the t-test for statistics-related anxiety were also statistically significant indicating a decrease in anxiety from pretest to posttest. The implications of the present study are significant for both teachers and students. For teachers, using computer games developed by the researchers can help to create a more dynamic and engaging classroom environment, as well as improve student learning outcomes. For students, playing these educational games can help to develop important skills such as problem solving, critical thinking, and collaboration. Students can develop interest in the subject matter and spend quality time to learn the course as they play the game without knowing that they are even learning the presupposed hard course. The future directions of the present study are promising, as technology continues to advance and become more widely available. Some potential future developments include the integration of virtual and augmented reality into educational games, the use of machine learning and artificial intelligence to create personalized learning experiences, and the development of new and innovative game-based assessment tools. It is also important to consider the ethical implications of computer game-based pedagogy, such as the potential for games to perpetuate harmful stereotypes and biases. As the field continues to evolve, it will be crucial to address these issues and work towards creating inclusive and equitable learning experiences for all students. This study has the potential to revolutionize the way basic statistics graduate students learn and offers exciting opportunities for future development and research. It is an important area of inquiry for educators, researchers, and policymakers, and will continue to be a dynamic and rapidly evolving field for years to come.

Keywords: pretest-posttest within subjects, experimental design, achievement, statistics-related anxiety

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Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

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Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

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Authors: Bacha Zakaria

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This study aimed to investigate the reality of humane treatment and work environment problems for nurses in public hospitals and their repercussions on the patients arriving there. In this curve, our field study was based on a sample of nurses in Algiers hospitals estimated at 100 nurses. The questionnaire prepared by the two researchers was applied face to face with the nurses, and after obtaining and analyzing the data, we concluded the most important results: The presence of many problems in the work environment, such as work pressures, lack of appreciation, verbal and physical violence, risk of infection, poor salary and incentives, working during fatigue, administrative problems etc. And accordingly, The embodiment of humane dealing with patients requires providing a humane work environment for nurses and dealing with them humanely so that they embody positive behaviors while dealing with patients.

Keywords: nursing, future, family-focused care, health equity

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Authors: Ameni Mejri, Moufida Hajjaj, Salem Hasnaoui, Ridha Bouallegue

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The technology advances have most lately made the millimeter wave (mmWave) communication possible. Due to the huge amount of spectrum that is available in MmWave frequency bands, this promising candidate is considered as a key technology for the deployment of 5G cellular networks. In order to enhance system capacity and achieve spectral efficiency, very large antenna arrays are employed at mmWave systems by exploiting array gain. However, it has been shown that conventional beamforming strategies are not suitable for mmWave hardware implementation. Therefore, new features are required for mmWave cellular applications. Unlike traditional multiple-input-multiple-output (MIMO) systems for which only digital precoders are essential to accomplish precoding, MIMO technology seems to be different at mmWave because of digital precoding limitations. Moreover, precoding implements a greater number of radio frequency (RF) chains supporting more signal mixers and analog-to-digital converters. As RF chain cost and power consumption is increasing, we need to resort to another alternative. Although the hybrid precoding architecture has been regarded as the best solution based on a combination between a baseband precoder and an RF precoder, we still do not get the optimal design of hybrid precoders. According to the mapping strategies from RF chains to the different antenna elements, there are two main categories of hybrid precoding architecture. Given as a hybrid precoding sub-array architecture, the partially-connected structure reduces hardware complexity by using a less number of phase shifters, whereas it sacrifices some beamforming gain. In this paper, we treat the hybrid precoder design in mmWave MIMO systems as a problem of matrix factorization. Thus, we adopt the alternating minimization principle in order to solve the design problem. Further, we present our proposed algorithm for the partially-connected structure, which is based on the iterative hard thresholding method. Through simulation results, we show that our hybrid precoding algorithm provides significant performance gains over existing algorithms. We also show that the proposed approach reduces significantly the computational complexity. Furthermore, valuable design insights are provided when we use the proposed algorithm to make simulation comparisons between the hybrid precoding partially-connected structure and the fully-connected structure.

