Search results for: safety and health

Authors: Sophie Lemoussu, Jean-Charles Chaudemar, Robertus A. Vingerhoeds

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Many innovative projects exist in the field of aeronautics, each addressing specific areas so to reduce weight, increase autonomy, reduction of CO2, etc. In many cases, such innovative developments are being carried out by very small enterprises (VSE’s) or small and medium sized-enterprises (SME’s). A good example concerns airships that are being studied as a real alternative to passenger and cargo transportation. Today, no international regulations propose a precise and sufficiently detailed framework for the development and certification of airships. The absence of such a regulatory framework requires a very close contact with regulatory instances. However, VSE’s/SME’s do not always have sufficient resources and internal knowledge to handle this complexity and to discuss these issues. This poses an additional challenge for those VSE’s/SME’s, in particular those that have system integration responsibilities and that must provide all the necessary evidence to demonstrate their ability to design, produce, and operate airships with the expected level of safety and reliability. The main objective of this research is to provide a methodological framework enabling VSE’s/SME’s with limited resources to organize the development of airships while taking into account the constraints of safety, cost, time and performance. This paper proposes to provide a contribution to this problematic by proposing a Model-Based Systems Engineering approach. Through a comprehensive process modeling approach applied to the development processes, the regulatory constraints, existing best practices, etc., a good image can be obtained as to the process landscape that may influence the development of airships. To this effect, not only the necessary regulatory information is taken on board, also other international standards and norms on systems engineering and project management are being modeled and taken into account. In a next step, the model can be used for analysis of the specific situation for given developments, derive critical paths for the development, identify eventual conflicting aspects between the norms, standards, and regulatory expectations, or also identify those areas where not enough information is available. Once critical paths are known, optimization approaches can be used and decision support techniques can be applied so to better support VSE’s/SME’s in their innovative developments. This paper reports on the adopted modeling approach, the retained modeling languages, and how they all fit together.

Keywords: aeronautics, certification, process modeling, project management, regulation, SME, systems engineering, VSE

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Authors: Myunghoun Jang

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Most engineering colleges in South Korea have engineering design classes in order to develop and enhance a student's creativity and problem-solving ability. Many cases about engineering design class are shown in journals and magazines, but a case lasting many years is few. The engineering design class in the Department of Architectural Engineering, Jeju National University was open in 2009 and continues to this year. 3-5 teams in every year set up their problems found their solutions and produced good results. Three of the results obtained patents. The class also provides students with opportunities to improve communication skill because they have many discussions in solving their problems.

Keywords: engineering design, architectural engineering, team-based learning, construction safety

Procedia PDF Downloads 237

Authors: Funmilayo Juliana Afolabi, Joke Haafkens, Paul De Beer

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Globally, there is a growing concern on reducing workplace accidents in the informal sector. However, there is a dearth of study on the perception of the informal workers on occupational risks they are exposed to. The way a worker perceives the workplace risk will influence his/her risk tolerance and risk behavior. The aim of this paper, therefore, is to have an in-depth understanding of the way the artisans perceive the risks at their workplace and how it influences their risk tolerance and risk behavior. This will help in designing meaningful intervention for the artisans and it will assist the policy makers in formulating a policy that will help them. Methods: Forty-three artisans were purposely selected for the study; data were generated through observation of the workplace and work practices of the artisans and in-depth interview from automobile artisans (Panel beater, Mechanic, Vulcanizer, and Painters) in Osun State, Nigeria. The transcriptions were coded and analyzed using MAXQDA software. Results: The perceived occupational risks among the study groups are a danger of being run over by oncoming vehicles while working by the roadside, a risk of vehicle falling on workers while working under the vehicle, cuts, and burns, fire explosion, falls from height and injuries from bursting of tires. The identified risk factors are carelessness of the workers, pressure from customers, inadequate tools, preternatural forces, God’s will and lack of apprentices that will assist them in the workplace. Furthermore, the study revealed that artisans engage in risky behavior like siphoning fuel with mouth because of perception that fuel is good for expelling worms and will make them free from any stomach upset. Conclusions: The study concluded that risky behaviors are influenced by culture, beliefs, and perception of the artisans. The study, therefore, suggested proper health and safety education for the artisans.

Keywords: automobile artisans, informal, occupational risks, Nigeria, sociological enquiry

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Authors: Abdesselam Babouri, Ahcène Lemzadmi, M Rahmane, B. Belhadi, N. Abouchi

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Medical monitoring aims at monitoring and remotely controlling the vital physiological parameters of the patient. The physiological sensors provide repetitive measurements of these parameters in the form of electrical signals that vary continuously over time. Various measures allow informing us about the health of the person's physiological data (weight, blood pressure, heart rate or specific to a disease), environmental conditions (temperature, humidity, light, noise level) and displacement and movements (physical efforts and the completion of major daily living activities). The collected data will allow monitoring the patient’s condition and alerting in case of modification. They are also used in the diagnosis and decision making on medical treatment and the health of the patient. This work presents the implementation of a monitoring system to be used for the control of physiological parameters.

