Search results for: occupational health and safety in Turkey

Authors: Jonathan D. Recchi

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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

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Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection

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Authors: Sudhir Kumar Singh, Debashish Chakravarty

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Slope stability analysis is an important aspect in the field of geotechnical engineering. It is also important from safety, and economic point of view as any slope failure leads to loss of valuable lives and damage to property worth millions. This paper aims at mitigating the risk of slope failure by studying the effect of different joint sets on the stability of mine pit slopes under the influence of various external factors, namely degree of saturation, rainfall intensity, and seismic coefficients. Supervised machine learning approach has been utilized for making accurate and reliable predictions regarding the stability of slopes based on the value of Factor of Safety. Numerous cases have been studied for analyzing the stability of slopes using the popular Finite Element Method, and the data thus obtained has been used as training data for the supervised machine learning models. The input data has been trained on different supervised machine learning models, namely Random Forest, Decision Tree, Support vector Machine, and XGBoost. Distinct test data that is not present in training data has been used for measuring the performance and accuracy of different models. Although all models have performed well on the test dataset but Random Forest stands out from others due to its high accuracy of greater than 95%, thus helping us by providing a valuable tool at our disposition which is neither computationally expensive nor time consuming and in good accordance with the numerical analysis result.

Keywords: finite element method, geotechnical engineering, machine learning, slope stability

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Authors: Renjith George, Preethy Mary Donald

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Use of internet sources to retrieve health care related information among health care professionals has increased tremendously as the accessibility to internet is made easier through smart phones and tablets. Though there are huge data available at a finger touch, it is doubtful whether all the sources providing health care information adhere to evidence based practice. The objective of this survey was to study the prevalence of use of internet sources to get health care information, to assess the mind-set towards the authenticity of health care information available via internet sources and to study the awareness about evidence based practice in health care among medical and dental students in Melaka-Manipal Medical College. The survey was proposed as there is limited number of studies reported in the literature and this is the first of its kind in Malaysia. A cross sectional survey was conducted among the medical and dental students of Melaka-Manipal Medical College. A total of 521 students including medical and dental students in their clinical years of undergraduate study participated in the survey. A questionnaire consisting of 14 questions were constructed based on data available from the published literature and focused group discussion and was pre-tested for validation. Data analysis was done using SPSS. The statistical analysis of the results of the survey proved that the use of internet resources for health care information are equally preferred over the conventional resources among health care students. Though majority of the participants verify the authenticity of information from internet sources, there was considerable percentage of candidates who feels that all the information from the internet can be utilised for clinical decision making or were not aware about the need of verification of authenticity of such information. 63.7 % of the participants rely on evidence based practice in health care for clinical decision making while 34.2 % were not aware about it. A minority of 2.1% did not agree with the concept of evidence based practice. The observations of the survey reveals the increasing use of internet resources for health care information among health care students. The results warrants the need to move towards evidence based practice in health care as all health care information available online may not be reliable. The health care person should be judicious while utilising the information from such resources for clinical decision making.

Keywords: authenticity, evidence based practice, health care information, internet

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Authors: Metkel Gebremedhin, Biruk Kebede, Guash Abay

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Job satisfaction largely determines the productivity and efficiency of human resources for health. There is scanty evidence on factors influencing the job satisfaction of health extension professionals (HEPs) in Addis Ababa. The objective of this study was to determine the level of and factors influencing job satisfaction among extension health workers in Addis Ababa city. This was a cross-sectional study conducted in Addis Ababa, Ethiopia. Among all public health centers found in the Addis Ababa city administration health bureau that would be included in the study, a multistage sampling technique was employed. Then we selected the study health centers randomly and urban health extension professionals from the selected health centers. In-depth interview data collection methods were carried out for a comprehensive understanding of factors affecting job satisfaction among Health extension professionals (HEPs) in Addis Ababa. HEPs working in Addis Ababa areas are the primary study population. Multivariate logistic regression with 95% CI at P ≤ 0.05 was used to assess associated factors to job satisfaction. The overall satisfaction rate was 10.7% only, while 89.3%% were dissatisfied with their jobs. The findings revealed that variables such as marital status, staff relations, community support, supervision, and rewards have a significant influence on the level of job satisfaction. For those who were not satisfied, the working environment, job description, low salary, poor leadership and training opportunities were the major causes. Other factors influencing the level of satisfaction were lack of medical equipment, lack of transport facilities, lack of training opportunities, and poor support from woreda experts. Our study documented a very low level of overall satisfaction among health extension professionals in Addis Ababa city public health centers. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of extension health professionals as they represent a sensitive domain of the health system of Addis Ababa city. Improving the overall work environment, review of job descriptions and better salaries might bring about a positive change.

