Search results for: health care professional-patient relation

Authors: Farrin Nayebzadeh, Mohammadreza Eslami Amirabadi

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According to technological progress and urban development, the cities of the world are growing to become metropolitans, living in which can be enthusiastic, entertaining and accessibility to the facilities like education, economic factors, hygiene and welfare is high. On the other hand, there are some problems that have been ignored in planning for such high quality of life, most important of which, is human health. Two aspects of human health are physical health and mental health, that are closely associated. Human mental health depends on two important factors: Biological factor and environmental factor. Air pollution is one of the most important environmental risk factors that affects mental health. Psychological and toxic effects of air pollution can lead to psychiatric symptoms, including anxiety and changes in mood, cognition, and behavior, depression and also children's mental disorders like hyperactivity, aggression and agitation. Increased levels of some air pollutants are accompanied by an increase in psychiatric admissions and emergency calls and, in some studies, by changes in behavior and a reduction in psychological well-being. Numerous toxic pollutants interfere with the development and adult functioning of the nervous system. Psychosocial stress can cause symptoms similar to those of organic mental disorders. These factors can cause resonance of psychiatric disorders. So, in cities of developing countries, people challenge with mental health problems due to environmental factors especially air pollution that have not been forecasted in urban planning.

Keywords: air pollution, environmental factors, mental health, psychiatric disorder

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Authors: Vathsala Kaluarachchi, Oshani Wimalarathna, Charith Vandebona, Gayani Chandrarathna, Lakmal Rupasinghe, Windhya Rankothge

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It is the fundamental function of a monitoring system to allow users to collect and process data. A worldwide threat, the corona outbreak has wreaked havoc in Sri Lanka, and the situation has gotten out of hand. Since the epidemic, the Sri Lankan government has been unable to establish a systematic system for monitoring corona patients and providing emergency care in the event of an outbreak. Most patients have been held at home because of the high number of patients reported in the nation, but they do not yet have access to a functioning medical system. It has resulted in an increase in the number of patients who have been left untreated because of a lack of medical care. The absence of competent medical monitoring is the biggest cause of mortality for many people nowadays, according to our survey. As a result, a smartphone app for analyzing the patient's state and determining whether they should be hospitalized will be developed. Using the data supplied, we are aiming to send an alarm letter or SMS to the hospital once the system recognizes them. Since we know what those patients need and when they need it, we will put up a desktop program at the hospital to monitor their progress. Deep learning, image processing and application development, natural language processing, and blockchain management are some of the components of the research solution. The purpose of this research paper is to introduce a mechanism to connect hospitals and patients even when they are physically apart. Further data security and user-friendliness are enhanced through blockchain and NLP.

Keywords: blockchain, deep learning, NLP, monitoring system

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Authors: Joyraj Chakraborty, Geoffrey Ottoy, Jean-Pierre Goemaere, Lieven De Strycker

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Sensor swarms can be a cost-effectieve and more user-friendly alternative for location based service systems in different application like health-care. To increase the lifetime of such swarm networks, the energy consumption should be scaled to the required localization accuracy. In this paper we have investigated some parameter for energy model that couples localization accuracy to energy-related sensor parameters such as signal length,Bandwidth and sample frequency. The goal is to use the model for the localization of undetermined environmental sounds, by means of wireless acoustic sensors. we first give an overview of TDOA-based localization together with the primary sources of TDOA error (including reverberation effects, Noise). Then we show that in localization, the signal sample rate can be under the Nyquist frequency, provided that enough frequency components remain present in the undersampled signal. The resulting localization error is comparable with that of similar localization systems.

Keywords: sensor swarms, localization, wireless sensor swarms, scalable energy

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Authors: Monday Agbonica Bello Eje

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The language of the print media is characterized by the use of apposition. This linguistic element function strategically in journalistic discourse where it is communicatively necessary to name individuals and provide information about them. Linguistic studies on the language of the print media with bias for apposition have largely dwelt on other areas but the examination of the typology of appositive reference in newspaper discourse. Yet, it is capable of revealing ways writers communicate and provide information necessary for readers to follow and understand the message. The study, therefore, analyses the patterns of appositional occurrences and the typology of reference in newspaper articles. The data were obtained from The Punch and Daily Trust Newspapers. A total of six editions of these newspapers were collected randomly spread over three months. News and feature articles were used in the analysis. Guided by the referential theory of meaning in discourse, the appositions identified were subjected to analysis. The findings show that the semantic relation of coreference and speaker coreference have the highest percentage and frequency of occurrence in the data. This is because the subject matter of news reports and feature articles focuses on humans and the events around them; as a result, readers need to be provided with some form of detail and background information in order to identify as well as follow the discourse. Also, the non-referential relation of absolute synonymy and speaker synonymy no doubt have fewer occurrences and percentages in the analysis. This is tied to a major feature of the language of the media: simplicity. The paper concludes that appositions is mainly used for the purpose of providing the reader with much detail. In this way, the writer transmits information which helps him not only to give detailed yet concise descriptions but also in some way help the reader to follow the discourse.

