Search results for: patient perspectives

Authors: Mahla Azimi

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Introduction: Post-bladder catheter infection is a common and significant healthcare-associated infection that affects individuals with indwelling urinary catheters. These infections can lead to various complications, including urinary tract infections (UTIs), bacteremia, sepsis, and increased morbidity and mortality rates. This article aims to provide a comprehensive review of post-bladder catheter infections, including their causes, risk factors, clinical presentation, diagnosis, treatment options, and preventive measures. Causes and Risk Factors: Post-bladder catheter infections primarily occur due to the colonization of microorganisms on the surface of the urinary catheter. The most common pathogens involved are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species. Several risk factors contribute to the development of these infections, such as prolonged catheterization duration, improper insertion technique, poor hygiene practices during catheter care, compromised immune system function in patients with underlying conditions or immunosuppressive therapy. Clinical Presentation: Patients with post-bladder catheter infections may present with symptoms such as fever, chills, malaise, suprapubic pain or tenderness, and cloudy or foul-smelling urine. In severe cases or when left untreated for an extended period of time, patients may develop more severe symptoms like hematuria or signs of systemic infection. Diagnosis: The diagnosis of post-bladder catheter infection involves a combination of clinical evaluation and laboratory investigations. Urinalysis is crucial in identifying pyuria (presence of white blood cells) and bacteriuria (presence of bacteria). A urine culture is performed to identify the causative organism(s) and determine its antibiotic susceptibility profile. Treatment Options: Prompt initiation of appropriate antibiotic therapy is essential in managing post-bladder catheter infections. Empirical treatment should cover common pathogens until culture results are available. The choice of antibiotics should be guided by local antibiogram data to ensure optimal therapy. In some cases, catheter removal may be necessary, especially if the infection is recurrent or associated with severe complications. Preventive Measures: Prevention plays a vital role in reducing the incidence of post-bladder catheter infections. Strategies include proper hand hygiene, aseptic technique during catheter insertion and care, regular catheter maintenance, and timely removal of unnecessary catheters. Healthcare professionals should also promote patient education regarding self-care practices and signs of infection. Conclusion: Post-bladder catheter infections are a significant healthcare concern that can lead to severe complications and increased healthcare costs. Early recognition, appropriate diagnosis, and prompt treatment are crucial in managing these infections effectively. Implementing preventive measures can significantly reduce the incidence of post-bladder catheter infections and improve patient outcomes. Further research is needed to explore novel strategies for prevention and management in this field.

Keywords: post-bladder catheter infection, urinary tract infection, bacteriuria, indwelling urinary catheters, prevention

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Authors: Anthony Idowu Ajayi, Ezebunwa Ethelbert Nwokocha, Wilson Akpan, Oladele Vincent Adeniyi

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Studies on emergency contraception (EC) mostly utilise quantitative methods and focus on medically approved drugs for the prevention of unwanted pregnancies. This methodological bias necessarily obscures insider perspectives on sexual behaviour, particularly on why specific methods are utilized by women who seek to prevent unplanned pregnancies. In order to privilege this perspective, with a view to further enriching the discourse and policy on the prevention and management of unplanned pregnancies, this paper brings together the findings from several focus groups and in-depth interviews conducted amongst unmarried female undergraduate students in two Nigerian universities. The study found that while the research participants had good knowledge of the consequences of unprotected sexual intercourses - with abstinence and condom widely used - participants’ willingness to rely only on medically sound measures to prevent unwanted pregnancies was not always mediated by such knowledge. Some of the methods favored by participants appeared to be those commonly associated with people of low socio-economic status in the society where the study was conducted. Medically unsafe concoctions, some outright dangerous, were widely believed to be efficacious in preventing unwanted pregnancy. Furthermore, respondents’ narratives about their sexual behaviour revealed that inadequate sex education, socio-economic pressures, and misconceptions about the efficacy of “crude” emergency contraception methods were all interrelated. The paper therefore suggests that these different facets of the unplanned pregnancy problem should be the focus of intervention.

Keywords: unplanned pregnancy, unsafe abortion, emergency contraception, concoctions

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Authors: Esubalew Yehualaw Melaku, Tigistu Haile Eritro

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In this study, two basic geophysical methods are applied for mapping the groundwater aquifer system in the Lisana area along the Guder River, northeast of Hosanna town, near the western margin of the Central Main Ethiopian Rift. The main target of the study is to map the potential aquifer zone and investigate the groundwater potential for current and future development of the resource in the Gode area. The geophysical methods employed in this study include, Vertical Electrical Sounding (VES) and magnetic survey techniques. Electrical sounding was used to examine and map the depth to the potential aquifer zone of the groundwater and its distribution over the area. On the other hand, a magnetic survey was used to delineate contact between lithologic units and geological structures. The 2D magnetic modeling and the geoelectric sections are used for the identification of weak zones, which control the groundwater flow and storage system. The geophysical survey comprises of twelve VES readings collected by using a Schlumberger array along six profile lines and more than four hundred (400) magnetic readings at about 10m station intervals along four profiles and 20m along three random profiles. The study result revealed that the potential aquifer in the area is obtained at a depth range from 45m to 92m. This is the response of the highly weathered/ fractured ignimbrite and pumice layer with sandy soil, which is the main water-bearing horizon. Overall, in the neighborhood of four VES points, VES- 2, VES- 3, VES-10, and VES-11, shows good water-bearing zones in the study area.

