Search results for: quality of care

Authors: Claudia Norambuena, Myissa Weiss, Maria Ruiz Maya, Matthew Straley, Elijah Hammond, Benjamin Chesebrough, David Grow

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The purpose of this project is to develop a low-cost, portable sensor device that can be used at home for long-term analysis of gait and balance abnormalities. One area of particular concern involves the asymmetries in movement and balance that can accompany certain types of injuries and/or the associated devices used in the repair and rehabilitation process (e.g. the use of splints and casts) which can often increase chances of falls and additional injuries. This device has the capacity to monitor a patient during the rehabilitation process after injury or operation, increasing the patient’s access to healthcare while decreasing the number of visits to the patient’s clinician. The sensor device may thereby improve the quality of the patient’s care, particularly in rural areas where access to the clinician could be limited, while simultaneously decreasing the overall cost associated with the patient’s care. The device consists of nine interconnected accelerometer/ gyroscope/compass chips (9-DOF IMU, Adafruit, New York, NY). The sensors attach to and are used to determine the orientation and acceleration of the patient’s lower abdomen, C7 vertebra (lower neck), L1 vertebra (middle back), anterior side of each thigh and tibia, and dorsal side of each foot. In addition, pressure sensors are embedded in shoe inserts with one sensor (ESS301, Tekscan, Boston, MA) beneath the heel and three sensors (Interlink 402, Interlink Electronics, Westlake Village, CA) beneath the metatarsal bones of each foot. These sensors measure the distribution of the weight applied to each foot as well as stride duration. A small microntroller (Arduino Mega, Arduino, Ivrea, Italy) is used to collect data from these sensors in a CSV file. MATLAB is then used to analyze the data and output the hip, knee, ankle, and trunk angles projected on the sagittal plane. An open-source program Processing is then used to generate an animation of the patient’s gait. The accuracy of the sensors was validated through comparison to goniometric measurements (±2° error). The sensor device was also shown to have sufficient sensitivity to observe various gait abnormalities. Several patients used the sensor device, and the data collected from each represented the patient’s movements. Further, the sensors were found to have the ability to observe gait abnormalities caused by the addition of a small amount of weight (4.5 - 9.1 kg) to one side of the patient. The user-friendly interface and portability of the sensor device will help to construct a bridge between patients and their clinicians with fewer necessary inpatient visits.

Keywords: biomedical sensing, gait analysis, outpatient, rehabilitation

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Authors: Maari Sugawara

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This study investigates the constructed notion of “motherhood” and queered forms of care in contemporary Japan, focusing on rental family services. In Japan, the concept of motherhood is often equated with womanhood, reflecting a pervasive ideology that views motherhood as an essential aspect of a woman's societal role, particularly amidst economic recovery and an aging population. This study interrogates these gendered expectations by linking rental family services, particularly the role of rental mothers, to traditional caregiving roles. It critiques the gendered construction of domestic labor and aims to expand conceptions of alternative family structures and caregiving roles beyond normative frameworks. Emerging in the 1980s to provide companionship for the elderly, rental family services have evolved to meet diverse social needs, with paid actors fulfilling familial roles at various social events. Despite their growing prevalence, academic exploration of this phenomenon remains limited. This research aims to fill that gap by investigating the cultural, social, and economic factors fueling the popularity of rental family services and analyzing their implications for contemporary understandings of family dynamics and care labor in Japan. Furthermore, this study underscores the disproportionate domestic labor burden women in Japan bear, often managing time-intensive household tasks, which creates a "double burden" for those in full-time employment. Care work, including elderly and disability support, is undervalued and typically compensated at near-minimum wage levels, with women predominantly filling these low-wage roles. This gender disparity in Japan's care industry contributes to labor shortages in caregiving and childcare, highlighting broader structural inequities in the labor market. Through semi-structured qualitative interviews with fifteen rental mothers, this study investigates their experiences, motivations, role dynamics, and emotional labor. It critically examines whether the labor performed by rental family actors constitutes a subversive practice deserving of appropriate compensation. Utilizing a role-playing method, the author engages with rental mothers as if they were her own, reflecting the dynamics of compensated labor. This interaction delves into the economic and emotional aspects of constructed motherhood, facilitating a broader inquiry into the value of both productive and reproductive labor in Japan. The study also investigates the relationship between sex work and rental family services within the socio-economic landscape, recognizing the links between the welfare sector and female employment in legal sex work. Although distinct, these sectors merit joint consideration due to the commonality of male clients in both industries. This research engages with theoretical perspectives framing mobile sex work as inherently queer, directly challenging the dominance of heteronormativity. The agency exercised by sex workers complicates narratives of conformity and deviance, underscoring the need to reevaluate caregiving labor in both paid and unpaid contexts. Ultimately, this research critiques the intersection of gender, care, and labor in contemporary Japan by examining the undervaluation of traditional caregiving roles alongside the labor involved in rental family services. It challenges Japanese policies that equate womanhood with motherhood and explores the potential of viewing outsourced care as queered maternal and non-reproductive labor, advocating for the recognition of alternative family structures and non-reproductive forms of motherhood.