Keywords: job satisfaction, extension health professionals, Addis Ababa

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Authors: Afolabi Joseph Fasoranti

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Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis. Tuberculosis is a major public health problem in Nigeria, being one of the ten leading causes of hospital admissions and a leading cause of death in adults, especially among the economically productive age group. This paper critically examined the importance of health education towards the eradication and prevention of tuberculosis in Nigeria. It was reviewed and discussed under the following subheadings; Global burden of tuberculosis in Nigeria, concept, definition and etiology of tuberculosis, Signs and symptoms of tuberculosis, diagnosis of tuberculosis, causative agent, modes of infection and incubation period, risk factors of pulmonary tuberculosis Dots and stop TB programmes in Nigeria Treatment and prevention of tuberculosis TB treatment strategies, Dealing with treatment problems in Nigeria Stigmatization against Tuberculosis Patients Health education as a tool for achieving free tuberculosis country. Emphasis for Tb control has been placed on the development of improved vaccines, diagnostic and treatment courses but less on health education and awareness. Although the need for these tools is indisputable, the obstacle facing the spread of TB go beyond technological. The findings of this study may stimulate health system policy makers, Government and non- governmental organizations, donor agencies and other stakeholders in planning and designing health education intervention programs on the control and eradication of tuberculosis. It therefore recommended that Government should implement health education as part of the DOTs, this will thus empower the tuberculosis patients on ways to live healthy, lifestyle, in doing this, they will recover fast and prevent them from spreading the disease.

Keywords: tuberculosis, health education, panacea, Nigeria, prevention

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Authors: Esengül Elibol, Arzu Kader Harmancı Seren

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Individuals' reasons to choose a profession, profession image perceptions and future plans related to that profession affect their success in their future work lives. For nursing profession, this situation at the same time is important in terms of the health and safety of patients. The purpose of this study is to determine why medical vocational high school students in İstanbul choose nursing profession, their nursing image perceptions and future plans related to the profession. Descriptive and cross-sectional design are used. The study was carried out in four medical vocational high school in İstanbul. All third and fourth grade students who are attending to nursing programs and voluntary for participation were included in the study. In collecting data, two questionnaires that aim to learn about socio-demographic characteristics, profession choice reasons and future plans of nursing students and ‘Nursing Image Scale’ were used. Scale consisted of 28 items including individuals' opinions on nursing profession image and three sub-categories ‘General View,’ ‘Communication,’ and ‘Vocational-Educational Qualities.’ Analyzing profession choice reasons and future plans of participants, it is determined that majority chose nursing for easily finding a job (46.9%) and that majority had a dream profession other than nursing (65.8%). Analyzing nursing image perception of participants, it is determined that average of general view sub-category total scores was 9.75±2.27, average of communication sub-category total scores was8.68±2.86, and average of vocational-educational qualities sub-category total score was 21.18±3.96. In the perception score averages, meaningful differences were found according to independent variables. In conclusion, it was determined that majority of the participant students chose nursing for easily finding a job, perceived profession image negatively, and had a dream profession other than nursing.