Keywords: clinical monitoring, physiological parameters, biomedical sensors, personal health

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Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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Authors: Jessica Chukwuyem Molua, Collins O Molua

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The effective dose of selected health care workers who are constantly exposed to X-ray radiation was measured using thermoluminescence dosimeters (TLD) placed over the lead apron at the chest region in all categories of medical personnel investigated. To measure radiation in all the selected hospitals to ascertain the exposure of x-ray machines at exactly 1m from the primary source. The work was carried out within a year in each of the selected centers. The personnel examination records containing the type of examination each day, peak tube voltage, tube current, and exposure time, including the actual number of films used, were obtained. A total of 40personel were examined in government hospital Agbor, 21 in central hospital Owa Alero and 18 in Okonye hospital The method used here has also been used by other researchers. Findings showed that the results obtained from the three hospitals investigated in this work were found to conform with the recommendations of the National Commission on radiological and protection {NCRP} 70 and 116 protocols. The Radiologist in the three study areas has the highest dose level, but of particular note is the dosage of the radiologist in Okonye hospital. This, as observed, is because the protective shielding parameters were inadequate and this could result in severe health consequences over time.

Keywords: radiology, health, Agbor, Owa

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Authors: Mahnaz Khalafehnilsaz, Rozina Rahnama

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Introduction: The elderly population is growing rapidly, and with this growth comes an increased demand for healthcare services. Artificial intelligence (AI) has the potential to revolutionize the delivery of healthcare services to the elderly population. In this study, the various ways in which AI is used to create health content for elderly people and its transformative impact on the healthcare industry will be explored. Method: A systematic review of the literature was conducted to identify studies that have investigated the role of AI in creating health content specifically for elderly people. Several databases, including PubMed, Scopus, and Web of Science, were searched for relevant articles published between 2000 and 2022. The search strategy employed a combination of keywords related to AI, personalized health content, and the elderly. Studies that utilized AI to create health content for elderly individuals were included, while those that did not meet the inclusion criteria were excluded. A total of 20 articles that met the inclusion criteria were identified. Finding: The findings of this review highlight the diverse applications of AI in creating health content for elderly people. One significant application is the use of natural language processing (NLP), which involves the creation of chatbots and virtual assistants capable of providing personalized health information and advice to elderly patients. AI is also utilized in the field of medical imaging, where algorithms analyze medical images such as X-rays, CT scans, and MRIs to detect diseases and abnormalities. Additionally, AI enables the development of personalized health content for elderly patients by analyzing large amounts of patient data to identify patterns and trends that can inform healthcare providers in developing tailored treatment plans. Conclusion: AI is transforming the healthcare industry by providing a wide range of applications that can improve patient outcomes and reduce healthcare costs. From creating chatbots and virtual assistants to analyzing medical images and developing personalized treatment plans, AI is revolutionizing the way healthcare is delivered to elderly patients. Continued investment in this field is essential to ensure that elderly patients receive the best possible care.

Keywords: artificial intelligence, health content, older adult, healthcare

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Authors: Sadia Saleem

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Infertility is a global health concern that may have a long-lasting effect on the psychosocial functioning of an individual. Rich research evidence has shown that women with infertility are at greater risk of adverse psychological experiences than men. The culture plays a risk factor when it comes to infertility. Family is considered as a central focus of a collectivistic culture like Pakistan and having children is the key factor that determines the quality of a marital relationship, individual well-being and overall standing in the society. In this collectivistic cultural context, women usually get the blame and experience more psychological distress and social isolation. A total sample of 121 (M 28.17, SD 4.73) women with primary infertility selected through purposive sampling were tested using Emotional Disclosure Questionnaire, Couple Satisfaction Index and Depression Anxiety Stress Scale. The results indicate that negative emotional disclosure positively mediates the relationship between marital satisfaction and mental health problems (p < .001) in women with primary infertility. The results are discussed in terms of psychosocial counseling and family psychoeducation in Pakistani collectivistic cultural context.

Keywords: infertility, couple satisfaction, emotional disclosure, mental health

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Authors: Hasan Al Banna, Nazmus Sakib, Anjan Roy

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From the perspective of the underdeveloped countries such as Bangladesh, health issue can readily be pointed out as the most demanding but the least promoted concern due to lack of initiatives from both government and NGOs. Furthermore an worldwide scenario is that most death and suffering from various pathogenic and non-pathogenic diseases occur due to delay diagnosis, and this happen for the lacking of regular health check-up facility or tradition. In this epistle, an innovative proposal on social business can be introduced to ensure the one-stop medical facility to the door-step of the rural society and create jobs for the educated rural youths to serve their own people. To illustrate the policy, this newly proposed organization will work as a health club which will offer a life-time membership to villagers within a very affordable fee of 250 BDT (2.63 Euro) per month. In this package the members will get the facility of tri-monthly full health check-up by specialist doctors, a health record book and computerized health database for each member and anytime medical consultancy for the members only. We will also organize free medical campaign and workshops on nutrition, sanitation, adulteration, pregnancy-care, child-health etc with the assistance of different sponsors. Among other services that will be provided on payment include emergency ambulance facility in low rents, quality diagnostic lab and 24-hour dispensary facility. Likewise, this policy will involve local educated people by recruiting them after providing intensive courses on nursing and other medical instrumental skills. Henceforth, the engagement of local youth will make the program more acceptable to the rural community. In the later part of this paper, a survey report on Daragram union of Manikganj district, Bangladesh, having population above 25000, will be presented to delineate the scenario how this policy can repay the initial capital expense of BDT 7 million (around 73381 Euro) within 5 years and how I can realistically earn handsome revenue from the first month of business. To recapitulate, this policy is very promising to enlighten the underprivileged community by providing health assurance, and alleviating unemployment besides the investor’s financial profit.

