Search results for: rural healthcare

Authors: Farnaz Firuzian, Farhad Choobdar, Ali Mazouri

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As Very Low Birth Weight (VLBW) neonates cannot tolerate enteral feeding, parenteral nutrition (PN) must be administered shortly after birth. To find an optimal combination of nutrition, in this study, we compare administering high glucose versus high protein intake as a component of total parenteral nutrition (TPN) to test their effect on birth weight (BW) regain in VLBW. This study employs a multi-arm randomized trial: 145 newborns with BW < 1500 g were randomized to control (C) or experimental groups: high glucose (G) or high protein (P). All samples in each group received the same TPN regimens except glucose and protein intake: Glocuse was provided by dextrose water (DW) serum: 7-15 g/kg/d (10% DW) in groups C and P versus 8.75-18.75 g/kg/d (12.5% DW) in group G. Protein provided by amino acids 3 g/kg/d for groups C and G versus 4 g/kg/d for group P. Outcomes (weight, height, and head circumference) was monitored on a daily basis until the BW was regained. Data has been gathered recently and is being processed. We hypothesize that neonates with higher amino acid intake will result in sooner BW regain than other groups. The result will be presented at the conference. The findings of this study not only can help optimize nutrition, cost reduction, and shorter NICU admission of VLBW neonates at the hospital level but eventually contribute to reduced healthcare-associated infections (HAIs) and an improved health economy.

Keywords: very low birth weight neonates, weight gain, parenteral nutrition, glucose, amino acids

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Authors: Adandé Belarmain Fandohan

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Climate change has become a major concern globally, particularly in rural communities that have to find rapid coping solutions. Several vulnerability assessment approaches have been developed in the last decades. This comes along with a higher risk for different methods to result in different conclusions, thereby making comparisons difficult and decision-making non-consistent across areas. The effect of methods and computational approaches on estimates of people’s vulnerability was assessed using data collected from the Gambia. Twenty-four indicators reflecting vulnerability components: (exposure, sensitivity, and adaptive capacity) were selected for this purpose. Data were collected through household surveys and key informant interviews. One hundred and fifteen respondents were surveyed across six communities and two administrative districts. Results were compared over three computational approaches: the maximum value transformation normalization, the z-score transformation normalization, and simple averaging. Regardless of the approaches used, communities that have high exposure to climate change and extreme events were the most vulnerable. Furthermore, the vulnerability was strongly related to the socio-economic characteristics of farmers. The survey evidenced variability in vulnerability among communities and administrative districts. Comparing output across approaches, overall, people in the study area were found to be highly vulnerable using the simple average and maximum value transformation, whereas they were only moderately vulnerable using the z-score transformation approach. It is suggested that assessment approach-induced discrepancies be accounted for in international debates to harmonize/standardize assessment approaches to the end of making outputs comparable across regions. This will also likely increase the relevance of decision-making for adaptation policies.

Keywords: maximum value transformation, simple averaging, vulnerability assessment, West Africa, z-score transformation

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Authors: Usman Ahmed Khan

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Urbanization directly affects the existing infrastructure, landscape modification, environmental contamination, and traffic pollution, especially if there is a lack of urban planning. Recently, the rapid urban sprawl has resulted in less developed green areas and has devastating environmental consequences. This study was aimed to study the past urban expansion rates and measure LST from satellite data. The land use land cover (LULC) maps of years 1996, 2010, 2013, and 2017 were generated using landsat satellite images. Four main classes, i.e., water, urban, bare land, and vegetation, were identified using unsupervised classification with iterative self-organizing data analysis (isodata) technique. The LST from satellite thermal data can be derived from different procedures: atmospheric, radiometric calibrations and surface emissivity corrections, classification of spatial changeability in land-cover. Different methods and formulas were used in the algorithm that successfully retrieves the land surface temperature to help us study the thermal environment of the ground surface. To verify the algorithm, the land surface temperature and the near-air temperature were compared. The results showed that, From 1996-2017, urban areas increased to about a considerable increase of about 48%. Few areas of the city also shown in a reduction in LST from the year 1996-2017 that actually began their transitional phase from rural to urban LULC. The mean temperature of the city increased averagely about 1ºC each year in the month of October. The green and vegetative areas witnessed a decrease in the area while a higher number of pixels increased in urban class.

Keywords: LST, LULC, isodata, urbanization

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Authors: Farhan E Shafrin, Khandaker Shabbir Ahmed

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Natural ventilation strategies continue to be a key alternative to costly mechanical ventilation systems, especially in healthcare facilities, due to increasing energy issues in developing countries, including Bangladesh. Besides, overcrowding and insufficient ventilation strategies remain significant causes of thermal discomfort and hospital infection in Bangladesh. With the proper location of inlet and outlet windows, uniform flow is possible in the occupancy area to achieve thermal comfort. It also determines the airflow pattern of the ward that decreases the movement of the contaminated air. This paper aims to establish a relationship between the location of the windows and the thermal comfort of the occupants in a naturally ventilated hospital ward. It defines the openings and ventilation variables that are interrelated in a way that enhances or limits the health and thermal comfort of occupants. The study conducts a full-scale experiment in one of the naturally ventilated wards in a primary health care hospital in Manikganj, Dhaka. CFD simulation is used to explore the performance of various opening positions in ventilation efficiency and thermal comfort in the study area. The results indicate that the opening located in the hospital ward has a significant impact on the thermal comfort of the occupants and the airflow pattern inside the ward. The findings can contribute to design the naturally ventilated hospital wards by identifying and predicting future solutions when it comes to relationships with the occupants' thermal comforts.