Keywords: vertical electrical sounding, magnetic survey, aquifer, groundwater potential

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Authors: Dmitriy Chernov, Maria Karavassilis, Suhyoun Youn, Amna Izhar, Devasenan Devendra

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Introduction and Background: A well-structured and comprehensive departmental induction improves patient safety and job satisfaction amongst doctors. The aims of our Project were as follows: 1. Assess the perceived preparedness of junior doctors starting their rotation in Acute Medicine at Watford General Hospital. 2. Develop a supplemental Induction Guide and Pocket reference in the form of an iOS mobile application. 3. To collect feedback after implementing the mobile application following a trial period of 8 weeks with a small cohort of junior doctors. Materials and Methods: A questionnaire was distributed to all new junior trainees starting in the department of Acute Medicine to assess their experience of current induction. A mobile Induction application was developed and trialled over a period of 8 weeks, distributed in addition to the existing didactic induction session. After the trial period, the same questionnaire was distributed to assess improvement in induction experience. Analytics data were collected with users’ consent to gauge user engagement and identify areas of improvement of the application. A feedback survey about the app was also distributed. Results: A total of 32 doctors used the application during the 8-week trial period. The application was accessed 7259 times in total, with the average user spending a cumulative of 37 minutes 22 seconds on the app. The most used section was Clinical Guidelines, accessed 1490 times. The App Feedback survey revealed positive reviews: 100% of participants (n=15/15) responded that the app improved their overall induction experience compared to other placements; 93% (n=14/15) responded that the app improved overall efficiency in completing daily ward jobs compared to previous rotations; and 93% (n=14/15) responded that the app improved patient safety overall. In the Pre-App and Post-App Induction Surveys, participants reported: a 48% improvement in awareness of practical aspects of the job; a 26% improvement of awareness on locating pathways and clinical guidelines; a 40% reduction of feelings of overwhelmingness. Conclusions and recommendations: This study demonstrates the importance of technology in Medical Education and Clinical Induction. The mobile application average engagement time equates to over 20 cumulative hours of on-the-job training delivered to each user, within an 8-week period. The most used and referred to section was clinical guidelines. This shows that there is high demand for an accessible pocket guide for this type of material. This simple mobile application resulted in a significant improvement in feedback about induction in our Department of Acute Medicine, and will likely impact workplace satisfaction. Limitations of the application include: post-app surveys had a small number of participants; the app is currently only available for iPhone users; some useful sections are nested deep within the app, lacks deep search functionality across all sections; lacks real time user feedback; and requires regular review and updates. Future steps for the app include: developing a web app, with an admin dashboard to simplify uploading and editing content; a comprehensive search functionality; and a user feedback and peer ratings system.

Keywords: mobile app, doctor induction, medical education, acute medicine

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Authors: Naima Nur, Safa Islam, Saeema Islam, Md. Faridul Alam

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Background: The worldwide increase in pediatric presumptive tuberculosis (TB) is the most life-threatening challenge in effectively controlling TB. The objective of this study was to determine the proportion of presumptive TB and the factors associated with it. Methods: A cross-sectional study was conducted between March and November 2013 at ICDDR-Bangladesh. Two hundred twelve pulmonary and extra-pulmonary specimens were collected from 84 suspected pediatric patients diagnosed with TB based on their clinical symptoms/radiological findings. Presumptive TB and confirmed TB were considered presumptive TB and non-presumptive TB and were isolated by smear-microscopy, culture, and GeneXpert. Logistic regression was used to analyze associations between outcome and predictor variables. Results: The proportion of presumptive TB was 85.7%, and 14.3% of non-presumptive TB. In presumptive TB, vaccine scars, family TB history, and school-going children were 16.6%, 33.3%, and 56.9%, respectively. In contrast, vaccine scars and family TB history were 8.3%, and school-going children were 58.3% in non-presumptive TB. Significant factors did not appear in the logistic regression analysis. Conclusion: Despite the high proportion of presumptive TB, there was no statistically significant between presumptive TB and non-presumptive TB.

Keywords: presumptive tuberculosis, confirmed tuberculosis, patient's characteristics, diagnosis

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Authors: Minttu Laukkanen, Janne Huiskonen

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This study investigates the sharing economy business models as examples of the sustainable business models. The aim is to contribute to the limited literature on sharing economy in connection with sustainable business models by explaining sharing economy business models value capturing. Specifically, this research answers the following question: How business model choices affect captured sustainable value? A multiple case study approach is applied in this study. Twenty different successful sharing economy business models focusing on consumer business and covering four main areas, accommodation, mobility, food, and consumer goods, are selected for analysis. The secondary data available on companies’ websites, previous research, reports, and other public documents are used. All twenty cases are analyzed through the sharing economy business model framework and sustainable value analysis framework using qualitative data analysis. This study represents general sharing economy business model value attributes and their specifications, i.e. sustainable value propositions for different stakeholders, and further explains the sustainability impacts of different sharing economy business models through captured and uncaptured value. In conclusion, this study represents how business model choices affect sustainable value capturing through eight business model attributes identified in this study. This paper contributes to the research on sustainable business models and sharing economy by examining how business model choices affect captured sustainable value. This study highlights the importance of careful business model and sustainability impacts analyses including the triple bottom line, multiple stakeholders and value captured and uncaptured perspectives as well as sustainability trade-offs. It is not self-evident that sharing economy business models advance sustainability, and business model choices does matter.

Keywords: sharing economy, sustainable business model innovation, sustainable value, value capturing

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Authors: Seung-Ho Choi, Jae Yuel Oh, Chi Sung Lim, Ho Seong Jung, Kang Su Kim

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In recent years, various strengthening methods for buildings have been developed, but most of them require quite a long construction period during which the building users need to be patient on uncomfortable working environments including various lousy noises or even evacuation of the buildings. In this study, externally anchored precast wall-panel method (EPCW) for strengthening non-seismic reinforced concrete (RC) structures has been proposed, which is occupant-friendly technique because the strengthening walls are manufactured at factory and can be tightened to the members very quickly at the site. In order to investigate the structural performance of the specimens strengthened by the EPCW method, a total of four specimens were fabricated, and tested under axial and reversed cyclic lateral loads. The test results showed that the lateral resistances of the specimens strengthened by the EPCW method were greatly enhanced in both positive and negative directions, compared to the RC specimen having non-seismic details.

