Search results for: trauma care

Authors: Richard Nelson

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The knowledge, skills, and identity of the Higher Education professional are constantly challenged with a demanding environment of teaching, research, administration, and pastoral care. It is more important than ever for professors and lecturers to maintain their professional development in a constantly changing environment. The importance of professional development has become more focused as new skills are needed to meet the demands of remote teaching and learning during a pandemic. Uncertainty and performance pressures influence teachers to try to return to physical spaces or recreate lecture and seminar rooms despite more effective online spaces being available. This case study uses the Boys’ spatial triad as a framework for qualitative interviews to capture the Lecturers’ experiences in Universities in the UK and the USA of moving to online learning spaces. The study finds that without effective professional development and time to reflect critically on remote learning innovation in their teaching practices, lecturers attempt to defer to lecture theatres and seminar rooms, or similes of, as their preferred space for teaching and learning. Professional Development is needed to encourage teachers to reflect on their professional identity and relationship to the teaching space.

Keywords: professional identity, learning, online, remote

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Authors: Katarzyna Kamińska

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The main purpose of the work is to present the results of the studies regarding joint physical custody in the Polish legal system. The issues addressed fit into the ongoing process of modernising family law regulations and their adaptation to changing social reality in Poland. The Polish legislator now faces a dilemma: whether to introduce into Polish law a developed substantive or procedural regulation of joint physical custody and then whether it should be considered a legal presumption. Joint physical custody after divorce or separation is theoretically possible in Poland. It can either follow from the court’s independent proposal based on the assessment of the circumstances or from the parenting plan submitted by parents wishing to jointly retain full parental authority. However, joint physical custody does not result directly from the Polish Family and Guardianship Code. Therefore, there is real legal uncertainty in this matter, which leads to different treatment of citizens by the public authorities and courts. Another problem is that joint physical custody is misunderstood by the Polish courts. The main thesis of the work is that joint physical custody does not only mean the system of symmetrical child care (50/50), and the possibility to award joint physical custody will require the courts to carefully weigh the pros and cons of such an arrangement in each individual case.

Keywords: joint physical custody, shared parenting, divorce, separation, parental authority

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Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

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Introduction: Identifying sexual health needs, developing appropriate plans, and delivering services to meet those needs is an essential component of health programs for women, men, and children all over the world, especially in poor countries. Main Subject: The aim of this study was to describe the needs of sexual health from the viewpoint of health policymakers in Iran. Methods: A qualitative study using thematic content analysis was designed and conducted. Data gathering was conducted through semi-structured, in-depth interviews with 25 key informants within the healthcare system. Key informants were selected through both purposive and snowball sampling. MAXQUDA software (version 10) was used to facilitate transcription, classification of codes, and conversion of data into meaningful units, by the process of reduction and compression. Results: The analysis of narratives and information categorized sexual health needs into five categories: culturalization of sexual health discourse, sexual health care services, sexual health educational needs, sexual health research needs, and organizational needs. Conclusion: Identifying and explaining sexual health needs is an important factor in determining the priority of sexual health programs and identification of barriers to meet these needs. This can help other policymakers and health planners to develop appropriate programs to promote sexual and reproductive health.

Keywords: sexual health, sexual health needs, policy makers, health system, qualitative study

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Authors: Amao Funmilayo Lanrewaju, T. Ogunlade

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The paper examines the causes and characteristics of informal settlements and outdoor advertisement in the evaluation of quality of environment. The paper identifies the problems that have aided informal settlements to: Urbanization, poverty, growth of informal sector, non-affordability of land and housing shortage. The paper asserts that the informal settlements have serious adverse effects on the people’s health, their built environment and quality of life. The secondary data was obtained from books, journals and seminar papers. The paper argues that, although the urban upgrading possesses great potential for improving quality of built environment in informal settlements, there is a need to repackage the upgrading exercise so that majority can benefit from it. It is necessary to incorporate community participation into the urban upgrading in order to assist the very poor that cannot take care of their housing consumption needs. Therefore, government is encouraged to see informal settlements as a solution to new city planning rather than problem to the urban areas. This paper suggests the implementation of policies and planning, physical infrastructural development, social economic improvement, environment and health improvement. Government, private and communities interventions on informal settlements are required in order to prevent further decay for sustainable development.