Keywords: motherhood, alternative family structures, carework, Japan, queer studies

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Authors: Amani K. Abu-Shaheen, Abdullah Nofal, Humariya Heena

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Introduction: Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective: To identify the prevalence of asthma and to investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods: A two-stage cross-sectional survey of 2000 parents of children aged 3–15 years from schools located in all five districts of Riyadh province located in central Saudi Arabia, was conducted. Data collection was accomplished using a self-administered questionnaire based on information obtained from the literature. Results: Of 1450 children whose parents participated in the study, 600 had asthma, dyspnea, or chest allergy. The overall number of children with parental reports of ever having been diagnosed with asthma was 478 (32.9%). The majority of parents (321, 53.5%) believed that asthma was a hereditary disease. Of these parents, 361 (60.3%) were concerned about side effects of inhaled steroids, and 192 (32%) about development of dependency on asthma medications. Three hundred sixty seven (61.2%) parents reported that they could treat the asthma attack at home and almost 76% of parents went to pediatric emergency department during asthma attack. Conclusions: In this study, the overall prevalence of children whose parents reported that they were diagnosed with asthma was high (32.9%). Furthermore, parents of children with asthma had misperceptions regarding asthma and exhibited ineffective practices in its management. To improve asthma care and compliance, adequate education should be provided to parents.

Keywords: asthma, management, parents, quality of life

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Authors: Elena Kalcheva, Ahmad Taki, Yuri Hadi

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Urban regeneration often includes residential high-rises as a way of optimum use of land. However, high-rises are in many cases connected to placelessness, this is not due to some intrinsic characteristic of the typology, but more to a failure to provide meaningful places in connection to them. The reason to study the Isle of the Dogs regeneration is the successful process that led to vibrant area with strong identity and social sustainability. Therefore, the purpose of this research is to identify the gaps into the sound strategy for the development of the area and in its implementation which will make the place more sustainable. The paper addresses four research questions: are the residential high-rises supporting a proper physical form; is there deployed properly scaled mix of land uses and functions in connection with residential high-rises; are there possible quality activities in quality places near the residential high-rises; and is there a strong sense of place created with the residential high-rise buildings and their surroundings. The methodology relies on observational survey of the researched area together with structured questions, to evaluate the external qualities of the residential high-rises and their surroundings. Visual information can help identify the mistakes and the omissions of the provided project examples. It can provide insight on how can be improved imageability, legibility and human scale. In this connection, the paper argues that although the quality of the architecture of the high-rises is superb, there is a failure to create meaningful, high quality public realm in connection with them. As such, it does not function as well as the designers intended to do: the functional quality of the public realm is quite low. The implications of the study suggest that actions need to take place in order to improve and foster further regeneration of the area.

Keywords: high-rises, isle of the dogs, public realm, regeneration

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Authors: Kubra Dogan, Fatih Tornuk

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Due to increasing consumer demand for the high-quality food products and awareness regarding the health benefits of different nutrients in food minimal processing becomes more popular in modern food preservation. To date, heat treatment is often used for inactivation of spoilage microorganisms in foods. However, it may cause significant changes in the quality and nutritional properties of food. In order to overcome the detrimental effects of heat treatment, several alternatives of non-thermal microbial inactivation processes have been investigated. Ultraviolet (UV) inactivation is a promising and feasible method for better quality and longer shelf life as an alternative to heat treatment, which aims to inhibit spoilage and pathogenic microorganisms and to inactivate the enzymes in vegetable juice production. UV-C is a sub-class of UV treatment which shows the highest microcidal effect between 250-270 nm. The wavelength of 254 nm is used for the surface disinfection of certain liquid food products such as vegetable juice. Effects of UV-C treatment on microbiological load and quality parameter of vegetable juice which is a mix of celery, carrot, lemon and orange was investigated. Our results showed that storing of UV-C applied vegetable juice for three months, reduced the count of TMAB by 3.5 log cfu/g and yeast-mold by 2 log cfu/g compared to control sample. Total phenolic content was found to be 514.3 ± 0.6 mg gallic acid equivalent/L, and there wasn’t a significant difference compared to control. The present work suggests that UV-C treatment is an alternative method for disinfection of vegetable juice since it enables adequate microbial inactivation, longer shelf life and has minimal effect on degradation of quality parameters of vegetable juice.

Keywords: heat treatment, phenolic content, shelf life, ultraviolet (UV-C), vegetable juice

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Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

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Authors: Meryem Saban Guler, Saniye Bilici

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Malnutrition is a problem that significantly affects patients with cancer throughout the course of their illness, and it may be present from the moment of diagnosis until the end of treatment. We searched electronic databases using key terms such as ‘malnutrition in cancer patients’ or ‘nutritional status in cancer’ or ‘nutritional screening tools’ etc. Decline in nutritional status and continuing weight loss are associated with an increase in number and severity of complications, impaired quality of life and decreased survival rate. Nutrition is an important factor in the treatment and progression of cancer. Cancer patients are particularly susceptible to nutritional depletion due to the combined effects of the malignant disease and its treatment. With increasing incidence of cancer, identification and management of nutritional deficiencies are needed. Early identification of malnutrition, is substantial to minimize or prevent undesirable outcomes throughout clinical course. In determining the nutritional status; food consumption status, anthropometric methods, laboratory tests, clinical symptoms, psychosocial data are used. First-line strategies must include routine screening and identification of inpatients or outpatients at nutritional risk with the use of a simple and standardized screening tool. There is agreement among international nutrition organizations and accredited health care organizations that routine nutritional screening should be a standard procedure for every patient admitted to a hospital. There are f management of all cancer patients therefore routine nutritional screening with validated tools can identify cancer patients at risk.