Keywords: alternating minimization, hybrid precoding, iterative hard thresholding, low-complexity, millimeter wave communication, partially-connected structure

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Authors: Wissem Abdaoui, Ilhem Mokhtari, Adel Gouri, Benouareth Djamel Eddine

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Contracted in a health facility, hospital-acquired infections are a major public health problem in recent years. The increase of nosocomial infections is partly related to diagnostic and therapeutic advances in medicine. The aim of our study was to isolate and diagnose some types of bacteria that are circulating in the hospital by performing different samples at two medical services: Pulmonary and Infectious Diseases. The antibiotic susceptibility tests were performed for bacterial isolates. The results have shown that there is a predominance of enterobacteria followed by the staphylococcus with its two species epidermidis ans saprophyticus. The study of the antibiogramme identified that some of these bacteria have a resistant profile against all the tested antibiotics. The fight against nosocomial infections is difficult because it must act on several factors: quality of care, safety of the hospital environment, hygiene, wearing gloves etc. are all areas that should be of heightened vigilance and preventive measures.

Keywords: nosocomial infection, isolation, identification, sensitivity and resistance to antibiotics

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Authors: Mebruka Mohammed, Daniel Bisrat, Asfaw Debella, Tarekegn Birhanu

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Lack of quality control standards for medicinal plants and their preparations is considered major barrier to their integration in to effective primary health care in Ethiopia. Poor quality herbal preparations led to countless adverse reactions extending to death. Denial of penetration for the Ethiopian medicinal plants in to the world’s booming herbal market is also another significant loss resulting from absence of herbal quality control system. Thus, in the present study, Gnidia stenophylla Gilg (popular antimalarial plant of south eastern Ethiopia), is standardized and a full monograph is produced that can serve as a guideline in quality control of the crude drug. Morphologically, the roots are found to be cylindrical and tapering towards the end. It has a hard, corky and friable touch with saddle brown color externally and it is relatively smooth and pale brown internally. It has got characteristic pungent odor and very bitter taste. Microscopically it has showed lignified xylem vessels, wider medullary rays with some calcium oxalate crystals, reddish brown secondary metabolite contents and slender shaped long fibres. Physicochemical standards quantified and resulted: foreign matter (5.25%), moisture content (6.69%), total ash (40.80%), acid insoluble ash (8.00%), water soluble ash (2.30%), alcohol soluble extractive (15.27%), water soluble extractive (10.98%), foaming index (100.01 ml/g), swelling index (7.60 ml/g). Phytochemically: Phenols, flavonoids, steroids, tannins and saponins were detected in the root extract; TLC and HPLC fingerprints were produced and an analytical marker was also tentatively characterized as 3-(3,4-dihydro-3,5-dihydroxy-2-(4-hydroxy-5-methylhex-1-en-2-yl)-7-methoxy-4-oxo-2H-chromen-8-yl)-5-hydroxy-2-(4-hydroxyphenyl)-7-methoxy-4H-chromen-4-one. Residue wise pesticides (i.e. DDT, DDE, g-BHC) and radiochemical levels fall below the WHO limit while Heavy metals (i.e. Co, Ni, Cr, Pb, and Cu), total aerobic count and fungal load lie way above the WHO limit. In conclusion, the result can be taken as signal that employing non standardized medicinal plants could cause many health risks of the Ethiopian people and Africans’ at large (as 80% of inhabitants in the continent depends on it for primary health care). Therefore, following a more universal approach to herbal quality by adopting the WHO guidelines and developing monographs using the various quality parameters is inevitable to minimize quality breach and promote effective herbal drug usage.