Keywords: nursing image, medical vocational health school, perception, profession, student nurse

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Authors: Anum Obaid, Iman Fatima, Wanisha Feroz, Haleema Imran, Hammad Tariq

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In Pakistan, the health of unmarried women over thirty is an emerging public health concern due to its increasing prevalence. Achieving the Sustainable Development Goals (SDGs) requires addressing nutrition and public health issues. This research investigates these goals through the lens of nutrition and public health, specifically examining the challenges faced by unmarried women over thirty in Faisalabad, Pakistan. According to a recent United Nations report, there are 10 million unmarried women over the age of 35 in Pakistan. The United Nations defines health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." Being unmarried and under constant societal pressure profoundly influences the dietary behaviors and nutritional status of these women, affecting their overall health, including physical, mental, and social well-being. A qualitative research approach was employed, involving interviews with both unmarried and married women over thirty. This research examines how marital status influences dietary practices, nutritional status, mental and social health, and their subsequent impacts. Factors such as physical health, mental and emotional status, societal pressure, social health, economic independence, and decision-making power were analyzed to understand the effect of singleness on overall wellness. Findings indicated that marital status significantly affects the dietary patterns and nutritional practices among women in Faisalabad. It was also revealed that unmarried women experienced more stress and had a less optimistic mindset compared to married women, due to loneliness or the absence of a spouse in their lives. Nutritional knowledge varied across marital status, impacting the overall health triangle, including physical, mental, and social health. Understanding these dynamics is crucial for developing targeted interventions to improve nutritional outcomes and overall health among unmarried women in Faisalabad. This study highlights the importance of fostering supportive environments and raising awareness about the health needs of unmarried women over thirty to enhance their overall well-being.

Keywords: health triangle, unmarried woman over thirty, socio-cultural barriers, women’s health

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Authors: Ghufran Ahmed, Muhammad Osama Siddiqui, Shahbaz Siddiqui, Rauf Ahmad Shams Malick, Faisal Khan, Mubashir Khan

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In this paper, a machine learning-based approach for early prediction of diseases in cows is proposed. Different ML algos are applied to extract useful patterns from the available dataset. Technology has changed today’s world in every aspect of life. Similarly, advanced technologies have been developed in livestock and dairy farming to monitor dairy cows in various aspects. Dairy cattle monitoring is crucial as it plays a significant role in milk production around the globe. Moreover, it has become necessary for farmers to adopt the latest early prediction technologies as the food demand is increasing with population growth. This highlight the importance of state-ofthe-art technologies in analyzing how important technology is in analyzing dairy cows’ activities. It is not easy to predict the activities of a large number of cows on the farm, so, the system has made it very convenient for the farmers., as it provides all the solutions under one roof. The cattle industry’s productivity is boosted as the early diagnosis of any disease on a cattle farm is detected and hence it is treated early. It is done on behalf of the machine learning output received. The learning models are already set which interpret the data collected in a centralized system. Basically, we will run different algorithms on behalf of the data set received to analyze milk quality, and track cows’ health, location, and safety. This deep learning algorithm draws patterns from the data, which makes it easier for farmers to study any animal’s behavioral changes. With the emergence of machine learning algorithms and the Internet of Things, accurate tracking of animals is possible as the rate of error is minimized. As a result, milk productivity is increased. IoT with ML capability has given a new phase to the cattle farming industry by increasing the yield in the most cost-effective and time-saving manner.

Keywords: IoT, machine learning, health care, dairy cows

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Authors: A. Sekhar, N. Ramakrishna Raju

