Search results for: rural healthcare

Authors: Zahid Ullah, Atlas Khan

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In today's data-driven world, the role of mathematics in bridging the gap between theory and applications is becoming increasingly vital. This abstract highlights the significance of mathematics as a powerful tool for analyzing, interpreting, and extracting meaningful insights from vast amounts of data. By integrating mathematical principles with real-world applications, researchers can unlock the full potential of data-driven decision-making processes. This abstract delves into the various ways mathematics acts as a bridge connecting theoretical frameworks to practical applications. It explores the utilization of mathematical models, algorithms, and statistical techniques to uncover hidden patterns, trends, and correlations within complex datasets. Furthermore, it investigates the role of mathematics in enhancing predictive modeling, optimization, and risk assessment methodologies for improved decision-making in diverse fields such as finance, healthcare, engineering, and social sciences. The abstract also emphasizes the need for interdisciplinary collaboration between mathematicians, statisticians, computer scientists, and domain experts to tackle the challenges posed by the data-driven landscape. By fostering synergies between these disciplines, novel approaches can be developed to address complex problems and make data-driven insights accessible and actionable. Moreover, this abstract underscores the importance of robust mathematical foundations for ensuring the reliability and validity of data analysis. Rigorous mathematical frameworks not only provide a solid basis for understanding and interpreting results but also contribute to the development of innovative methodologies and techniques. In summary, this abstract advocates for the pivotal role of mathematics in bridging theory and applications in a data-driven world. By harnessing mathematical principles, researchers can unlock the transformative potential of data analysis, paving the way for evidence-based decision-making, optimized processes, and innovative solutions to the challenges of our rapidly evolving society.

Keywords: mathematics, bridging theory and applications, data-driven world, mathematical models

Procedia PDF Downloads 73

Authors: Lun Lou, Jintu Fan

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While personal protective equipment (PPE) prevents the healthcare personnel from exposing to harmful surroundings, it creates a barrier to the dissipation of body heat and perspiration, leading to severe heat stress during prolonged exposure, especially in hot environments. It has been found that most of the existed personal cooling strategies have limitations in achieving effective cooling performance with long duration and lightweight. This work aimed to develop a lightweight (<1.0 kg) and less expensive wearable air cooling and dehumidifying system (WCDS) that can be applied underneath the protective clothing and provide 50W mean cooling power for more than 5 hours at 35°C environmental temperature without compromising the protection of PPE. For the WCDS, blowers will be used to activate an internal air circulation inside the clothing microclimate, which doesn't interfere with the protection of PPE. An air cooling and dehumidifying chamber (ACMR) with a specific design will be developed to reduce the air temperature and humidity inside the protective clothing. Then the cooled and dried air will be supplied to upper chest and back areas through a branching tubing system for personal cooling. A detachable ice cooling unit will be applied from the outside of the PPE to extract heat from the clothing microclimate. This combination allows for convenient replacement of the cooling unit to refresh the cooling effect, which can realize a continuous cooling function without taking off the PPE or adding too much weight. A preliminary thermal manikin test showed that the WCDS was able to reduce the microclimate temperature inside the PPE averagely by about 8°C for 60 minutes when the environmental temperature was 28.0 °C and 33.5 °C, respectively. Replacing the ice cooling unit every hour can maintain this cooling effect, while the longest operation duration is determined by the battery of the blowers, which can last for about 6 hours. This unique design is especially helpful for the PPE users, such as health care workers in infectious and hot environments when continuous cooling and dehumidifying are needed, but the change of protective clothing may increase the risk of infection. The new WCDS will not only improve the thermal comfort of PPE users but can also extend their safe working duration.

Keywords: personal thermal management, heat stress, ppe, health care workers, wearable device