Keywords: CFD simulation, hospital ward, natural ventilation, thermal comfort, window location

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Authors: Tsoaledi D. Thobejane, Barnabas C. Okere

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Gender mainstreaming has been adopted as a strategy for promoting gender equality in institutions of higher learning Worldwide, not least in Africa. This study investigated Gender Mainstreaming at the University of Venda, in Limpopo Province, South Africa. The study was based on the Feminist Theoretical Framework. Both qualitative and quantitative approaches were used. A case study research design was adopted. The study involved a population of 60 participants and a sample of 25 male and female workers selected using the purposive sampling technique. Data were presented in pie charts, tables, themes and in textual forms. Data were analysed through descriptive statistics and thematic analysis. The major findings and conclusions of the study were that the University of Venda faces enormous challenges in mainstreaming gender in the university functions. There are perceptions that most strategic higher positions in the institution are dominated by men while women are marginalized. Although the University has policies on gender, staff members do not know about them while management does not implement its policies. University of Venda makes use of the Employment Equity Act of 1998, but it is not clear whether line managers are aware of its implementation and how. In addition, favouritism, nepotism, patronage, and patriarchy played a role in gender mainstreaming. The study recommended that there should be more gender awareness activities, such as workshops, conferences, and symposia for workers and staff members in order to sensitize them about gender towards understanding. The study also recommended that deserving female staff members should be promoted, and all employees should be encouraged to read and understand gender policies. In addition, management should implement the institutions and national gender policies without fear or favour.

Keywords: gender mainstreaming, gender equality, institutions, representation

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Authors: Fatihin Khoirul, Muhammad Muqorrobin Ist

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Bojonegoro Regency is one of the districts that use the concept Agropolitan as the Territorial Development Policy. Three sub-district designated as Area Development District of Agropolitan are Kapas, Dander, and Kalitidu or commonly called KADEKA. Current policy has been shown results, but there was an inequality of results in some areas. One of them occurred in the Ngringinrejo village with the main commodities is Starfruit and Wedi village with the main commodities is Salak fruit. Therefore, a comparative study is used to search for causal factors of inequality result of the policy by using the 5 aspects compared, namely: (1) Management Development Agropolitan; (2) Physical Condition agropolitan Region; (3) Implementing Agency at the Village Level; (4) Village Government Support; and (5) Community support. Based on the discussion of qualitative analysis, it was found that five aspects have their respective roles in creating inequality of outcomes that occur in both villages. But beyond that, there are conditions where the two villages experienced the same condition that is when the initial implementation of the policy. The condition is referred to as 'the phenomenon of price trap.' The condition is caused by lower commodity prices, causing the village government's commitment in implementing policies too low, followed by public awareness in support of the policy is also low, so care for commodities is also low, and the quality is too low lead and eventually back causing low price. However, the difference is that the village Ngringinrejo able to get out of this condition with 'the new culture of administration' at the end of 2013. While the conditions in the village of Wedi compounded by not respected request assistance by the irrigation district.

Keywords: comparative policy analysis, qualitative comparative, inequallity, price trap, new culture of administration

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Authors: Poglajen Andrej, Malečihar Špela

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Social work in rehabilitation needs constant development and embetterment of its practitioners. This became even more evident during the covid pandemic at times when outside sources of help, care and support were non-existent, or the access to such sources was severely limited. Social workers are, at our core, researchers of the rehabilitated world – from a personal and intrapersonal to a systematic perspective. This is also why a method of research was used in order to see if clinical social work practice can be further improved. The first stage of research showcased how action research and social work practice share many of the core values, whereas the Implementation of the new behaviour principle was severely lacking and thus became the main focus of the follow-up research. Twenty randomly selected case files of clinical social work practice in rehabilitation were qualitatively analyzed and potential benefits of action research on practice were assessed in the process of intervention while also getting feedback of the usefulness by the patients themselves using pre and post evaluation forms where a mixed-method approach was used. Implementation of new behaviour principle was recognized as a potential, improving factor of clinical social work practice in most analyzed cases, while it wasn’t deemed necessary in all of them. Potential improvements of newly implemented behaviour span across different areas of life and were also noted in the feedback from the rehabilitates. Despite the benefits of practice embetterment, the inclusion and focus on Implementation of new behaviour principle also caused additional workload, lack of time and stressful situations for the practitioners, which showcased the need to address certain systemic obstacles in the context of social work in healthcare in Slovenia.

