Search results for: care coordination

Authors: Ahmad Haidar

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The rapid adoption of Artificial Intelligence (AI) technology holds unforeseen risks like privacy violation, unemployment, and algorithmic bias, triggering research institutions, governments, and companies to develop principles of AI ethics. The extensive and diverse literature on AI lacks an analysis of the evolution of principles developed in recent years. There are two fundamental purposes of this paper. The first is to provide insights into how the principles of AI ethics have been changed recently, including concepts like risk management and public participation. In doing so, a NOISE (Needs, Opportunities, Improvements, Strengths, & Exceptions) analysis will be presented. Second, offering a framework for building Ethical AI linked to sustainability. This research adopts an explorative approach, more specifically, an inductive approach to address the theoretical gap. Consequently, this paper tracks the different efforts to have “trustworthy AI” and “ethical AI,” concluding a list of 12 documents released from 2017 to 2022. The analysis of this list unifies the different approaches toward trustworthy AI in two steps. First, splitting the principles into two categories, technical and net benefit, and second, testing the frequency of each principle, providing the different technical principles that may be useful for stakeholders considering the lifecycle of AI, or what is known as sustainable AI. Sustainable AI is the third wave of AI ethics and a movement to drive change throughout the entire lifecycle of AI products (i.e., idea generation, training, re-tuning, implementation, and governance) in the direction of greater ecological integrity and social fairness. In this vein, results suggest transparency, privacy, fairness, safety, autonomy, and accountability as recommended technical principles to include in the lifecycle of AI. Another contribution is to capture the different basis that aid the process of AI for sustainability (e.g., towards sustainable development goals). The results indicate data governance, do no harm, human well-being, and risk management as crucial AI for sustainability principles. This study’s last contribution clarifies how the principles evolved. To illustrate, in 2018, the Montreal declaration mentioned eight principles well-being, autonomy, privacy, solidarity, democratic participation, equity, and diversity. In 2021, notions emerged from the European Commission proposal, including public trust, public participation, scientific integrity, risk assessment, flexibility, benefit and cost, and interagency coordination. The study design will strengthen the validity of previous studies. Yet, we advance knowledge in trustworthy AI by considering recent documents, linking principles with sustainable AI and AI for sustainability, and shedding light on the evolution of guidelines over time.

Keywords: artificial intelligence, AI for sustainability, declarations, framework, regulations, risks, sustainable AI

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Authors: Bahaa Eldin Kornah

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The organism profile for peri-prosthetic joint infection caused by hematogenous seeding or direct inoculations is changing. The organisms that cause prosthetic joint infections range from normal skin colonizers to highly virulent pathogens. The pathogens continue to evolve. While Staphylococcus aureus continues to be the leading organism, gram-negative bacilli account for approximately 7% of cases and that incidence is increasing. Methicillin-resistant S. aureus(MRSA) accounts for approximately 10% of all infections occurring in the community setting and 20% of those in the health care setting. The list of organisms causing PJI has expanded in recent years. It is important to have an understanding of which organisms may be causing a periprosthetic joint infection based on where the patient contracted it and their recent medical history. Also, recent technology has expanded rapidly and new methods to detect the pathogen and why we failed in detecting it. There are a number of explanations for the latter finding, perhaps the most important reason being the liberal use of antibiotics that interferes with the isolation of the infective organism.

Keywords: infection, periprosthetic, hip, organism profile, joint infection, joint infection

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Authors: Chirag Kothawade, Gourie Jagtap, PreetKaur Relusinghani, Vedang Chavan, Smitha S. Bhosale

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Psychological research has proven that music relieves stress, elevates mood, and is responsible for the release of “feel-good” chemicals like oxytocin, serotonin, and dopamine. It comes as no surprise that music has been a popular tool in rehabilitation centers and therapy for various disorders, thus with the interminably rising numbers of people facing mental health-related issues across the globe, addressing mental health concerns is more crucial than ever. Despite the existing music recommendation systems, there is a dearth of holistically curated algorithms that take care of the needs of users. Given that, an undeniable majority of people turn to music on a regular basis and that music has been proven to increase cognition, memory, and sleep quality while reducing anxiety, pain, and blood pressure, it is the need of the hour to fashion a product that extracts all the benefits of music in the most extensive and deployable method possible. Our project aims to ameliorate our users’ mental state by building a comprehensive mood-based music recommendation system called “Viby”.