Keywords: cancer, malnutrition, nutrition, nutritional screening

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Authors: Honey Bryant, Elvina Chu

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Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

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Authors: A. K. Tekile, I. L. Kim, J. Y. Lee

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Human activities put freshwater quality under risk, mainly due to expansion of agriculture and industries, damming, diversion and discharge of inadequately treated wastewaters. The rapid human population growth and climate change escalated the problem. External controlling actions on point and non-point pollution sources are long-term solution to manage water quality. To have a holistic approach, these mechanisms should be coupled with the in-water control strategies. The available in-lake or river methods are either costly or they have some adverse effect on the ecological system that the search for an alternative and effective solution with a reasonable balance is still going on. This study aimed at the physical and chemical water quality improvement in a stagnant Yeo-cheon River reach (Korea), which has recently shown sign of water quality problems such as scum formation and fish death. The river water quality was monitored, for the duration of three months by operating only water flow generator in the first two weeks and then ultrasonic irradiation device was coupled to the flow unit for the remaining duration of the experiment. In addition to assessing the water quality improvement, the correlation among the parameters was analyzed to explain the contribution of the ultra-sonication. Generally, the combined strategy showed localized improvement of water quality in terms of dissolved oxygen, Chlorophyll-a and dissolved reactive phosphate. At locations under limited influence of the system operation, chlorophyll-a was highly increased, but within 25 m of operation the low initial value was maintained. The inverse correlation coefficient between dissolved oxygen and chlorophyll-a decreased from 0.51 to 0.37 when ultrasonic irradiation unit was used with the flow, showing that ultrasonic treatment reduced chlorophyll-a concentration and it inhibited photosynthesis. The relationship between dissolved oxygen and reactive phosphate also indicated that influence of ultra-sonication was higher than flow on the reactive phosphate concentration. Even though flow increased turbidity by suspending sediments, ultrasonic waves canceled out the effect due to the agglomeration of suspended particles and the follow-up settling out. There has also been variation of interaction in the water column as the decrease of pH and dissolved oxygen from surface to the bottom played a role in phosphorus release into the water column. The variation of nitrogen and dissolved organic carbon concentrations showed mixed trend probably due to the complex chemical reactions subsequent to the operation. Besides, the intensive rainfall and strong wind around the end of the field trial had apparent impact on the result. The combined effect of water flow and ultrasonic irradiation was a cumulative water quality improvement and it maintained the dissolved oxygen and chlorophyll-a requirement of the river for healthy ecological interaction. However, the overall improvement of water quality is not guaranteed as effectiveness of ultrasonic technology requires long-term monitoring of water quality before, during and after treatment. Even though, the short duration of the study conducted here has limited nutrient pattern realization, the use of ultrasound at field scale to improve water quality is promising.

Keywords: stagnant, ultrasonic irradiation, water flow, water quality

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Authors: M. E. Silva, I. Brás

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The aim of this work was to study the viability of recycling the residual yeast and diatomaceous earth (RYDE) slurry generated by the beer brewing industry by composting with animal manures, as well as to evaluate the quality of the composts obtained. Two pilot composting trials were carried out with different mixes: cow manure/RYDE slurry (Pile CM) and sheep manure/RYDE slurry (Pile SM). For all piles, wood chips were applied as bulking agent. The process was monitored by evaluating standard physical and chemical parameters. The compost quality was assessed by the heavy metals content and phytotoxicity. Both piles reached a thermophilic phase in the first day, however having different trends. The pH showed a slight alkaline character. The C/N reached values lower than 19 at the end of composting process. Generally, all the piles exhibited absence of heavy metals. However, the pile SM exhibited phytotoxicity. This study showed that RYDE slurry can be valorized by composting with cow manure.

Keywords: beer brewing wastes, compost, valorization, quality

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Authors: N. Rashed, Z. Aysha, M. Fakher

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Patient satisfaction is one of the core objectives of health care facilities. It is difficult to evaluate patients response in the emergency setting. The current study aimed to evaluate patients and family aspects of satisfaction in both adult and pediatric emergency departments and their recommendations for improvement. Cross-section survey(Brief Emergency department Patient Satisfaction Scale (BEPSS), was translated and validated, then performed to evaluate patients satisfaction in two governmental hospitals Emergency departments. Three hundred patients and their families were enrolled in the study. The waiting time in the adult Emergency department ranged from (5 minutes to 120 minutes), and most admissions were at the morning shift while at the pediatric hospital the waiting time ranged from 5 minutes to 100 minutes) and most admissions were at the afternoon shift. The results showed that the main domain of satisfaction in BEPSS in the adult emergency department was respecting the patients family while in the pediatric emergency department, the main domain was the nursing care about treatment. The main recommendation of improvement in pediatric Emergency Department was modifying the procedures while in adult Emergency Department was improving the training of physicians.