Keywords: apposition, discourse, newspaper, Nigeria, reference

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Authors: Jou-An Chen, Julio Castillo, Errol Duncan Cason, Gabre Kemp, Leana Esterhuizen, Angel Valverde Portal, Esta Van Heerden

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Emerging contaminants (EC) such as pharmaceutical and personal care products have been accumulating for years in water bodies all over the world. However, very little is known about the occurrences, levels, and effects of ECs in South African water resources. This study provides an initial assessment of the distribution of eight ECs (Acetaminophen, Atrazine, Terbuthlyazine, Carbamazepine, Phenyton, Sulfmethoxazole, Nevirapine and Fluconozole) in fifteen water sources from the Free State and Easter Cape provinces of South Africa. Overall, the physiochemical conditions were different in surface and groundwater samples, with concentrations of several elements such as B, Ca, Mg, Na, NO3, and TDS been statistically higher in groundwater. In contrast, ECs levels, quantified at ng/mL using the LC/MS/ESI, were much lower in groundwater samples. The ECs with higher contamination levels were Carbamazepine, Sulfmethoxazole, Nevirapine, and Terbuthlyazine, while the most widespread were Sulfmethoxazole and Fluconozole, detected in all surface and groundwater samples. Fecal and E. coli tests indicated that surface water was more contaminated than groundwater. Microbial communities, assessed using NGS, were dominated by the phyla Proteobacteria and Bacteroidetes, in both surface and groundwater. Actinobacteria, Planctomycetes, and Cyanobacteria, were more dominant in surface water, while Verrucomicrobia were overrepresented in groundwater. In conclusion, ECs contamination is closely associated with human activities (human wastes). The microbial diversity identified can suggest possible biodegradation processes.

Keywords: emerging contaminants, EC, personal care products, pharmaceuticals, natural attenuation process

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Authors: Seham Alsaif, Susan Wray

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Obesity is a worldwide disorder influencing women’s health and childbearing. There is a close relation between obesity and pregnancy related complications. Dyslipidemia and adipokine dysregulation are core environmental changes that may mechanistically link these complications with obesity in pregnant women. We have previously found that visfatin has a relaxant effect on mouse, rat and human myometrial contractility. We hypothesised that visfatin inhibits mouse myometrial contractility through the NAD+ pathway. This study was designed to examine the mechanism of action of visfatin on myometrial contractility. To examine the NAD+ pathway, FK866 which is a potent inhibitor of NAD+ biosynthesis was used. Methods: Myometrial strips from term pregnant mice were dissected, superfused with physiological saline and the effects of visfatin (10nM) on oxytocin-induced contractions (0.5nM) alone and after the infusion of FK866 (10uM) were studied. After regular contractions were established, contractility was examined for control (100%) and test response at 37 °C for 10 min each. Results: FK866 was found to inhibit the effect of visfatin on myometrial contractility (the AUC increased from 89±2% of control, P=0.0009 for visfatin alone to 97±4% of control, P>0.05 for visfatin combined with FK866, n=8). In conclusion, NAD+ pathway appears to be involved in the mechanism of action of visfatin on mouse myometrium. This could have a role in making new targets to prevent obesity-related complications.

Keywords: myometrium, obesity, oxytocin, pregnancy, visfatin

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Authors: Nikolaos Souvlakis

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One of the prominent phenomena that have survived even in the 21st century, when science is gaining more and more space in the scientific world, is the evil eye within non-Westernized societies and more specifically in Greek culture. The presentation is based on the Christian Orthodox beliefs and folklore about the evil eye. Evil eye occupies an important role in individuals' everyday life and it is fuelled by Satanic powers. Satanic powers and the belief on them have an immense effect on individual's well-being and mental health causing spiritual suffering. The present paper examines the psychological manifestations of the belief of evil eye in individuals' mental health and the ways to protect from it according to the Greek Orthodox tradition.

Keywords: spirituality, belief, evil eye, mental health, well-being, healing

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Authors: Safdari Reza, Zahmatkeshan Maryam, Goli Arji

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Background and Aim: Urban health is one of the challenges of the 21st century. Rapid growth and expanding urbanization have implications for health. In this regard, information technology can remove a large number of modern cities’ problems. Therefore, the present article aims to study modern information technologies in the development of urban health. Materials and Methods:. This is a review article based on library research and Internet searches on valid websites such as Science Direct, Magiran, Springer and advanced searches in Google. Some 164 domestic and foreign texts were studied on such topics as the application of ICT tools including cell phones and wireless tools, GIS, and RFID in the field of urban health in 2011. Finally, 30 sources were used. Conclusion: Information and communication technologies play an important role in improving people's health and enhancing the quality of their lives. Effective utilization of information and communication technologies requires the identification of opportunities and constraints, and the formulation of appropriate planning principles with regard to social and economic factors together with preparing the technological, communication and telecommunications, legal and administrative infrastructures.

Keywords: Urban Health, Information Technology, Information & Communication, Technology

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Authors: Lateef Bamidele

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Over the years, radiographic examinations are the most used diagnostic tools in the Nigerian health care system, but most diagnostic examinations carried out do not have records of patient doses. Lack of adequate information on patient doses has been a major hindrance in quantifying the radiological risk associated with radiographic examinations. This study aimed at estimating dose–area product (DAP) of patient examined in X-Ray units in selected hospitals in Southern Nigeria. The standard projections selected are chest posterior-anterior (PA), abdomen anterior-posterior (AP), pelvis AP, pelvis lateral (LAT), skull AP/PA, skull LAT, lumbar spine AP, lumbar spine, LAT. Measurement of entrance surface dose (ESD) was carried out using thermoluminescent dosimeter (TLD). Measured ESDs were converted into DAP using the beam area of patients. The results show that the mean DAP ranged from 0.17 to 18.35 Gycm². The results obtained in this study when compared with those of NRPB-HPE were found to be higher. These are an indication of non optimization of operational conditions.

Keywords: dose–area product, radiographic examinations, patient doses, optimization

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Authors: Ahmed Mudi, Bala Zakar

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The paper assesses the impact of safe motherhood initiative on maternal health of women in Gumel Local Government Area of Jigawa State. The work will specifically concentrate on the background on safe motherhood scheme and maternal health of women. The objective of this paper is to assess the level of safe motherhood scheme in Gumel local government area, to find out the level of maternal health in Gumel local government as well as to determine the impact of safe motherhood scheme on maternal health on women in Gumel Local Government Area Jigawa State. Various literature on the topic are reviewed, the paper adopts survey design and use questionnaire to collect data from the respondent. The study comprises 350 women selected from six rural communities in Gumel using random sampling techniques, and the data was analysed by simple frequency and percentage. The research concluded that safe motherhood initiative has a significant impact on the maternal health of women in Gumel Local Government Area of Jigawa State. Finally, suitable recommendations were given on how to improve the scheme to ensure better maternal health in the region.