Procedia PDF Downloads 75

Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

Procedia PDF Downloads 130

Authors: S. M. Abdus Sattar

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Introduction: The objectives of the study are to assess different aspects of the tourism and hospitality industry, analyze its contributions to the Gross Domestic Product of Bangladesh, identify the importance of the tourism and hospitality industry, explore future prospects in the sectors, identify challenges and provide recommendations for the development of these industries. The study explores the significance of the tourism and hospitality industry in economic growth and defines its role. Tourism is one of the fastest-growing industries in the world today. Methodology: The study adopts statistical methods and utilizes both quantitative and qualitative research techniques. Data is collected through surveys, interviews, visitor registration, online platforms and analysis of various tourism-related records. The study focuses on marketing, management, attractions and services in the tourism and hospitality sectors. Result: The tourism and hospitality industry offers great opportunities for emerging economies and developing countries. The industry provides job creation, infrastructure development, cultural assets and environmental conservation, essential skills development, revenue generated, foreign exchange earned, economic growth and reduced poverty and inequality. Discussion: The study focuses on improving infrastructure and service quality in the tourism and hospitality industry to attract tourists. The industry significantly contributes to the Gross Domestic Product of Bangladesh. It highlights how the tourism and hospitality sectors can drive economic development, reduce poverty and promote cultural and environmental conservation. It also explores the challenges and future prospects in the tourism and hospitality sectors. Conclusion and Future Scope: The opportunities for tourism of Bangladesh are agricultural tourism, religious tourism, sports tourism, eco-tourism, educational tourism, rural tourism and cultural tourism. However, there is a lack of research and plans to explore the development of the industry. The tourism and hospitality industry offers numerous opportunities for growth and development. There are job opportunities for travel consultants, tour operators, event planners, hotel managers, travel writers, tourism development officers and airline executives in the future. The study recommends to development of tourism infrastructure, maintaining tourist destinations, railway stations, airports, rest houses, hotels and improving the quality of services.

Keywords: tourism, hospitality, employment, economic, development

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Authors: Liang Sun, Yi He

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The origination and development of Chinese traditional villages have a strong link with clan society. Thousands of traditional villages are constituted by one big family who have the same surname. Villages’ basic social relationships are built on the basis of family kinship. Clan power controls family courtyards’ spatial structure and influences their evolvement process. Compared with other countries, research from perspective of clanism is a particular and universally applicable manner to recognize Chinese traditional villages’ space features. This paper takes traditional villages in astern Zhejiang province as examples, especially a single-clan village named Zoumatang. Through combining rural sociology with architecture, it clarifies the coupling relationship between clan structure and village space, reveals spatial composition and evolvement logic of family courtyards. Clan society pays much attention to the patrilineal kinship and genealogy. In astern Zhejiang province, clan is usually divided to ‘clan-branches-families’ three levels. Its structural relationship looks like pyramid, which results in ‘center-margin’ structure when projecting to villages’ space. Due to the cultural tradition of ancestor worship, family courtyards’ space exist similar ‘center-margin’ structure. Ancestor hall and family temple are respectively the space core of village and courtyard. Other parts of courtyard also shows order of superiority and inferiority. Elder and men must be the first. However, along with the disintegration of clan society, family courtyard gradually appears fragmentation trend. Its spatial structure becomes more and more flexible and its scale becomes smaller and smaller. Living conditions rather than ancestor worship turn out to be primary consideration. As a result, there are different courtyard historical prototype in different historic period. To some extent, Chinese present traditional villages’ conservation ignore the impact of clan society. This paper discovers the social significance of courtyard’s spatial texture and rebuilds the connection between society and space. It is expected to promote Chinese traditional villages’ conservation paying more attention to authenticity which defined in the historical process and integrity which built on the basis of social meaning.

Keywords: China, clanism, courtyard, evolvement process, spatial structure, traditional village

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Authors: Sharvari Parikh

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Climate change has always been looked upon as a threat. Increased use of fossil fuels, depletion of bio diversity, certain human activities, rising levels of Greenhouse Gas (GHG) emissions are the factors that have caused climate change. Climate change is creating new risks and aggravating the existing ones. The paper focuses on breaking the stereotypical perception of climate change and draws attention towards the constructive side of it. Researches around the world have concluded that climate change has provided us with many untapped opportunities. The next 15 years will be crucial, as it is in our hands whether we are able to grab these opportunities or just let the situation get worse. The world stands at a stage where we cannot think of making a choice between averting climate change and promoting growth and development. In fact, the solution to climate change itself has got economic opportunities. The data evidences from the paper show how we can create the opportunity to improve the lives of the world’s population at large through structural change which will promote environment friendly investments. Rising Investment in green energy and increased demand of climate friendly products has got ample of employment opportunities. Old technologies and machinery which are employed today lack efficiency and demand huge maintenance because of which we face high production cost. This can be drastically brought down by adaptation of Green technologies which are more accessible and affordable. Overall GDP of the world has been heavily affected in aggravating the problems arising out of increasing weather problems. Shifting to green economy can not only eliminate these costs but also build a sound economy. Accelerating the economy in direction of low-carbon future can lessen the burdens such as subsidies for fossil fuels, several public debts, unemployment, poverty, reduce healthcare expenses etc. It is clear that the world will be dragged into the ‘Darker phase’ if the current trends of fossil fuels and carbon are being consumed. Switching to Green economy is the only way in which we can lift the world from darker phase. Climate change has opened the gates for ‘Green and Clean economy’. It will also bring countries of the world together in achieving the common goal of Green Economy.