Keywords: emergency, department-patient, satisfaction-adult-pediatric

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Authors: Ahuva Even-Zohar, Shoshi Werner

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Context: Sexuality is an important aspect of overall quality of life for individuals across different age groups and health conditions. Sexual interest and activity continue to be important and play a role in people's life as they age. Despite this, there is limited research on the sexual health of older adults. Research Aim: The study aims to examine the knowledge, attitudes, and sexual activity of older adults and to explore the relationship between sexual activity and quality of life among this population. Methodology: The study involved 203 Jewish participants from Israel, with an average age of 69.59. The participants completed questionnaires administered through an Internet panel. The questionnaires measured variables such as knowledge about and attitudes towards sexuality, sexual activity, quality of life, and socio-demographic information. Findings: The study found that a majority of the participants reported engaging in sexual activity, with most of them experiencing full sexual intercourse. Approximately half of the participants expressed high levels of satisfaction with their sexual activity. The results indicated that older adults demonstrated a moderate level of knowledge and permissive attitudes towards sexuality in later life. Moreover, higher levels of knowledge and permissive attitudes were associated with increased sexual activity. The frequency of sexual activity was identified as a predictor of quality of life, with a mediating effect on the relationship between attitudes towards older adults' sexuality and quality of life. Notably, men and older adults who were married or in a relationship reported higher frequencies of sexual activity compared to women and older adults without a partner. Furthermore, a majority of participants did not seek professional help or discuss their sexual concerns with a therapist. Theoretical Importance: This research contributes to our understanding of a topic that is often considered taboo - sexuality among older adults. It highlights that older adults maintain an interest in sexual activity, and that engaging in such activity contributes to their overall quality of life. Data Collection and Analysis Procedures: The data for this study were collected using structured questionnaires administered through an Internet panel. The questionnaires included closed-ended questions, allowing for quantitative data analysis. Descriptive statistics and regression analysis were performed to examine the relationships between the variables. Questions Addressed: This study aimed to address the following questions: What is the level of knowledge and attitudes towards sexuality among older adults? How prevalent is sexual activity among older adults and what factors are associated with it? How does sexual activity impact the quality of life of older adults? Do older adults seek professional help for their sexual concerns? Conclusion: The main conclusion drawn from this research is that sexuality is a crucial aspect of older adults' lives and significantly contributes to their quality of life. The study emphasizes the need for educational programs aimed at older adults and professionals, which promote the understanding and benefits of sexuality in later life. It also suggests that professionals should actively encourage older individuals to seek help and support when experiencing difficulties related to sexuality.

Keywords: men, older adults, quality of life, sexuality, women

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Authors: Sung-Jun Yoo, Kazuhide Ito

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In this study, a comprehensive computer simulated person (CSP) that integrates computational human model (virtual manikin) and respiratory tract model (virtual airway), was applied for estimation of indoor environmental quality. Moreover, an inclusive prediction method was established by integrating computational fluid dynamics (CFD) analysis with advanced CSP which is combined with physiologically-based pharmacokinetic (PBPK) model, unsteady thermoregulation model for analysis targeting micro-climate around human body and respiratory area with high accuracy. This comprehensive method can estimate not only the contaminant inhalation but also constant interaction in the contaminant transfer between indoor spaces, i.e., a target area for indoor air quality (IAQ) assessment, and respiratory zone for health risk assessment. This study focused on the usage of the CSP as an air/thermal quality sensor in indoors, which means the application of comprehensive model for assessment of IAQ and thermal environmental quality. Demonstrative analysis was performed in order to examine the applicability of the comprehensive model to the heating, ventilation, air conditioning (HVAC) control scheme. CSP was located at the center of the simple model room which has dimension of 3m×3m×3m. Formaldehyde which is generated from floor material was assumed as a target contaminant, and flow field, sensible/latent heat and contaminant transfer analysis in indoor space were conducted by using CFD simulation coupled with CSP. In this analysis, thermal comfort was evaluated by thermoregulatory analysis, and respiratory exposure risks represented by adsorption flux/concentration at airway wall surface were estimated by PBPK-CFD hybrid analysis. These Analysis results concerning IAQ and thermal comfort will be fed back to the HVAC control and could be used to find a suitable ventilation rate and energy requirement for air conditioning system.

Keywords: CFD simulation, computer simulated person, HVAC control, indoor environmental quality

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Authors: Evelyn Smith, Susan Simpson

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Background: Eating disorder (ED) treatment is complicated by high rates of chronicity, comorbidity, complex personality traits and client dropout. Given these complexities, Schema Therapy (ST) has been identified as a suitable treatment option. The study primarily aims to evaluate the efficacy of group ST for the treatment of EDs. The study further evaluated the effectiveness of ST in reducing schemas and improving quality of life. Method: Participant suitability was ascertained using the Eating Disorder Examination. Following this, participants attended 90-minute weekly group sessions over 25 weeks. Groups consisted of six to eight participants and were facilitated by two psychologists, at least one of who is trained in ST. Measures were completed at pre, mid and post-treatment. Measures assessed ED symptoms, cognitive schemas, schema mode presentations, quality of life, self-compassion and psychological distress. Results: As predicted, measures of ED symptoms were significantly reduced following treatment. No significant changes were observed in early maladaptive schema severity; however, reductions in schema modes were observed. Participants did not report improvements in general quality of life measures following treatment, though improvement in psychological well-being was observed. Discussion: Overall, the findings from the current study support the use of group ST for the treatment of EDs. It is expected that lengthier treatment is needed for the reduction in schema severity. Given participant dropout was considerably low, this has important treatment implications for the suitability of ST for the treatment of EDs.