Keywords: action research, practice, rehabilitation, social work

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Authors: Ana C. V. Freitas, Luciana B. M. Pires, Joao P. Martins

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In recent years, fire dynamics in deforestation areas of tropical forests have received considerable attention because of their relationship to climate change. Climate models project great increases in the frequency and area of drought in the Amazon region, which may increase the occurrence of fires. This study analyzes the historical record number of fire outbreaks in 2017 using satellite-derived data sets of active fire detections, burned area, precipitation, and data of the Fire Program from the Center for Weather Forecasting and Climate Studies (CPTEC/INPE). A downward trend in the number of fire outbreaks occurred in the first half of 2017, in relation to the previous year. This decrease can be related to the fact that 2017 was not an El Niño year and, therefore, the observed rainfall and temperature in the Amazon region was close to normal conditions. Meanwhile, the worst period in history for fire outbreaks began with the subsequent arrival of the dry season. September of 2017 exceeded all monthly records for number of fire outbreaks per month in the entire series. This increase was mainly concentrated in Bolivia and in the states of Amazonas, northeastern Pará, northern Rondônia and Acre, regions with high densities of rural settlements, which strongly suggests that human action is the predominant factor, aggravated by the lack of precipitation during the dry season allowing the fires to spread and reach larger areas. Thus, deforestation in the Amazon is primarily a human-driven process: climate trends may be providing additional influences.

Keywords: Amazon forest, climate change, deforestation, human-driven process, fire outbreaks

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Authors: Samuel Nderitu Muchiri, Tracy Wangechi Maina

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Truck drivers face a myriad of challenges in their profession. Enhancements in logistics effectiveness can be pivotal in propelling economic developments. The specific objective of the study was to assess the influence of driver distraction on crash risk. The study is significant as it elucidates best practices that truck drivers can embrace in an effort to enhance road safety. These include amalgamating behaviors that enable drivers to fruitfully execute multifaceted functions such as finding and following routes, evading collisions, monitoring speed, adhering to road regulations, and evaluating vehicle systems’ conditions. The analysis involved an empirical review of ten previous studies related to the research topic. The articles revealed that driver distraction plays a substantial role in road accidents and other crucial road security incidents across the globe. Africa depends immensely on the freight transport sector to facilitate supply chain operations. Several studies indicate that drivers who operate primarily on rural roads, such as those found in Sub-Saharan Africa, have an increased propensity to engage in distracted activities such as cell phone usage while driving. The findings also identified the need for digitalization in truck driving operations, including carrier management techniques such as fatigue management, artificial intelligence, and automating functions like cell phone usage controls. The recommendations can aid policymakers and commercial truck carriers in deepening their understanding of driver distraction and enforcing mitigations to foster road safety.

Keywords: truck drivers, distraction, digitalization, crash risk, road safety

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Authors: Oscar Kallay

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Objective: This study compares the sustainability, financial implications, and surgical efficiency of two phacoemulsification cassette systems for cataract surgery: a machine with single-use cassettes and another with daily, reusable ones. Methods: The observational study involves retrospective cataract surgery data collection at the Centre Médical de l'Alliance, Braine-L’alleud, Belgium, a tertiary eye care center. Information on cassette weight, quantities, and transport volume was obtained from routine procedures and purchasing records. The costs for each machine were calculated by reviewing the invoices received from the accounting department. Results: We found significant differences across comparisons. The reusable cassette machine, when compared to the single-use machine, used 306.7 kg less plastic (75.3% reduction), required 2,494 cubic meters less storage per 1000 surgeries (67.7% decrease), and cost €54.16 less per 10 procedures (16.9% reduction). The machine with daily reusable cassettes also exhibited a 7-minute priming time advantage for 10 procedures, reducing downtime between cases. Conclusions: Our findings underscore the benefits of adopting reusable cassette systems: reduced plastic consumption, storage volume, and priming time, as well as enhanced efficiency and cost savings. Healthcare professionals and institutions are encouraged to embrace environmentally conscious initiatives. The use of reusable cassette systems for cataract surgeries offers a pathway to sustainable practices.

Keywords: cataract, epidemiolog, surgery treatment, lens and zonules, public health

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Authors: Ju Young Kim, Mohammad Zahirul Islam, Mahmuda Akter Mele, Su Jeong Han, Hyuk Sung Yoon, In-Lee Choi, Ho-Min Kang

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Strawberry and tomato fruits were harvested at the red ripens maturity stage in the Republic of Korea. The fruits were dipped in fungi solution and afterwards were sterilized with sodium hypochlorite (NaOCl) and chlorine dioxide (ClO2) gas. Some fruits were dipped in 150μL/L NaOCl solution for 10 minutes, and others were treated with 5μL/L ClO2 gas for 12 hours and packed with 20,000 cc OTR (oxygen transmission rate) film, the rest were packed in 10,000 cc OTR film inserted with 5μL/L ClO2 gas. 5μL/L ClO2 gas insert treatment showed the lowest carbon dioxide and ethylene, and the highest oxygen concentration was on the final storage day (15th day) in both strawberry and tomato fruits. Tomato fruits showed the lowest fresh weight loss in 5μL/L ClO2 gas insert treatment. The visual quality as well as shelf life showed the highest in 5μL/L ClO2 gas insert treatment of both strawberry and tomato fruits. In addition, the fungal incidence of strawberry and tomato fruits were the most suppressed in 5μL/L ClO2 gas insert treatment. 5μL/L ClO2 gas insert treatment showed higher firmness and soluble solids in both strawberry and tomato fruits. So, 5μL/L ClO2 gas insert treatment may be useful to prevent the fungal incidence as well as retaining the postharvest quality, and increase the shelf life of strawberry and tomato fruits for long term storage. This study was supported by Export Promotion Technology Development Program (314027-03), IPET, Ministry of Agriculture, Food and Rural Affairs, Republic of Korea.