Keywords: quality of environment, informal settlements, urban upgrading, outdoor advertisement

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Authors: Nahla S. Abdel-Azim, Khaled A. Shams, Elsayed A. Omer, Mahmoud M. Sakr

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Medicinal plants play a significant role in the health care system in Egypt. Knowledge developed over the years by people is mostly unrecorded and orally passes on from one generation to the next. This knowledge is facing the danger of becoming extinct. Therefore there is an urgent need to document the medicinal and aromatic plants associated with traditional knowledge. The Egyptian Encyclopedia of wild medicinal plants (EEWMP) is the first attempt to collect most of the basic elements of the medicinal plant resources of Egypt and their traditional uses. It includes scientific data on about 500 medicinal plants in the form of monographs. Each monograph contains all available information and scientific data on the selected species including the following: names, description, distribution, parts used, habitat, conservational status, active or major chemical constituents, folk medicinal uses and heritage resources, pharmacological and biological activities, authentication, pharmaceutical products, and cultivation. The DNA bar-coding is also included (when available). A brief Arabic summary is given for every monograph. This work revealed the diversity in plant parts used in the treatment of different ailments. In addition, the traditional knowledge gathered can be considered a good starting point for effective in situ and ex-situ conservation of endangered plant species.

Keywords: encyclopedia, medicinal plant, traditional medicine, wild flora

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Authors: Danielle M. Barna, Kolbjørn Engeland, Thordis Thorarinsdottir, Chong-Yu Xu

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Design flood values give estimates of flood magnitude within a given return period and are essential to making adaptive decisions around land use planning, infrastructure design, and disaster mitigation. Often design flood values are needed at locations with insufficient data. Additionally, in hydrologic applications where flood retention is important (e.g., floodplain management and reservoir design), design flood values are required at different flood durations. A statistical approach to this problem is a development of a regression model for extremes where some of the parameters are dependent on flood duration in addition to being covariate-dependent. In hydrology, this is called a regional flood-duration-frequency (regional-QDF) model. Typically, the underlying statistical distribution is chosen to be the Generalized Extreme Value (GEV) distribution. However, as the support of the GEV distribution depends on both its parameters and the range of the data, special care must be taken with the development of the regional model. In particular, we find that the GEV is problematic when developing a GAMLSS-type analysis due to the difficulty of proposing a link function that is independent of the unknown parameters and the observed data. We discuss these challenges in the context of developing a regional QDF model for Norway.

Keywords: design flood values, bayesian statistics, regression modeling of extremes, extreme value analysis, GEV

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Authors: Virgil Miranda, Gissele Mosqueda, Pablo Delgado, Yimesker Yihun

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Muscular fatigue affects the muscle activation that is needed for producing the desired clinical outcome. Integrating optimal muscle relaxation periods into a variety of health care rehabilitation protocols is important to maximize the efficiency of the therapy. In this study, four muscle relaxation periods (30, 60, 90, and 120 seconds) and their effectiveness in producing consistent muscle activation of the muscle biceps brachii between sets of elbow flexion and extension task was investigated among a sample of 10 subjects with no disabilities. The same resting periods were then utilized in a controlled exoskeleton-based exercise for a sample size of 5 subjects and have shown similar results. On average, the muscle activity of the biceps brachii decreased by 0.3% when rested for 30 seconds, and it increased by 1.25%, 0.76%, and 0.82% when using muscle relaxation periods of 60, 90, and 120 seconds, respectively. The preliminary results suggest that a muscle relaxation period of about 60 seconds is needed for optimal continuous muscle activation within rehabilitation regimens. Robot-based rehabilitation is good to produce repetitive tasks with the right intensity, and knowing the optimal resting period will make the automation more effective.