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This paper is a result of ground improvement using deep vibro techniques with combination of sand and stone columns performed on a highly liquefaction susceptible site (70 to 80% sand strata and balance silt) with low bearing capacities due to high settlements located (earth quake zone V as per IS code) at Madhepura, Bihar state in northern part of India. Initially, it was envisaged with bored cast in-situ/precast piles, stone/sand columns. However, after detail analysis to address both liquefaction and improve bearing capacities simultaneously, it was analyzed the deep vibro techniques with combination of sand and stone columns is excellent solution for given site condition which may be first time in India. First after detail soil investigation, pre eCPT test was conducted to evaluate the potential depth of liquefaction to densify silty sandy soils to improve factor of safety against liquefaction. Then trail test were being carried out at site by deep vibro compaction technique with sand and stone columns combination with different spacings of columns in triangular shape with different timings during each lift of vibro up to ground level. Different spacings and timing was done to obtain the most effective spacing and timing with vibro compaction technique to achieve maximum densification of saturated loose silty sandy soils uniformly for complete treated area. Then again, post eCPT test and plate load tests were conducted at all trail locations of different spacings and timing of sand and stone columns to evaluate the best results for obtaining the required factor of safety against liquefaction and the desired bearing capacities with reduced settlements for construction of industrial structures. After reviewing these results, it was noticed that the ground layers are densified more than the expected with improved factor of safety against liquefaction and achieved good bearing capacities for a given settlements as per IS codal provisions. It was also worked out for cost-effectiveness of lightly loaded single storied structures by using deep vibro technique with sand column avoiding stone. The results were observed satisfactory for resting the lightly loaded foundations. In this technique, the most important is to mitigating liquefaction with improved bearing capacities and reduced settlements to acceptable limits as per IS: 1904-1986 simultaneously up to a depth of 19M. To our best knowledge it was executed first time in India.

Keywords: ground improvement, deep vibro techniques, liquefaction, bearing capacity, settlement

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Authors: Zahra Ghasemi, Fatemeh Babaei

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Plasma-derived medicinal products are vital categories of biological therapies. These products are used to treat rare, chronic, severe, and life-threatening conditions, such as bleeding disorders (Hemophilia A and B), hemolytic disease of the fetus and newborn, severe infections, burns and liver diseases, and other diseases caused by the absence or malfunction of certain proteins. In addition, they improve the patient’s quality of life. The process of producing plasma-derived medicinal products begins with the collection of human plasma from healthy donors. This initial stage is complex and is monitored with high precision and sensitivity by global authorities to maintain the quality and safety of the final products as well as the health of the donors. The amount of manufactured plasma-derived medicinal products depends on the availability of its raw material, human plasma, so collecting enough plasma for fractionation is essential. Therefore, adopting a suitable national policy regarding plasma donation, establishing collection centers, and increasing public awareness of the importance of plasma donation will improve any country’s conditions regarding the timely and sufficient supply of these medicines. In this study, we tried to briefly examine the importance of sustainability of the plasma industry and its situation in our beloved country of Iran.

Keywords: plasma, source plasma, plasma-derived medicinal products, fractionation

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Authors: Kishor Bhagwat, Gayatri Vyas

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Construction industry is earmarked with complex processes depending on the nature and scope of the project. In recent years, developments in this sector are remarkable and have resulted in both positive and negative impacts on the environment and human being. Sustainable construction can be looked upon as one of the solution to overcome the negative impacts since sustainable construction is a vast concept, which includes many parameters, and sometimes the use of multi-criteria decision making [MCDM] tools becomes necessary. The main objective of this study is to determine the weightage of sustainable building parameters with the help of MCDM tools. Questionnaire survey was conducted to examine the perspective of respondents on the importance of weights of the criterion, and the respondents were architects, green building consultants, and civil engineers. This paper presents an overview of research related to Indian and international green building rating systems and MCDM. The results depict that economy, environmental health, and safety, site selection, climatic condition, etc., are important parameters in sustainable construction.