Keywords: action, assessment, maternal health, safe motherhood, surgery

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Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

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Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

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Authors: Aline Giardin, Maria Rosa Chitolina, Maria Catarina Zanini

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In this paper, we analyze the conceptions of high school students about mental health issues, and discuss the creation of mental basic health programs in schools. We base our findings in a quantitative survey carried out by us with 156 high school students of CTISM (Colégio Técnico Industrial de Santa Maria) school, located in Santa Maria city, Brazil. We have found that: (a) 28 students relate the subject ‘mental health’ with psychiatric hospitals and lunatic asylums; (b) 28 students have relatives affected by mental diseases; (c) 76 students believe that mental patients, if treated, can live a healthy life; (d) depression, schizophrenia and bipolar disorder are the most cited diseases; (e) 84 students have contact with mental patients, but know nothing about the disease; (f) 123 students have never been instructed about mental diseases while in the school; and (g) 135 students think that a mental health program would be important in the school. We argue that these numbers reflect a vision of mental health that can be related to the reductionist education still present in schools and to the lack of integration between health professionals, sciences teachers, and students. Furthermore, this vision can also be related to a stigmatization process, which interferes with the interactions and with the representations regarding mental disorders and mental patients in society.

Keywords: mental health, schools, mental illness, conception

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Authors: Andrew Anis Fakhrey Mosaad

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Objectives: Physiotherapy in the intensive care unit (ICU) improves patient outcomes. We aimed to determine the characteristics of physiotherapy practice and critical barriers to applying physiotherapy in ICUs. Materials and Methods: A 54-item survey for determining the characteristics physiotherapists and physiotherapy applications in the ICU was developed. The survey was electronically sent to potential participants through the Turkish Physiotherapy Association network. Sixty-five physiotherapists (47F and 18M; 23–52 years; ICU experience: 6.0±6.2 years) completed the survey. The data were analyzed using quantitative and qualitative methods. Results: The duration of ICU practice was 3.51±2.10 h/day. Positioning (90.8%), active exercises (90.8%), breathing exercises (89.2%), passive exercises (87.7%), and percussion (87.7%) were the most commonly used applications. The barriers were related to physiotherapists (low level of employment and practice, lack of shift); patients (unwillingness, instability, participation restriction); teamwork (lack of awareness and communication); equipment (inadequacy, non-priority to purchase); and legal (reimbursement, lack of direct physiotherapy access, non-recognition of autonomy) procedures. Conclusion: The most common interventions were positioning, active, passive, breathing exercises, and percussion. Critical barriers toward physiotherapy are multifactorial and related to physiotherapists, patients, teams, equipment, and legal procedures. Physiotherapist employment, service maintenance, and multidisciplinary teamwork should be considered for physiotherapy effectiveness in ICUs.

Keywords: intensive care units, physical therapy, physiotherapy, exercises

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Authors: Mary Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Exposure to violence not only has negative psychological impact on children but is a risk factor for children becoming recurrent victims of violence. However, little is known regarding the degree to which child victims of violence are exposed to trauma at home and in their community, or its association with specific psychological diagnoses. Objective: The aims of this study were to perform in-depth characterizations of family, community and psychological wellness amongst pediatric victims of interpersonal violence. Methods: As standard of care at the Saint Louis Children’s Hospital pediatric emergency department (ED), social workers perform in-depth interviews with all children presenting due to violent interpersonal encounters. In this retrospective cross-sectional study, we collected data from social work interviews on family structure, exposure to violence in the community and the home, as well as history of psychological diagnoses amongst children ages 8-19 years who presented to the ED for injuries related to interpersonal violence from 2014-2017. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed. The average age of studied youths was 14.7 years (SD 2.5). Youths were 97.5% African American ethnicity and 66.6% male. 67.8% described their home having a nonnuclear family structure, 50% of which reported living with a single mother. Of the 21% who reported having incarcerated family members, 56.3% reported their father being incarcerated, 15% reported their mother being incarcerated, and 12.5% reported multiple family members being incarcerated. 11.3% reported witnessing domestic violence in their home. 12.8% of youths reported some form of child abuse. The type of child abuse was not specified in 29.3% of cases, but physical abuse (32.8%) followed by sexual abuse (22.4%) were the most commonly reported. 14.5% had history of placement in foster care and/or adoption. 64% reported having witnessed violence in their community. 30.2% reported having lost friends or family due to violence, and of those, 26.4% reported the loss of a cousin, 18.9% the loss of a friend, 16% the loss of their father, and 12.3% the loss of their brother due to violence. Of the 22.4% youths with psychiatric diagnose(s), 48.4% had multiple diagnoses, the most common of which were ADD/ADHD (62.6%), followed by depression (31.9%), bipolar disorder (27.5%) and anxiety (15.4%). Conclusions: A remarkable proportion of children presenting to EDs due to interpersonal violence have a history of exposure to instability and violence in their homes and communities. Additionally, psychological diagnoses are frequent among pediatric victims of violence. More research is needed to better understand the association between trauma exposure, psychological health and violent victimization amongst children.