Keywords: language, communication, speech recognition, interaction

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Authors: Giorgia Carratta

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Since the beginning of mass production, plastic items have been crucial in our daily lives. Thanks to their physical and chemical properties, plastic materials have proven almost irreplaceable in a number of economic sectors such as packaging, automotive, building and construction, textile, and many others. At the same time, the disruptive consequences of plastic pollution have been progressively brought to light in all environmental compartments. The overaccumulation of plastics in the environment, and its adverse effects on habitats, wildlife, and (most likely) human health, represents a call for action to decision-makers around the globe. From a regulatory perspective, plastic production is an unprecedented challenge at all levels of governance. At the international level, the design of new legal instruments, the amendment of existing ones, and the coordination among the several relevant policy areas requires considerable effort. Under the pressure of both increasing scientific evidence and a concerned public opinion, countries seem to slowly move towards the discussion of a new international ‘plastic treaty.’ However, whether, how, and with which scopes such instrument would be adopted is still to be seen. Additionally, governments are establishing regional-basedstrategies, prone to consider the specificities of the plastic issue in a certain geographical area. Thanks to the new Circular Economy Action Plan, approved in March 2020 by the European Commission, EU countries are slowly but steadily shifting to a carbon neutral, circular economy in the attempt to reduce the pressure on natural resources and, parallelly, facilitate sustainable economic growth. In this context, the EU Plastic Strategy is promising to change the way plastic is designed, produced, used, and treated after consumption. In fact, only in the EU27 Member States, almost 26 million tons of plastic waste are generated herein every year, whose 24,9% is still destined to landfill. Positive effects of the Strategy also include a more effective protection of our environment, especially the marine one, the reduction of greenhouse gas emissions, a reduced need for imported fossil energy sources, more sustainable production and consumption patterns. As promising as it may sound, the road ahead is still long. The need to implement these measures in domestic legislations makes their outcome difficult to predict at the moment. An analysis of the current international and European Union legal framework on plastic pollution, binding, and voluntary instruments included, could serve to detect ‘blind spots’ in the current governance as well as to facilitate the development of policy interventions along the plastic value chain, where it appears more needed.

Keywords: environmental law, European union, governance, plastic pollution, sustainability

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Authors: Nadjat Zerf Boudjettou, Fahima Nader, Rachid Chalal

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Knowledge management is to acquire and represent knowledge relevant to a domain, a task or a specific organization in order to facilitate access, reuse and evolution. This usually means building, maintaining and evolving an explicit representation of knowledge. The next step is to provide access to that knowledge, that is to say, the spread in order to enable effective use. Knowledge management in the medical field aims to improve the performance of the medical organization by allowing individuals in the care facility (doctors, nurses, paramedics, etc.) to capture, share and apply collective knowledge in order to make optimal decisions in real time. In this paper, we propose a knowledge management approach based on integration technique of heterogeneous data in the medical field by creating a data warehouse, a technique of extracting knowledge from medical data by choosing a technique of data mining, and finally an exploitation technique of that knowledge in a case-based reasoning system.

Keywords: data warehouse, data mining, knowledge discovery in database, KDD, medical knowledge management, Bayesian networks

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Authors: Mubarak Saadu Nabunkari, Abdullahi Abdu Ibrahim, Muhammad Ilyas

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This study looks at how Internet of Things (IoT) devices are used in healthcare to monitor and treat patients better. However, using these devices in healthcare comes with security problems. The research explores using Security Information and Event Management (SIEM) systems with healthcare IoT devices to solve these security challenges. Reviewing existing literature shows the current state of IoT security and emphasizes the need for better protection. The main worry is that healthcare IoT devices can be easily hacked, putting patient data and device functionality at risk. To address this, the research suggests a detailed security framework designed for these devices. This framework, based on literature and best practices, includes important security measures like authentication, data encryption, access controls, and anomaly detection. Adding SIEM systems to this framework helps detect threats in real time and respond quickly to incidents, making healthcare IoT devices more secure. The study highlights the importance of this integration and offers guidance for implementing healthcare IoT securely, efficiently, and effectively.

Keywords: cyber security, threat intelligence, forensics, heath care

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Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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Authors: Dewan Ahsan

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Denmark is well ahead in generating electricity from renewable sources. The offshore wind sector is playing the pivotal role to achieve this target. Though there is a rapid growth of offshore wind sector in Denmark, still there is a dearth of synchronization in OHS (occupational health and safety) regulation and standards. Therefore, this paper attempts to ascertain: i) what are the major challenges of the company specific OHS standards? ii) why does the offshore wind industry need a standardized OHS management system? and iii) who can play the key role in this process? To achieve these objectives, this research applies the interview and survey techniques. This study has identified several key challenges in OHS management system which are; gaps in coordination and communication among the stakeholders, gaps in incident reporting systems, absence of a harmonized OHS standard and blame culture. Furthermore, this research has identified eleven key stakeholders who are actively involve with the offshore wind business in Denmark. As noticed, the relationships among these stakeholders are very complex specially between operators and sub-contractors. The respondent technicians are concerned with the compliance of various third-party OHS standards (e.g. ISO 31000, ISO 29400, Good practice guidelines by G+) which are applying by various offshore companies. On top of these standards, operators also impose their own OHS standards. From the technicians point of angle, many of these standards are not even specific for the offshore wind sector. So, it is a big challenge for the technicians and sub-contractors to comply with different company specific standards which also elevate the price of their services offer to the operators. For instance, when a sub-contractor is competing for a bidding, it must fulfill a number of OHS requirements (which demands many extra documantions) set by the individual operator and/the turbine supplier. According to sub-contractors’ point of view these extra works consume too much time to prepare the bidding documents and they also need to train their employees to pass the specific OHS certification courses to accomplish the demand for individual clients and individual project. The sub-contractors argued that in many cases these extra documentations and OHS certificates are inessential to ensure the quality service. So, a standardized OHS management procedure (which could be applicable for all the clients) can easily solve this problem. In conclusion, this study highlights that i) development of a harmonized OHS standard applicable for all the operators and turbine suppliers, ii) encouragement of technicians’ active participation in the OHS management, iii) development of a good safety leadership, and, iv) sharing of experiences among the stakeholders (specially operators-operators-sub contractors) are the most vital strategies to overcome the existing challenges and to achieve the goal of 'zero accident/harm' in the offshore wind industry.