Keywords: precast wall, seismic strengthening, reinforced concrete, externally-anchored

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Authors: Ayelet Gur

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Background: Parents with intellectual disability are of great interest to social service professionals. Article 23 of the United Nations Convention on the Rights of Persons with Disabilities aims to ensure that persons with disabilities can create a family by providing adequate supports. The aim of the current investigation was to portray families with parents with intellectual disabilities within Muslim- Arab society in Israel. Method: Qualitative method using semi-structured interviews with nine-teen Muslim Israeli social workers was employed. Thematic analysis was used to identify major themes. Results: Families with parents with intellectual disability are not a rare phenomenon in the Arab society. The common type is of marriage between a man with intellectual disability and a woman without disability. Findings indicated two main motives for the arranged marriage of a man with intellectual disability: the extended family's concerns about his future and their desire for the family continuity. The non-disabled wives' motives for marrying men with intellectual disabilities revolved around their lack of other opportunities to create a family and their desire to leave their parents' household and live independently. Those women were described as partly or fully aware of their husbands' disability prior to the marriage. The family life of those families were described in relation to the fathers' involvement in family life and relation to the wives' high burden and in many cases, acceptance of their life situation. Conclusions: Findings are discussed with respect to religious values on disability, arranged marriage and the status of Muslim women. Services and supports for parents with intellectual disabilities should be developed with respect to the cultural values and norms.

Keywords: Arab society in Israel, intellectual and developmental disability, parents with intellectual disability, social work

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Authors: Onyebueke Godwin, Okwarafor Friday

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Introduction: Persons with HIV/AIDS disease are predisposed to mental health disorders such as depression and suicide. HIV/AIDS, being a chronic medical illness with antecedent stigmatization ostracization, leads to low mood, low self-esteem, and a tendency to kill oneself due to the burden of the disease in terms of cost and disability. The aim of one study was to examine the prevalence of depression and risk of suicide among HIV/AIDS patients compared to negative persons. Instruments: The Major Depressive Episode and Suicidality modules of the MINI-Neuropsychiatric inventory were used to screen the attendees. Report: The prevalence of depression and risk of suicide were 27.8% and 7.8%, respectively, for the HIV positive subjects, but 1208% and 2.2%, respectively, for negative subjects. Conclusion and Significance: Persons with HIV/AIDS usually present with mental health symptoms, but the attending physicians usually pay attention to physical symptoms. The symptoms of the disease or the side effects of the medication may mask the mental health disease. Recommendation: There is need to screen HIV/AIDS patents for mental health disorders during clinic visits.

Keywords: depression, HIV/AIDS, suicidality

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Authors: Nasim Nosoudi, Amir Zadeh, Hunter White, Joshua Conrad, Joon W. Shim

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De novo Malignancy has become one of the major causes of death after transplantation, so early cancer diagnosis and detection can drastically improve survival rates post-transplantation. Most previous work focuses on using artificial intelligence (AI) to predict transplant success or failure outcomes. In this work, we focused on predicting de novo malignancy after liver transplantation using AI. We chose the patients that had malignancy after liver transplantation with no history of malignancy pre-transplant. Their donors were cancer-free as well. We analyzed 254,200 patient profiles with post-transplant malignancy from the US Organ Procurement and Transplantation Network (OPTN). Several popular data mining methods were applied to the resultant dataset to build predictive models to characterize de novo malignancy after liver transplantation. Recipient's bilirubin, creatinine, weight, gender, number of days recipient was on the transplant waiting list, Epstein Barr Virus (EBV), International normalized ratio (INR), and ascites are among the most important factors affecting de novo malignancy after liver transplantation

Keywords: De novo malignancy, bilirubin, data mining, transplantation

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Authors: Yasuyuki Takahashi, Maya Yamashita, Kyoko Saito

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In general, dynamic SPECT data acquisition needs a few minutes for one rotation. Thus, the time-activity curve (TAC) derived from the dynamic SPECT is relatively coarse. In order to effectively shorten the interval, between data points, we adopted a 180-degree interpolation method. This method is already used for reconstruction of the X-ray CT data. In this study, we applied this 180-degree interpolation method to SPECT and investigated its effectiveness.To briefly describe the 180-degree interpolation method: the 180-degree data in the second half of one rotation are combined with the 180-degree data in the first half of the next rotation to generate a 360-degree data set appropriate for the time halfway between the first and second rotations. In both a phantom and a patient study, the data points from the interpolated images fell in good agreement with the data points tracking the accumulation of 99mTc activity over time for appropriate region of interest. We conclude that data derived from interpolated images improves the apparent time resolution of dynamic SPECT.

Keywords: dynamic SPECT, time resolution, 180-degree interpolation method, 99mTc-GSA.

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Authors: S. S. Patil, B. U. Janugade, S. V. Patil

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Pulsatile systems are gaining a lot of interest as they deliver the drug at the right site of action at the right time and in the right amount, thus providing spatial and temporal delivery thus increasing patient compliance. These systems are designed according to the circadian rhythm of the body. Chronotherapeutics is the discipline concerned with the delivery of drugs according to inherent activities of a disease over a certain period of time. It is becoming increasingly more evident that the specific time that patients take their medication may be even more significant than was recognized in the past. The tradition of prescribing medication at evenly spaced time intervals throughout the day, in an attempt to maintain constant drug levels throughout a 24-hour period, may be changing as researcher’s report that some medications may work better if their administration is coordinated with day-night patterns and biological rhythms. The potential benefits of chronotherapeutics have been demonstrated in the management of a number of diseases. In particular, there is a great deal of interest in how chronotherapy can particularly benefit patients suffering from allergic rhinitis, rheumatoid arthritis and related disorders, asthma, cancer, cardiovascular diseases, and peptic ulcer disease.