Keywords: chlorine dioxide, ethylene, fungi, sodium hypochlorite

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Authors: Muhammad Yahaya Ubale

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Substantial rate of urbanization as well as economic growth is the tasks and prospects of sustainability. Objectives of the paper are: to ascertain the fate of sustainability in urbanized cities and; to identify the challenges of land use array in urbanized cities. Methodology engaged in this paper employed the use of secondary data where articles, conference proceedings, seminar papers and literature materials were effectively used. The paper established the fact that while one thinks globally, it is reciprocal to act locally if at all sustainability should be achieved. The speed and scale of urbanization must be equal to natural and cost-effective deliberations. It also discovered a podium that allows a city to work together as an ideal conglomerate, engaging all city departments as a source of services, engaging residents, businesses, and contractors. It also revealed that city should act as a leader and partner within an urban region, engaging senior government officials, utilities, rural settlements, private sector stakeholders, NGOs, and academia. Cities should assimilate infrastructure system design and management to enhance efficiency of resource flows in an urban area. They should also coordinate spatial development; integrate urban forms and urban flows, combine land use, urban design, urban density, and other spatial attributes with infrastructural development. Finally, by 2050, urbanized cities alone could be consuming 140 billion tons of minerals, ores, fossil fuels and biomass annually (three times its current rate of consumption), sustainability can be accomplished through land use control, limited access to finite resources, facilities, utilities and services as well as property right and user charge.

Keywords: sustainability, land use array, urbanized cities, fate of sustainability and perseverance

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Authors: Floris Burgers, Arjan Verschoor

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Poor farmers in developing countries typically do not have the resources or access to institutions to protect themselves against all kinds of income shocks, which makes their farm income highly sensitive to weather and crop price fluctuations, and various other intervening forces. Consequently, the relationship between farming effort and farming outcomes can be noisy, potentially resulting in a situation in which farmers perceive little personal control over the outcomes of their farming efforts. This perceived lack of control can result in learned helplessness in some farmers, who would then be less motivated to invest in their farm. This paper presents the results of a household survey and controlled field experiment conducted in ten villages in a farming area in eastern Uganda with a view to examining the link between learned helplessness and agricultural investment. The results show that (I) farmers with a more pessimistic attributional style for negative life events invest less in their farm, (II) an experience of uncontrollability over income in a priming task increases investment in the farm in a subsequent task if losses in the priming task are small, and decreases investment in the subsequent task if losses are moderate or big, and (III) the relationship between the number of income shocks experienced in the past two years and investment in the farm is more negative among farmers with a more pessimistic attributional style. These results are in line with the reformulated learned helplessness theory underlying this research, which leads this paper to conclude that learned helplessness can cause agricultural underinvestment in a developing country context, potentially contributing to a poverty trap.

Keywords: agricultural investment, attributional style, farmers, learned helplessness, poverty, income shocks

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Authors: Neha Toppo

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Plans and programs for successful secondary education are incomplete without the inclusion of teaching English as an important area. Even after sixteen years of the formation of Jharkhand as a separate state, the students are still struggling to achieve quality education of English. This paper intends to account the present condition of teaching English in Jharkhand board secondary level schools through discussion on various issues of English language teaching, language need and learning challenges of its students. The study is to analyze whether the learning environment, teaching methods and materials, teaching resources, goals of language curriculum are appropriately convincing for the students of the board or require to be reanalyzed and also to provide appropriate suggestions for improvement. Immediate attention must be drawn towards the problem for benefitting those students, who despite their knowledge and talent are lagging behind in numerous fields only due to the lack of proficiency in English. The data and discussion provided are on the basis of a survey, in which semi structured interview with teachers, students and administrators in several schools including both rural and urban area has been taken. Questionnaire, observation and testing were used as important tools. The survey has been conducted in Ranchi district, as it covers large geographical area which includes number of villages and at the same time several towns. The district primarily possesses tribes as well as different class of people including immigrants from all over and outside Jharkhand with their social, economical strata. The observation makes it clear that the English language teaching at the state board is not complementing its context and the whole language teaching system should be re-examined to establish learner oriented environment.

Keywords: material, method, secondary level, teaching resources

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Authors: B. Kulaga, A. Cinti, F. J. Mazzocchini

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Despite the fact that growing academic attention on dark tourism is a fairly recent phenomenon, among the various reasons for travelling death-related ones, are very ancient. Furthermore, the darker side of human nature has always been fascinated and curious regarding death, or at least, man has always tried to learn lessons from death. This study proposes to describe the phenomenon of dark tourism related to the 2016 earthquake in Central Italy, deadly for 302 people and highly destructive for the rural areas of Lazio, Marche, and Umbria Regions. The primary objective is to examine the motivation-experience relationship in a dark tourism site, using the structural equation model, applied for the first time to a dark tourism research in 2016, in a study conducted after the Beichuan earthquake. The findings of the current study are derived from the calculations conducted on primary data compiled from 350 tourists in the areas mostly affected by the 2016 earthquake, including the town of Amatrice, near the epicenter, Castelluccio, Norcia, Ussita and Visso, through conducting a Likert scale survey. Furthermore, we use the structural equation model to examine the motivation behind dark travel and how this experience can influence the motivation and emotional reaction of tourists. Expected findings are in line with the previous study mentioned above, indicating that: not all tourists visit the thanatourism sites for dark tourism purpose, tourists’ emotional reactions influence more heavily the emotional tourist experience than cognitive experiences do, and curious visitors are likely to engage cognitively by learning about the incident or related issues.