Keywords: create job for the rural people, handsome financial profit, quality health services, underprivileged areas of underdeveloped countries

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Authors: Aysha Zahidie, Meesha Iqbal

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This paper aims to assess the effectiveness of strategies adopted by national health systems across the globe in different ‘geographical regions’ in the Northern Hemisphere to combat COVID-19 pandemic. Data is included from the first case reported in November 2019 till mid-April 2020. Sources of information are COVID-19 case repositories, official country websites, university research teams’ perspectives, official briefings, and available published research articles to date. We triangulated all data to formulate a comprehensive illustration of COVID-19 situation in each country included. It has been found that the 2002-2004 SARS outbreak experienced in China, Taiwan, and South Korea saw better strategies adopted by leadership to combat COVID-19 pandemic containment as compared to Iran, Italy, and the United States of America. Saudi Arabia has so far been successful in the implementation of containment strategies as there have been no large outbreaks in major cities or confined areas such as prisons. The situation has yet to unfold in India and Pakistan, which exhibit their own weaknesses in policy formulation or implementation in response to health crises.

Keywords: national health systems, COVID-19, prevention, response

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Authors: Ken Munro

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Cruise ships are possibly the most complex collection of systems it is possible to find in one physical, moving location. Propulsion, navigation, power generation and more, combined with a hotel, restaurant, casino, theatre etc, with safety and fire control systems to boot. That complexity creates huge challenges with keeping OT and IT systems apart. Ships engines are often remotely managed, network segregation is often defeated through troubleshooting when at sea. This session will refer to multiple entertaining and informative tales of taking control of ships, including accessing a ships Azipods via a game simulator for passengers. Fortunately, genuine attacks against vessels are very rare, but the effects and impacts to world trade are becoming increasingly obvious.

Keywords: maritime security, cybersecurity, OT, IT, networks

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Authors: N. W. Paul, M. Banerjee

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Discussing the nexus between global health policy and local practices, this article addresses the recent Ebola outbreak as a role model for narrative co-constructions of epidemic risk. We will demonstrate in how far a theory-driven and methodologically rooted analysis of narrativity can help to improve mechanisms of prevention and intervention whenever epidemic risk needs to be addressed locally in order to contribute to global health. Analyzing the narrative transformation of Ebola, we will also address issues of transcultural problem-solving and of normative questions at stake. In this regard, we seek to contribute to a better understanding of a key question of global health and justice as well as to the underlying ethical questions. By highlighting and analyzing the functions of narratives, this paper provides a translational approach to refine our practices by which we address epidemic risk, be it on the national, the transnational or the global scale.

Keywords: ebola, epidemic risk, medical ethics, medical humanities

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Authors: Rachel Cherner

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Introduction: The current study investigates several user characteristics that may predict the adoption of digital mental health supports. The extent to which individual characteristics predict preferences for functional elements of computer-mediated social support (CMSS) platforms and mental health (MH) apps is relatively unstudied. Aims: The present study seeks to illuminate the relationship between broad user characteristics and perceived attraction to CMSS platforms and MH apps. Methods: Participants (n=353) were recruited using convenience sampling methods (i.e., digital flyers, email distribution, and online survey forums). The sample was 68% male, and 32% female, with a mean age of 29. Participant racial and ethnic breakdown was 75% White, 7%, 5% Asian, and 5% Black or African American. Participants were asked to complete a 25-minute self-report questionnaire that included empirically validated measures assessing a battery of characteristics (i.e., subjective levels of anxiety/depression via PHQ-9 (Patient Health Questionnaire 9-item) and GAD-7 (Generalized Anxiety Disorder 7-item); attachment style via MAQ (Measure of Attachment Qualities); personality types via TIPI (The 10-Item Personality Inventory); growth mindset and mental health-seeking attitudes via GM (Growth Mindset Scale) and MHSAS (Mental Help Seeking Attitudes Scale)) and subsequent attitudes toward CMSS platforms and MH apps. Results: A stepwise linear regression was used to test if user characteristics significantly predicted attitudes towards key features of CMSS platforms and MH apps. The overall regression was statistically significant (R² =.20, F(1,344)=14.49, p<.000). Conclusion: This original study examines the clinical and sociocultural factors influencing decisions to use CMSS platforms and MH apps. Findings provide valuable insight for increasing adoption and engagement with digital mental health support. Fostering a growth mindset may be a method of increasing participant/patient engagement. In addition, CMSS platforms and MH apps may empower under-resourced and minority groups to gain basic access to mental health support. We do not assume this final model contains the best predictors of use; this is merely a preliminary step toward understanding the psychology and attitudes of CMSS platform/MH app users.