Keywords: pulsatile drug delivery, chronotherapeutics, circadian rhythm, asthma, chronobiology

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Authors: Jelena Filipović, Milenko Košutić, Vladimir Filipović

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In the last decades urban population is characterized by sedentary lifestyles, low physical activity and "fast food". These changes in diet and physical non activity have been associated with the increase of chronic non diseases. Bread is one of the most popularly wheat products consumed worldwide. Spelt wheat has shown potential in various food applications, including bread, pasta, breakfast cereal and other products of altered nutritional characteristics compared to conventional wheat products. It has very high protein content and even 30 to 60% higher concentration of mineral elements Fe, Zn, Cu, Mg and P compared to Triticum Aestivum. Spelt wheat is growing without the use of pesticides in harsh ecological conditions and it is an old cultivar. So it can be used for organic and health safe food. Changes in the formulation of bread with the aim to improve their nutritional and functional properties usually lead to changes in the dough properties which is related reflected to the quality of the finished product. The aim of this paper is researching the impact of adding yeast extract to bread on sensory characteristics and consumer acceptance of a new product as a key factor for successful marketing of a new product. The sensory analysis of bread with 5% yeast extract is as follows: the technological quality is very good (3.8) and the color of the product is excellent (4.85). Based on data consumers survey declared that they liked the taste of bread with 5% yeast extract (74%), consumers marked the product as likeable (70%), and 75% of the total number of respondents would buy this new product. This paper is promoting a new type of bread with 5% yeast extract (Z score 0.80) to improve diet and novel functional product which intended for consumers conscious about their health and diet.

Keywords: bread, yeast extract, sensory analysis, consumer survey, score analysis Z

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Authors: Muna Jalal Ali, Essam A. Makky, Mashitah M. Yusoff

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Objectives: The aim of this study to evaluate the antimicrobial susceptibility of combined toothpaste with medicinal plants and the relations between the commercial toothpaste to its price and the patient age as well. Materials and Methods: Oral isolates of different patients aged 3 to 60 years were obtained, purified, and tested against four different ethnomedicinal plant extracts for antimicrobial activity. A total of 10 different commercial toothpastes (different brands and prices) were collected from the market, and the combined action of the medicinal plants and toothpaste was studied. Results: We found a higher bacterial population in the age group of 3–40 years than the group of 40–60 years, with approximately 44% and 32%, respectively. The combined action of ethanolic extract (alone) against oral isolates showed a synergistic effect, with 32.20, 30.50, and 25.42% for combinations A (Ci/Ca), B (Ci/Ca/P), and C (Ci/Ca/P/N), respectively. By contrast, the combined action of ethnomedicinal plants with 10 different toothpastes improved the antimicrobial sensitivity by 60, 100, and 0% for combinations A, B, and C respectively. Clinical relevance: The ethanolic extract of only combinations A and B with commercial toothpaste showed high antibacterial activity against oral isolates and the effectiveness of toothpaste is not related to the price.

Keywords: microbial evolution, oral isolates, ethnomedicinal plants, antimicrobial activity, toothpaste

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Authors: O. Maranci, A. B. Tugrul

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Scintigraphy is an imaging method of nuclear events provoked by collisions or charged current interactions with radiation. It is used for diagnostic test used in nuclear medicine via radiopharmaceuticals emitting radiation which is captured by gamma cameras to form two-dimensional images. Liver scintigraphy is widely used in nuclear medicine.Tc-99m and Cr-51 gamma radioisotopes can be used for this purpose. Cr-51 usage is more important for patients’ organ dose that has higher energy and longer half-life as compared to Tc-99m. In this study, it is aimed to determine the required dose for critical organs of patient through liver scintigraphy via Cr-51 gamma radioisotope. Experimental studies were conducted on patients even though conducting experimental studies on patients is extremely difficult for determination of critical organ doses. Torso phantom was utilized to simulate the liver scintigraphy by using 20 mini packages of Cr-51 that were placed on the organ. The radioisotope was produced by irradiation in central thimble of TRIGA MARK II Reactor at 250 KW power. As the results of the study, critical organ doses were determined and evaluated with different critic organs.

Keywords: critical organ doses, liver, scintigraphy, TRIGA Mark-II

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Authors: Md. Abu Sufian, Robiqul Islam, Imam Hossain Shajid, Mahesh Hanumanthu, Jarasree Varadarajan, Md. Sipon Miah, Mingbo Niu

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Coronary Heart Disease (CHD) remains a principal cause of global morbidity and mortality, characterized by atherosclerosis—the build-up of fatty deposits inside the arteries. The study introduces an innovative methodology that leverages cloud-based platforms like AWS Live Streaming and Artificial Intelligence (AI) to early detect and prevent CHD symptoms in web applications. By employing novel simulation processes and AI algorithms, this research aims to significantly mitigate the health and societal impacts of CHD. Methodology: This study introduces a novel simulation process alongside a multi-phased model development strategy. Initially, health-related data, including heart rate variability, blood pressure, lipid profiles, and ECG readings, were collected through user interactions with web-based applications as well as API Integration. The novel simulation process involved creating synthetic datasets that mimic early-stage CHD symptoms, allowing for the refinement and training of AI algorithms under controlled conditions without compromising patient privacy. AWS Live Streaming was utilized to capture real-time health data, which was then processed and analysed using advanced AI techniques. The novel aspect of our methodology lies in the simulation of CHD symptom progression, which provides a dynamic training environment for our AI models enhancing their predictive accuracy and robustness. Model Development: it developed a machine learning model trained on both real and simulated datasets. Incorporating a variety of algorithms including neural networks and ensemble learning model to identify early signs of CHD. The model's continuous learning mechanism allows it to evolve adapting to new data inputs and improving its predictive performance over time. Results and Findings: The deployment of our model yielded promising results. In the validation phase, it achieved an accuracy of 92% in predicting early CHD symptoms surpassing existing models. The precision and recall metrics stood at 89% and 91% respectively, indicating a high level of reliability in identifying at-risk individuals. These results underscore the effectiveness of combining live data streaming with AI in the early detection of CHD. Societal Implications: The implementation of cloud-based AI for CHD symptom detection represents a significant step forward in preventive healthcare. By facilitating early intervention, this approach has the potential to reduce the incidence of CHD-related complications, decrease healthcare costs, and improve patient outcomes. Moreover, the accessibility and scalability of cloud-based solutions democratize advanced health monitoring, making it available to a broader population. This study illustrates the transformative potential of integrating technology and healthcare, setting a new standard for the early detection and management of chronic diseases.