Keywords: dark tourism, emotional reaction, experience, motivation, structural equation model

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Authors: R. T. Aggangan

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Woodfuels continue to be a major component of the energy supply mix of the Philippines due to increasing demand for energy that are not adequately met by decreasing supply and increasing prices of fuel oil such as liquefied petroleum gas (LPG) and kerosene. The Development Academy of the Philippines projects the demand of woodfuels in 2016 as 28.3 million metric tons in the household sector and about 105.4 million metric tons combined supply potentials of both forest and non-forest lands. However, the Revised Master Plan for Forestry Development projects a demand of about 50 million cu meters of fuelwood in 2016 but the capability to supply from local sources is only about 28 million cu meters indicating a 44 % deficiency. Household demand constitutes 82% while industries demand is 18%. Domestic household demand for energy is for cooking needs while the industrial demand is for steam power generation, curing barns of tobacco: brick, ceramics and pot making; bakery; lime production; and small scale food processing. Factors that favour increased use of wood-based energy include the relatively low prices (increasing oil-based fuel prices), availability of efficient wood-based energy utilization technology, increasing supply, and increasing population that cannot afford conventional fuels. Moreover, innovations in combustion technology and cogeneration of heat and power from biomass for modern applications favour biomass energy development. This paper recommends policies and strategic directions for the development of the woodfuel industry with the twin goals of sustainably supplying the energy requirements of households and industry.

Keywords: biomass energy development, fuelwood, households and industry, innovations in combustion technology, supply and demand

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Authors: Udeh Nneka Evelyn

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The shortcoming of traditional costing system in terms of validity, accuracy, consistency, and Relevance increased the need for modern management accounting system. Activity –Based Costing (ABC) can be used as a modern tool for planning, Control and decision making for management. Past studies on ABC system have focused on manufacturing firms thereby making the studies on service firms scanty to some extent. This paper reviewed the application and relevance of activity-based costing technique in service oriented business organizations by employing a qualitative research method which relied heavily on literature review of past and current relevant articles focusing on ABC. Findings suggest that ABC is not only appropriate for use in a manufacturing environment; it is also most appropriate for service organizations such as financial institutions, the healthcare industry and government organization. In fact, some banking and financial institutions have been applying the concept for years under other names. One of them is unit costing, which is used to calculate the cost of banking services by determining the cost and consumption of each unit of output of functions required to deliver the service. ABC in very basic terms may provide very good payback for businesses. Some of the benefits that relate directly to the financial services industry are: identification the most profitable customers: more accurate product and service pricing: increase product profitability: Well organized process costs.

Keywords: business, costing, organizations, planning, techniques

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Authors: Smaran Manchala

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Homomorphic Encryption (HE) enables computations on encrypted data without requiring decryption, mitigating data vulnerability during processing. Usable Fully Homomorphic Encryption (FHE) could revolutionize secure data operations across cloud computing, AI training, and healthcare, providing both privacy and functionality, however, the computational inefficiency of schemes like Cheon-Kim-Kim-Song (CKKS) hinders their widespread practical use. This study focuses on optimizing CKKS for faster matrix operations through the implementation of vector computation parallelization and GPU acceleration. The variable effects of vector parallelization on GPUs were explored, recognizing that while parallelization typically accelerates operations, it could introduce overhead that results in slower runtimes, especially in smaller, less computationally demanding operations. To assess performance, two neural network models, MLPN and CNN—were tested on the MNIST dataset using both ARM and x86-64 architectures, with CNN chosen for its higher computational demands. Each test was repeated 1,000 times, and outliers were removed via Z-score analysis to measure the effect of vector parallelization on CKKS performance. Model accuracy was also evaluated under CKKS encryption to ensure optimizations did not compromise results. According to the results of the trail runs, applying vector parallelization had a 2.63X efficiency increase overall with a 1.83X performance increase for x86-64 over ARM architecture. Overall, these results suggest that the application of vector parallelization in tandem with GPU acceleration significantly improves the efficiency of CKKS even while accounting for vector parallelization overhead, providing impact in future zero trust operations.