Keywords: rest intervals, muscle biceps brachii, robot rehabilitation, muscle fatigue

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Authors: Aiswarya C. L, Swatantra Pratap Singh

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In recent years, most desalination plants have been powered by fossil fuels, and to a lesser extent, by green energy. Greenhouse gases emitted by fossil-fuelled plants significantly impact the global climate. So scientists are forced to develop a powerful energy source to protect the environment with greater sustainability due to climate change issues. Nuclear energy can supply much more fresh water than what is currently available. Furthermore, it is more affordable and does not emit any greenhouse gases. This review compares conventional desalination plants with nuclear-powered desalination plants in terms of cost, energy consumption, water recovery, and environmental issues. On the basis of the review conducted, nuclear desalination has been demonstrated to be technically feasible and economically competitive with a variety of fossil fuels, renewable energy sources, and waste heat sources. Nuclear sources have been criticized due to their lack of safety. But studies show, if we were able to handle the issue with care, the problems could be eliminated. Here we're looking at the Seawater Reverse Osmosis Plant (SWROP) at Kudankulam Nuclear Power Plant in Tamil Nadu, India and review the further possibility of implementing nuclear desalination technology in other states of India.

Keywords: energy consumption, environmental impacts, nuclear desalination, water recovery

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Authors: Muhammad Waqas, Shahan Waheed, Mohsin Qadeer, Ehsan Bari, Salman Ahmed, Iqra Patoli

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Objective: To determine the value of aPTT, platelets and INR as the predictor of unfavorable outcomes in patients with blunt isolated traumatic brain injury. Methods: This was an observational cohort study conducted in a tertiary care facility from 1st January 2008 to 31st December 2012. All the patients with isolated traumatic brain injury presenting within 24 hours of injury were included in the study. Coagulation parameters at presentation were recorded and Glasgow Outcome Scale calculated on last follow up. Outcomes were dichotomized into favorable and unfavorable outcomes. Relationship of coagulopathy with GOS and unfavorable outcomes was calculated using Spearman`s correlation and area under curve ROC analysis. Results: 121 patients were included in the study. The incidence of coagulopathy was found to be 6 %. aPTT was found to a significantly associated with unfavorable outcomes with an AUC = 0.702 (95%CI = 0.602-0.802). Predictive value of platelets and INR was not found to be significant. Conclusion: Incidence of coagulopathy was found to be low in current population compared to data from the West. aPTT was found to be a good predictor of unfavorable outcomes compared with other parameters of coagulation.

Keywords: aPTT, coagulopathy, unfavorable outcomes, parameters

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Authors: I. Kočvarová, E. Machů, N. Bártlová

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The issue of inclusion - segregation in the current Czech educational system is highly actual due to changes in legislation. It applies primarily to pupils with special educational needs, but it should also apply to pupils with giftedness. The paper presents chosen results of an exploratory survey that was carried out on a convenience sample of 1101 Czech teachers working in lower secondary education (ISCED2). The rate of teachers´ agreement with segregation of gifted pupils in the education system was monitored during this investigation. A validated questionnaire of our own design was used for the purpose of this investigation. The results were compared across groups of teachers in terms of selected variables. Results show that 36,3 % of teachers incline to segregation (rather than inclusion) of gifted pupils. Teachers who are not educated in this field and have no experience in teaching gifted pupils tend to support their segregation more in comparison with other teachers. Teachers of specialized schools for gifted pupils paradoxically agree with segregation to a slightly lesser extent than teachers from traditional schools, but they also manifest the most hesitant attitude in this issue. Preferences for segregation of gifted pupils are not related to attitudes toward gifted pupils or teachers' self-evaluation in terms of care for the gifted. Investigation indicates that the issue of education of gifted children and their inclusion in the educational system needs more space within the further education of teachers.

Keywords: educational system, evaluation, gifted pupil, inclusion, segregation, teacher

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Authors: Salaam Mujeeb, Adeola Segun, Abdullahi Olasunkanmi

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Dementia is becoming a major concern as the world population is increasing and elderly populations are being neglected. Liver and kidney Diseases have been implicated as risk factors in the etiology of Dementia. This study, therefore, evaluates the plasma Gamma Glutamyl Transferase (GGT) activity and plasma Electrolytes in other to find an association between the biomarkers and Dementia. The subjects (38) were age and sex-matched with their corresponding controls and structured questionnaires were used to obtain medical information. Using spectrophotometric and ion selective Electrode techniques respectively, we found and elevated GGT activity in the Dementia Subjects. Remarkably, no association was found between the plasma Electrolytes level and Dementia subjects. It was also observed that severity of Dementia worsens with age. Moreover, the condition of the dementia subjects worsens with reducing weight. Furthermore, the presence of Comorbidity e.g. Hypertension, Obesity, Diabetes and Habits like Smoking, Drugs and Alcohol consumption interferes with Electrolyte balance. Weight loss monitoring and IBM check are advised in Elderly individuals particularly females as they may be inductive of early or future cognitive impairments. Therefore, it might be useful as an early detection tool. Government and society should invest more on the Geriatric population by establishing Old people's home and providing social care services.