Keywords: coronary heart disease, cloud-based ai, machine learning, novel simulation techniques, early detection, preventive healthcare

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Authors: Dalia Almaghaslah

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Design thinking approach; empathize, define, ideate prototype, test, implement, was used to assess outpatient experiences in two hospital pharmacies in the Asir region, Saudi Arabia. Semi-structured interviews were conducted with 40 patients. The data were analyzed using thematic analysis. The findings suggested that patients were generally satisfied with pharmaceutical services provided in both pharmacies. Pharmacists were found to have enough knowledge, good attitude, and efficient communication and counselling skills. Non-pharmacy-related factors such as cultural factors (gender segregation), long waiting times, uncomfortable waiting areas, lack of electronic prescribing, number waiting system were found to have a negative impact on patients' experiences and satisfaction. Prototypes will be used to test the effects of implementing the electronic system in Al -mahal hospital and to test changing the physical layout of the waiting area in Asir hospital.

Keywords: design thinking, hospital pharmacy, patient satisfaction, Saudi Arabia

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Authors: Rose Lastovicka, Bernard Guy, Diana Burton

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Greek myth and art acted as tools to think with, and a lens through which to explore complex topics as a form of social media. In particular, coins were a form of propaganda to communicate the wealth and power of the city-states they originated from as they circulated from person to person. From this, how can the application of 3D printing technologies explore the infusion of ancient forms with contemporary commentaries to promote discussion? The digital reconstruction of artifacts is a topic that has been researched by various groups all over the globe. Yet, the exploration of Greek myth through artifacts infused with contemporary issues is currently unexplored in this medium. Using the Stratasys J750 3D printer - a multi-material, full-colour 3D printer - a series of coins inspired by ancient Greek currency and myth was created to present commentaries on the adversities surrounding individuals in the LGBT+ community. Using the J750 as the medium for expression allows for complete control and precision of the models to create complex high-resolution iconography. The coins are printed with a hard, translucent material with coloured 3D visuals embedded into the coin to then be viewed in close contact by the audience. These coins as commentaries present an avenue for wider understanding by drawing perspectives not only from sources concerned with the contemporary LGBT+ community but also from sources exploring ancient homosexuality and the perception and regulation of it in antiquity. By displaying what are usually points of contention between anti- and pro-LGBT+ parties, this visual medium opens up a discussion to both parties, suggesting heritage can play a vital interpretative role in the contemporary world.

Keywords: 3D printing, design, Greek mythology, LGBT+ community

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Authors: Chanpen Meenakorn

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This research aimed to examine the relationships between customer expectations and service quality management of Banpaew Hospital Samutsakorn in Thailand. The study sample consisted of 360 customers in patient unit. Data were collected using self-administered questionnaire. Descriptive statistics used were percentage, mean, and standard deviation. The analytical statistics comprised Pearson’s product moment correlation coefficient analysis. The result showed that service quality of nurses was very good with sustainable development trend. Physical evidence was at a high level, and the process and personal were rated at a high level. Additional, the study suggested that head nurse should be encouraged to improve service quality management, management training. Nurse administrators should create an appropriate nursing department climate, and provide necessary resources in the department. In addition, the nurse administrators should continuously follow up the results of customer expectations and focus on patients/customers, process management, information and knowledge management, and evaluation of service quality also.

Keywords: Banpaew Hospital, Customer Expectations, Service Provided, Samutsakorn

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Authors: B. Manyonga

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Across the world, higher education (HE) is expanding rapidly and issues of curriculum change have become more contentious and political than ever before. Although research informing curricula review in social sciences and particularly sociology has been conducted, much analysis has been devoted to teaching and transmitting disciplinary knowledge, student identity and epistemology, with little focus on curriculum conceptualisation and capability formation. This paper builds on and contributes to accumulating knowledge in the field of sociology curriculum design in the South African HE context. Drawing from the principles of Capabilities Approach (CA) of Amartya Sen and Martha Nussbaum, the paper argues that sociology curriculum conceptualisation may be enriched by capabilities identification for students. Thus, the sociological canon ought to be the vehicle through which student capabilities could be developed. The CA throws a fresh light on how curriculum ought to be designed to offer students real opportunities, expanding choices for individuals to be what they want to be and do. The paper uses a case of two South African universities to present analysis of qualitative data collected from undergraduate sociology lecturers. The major findings of the paper indicate that there is no clear philosophy guiding the conceptualisation of curriculum. The conceptualisation is based on lecturer expertise, carrying out research, response to topical and societal issues. Sociology lecturers highlighted that they do not consult students on what they want to do and to be as a result of studying for a sociology degree. Although lecturers recognise some human development capabilities such as critical thinking, multiple perspectives and problem solving as important for sociology students, there is little evidence to illustrate how these are being cultivated in students. Taken together, the results suggest that sociological canon is being regarded as the starting point for curriculum planning and construction.