Keywords: green energy, offshore, safety, Denmark

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Authors: Wondale Getinet Alemu, Lillian Mwanri, Clemence Due, Telake Azale, Anna Ziersch

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Background: Mental illness is one of the most severe, chronic, and disabling public health problems that affect patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods: A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total number of study participants who had a follow-up appointment during the data collection period (2400) by the total sample size of 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the QoL of people with mental illness. The domains and Health-Related Quality of Life (HRQoL) were identified. The indirect and direct effects of variables were calculated using structural equation modeling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results: A total of 636 (99.7%) participants responded and completed the WHOQOL-BREF questionnaire. The mean score of overall HRQoL of people with mental illness in the outpatient clinic was (49.6 ± 10 Sd). The highest QoL was found in the physical health domain (50.67 ±9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41±10 Sd). Rural residents, drug nonadherence, suicidal ideation, not getting counseling, moderate or severe subjective severity, the family does not participate in patient care, and a family history of mental illness had an indirect negative effect on HRQoL. Alcohol use and psychological health domain had a direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having a history of mental illness in the family had both direct and indirect effects on QoL. Furthermore, sociodemographic factors (residence, educational status, marital status), social support-related factors (self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use,) and clinical factors (objective and subjective severity of illness, not getting counseling, suicidal ideation, number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions: In this study, the QoL of people with mental illness was poor, with the psychological health domain being the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors directly and indirectly, affect QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the scourge of mental health, including the development of policy and practice drivers that address the above-identified factors.

Keywords: quality of life, mental wellbeing, mental illness, mental disorder, Ethiopia

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Authors: Farhana Karim, Abdullah N. S. Khan, Mohiuddin A. K. Chowdhury, Nabila Zaka, Alexander Manu, Shams El Arifeen, Sk Masum Billah

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Breastfeeding, an integral part of newborn care, can reduce 55-87% of all-cause neonatal mortality and morbidity. Early initiation of breastfeeding within 1 hour of birth can avert 22% of newborn mortality. Only 45% of world’s newborns and 42% of newborns in South-Asia are put to the breast within one hour of birth. In Bangladesh, only a half of the mothers practice early initiation of breastfeeding which is less likely to be practiced if the baby is born in a health facility. This study aims to generate strong evidence for early initiation of breastfeeding practices in the government health facilities and to explore the associated factors influencing the practice. The study was conducted in selected health facilities in three neighbouring districts of Northern Bangladesh. Total 249 normal vaginal delivery cases were observed for 24 hours since the time of birth. The outcome variable was initiation of breastfeeding within 1 hour while the explanatory variables included type of health facility, privacy, presence of support person, stage of labour at admission, need for augmentation of labour, complications during delivery, need for episiotomy, spontaneous cry of the newborn, skin-to-skin contact with mother, post-natal contact with the service provider, receiving a post-natal examination and counselling on breastfeeding during postnatal contact. The simple descriptive statistics were employed to see the distribution of samples according to socio-demographic characteristics. Kruskal-Wallis test was carried out for testing the equality of medians among two or more categories of each variable and P-value is reported. A series of simple logistic regressions were conducted with all the potential explanatory variables to identify the determining factors for breastfeeding within 1 hour in a health facility. Finally, multiple logistic regression was conducted including the variables found significant at bi-variate analyses. Almost 90% participants initiated breastfeeding at the health facility and median time to initiate breastfeeding was 38 minutes. However, delivering in a sub-district hospital significantly delayed the breastfeeding initiation in comparison to delivering in a district hospital. Maintenance of adequate privacy and presence of separate staff for taking care of newborn significantly reduced the time in early breastfeeding initiation. Initiation time was found longer if the mother had an augmented labour, obstetric complications, and the newborn needed resuscitation. However, the initiation time was significantly early if the baby was put skin-to-skin on mother’s abdomen and received a postnatal examination by a provider. After controlling for the potential confounders, the odds of initiating breastfeeding within one hour of birth is higher if mother gives birth in a district hospital (AOR 3.0: 95% CI 1.5, 6.2), privacy is well-maintained (AOR 2.3: 95% CI 1.1, 4.5), babies cry spontaneously (AOR 7.7: 95% CI 3.3, 17.8), babies are put to skin-to-skin contact with mother (AOR 4.6: 95% CI 1.9, 11.2) and if the baby is examined by a provider in the facility (AOR 4.4: 95% CI 1.4, 14.2). The evidence generated by this study will hopefully direct the policymakers to identify and prioritize the scopes for creating and supporting early initiation of breastfeeding in the health facilities.

Keywords: Bangladesh, early initiation of breastfeeding, health facility, normal vaginal delivery, skin to skin contact

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Authors: Sireethorn Nimitvilai, Ussanee Poolvivatchaikarn, Nuchanart Tomeun

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Objective: To determine the simple laboratory parameters to predict disease severity among COVID-19 patients in resource-limited settings. Material and methods: A retrospective cohort study was conducted at Nakhonpathom Hospital, a 722-bed tertiary care hospital, with an average of 50,000 admissions per year, during April 15 and May 15, 2021. Eligible patients were adults aged ≥ 15 years who were hospitalized with COVID-19. Baseline characteristics, comorbid conditions ad laboratory findings at admission were collected. Predictive factors for severe COVID-19 infection were analyzed. Result: There were 207 patients (79 male and 128 female) and the mean age was 46.7 (16.8) years. Of these, 39 cases (18.8%) were severe and 168 (81.2%) cases were non-severe. Factors associated with severe COVID-19 were neutrophil to lymphocyte ratio ≥ 4 (OR 8.1, 95%CI 2.3-20.3, P < 0.001) and C-reactive protein to albumin ratio ≥ 10 (OR 3.49, 95%CI 1.3-9.1, p 0.01). Conclusions: Complete blood counts, C-reactive protein and albumin are simple, inexpensive, widely available tests and can be used to predict severe COVID-19 in resource-limited settings.