Keywords: computer-mediated social support platforms, digital mental health, growth mindset, health-seeking attitudes, mental health apps, user characteristics

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Authors: Laxmi R. Kasaraneni

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The Internet connects all the networks, including the nation’s critical infrastructure that are used extensively by not only a nation’s government and military to protect sensitive information and execute missions, but also the primary infrastructure that provides services that enable modern conveniences such as education, potable water, electricity, natural gas, and financial transactions. It has become the central nervous system for the government, the citizens, and the industries. When it is attacked, the effects can ripple far and wide impacts not only to citizens’ well-being but nation’s economy, civil infrastructure, and national security. As such, these critical services may be targeted by malicious hackers during cyber warfare, it is imperative to not only protect them and mitigate any immediate or potential threats, but to also understand the current or potential impacts beyond the IT networks or the organization. The Nation’s IT infrastructure which is now vital for communication, commerce, and control of our physical infrastructure, is highly vulnerable to attack. While existing technologies can address some vulnerabilities, fundamentally new architectures and technologies are needed to address the larger structural insecurities of an infrastructure developed in a more trusting time when mass cyber attacks were not foreseen. This research is intended to improve the core functions of the Internet and critical-sector information systems by providing a clear path to create a safe, secure, and resilient cyber environment that help stakeholders at all levels of government, and the private sector work together to develop the cybersecurity capabilities that are key to our economy, national security, and public health and safety. This research paper also emphasizes the present and future cyber security threats, the capabilities and goals of cyber attackers, a strategic concept and steps to implement cybersecurity for maximum effectiveness, enabling technologies, some strategic assumptions and critical challenges, and the future of cyberspace.

Keywords: critical challenges, critical infrastructure, cyber security, enabling technologies, national security

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Authors: Tzu-Ting Hu, Jung-Der Wang, Ming-Yeng Lin, Jin-Luh Chen, Perng-Jy Tsai

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The vinyl chloride monomer (VCM) has been classified as group 1 (human) carcinogen by the IARC. Workers exposed to VCM are known associated with the development of the liver cancer and hence might cause economical and health losses. Particularly, for those work for the petrochemical industry have been seriously concerned in the environmental and occupational health field. Considering assessing workers’ health risks and their resultant economical and health losses requires the establishment of long-term VCM exposure data for any similar exposure group (SEG) of interest, the development of suitable technologies has become an urgent and important issue. In the present study, VCM exposures for petrochemical industry workers were determined firstly based on the database of the 'Workplace Environmental Monitoring Information Systems (WEMIS)' provided by Taiwan OSHA. Considering the existence of miss data, the reconstruction of historical exposure techniques were then used for completing the long-term exposure data for SEGs with routine operations. For SEGs with non-routine operations, exposure modeling techniques, together with their time/activity records, were adopted for determining their long-term exposure concentrations. The Bayesian decision analysis (BDA) was adopted for conducting exposure and health risk assessments for any given SEG in the petrochemical industry. The resultant excessive cancer risk was then used to determine the corresponding loss of quality-adjusted life expectancy (QALE). Results show that low average concentrations can be found for SEGs with routine operations (e.g., VCM rectification 0.0973 ppm, polymerization 0.306 ppm, reaction tank 0.33 ppm, VCM recovery 1.4 ppm, control room 0.14 ppm, VCM storage tanks 0.095 ppm and wastewater treatment 0.390 ppm), and the above values were much lower than that of the permissible exposure limit (PEL; 3 ppm) of VCM promulgated in Taiwan. For non-routine workers, though their high exposure concentrations, their low exposure time and frequencies result in low corresponding health risks. Through the consideration of exposure assessment results, health risk assessment results, and QALE results simultaneously, it is concluded that the proposed method was useful for prioritizing SEGs for conducting exposure abatement measurements. Particularly, the obtained QALE results further indicate the importance of reducing workers’ VCM exposures, though their exposures were low as in comparison with the PEL and the acceptable health risk.

Keywords: exposure assessment, health risk assessment, petrochemical industry, quality-adjusted life years, vinyl chloride monomer

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Authors: Zhongmin Wang, Wudong Fan, Hengshan Zhang, Yimin Zhou

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In data-driven prognostic methods, the prediction accuracy of the estimation for remaining useful life of bearings mainly depends on the performance of health indicators, which are usually fused some statistical features extracted from vibrating signals. However, the existing health indicators have the following two drawbacks: (1) The differnet ranges of the statistical features have the different contributions to construct the health indicators, the expert knowledge is required to extract the features. (2) When convolutional neural networks are utilized to tackle time-frequency features of signals, the time-series of signals are not considered. To overcome these drawbacks, in this study, the method combining convolutional neural network with gated recurrent unit is proposed to extract the time-frequency image features. The extracted features are utilized to construct health indicator and predict remaining useful life of bearings. First, original signals are converted into time-frequency images by using continuous wavelet transform so as to form the original feature sets. Second, with convolutional and pooling layers of convolutional neural networks, the most sensitive features of time-frequency images are selected from the original feature sets. Finally, these selected features are fed into the gated recurrent unit to construct the health indicator. The results state that the proposed method shows the enhance performance than the related studies which have used the same bearing dataset provided by PRONOSTIA.