Keywords: community violence, emergency department, pediatric interpersonal violence, pediatric trauma, psychological effects of trauma

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Authors: Zdravko Trivic, John Chye Fung, Ruzica Bozovic-Stamenovic

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Within the context of rapidly ageing population in Singapore and the pressing demands on both caregivers and care providers, an integrated approach to ageing-friendly and ability-sensitive enabling environment becomes an imperative. This particularly applies to nursing home environments and their immediate surroundings, as they are becoming one of the main available options of long-term care for many senior adults who are unable to age at home. Yet, despite the considerable efforts to break the still predominant clinical approach to eldercare and to introduce more home-like design and person-centric care model, nursing homes keep being stigmatised and perceived as not so desirable environments to grow old in. The challenges are further emphasised by the associated physical, sensorial, psychological and cognitive declines that are the common consequences of ageing. Such declines have an immense impact on almost all aspects of older adults’ daily functioning, including problems with mobility and spatial orientation, difficulties in communication, withdrawal from social interaction, higher level of depression and decreased sense of independence and autonomy. However, typical nursing home designs tend to neglect the full capacities of balanced and carefully integrated multisensory stimuli as active component of care and ability building. This paper outlines part of a larger multi-disciplinary study of six nursing homes in Singapore, with overarching objectives to create new models of supportive nursing home environments that go beyond the clinical care model and encourage community integration with the nursing home settings. The paper focuses on the largely neglected aspects of sensorial comfort and multi-sensorial properties of nursing homes, including both indoor and immediate outdoor spaces (boundaries). The objective was to investigate the sensory rhythms and explore their role in nursing home users’ daily routine and therapeutic capacities. Socio-sensory rhythms were captured and analysed through a combination of on-site sensory recordings of “objective” quantitative sensory data (air temperature and humidity, sound level and luminance) using multi-function environment meter, perceived experienced data, spatial mapping, first-person observations of nursing home users’ activity patterns, and interviews. This was done in addition to employment of available assessment tools, such as Wisconsin Person Directed Care assessment tool, Dementia Quality of Life [DQoL] instrument, and Resident Environment Impact Scale [REIS], as these tools address the issues of sensorial experience insufficiently and selectively. Key findings indicate varied levels of sensory comfort, as well as diversity, intensity, and customisation of multi-sensory conditions within different nursing home spaces. Sensory stimulation is typically concentrated in communal living areas of the nursing homes or in the areas that often provide controlled or limited access, including specifically designed sensory rooms and outdoor green spaces (gardens and terraces). Opportunities for sensory stimulation are particularly limited for bed-bound senior residents and within more functional areas, such as corridors. This suggests that the capacities of nursing home designs to provide more diverse and better integrated pleasant sensory conditions as integrated “therapeutic devices” to build nursing home residents’ physical and mental abilities, encourage activity and improve wellbeing are far from exhausted.

Keywords: ageing-supportive environment, enabling design, multi-sensory assessment, nursing home environment

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Authors: Ji Lian Yap

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This paper will critically consider developments in 2014 in relation to the law relating to security over personal property in Hong Kong. The rules governing the registration of charges under the Hong Kong Companies Ordinance will be examined. Case law relating to personal property security will also be discussed. The transplantation of the floating charge into China’s Property Law will also be considered.

Keywords: personal property, security law, reform of the law, law

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Authors: Wiseman Emmanuel Nkhomah, Chiyembekezo Kachimanga, Moses Banda Aron, Julia Higgins, Manuel Mulwafu, Kondwani Mpinga, Mwayi Chunga, Grace Momba, Enock Ndarama, Dickson Sumphi, Atupere Phiri, Fabien Munyaneza

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Background: Data is key to supporting health service delivery as stakeholders, including NGOs rely on it for effective service delivery, decision-making, and system strengthening. Several studies generated debate on data quality from national health management information systems (HMIS) in sub-Saharan Africa. This limits the utilization of data in resource-limited settings, which already struggle to meet standards set by the World Health Organization (WHO). We aimed to evaluate data quality improvement of Neno district HMIS over a 4-year period (2018 – 2021) following quarterly data reviews introduced in January 2020 by the district health management team and Partners In Health. Methods: Exploratory Mixed Research was used to examine report rates, followed by in-depth interviews using Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). We used the WHO module desk review to assess the quality of HMIS data in the Neno district captured from 2018 to 2021. The metrics assessed included the completeness and timeliness of 34 reports. Completeness was measured as a percentage of non-missing reports. Timeliness was measured as the span between data inputs and expected outputs meeting needs. We computed T-Test and recorded P-values, summaries, and percentage changes using R and Excel 2016. We analyzed demographics for key informant interviews in Power BI. We developed themes from 7 FGDs and 11 KIIs using Dedoose software, from which we picked perceptions of healthcare workers, interventions implemented, and improvement suggestions. The study was reviewed and approved by Malawi National Health Science Research Committee (IRB: 22/02/2866). Results: Overall, the average reporting completeness rate was 83.4% (before) and 98.1% (after), while timeliness was 68.1% and 76.4 respectively. Completeness of reports increased over time: 2018, 78.8%; 2019, 88%; 2020, 96.3% and 2021, 99.9% (p< 0.004). The trend for timeliness has been declining except in 2021, where it improved: 2018, 68.4%; 2019, 68.3%; 2020, 67.1% and 2021, 81% (p< 0.279). Comparing 2021 reporting rates to the mean of three preceding years, both completeness increased from 88% to 99% (in 2021), while timeliness increased from 68% to 81%. Sixty-five percent of reports have maintained meeting a national standard of 90%+ in completeness while only 24% in timeliness. Thirty-two percent of reports met the national standard. Only 9% improved on both completeness and timeliness, and these are; cervical cancer, nutrition care support and treatment, and youth-friendly health services reports. 50% of reports did not improve to standard in timeliness, and only one did not in completeness. On the other hand, factors associated with improvement included improved communications and reminders using internal communication, data quality assessments, checks, and reviews. Decentralizing data entry at the facility level was suggested to improve timeliness. Conclusion: Findings suggest that data quality in HMIS for the district has improved following collaborative efforts. We recommend maintaining such initiatives to identify remaining quality gaps and that results be shared publicly to support increased use of data. These results can inform Ministry of Health and its partners on some interventions and advise initiatives for improving its quality.