Keywords: COVID-19, predictor of severity, resource-limiting settings, simple laboratory parameters

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Authors: Ankur Mundhra, Shubhadeep Chakraborty, Y. R. Singh, Vishal Das

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Seismic data scaling affects the dynamic range of a data and with present day lower costs of storage and higher reliability of Hard Disk data, scaling is not suggested. However, in dealing with data of different vintages, which perhaps were processed in 16 bits or even 8 bits and are need to be processed with 32 bit available data, scaling is performed. Also, scaling amplifies low amplitude events in deeper region which disappear due to high amplitude shallow events that saturate amplitude scale. We have focused on significance of scaling data to aid interpretation. This study elucidates a proper seismic loading procedure in workstations without using default preset parameters as available in most software suites. Differences and distribution of amplitude values at different depth for seismic data are probed in this exercise. Proper loading parameters are identified and associated steps are explained that needs to be taken care of while loading data. Finally, the exercise interprets the un-certainties which might arise when correlating scaled and unscaled versions of seismic data with synthetics. As, seismic well tie correlates the seismic reflection events with well markers, for our study it is used to identify regions which are enhanced and/or affected by scaling parameter(s).

Keywords: clipping, compression, resolution, seismic scaling

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Authors: Brian Smith

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This paper seeks to contrast the contemporary anti-immigration rhetoric since the US pullout of Afghanistan with the debate about enemy aliens in the early modern period. In the seventeenth century, Sir Edward Coke declared that “infidels” should be seen as perpetui inimici (perpetual enemies) since their values were inimical to those of Christian states. As such, they could be perpetually excluded and denied legal standing. Even at that time, these anti-“infidel” arguments clashed with the natural law tradition of hospitality, which assumed that states had a moral responsibility to admit and care for strangers. In particular, this paper looks at the conflict between Hugo Grotius, Samuel Pufendorf, and John Locke. Grotius argues that states have a duty to admit foreigners. He goes out of his way to plan for the admittance of Jewish immigrants. In contrast, Pufendorf claimed that sovereigns had a duty exclude foreigners who would alter the constitutional character of the state. Much like Grotius, Locke argued that non-Christian peoples should be treated as friends and admitted without reservation.

Keywords: enemy aliens, perpetual enemies, hospitality, refugees

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Authors: John Hardy

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Over the last decade, the world has witnessed an unprecedented rise in the quality and availability of violent extremist propaganda. This phenomenon has been fueled primarily by three interrelated trends: rapid adoption of online content mediums by creators of violent extremist propaganda, increasing sophistication of violent extremist content production, and greater coordination of content and action across violent extremist organizations. In particular, the self-styled ‘Islamic State’ attracted widespread attention from its supporters and detractors alike by mixing shocking video and imagery content in with substantive ideological and political content. Although this practice was widely condemned for its brutality, it proved to be effective at engaging with a variety of international audiences and encouraging potential supporters to seek further information. The reasons for the noteworthy success of this kind of shock-value propaganda content remain unclear, despite many governments’ attempts to produce counterpropaganda. This study examines violent extremist propaganda distributed by five terrorist organizations between 2010 and 2016, using material released by the ‎Al Hayat Media Center of the Islamic State, Boko Haram, Al Qaeda, Al Qaeda in the Arabian Peninsula, and Al Qaeda in the Islamic Maghreb. The time period covers all issues of the infamous publications Inspire and Dabiq, as well as the most shocking video content released by the Islamic State and its affiliates. The study uses frame analysis to distinguish thematic from symbolic content in violent extremist propaganda by contrasting the ways that substantive ideology issues were framed against the use of symbols and violence to garner attention and to stylize propaganda. The results demonstrate that thematic content focuses significantly on diagnostic frames, which explain violent extremist groups’ causes, and prognostic frames, which propose solutions to addressing or rectifying the cause shared by groups and their sympathizers. Conversely, symbolic violence is primarily stylistic and rarely linked to thematic issues or motivational framing. Frame analysis provides a useful preliminary tool in disentangling substantive ideological and political content from stylistic brutality in violent extremist propaganda. This provides governments and researchers a method for better understanding the framing and content used to design narratives and propaganda materials used to promote violent extremism around the world. Increased capacity to process and understand violent extremist narratives will further enable governments and non-governmental organizations to develop effective counternarratives which promote non-violent solutions to extremists’ grievances.