Keywords: clinical characteristics, dementia, electrolytes, gamma glutamyl transpeptidase, GGT

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Authors: Todor Nickolov Stoyanov

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These factors appear as a reason for difficulties in financing from programs for rural development of the European Union. Credit conditions for commercial banks are difficult to implement, and its interest rate is too high. One of the possibilities for short-term loans at preferential conditions for the small and medium-sized agricultural and forest owners is credit cooperative. After the changes, occurred in the country after 1990, the need to restore credit cooperatives raised. The purpose for the creation of credit cooperatives is to assist private agricultural and forest owners to take care for them, to assist in the expansion and strengthening of their farms, to increase the quality of life and to improve the local economy. It was found that: in Bulgaria there is a legal obstacle for credit cooperatives to expand their business in the deposit and lending sphere; private forest and agricultural owners need small loans to solve a small problem for a certain season; providing such loans is not attractive for banks, but it is extremely necessary for owners of small forests and lands; if a special law on credit cooperatives is adopted, as required by the Cooperatives Act, it will allow more local people to be members of such credit structures and receive the necessary loans. In conclusion, proposals to create conditions for the development of credit cooperatives in the country are made and positive results expected from the creation of credit cooperatives, are summarized.

Keywords: cooperatives, credit cooperatives, forestry, forest owners

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Authors: Chidambaram Thamaraiselvan, Carlos Dosoretz

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This work will explore the influence of low voltage electric field, both alternating (AC) and direct (DC) currents, on biofouling control to highly electrically conductive self-supporting carbon nanotubes (CNT) membranes at conditions which encourage bacterial growth. A mutant strain of Pseudomonas putida S12 was used a model bacterium. The antibiofouling studies were performed with flow-through mode connecting an electric circuit in resistive mode. Major emphasis was placed on AC due to its ability of repulsing and inactivating bacteria. The observations indicate that an AC potential >1500 mV, 1 kHz frequency, 100 Ω external resistance on ground side and pulse wave above the offset (+0.45) almost completely prevented attachment of bacteria (>98.5%) and bacterial inactivation (95.3±2.5%). Findings suggest that at the conditions applied, direct electron transfer might be dominant in a decrease of cell viability. AC resulted more effective than DC, both in terms of biofouling reduction compared to cathodic DC and in terms of cell inactivation compared to anodic DC. This electrically polarized CNT membranes offer a viable antibiofouling strategy to hinder biofouling and simplify membrane care during filtration.

Keywords: bacterial attachment, biofouling control, low electric potential, water treatment

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Authors: Kuniko Muramoto, Tadashi Nakamura, Shiro Dan

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On March 11, 2011 the Great East Japan Disaster caused widespread damage. In the aftermath, we searched for ways to provide long-term support and enhanced resilience to affected areas, arriving at the Family Manga Exhibition: an art collection portraying family life. It became a tool for community outreach and intervention, and we implemented support programs by collaborating with local support agencies. This 10-year project has been touring through four prefectures in Tohoku since the disaster struck, bearing witness to the effects of disaster and recovery alike. At this five-year mark, we use a narrative perspective to present our findings and reflect on post-disaster community support. It is important to note that the exhibition’s art does not directly depict the disaster; it portrays stories of anonymous families instead. They stimulate viewers’ memories and remind them of their own family stories. We analyzed viewers' oral and written responses to the exhibition and discovered that family manga as an art form enhances the viewer’s sense of connection to people close to them. We also discovered that the viewers gained more universal perspective on their own situations by viewing the exhibition. Manga, we found, offered a certain safety by enabling the viewers to control how they would interact with the exhibition's content and themes. In addition, the purpose of the project was for us to become witnesses of the disaster and recovery. Supporters of the project became active listeners, functioning as interactive agents who helped forming stories. Voices of the story tellers and the listeners layered upon each other and, as a result, converged into brand new narratives. The essence of traumatic experience is ‘the sense of overwhelming powerlessness and isolation’. When we redefine trauma as ‘broken relationships’, we can say that ‘enhancing relationships’ and ‘weaving relationships’ are what strengthen our resilience. This project used narrative as a modality to fortify the resilience of people involved by enhancing the social capital of bonding, bridging, and linking. The manga exhibition functioned as a tool to achieve this end, suggesting that similar applications are possible. Programs we held in-between manga exhibitions also served to enhance narratives of resiliency in the regions. However, we will save that story for another time. We hope to continue collecting the precious and polyphonic voices of people to present as stories born out of the Great East Japan Disaster. This effort extends beyond the immediately affected area by helping us prepare our resilience for future disasters.