Keywords: data quality, data utilization, HMIS, collaboration, completeness, timeliness, decision-making

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Authors: Dawid Jakimiuk, Krzysztof Mitura, Leszek Szpakowski, Sławomir Pilip, Daniel Celiński

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The Emergency Medical Teams (EMS) of the Ambulance Service in Siedlce serve the population living in the Mazowieckie Voivodeship (the area of eastern Poland with approximately 550,000 inhabitants). They provide health services at the pre-hospital stage to all life-threatening patients. The analysis covered the interventions of emergency medical teams in cases of suicide attempts that occurred in the years 2015-2018. The study was retrospective. The data was obtained on the basis of digital medical records of completed call-outs. When defining the disease entity, the International Statistical Classification of Diseases and Health Problems ICD-10 prepared by WHO was used. The relationship between selected disease entities and the area of EMT intervention, the patient's sex and age, and the time of occurrence of the event were investigated. Non-urban area was defined as the area inhabited by a population below 10,000 residents. Statistical analysis was performed using Pearson's Chi ^ 2 test and presenting the percentage of cases in the study group. Of all the suicide attempts, drug abuse cases were the most frequent, including: X60 (Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics); X61 (Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonian and psychotropic drugs, not elsewhere classified); X62 (Intentional self-poisoning by and exposure to narcotics and psycholeptics [hallucinogens], not elsewhere classified); X63 (Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system); X64 (Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substance) oraz X70 (Intentional self-harm by hanging, strangulation and suffocation). In total, they accounted for 69.4% of all interventions to suicide attempts in the studied period. Statistical analysis shows significant differences (χ2 = 39.30239, p <0.0001, n = 561) between the area of EMT intervention and the type of suicide attempt. In non-urban areas, a higher percentage of X70 diagnoses was recorded (55.67%), while in urban areas, X60-X64 (72.53%). In non-urban areas, a higher proportion of patients attempting suicide was observed compared to patients living in urban areas. For X70 and X60 - X64 in total, the incidence rates in non-urban areas were 80.8% and 56%, respectively. Significant differences were found (χ2 = 119.3304, p <0.0001, n = 561) depending on the method of attempting suicide in relation to the patient's sex. The percentage of women diagnosed with X60-X64 versus X70 was 87.50%, which was the largest number of patients (n = 154) as compared to men. In the case of X70 in relation to X60-X64, the percentage of men was 62.08%, which was the largest number of patients (n = 239) as compared to women (n = 22). In the case of X70, the percentage of men compared to women was as high as 92%. Significant differences were observed (χ2 = 14.94848, p <0.01058) between the hour of EMT intervention and the type of suicide attempt. The highest percentage of X70 occurred between 04:01 - 08:00 (64.44%), while X60-X64 between 00:01 - 04:00 (70.45%). The largest number of cases of all tested suicide attempts was recorded between 16:01 - 20:00 for X70 (n = 62), X60 - X64 (n = 82), respectively. The highest percentage of patients undertaking all suicide attempts studied at work was observed in the age range of 18-30 (31.5%), while the lowest was in the age group over 60 years of age. (11%). There was no significant correlation between the day of the week or individual months of the year and the type of suicide attempt - respectively (χ2 = 6.281729, p <0.39238, n = 561) and (χ2 = 3.348913, p <0.9857, n = 561). There were also no significant differences in the incidence of suicide attempts for each year in the study period (χ2 = 3.348913, p <0.9857 n = 561). The obtained results suggest the necessity to undertake preventive measures in order to minimize the number of suicide attempts. Such activities should be directed especially at young patients living in non-urban areas.

Keywords: emergency med, emergency medical team, attempted suicide, pre-hospital

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Authors: Teoman Ozer, Ozlem Orhan

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This study deals with symmetry group properties and conservation laws of partial differential equations. We give a geometrical interpretation of notion of μ-prolongations of vector fields and of the related concept of μ-symmetry for partial differential equations. We show that these are in providing symmetry reduction of partial differential equations and systems and invariant solutions.

Keywords: λ-symmetry, μ-symmetry, classification, invariant solution

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Authors: Mirjana Dokmanovic

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In recent years, the disadvantaged and marginalised position of rural women in the Republic of Serbia has been recognised in a number of national strategies and policy papers. A number of measures have been adopted by the government aimed at economic empowerment of rural women and eliminating barriers to accessing decision making and economic and social opportunities. However, their implementation pace is still slow. The aim of the paper is to indicate the necessity of a comprehensive policy approach to eliminating discrimination against rural women that would include policy and financial commitments for enhancing agricultural and rural development as a whole, instead of taking fragmented measures targeting consequences instead of causes. The paper introduces main findings of the study of challenges, constraints, and opportunities of rural women in Serbia to enjoy their economic and social rights. The research methodology included the desk research and the qualitative analysis of the available data, statistics, policy papers, studies, and reports produced by the government, ministries and other governmental bodies, independent human rights bodies, and civil society organizations (CSOs). The findings of the study reveal that rural women are at great risk of poverty, particularly in remote areas, and when getting old or widowed. Young rural women working in agriculture are also in unfavorable position, as they do not have opportunities to enjoy their rights during pregnancy and maternity leave, childcare leave and leave due to the special care of a child. The study indicates that the main causes of their unfavorable position are related to the prevalent patriarchal surrounding and economic and social underdevelopment of rural areas in Serbia. Gender inequalities have been particularly present in accessing land and property rights, inheritance, education, social protection, healthcare, and decision making. Women living in the rural areas are exposed at high risk of discrimination in all spheres of public and private life that undermine their enjoyment of basic economic, social and cultural rights. The vulnerability of rural women to discrimination increases in cases of the intersectionality of other grounds of discrimination, such as disability, ethnicity, age, health condition and sexual discrimination. If they are victims of domestic violence, their experience lack of access to shelters and protection services. Despite the State’s recognition of the marginalized position of rural women, there is still a lack of a comprehensive policy approach to improving the economic and social position of rural women.