Keywords: countering violent extremism, counternarratives, frame analysis, propaganda, terrorism, violent extremism

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Authors: Burra Vijitha

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A prospective randomized comparative study for the prevention of postoperative nausea and vomiting in the patients undergoing general anesthesia ,for elective laparoscopic surgeries with respect to efficacy and side effects of granisetron and palonosetron. Sixty adult patients of class ASA 1,2 of either sex in age group between 20-70 yrs,scheduled for elective laparoscopic surgeries were selected for the study.Patients were randomly divided into two groups 30 each. Group G: Granisetron group (n=30), 40µg/kg; Group P: Palonosetron group (n=30), 0.075 mg. at end of surgery before extubation group G patients 40 µg/kg of inj.granisetron and group P patients received 0.075 mg of inj.palonosetron slow iv over 30 sec.In post anesthesia care unit, episodes of nausea and vomiting experienced by each patient was recorded by direct questioning the patient .study medication was assessed in terms of incidence of nausea and vomiting during periods of 0-4 hrs,4-12 hrs,12-24 hrs,24-48hrs.our study demonstrated that complete response for those patients who received granisetron were 86.66%,80% and 66.66% ,while those received palonosetron were 100%,86.6%,90% between 0-4hrs,4-12hrs,12-24 hrs. It shows no statistically signidficant differences between the baseline values of hemodynamic variables beween two groups during study. Keywords: Granisetron, nausea, palonosetron, vomiting.

Keywords: granisetron, palonosetron, nausea, vomiting

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Authors: Zainal Abedin

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Introduction: Reproductive health is one of the major priorities of global health and is a fundamental and inalienable part of women’s health due to childbearing, and it is closely associated with nutritional status. Objective: This study was done to assess reproductive health behavior and nutritional status of reproductive-age ethnic women residing in plain land. Method: It was a cross-sectional study conducted among conveniently selected 120 reproductive-aged ethnic women at three Upazila of Rajshahi District. Nutritional status was determined by the WHO cut-off value of BMI for the Asian population. Results: About 88% of respondents noticed that they seek treatment in response to disease, and most of them seek treatment from the pharmacy attendant. Two-thirds of women used contraceptives, and 76% of women received antenatal care visits from Govt health centers, private clinics, and NGO clinics, but 86% of respondents delivered at home. In terms of nutritional status, 70% were normal, 23% underweight, and 7% overweight. Conclusion: Though most of them were normal regarding nutritional status but one-fourth were still underweight. Local pharmacy/quack-dependent treatment should be reduced.

Keywords: reproductive health behavior, nutritional status, plain land, ethnic women

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Authors: Swati Naruka

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"Looking after one’s mind is as important as looking after one’s body". As part of one’s overall health, mental and emotional health or well being is a necessary condition to enable one to manage one’s life successfully. Mental health is the capacity of an individual to form harmonious adjustments to one’s social and physical environments. Universities and colleges are dealing with substantial challenges posed by the changing mental health needs of today’s college students. It is important for administrators, faculty, and staff to understand the profound impact that mental health problems can have on all aspects of campus life, and to treat mental health issues as an institutional responsibility and priority. Counselling centres can respond effectively to the current challenges if they have the support and commitment of the administration; and if they take steps to balance the demand for services with existing resources by reviewing priorities, establishing appropriate limits, employing innovative strategies, and practicing good self-care to minimize stress and burnout. The need for counselling centres has never been greater. They will continue to play an important role in supporting the mission of higher education institutions by providing counselling for students who are experiencing problems and assisting them in achieving their educational and personal goals.

Keywords: mental health, well being, India, college students

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Authors: Jacqueline Eleonora Ek, Michael Spiteri, Chris Giordimaina, Pierre Agius

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Background: Malta is known for being a key player as a frontline country with regard to irregular immigration from Africa to Europe. Every year the island experiences an influx of migrants as boat movement across the Mediterranean continues to be a humanitarian challenge. Irregular immigration and applying for asylum is both a lengthy and mentally demanding process. Those doing so are often faced with multiple challenges, which can adversely affect their mental health. Between January and August 2020, Malta disembarked 2 162 people rescued at sea, 463 of them between July & August. Given the small size of the Maltese islands, this regulation places a disproportionately large burden on the country, creating a backlog in the processing of asylum applications resulting in increased time periods of detention. These delays reverberate throughout multiple management pathways resulting in prolonged periods of detention and challenging access to health services. Objectives: To better understand the spatial dimensions of this humanitarian crisis, this study aims to assess disparities in the acute medical management of migrants presenting to the emergency department (ED) with acute mental health presentations as compared to that of local and non-local residents. Method: In this retrospective study, 17795 consecutive ED attendances were reviewed to look for acute mental health presentations. These were further evaluated to assess discrepancies in transportation routes to hospital, nature of presenting complaint, effects of language barriers, use of CT brain, treatment given at ED, availability of psychiatric reviews, and final admission/discharge plans. Results: Of the ED attendances, 92.3% were local residents, and 7.7% were non-locals. Of the non-locals, 13.8% were migrants, and 86.2% were other-non-locals. Acute mental health presentations were seen in 1% of local residents; this increased to 20.6% in migrants. 56.4% of migrants attended with deliberate self-harm; this was lower in local residents, 28.9%. Contrastingly, in local residents, the most common presenting complaint was suicidal thought/ low mood 37.3%, the incidence was similar in migrants at 33.3%. The main differences included 12.8% of migrants presenting with refused oral intake while only 0.6% of local residents presented with the same complaints. 7.7% of migrants presented with a reduced level of consciousness, no local residents presented with this same issue. Physicians documented a language barrier in 74.4% of migrants. 25.6% were noted to be completely uncommunicative. Further investigations included the use of a CT scan in 12% of local residents and in 35.9% of migrants. The most common treatment administered to migrants was supportive fluids 15.4%, the most common in local residents was benzodiazepines 15.1%. Voluntary psychiatric admissions were seen in 33.3% of migrants and 24.7% of locals. Involuntary admissions were seen in 23% of migrants and 13.3% of locals. Conclusion: Results showed multiple disparities in health management. A meeting was held between entities responsible for migrant health in Malta, including the emergency department, primary health care, migrant detention services, and Malta Red Cross. Currently, national quality-improvement initiatives are underway to form new pathways to improve patient-centered care. These include an interpreter unit, centralized handover sheets, and a dedicated migrant health service.