Keywords: climate change, economic opportunities, green economy, green technology

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Authors: Sadaf Rafiq, Muhammad Waqas, Shakeel Ahmad Khan, Nisar Ahmad

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Everyday life information seeking (ELIS) is considered as the mastery of life. It plays an important role in daily problem solving activities. Female students living in university hostels need variety of information to fulfil their everyday information needs. To find accurate and timely information is really challenging for females students who move from rural areas for educational purposes. These challenges involve culture differences, stress, financial issues, homesickness, diet needs and change in sleeping and eating habits. These complications create numerous problems for female students to adjust themselves in new and unfamiliar environment. Although the Internet has increased the ease of seeking everyday life information to survive successfully but there is still uncertainty to fully rely on the quality of information available on the web. Pakistan is an underdeveloped country where limited budget is allocated for educational institutions to enable them in developing well established hostels for their students. Female students who pursue for higher education has to stay at hostels for years to obtain education goals. It really becomes very difficult for them to spend life in hostels if they are not properly facilitated with relevant information sources to acquire everyday life information. The proposed study attempts to investigate the everyday life information seeking behavior of female students who are living in university and private hostels of Lahore. It investigates the various sources of information used by female students. It also identifies the problems faced by the female students in accessing everyday life information. The results of this study will be helpful for university management to understand their information need and provide required information sources which are essential for them to spend a comfortable, successful and peaceful life in hostels and achieve their educational goals. To achieve the objectives of the study, we will use quantitative research approach by using questionnaire as a data collection tool. The population of this study will be the university students living in public and private hostels of Lahore, Pakistan. This study will increase the understanding of everyday life information seeking behavior of female students living in hostels. Results of the study will be helpful for hostel administrations to better understand the students’ everyday life information needs and provide high quality of information services and living environment.

Keywords: everyday, information seeking, hostel, female

Procedia PDF Downloads 146

Authors: Annunziata Albano

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Intimate Partner Violence (IPV) and Non-Partner Sexual Violence (NPSV) are still the most common forms of interpersonal violence against women today, and numerous studies have shown how they can affect women's physical and psychological well-being, frequently leading to depression, posttraumatic stress disorder (PTSD), and substance abuse. The primary goal of Italian Anti-Violence Centres (AVCs) is to provide an appropriate context for women to embark on a personalised path out of violence by providing various services such as listening groups, psychological and legal support, housing support in collaboration with shelters, work orientation, and specific support in the case of minor children. However, their physical environment is frequently overlooked, partly because these centres are typically established in pre-existing buildings and have a limited budget. Several studies on healthcare design and mental health, on the other hand, emphasise the potential of the built environment to facilitate healing by providing a restorative setting that aids in coping with stress and traumatic experiences, investigating the positive role of natural features and sensorial qualities such as light, colours, sound, and smell. This research aims to collect and summarise the key evidence-based principles derived from a multidisciplinary literature review about interior design elements that can help women recover after their traumatic experience. Furthermore, the study examines multiple case studies of Italian AVCs through the lens of previously determined principles, to understand how and whether these guidelines have been applied and which outcomes can provide relevant insights for design practice, with an emphasis on sensory qualities, usually overlooked in favour of other requirements. The outlined guidelines may serve as a framework for various typologies of services provided to women who are the victims of interpersonal violence, such as women's crisis centres and shelters.