Keywords: Gnidia stenophylla Gilg, standardization/monograph, pharmacognostic, residue/impurity, quality

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Authors: May B. Eclar, Romeo M. Alip, Ailyn C. Eay, Jennifer M. Alip, Michelle A. Mejica, Eloy C.eclar

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The COVID-19 pandemic has significantly changed the educational landscape of the Philippines. The groups affected by these changes are the poor and those living in the Geographically Isolated and Depressed Areas (GIDA), such as the Indigenous Peoples (IP). This was heavily experienced by the ten IP schools in Zambales, a province in the country. With this in mind, plus other factors relative to safety, the Schools Division of Zambales selected these ten schools to conduct the pilot implementation of in-person classes two (2) years after the country-wide school closures. This study aimed to explore the lived experiences of the school heads of the first ten Indigenous People’s (IP) schools that shifted from distance learning to limited in-person learning. These include the challenges met and the coping mechanism they set to overcome the challenges. The study is linked to experiential learning theory as it focuses on the idea that the best way to learn things is by having experiences). It made use of qualitative research, specifically phenomenology. All the ten school heads from the IP schools were chosen as participants in the study. Afterward, participants underwent semi-structured interviews, both individual and focus group discussions, for triangulation. Data were analyzed through thematic analysis. As a result, the study found that most IP schools did not struggle to convince parents to send their children back to school as they downplay the pandemic threat due to their geographical location. The parents struggled the most during modular learning since many of them are either illiterate, too old to teach their children, busy with their lands, or have too many children to teach. Moreover, there is a meager vaccination rate in the ten barangays where the schools are located because of local beliefs. In terms of financial needs, school heads did not find it difficult even though funding is needed to adjust the schools to the new normal because of the financial support coming from the central office. Technical assistance was also provided to the schools by division personnel. Teachers also welcomed the idea of shifting back to in-person classes, and minor challenges were met but were solved immediately through various mechanisms. Learning losses were evident since most learners struggled with essential reading, writing, and counting skills. Although the community has positively received the conduct of in-person classes, the challenges these IP schools have been experiencing pre-pandemic were also exacerbated due to the school closures. It is therefore recommended that constant monitoring and provision of support must continue to solve other challenges the ten IP schools are still experiencing due to in-person classes

Keywords: In-person learning, indigenous peoples, phenomenology, philippines

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Authors: Onyia Comfort Ngozi, Iketaku Ifeoma Roseline

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Inspite of the laudable goals and objectives in education, Nigerian women, still face a lot of challenges that hinder the personal and national development. There are unbalances between males and females at all levels of the science education sector in Nigeria. Educate a woman, and you educate a nation, and if you educate a man, you educate an individual. It is on this note that the paper focuses on bridging the gender gap as it concerns science education in Nigeria. Suggestions were made as measures of bridging the gender gap in Nigerian education sector. The researchers concluded that achieving gender equality will promote greater equality in employment, help postpone early marriages, reduce infant mortality rates and improve health and education for a future generation. Thus, the paper recommended that government should involve women in policy making to take care of any gender issue and bias that may be included either consciously or not, during formulation stage.