Keywords: eating disorders, schema therapy, treatment, quality of life

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Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

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Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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Authors: Ali Ait Boughrous, Said Benyoussef, Hossain El Ouarghi, Moulay Abdelazize Aboulhassan, Samah Aitbnichou, Said Benguamra

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The Rhiss-Nekor aquifer represents a primary water source for the central Rif region. Many operating structures were built for irrigation and drinking water supply. Because of the vulnerability of this aquifer, a thorough knowledge of the environment is needed to evaluate and protect resources. This work aims at the quality assessment of the water table of the plain Ghiss-Nekor and determination of pollution sources in order to establish a map of the web. The plain-Rhiss Nekor, with an area of 100 km2, is located on the Mediterranean coast of Morocco. It has a particular geological structure resulting from the opening of a graben at the end of the Tertiary, which is filled by the accumulation of hundreds of meters of sediment, generating considerable heterogeneity in deposits. This heterogeneity gives various hydrodynamic properties within the aquifer of the plain. The analysis of the water quality of twenty water points, well distributed over the plain, showed high natural salinity linked to the geological nature of the area. This salinity increases in the littoral area by the seawater intrusion phenomenon. This is accentuated by overexploitation of the ground water due to the growing demand. Some wells, located inland, are characterized by organic pollution caused by wastewater seepage from septic tanks and lost wells widespread in the region.

Keywords: anthropogenic factors, groundwater quality, marine intrusion, Rhiss-Nekor aquifer

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Authors: Mubarak Jan Beebee Zeba Mahetaab, Sumera Bibi Keenoo

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Background: Covid-19 was first reported in Wuhan. On 13th March 2020, WHO declared Covid-19 as a pandemic disease with 140,936 cases globally. The outbreak of covid-19 occurred in over 184 countries, and it created a lot of medical and mental burdens. Aside from the physical problems, the mental health of the medical staff has been of critical concern. Aims and Objectives: To determine the prevalence of burnout among HCW dealing with COVID-19, identify the risk factors and find measures to support their mental health while dealing with the current and future pandemic. Methodology: A cross-sectional study was conducted among the HCW who fought against COVID-19 in SSRN Hospital in Mauritius. The HCWs were recruited using the snowballing sampling technique. Age, gender, job category, income, duration of vacation, working environment and importance of mental health were measured. Results: The prevalence of burnout was highest among HCA. Age had no significant association with pandemic-related burnout. In Mauritius, burnout during the pandemic is linked with lower income and having less vacation days. Conclusion: Burnout is prevalent among healthcare workers working during the Covid-19 Pandemic. Interventions such as psychological counselling, yoga and financial increments need to be implemented to help the healthcare workers.

Keywords: burnout, Covid-19, health care professionals, pandemic

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Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix

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In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.

Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference

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Authors: Funmilayo L. Amao

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As a result of the high cost of housing, the increasing population is forced to live in substandard housing and unhealthy conditions giving rise to poor residential neighborhoods. The paper examines the causes and characteristics of poor residential neighborhood. The paper finds the problems that have influence poor neighborhoods to; poverty, growth of informal sector and housing shortage. The paper asserts that poor residential neighborhoods have adverse effects on the people. The secondary data was obtained from books, journals and seminar papers while primary data relating to building and environmental quality from structured questionnaire administered on sample of 500 household heads, from sampling frame of 5000 housing units. The study reveals that majority of the respondents are poor and employed in informal sector. The paper suggests urban renewal and slum upgrading programs as methods in dealing with the situation and an improvement in the socio-economic circumstances of the inhabitants.

Keywords: environmental degeneration, housing, poverty, quality of life, urban upgrading

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Authors: Ghassan Al-Dulaimi

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This paper studied the biochemical parameter (BOD5) and (DO) for the Thames River (Canada-Ontario). Water samples have been collected from Thames River along different points between Chatham to Woodstock and were analysed for various water quality parameters during the low flow season (April). The study involves the application of the stream water quality model QUAL2K model to simulate and predict the dissolved oxygen (DO) and biochemical oxygen demand (BOD5) profiles for Thames River in a stretch of 251 kilometers. The model output showed that DO in the entire river was within the limit of not less than 4 mg/L. For Carbonaceous Biochemical Oxygen Demand CBOD, the entire river may be divided into two main reaches; the first one is extended from Chatham City (0 km) to London (150 km) and has a CBOD concentration of 2 mg/L, and the second reach has CBOD range (2–4) mg/L in which begins from London city and extend to near Woodstock city (73km).

Keywords: biochemical oxygen demand, dissolved oxygen, Thames river, QUAL2K model

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Authors: Sana Mohammad Jafar

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Salmonella is one of the major causes of foodborne diseases throughout the world. Shrimp are an important commodity in world fishery trade. The microbiological quality of shrimp must be evaluated for assurance of shrimp. The aim of this study was to evaluate the microbiological quality and to determine the prevalence of Salmonella in shrimp sold in Khuzestan province. In this study, a total of 245 samples of shrimp sold in Khuzestan province were tested for Salmonella prevalence and total microbial population. The mean aerobic bacterial count in 50.2% of samples was 2200, in 29.8% of samples was 13,600, in 20% of samples was 36,700, and the mean aerobic bacterial count in the total samples was 20,000. (20,000 cfu/cc). Of the total samples, 33 samples were positive for Salmonella and the prevalence of Salmonella was determined 13.4%. These results indicate the possibility that shrimp contribute to foodborne infections. The improvement of shrimp quality is an important issue, and shrimp before consuming should be washed with water containing chlorine, with the aim of increasing safety. In addition, it should be avoided to eat shrimp as raw or not cooked properly.