Keywords: continuous wavelet transform, convolution neural net-work, gated recurrent unit, health indicators, remaining useful life

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Authors: Biniam Bahiru Tufa, Hana Delil Tesfaye, Seife Demisse Legesse, Manaye Tamire

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The healthcare industry is witnessing a digital transformation, with artificial intelligence (AI) offering potential solutions for challenges in health supply chain management (HSCM). However, the adoption of AI in this field remains limited. This research aimed to assess the knowledge, attitude, and practice of AI among students and employees in the health supply chain sector in Ethiopia. Using an explanatory case study research design with a concurrent mixed approach, quantitative and qualitative data were collected simultaneously. The study included 153 participants comprising students and employed health supply chain professionals working in various sectors. The majority had a pharmacy background, and one-third of the participants were male. Most respondents were under 35 years old, and around 68.6% had less than 10 years of experience. The findings revealed that 94.1% of participants had prior knowledge of AI, but only 35.3% were aware of its application in the supply chain. Moreover, the majority indicated that their training curriculum did not cover AI in health supply chain management. Participants generally held positive attitudes toward the necessity of AI for improving efficiency, effectiveness, and cost savings in the supply chain. However, many expressed concerns about its impact on job security and satisfaction, considering it as a burden Graduate students demonstrated higher knowledge of AI compared to employed staff, while graduate students also exhibited a more positive attitude toward AI. The study indicated low previous utilization and potential future utilization of AI in the health supply chain, suggesting untapped opportunities for improvement. Overall, while supply chain experts and graduate students lacked sufficient understanding of AI and its significance, they expressed favorable views regarding its implementation in the sector. The study recommends that the Ethiopian government and international organizations consider introducing AI in the undergraduate pharmacy curriculum and promote its integration into the health supply chain field.

Keywords: knowledge, attitude, practice, supply chain, articifial intellegence

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Authors: Parvin Abedi, Poorandokht Afshari

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Introduction: In 2022, the Youth Law of the Population was notified to all organizations, including the Iranian Ministry of Health. Some of the articles of this law are about the role of midwives in health and treatment to promote childbearing. In this regard, articles number 45, 48, 49, and 50 are related to midwifery work that will be reviewed in this article. Methods: In this review, the law of population youth was reviewed. In this regard, the statistics of midwives working in the treatment and health sector were collected and analyzed according to the population youth law. Results: Nearly 47 000 midwives are working in the public and private sectors of the country and in the healthcare sector; according to Article 49, which states that there should be one midwife for every two parturient women, about 12,000 midwives are needed in the treatment department and about 8,000 midwives are needed in the health department. In Article 50 it is mentioned to modify tariffs and efficiency in order to increase natural childbirth, and in this field, insurance organizations should have sufficient cooperation with payments. The tariff for midwifery services has been increased, but it is not enough for the stressful job of midwifery. The labor incentive for delivery by midwives is also low. Conclusion: Midwives are one of the fundamental pillars of the law of the population, and without increasing the motivation of midwives, it is not possible to increase the rate of natural childbirth and make childbirth pleasant.

Keywords: law of the population, midwife, motivation, childbearing

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Aleksandr Kavetskiy, Galina Yakubova, Nikolay Sargsyan, Stephen A. Prior, H. Allen Torbert

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The carbon sequestration question of modern times requires the development of an in-situ method of measuring soil carbon over large landmasses. Traditional chemical analytical methods used to evaluate large land areas require extensive soil sampling prior to processing for laboratory analysis; collectively, this is labor-intensive and time-consuming. An alternative method is to apply nuclear physics analysis, primarily in the form of pulsed fast-thermal neutron-gamma soil carbon analysis. This method is based on measuring the gamma-ray response that appears upon neutron irradiation of soil. Specific gamma lines with energies of 4.438 MeV appearing from neutron irradiation can be attributed to soil carbon nuclei. Based on measuring gamma line intensity, assessments of soil carbon concentration can be made. This method can be done directly in the field using a specially developed pulsed fast-thermal neutron-gamma system (PFTNA system). This system conducts in-situ analysis in a scanning mode coupled with GPS, which provides soil carbon concentration and distribution over large fields. The system has radiation shielding to minimize the dose rate (within radiation safety guidelines) for safe operator usage. Questions concerning the effect of neutron irradiation on soil health will be addressed. Information regarding absorbed neutron and gamma dose received by soil and its distribution with depth will be discussed in this study. This information was generated based on Monte-Carlo simulations (MCNP6.2 code) of neutron and gamma propagation in soil. Received data were used for the analysis of possible induced irradiation effects. The physical, chemical and biological effects of neutron soil irradiation were considered. From a physical aspect, we considered neutron (produced by the PFTNA system) induction of new isotopes and estimated the possibility of increasing the post-irradiation gamma background by comparisons to the natural background. An insignificant increase in gamma background appeared immediately after irradiation but returned to original values after several minutes due to the decay of short-lived new isotopes. From a chemical aspect, possible radiolysis of water (presented in soil) was considered. Based on stimulations of radiolysis of water, we concluded that the gamma dose rate used cannot produce gamma rays of notable rates. Possible effects of neutron irradiation (by the PFTNA system) on soil biota were also assessed experimentally. No notable changes were noted at the taxonomic level, nor was functional soil diversity affected. Our assessment suggested that the use of a PFTNA system with a neutron flux of 1e7 n/s for soil carbon analysis does not notably affect soil properties or soil health.