Keywords: capabilities approach, graduate attributes, higher education, sociology curriculum

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Authors: Priyanwada I. Singhapathirana

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The public land ownership is a common phenomenon in many countries in the world however, the development approaches and the institutional structures are greatly diverse. The existing scholarship around public land development has been greatly limited to Europe and advanced Asian economies. Inferences of such studies seem to be inadequate and inappropriate to comprehend the peculiarities of public land development in developing Asian economies. The absence of critical inquiry on the public land ownership and the long-established institutional structures which govern the development has restrained these countries from institutional innovations. In this context, this research investigates the issues related to public land development and the institutional responses in Sri Lanka. This study introduces the concept of ‘Institutional Responsiveness’ in Public land development, which is conceptualized as the ability of the institutions to respond to the spatial, market and fiscal stimulus. The inquiry was carried out through in-depth interviews with five key informants from apex public agencies in order to explore the responsiveness of land institutions form decision-makers' perspectives. Further, the analysis of grey literature and recent media reports are used to supplement the analysis. As per the findings, long term abandonment of public lands and high transaction costs are some of the key issues in relation to public land development. The inability of the institutions to respond to the market and fiscal stimulus has left many potential public lands underutilized. As a result, the public sector itself and urban citizens have not been able to relish the benefits of the public lands in cities. Spatial analysis at the local scale is suggested for future studies in order to capture the multiple dimensions of the responsiveness of institutions to the development stimulus.

Keywords: institutions, public land, responsiveness, under-utilization

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Authors: S. M. Arciniegas, D. Vargas, L. Gutierrez

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The aim of this study was to develop oral drug presentation of doxycycline hyclate that maintains longer therapeutic levels than conventional forms. A polymethacrylate and acrylic acid based matrix were used in different proportions to obtain controlled-release formulations; DOX1 (1:0.25:0.0035), DOX2 (1:2:0.0225) and DOX-C (without excipients). All were tested in vivo in healthy dogs and their serum concentrations vs. time profile was investigated after its oral administration in this species. DOX1 and DOX2 show therapeutic concentrations for 60 hours, while DOX-C only for 24 hours. The pharmacokinetics values tested were K½el, Cmax, Tmax, AUC, AUC∞, AUCt, AUMC, RT, Kel, Vdss, Clb and Frel. DOX1 does not differ significantly from DOX-C, but shows significant differences in all variables with DOX2 (p<0.05). In conclusion, DOX1 presents best pharmacokinetics for time-dependent drug and longer release time of 60 hours, thereby reducing the frequency of administration, the patient's stress, the occurrence of adverse effects and the cost of treatment.

Keywords: tetracyclines, long-acting, sustained-release, carbopol, eudragit, canine

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Authors: Supriyo Das, Elbir Jove, Ajay Singh, Sophie Corbet, Noel Carr, Martin Deetz

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Water is a critical commodity in the healthcare and medical field. The utility of medical-grade water spans from washing surgical equipment, drug preparation to the key element of life-saving therapy such as hydrotherapy and hemodialysis for patients. A properly treated medical water reduces the bioburden load and mitigates the risk of infection, ensuring patient safety. However, any compromised condition during the production of medical-grade water can create a favorable environment for microbial growth putting patient safety at high risk. Therefore, proper upstream treatment of the medical water is essential before its application in healthcare, pharma and medical space. Reverse Osmosis (RO) is one of the most preferred treatments within healthcare industries and is recommended by all International Pharmacopeias to achieve the quality level demanded by global regulatory bodies. The RO process can remove up to 99.5% of constituents from feed water sources, eliminating bacteria, proteins and particles sizes of 100 Dalton and above. The combination of RO with other downstream water treatment technologies such as Electrodeionization and Ultrafiltration meet the quality requirements of various pharmacopeia monographs to produce highly purified water or water for injection for medical use. In the reverse osmosis process, the water from a liquid with a high concentration of dissolved solids is forced to flow through an especially engineered semi-permeable membrane to the low concentration side, resulting in high-quality grade water. However, these specially engineered RO membranes need to be sanitized either chemically or at high temperatures at regular intervals to keep the bio-burden at the minimum required level. In this paper, we talk about Dupont´s FilmTec Heat Sanitizable Reverse Osmosis membrane (HSRO) for the production of medical-grade water. An HSRO element must be pre-conditioned prior to initial use by exposure to hot water (80°C-85°C) for its stable performance and to meet the manufacturer’s specifications. Without pre-conditioning, the membrane will show variations in feed pressure operations and salt rejection. The paper will discuss the critical variables of pre-conditioning steps that can affect the overall performance of the HSRO membrane and demonstrate the data to support the need for pre-conditioning of HSRO elements. Our preliminary data suggests that there can be up to 35 % reduction in flow due to initial heat treatment, which also positively affects the increase in salt rejection. The paper will go into detail about the fundamental understanding of the performance change of HSRO after the pre-conditioning step and its effect on the quality of medical water produced. The paper will also discuss another critical point, “regular hot water sanitization” of these HSRO membranes. Regular hot water sanitization (at 80°C-85°C) is necessary to keep the membrane bioburden free; however, it can negatively impact the performance of the membrane over time. We will demonstrate several data points on hot water sanitization using FilmTec HSRO elements and challenge its robustness to produce quality medical water. The last part of this paper will discuss the construction details of the FilmTec HSRO membrane and features that make it suitable to pre-condition and sanitize at high temperatures.