Keywords: determination, total microbial, Salmonella, shrimp

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Authors: Alicja Zapolnik-Plachetka

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The paper examines the impact of the Members’ of the European Parliament (MEPs) language choice on the linguistic quality of their political discourse as delivered by the interpreters. The study, designed by the author, who is an EU interpreter herself, consisted of three phases. First, a number of speeches of Polish and Spanish MEPs were analyzed to determine whether the incidence of use of certain figures of speech depending on whether the speech had been delivered in English or their respective mother tongue. Then the use of figures of speech was also analyzed based on speeches by some British MEPs, in order to determine what was the incidence for the native users of English. Subsequently, the speeches were compared with their interpretations to find out whether the interpreters managed to convey accurately the means of oratory used by the MEPs. The final result shows that in case of institutional environments dependant on simultaneous interpretation the speakers’ choices can, in fact, influence the linguistic quality of the political communication.

Keywords: content accuracy, European Parliament, political discourse, simultaneous interpreting

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Authors: Amin Adeli, Maryam Zarei

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Background and purpose: Royal jelly (RJ) is a natural product with anti-hyperlipidemic and antioxidant properties. In ovo administration of RJ may improve lipid profile and antioxidant properties. This study was conducted to evaluate, for first time, the effects of in ovo injection of the RJ on hatchability, one-day old chick quality, total antioxidant status and blood lipoproteins. Methods: 400 incubating eggs produced by Ross 308 strain (52 weeks of age in first stage of production) were prepared and assigned into 4 groups (n=100) and 4 replications per group (n=25). These 4 groups were injected by the following pattern: 1) 0.1 ml normal saline (control), 2) 0.1 mg RJ+0.1 ml normal saline, 3) 0.2 mg RJ+0.1 ml normal saline, and 4) 0.3 mg RJ+0.1 ml normal saline. Injections were performed using a laminar flow system Lipid profile, antioxidant properties, hatchability, and one-day old chicken quality were assessed. Results: The administration of RJ at concentration of 0.1increased the percentage of hatchability compared to concentration of 0.2 and control, significant differences have not been observed among groups for quality scores (P>0.05). The results showed that in ovo injection of the RJ did not have any significant effects on lipid profile; but administration of the RJ only decreased High-density lipoprotein (HDL cholesterol, HDL-C) (P<0.05). The results showed that injection of the RJ at concentration of 0.3 increased total antioxidant capacity (TAC) compared to control group (p<0.05). Injection of the RJ progressively increased gluthation peroxidase (GPx) activity (p<0.05). The results showed that injection of the RJ decreased superoxide dismutase (SOD) compared to control group (p<0.05). Conclusion: In ovo injection of the RJ at the highest concentration increased TAC and GPx, but it did not have significant effects on lipid profile. Future studies are needed to investigate the effects of the RJ on the above-mentioned mechanisms.

Keywords: antioxidant enzymes, chicken quality, hatchability, royal jelly

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Authors: Bikash Ranjan Mishra, Lopamudra D. Satpathy

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In the wake of the phenomenal surge in international business in the last decades or more, both the developed and developing economies around the world are in massive competition to attract more and more FDI flows. While the developed countries have marched ahead in the race, the developing countries, especially those of Asian economies, have followed them at a rapid pace. While most of the previous studies have analysed the role of institutional quality in the promotion of FDI flows in developing countries, very few studies have taken an integrated approach of examining the comprehensive impact of institutional quality, globalization pattern and domestic financial development on FDI flows. In this context, the paper contributes to the literature in two important ways. Firstly, two composite indices of institutional quality and domestic financial development for the Asian countries are constructed in comparison to earlier studies that resort to a single variable for indicating the institutional quality and domestic financial development. Secondly, the impact of these variables on FDI flows through their interaction with geographical region is investigated. The study uses panel data covering the time period of 1996 to 2012 by selecting twenty Asian developing countries by emphasizing the quality of institutions from the geographical regions of eastern, south-eastern, southern and western Asia. Control of corruption, better rule of law, regulatory quality, effectiveness of the government, political stability and voice and accountability are used as indicators of institutional quality. Besides these, the study takes into account the domestic credits in the hands of public, private sectors and in stock markets as domestic financial indicators. First in the specification of model, a factor analysis is performed to reduce the vast determinants, which are highly correlated with each other, to a manageable size. Afterwards, a reduced version of the model is estimated with the extracted factors in the form of index as independent variables along with a set of control variables. It is found that the institutional quality index and index of globalization exert a significant effect on FDI inflows of the host countries; in contrast, the domestic financial index does not seem to play much worthy role. Finally, some robustness tests are performed to make sure that the results are not sensitive to temporal and spatial unobserved heterogeneity. On the basis of the above study, one general inference can be drawn from the policy prescription point of view that the government of these developing countries should strengthen their domestic institution, both financial and non-financial. In addition to these, welfare policies should also target for rapid globalization. If the financial and non-financial institutions of these developing countries become sound and grow more globalized in the economic, social and political domain, then they can appeal to more amounts of FDI inflows that will subsequently result in advancement of these economies.