Keywords: carbon sequestration, neutron gamma analysis, radiation effect on soil, Monte-Carlo simulation

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Authors: Khlood F. Salman, Richard Zoucha, Hani Nawafleh

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Introduction: Jordan ranks the fourth highest breast cancer prevalence after Lebanon, Bahrain, and Kuwait. Considerable evidence showed that cultural, ethnic, and economic differences influence a woman’s practice to early detection and prevention of breast cancer. Objectives: To understand women’s health beliefs and values in relation to early detection of breast cancer; and to explore the impact of these beliefs on their decisions regarding reluctance or acceptance of early detection measures such as mammogram screening. Design: A qualitative focused ethnography was used to collect data for this study. Settings: The study was conducted in the second largest city surrounded by a large rural area in Ma’an- Jordan. Participants: A total of twenty seven women, with no history of breast cancer, between the ages of 18 and older, who had prior health experience with health providers, and were willing to share elements of personal health beliefs related to breast health within the larger cultural context. The participants were recruited using the snowball method and words of mouth. Data collection and analysis: A short questionnaire was designed to collect data related to socio demographic status (SDQ) from all participants. A Semi-structured interviews guide was used to elicit data through interviews with the informants. Nvivo10 a data manager was utilized to assist with data analysis. Leininger’s four phases of qualitative data analysis was used as a guide for the data analysis. The phases used to analyze the data included: 1) Collecting and documenting raw data, 2) Identifying of descriptors and categories according to the domains of inquiry and research questions. Emic and etic data is coded for similarities and differences, 3) Identifying patterns and contextual analysis, discover saturation of ideas and recurrent patterns, and 4) Identifying themes and theoretical formulations and recommendations. Findings: Three major themes were emerged within the cultural and religious context; 1. Fear, denial, embarrassment and lack of knowledge were common perceptions of Ma’anis’ women regarding breast health and screening mammography, 2. Health care professionals in Jordan were not quick to offer information and education about breast cancer and screening, and 3. Willingness to learn about breast health and cancer prevention. Conclusion: The study indicated the disparities between the infrastructure and resourcing in rural and urban areas of Jordan, knowledge deficit related to breast cancer, and lack of education about breast health may impact women’s decision to go for a mammogram screening. Cultural beliefs, fear, embarrassments as well as providers lack of focus on breast health were significant contributors against practicing breast health. Health providers and policy makers should provide resources for the establishment health education programs regarding breast cancer early detection and mammography screening. Nurses should play a major role in delivering health education about breast health in general and breast cancer in particular. A culturally appropriate health awareness messages can be used in creating educational programs which can be employed at the national levels.

Keywords: breast health, beliefs, cultural context, ethnography, mammogram screening

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Authors: P. Pérez-Martín, G. Pedrós, P. Martínez-Jiménez, M. Varo-Martínez

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In recent decades, family habits related to children’s displacements to school have changed, increasing motorized travels against active modes. This entails a major negative impact on the urban environment, road safety in cities and the physical and psychological development of children. One of the more common actions used to reverse this trend is Walking School Bus (WSB), which consists of a predefined adult-scorted pedestrian route to school with several stops along the path where schoolchildren are collected. At Tirso de Molina School in Cordoba (Spain), a new ICT-based methodology to deploy WSB has been tested. A mobile app that allows the geoposition of the group, the notification of the arrival and real-time communication between the WSB participants have been presented to the families in order to organize and register the daily participation. After an initial survey to know the travel mode and the spatial distribution of the interested families, three WSB routes have been established and the families have been trained in the app usage. During nine weeks, 33 children have joined the WSB and their parents have accompanied the groups in turns. A high recurrence in the attendance has been registered. Through a final survey, participants have valued highly the tool and the methodology designed, emphasizing as most useful features of the mobile app: notifications system, chat and real-time monitoring. It has also been found that the tool has had a major impact on the degree of confidence of parents regarding the autonomous on foot displacement of their children to school. Moreover, 37,9% of the participant families have reported a total or partial modal shift from car to walking, and the benefits more reported are an increment of the parents available time and less problems in the travel to school daily organization. As a consequence, It has been proved the effectiveness of this user-centric innovative ICT-based methodology to reduce the levels of private car drop offs, minimize barriers of time constraints, volunteer recruitment, and parents’ safety concerns, while, at the same time, increase convenience and time savings for families. This pilot study can offer guidance for community coordinated actions and local authority interventions to support sustainable school travel outcomes.