Keywords: CKKS scheme, runtime efficiency, fully homomorphic encryption (FHE), GPU acceleration, vector parallelization

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Authors: Y. Y. Babanyara, B. A. Gana, T. Garba, M. A. Batari

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Proper management of dental waste is a crucial issue for maintaining human health and the environment. The waste generated in the dental clinics has the potential for spreading infections and causing diseases, so improper disposal of these dental wastes can cause harm to the dentist, the people in immediate vicinity of the dentist, waste handlers, general public and the environment through production of toxins or as by-products of the destruction process. Staff that provide dental healthcare ought to be aware of the proper handling and the system of management of dental waste used by different dental hospitals. The method of investigation adopted in the paper involved a desk study in which documents and records relating to dental waste handling were studied to obtain background information on existing dental waste management in Nigeria other countries of the world are also mentioned as examples. Additionally, information on generation, handling, segregation, risk associated during handling and treatment of dental medical waste were sought in order to determine the best method for safe disposal. This article provides dentists with the information they need to properly dispose of mercury and amalgam waste, and provides suggestions for managing the other wastes that result from the day-to-day activities of a dental office such as: used X-ray fixers and developers; cleaners for X-ray developer systems; lead foils, shields and aprons; chemiclave/chemical sterilant solutions; disinfectants, cleaners, and other chemicals; and, general office waste. Additionally, this study may be beneficial for authorities and researchers of developing countries to work towards improving their present dental waste management system.

Keywords: clinic, dental, disposal, environment, waste management

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Authors: Joanne Joyce-McCoach

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Short courses are an integral part of the higher education sector, providing a pathway into tertiary qualifications. Recently, the Australian government has implemented a range of initiatives to support the development of short courses and micro-credentials designed to upskill the labor market and meet the needs of the healthcare workforce. While short courses have been an ongoing component of Australian nursing continuing professional development, there is an immediate need for more education opportunities as a response to the workforce shortages. However, despite the support for short courses, there are identified challenges for learners undertaking these courses online. As a result of restrictions to face-to-face classes and limited access to health services caused by the pandemic, education providers have had to transition to an online delivery requiring the redesign of skills acquisition. This paper will outline the transition of an immunisation short course to a fully online format, including the redesign of classes, content and assessment. Concurrently the enrolments for the immunisation short course substantially increased in direct response to the demand for nurse immunisers. In addition to providing a description of the curriculum changes implemented, an analysis of learners’ feedback on their experience of the new format will be discussed. Furthermore, it will explore the principles identified in the transition process for improving the short course design and learning activities. Finally, it will propose recommendations to integrate into the delivery of online short courses and to meet the learners' needs.

Keywords: nurse, immunisation, short course, micro-credential, continuing professional development, online design

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Authors: Chuan Yang, Jing Bie, Zhong Wang, Panagiotis Psimoulis

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Contemporary studies investigating the association between the spatial configuration of the urban network and economic activities at the street level were mostly conducted within space syntax conceptual framework. These findings supported the theory of 'movement economy' and demonstrated the impact of street configuration on the distribution of pedestrian movement and land-use shaping, especially retail activities. However, the effects varied between different urban contexts. In this paper, the relationship between economic activity distribution and the urban configurational characters was examined at the segment level. In the study area, three kinds of neighbourhood types, urban, suburban, and rural neighbourhood, were included. And among all neighbourhoods, three kinds of urban network form, 'tree-like', grid, and organic pattern, were recognised. To investigate the nested effects of urban configuration measured by space syntax approach and urban context, multilevel zero-inflated negative binomial (ZINB) regression models were constructed. Additionally, considering the spatial autocorrelation, spatial lag was also concluded in the model as an independent variable. The random effect ZINB model shows superiority over the ZINB model or multilevel linear (ML) model in the explanation of economic activities pattern shaping over the urban environment. And after adjusting for the neighbourhood type and network form effects, connectivity and syntax centrality significantly affect economic activities clustering. The comparison between accumulative and new established economic activities illustrated the different preferences for economic activity location choice.

Keywords: space syntax, economic activities, multilevel model, Chinese city

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Authors: Ritu Sharma

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In order to be objective, critics must examine the dynamic relationships between the author, the reader, the text, and the outside world. However, it is also crucial to recognize that because the language was created by God, meaning is ingrained in it. Meaning is located in and discovered through literature rather than being limited to the author, reader, text, or the outside world. The link between the author, the reader, and the text is crucial because literature unites an author and a reader through the use of language. Literature is a potent kind of communication, and Ethan Frome's audience is forever changed as a result of the book's language and the language its characters use. The narrative of Ethan Frome and his wife Zeena is presented in Ethan Frome. Ethan's story is told throughout the course of the book, revealed through the eyes of the narrator, an outsider passing through Starkfield, as well as through the insight that the narrator gains from the townspeople and his stay on the Frome farm. The story is set in the rural New England community of Starkfield, Massachusetts. The weather provides the ideal setting for Ethan and the narrator to get to know one another as the narrator gets preoccupied with unraveling the narrative that underlies Ethan's physical anomalies. In addition to telling a gripping tale and capturing human nature as it is, Ethan Frome uses its storyline to achieve something more significant. The book by Edith Wharton supports language. Zeena's deliberate and convincing language challenges relativity and meaninglessness. Ethan and Mattie's effort to effectively use words reflects the complexity of language, and their battle illustrates the influence that language may have if and when it is used. Ethan Frome defends the written word, the foundation upon which it is constructed, as a literary work. Communication is based on language, and as the characters respond to and get involved in disputes throughout the book, Zeena, Ethan, and Mattie, each reflects particular theories of communication that help define their uses of communication within the broader context of language.