Keywords: community, manga, narrative, resilience

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Authors: M. Mohemmed Sha Mohamed Kunju, Abdalla A. Al-Ameen Abdurahman, T. Manesh Thankappan, A. Mohamed Mustaq Ahmed Hameed

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Web service composition is an effective approach to complete the web based tasks with desired quality. A single web service with limited functionality is inadequate to execute a specific task with series of action. So, it is very much required to combine multiple web services with different functionalities to reach the target. Also, it will become more and more challenging, when these services are from different providers with identical functionalities and varying QoS, so while composing the web services, the overall QoS is considered to be the major factor. Also, it is not true that the expected QoS is always attained when the task is completed. A single web service in the composed chain may affect the overall performance of the task. So care should be taken in different aspects such as functionality of the service, while composition. Dynamic and automatic service composition is one of the main option available. But to achieve the actual functionality of the task, quality of the individual web services are also important. Normally the QoS of the individual service can be evaluated by using the non-functional parameters such as response time, throughput, reliability, availability, etc. At the same time, the QoS is not needed to be at the same level for all the composed services. So this paper proposes a framework that allows composing the services in terms of QoS by setting the appropriate weight to the non-functional parameters of each individual web service involved in the task. Experimental results show that the importance given to the non-functional parameter while composition will definitely improve the performance of the web services.

Keywords: composition, non-functional parameters, quality of service, web service

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Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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Authors: Khaled Alabduljabbar

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Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

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Authors: Debasis Sarkar

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Development of a Smart City would depend upon the development of its infrastructure in a smart way. Primarily based on the ideology of the fourth industrial revolution a Smart City project should have Smart governance, smart health care, smart building, smart transportation, smart mobility, smart energy, smart technology and smart citizen. Considering the Indian scenario of current state of cities in India, it has become very essential to decide the specific parameters which would govern the development of a Smart City project. It has been observed that there are significant parameters beyond Information and Communication Technology (ICT), which govern the development of a Smart City project. This paper is an attempt to identify the Critical Success Factors (CSF) which are significantly responsible for the development of a Smart City project in Western India. Responses to questionnaire survey were analyzed on basis of Likert scale. They were further critically evaluated with help of Factor Comparison Method (FCM) and Analytical Hierarchy Process (AHP). The project authorities need to incorporate Building Information Modeling (BIM) to make the smart city project more collaborative. To make the project more sustainable, use of flyash in the concrete used, reduced usage of cement and steel, use of alternate fuels like biodiesel is recommended.

Keywords: analytical hierarchical process, building information modeling, critical success factors, factor comparison method

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Authors: Sajjad Baghernezhad

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Meta-heuristic and hybrid algorithms have high adeer in modeling medical problems. In this study, a neural network was used to predict covid-19 among high-risk and low-risk patients. This study was conducted to collect the applied method and its target population consisting of 550 high-risk and low-risk patients from the Kerman University of medical sciences medical center to predict the coronavirus. In this study, the memetic algorithm, which is a combination of a genetic algorithm and a local search algorithm, has been used to update the weights of the neural network and develop the accuracy of the neural network. The initial study showed that the accuracy of the neural network was 88%. After updating the weights, the memetic algorithm increased by 93%. For the proposed model, sensitivity, specificity, positive predictivity value, value/accuracy to 97.4, 92.3, 95.8, 96.2, and 0.918, respectively; for the genetic algorithm model, 87.05, 9.20 7, 89.45, 97.30 and 0.967 and for logistic regression model were 87.40, 95.20, 93.79, 0.87 and 0.916. Based on the findings of this study, neural network models have a lower error rate in the diagnosis of patients based on individual variables and vital signs compared to the regression model. The findings of this study can help planners and health care providers in signing programs and early diagnosis of COVID-19 or Corona.