Keywords: active travel, mobile app, sustainable mobility, urban transportation planning, walking school bus

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Authors: Shasta Bula

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This research provides the first case study of the Santa Ana riverbed homeless encampment. It contributes valuable information about the little-studied factors contributing to the formation and dismantling of transient homeless encampments. According to the author’s best knowledge, this is the discussion of three reoccurring characteristics of homeless camps: camps form a self-governing system, camps are viewed by the community as unsavory places, and the campers are viewed as being unable or unwilling to participate in normal society. Three theories are proposed as explanations for these characteristics: the social capital theory as a reason for homeless campers to develop a system of self-government, the aesthetics theory as rationale for camps being viewed as unsavory places, and the theory of vulnerable and inevitable inequality as a reason why campers are seen as being unable or unwilling to participate in normal society. Three hypotheses are introduced to assess these theories: The encampment was created because it provided inhabitants a sense of safety and autonomy. It was dismantled due to its highly visible location and lack of adherence to the Orange County consumption and leisure aesthetic. Most homeless people from this encampment relocated approximately thirty miles east to Riverside County to avoid harassment by police. An extensive review of interviews with camp inhabitants revealed that fifty-one percent resided in the camp because it gave them a sense of safety and autonomy. An examination of Anaheim city council meeting meetings showed that thirty-eight percent of complaints were related to aesthetic concerns. Analysis of population reports from the U.S. Department of Housing and Urban Development indicated that there was a notable increase in homelessness in Orange County the year after the camp was dismantled. These results reflect that the social capital theory is an applicable explanation for the homeless being drawn to set up camp as a collective. The aesthetics theory can be used to explain why a third of residents complained about the encampment. Camp residents did not move East to Riverside after the camp was dismantled. Further investigation into the enforcement of anti-camping ordinances needs to be conducted to evaluate if policing contributed to the vulnerability of the homeless.

Keywords: poverty, social relations, transformation of urban settlements, urban anthropology

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Authors: Saidi Abdelkrim, Hamouine Abdelmadjid, Abdellatif Megnounif

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The study of interaction between vehicles and bridge structures has become extremely important. Large deflections and vibration induced by heavy and high-speed vehicles affect significantly the safety and efficiency of bridge. The vibration of a bridge caused by passage of vehicles is one of the most imperative considerations in the design of a bridge as a common sort of transportation structure. A major goal of this study is to create a simplified model of a vehicle bridge system in MATLAB. The model will then be used to study the influence of parameters to vehicle-bridge vibrations.

Keywords: vehicle-bridge interaction, Newmark-β, MATLAB code

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Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

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Authors: Narmeen Ali, Muhammad Arshad

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Cohesion has an exact association with family functioning and enmeshment (togetherness) on one side and disengagement (separateness) on the other. Family cohesion can apprehend as a concerned association that family members have with each other and an affirmation of association inside the family. Family cohesion, assigned as the level of congruity or sympathetic or emotional attachment that relatives have toward each other, and it was seen to be associated with relational well-being and feeling of comfort in the young generation. The cross-sectional research design was used by the researcher to answer the research questions. A stratified sampling technique was used to collect the data from the participants. The data was collected equally from the males and females of different universities and different departments of Lahore, Pakistan. A self-report questionnaire was developed of given literature and which were found to be associated with family cohesion, interpersonal difficulties and mental health problems of university students. The demographic information included age, gender, university’s name, class, family system, parent’s education, parent’s profession, number of siblings and birth order. Correlation shows the negative relation between balanced cohesion and interpersonal difficulties, while interpersonal difficulties have a highly positive relationship with mental health problems. Mental health problems also have a negative correlation with the balanced family cohesion. Gender, family system, depression and anxiety are the significant predictors of interpersonal difficulties scale in university students. And gender showed a significant difference regarding family cohesion and interpersonal difficulty scale, as women reported more interpersonal difficulties than men.

Keywords: family cohesion, interpersonal difficulties, mental health problems, university students

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Authors: Tallal Abdel Karim Bouzir, Nourdinne Zemmouri, Djihed Berkouk

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In this research, a quantitative assessment of the urban sound environment of the city of Biskra, Algeria, was conducted. To determine the quality of the soundscape based on in-situ measurement, using a Landtek SL5868P sound level meter in 47 points, which have been identified to represent the whole city. The result shows that the urban noise level varies from 55.3 dB to 75.8 dB during the weekdays and from 51.7 dB to 74.3 dB during the weekend. On the other hand, we can also note that 70.20% of the results of the weekday measurements and 55.30% of the results of the weekend measurements have levels of sound intensity that exceed the levels allowed by Algerian law and the recommendations of the World Health Organization. These very high urban noise levels affect the quality of life, the acoustic comfort and may even pose multiple risks to people's health.