Keywords: anti-violence centres, environmental psychology, interior design, interpersonal violence, restorative environments

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Authors: Mohamed El Kory Yacoub, Ahmed Bezeid El Mamy Beyatt, Djibril Barry, Yanogo Pauline, Nicolas Meda

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Introduction: Rift Valley Fever is a zoonotic arbovirosis that severely affects ruminants, as well as humans. It causes abortions in pregnant females and deaths in young animals. The disease occurs during heavy rains followed by large numbers of mosquito vectors. The objective of this work is to evaluate the surveillance system for Rift Valley Fever. Methods: We conducted an evaluation of the Rift Valley Fiver surveillance system. Data were collected from the analysis of the national database of the Mauritanian Network of Animal Disease Epidemiological Surveillance at the Ministry of Rural Development, of RVF cases notified from the whole national territory, of questionnaires and interviews with all persons involved in RVF surveillance at the central level. The quality of the system was assessed by analyzing the quantitative attributes defined by the Centers for Disease Control and Prevention. Results: In 2019, 443 cases of RVF were notified by the surveillance system, of which 36 were positive. Among the notified cases of Rift Valley Fever, the 0- to the 3-year-old age group of small ruminants was the most represented with 49.21% of cases, followed by 33.33%, which was recorded in large ruminants in the 0 to 7-year-old age group, 11.11% of cases were older than seven years. The completeness of the data varied between 14.2% (age) and 100% (species). Most positive cases were recorded between October and November 2019 in seven different regions. Attribute analysis showed that 87% of the respondents were able to use the case definition well, and 78.8% said they were familiar with the reporting and feedback loop of the Rift Valley Fever data. 90.3% of the respondents found it easy, while 95% of them responded that it was easy for them to transmit their data to the next level. Conclusions: The epidemiological surveillance system for Rift Valley Fever in Mauritania is simple and representative. However, data quality, stability, and responsiveness are average, as the diagnosis of the disease requires laboratory confirmation and the average delay for this confirmation is long (13 days). Consequently, the lack of completeness of the recorded data and of description of cases in terms of time-place-animal, associated with the delay between the stages of the surveillance system can make prevention, early detection of epidemics, and the initiation of measures for an adequate response difficult.

Keywords: evaluation, epidemiological surveillance system, rift valley fever, mauritania, ruminants

Procedia PDF Downloads 145

Authors: Ruben Peralta, Sam Thomas, Nazia Hirani, Ayman El-Menyar, Hassan Al-Thani, Mohammed Al-Thani, Mohammed Al-Hajjaj, Rafael Consunji

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Moderate to severe work-related injuries [WRI's] are a leading cause of trauma admission in Qatar but information on risk factors for their incidence are lacking. This study aims to document and analyze the predictive characteristics for WRI to inform the creation of targeted interventions to improve worker safety in Qatar. This study was conducted as part of the NPRP grant # 7 - 1120 - 3 - 288, titled "A Unified Registry for Occupational Injury Prevention in Qatar”. 266 workers were interviewed using a standard questionnaire, during ‘World Day for Safety and Health at Work’, a Ministry of Public Health event, none refused interview. Nurses and doctors from the Hamad Trauma Center conducted the interviews. Questions were translated into the worker’s native language when it was deemed necessary. Standard information on epidemiologic characteristics and incidence of work-related injury were collected and compared between nationalities and those injured versus those not injured. 262 males and 4 females were interviewed. 17 [6.4%] reported a WRI in the last 24 months. More than half of the injured worked in construction [59%] followed by water supply [11.8%]. Factors significantly associated with recent injury were: Working for a company with > 500 employees and speaking Hindi. Protective characteristics included: Being from the Philippines or Sri Lanka, speaking Arabic, working in healthcare, an office or trading and company size between 100-500 employees. Years of schooling and working in Qatar were not predictive factor for WRI. The findings from this survey should guide future research that will better define worker populations at an increased risk for WRI and inform recruiters and sending countries. A focus on worker language skills, interventions in the construction industry and occupational safety in large companies is needed.

Keywords: occupational injury, prevention, safety, trauma, work related injury

Procedia PDF Downloads 321

Authors: Adebisi A. Sunday, Babajide Adeokin

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The persistent rise in farm theft in rural region of Nigeria is attributed to the lack of adequate and effective policing in the regions; thus, this brought about the inevitable introduction of native charms on farmlands as a means of fortification of harvests against theft in Ayetoro community. The use of charm by farmers as security on farmlands is a traditional crime control mechanism that is largely based on unwritten laws which greatly influenced the lives of people, and their attitudes toward the society. This research presents a qualitative sociological study on how native charms are deployed by farmers for protection against theft. The study investigated the various types of charms that are employed as security measures among farmers in Ayetoro community and the rationale behind the use of these mechanisms as farm security. The study utilized qualitative method to gather data in the research process. Under the qualitative method, in-depth interview method was adopted to generate a robust and detailed data from the respondents. Also the data generated were analysed qualitatively using thematic content analysis and simple description which was preceded by transcription of data from the recorder. It was revealed that amidst numerous charms known, two major charms are used on farmlands as a measure of social control in Ayetoro community, Ogun state South West Nigeria. Furthermore, the result of this study showed that, the desire for safekeeping of harvest from pilferers and the heavy punishments dispense on offenders by native charms are the reasons why farmers deploy charms on their farms. In addition, findings revealed that the adoption of these charms for protection has improved yields among farmers in the community because the safety of harvest has been made possible by virtue of the presence of various charms in the farm lands. Therefore, based on the findings of this study, it is recommended that such measures should be recognized in mainstream social control mechanisms in the fight against crime in Nigeria and the rest of the world. Lastly, native charms could be installed in all social and cooperate organisation and position of authority to prevent theft of valuables and things hold with utmost importance.