Keywords: green building, sustainability, multi-criteria decision making method [MCDM], analytical hierarchy process [AHP], technique for order preference by similarity to an ideal solution [TOPSIS], entropy

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Authors: Nayab Kanwal, Noor Us Saher

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The management and utilization of food resources is becoming a big issue due to rapid urbanization, wastage and non-sustainable use of food, especially in developing countries. Therefore, the use of seafood as alternative sources is strongly promoted worldwide. Marine pollution strongly affects marine organisms, which ultimately decreases their export quality. The monitoring of contamination in marine organisms is a good indicator of the environmental quality as well as seafood quality. Monitoring the accumulation of chemical elements within various tissues of organisms has become a useful tool to survey current or chronic levels of heavy metal exposure within an environment. In this perspective, this study was carried out to compare the previous and current levels (Year 2012 and 2014) of heavy metals (Cd, Pb, Cr, Cu and Zn) in crabs marketed in Karachi and to estimate the toxicological risk associated with their intake. The accumulation of metals in marine organisms, both essential (Cu and Zn) and toxic (Pb, Cd and Cr), natural and anthropogenic, is an actual food safety issue. Significant (p>0.05) variations in metal concentrations were found in all crab species between the two years, with most of the metals showing high accumulation in 2012. For toxicological risk assessment, EWI (Estimated weekly intake), Target Hazard quotient (THQ) and cancer risk (CR) were also assessed and high EWI, Non- cancer risk (THQ < 1) showed that there is no serious threat associated with the consumption of shellfish species on Karachi coast. The Cancer risk showed the highest risk from Cd and Pb pollution if consumed in excess. We summarize key environmental health research on health effects associated with exposure to contaminated seafood. It could be concluded that considering the Pakistan coast, these edible species may be sensitive and vulnerable to the adverse effects of environmental contaminants; more attention should be paid to the Pb and Cd metal bioaccumulation and to toxicological risks to seafood and consumers.

Keywords: cancer risk, edible crabs, heavy metals pollution, risk assessment

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Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei

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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.

Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality

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Authors: Xinrong Li, Jiawei Dai

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Food production, food safety, and the food supply chain are causing a great challenge to human health and the environment. Different kinds of food have different environmental costs. Therefore, a healthy diet can alleviate this problem to a certain extent. In this project, an online questionnaire was conducted to understand the purchase behaviour of consumers and their attitudes towards basic food information. However, the data shows that the public's current consumption habits and ideology do not meet the long-term development of sustainable social needs. In order to solve the environmental problems caused by the unbalanced diet of the public and the social problems of unequal food distribution, the purpose of this paper is to explore how to use the emerging media of VR to visualize food supply chain information so as to attract users' attention to the environmental cost of food. In this project, the food supply chain of imported and local cheese was compared side-by-side in the virtual reality environment, including the origin, transportation, sales, and other processes, which can effectively help users understand the difference between the two processes and environmental costs. Besides, the experimental data demonstrated that the participant would like to choose low environmental cost food after experiencing the whole process.

Keywords: virtual reality, information design, food supply chain, environmental cost

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Authors: Sehrish Ather

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Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

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Authors: Mina Rahmani Pour

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Negative consequences of unemployment are: increasing age at marriage, addiction, depression, drug trafficking, divorce, immigration, elite, frustration, delinquency, theft, murder, etc., has led to addressing the issue of employment by economic planners, public authorities, chief executive economic conditions in different countries and different time is important. All countries are faced with the problem of unemployment. By identifying the influential factors of occupational employment and employing strengths in the basic steps can be taken to reduce unemployment. In this study, the most significant factors affecting employment has identified 12 variables based on interviews conducted Choose Vtasyrafzaysh engaged in three main business is discussed. DRGAM next question the 8 expert ministry to respond to it is distributed and for weight Horns AZFN Shannon entropy and the ranking criteria of the (SAW, TOPSIS) used. According to the results of the above methods are not compatible with each other, to reach a general consensus on the rating criteria of the technique of integrating (POSET) involving average, Borda, copeland is used. Ultimately, there is no difference between the employments in the economic sector jobs of increased employment.