Keywords: emergency department, communication, health, migration

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Authors: Mohamad Sharif bin Mustaffa, Maizatul Akmam binti Abu Bakar, Mohd Harriszamani bin Abu Bakar

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Most teens who gave birth to an illegitimate child will suffer from depression. This depression issues arising from the incident itself which contains the teen will feel ashamed because labeled as immoral, apart from that most teenagers go through this episode without support from their spouse or family. Teens also face the possibility of a large part with the will be born babies because the issue of too young and needs to go back to school. Teens also can not make a decision on the future of the baby later because they are too immature and no baby care skills other than financial issues, where young people themselves are still dependent on their family. This paper will look at how to apply neurofeedback can be used to see the level of depression experienced by teenagers who get pregnant out of wedlock. Play therapy that will help improve adolescent focus will be used for this purpose. Each level experienced by teenagers going through the phase of easy-to-high difficulty level. Apart from that a recovery module will also be developed as a whole to reduce the level of depression to enable the youth to perform routine healthy activities and can go back to school with cheerful feeling, motivated and active.

Keywords: neurofeedback, depression, pregnant, adolescent, illegitimate

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Authors: Peter Okpamen

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Food security concentrates on the collective efforts of all nations to produce enough food to feed their people. Recently, though the emphasis shifted from food availability to accessibility constraints, which entails the difficulties undernourished people face in gaining access to food even when it is available. Broadly speaking, access to food depends on an individual’s access to resources, markets and food transfers. The opportunities to obtain food through these channels are entitlements, which when denied constitute food insecurity. Evidence shows that a significant percentage of Nigerians are undernourished with adverse implications for the fight against poverty. The greatest danger or consequence of food insecurity is malnutrition. Food insecurity as both an agent and consequence of poverty also increases the economic, political and social tensions in the country. The undernourished in Nigeria are marginalised in several ways to the extent that they are often ill; and because of illness, their work capacity is reduced with attendant reduction in their income. Without adequate income, they cannot save nor invest enough resources to take care of their basic needs. In this paper therefore, we used the political economy approach and statistical analysis to demonstrate that poverty alleviation in Nigeria would be a mirage if food security problems are not adequately resolved.

Keywords: alleviation, demographic, food insecurity, undernourished

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Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

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Authors: V. Nikolov, I. Koseva, R. Sole, F. Diaz

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Cr4+ doped oxide compounds are particularly preferred active media for solid-state lasers with a wide emission region from 1.1 to 1.6 µm. However, obtaining of single crystals of these compounds is often problematic. An alternative solution of this problem is replacing the single crystals with a transparent glassceramics containing the desired crystalline phase. Germanate compounds, especially Li2MgGeO4, Li2ZnGeO4 and Li2CaGeO4, are suitable for Cr4+ doped glass-ceramics because of their relatively low melting temperature and tetrahedral coordination of all ions. The latter ensures the presence of chromium in the 4+ valence. Cr doped Li2CaGeO4 g lass-ceramic was synthesized by thermal treating using glasses from the Li2O-CaO-GeO2-B2O3 system. Special investigations were carried out for optimizing the initial glasscomposition, as well as the thermal treated conditions. The synthesis of the glass ceramics was accompanied by appropriate characterization methods such as: XRD, TEM, EPR, UVVIS-NIR, emission spectra and time decay as main characteristic for the laser emission. From the systematic studies carried out in the four-component system Li2O-CaO-GeO2-B2O3 for establishing the Li2CaGeO4 crystallization area and suitable thermal treatment conditions, several main conclusions can be drawn: 1. The crystallization region of Li2CaGeO4 is relatively narrow, localized around the stoichiometric composition of the Li2CaGeO4 compound. 2. The presence of the glass former B2O3 strongly supports the obtaining of homogeneous glasses at relatively low temperatures, but it is also the reason for the crystallization of borate phases. 3. The crystallization of glasses during thermal treatment is related to the production of more than one phase and it is correct to speak for crystallization of a main phase and accompanying crystallization of other phases. The crystallization of a given phase is related to changing the composition of the residual glass and creating conditions for the crystallization of other phases. 4. The separate studies show that glass-ceramics with different crystallized phases in different quantitative ratios can be obtained from the same composition of glass playing by the thermal treatment conditions. In other words, the choice of temperature and time of thermal treatment of the glass is an extremely important condition, along with the optimization of the starting glass composition. As a result of the conducted research, an optimal composition of the starting glass and an optimal mode of thermal treatment were selected. Glass-ceramic with a main phase Li2CaGeO4 doped by Cr4+ was obtained. The obtained glass-ceramic possess very good properties containing up to 60 mass% of Li2CaGeO4, with an average size of nanoparticles of 20 nm and with transparency about 70 % relative to the transparency of the parent glass. The emission of the obtained glass-ceramics is in a wide range between 1050 and 1500 nm. The obtained results are the basis for further optimization of the glass-ceramic characteristics to obtain an effective laser-active medium with radiation in the 1.1-1.6 nm range.