Keywords: Ayetoro, farm theft, mechanism, native charms, Pilferer

Procedia PDF Downloads 140

Authors: Palingba Aimé Marie Doilkom, Mahamadou Koïta, Jean-michel Vouillamoz, Angelbert Biaou

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Most African populations rely on groundwater in rural areas for their consumption. Indeed, in the face of climate change and strong demographic growth, groundwater, particularly in the basement, is increasingly in demand. The question of the sustainability of water resources in this type of environment is therefore becoming a major issue. Groundwater recharge can be natural or artificial. Unlike natural recharge, which often results from the natural infiltration of surface water (e.g. a share of rainfall), artificial recharge consists of causing water infiltration through appropriate developments to artificially replenish the water stock of an aquifer. Artificial recharge is, therefore, one of the measures that can be implemented to secure water supply, combat the effects of climate change, and, more generally, contribute to improving the quantitative status of groundwater bodies. It is in this context that the present research is conducted with the aim of developing artificial recharge in order to contribute to the sustainability of basement aquifers in a context of climatic variability and constantly increasing water needs of populations. In order to achieve the expected results, it is therefore important to determine the characteristics of the infiltration basins and to identify the areas suitable for their implementation. The geometry of the aquifer was reproduced, and the hydraulic properties of the aquifer were collected and characterized, including boundary conditions, hydraulic conductivity, effective porosity, recharge, Van Genuchten parameters, and saturation indices. The aquifer of the Sanon experimental site is made up of three layers, namely the saprolite, the fissured horizon, and the healthy basement. Indeed, the saprolite and the fissured medium were considered for the simulations. The first results with FEFLOW model show that the water table reacts continuously for the first 100 days before stabilizing. The hydraulic charge increases by an average of 1 m. The further away from the basin, the less the water table reacts. However, if a variable hydraulic head is imposed on the basins, it can be seen that the response of the water table is not uniform over time. The lower the basin hydraulic head, the less it affects the water table. These simulations must be continued by improving the characteristics of the basins in order to obtain the appropriate characteristics for a good recharge.

Keywords: basement area, FEFLOW, infiltration basin, MAR

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Authors: Ethel E. Phiri, Lionel Hartzenberg, Percy Chimwamuromba, Emmanuel Nepolo, Jens Kossmann, James R. Lloyd

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Orphan crops are underresearched and underutilized food plant species that have not been categorized as major food crops, but have the potential to be economically and agronomically significant. They have been documented to have the ability to tolerate extreme environmental conditions. However, limited research has been conducted to uncover their potential as food crop species. The New Partnership for Africa’s Development (NEPAD) has classified Marama bean, Tylosema esculentum, as an orphan crop. The plant is one of the 101 African orphan crops that must have their genomes sequenced, assembled, and annotated in the foreseeable future. Marama bean is a perennial leguminous plant that primarily grows in poor, arid soils in southern Africa. The plants produce large tubers that can weigh as much as 200kg. While the foliage provides fodder, the tuber is carbohydrate rich and is a staple food source for rural communities in Namibia. Also, the edible seeds are protein- and oil-rich. Marama Bean plants respond rapidly to increased temperatures and severe water scarcity without extreme consequences. Advances in molecular biology and biotechnology have made it possible to effectively transfer technologies between model- and major crops to orphan crops. In this research, the aim was to assemble the first transcriptomic analysis of Marama Bean RNA-sequence data. Many model plant species have had their genomes sequenced and their transcriptomes assembled. Therefore the availability of transcriptome data for a non-model crop plant species will allow for gene identification and comparisons between various species. The data has been sequenced using the Ilumina Hiseq 2500 sequencing platform. Data analysis is underway. In essence, this research will eventually evaluate the potential use of Marama Bean as a crop species to improve its value in agronomy. data for a non-model crop plant species will allow for gene identification and comparisons between various species. The data has been sequenced using the Ilumina Hiseq 2500 sequencing platform. Data analysis is underway. In essence, this researc will eventually evaluate the potential use of Marama bean as a crop species to improve its value in agronomy.