Keywords: Asian developing economies, FDI, institutional quality, panel data

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Authors: Begzod Nishanov, Farhod Karimov

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Globalization and the internet have completely changed the way in which businesses operate as well as has equipped customers with endless potential. Today, consumers’ product choice is not only affected by branding, price and quality of the product, but also by the country-of-origin information. Precisely, ‘Made In’ label is considered as one of the driving factors which directly impact on consumers’ preferences. Generally, it is obvious that products manufactured in less developed countries are considered to be of lower quality and riskier compared to the products made in developed countries. In this regard, it is worth to note that this phenomenon is mainly applicable to western developed countries. However, there is a lack of empirical research on underlying the influence of country-of-origin phenomenon in emerging economies such as Uzbekistan. Today, Uzbek market is being dominated by growing number of foreign made products. Uzbek manufacturers are facing intense competition not only from local producers but also from the availability of foreign goods suppliers. Consequently, consumers are given wider choice of products than ever before. In this regard, it is important to define the importance of country-of-origin information in order to understand Uzbek consumers’ preference. The methodology of the research is formulated based on the methodology of previous papers. A total 527 online questionnaires were completed. Data analysis was conducted using factor analysis and analysis of variance test (ANOVA). Findings of the research support the view that Uzbek consumers attach great importance to the country-of-origin information of products. Precisely, it can be stated that Uzbek people perceive product quality by its ‘Made in...’ label, especially when buying high involvement goods such as car or refrigerator. Another findings of the paper show that products manufactured in developed countries including Germany, Japan and USA are found to be of high quality, while products manufactured in less developed countries are considered to be of lower quality. Marketers can use this information for segmentation purposes. For example, products manufactured in less developed countries can be targeted for low-to-middle income families while goods manufactured in developed countries can be targeted for higher income families. In conclusion, it can be stated that perceived product quality of products that are made in Uzbekistan has slightly increased since 18 years. It implies that nowadays products under ‘Made in Uzbekistan’ label is continually becoming available to many consumers in foreign markets, especially among Commonwealth of Independent States (CIS) countries. Therefore, conducting further research to explore the phenomenon of country-of-origin information and perceived product quality in emerging markets is of paramount importance.

Keywords: country-of-origin, consumer behavior, product evaluation, perceived quality

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Authors: Barry D. Kyle, Jessica Boyd, Robin Pickersgill, Nicole Squires, Cynthia Balion

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Background-Aim: Fentanyl is a highly-potent synthetic μ-opioid receptor agonist used for exceptional pain management. Its main metabolite, norfentanyl, is typically present in urine at significantly high concentrations (i.e. ~20%) representing an effective targeting molecule for immunoassay detection. Here, we evaluated the NCS^TM One Step Fentanyl Test Device© and the BTNX Rapid Response^TM Single Drug Test Strip© point of care (POC) test strips targeting norfentanyl (20 ng/ml) and fentanyl (100 ng/ml) molecules for potential risperidone interference. Methods: POC tests calibrated against norfentanyl (20 ng/ml) used [immunochromatographic] lateral flow devices to provide qualitative results within five minutes of urine sample contact. Results were recorded as negative if lines appeared in the test and control regions according to manufacturer’s instructions. Positive results were recorded if no line appeared in the test region (i.e., control line only visible). Pooled patient urine (n=20), that screened negative for drugs of abuse (using NCS One Step Multi-Line Screen) and fentanyl (using BTNX Rapid Response Strip) was used for spiking studies. Urine was spiked with risperidone alone and with combinations of fentanyl, norfentanyl and/or risperidone to evaluate cross-reactivity in each test device. Results: A positive screen result was obtained when 8,000 ng/mL of risperidone was spiked into drug free urine using the NCS test device. Positive screen results were also obtained in spiked urine samples containing fentanyl and norfentanyl combinations below the cut-off concentrations when 4000 ng/mL risperidone was present using the NCS testing device. There were no screen positive test results using the BTNX test strip with up to 8,000 ng/mL alone or in combination with concentrations of fentanyl and norfentanyl below the cut-off. Both devices screened positive when either fentanyl or norfentanyl exceeded the cut-off threshold in the absence and presence of risperidone. Conclusion: We report that urine samples containing risperidone may give a false positive result using the NCS One Step Fentanyl Test Device.