Keywords: employment, effective techniques, SAW, TOPSIS

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Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

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Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

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Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

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Authors: Brizita Djordjevic, Bojana Vidovic, Milica Zrnic, Uros Cakar, Ivan Stankovic, Davor Korcok, Sladjana Sobajic

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Histamine is a biogenic amine, which is formed by enzymatic decarboxylation from the amino acid histidine. It can be found in foods such as fish and fish products, meat and fermented meat products, cheese, wine and beer. The presence of histamine in these foods can indicate microbiological spoilage or poor manufacturing processes. The consumption of food containing large amounts of histamine can have toxicological consequences. In 62 food products (31 canned fish products, 19 wines and 12 cheeses) from the market of Serbia the content of histamine was determined using enzyme-linked immunosorbent assay (ELISA) test kit according to the manufacturer's instructions (Immunolab GmbH, Kassel, Germany). The detection limits of this assay were 20 µg/kg for fish and cheese and 4 µg/L for wine. The concentration of histamine varied between 0.16-207 mg/kg in canned fish products, 0.03-1.47 mg/kg in cheeses and 0.01- 0.18 mg/L in wines. In all analyzed canned fish products the results obtained for the histamine were below the limits set by European and national legislation, so they can be considered acceptable and safe for the health consumers. The levels of histamine in analyzed cheeses and wines were very low and did not pose safety concerns.

Keywords: cheese, enzyme-linked immunosorbent assay, histamine, fish products, wine

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Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

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Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

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Authors: Müjde Erol Genevois, Hatice Kocaman

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Growing concerns about the increasing consumption of fossil energy and the improved recognition of environmental protection require sustainable road transportation technology. Electric vehicles (EVs) can contribute to improve environmental sustainability and to solve the energy problem with the right infrastructure. The problem of where to locate electric vehicle charging station can be grouped as decision-making problems because of including many criteria and alternatives that have to be considered simultaneously. The purpose of this paper is to present an integrated AHP and TOPSIS model to rank the optimal sites of EVs charging station in Istanbul, Turkey. Ten different candidate points and three decision criteria are identified. The performances of each candidate points with respect to criteria are obtained according to AHP calculations. These performances are used as an input for TOPSIS method to rank the candidate points. It is obtained accurate and robust results by integrating AHP and TOPSIS methods.

Keywords: electric vehicle charging station (EVCS), AHP, TOPSIS, location selection

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Authors: Lian Zeng

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Double-Spear 1-H2-1 (DS1-H2-1) is an oncolytic virus and an innovative biological drug candidate. The chemical composition of the drug product is a live attenuated West Nile virus (WNV) containing the human T cell costimulator (CD86) gene. After intratumoral injection, the virus can rapidly self-replicate in the injected site and lyse/kill the tumor by repeated infection among tumor cells. We also established xenograft tumor models in mice to evaluate the drug candidate's efficacy on those tumors. The results from preclinical studies on transplanted tumors in immunodeficient mice showed that DS1-H2-1 had significant oncolytic effects on human-origin cancers: it completely (100%) shrieked human glioma; limited human neuroblastoma growth reached as high as 95% growth inhibition rate (%TGITW). The safety data of preclinical animal experiments confirmed that DS1-H2-1 is safe as a biological drug for clinical use. In the preclinical drug efficacy experiment, virus-drug administration with different doses did not show abnormal signs and disease symptoms in more than 300 tested mice, and no side effects or death occurred through various administration routes. Intravenous administration did not cause acute infectious disease or other side effects. However, the replication capacity of the virus in tumor tissue via intravenous administration is only 1% of that of direct intratumoral administration. The direct intratumoral administration of DS1-H2-1 had a higher rate of viral replication. Therefore, choosing direct intratumoral injection can ensure both efficacy and safety.

Keywords: oncolytic virus, WNV-CD86, immunotherapy drugs, glioma, neuroblastoma

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Authors: Jaseel C. K., Surya M.