Keywords: 101 African orphan crops, RNA-Seq, Tylosema esculentum, underutilised crop plants

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Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra

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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.

Keywords: disability, India, malingering, neuropsychological assessment

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: Alami Ilyass, Loubna Kharchoufa, Elachouri Mostafa

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The two great realms of living diversity are cultural and biological. Today, both are being lost at an alarming rate. Of all the Earth’s biological diversity, plant kingdom is of high significance, and most essential to human welfare, in fact, medicinal plants are extensively exploited for countless purposes. Among these multiple uses, medicinal plants are the most important source of medicine for humankind healthcare and well being. In recent years there has been a great surge of public interest in the use of herbs and plants. Some scientists have viewed this phenomenon as a modern “herbal renaissance”. The importance of plants as medicines in developed and developing countries has recently been acknowledged by the United Nations (UN). However, to date fewer than 5% of the approximately 250,000 species of higher plants have been exhaustively studied for their potential pharmacological activity. A number of drugs from ethnobotanical leads have provided significant milestones in Western medicine. Despite this success, pharmacognosy research on Moroccan flora needs more studies aimed at the exploration of their therapeutic potential. A major weakness is the absence of strong funding agencies in the country, and a real national drug discovery program. Moreover, the lack of the coordination between different universities and research institutions leads, in most cases, to a waste of time, money and efforts of many researchers. In this work, we focus our attention on research into traditional indigenous medicinal plants in Morocco. Three parts constitute the head lines of this work: In the first one, we take up Moroccan biodiversity matter, the second part is devoted principally to the state of research into medicinal plants by Moroccan scholars and the last one is consecrated to the debate of factors which handicap the progress of research on phytomedicine in Morocco. The objectives of the present study are twofold: first, to highlight the state of the medicinal plants researches in Morocco. Second goal is to assess and correlate the levels of knowledge of the local flora to the research on medicinal plants to attempt to build capacity for research within Moroccan Scientific community at rate of developing country.

Keywords: Morocco, medicinal plants, ethnobotanical, pharmacognosy, phytomedicine

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Authors: Sabyasachi Behera, Shiv Kumar, Pramod Gautam, Anisur Rahman, Pawan Pathak, Rahul Bhadouria

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Background: The increasing proportion of population especially urban poor and vulnerable groups or groups with specific needs, with health indicators worse than their rural counterparts in India face various issues related with availability and quality of health care. The reasons are myriad, starting from information and awareness of the community, especially, in a scenario wherein the needs and challenges of floating and migrant urban populations remain poorly understood. Weak linkages between health care facilities and slum dwellers and vulnerable populations hinder the improvement of health services for urban poor. Method: To address this issue, TCIHC program is helping health department of Indore city of Madhya Pradesh to establish a referral mechanism with a dual approach: at both community and facility level. The former is based on the premise of ‘building social capital’, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services at appropriate levels of care (Minus 2: Accredited Social Health Activist and Community Health Groups; Minus 1: Urban Health Nutrition Days; Zero: Urban Primary Health Center; Plus 1: secondary facility with BEmONC services; Plus 2: secondary facilities with CEmONC services; Plus 3: tertiary level facility) for the urban poor. The latter focuses on encouraging the provision of all services at various levels of service delivery points and stakeholders to function in a coordinated manner to ensure better health service availability and coverage in underserved slum areas. Results: This initiative has enhanced the utilization of community based, primary and secondary level services through defined referral pathways that are clearly known to a community dweller. Conclusion: An ideal referral mechanism should begin with referral at the community level wherein services of a frontline health care provider are accessed by them at their door-step, causing no delay in both understanding and decision on the health issues faced by them.