Keywords: fentanyl, interferences, point of care test, Risperidone

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Authors: Desmond Okorie, Emmanuel Prince

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Availability of portable water has been a global challenge especially to the developing continents/nations such as Africa/Nigeria. The World Health Organization WHO has produced the guideline for drinking water quality GDWQ which aims at ensuring water safety from source to consumer. Portable water parameters test include physical (colour, odour, temperature, turbidity), chemical (PH, dissolved solids) biological (algae, plytoplankton). This paper discusses the use of wireless sensor networks to monitor water quality using efficient and effective sensors that have the ability to sense, process and transmit sensed data. The integration of wireless sensor network to a portable sensing device offers the feasibility of sensing distribution capability, on site data measurements and remote sensing abilities. The current water quality tests that are performed in government water quality institutions in Benue State Nigeria are carried out in problematic locations that require taking manual water samples to the institution laboratory for examination, to automate the entire process based on wireless sensor network, a system was designed. The system consists of sensor node containing one PH sensor, one temperature sensor, a microcontroller, a zigbee radio and a base station composed by a zigbee radio and a PC. Due to the advancement of wireless sensor network technology, unexpected contamination events in water environments can be observed continuously. local area network (LAN) wireless local area network (WLAN) and internet web-based also commonly used as a gateway unit for data communication via local base computer using standard global system for mobile communication (GSM). The improvement made on this development show a water quality monitoring system and prospect for more robust and reliable system in the future.

Keywords: local area network, Ph measurement, wireless sensor network, zigbee

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Authors: H. S. Aljabeili, E. A. Abd El-Hady, M. M. Abd El-Razik, M. Abd Elgadir

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The aim of the study is determining the quality characteristics of produced curing and dried camel meat contained some medicinal plants of thyme, rosemary, clove and ginger as natural preservatives. Camel meat samples were sliced and divided into five batches, one batch recorded as control sample was treated by the curing mixture (2.5%) contained the following ingredients: black pepper 1 gm, cumin 0.4 gm, spices mixture 0.5 gm, dried onion 3 gm, dried garlic 0.5 gm and salt 2 gm. To evaluate the effect of different natural preservatives sources of thyme, rosemary, clove and ginger, 3.0% of the aforementioned natural preservatives was mixed with the aforementioned curing mixture and used for curing the four batches of sliced camel meat. After curing process, cured sliced camel meat (control and treated with the natural preservatives) were conducting to drying process at 35 ± 3 °C for 36 h in a drying cabinet. The quality characteristics of prepared dried camel meat were evaluated such as chemical composition, microbiological characteristics and sensory characteristics. Based on the microbiological and sensory characteristics, it could be suggested that the selected medicinal plants specially thyme and rosemary could be used as natural preservatives for preparing semi dry camel meat without negative effects.

Keywords: curing, dried camel meat, medicinal plants, natural preservatives, quality characteristics

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Authors: Fardis Teifoori, Mehdi Dehghani, Idoia Postigo, Jorge Martinez

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Introduction: Many skin disorders, such as atopic dermatitis (AD), is characterized by inflammation, infection, and hyperplasia. In this work, keratinocytes from AD patients are used to study the pomegranate seed oil properties for skin care. Material and methods: Isolated keratinocytes from patients with AD were cultured and stimulated by IL-9 (20 ng/ml) and TNF-α (50ng/ml) for 48h to induce vascular endothelial growth factor (VEGF) and Regulated upon activation, normal T cell expressed and secreted (RANTES) production, respectively, in the presence of different concentrations of pomegranate seed oil (20, 50, 100, and 200 µM). Finally, the concentrations of RANTES and VEGF in the cell culture supernatant were quantified according to the standard protocol of commercial ELISA kits. Results: The results indicated that pomegranate seed oil concentrations of 50, 100, and 200 µM could significantly inhibit the production of VEGF and RANTES by stimulating keratinocytes with IL-9 (20 ng/ml) and TNF-α (50ng/ml), respectively. The decrease in VEGF and RANTES concentration in the presence of the pomegranate seed oil concentrations of 20 and 50 uM was not significant. Conclusion: It was concluded that pomegranate seed oil (PSO) counteracts atopic dermatitis conditions dose-dependently: with the highest effect at the concentration of 200 µM. We suggest that the inexpensive and easily available pomegranate seed oil is a good candidate for cosmetics and clinical utilization for skin care.

Keywords: atopic dermatitis, pomegranate, Punica granatum, RANTES, VEGF

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Authors: Ravneet Kaur

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The concept of Agile Requirements Engineering and Management is not new. However, the struggle to figure out how traditional Requirements Management Process fits within an Agile framework remains complex. This paper talks about a process that can merge the organization’s traditional Requirements Management Process nicely into the Agile Software Development Process. This process provides Traceability of the Product Backlog to the external documents on one hand and User Stories on the other hand. It also gives sufficient evidence that the system will deliver the right functionality with good quality in the form of various statistics and reports. In the nutshell, by overlaying a process on top of Agile, without disturbing the Agility, we are able to get synergic benefits in terms of productivity, profitability, its reporting, and end to end visibility to all Stakeholders. The framework can be used for just-in-time requirements definition or to build a repository of requirements for future use. The goal is to make sure that the business (specifically, the product owner) can clearly articulate what needs to be built and define what is of high quality. To accomplish this, the requirements cycle follows a Scrum-like process that mirrors the development cycle but stays two to three steps ahead. The goal is to create a process by which requirements can be thoroughly vetted, organized, and communicated in a manner that is iterative, timely, and quality-focused. Agile is quickly becoming the most popular way of developing software because it fosters continuous improvement, time-boxed development cycles, and more quickly delivering value to the end users. That value will be driven to a large extent by the quality and clarity of requirements that feed the software development process. An agile, lean, and timely approach to requirements as the starting point will help to ensure that the process is optimized.

Keywords: requirements management, Agile

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