Keywords: education, gender, science education, women, equality

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Authors: Mary A. Lindell

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Adults with intellectual disabilities (ID) are increasingly attending postsecondary institutions, including inclusive residential programs at four-year universities. The legislation, national organizations, and researchers support developing postsecondary education (PSE) options for this historically underserved population. Simultaneously, researchers are assessing the quality of life indicators (QOL) for people with ID. This study explores the quality of life characteristics for individuals with ID entering a two-year PSE program. A survey aligned with the PSE program was developed and administered to participants before they began their college program (in future studies, the same survey will be administered 6 months and 1 year after graduating). Employment, income, and housing are frequently cited QOL measures. People with disabilities, and especially people with ID, are more likely to experience unemployment and low wages than people without disabilities. PSE improves adult outcomes (e.g., employment, income, housing) for people with and without disabilities. Similarly, adults with ID who attend PSE are more likely to be employed than their peers who do not attend PSE; however, adults with ID are least likely among their typical peers and other students with disabilities to attend PSE. There is increased attention to providing individuals with ID access to PSE and more research is needed regarding the characteristics of students attending PSE. This study focuses on the participants of a fully residential two-year program for individuals with ID. Students earn an Applied Skills Certificate while focusing on five benchmarks: self-care, home care, relationships, academics, and employment. To create a QOL measure, the goals of the PSE program were identified, and possible assessment items were initially selected from the National Core Indicators (NCI) and the National Transition Longitudinal Survey 2 (NTLS2) that aligned with the five program goals. Program staff and advisory committee members offered input on potential item alignment with program goals and expected value to students with ID in the program. National experts in researching QOL outcomes of people with ID were consulted and concurred that the items selected would be useful in measuring the outcomes of postsecondary students with ID. The measure was piloted, modified, and administered to incoming students with ID. Research questions: (1) In what ways are students with ID entering a two-year PSE program similar to individuals with ID who complete the NCI and NTLS2 surveys? (2) In what ways are students with ID entering a two-year PSE program different than individuals with ID who completed the NCI and NTLS2 surveys? The process of developing a QOL measure specific to a PSE program for individuals with ID revealed that many of the items in comprehensive national QOL measures are not relevant to stake-holders of this two-year residential inclusive PSE program. Specific responses of students with ID entering an inclusive PSE program will be presented as well as a comparison to similar items on national QOL measures. This study explores the characteristics of students with ID entering a residential, inclusive PSE program. This information is valuable for, researchers, educators, and policy makers as PSE programs become more accessible for individuals with ID.

Keywords: intellectual disabilities, inclusion, post-secondary education, quality of life

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Authors: Rangika Perera, Shyamani Hettiarachchi, Fran Hagstrom

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Dyslexia is the most common reading reading-related difficulty among the school school-aged population and currently, 5-10% are showing the features of dyslexia in Sri Lanka. As there is an insufficient number of speech and language pathologists in the country and few speech and language pathologists working in government mainstream school settings, these children who are at risk of dyslexia are not receiving enough quality early intervention services to develop their reading skills. As teachers are the key professionals who are directly working with these children, using them as the primary facilitators to improve their reading skills will be the most effective approach. This study aimed to identify the efficacy of a two and half a day of intensive training provided to fifteen mainstream government school teachers of grade two classes. The goal of the training was to enhance their knowledge of dyslexia and provide full classroom skills training that could be used to support the development of the students’ reading competencies. A closed closed-ended multiple choice questionnaire was given to these teachers pre and -post-training to measure teachers’ knowledge of dyslexia, the areas in which these children needed additional support, and the best strategies to facilitate reading competencies. The data revealed that the teachers’ knowledge in all areas was significantly poorer prior to the training and that there was a clear improvement in all areas after the training. The gain in target areas of teaching skills selected to improve the reading skills of children was evaluated through peer feedback. Teachers were assigned to three groups and expected to model how they were going to introduce the skills in recommended areas using researcher developed, validated and reliability reliability-tested materials and the strategies which were introduced during the training within the given tasks. Peers and the primary investigator rated teachers’ performances and gave feedback on organizational skills, presentation skills of materials, clarity of instruction, and appropriateness of vocabulary. After modifying their skills according to the feedback the teachers received, they were expected to modify and represent the same tasks to the group the following day. Their skills were re-evaluated by the peers and primary investigator using the same rubrics to measure the improvement. The findings revealed a significant improvement in their teaching skills development. The data analysis of both knowledge and skills gains of the teachers was carried out using quantitative descriptive data analysis. The overall findings of the study yielded promising results that support intensive training as a method for improving teachers’ knowledge and teaching skill development for use with children in a whole class intervention setting who are at risk of dyslexia.