Keywords: levels of care, linkages, referral mechanism, service delivery

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Authors: Jean Paul Hategekimana, Bampire Claudine, Niyonsenga Nadia, Irakoze Josiane

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Peas, soybeans and rice are crops which are grown in Rwanda and are available in rural and urban local markets and they give contribution in reduction of health problems especially in fighting malnutrition and food insecurity in Rwanda. Several research activities have been conducted on how cereals flour can be mixed with legumes flour for developing baked products which are rich in protein, fiber, minerals as they are found in legumes. However, such activity was not yet well studied in Rwanda. The aim of the present study was to develop bread and biscuit products from peas, soybeans and rice as functional ingredients combined with wheat flour and then analyze the nutritional content and consumer acceptability of new developed products. The malnutrition problem can be reduced by producing bread and biscuits which are rich in protein and are very accessible for every individual. The processing of bread and biscuit were made by taking peas flour, soybeans flour and rice flour mixed with wheat flour and other ingredients then a dough was made followed by baking. For bread, two kind of products were processed, for each product one control and three experimental samples in different three ratios of peas and rice were prepared. These ratios were 95:5, 90:10 and 80:20 for bread from peas and 85:5:10, 80:10:10 and 70:10:20 for bread from peas and rice. For biscuit, two kind of products were also processed, for each product one control sample and three experimental samples in three different ratios were prepared. These ratios are 90:5:5,80:10:10 and 70:10:20 for biscuit from peas and rice and 90:5:5,80:10:10 and 70:10:20 for biscuit from soybean and rice. All samples including the control sample were analyzed for the consumer acceptability (sensory attributes) and nutritional composition. For sensory analysis, bread from of peas and rice flour with wheat flour at ratio 85:5:10 and bread from peas only as functional ingredient with wheat flour at ratio 95:5 and biscuits made from a of soybeans and rice at a ratio 90:5:5 and biscuit made from peas and rice at ratio 90:5:5 were most acceptable compared to control sample and other samples in different ratio. The moisture, protein, fat, fiber and minerals (Sodium and iron.) content were analyzed where bread from peas in all ratios was found to be rich in protein and fiber compare to control sample and biscuit from soybean and rice in all ratios was found to be rich in protein and fiber compare to control sample.

Keywords: bakery products, peas and rice flour, wheat flour, sensory evaluation, proximate composition

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Authors: Maria Consuelo Doble

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For decades, basic public education in the Philippines has been beleaguered by a governance scenario of multi-layered decision-making and the lack of collaboration between sectors in addressing issues on poor access to schools, high dropout rates, low survival rates, and poor student performance. These chronic problems persisted despite multiple efforts making it appear that the education system is incapable of reforming itself. In the mountainous rural towns of La Trinidad and Tuba, in the province of Benguet in Northern Philippines, collaborative education governance was catalyzed by the intervention of Synergeia Foundation, a coalition made up of individuals, institutions and organizations that aim to improve the quality of education in the Philippines. Its major thrust is to empower the major stakeholders at the community level to make education work by building the capacities of School Governing Councils (SGCs). Although mandated by the Department of Education in 2006, the SGCs in Philippine public elementary schools remained dysfunctional. After one year of capacity-building by Synergeia Foundation, some SGCs are already exhibiting active community-based multi-sectoral collaboration, while there are many that are not. With the myriad of factors hindering collaboration, Synergeia Foundation is now confronted with the pressing question: What are the factors that promote collaborative governance in the SGCs so that they can address the education-related issues that they are facing? Using Emerson’s (2011) framework on collaborative governance, this study analyzes the application of collaborative governance by highly-functioning SGCs in the public elementary schools of Tuba and La Trinidad. Findings of this action research indicate how the dynamics of collaboration composed of three interactive and iterative components – principled engagement, shared motivation and capacity for joint action – have resulted in meaningful short-term impact such as stakeholder engagement and decreased a number of dropouts. The change in the behavior of stakeholders is indicative of adaptation to a more collaborative approach in governing education in Benguet highland settings such as Tuba and La Trinidad.

Keywords: basic public education, Benguet highlands, collaborative governance, School Governing Council

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Authors: Estibe Dagne Mekonnen