Keywords: agricultural and rural development, care economy, discrimination against women, economic and social rights, feminization of poverty, Republic of Serbia, rural women

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Authors: Pelin Sonmez

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Health services provided to refugees and asylum seekers are very important and of priority due to their physical damages during the war and conflict situation, possible diseases in migration journey and negative psychological mood. However, there are very poor international standards in regards to providing health services to these people, which in return cause each country to differ their regulations. United Nations Sustainable Development Goals that are in effect as of 2016 assure that attention should be provided to non-citizen vulnerable groups in terms of health policies and they should be included in the global development, thereby aims to decrease the problems arising from providing health services to refugees. Though, we should not forget that these are the recent and yet uncertain attempts, mostly, as a result of Syrian War's forced migration wave. As an attempt to reveal different attitudes of international actors, this study compares/analyzes health services provided to refugees and asylum seekers on the basis of Turkey-EU policy implementations. While doing so, two research data will be focused upon. In this globe, results of the focus group interviews and a field study in a specific work (from its health related section) which was done in 2017 to 5000 Syrian women living in Turkey and presented to Republic of Turkey Disaster and Emergency Management Presidency will be utilized.

Keywords: European Union, health policies, refugee, Syrian women, Turkey

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Authors: Corinne Kowalski, Lea de Jong, Rainer Sauerborn, Niamh Herlihy, Anneliese Depoux, Jale Tosun

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Climate change is considered one of the biggest threats to human health of the 21st century. The link between climate change and health has received relatively little attention in the media, in research and in policy-making. A long term and broad overview of how health is represented in the legislation on climate change is missing in the legislative literature. It is unknown if or how the argument for health is referred in legal clauses addressing climate change, in national and European legislation. Integrating scientific based evidence into policies regarding the impacts of climate change on health could be a key step to inciting the political and societal changes necessary to decelerate global warming. This may also drive the implementation of new strategies to mitigate the consequences on health systems. To provide an overview of this issue, we are analyzing the Global Climate Legislation Database provided by the Grantham Research Institute on Climate Change and the Environment. This institution was established in 2008 at the London School of Economics and Political Science. The database consists of (updated as of 1st January 2015) legislations on climate change in 99 countries around the world. This tool offers relevant information about the state of climate related policies. We will use the database to systematically analyze the 829 identified legislations to identify how health is represented as a relevant aspect of climate change legislation. We are conducting explorative research of national and supranational legislations and anticipate health to be addressed in various forms. The goal is to highlight how often, in what specific terms, which aspects of health or health risks of climate change are mentioned in various legislations. The position and recurrence of the mention of health is also of importance. Data will be extracted with complete quotation of the sentence which mentions health, which will allow for second qualitative stage to analyze which aspects of health are represented and in what context. This study is part of an interdisciplinary project called 4CHealth that confronts results of the research done on scientific, political and press literature to better understand how the knowledge on climate change and health circulates within those different fields and whether and how it is translated to real world change.

Keywords: climate change, explorative research, health, policies

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Authors: Thoetchai Peeraphatdit, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham, Niyada Naksuk

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Background: Serum electrolyte abnormalities are a common cause of an acquired prolonged QT syndrome, especially, in the coronary care unit (CCU) setting. Optimal electrolyte ranges among the CCU patients have not been sufficiently investigated. Methods: We identified 8,498 consecutive CCU patients who were admitted to the CCU at Mayo Clinic, Rochester, the USA, from 2004 through 2013. Association between first serum electrolytes and baseline corrected QT intervals (QTc), as well as in-hospital mortality, was tested using multivariate linear regression and logistic regression, respectively. Serum potassium 4.0- < 4.5 mEq/L, ionized calcium (iCa) 4.6-4.8 mg/dL, and magnesium 2.0- < 2.2 mg/dL were used as the reference levels. Results: There was a modest level-dependent relationship between hypokalemia ( < 4.0 mEq/L), hypocalcemia ( < 4.4 mg/dL), and a prolonged QTc interval; serum magnesium did not affect the QTc interval. Association between the serum electrolytes and in-hospital mortality included a U-shaped relationship for serum potassium (adjusted odds ratio (OR) 1.53 and OR 1.91for serum potassium 4.5- < 5.0 and ≥ 5.0 mEq/L, respectively) and an inverted J-shaped relationship for iCa (adjusted OR 2.79 and OR 2.03 for calcium < 4.4 and 4.4- < 4.6 mg/dL, respectively). For serum magnesium, the mortality was greater only among patients with levels ≥ 2.4 mg/dL (adjusted OR 1.40), compared to the reference level. Findings were similar in sensitivity analyses examining the association between mean serum electrolytes and mean QTc intervals, as well as in-hospital mortality. Conclusions: Serum potassium 4.0- < 4.5 mEq/L, iCa ≥ 4.6 mg/dL, and magnesium < 2.4 mg/dL had a neutral effect on QTc intervals and were associated with the lowest in-hospital mortality among the CCU patients.