Keywords: Dyslexia, knowledge, teaching skills, training program

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Authors: Hareem Kausar

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Women of today’s world are energetic, enthusiastic and high-spirited. They tend to be the best in whatever they do and strive to accept and fulfil each challenge with utmost liveliness. The aim of the research was about studying the impact of Maternal Employment on the Child’s Behavioral Development. It was conducted as an initiative to study the impact factor in Pakistani culture and for deep insight to the subject using qualitative research methodology. The samples were interviewed through semi-structured interview method in three phases including two working mothers, two children and a day care center official and the data was collected and analyzed through content analysis. Further, it was linked with the literature from the west and the results show that children of working mothers tend to be sound mentally and physically but at some points they face the inner feeling of solitude. Overall, develop the mechanism in independence in their nature and behavior but maternal employment definitely affects the overall behavioral development of the children.

Keywords: maternal employment, child behavior- development, childhood, impact

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Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya

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Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.

Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia

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Authors: Julia Córdoba

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People are not completely autonomous, as we live in society; therefore, people could be defined as relationally dependent. The lack, decrease or loss of physical, psychological and/or social interdependence due to a disability situation is known as dependence. This is related to the need for help from another person in order to carry out activities of daily living. This population group lives with major social limitations that significantly reduce their participation and autonomy. They have high levels of stigma and invisibility from private environments (family and close networks), as well as from the public order (environment, community). The importance of this study lies in the fact that the lack of support and adjustments leads to what authors call the circle of exclusion. This circle describes how not accessing services - due to the difficulties caused by the disability situation impacts biological, social and psychological levels. This situation produces higher levels of exclusion and vulnerability. This study will focus on the process of autonomy and dependence of adults with disability from the model of disability proposed by the International Classification of Functioning, Health and Disability (ICF). The objectives are: i) to write down the relationship between autonomy and dependence based on socio-health variables and ii) to determine the relationship between the situation of autonomy and dependence and the expectations and interests of the participants. We propose a study that will use a survey technique through a previously validated virtual questionnaire. The data obtained will be analyzed using quantitative and qualitative methods for the details of the profiles obtained. No less than 200 questionnaires will be administered to people between 18 and 64 years of age who self-identify as having some degree of dependency due to disability. For the analysis of the results, the two main variables of autonomy and dependence will be considered. Socio-demographic variables such as age, gender identity, area of residence and family composition will be used. In relation to the biological dimension of the situation, the diagnosis, if any, and the type of disability will be asked. For the description of these profiles of autonomy and dependence, the following variables will be used: self-perception, decision-making, interests, expectations and life project, care of their health condition, support and social network, and labor and educational inclusion. The relationship between the target population and the variables collected provides several guidelines that could form the basis for the analysis of other research of interest in terms of self-perception, autonomy and dependence. The areas and situations where people state that they have greater possibilities to decide and have a say will be obtained. It will identify social (networks and support, educational background), demographic (age, gender identity and residence) and health-related variables (diagnosis and type of disability, quality of care) that may have a greater relationship with situations of dependency or autonomy. It will be studied whether the level of autonomy and/or dependence has an impact on the type of expectations and interests of the people surveyed.

Keywords: life project, disability, inclusion, autonomy

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Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

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The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

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Authors: Syeda Mahnaz Hassan

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Social work as a specialized field, grounded in scientific knowledge and skills, is more inclined towards problem-solving process rather than charity focused approach. Medical social work, as a primary method, deals with the bio-psychosocial-spiritual elements of an individual with a problem and assesses the pliability and strength of the patients, social support systems, and their families, to assist the patients to resolve their problems independently. The medical social worker, also known as case-worker or care-worker, has to play a substantial role in the rehabilitation and retrieval of an affected person. This paper examines the roles played and responsibilities discharged by the Medical Social Workers internationally and specifically concerning Pakistan. The capacity constraints and challenges confronted by Medical Social Workers in hospitals have also been highlighted, and some policy implications have been suggested to enhance the capabilities of Medical Social Workers for serving the patients in a befitting manner.

Keywords: medical social work, Pakistan, patients, rehabilitation

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