Keywords: heat sanitizable reverse osmosis, HSRO, medical water, hemodialysis water, water for Injection, pre-conditioning, heat sanitization

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Authors: Ahlam Alnatour

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Background: To our knowledge, there is lack of studies that describe the experience of studying health promotion courses using an interactive approach, and compare students’ and teachers perceptions about this method of teaching. The purpose of this study is to provide a comparison between student and teacher experiences and perspectives in learning health promotion course using interactive learning. Design: A descriptive qualitative design was used to provide an in-depth description and understanding of students’ and teachers experiences and perceptions of learning health promotion courses using an interactive learning. Study Participants: About 14 fourteen students (seven male, seven female) and eight teachers at governmental university in northern Jordan participated in this study. Data Analysis: Conventional content analysis approach was used for participants’ scripts to gain an in-depth description for both students' and teacher’s experiences. Results: The main themes emerged from the data analysis describing the students’ and teachers perceptions of the interactive health promotion class: teachers’ and students positive experience in adopting interactive learning, advantages and benefits of interactive teaching, barriers to interactive teaching, and suggestions for improvement. Conclusion: Both teachers and students reflected positive attitudes toward interactive learning. Interactive learning helped to engage in learning process physically and cognitively. Interactive learning enhanced learning process, promote student attention, enhanced final performance, and satisfied teachers and students accordingly. Interactive learning approach should be adopted in teaching graduate and undergraduate courses using updated and contemporary strategies. Nursing scholars and educators should be motivated to integrate interactive learning in teaching different nursing courses.

Keywords: interactive learning, nursing, health promotion, qualitative study

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Authors: C. Galasso

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The ancestral relationship between humans and geographical environment has long been at the center of an interdisciplinary dialogue, which sees one of its main research nodes in the relationship between memory and places. Given its deep complexity, this symbiotic connection continues to look for a proper definition that appears increasingly negotiated by different disciplines. Numerous fields of knowledge are involved, from anthropology to semiotics of space, from photography to architecture, up to subjects traditionally far from these reasonings. This is the case of Design of Communication, a young discipline, now confident in itself and its objectives, aimed at finding and investigating original forms of visualization and representation, between sedimented knowledge and new technologies. In particular, Design of Communication for the Territory offers an alternative perspective to the debate, encouraging the reactivation and reconstruction of the memory of places. Recognizing mnemotopes as a cultural object of vertical interpretation of the memory-place relationship, design can become a real mediator of the territorial fixation of memories, making them increasingly accessible and perceptible, contributing to build a topography of memory. According to a mnemotopic vision, Communication Design can support the passage from a memory in which the observer participates only as an individual to a collective form of memory. A mnemotopic form of Communication Design can, through geolocation and content map-based systems, make chronology a topography rooted in the territory and practicable; it can be useful to understand how the perception of the memory of places changes over time, considering how to insert them in the contemporary world. Mnemotopes can be materialized in different format of translation, editing and narration and then involved in complex systems of communication. The memory of places, therefore, if stabilized by the tools offered by Communication Design, can make visible ruins and territorial stratifications, illuminating them with new communicative interests that can be shared and participated.

Keywords: memory of places, design of communication, territory, mnemotope, topography of memory

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Authors: Deng Qiaoshan

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With the rise of feminism in the global film industry, feminist expressions in Chinese films have also evolved, reflecting societal focus on gender issues. This article focuses on young Chinese female directors such as Yang Lina, Teng Congcong, and Yang Mingming. Their films now present richer female perspectives and consciously incorporate unique female life experiences. They highlight women's real-life struggles, portraying ’struggling’ female identities—characters facing professional failures and desire identity issues, ultimately returning to family roles. These films commonly explore the ‘mother-daughter relationship’, with some using genre storytelling for commercial appeal and others deconstructing the ‘myth of motherhood’ to reflect reality, rewriting traditional maternal roles. The ‘struggling’ female identity in these directors' films shows an aesthetic of ‘pseudo-reality’, blending realistic situations with poetic, lyrical elements, reflecting their creative traits and internal conflicts. These contradictions are closely related to the unique creative context of Chinese cinema in which they operate. Emerging under China's strict film censorship system, film industrialization, consumerist culture, and internet environment, new-generation directors face multiple demands. How to ‘survive’ amidst complex commercial requirements while creating films with a clear feminist consciousness is the fundamental dilemma faced by young Chinese female directors.

Keywords: female directors, feminism film, female dilemma, film censorship system

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Authors: Odoh Ben Uruchi

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Access to Justice implies access to social and distributive Justice. Access to social justice in Nigeria remains an illusion where cases last in courts for unduly long period of time, as is currently the situation in the country. As the popular saying goes– justice delayed is justice denied. It is, however, important to underscore the point that these perspectives are not necessarily disconnected since the extent to which one can have distributive justice in any system is largely determined by the level and effectiveness of social justice in the country. Generally, Alternative Dispute Resolution (ADR) Processes are increasingly being accepted in Nigeria as appropriate mechanisms for resolving disputes. While some jurisdictions have institutionalized ADR through the concept of a Multidoor Courthouse, many other are at different stages of doing same. With these developments, it is obvious that stakeholders in the administration of justice in Nigeria, can no longer be indifferent about understanding and fully mainstreaming ADR into their various activities and professional practice. Any framework for promoting social justice in Nigeria should therefore of necessity include provision of avenues for use of ADR in the protection and enforcement of citizen’s rights. The constitutional and other legal provisions that guarantee various rights of citizens cannot of itself ensure the enjoyment of the rights in the absence of an effective framework for dispute resolution. Excessive reliance on litigation and other adversarial approaches will also fail to ensure a sound regime of social justice. There should be structured mainstreaming of alternative dispute resolution mechanisms in justice delivery if the society must provide and guarantee social justice to the citizens. This paper seeks to address some of the fundamental issues affecting the perception, knowledge and skills of ADR in the provision of social justice. In doing this, the paper proposes to unlock the full enormous potentials of Alternative Dispute Resolution (ADR) in promoting access to justice in Nigeria.