Keywords: calcium, electrocardiography, long-QT syndrome, magnesium, mortality, potassium

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Authors: Saman Kumara, Duminda Guruge, Krishani Jayasinghe

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Introduction: Nutrition strongly influences good health and development in early life. This study, based on a health promotion approach, used a community-based intervention to improve child nutrition. The approach provides the community with control of interventions, thereby building its capacity and empowering individuals and communities. The aim of this research was to reduce stunting, low birth weight and underweight in communities from Anuradhapura District in Sri Lanka, by identifying and addressing the underlying determinants of under-nutrition and strengthening families and communities to address them. Methods: A health promotion intervention was designed and implemented-based on a logical framework developed in collaboration with members of targeted community. Community members’ implements action, so they fully own the process. Members of the community identify and address the most crucial determinants of health including child health and development and monitor the initial results of their action and modify action to optimize outcomes as well as future goals. Group Discussion, group activities, awareness programs, cluster meetings, community tools and sharing success stories were major activities to address determinants. Continuous data collection was planned at different levels. Priority was given to strengthening the ability of families and groups or communities to collect meaningful data and analyze these themselves. Results: Enthusiasm and interest of the mother, happiness of the child/ family, dietary habits, money management, tobacco and alcohol use of fathers, media influences, illnesses in the child or others, hygiene and sanitary practices, community sensitiveness and domestic violence were the major perceived determinants elicited from the study. There were around 1000 well-functioning mothers groups in this district. ‘Happiness calendar’, ‘brain calendar’, ‘money tool’ and ‘stimulation books’ were created by the community members, to address determinants and measure the process. Evaluation of the process has shown positive early results, such as improvement of feeding habits among mothers, innovative ways of providing early stimulation and responsive care, greater involvement of fathers in childcare and responsive feeding. There is a positive movement of communities around child well-being through interactive play areas. Family functioning and community functioning improved. Use of alcohol and tobacco declined. Community money management improved. Underweight was reduced by 40%. Stunting and low birth weight among under-fives also declined within one year. Conclusion: The health promotion intervention was effective in changing the determinants of under-nutrition in early childhood. Addressing the underlying determinants of under-nutrition in early childhood can be recommended for similar contexts.

Keywords: birth-weight, community, determinants, stunting, underweight

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Authors: Tasneem Alfalah, Salsabeel Alfalah, Jannat Alfalah

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The quality of higher education as a service is fundamental to a country’s development because universities prepare the professionals who will work as managers in companies and manage public and private resources and care for the health and education of new generations. Knowledge sharing involves the interaction of all activities between individuals. Thus, the higher education institutions are aiming to improve and assist their academics in generating new ideas by encouraging them to work as a team, to simplify the exchange of the new knowledge and to further improve the learning process and achieving institutional aims. Moreover, the sources of competitive advantage in universities derive from intellectual capital and innovations in which innovation comes through knowledge sharing. Using quality tools is to define the exact requirements needed to create the concept of knowledge sharing and what are the barriers to achieve this in universities. The purpose of this research is critically evaluating the role of using quality tools to facilitate the concept of knowledge sharing and improve the academic staff level in the Jordanian universities.

Keywords: higher education, knowledge sharing, quality, management tools

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Authors: Nashwah Alnajjar

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This research paper provides an overview of Replika, an AI chatbot application that uses natural language processing technology to engage in conversations with users. The app was developed to provide users with a virtual AI friend who can converse with them on various topics, including mental health. This study explores the experiences of Replika users using quantitative research methodology. A survey was conducted with 12 participants to collect data on their demographics, usage patterns, and experiences with the Replika app. The results showed that Replika has the potential to play a role in mental health support and well-being.

Keywords: Replika, chatbot, mental health, artificial intelligence, natural language processing

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Authors: Yu-Wen Lin, Chin-Sheng Tang, Wan-Yi Chen

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Various biological specimens, drugs, and chemicals exist in the hospital. The medical staffs and hypersensitive inpatients expose might expose to multiple hazards while they work or stay in the hospital. Therefore, the indoor air quality (IAQ) of the hospital should be paid more attention. Respiratory care wards (RCW) are responsible for caring the patients who cannot spontaneously breathe without the ventilators. The patients in RCW are easy to be infected. Compared to the bacteria concentrations of other hospital units, RCW came with higher values in other studies. This research monitored the IAQ of the RCW and checked the compliances of the indoor air quality standards of Taiwan Indoor Air Quality Act. Meanwhile, the influential factors of IAQ and the impacts of ventilator modules, with humidifier or with filter, were investigated. The IAQ of two five-bed wards and one nurse station of a RCW in a regional hospital were monitored. The monitoring was proceeded for 16 hours or 24 hours during the sampling days with a sampling frequency of 20 minutes per hour. The monitoring was performed for two days in a row and the AIQ of the RCW were measured for eight days in total. The concentrations of carbon dioxide (CO₂), carbon monoxide (CO), particulate matter (PM), nitrogen oxide (NOₓ), total volatile organic compounds (TVOCs), relative humidity (RH) and temperature were measured by direct reading instruments. The bioaerosol samples were taken hourly. The hourly air change rate (ACH) was calculated by measuring the air ventilation volume. Human activities were recorded during the sampling period. The linear mixed model (LMM) was applied to illustrate the impact factors of IAQ. The concentrations of CO, CO₂, PM, bacterial and fungi exceeded the Taiwan IAQ standards. The major factors affecting the concentrations of CO, PM₁ and PM₂.₅ were location and the number of inpatients. The significant factors to alter the CO₂ and TVOC concentrations were location and the numbers of in-and-out staff and inpatients. The number of in-and-out staff and the level of activity affected the PM₁₀ concentrations statistically. The level of activity and the numbers of in-and-out staff and inpatients are the significant factors in changing the bacteria and fungi concentrations. Different models of the patients’ ventilators did not affect the IAQ significantly. The results of LMM can be utilized to predict the pollutant concentrations under various environmental conditions. The results of this study would be a valuable reference for air quality management of RCW.