Keywords: dynamic relationships, potent, communication, complexity

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Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

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Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

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Authors: Azita Ramezani, Ghazal Mashhadiagha, Bahareh Sanabakhsh

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This study researches the combination of Random. Forest classifiers with large language models (LLMs) and natural language processing (NLP) to improve diagnostic accuracy in chest X-ray analysis using the Indiana University dataset. Utilizing advanced NLP techniques, the research preprocesses textual data from radiological reports to extract key features, which are then merged with image-derived data. This improved dataset is analyzed with Random Forest classifiers to predict specific clinical results, focusing on the identification of health issues and the estimation of case urgency. The findings reveal that the combination of NLP, LLMs, and machine learning not only increases diagnostic precision but also reliability, especially in quickly identifying critical conditions. Achieving an accuracy of 99.35%, the model shows significant advancements over conventional diagnostic techniques. The results emphasize the large potential of machine learning in medical imaging, suggesting that these technologies could greatly enhance clinician judgment and patient outcomes by offering quicker and more precise diagnostic approximations.

Keywords: natural language processing (NLP), large language models (LLMs), random forest classifier, chest x-ray analysis, medical imaging, diagnostic accuracy, indiana university dataset, machine learning in healthcare, predictive modeling, clinical decision support systems

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Authors: Akankunda Veronicah Karuhanga

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Dementia is an age mental disorder that makes victims lose normal functionality that needs delicate attention. It has been technically defined as a clinical syndrome that presents a number of difficulties in speech and other cognitive functions that change someone’s behaviors and can also cause impairments in activities of daily living, not forgetting a range of neurological disorders that bring memory loss and cognitive impairment. Family members are the primary healthcare givers and therefore, the way how they handle the situation in its early stages determines future deterioration syndromes like total memory loss. Unfortunately, most family members are ignorant about this condition and in most cases, the patients are brought to our facilities when their condition was already mismanaged by family members and we thus cannot do much. For example, incontinence can be managed at early stages through potty training or toilet scheduling before resorting to 24/7 diapers which are also not good. Professional Elderly care should be understood and practiced as an extension of homes, not a dumping place for people considered “abnormal” on account of ignorance. Immediate relatives should therefore be sensitized concerning the normalcy of dementia in the context of old age so that they can be understanding and supportive of dementia patients rather than discriminating against them as present-day lepers. There is a need to skill home-based caregivers on how to handle dementia in its early stages. Unless this is done, many of our elderly homes shall be filled with patients who should have been treated and supported from their homes. This skilling of home-based caregivers is a vital intervention because until elderly care is appreciated as a human moral obligation, many transactional rehabilitation centers will crop up and this shall be one of the worst moral decadences of our times.

Keywords: dementia, family, Alzheimers, relevancy

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Authors: Tanja Salary

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This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

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Authors: Jacob Medupe

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Life as we know it has changed since the global outbreak of Coronavirus Disease 2019 (COVID-19) and business as usual will not continue. The human impact of the COVID-19 crisis is already immeasurable. Moreover, COVID-19 has already negatively impacted economies, livelihoods and disrupted food systems around the world. The disruptive nature of the Corona virus has affected every sphere of life including the culture and teaching and learning. Right now the majority of education research is based around classroom management techniques that are no longer necessary with digital delivery. Instead there is a great need for new data about how to make the best use of the one-on-one attention that is now becoming possible (Diamandis & Kotler, 2014). The COVID-19 pandemic has necessitated an environment where the South African learners are focused to adhere to social distancing in order to minimise the wild spread of the Corona virus. This arrangement forces the student to utilise the online classroom technologies to continue with the lessons. The historical reality is that the country has not made much strides on the closing of the digital divide and this is particularly a common status quo in the deep rural areas. This will prove to be a toll order for most of the learners affected by the Corona Virus to be able to have a seamless access to the online learning facilities. The paper will seek to look deeply into this reality and how the Corona virus has brought us to the reality that South Africa remains a deeply unequal society in every sphere of life. The study will also explore the state of readiness for education system around the online classroom environment.

Keywords: virtual learning, virtual classroom, COVID-19, Corona virus, internet connectivity, blended learning, online learning, distance education, e-learning, self-regulated Learning, pedagogy, digital literacy

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Authors: Souhir Chelly, Chahida Harizi, Aicha Hechaichi, Sihem Aissaoui, Leila Ben Ayed, Maha Bergaoui, Mohamed Kouni Chahed