Keywords: COVID-19, decision support technique, neural network, genetic algorithm, memetic algorithm

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Authors: Pennapa Palapin

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This study aimed to examine the management and development of forest tourism Kamchanoad. Ban Dung, Udon Thani sustainability. Data were collected by means of qualitative research including in-depth interviews, semi-structured, and then the data were summarized and discussed in accordance with the objectives. And make a presentation in the form of lectures. The target population for the study consisted of 16 people, including representatives from government agencies, community leaders and the community. The results showed that Guidelines for the Management and Development of Forest Tourism Kamchanoad include management of buildings and infrastructure such as roads, water, electricity, toilets. Other developments are the establishment of a service center that provides information and resources to facilitate tourists.; nature trails and informative signage to educate visitors on the path to the jungle Kamchanoad; forest activities for tourists who are interested only in occasional educational activities such as vegetation, etc.; disseminating information on various aspects of tourism through various channels in both Thailand and English, as well as a website to encourage community involvement in the planning and management of tourism together with the care and preservation of natural resources and preserving the local cultural tourist area of Kamchanoad.

Keywords: guidelines for the management and development, forest tourism, Kamchanoad, sustainability

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Authors: Kerstin Grunden, Ann Svensson, Berit Forsman, Christina Karlsson, Ayman Obeid

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The research question of the article is to explore whether the dialogue meetings method could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in municipalities, or not. A testbed was planned to be implemented in a retirement home in a Swedish municipality, and the practitioners worked with a pre-study of that testbed. In the article, the dialogue between the researchers and the practitioners in the dialogue meetings is described and analyzed. The potential of dialogue meetings as an arena for learning and reflection among researchers and practitioners is discussed. The research methodology approach is participatory action research with mixed methods (dialogue meetings, focus groups, participant observations). The main findings from the dialogue meetings were that the researchers learned more about the use of traditional research methods, and the practitioners learned more about how they could improve their use of the methods to facilitate change processes in their organization. These findings have the potential both for the researchers and the practitioners to result in more relevant use of research methods in change processes in organizations. It is concluded that dialogue meetings could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in a health care organization.

Keywords: dialogue meetings, implementation, reflection, test bed, welfare technology, participatory action research

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Authors: Chien-Lin Wang, Cha-Ling Ko, Tainsong Chen

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Pulse Blood pressure (BP) is one of the vital signs, and is an index that helps determining the stability of life. In this respect, some spinal cord injury patients need to take the tilt table test. While doing the test, the posture changes abruptly, and may cause a patient’s BP to change abnormally. This may cause patients to feel discomfort, and even feel as though their life is threatened. Therefore, if a continuous non-invasive BP assessment system were built, it could help to alert health care professionals in the process of rehabilitation when the BP value is out of range. In our research, BP assessed by the pulse transit time technique was developed. In the system, we use a self-made photoplethysmograph (PPG) sensor and filter circuit to detect two PPG signals and to calculate the time difference. The BP can immediately be assessed by the trend line. According to the results of this study, the relationship between the systolic BP and PTT has a highly negative linear correlation (R2=0.8). Further, we used the trend line to assess the value of the BP and compared it to a commercial sphygmomanometer (Omron MX3); the error rate of the system was found to be in the range of ±10%, which is within the permissible error range of a commercial sphygmomanometer. The continue blood pressure measurement from pulse transit time technique may have potential to become a convenience method for clinical rehabilitation.