Keywords: glass, glass-ceramics, multicomponent systems, NIR emission

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Authors: Julaine Allan, Jacqui Cameron, Helen Simpson, Kenny Kor

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The pleasurable and intoxicating effects of psychoactive substances result in widespread use. However, deaths and injuries from psychoactive substance use, particularly among young people, are a global public health problem. Understanding the benefits and problems associated with different drugs is an important part of creating contextually and physiologically relevant harm reduction strategies. Nitrous oxide use is increasing. A systematic review sought information for harm reduction strategies. The aim of this study was to systematically collate and synthesize the disparate body of research on recreational nitrous oxide use to inform harm reduction approaches tailored for young people. A mixed-methods systematic review combined quantitative data such as prevalence and incidence statistics as well as interpretive data on the experience of N₂O use. Thirty-four studies were included in the final analysis. There was minimal information available to inform policy, health care, or individuals using N₂O. The cultural, contextual, and personal reasons for N₂O use are largely unexplored.

Keywords: substance misuse, nitrous oxide, harms, harm reduction, systematic review

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Authors: Hayden R Schott, John M Felder III

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Introduction: Chronic lower extremity wounds in the diabetic and vasculopathic populations are associated with a high degree of morbidity.When wounds require more extensive treatment than can be offered by wound care centers, more aggressive solutions involve local tissue transfer and microsurgical free tissue transfer for achieving definitive soft tissue coverage. These procedures of autologous tissue transfer (ATT) offer resilient, soft tissue coverage of limb-threatening wounds and confer promising limb salvage rates. However, chronic osteomyelitis and recalcitrant soft tissue infections are common in severe diabetic foot wounds and serve to significantly complicate ATT procedures. Stimulan is a resorbable calcium sulfate antibiotic carrier. The use of stimulan antibiotic beads to treat chronic osteomyelitis is well established in the orthopedic and plastic surgery literature. In these procedures, the beads are placed beneath the skin flap to directly deliver antibiotics to the infection site. The purpose of this study was to quantify the success of Stimulan antibiotic beads in treating recalcitrant infections in patients with diabetic foot wounds receiving ATT. Methods: A retrospective review of clinical and demographic information was performed on patients who underwent ATT with the placement of Stimulan antibiotic beads for attempted limb salvage from 2018-21. Patients were analyzed for preoperative wound characteristics, demographics, infection recurrence, and adverse outcomes as a result of product use. The primary endpoint was 90 day infection recurrence, with secondary endpoints including 90 day complications. Outcomes were compared using basic statistics and Fisher’s exact tests. Results: In this time span, 14 patients were identified. At the time of surgery, all patients exhibited clinical signs of active infection, including positive cultures and erythema. 57% of patients (n=8) exhibited chronic osteomyelitis prior to surgery, and 71% (n=10) had exposed bone at the wound base. In 57% of patients (n=8), Stimulan beads were placed beneath a free tissue flap and beneath a pedicle tissue flap in 42% of patients (n=6). In all patients, Stimulan beads were only applied once. Recurrent infections were observed in 28% of patients (n=4) at 90 days post-op, and flap nonadherence was observed in 7% (n=1). These were the only Stimulan related complications observed. Ultimately, lower limb salvage was successful in 85% of patients (n=12). Notably, there was no significant association between the preoperative presence of osteomyelitis and recurrent infections. Conclusions: The use of Stimulanantiobiotic beads to treat recalcitrant infections in patients receiving definitive skin coverage of diabetic foot wounds does not appear to demonstrate unnecessary risk. Furthermore, the lack of significance between the preoperative presence of osteomyelitis and recurrent infections indicates the successful use of Stimulan to dampen infection in patients with osteomyelitis, as is consistent with the literature. Further research is needed to identify Stimulan as the significant contributor to infection treatment using future cohort and case control studies with more patients. Nonetheless, the use of Stimulan antibiotic beads in patients with diabetic foot wounds demonstrates successful infection suppression and maintenance of definitive soft tissue coverage.

Keywords: wound care, stimulan antibiotic beads, free tissue transfer, plastic surgery, wound, infection

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Authors: Sudeshna Sengupta

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Women’s work lives weave a complex fabric of myriad work relations and complex structures. Lives, when seen from the lens of work, is a saga of conjugated oppression by intertwined structures that are vertically and horizontally interwoven in a very complex manner. Women interact with multiple institutions through their work. The interactions and interplay of institutions shape their organization of work. They intersperse productive work with reproductive work, unpaid economic activities with unpaid care work, and all kinds of activities with leisure and self-care. The proposed paper intends to understand how women working as home-based workers in the National Capital Region (NCR) of India are organizing their everyday work, and how the organization of work is influenced by the interplay of structures. Situating itself in a multidisciplinary theoretical framework, this paper brings out how the gendering of work is playing out in the political, economic and social domain and shaping the work-life within the family, and in the paid workspace. The paper will use a primary data source, which is qualitative in nature. It will comprise 15 qualitative interviews of women home-based workers from the National Capital Region. The research uses a life history approach. The sampling was purposive using snowballing as a method. The dataset is part of the primary data (qualitative) collected for the ongoing Ph.D. work in Gender Studies at Ambedkar University Delhi. The home-based workers interviewed were in “non-factory” wage relations based on piece rates with flexible working hours. Their workplaces were their own homes with no spatial divide between living spaces and workspaces. Home-based workers were recognized as a group in the domain of labor economics in the 1980s. When menial work was cheaper than machine work, the capital owners preferred to outsource work as home-based work to women. These production spaces are fragmented and the identity of gender is created within labor processes to favor material accumulation. Both the employers and employees acknowledged the material gain of the capital owner when work was subcontracted to women at home. Simultaneously the market reinforced women’s reproductive role by conforming to patriarchal ideology. The contractors played an important role in implementing localized control on workers and also in finding workers for fragmented, gendered production processes. Their presence helped the employers in bringing together multiple forms of oppression that ranged from creating a structure to flout laws by creating shadow employers. It created an intertwined social and economic structure as well as a workspace where the line between productive and reproductive work gets blurred. The state invisibilized itself either by keeping the sector out of the domain of laws or by not implementing its own laws regulating working conditions or social security. It allowed the local hierarchy to function and define localized working conditions. The productive reproductive continuum reveals a labor control that influenced both the productive and reproductive work of women.