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Introduction: The International Classification of Primary Care (ICPC) is part of the morbidity classification system. It had 17 chapters, and each is coded by an alphanumeric code: the letter corresponds to the chapter, the number to a paragraph in the chapter. The objective of this study is to show the utility of this classification in the coding of the reasons for demand for care in Primary health care (PHC), its advantages and limits. Methods: This is a cross-sectional descriptive study conducted in 4 PHC in Ariana district. Data on the demand for care during 2 days in the same week were collected. The coding of the information was done according to the CISP. The data was entered and analyzed by the EPI Info 7 software. Results: A total of 523 demands for care were investigated. The patients who came for the consultation are predominantly female (62.72%). Most of the consultants are young with an average age of 35 ± 26 years. In the ICPC, there are 7 rubrics: 'infections' is the most common reason with 49.9%, 'other diagnoses' with 40.2%, 'symptoms and complaints' with 5.5%, 'trauma' with 2.1%, 'procedures' with 2.1% and 'neoplasm' with 0.3%. The main advantage of the ICPC is the fact of being a standardized tool. It is very suitable for classification of the reasons for demand for care in PHC according to their specificity, capacity to be used in a computerized medical file of the PHC. Its current limitations are related to the difficulty of classification of some reasons for demand for care. Conclusion: The ICPC has been developed to provide healthcare with a coding reference that takes into account their specificity. The CIM is in its 10th revision; it would gain from revision to revision to be more efficient to be generalized and used by the teams of PHC.

Keywords: international classification of primary care, medical file, primary health care, Tunisia

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Authors: Parul Suraia, Harshit Sosan Lakra

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Indigenous communities represent some of the most marginalized populations globally, with India labeled as tribals, experiencing particularly pronounced marginalization and a concerning decline in their numbers. These communities often inhabit geographically challenging regions characterized by low population densities, posing significant challenges to providing essential infrastructure services. Jharkhand, a Schedule 5 state, is infamous for its low-level health status due to disparities in access to health care. The primary objective of this study is to investigate the spatial inequalities in healthcare accessibility among tribal populations within the state and pinpoint critical areas requiring immediate attention. Health indicators were selected based on the tribal perspective and association of Sustainable Goal 3 (Good Health and Wellbeing) with other SDGs. Focused group discussions in which tribal people and tribal experts were done in order to finalize the indicators. Employing Principal Component Analysis, two essential indices were constructed: the Tribal Health Index (THI) and the Tribal Health Intervention Index (THII). Index values were calculated based on the district-wise secondary data for Jharkhand. The bivariate spatial association technique, Moran’s I was used to assess the spatial pattern of the variables to determine if there is any clustering (positive spatial autocorrelation) or dispersion (negative spatial autocorrelation) of values across Jharkhand. The results helped in facilitating targeting policy interventions in deprived areas of Jharkhand.

Keywords: tribal health, health spatial disparities, health status, Jharkhand

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Authors: Nahashon Mwirigi

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The management of HIV/AIDS is a global challenge, demanding precise tools to predict disease progression and guide tailored treatment. CD4 cell count dynamics, a crucial immune function indicator, play an essential role in understanding HIV/AIDS progression and enhancing patient care through effective modeling. While several models assess disease progression, existing methods often fall short in capturing the complex, non-linear nature of HIV/AIDS, especially across diverse demographics. A need exists for models that balance predictive accuracy with clinical applicability, enabling individualized care strategies based on patient-specific progression rates. This study utilizes patient data from Kenyatta National Hospital (2003–2014) to model HIV/AIDS progression across six CD4-defined states. The Exponential, 2-Parameter Weibull, and 3-Parameter Weibull models are employed to analyze failure rates and explore progression patterns by age and gender. Model selection is based on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) to identify models best representing disease progression variability across demographic groups. The 3-Parameter Weibull model emerges as the most effective, accurately capturing HIV/AIDS progression dynamics, particularly by incorporating delayed progression effects. This model reflects age and gender-specific variations, offering refined insights into patient trajectories and facilitating targeted interventions. One key finding is that older patients progress more slowly through CD4-defined stages, with a delayed onset of advanced stages. This suggests that older patients may benefit from extended monitoring intervals, allowing providers to optimize resources while maintaining consistent care. Recognizing slower progression in this demographic helps clinicians reduce unnecessary interventions, prioritizing care for faster-progressing groups. Gender-based analysis reveals that female patients exhibit more consistent progression, while male patients show greater variability. This highlights the need for gender-specific treatment approaches, as men may require more frequent assessments and adaptive treatment plans to address their variable progression. Tailoring treatment by gender can improve outcomes by addressing distinct risk patterns in each group. The model’s ability to account for both accelerated and delayed progression equips clinicians with a robust tool for estimating the duration of each disease stage. This supports individualized treatment planning, allowing clinicians to optimize antiretroviral therapy (ART) regimens based on demographic factors and expected disease trajectories. Aligning ART timing with specific progression patterns can enhance treatment efficacy and adherence. The model also has significant implications for healthcare systems, as its predictive accuracy enables proactive patient management, reducing the frequency of advanced-stage complications. For resource limited providers, this capability facilitates strategic intervention timing, ensuring that high-risk patients receive timely care while resources are allocated efficiently. Anticipating progression stages enhances both patient care and resource management, reinforcing the model’s value in supporting sustainable HIV/AIDS healthcare strategies. This study underscores the importance of models that capture the complexities of HIV/AIDS progression, offering insights to guide personalized, data-informed care. The 3-Parameter Weibull model’s ability to accurately reflect delayed progression and demographic risk variations presents a valuable tool for clinicians, supporting the development of targeted interventions and resource optimization in HIV/AIDS management.

Keywords: HIV/AIDS progression, 3-parameter Weibull model, CD4 cell count stages, antiretroviral therapy, demographic-specific modeling

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