Keywords: continous blood pressure measurement, PPG, time transit time, transit velocity

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Authors: Asep Adianto, Rinda Ulfah L., Wellya Wichi M., Lasmaria Manik

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Garbage is the waste result of daily human activity which is in some to countries can leads to a crucial problem. It is realized that garbage can brings to disastrous consequences for the environment and humans. Piles of garbage will cause to overflow disaster and health problems for human being. Basically, garbage can be processed into recycled products or other utilization. However, in some cases, awareness of environment cleanliness by throwing the garbage to the dustbin is still lacking, in both adults and children. Children tend to do things based on their visual observations without thinking about the impact of their actions. Associated with awareness of cleanliness, children often littering due to the reluctance on throwing garbage to the dustbin because in some place, it’s not that easy to find where the dustbin is. The obstacle should be accommodated by making some kind of compatible dustbin. In addition, the influence of the social environment and lack of education to environmental concerns makes it even worse. Therefore, we need a method to educate people, especially children, to always care about the environment and neighborhood they live in. Because of the intended target is children, the required method should be fun, easy to do, and it doesn’t contain any compulsion act. Therefore, Eco-Mini Bag is one of considerable method to educate children in society to become more aware about environment cleanliness. Eco-Mini bag is a kind of compatible dustbin and it’s going to prevent the children not to throwing garbage in reckless way. In brief, Eco-Mini bag can increase the environment awareness on children and the whole society through exciting and convenience way.

Keywords: children, eco-mini bag, environment, garbage

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Authors: Fatema Ali Lanewala, Akhtar Jamal Khan

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The ocular complications in renal transplant recipients at the biggest transplant center in Pakistan were seen to be diverse, multiple, and sight-threatening. These complications could mainly be due to the primary disease causing renal failure, the process of transplantation, and/or the medications used pre and post-transplantation. A retrospective case series recently published in the Journal of Pakistan Medical Association highlights the common ocular pathologies encountered in renal transplant population. Majority of the patients suffered from cataract, which is a known side-effect of long-term steroids routinely used for graft survival. There was a unique finding in Pakistani population, never reported before from any other transplant centre world over; a large number of recipients was reported to be suffering from night blindness, which significantly improved on vitamin A supplementation. There were a variety of other ocular complications seen which emphasizes the necessity of ocular care and routine examination of transplant recipient’s eyes by an ophthalmologist in order to avoid visual compromise and improve the quality of life of the transplant recipient.

Keywords: cataract, night blindness, ocular complications, renal transplantation

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Authors: M. Malekian, M. E. Heydari, M. Irani Estyar

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Human papillomavirus (HPV) is one of the most common sexually transmitted infection, which may lead to cervical cancer as the main cause of it. With early diagnosis and treatment in health care services, cervical cancer and its complications are considered to be preventable. This study was aimed to compare the efficiency, sensitivity, and specificity of Pap smear and polymerase chain reaction (PCR) in detecting HPV. A literature search was performed in Google Scholar, PubMed and SID databases using the keywords 'human papillomavirus', 'pap smear' and 'polymerase change reaction' to identify studies comparing Pap smear and PCR methods for the detection. No restrictions were considered.10 studies were included in this review. All samples that were positive by pop smear were also positive by PCR. However, there were positive samples detected by PCR which was negative by pop smear and in all studies, many positive samples were missed by pop smear technique. Although The Pap smear had high specificity, PCR based HPV detection was more sensitive method and had the highest sensitivity. In order to promote the quality of detection and high achievement of the maximum results, PCR diagnostic methods in addition to the Pap smear are needed and Pap smear method should be combined with PCR techniques according to the high error rate of Pap smear in detection.

Keywords: human papillomavirus, cervical cancer, pap smear, polymerase chain reaction

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Authors: Ngozi N. Sydney-Agbor, Chioma N. Ihegboro

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Stress and personality as factors influencing nurses’ aggressive behaviour were investigated. The participants comprised of one hundred and fifty nurses selected through convenience sampling technique from four (4) private hospitals in Imo State, Nigeria; namely: Eastern Summit Specialist Clinics and Maternity, St. David Hospital, New Cross Hospital, and Christian Teaching Hospital. The nurses were all females with ages between 20–35 and a mean age of 25.10 years and a standard deviation of 4.15. The participants were administered with Job Related Tension Scale, Type A Behaviour Scale and Buss- Perry Aggressive Behaviour Scale. Two hypotheses were postulated and tested. Cross- sectional survey and Regression Analysis were adopted as design and statistics respectively. Results showed that as stress increased, nurses aggression also increased. Personality also predicted nurses aggressive behaviour with Type As’ exhibiting higher aggression than Type Bs’.The study recommended that hospital management board should improve the welfare of the nurses and their morale should be boosted by involving them in policy-making concerning their welfare and care of their patients, this will help minimise situations capable of increasing aggressive behaviour. There should also be sensitization on the negative impact of aggressive behaviour to patients especially amongst the personality Type A’s who are more susceptible to aggression.