Keywords: informal sector, paid work, women workers, labor processes

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Authors: Pedro G. Morouço

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One utmost challenge in Tissue Engineering is the production of 3D constructs capable of mimicking the functional hierarchy of native tissues. This is well stated for osteochondral tissue due to the complex mechanical functional unit based on the junction of articular cartilage and bone. Thus, the aim of the present study was to develop a new additive manufacturing system coupling micro-extrusion with hydrogels printing. An integrated system was developed with 2 main features: (i) the printing of up to three distinct hydrogels; (ii) in coordination with the printing of a thermoplastic structural support. The hydrogel printing module was projected with a ‘revolver-like’ system, where the hydrogel selection was made by a rotating mechanism. The hydrogel deposition was then controlled by pressured air input. The use of specific components approved for medical use was incorporated in the material dispensing system (Nordson EDF Optimum® fluid dispensing system). The thermoplastic extrusion modulus enabled the control of required extrusion temperature through electric resistances in the polymer reservoir and the extrusion system. After testing and upgrades, a hydrogel modulus with 3 syringes (3cm3 capacity each), with a pressure range of 0-2.5bar, a rotational speed of 0-5rpm, and working with needles from 200-800µm was obtained. This modulus was successfully coupled to the extrusion system that presented a temperature up to 300˚C, a pressure range of 0-12bar, and working with nozzles from 200-500µm. The applied motor could provide a velocity range 0-2000mm/min. Although, there are distinct printing requirements for hydrogels and polymers, the novel system could develop hybrid scaffolds, combining the 2 moduli. The morphological analysis showed high reliability (n=5) between the theoretical and obtained filament and pore size (350µm and 300µm vs. 342±4µm and 302±3µm, p>0.05, respectively) of the polymer; and multi-material 3D constructs were successfully obtained. Human tissues present very distinct and complex structures regarding their mechanical properties, organization, composition and dimensions. For osteochondral regenerative medicine, a multiphasic scaffold is required as subchondral bone and overlying cartilage must regenerate at the same time. Thus, a scaffold with 3 layers (bone, intermediate and cartilage parts) can be a promising approach. The developed system may give a suitable solution to construct those hybrid scaffolds with enhanced properties. The present novel system is a step-forward regarding osteochondral tissue engineering due to its ability to generate layered mechanically stable implants through the double-printing of hydrogels with thermoplastics.

Keywords: 3D bioprinting, bone regeneration, cartilage regeneration, regenerative medicine, tissue engineering

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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: Liana Khandolishvili, Giorgi Dvalashvili

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Karst waters in the world play an important role in the water supply. Among them, the Vaucluse in Chiatura municipality (Georgia) is used as drinking water and is irreplaceable for the local population. Accordingly, it is important to assess their geo-ecological conditions and take care to maintain sustainability. The aim of the paper is to identify the hazards of pollution of underground waters in the karst environment and to develop a scheme for their protection, which will take into consideration both the hydrogeological characteristics and the role of humans. To achieve this goal, the EPIK method was selected using which an epikarst zone of the study area was studied in detail, as well as the protective cover, infiltration conditions and frequency of karst network development, after which the conditions of karst waters in Chiatura municipality was assessed, their main pollutants were identified and the recommendations were prepared for their protection. The results of the study showed that the karst water pollution rate in Chiatura municipality is highest, where karst-fissured layers are represented and intensive extraction works are underway. The EPIK method is innovative in Georgia and was first introduced on the example of karst waters of Chiatura municipality.

Keywords: cave, EPIK method, pollution, Karst waters, geology, geography, ecology

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Authors: Amit Kumar, Himanshu Singal, Arnav Bhavsar

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In this modern era of automation, most of the academic exams and competitive exams are Multiple Choice Questions (MCQ). The responses of these MCQ based exams are recorded in the Optical Mark Reader (OMR) sheet. Evaluation of the OMR sheet requires separate specialized machines for scanning and marking. The sheets used by these machines are special and costs more than a normal sheet. Available process is non-economical and dependent on paper thickness, scanning quality, paper orientation, special hardware and customized software. This study tries to tackle the problem of evaluating the OMR sheet without any special hardware and making the whole process economical. We propose an image processing based algorithm which can be used to read and evaluate the scanned OMR sheets with no special hardware required. It will eliminate the use of special OMR sheet. Responses recorded in normal sheet is enough for evaluation. The proposed system takes care of color, brightness, rotation, little imperfections in the OMR sheet images.

Keywords: OMR, image processing, hough circle trans-form, interpolation, detection, binary thresholding

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Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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