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The study explored the post-traumatic growth experiences among divorcees. Although research studies on post-traumatic growth (PTG) are not few in number, the ones conducted in the population are quite rare and lack depth as most of them were solely dependent on the post-traumatic growth inventory scale and its statistical analyses. A total of 10 participants were interviewed (telephonic) using a semi-structured interview schedule prepared based on the research questions and the theoretical framework of post traumatic growth. The interviews were analyzed using thematic analysis, which generated five major themes and 17 subthemes. From the analysis, it was found that enhanced interpersonal relationships, changed perceptions about love and marriage, better management of emotions, prioritization of self, increased pro-social behavior, better character strengths, etc., are the most prominent positive shifts in the lives of divorcees. It was also found that factors like good relationships, professional support, work engagement, response to social stigma, and time facilitated post-traumatic growth in the population. Another interesting finding that came out of the study was that socio-economic status, educational background, and occupational status all have a positive impact on the PTG experiences among the divorced. The results of the study can hopefully help professionals working with divorcees to impart positivity to them and facilitate post-traumatic growth.

Keywords: divorcees, meaning making, positive changes, post traumatic growth, trauma

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Authors: Kyung-Sook Bang

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Background: The health status of school-age children has a great influence on their growth and life-long health. The purposes of this study were to identify physical and mental health status of late school-age children in Seoul, South Korea and to investigate the related factors for their health. Methods: After gaining the approval from Institutional Review Board (IRB), a cross-sectional study was conducted with elementary students in grade 4 or 5. Questionnaires were distributed to eight elementary schools located different regions of Seoul in November, 2016, and 302 participants were finally included. From all participants, informed consents from the parents, and assents from children were received. Children's socioeconomic status, family functioning, peer relations, physical health symptoms, and depression were measured with self-reported questionnaires. Data were analyzed with descriptive statistics, t-test, Pearson’s correlations, and multiple regression. Results: Children's physical health symptoms and depression were not significantly different, and only their peer relations were significantly different according to their socioeconomic status (t=-3.93, p<.001). Depression showed significant positive correlation with physical health symptoms (r=.720, p<.001) and negative correlations with family functioning (r=-.428, p<.001) and peer relations (r=-.775, p<.001). The multiple regression model, which explained 73.5% of variance, showed peer relations (r2 =.604), physical health symptoms (r2 change=.125), and family functioning (r2 change=.005) as significant predictors for depression. Only the peer relations was significant predictor for their physical health symptoms and explained 50.6% of it. Conclusions: The peer relations was the most important factor in their physical and mental health at this age, and it can be affected by their socioeconomic status. Nursing interventions for promoting social relations and family functioning are required to improve children’s physical and mental health, especially for vulnerable population.

Keywords: child, depression, health, peer relation

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Authors: Yunus Doğan, Ahmet Durap

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Coastal regions are the one of the most commonly used places by the natural balance and the growing population. In coastal engineering, the most valuable data is wave behaviors. The amount of this data becomes very big because of observations that take place for periods of hours, days and months. In this study, some statistical methods such as the wave spectrum analysis methods and the standard statistical methods have been used. The goal of this study is the discovery profiles of the different coast areas by using these statistical methods, and thus, obtaining an instance based data set from the big data to analysis by using data mining algorithms. In the experimental studies, the six sample data sets about the wave behaviors obtained by 20 minutes of observations from Mersin Bay in Turkey and converted to an instance based form, while different clustering techniques in data mining algorithms were used to discover similar coastal places. Moreover, this study discusses that this summarization approach can be used in other branches collecting big data such as medicine.

Keywords: clustering algorithms, coastal engineering, data mining, data summarization, statistical methods

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Authors: Leena Inamdar, David Allen, Sushma Acquilla, James Gore