Keywords: aggressive behaviour, nurses, personality, stress

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Authors: Jia Yin Tan, Daniel Rambei, Kate Mann, Samuel price, Ahmed Aboelela

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Introduction: Breastfeeding is a complex process, influenced by various factors. Tongue-tie may lead to breastfeeding difficulties due to an inability to suck effectively, causing sore nipples and poor infant weight gain. In the UK, most frenotomies on infants are performed by doctors, nurses, health visitors or midwives. Objectives: Evaluation of safety and efficacy of a multispecialty nurse-led rapid access tongue-tie service at Sheffield Children’s Hospital, run jointly by the ENT and paediatric surgery departments. Methodology: A retrospective observational study, including all patients attending the ENT and paediatric surgery nurse-led tongue tie clinics between 1/10/2021 and 30/09/2022. Results: During the study period there were 1135 referrals for frenotomy, with a mean of 15 days between referral to clinic episode. 86.8% of referred patients underwent frenotomy, with a complication rate of 0.1% and revision rate of 5.4%. Conclusions: Our findings suggest that our rapid access nurse-led outpatient tongue tie service is safe and efficacious, with low complication and revision rates. This suggests a potential for developing a community-based service, allowing safe and effective care closer to home.

Keywords: tongue tie, frenotomy, cost, nurse-led

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Authors: G. Yoga Sairam Teja, K. Harsha Vardhan, A. Vinay Kumar, K. Nithish Kumar, Ch. Shanthi Priyag

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The emergence of the Internet of Things (IoT) has facilitated better device control and monitoring in the modern world. The constant monitoring of a patient would be drastically altered by the usage of IoT in healthcare. As we've seen in the case of the COVID-19 pandemic, it's important to keep oneself untouched while continuously checking on the patient's heart rate and temperature. Additionally, patients with paralysis should be closely watched, especially if they are elderly and in need of special care. Our "IoT BASED PATIENT HEALTH MONITORING SYSTEM" project uses IoT to track patient health conditions in an effort to address these issues. In this project, the main board is an 8051 microcontroller that connects a number of sensors, including a heart rate sensor, a temperature sensor (LM-35), and a saline water measuring circuit. These sensors are connected via an ESP832 (WiFi) module, which enables the sending of recorded data directly to the cloud so that the patient's health status can be regularly monitored. An LCD is used to monitor the data in offline mode, and a buzzer will sound if any variation from the regular readings occurs. The data in the cloud may be viewed as a graph, making it simple for a user to spot any unusual conditions.

Keywords: IoT, ESP8266, 8051 microcontrollers, sensors

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Authors: Osuagwu Justine Ugochukwu

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Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought brand-new knowledge to leadership literature.

Keywords: workers performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership

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Authors: Berger Saintius, Edna Ariste, Djeamsly Salomon

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Background: Maternal mortality is a preventable global health problem that affects developed, developing, and underdeveloped countries alike. Globally, maternal mortality rates have declined since 1990, but 830 women die every day from pregnancy and childbirth-related causes that are often preventable. Haiti, with a number of 529 maternal deaths per 100,000 live births, is one of the countries with the highest maternal mortality rate in the Caribbean. This study consists of analyzing maternal death surveillance data in Haiti from 2017-2020. Method : A descriptive study was conducted; data were extracted from the National Epidemiological Surveillance Network of maternal deaths from 2017 to 2020. Sociodemographic variables were analyzed. Excel and Epi Info 7.2 were used for data analysis. Frequency and proportion measurements were calculated. Results: 756 deaths were recorded for the study period: 42 (6%) in 2017, 168 (22%) in 2018, 265 (35%) in 2019, and 281 (37%) in 2020. The North Department recorded the highest number of deaths, 167 (22%). 83(11%) in Les Cayes. 96% of these deaths are people aged between 15 and 49. Conclusion. Maternal mortality is a major health problem in Haiti. Mobilization, participation, and involvement of communities, increase in obstetric care coverage and promotion of Family Planning are among the strategies to fight this problem.

Keywords: epidemiology, maternal death, hospital, Haiti

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