Keywords: aspects, dimensions, alternative dispute resolution, social justice

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Authors: R. Pardo, P. Menendez, MA Gil-Olarte, S. Sanchez, E. García, R. Quintana, J. Martín

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Introduction : Within oncoplastic breast techniques there is increased interest in immediate partial breast reconstruction. The volume resected is greater than that of conventional conservative techniques. Central tumours of the breast have classically been treated with a mastectomy with regard to oncological safety and cosmetic secondary effects after wide central resection of the nipple and breast tissue beneath. Oncological results for central quadrantectomy have a recurrence level, disease- free period and survival identical to mastectomy. Grissoti flap is an oncoplastic surgical technique that allows the surgeon to perform a safe central quadrantectomy with excellent cosmetic results. Material and methods: The Grissoti flap is a glandular cutaneous advancement rotation flap that can fill the defect in the central portion of the excised breast. If the inferior border is affected by tumour and further surgery is decided upon at the Multidisciplinary Team Meeting, it will be necessary to perform a mastectomy. All patients with a Grisotti flap undergoing surgery since 2009 were reviewed obtaining the following data: age, hystopathological diagnosis, size, operating time, volume of tissue resected, postoperative admission time, re-excisions due to positive margins affected by tumour, wound dehiscence, complications and recurrence. Analysis and results of sentinel node biopsy were also obtained. Results: 12 patients underwent surgery between 2009-2015. The mean age was 54 years (34-67) . All had a preoperative diagnosis of ductal infiltrative carcinoma of less than 2 cm,. Diagnosis was made with Ultrasound, Mamography or both . Magnetic resonance was used in 5 cases. No patients had preoperative positive axilla after ultrasound exploration. Mean operating time was 104 minutes (84-130). Postoperative stay was 24 hours. Mean volume resected was 159 cc (70-286). In one patient the surgical border was affected by tumour and a further procedure with resection of the affected border was performed as ambulatory surgery. The sentinel node biopsy was positive for micrometastasis in only two cases. In one case lymphadenectomy was performed in 2009. In the other, treated in 2015, no lymphadenectomy was performed as the patient had a favourable histopathological prognosis and the multidisciplinary team meeting agreed that lymphadenectomy was not required. No recurrence has been diagnosed in any of the patients who underwent surgery and they are all disease free at present. Conclusions: Conservative surgery for retroareolar central tumours of the breast results in good local control of the disease with free surgical borders, including resection of the nipple areola complex and pectoral major muscle fascia. Reconstructive surgery with the inferior Grissoti flap adequately fills the defect after central quadrantectomy with creation of a new cutaneous disc where a new nipple areola complex is reconstructed with a local flap or micropigmentation. This avoids the need for contralateral symmetrization. Sentinel Node biopsy can be performed without added morbidity. When feasible, the Grissoti flap will avoid skin-sparing mastectomy for central breast tumours that will require the use of an expander, prosthesis or myocutaneous flap, with all the complications of a more complex operation.

Keywords: Grisotti flap, oncoplastic surgery, central tumours, breast

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Authors: Tosin T. Oye, Keng Goh, Naren Gupta, Toyosi K. Oye

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One of the most extreme difficulties confronting humankind in the twenty-first century is the consumption of energy. Non-renewable energy sources have been the fundamental energy assets for human culture. The consumption of energy sources emanating from the use of air-conditioning is still causing and has caused harm to the environment and human health. The request for energy could be double or perhaps triple in the future because of the utilization of air-conditioning systems as the worldwide population develops and emerging districts grow their economics. This has recently raised worries in sustainable development over climate change, global warming, ozone layer reduction, health issues, and possible supply problems. As a result of the improvement of way of life, air-conditioning has generally been applied. Nevertheless, environmental pollutions and health issues related with the use of air-conditioning unfolds more as often as possible. In order to diminish their level of undesirable impact on the environment, it is essential to establish suitable strategies for tackling climate change. Therefore, this paper aims to review and analyze studies in sustainability and air- conditioning and subsequently suggest strategies for combatting climate change. Future perspectives for tackling climate change are likewise suggested. The key findings revealed that it is required to establish sustainability measures to reduce the level of energy consumption and carbon emissions in a bid to effectively tackle climate change and its impact on the environment, and then raise public alertness towards the adverse impact of climate change arising from the use of air-conditioning systems. The research outcome offers valuable awareness to the general public, organizations, policymakers, and the government in making future municipal zones sustainable and more climate resilient.

Keywords: air-conditioning, climate change, environment, human health, sustainability

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Authors: Aref Zribi, Sonia Ben Nasr, Sana Fendri, Mahdi Balti, Abderazzek Haddaoui

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Background: Despite their benefit, Endocrine therapies (ET) are known to have substantial adverse events (AEs) such as hot flashes, mood disorders and osteoarticular pain. ET induced alopecia(EIA) is less frequently noted by patients and is less reported in the literature. The aim of our study was to report ET alopecia characteristics and their influence on patient and treatment observance. Method: We conducted a retrospective study including luminal BC patients treated in the oncology department of the military hospital of Tunis between January 2015 and December 2020. Patients treated with previous chemotherapy-inducing alopecia were excluded. Results: 145 female patients were included. The median age was 59 years. EIA was reported in 44% of cases. Alopecia was attributed to aromatase inhibitors in 53% and tamoxifen in 21%. Severity was grade 1 in 80% and grade 2 in the remaining cases. ET discontinuation because of alopecia was noted in 6.5 % of patients. Moderate improvement of alopecia was observed with topical minoxidil and Thallium metallicum 9CH homeopathy during ET in 60% of patients. Conclusions: EIA is frequent in BC patients and should be considered to improve treatment observance and patients’ quality of life.

Keywords: endocrine therapy, alopecia, breast cancer, Tunisia

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