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Health systems globally are facing increasingly complex challenges. Emerging health threats, changing population demographics and increasing health inequalities, globalisation, economic constraints on government spending are some of the most critical ones. These challenges demand not only innovative funding and cross-sectoral approaches, but also require a multidisciplinary public health workforce equipped with skills and expertise to meet the future challenges of the Sustainable Development Goals (SDGs). We aim to outline an approach to assessing the feasibility of establishing a competency-based public health training at a country level. Although the SDGs provide an enabling impetus for change and promote positive developments, public health training and education still lag behind. Large gaps are apparent in both the numbers of trained professionals and the options for high quality training. Public health training in most Low-Middle Income Countries is still largely characterized by a traditional and limited public health focus. There is a pressing need to review and develop core and emerging competences for a well-equipped workforce fit for the future. This includes the important role of national Health and Human Resource Ministries in determining these competences. Public health has long been recognised as a multidisciplinary field, with need for professionals from a wider range of disciplines such as management, health promotion, health economics, law. Leadership and communication skills are also critical to achieve the successes in meeting public health outcomes. Such skills and competences need to be translated into competency-based training and education, to prepare current public health professionals with the skills required in today’s competitive job market. Integration of academic and service based public-health training, flexible accredited programmes to support existing mid-career professionals, continuous professional development need to be explored. In the current global climate of austerity and increasing demands on health systems, the need for stepping up public health training and education is more important than ever. By using a case study, we demonstrate the process of assessing the in-county capacity to establish a competency based public health training programme that will help to develop a stronger, more versatile and much needed public health workforce to meet the SDGs.

Keywords: public health training, competency-based, assessment, SDGs

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Authors: Ritu Sarsoha

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According to World Summit 2002 health is an integral component of sustainable development. Due to overpopulation and lack of employment opportunities in villages and small towns, the rural youth tend to migrate to the big cities causing mushrooming of slums. These slums lack most of the basic necessities of life particularly regarding environmental pollution and appropriate health care system. Present paper deals with the socio-economic and environmental status of people living in slum area of Chandigarh which has now grown as a big city today as it has become a hub for the migrants from U. P. and Bihar. Here is a case study of Colony no. 5 of Chandigarh which is divided into more than one block.

Keywords: slum, socio-economic, environment pollution, health

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Authors: Tanu Malik, Eusebe Gnonlonfoun, Eudes L. Anihouvi

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The rise of nutrition-related diseases, increase of health care cost, and the social perception that food could directly affect health have naturally created an environment conducive to the development of foods and beverages with an asserted health benefit. Consumer habits have turned considerably healthier in recent years and led to the demand for fortified and enhanced foods that could adequately provide health benefits beyond necessary nutrients for humans when they are consumed as part of the diet and regularly. These trends have developed a global market for functional foods, that grows annually and undoubtedly requires to be diversified. Product development appears thus as a key research priority for both the food industry and science sectors. The health benefits of these functional foods are summarized in two possible ways: either indirectly as a desired result of biogenic effect or through the direct interaction of ingested live microorganisms with the host (probiotic effect). This paper reviews functional foods and their beneficial health effects with a key focus on probiotics for the possible expansion of their use by the food industry in order to develop non-dairy based probiotics foods. Likewise, it reveals the need for more researches oriented towards an accurate understanding of the possible interaction between probiotic strains and the matrix and, on the other hand, the interaction between probiotic strains and some enzymes used during food manufacturing.

Keywords: functional foods, food industry, health benefits, probiotics

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Authors: Jenny Clift, Rebeccah Sokol, LaTricia Mitchell, Nicholas Alexander, Karissa Rusnick

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Aims: This study sought to identify prevalent promotive factors supporting urban adolescent health and wellbeing, per adolescent and caregiver reports. Setting: The research team conducted online surveys with adolescent (n=520) and caregiver (n=73) respondents from a predominately Latinx urban high school. Methodology: A cross-sectional, qualitative study. Analysis: Inductive thematic analysis was used to analyze responses to open-ended questions. -Findings. Adolescent and caregiver respondents identified promotive factors (eight and six, respectively) that encourage adolescent health and well-being. Supportive relationships were the most frequently reported factor among adolescents (68%) and caregivers (55%). Implications: Health promotion interventions among adolescents should consider how to promote relationships to counteract negative social determinants of health (SDH) and promote optimal quality of life.

Keywords: Latinx adolescents, health and wellbeing, social determinants of health, school

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