Keywords: respiratory care ward, indoor air quality, linear mixed model, bioaerosol

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Authors: Wanying Xie

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Under the background of the increasing Sino-US trade friction, the two nations pay more attention to the medias’ words. This paper mainly studies the causality, effectiveness, and influence of discourse construction between traditional media and social media. Based on the Network Agenda Setting theory, a kind of associative memory pattern in Psychology, who focuses on how media affect audiences’ cognition of issues and attributes, as well as the significance of the relation between people and matters. The date of the sample chosen in this paper ranges from March 23, 2018, to April 30, 2019. A total of 395 Tweets of Donald Trump are obtained, and 731 related reports are collected from the mainstream American newspapers including New York Times, the Washington Post and the Washington Street, by using Factiva and other databases. The sample data are processed by MAXQDA while the media discourses are analyzed by SPSS and Cite Space, with an aim to study: 1) whether the inter-media discourse construction exists; 2) which media (traditional media V.S. social media) is dominant; 3) the causality between two media. The results show: 1) the discourse construction between three American mainstream newspapers and Donald Trump's Twitter is proved in some periods; 2) the dominant position is extremely depended on the events; 3) the causality between two media is decided by many reasons. New media technology shortens the time of agenda-setting effect to one day or less. By comparing the specific relation between the three major American newspapers and Donald Trump’s Twitter, whose popularity and influence could be reflected. Hopefully, this paper could enable readers to have a more comprehensive understanding of the international media language and political environment.

Keywords: discourse construction, media language, network agenda-setting theory, sino-us trade friction

Procedia PDF Downloads 253

Authors: Wan You Ning

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Addressing the rising prevalence of mental health issues among youths, the Multi-dimensional Approach to Resilience and Support in Advanced School-based Mental Health Service Delivery (MARS-ASMHSD) framework proposes the implementation of advanced mental health services in low-resource areas to further instil mental health resilience among students in a school-based setting. Recognizing the unsustainability of direct service delivery due to rapidly growing demands and costs, the MARS-ASMHSD framework endorses the deinstitutionalization of mental healthcare and explores a tiered, multi-dimensional approach in mental healthcare provision, establishing advanced school-based mental health service delivery. The framework is developed based on sustainable and credible evidence-based practices and modifications of existing mental health service deliveries in Asia, including Singapore, Thailand, Malaysia, Japan, and Taiwan. Dissemination of the framework model for implementation will enable a more progressive and advanced school-based mental health service delivery in low-resource areas. Through the evaluation of the mental health landscape and the role of stakeholders in the respective countries, the paper concludes with a multi-dimensional framework model for implementation in low-resource areas. A mixed-method independent research study is conducted to facilitate the framework's development.

Keywords: mental health, youths, school-based services, framework development

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Authors: Amr Mansour, Boaz Granot, Amani Tatar, Assil Mahamid, Mohammad Haj Yahia, Fairoz Jayyusi, Eyal Behrbalk

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INTRODUCTION: Distal radius fractures are common orthopedic injuries often treated in the fast-paced, high-stress environment of emergency departments (EDs). In such settings, patient satisfaction can be significantly influenced by the clarity of communication and the accessibility of information This study explores the impact of providing an informational pamphlet that outlines ED processes, treatment expectations, and follow-up instructions on patient satisfaction across key domains, including trust, communication, organization, responsiveness, and overall experience. We hypothesize that a structured informational pamphlet will enhance patient satisfaction by fostering better understanding and aligning patient expectations with the realities of the ED visit. METHODS: A total of 100 adult patients treated for distal radius fractures between January and August 2024 participated in this survey-based study. Patients were randomized into two equal groups: one group received an informational pamphlet detailing their condition and treatment, while the other did not. Satisfaction levels were assessed using a structured questionnaire addressing five domains. Fisher's exact test was used to compare satisfaction measures between the two groups, and multivariate logistic regression analysis was conducted to evaluate the association between receiving an information sheet and high satisfaction. The study was approved by the Institutional Review Board. RESULTS SECTION: Patients who received an informational pamphlet reported significantly higher satisfaction across all five domains (p < .001). In Trust and Understanding, 82% of info-sheet recipients felt “in good hands,” compared to 10% of non-recipients. For Communication, 86% rated doctor explanations as “very clear,” versus 16% among non-recipients. Logistic regression showed that receiving an informational pamphlet was a significant predictor of high satisfaction with Discharge Explanation—clarity on condition, treatment, and follow-up (OR = 17.65, 95% CI: 4.74 - 65.77, p < .001) and Reasonable Solution—feeling their primary concern was resolved (OR = 37.82, 95% CI: 8.75 - 163.42, p < .001). Other predictors, including fracture reduction, gender, and age, were not significant. DISCUSSION: This study highlights the substantial role that simple, cost-effective interventions like informational pamphlets can play in enhancing patient satisfaction in emergency care. By improving communication, fostering trust, and promoting a patient-centered approach, informational pamphlets offer a valuable tool for healthcare providers seeking to enhance the quality of care and patient experience in high-pressure emergency environments. However, the study's limitations, including its single-center design and reliance on self-reported satisfaction scores, may affect the generalizability of the results. Future research should consider a multi-center approach and explore long-term outcomes to further validate the efficacy of informational pamphlets in diverse ED settings. Ultimately, sustained improvement in patient satisfaction is a complex and dynamic issue necessitating a multifactorial approach, and other methods should also be explored to complement this strategy. SIGNIFICANCE/CLINICAL RELEVANCE: This study demonstrates that providing an informational pamphlet in the ED setting can significantly improve patient satisfaction across multiple domains, emphasizing its potential as a simple, cost-effective tool to enhance communication, trust, and overall patient experience during emergency care for distal radius fractures. Integrating such interventions into standard ED protocols may foster a more patient-centered approach, improving both patient outcomes and healthcare efficiency.

Keywords: distal radius fracture, quality care, patient satisfaction, emergency medicine, patient-centered care, communication

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