Keywords: road traffic, noise pollution, sound intensity, public health

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Authors: Viloria Marin Hermes, Paredes Santiago Maritza, Viloria Paredes Jonathan

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The aim of this study is to assess the prevalence of Burnout syndrome in a sample of 600 professors at the University of Guayaquil (Ecuador) using the Maslach Burnout Inventory (M.B.I.). In addition, assessment was made of the effects on health from professional burnout using the General Health Questionnaire (G.H.Q.-28), and the influence of Emotional Intelligence on prevention of its symptoms using the Spanish version of the Trait Meta-Mood Scale (T.M.M.S.-24). After confirmation of the underlying factor structure, the three measurement tools showed high levels of internal consistency, and specific cut-off points were proposed for the group of Latin American academics in the M.B.I. Statistical analysis showed the syndrome is present extensively, particularly on medium levels, with notably low scores given for Professional Self-Esteem. The application of Canonical Correspondence Analysis revealed that low levels of self-esteem are related to depression, with a lack of personal resources related to anxiety and insomnia, whereas the ability to perceive and control emotions and feelings improves perceptions of professional effectiveness and performance.

Keywords: burnout, academics, emotional intelligence, general health, canonical correspondence analysis

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Authors: Ilzira A. Minigalieva

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Assessment of cumulative health risks associated with the widely observed combined exposures to two or more metals and their compounds on the organism in industrial or general environment, as well as respective regulatory and technical risk management decision-making have presumably the theoretical and experimental toxicology of mixtures as their reliable scientific basis. Analysis of relevant literature and our own experience proves, however, that there is no full match between these different practices. Moreover, some of the contradictions between them are of a fundamental nature. This unsatisfactory state of things may be explained not only by unavoidable simplifications characteristic of the methodologies of risk assessment and permissible exposure standards setting but also by the extreme intrinsic complexity of the combined toxicity theory, the most essential issues of which are considered and briefly discussed in this paper.

Keywords: toxic metals, nanoparticles, typology of combined toxicity, mathematical modeling, health risk assessment and management

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Authors: Alexandria Carey, Angela Starkweather, Ann Horgas, Hwayoung Cho, Jason Beneciuk

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Background/Significance: Over 3.4 million acute axial low back pain (aLBP) cases are treated annually in the United States (US) emergency departments (ED). ED patients with aLBP receive varying verbal and written discharge routine care (RC), leading to ineffective patient self-management. Ineffective self-management increase chronic low back pain (cLPB) transition risks, a chief cause of worldwide disability, with associated costs >$60 million annually. This research addresses this significant problem by evaluating an ED digital pain self-management intervention (EDPSI) focused on improving self-management through improved knowledge retainment, skills, and self-efficacy (confidence) (KSC) thus reducing aLBP to cLBP transition in ED patients discharged with aLBP. The research has significant potential to increase self-efficacy, one of the most potent mechanisms of behavior change and improve health outcomes. Focusing on accessibility and usability, the intervention may reduce discharge disparities in aLBP self-management, especially with low health literacy. Study Questions: This research will answer the following questions: 1) Will an EDPSI focused on improving KSC progress patient self-management behaviors and health status?; 2) Is the EDPSI sustainable to improve pain severity, interference, and pain recurrence?; 3) Will an EDPSI reduce aLBP to cLBP transition in patients discharged with aLBP? Aims: The pilot randomized-controlled trial (RCT) study’s objectives assess the effects of a 12-week digital self-management discharge tool in patients with aLBP. We aim to 1) Primarily assess the feasibility [recruitment, enrollment, and retention], and [intervention] acceptability, and sustainability of EDPSI on participant’s pain self-management; 2) Determine the effectiveness and sustainability of EDPSI on pain severity/interference among participants. 3) Explore patient preferences, health literacy, and changes among participants experiencing the transition to cLBP. We anticipate that EDPSI intervention will increase likelihood of achieving self-management milestones and significantly improve pain-related symptoms in aLBP. Methods: The study uses a two-group pilot RCT to enroll 30 individuals who have been seen in the ED with aLBP. Participants are randomized into RC (n=15) or RC + EDPSI (n=15) and receive follow-up surveys for 12-weeks post-intervention. EDPSI innovative content focuses on 1) highlighting discharge education; 2) provides self-management treatment options; 3) actor demonstration of ergonomics, range of motion movements, safety, and sleep; 4) complementary alternative medicine (CAM) options including acupuncture, yoga, and Pilates; 5) combination therapies including thermal application, spinal manipulation, and PT treatments. The intervention group receives Booster sessions via Zoom to assess and reinforce their knowledge retention of techniques and provide return demonstration reinforcing ergonomics, in weeks two and eight. Outcome Measures: All participants are followed for 12-weeks, assessing pain severity/ interference using the Brief Pain Inventory short-form (BPI-sf) survey, self-management (measuring KSC) using the short 13-item Patient Activation Measure (PAM), and self-efficacy using the Pain Self-Efficacy Questionnaire (PSEQ) weeks 1, 6, and 12. Feasibility is measured by recruitment, enrollment, and retention percentages. Acceptability and education satisfaction are measured using the Education-Preference and Satisfaction Questionnaire (EPSQ) post-intervention. Self-management sustainment is measured including PSEQ, PAM, and patient satisfaction and healthcare utilization (PSHU) requesting patient overall satisfaction, additional healthcare utilization, and pain management related to continued back pain or complications post-injury.

Keywords: digital, pain self-management, education, tool

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