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In recent years, the prevalence of undernourishment was 30 percent for sub-Saharan Africa, compared with 16 percent for Asia and the Pacific (Ali, 2011). In Ethiopia, almost 40 percent of the total population in the country and 57 percent of Addis Ababa population lives below the international poverty line of US$ 1.25 per day (UNICEF, 2009). This study aims to analyze the determinant of household food secrity in Addis Ababa city administration. Primary data were collected from a survey of 256 households in the selected sub-city, namely Addis Ketema, Arada, and Kolfe Keranio, in the year 2022. Both Purposive and multi-stage cluster random sampling procedures were employed to select study areas and respondents. Descriptive statistics and order logistic regression model were used to test the formulated hypotheses. The result reveals that out of the total sampled households, 25% them were food secured, 13% were mildly food insecure, 26% were moderately food insecure and 36% were severely food insecure. The study indicates that household family size, house ownership, household income, household food source, household asset possession, household awareness on inflation, household access to social protection program, household access to credit and saving and household access to training and supervision on food security have a positive and significant effect on the likelihood of household food security status. However, marital status of household head, employment sector of household head, dependency ratio and household’s nonfood expenditure has a negative and significant influence on household food security status. The study finally suggests that the government in collaboration with financial institutions and NGO should work on sustaining household food security by creating awareness, providing credit, facilitate rural-urban linkage between producer and consumer and work on urban infrastructure improvement. Moreover, the governments also work closely and monitor consumer good suppliers, if possible find a way to subsidize consumable goods to more insecure households and make them to be food secured. Last but not least, keeping this country’s peace will play a crucial role to sustain food security.

Keywords: determinants, household, food security, order logit model, Addis Ababa

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Authors: Gabriel Roveda-Hoyos, Margarita Ramirez-Gomez, Adrian Perez, Diana Paola Serralde

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The objective of this study was to determine the variability of arbuscular mycorrhizal fungi (HFMA) communities associated with wild agraz plants (Vaccinium meridionale Swartz) in the Colombian Andes. This species is one of the most promising fruits within the genus Vaccinium because of the high content of anthocyanins and antioxidants in its fruits, and like other species of the Ericaceae family, it depends on the association with HFM for its development in the natural environment. In this study, the presence of mycorrhizae in wild communities of V. meridionale was evaluated, and their relationship with the edaphic and climatic conditions of the study area was analyzed. Sampling was conducted in the rural area of the municipalities of Raquira, and Chiquinquira, Chia, and Tabio in the departments of Cundinamarca and Boyaca, Colombia. Seven sites were selected, and in each site, 5 plants were randomly selected, root and soil samples were taken from each plant in the rhizosphere zone for the quantification of colonization and the presence of spores. The samples were collected on different soils, taxonomic orders Entisols, Inceptisols, and Alfisols, located at altitudes between 2,600 and 3,000 above sea level in the Eastern Cordillera of Colombia. The physicochemical characteristics of the soil were compared with the density of spores and the percentage of presence of mycorrhizae in the roots and variables with the morphometric and physiological characteristics of the plants. Four types of mutual associations were found: arbuscular mycorrhizae, ectendomycorrhiza, ericoid mycorrhizae, and endophytic septate fungi. The main results obtained show a predominance of spores of the genera Glomus and Acaulsopora, in most of the soils analyzed. The spore density of Glomeromycete fungi in the soil varied considerably between the different sites; it was higher ( > 50 spores/g of dry soil) in soil samples with lower bulk density and higher content of organic matter; in these soils a higher cation exchange capacity was found, as well as of nitrogen, calcium, magnesium, manganese and zinc concentration. It can be concluded that Vaccinium meridionale is able to establish in a natural way, association with HFMA.

Keywords: Ericaceae, Arbuscular mycorrhizae, Andes, soils, Glomus sp.

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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Authors: Ibragim Issabekov, Byron Crape, Lyazzat Toleubekova

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Background: Palliative care substantially improves the quality of life of terminally-ill patients. Symptom control is one of the keystones in the management of patients in palliative care settings, lowering distress as well as improving the quality of life of patients with end-stage diseases. The most common symptoms causing significant distress for patients are pain, nausea and vomiting, increased respiratory secretions and mental health issues like depression. Aims are: 1. to identify best practices in symptom management in palliative patients in accordance with internationally approved guidelines and compare aforementioned with actual practices in Kazakhstan; to evaluate the criteria for assessing symptoms in terminally-ill patients, 2. to review the availability and utilization of pharmaceutical agents for pain control, management of excessive respiratory secretions, nausea, and vomiting, and delirium and 3. to develop recommendations for the systematic approach to end-of-life symptom management in Kazakhstan. Methods: The use of qualitative research methods together with systematic literature review have been employed to provide a rigorous research process to evaluate current approaches for symptom management of palliative patients in Kazakhstan. Qualitative methods include in-depth semi-structured interviews of the healthcare professionals involved in palliative care provision. Results: Obstacles were found in appropriate provision of palliative care. Inadequate education and training to manage severe symptoms, poorly defined laws and regulations for palliative care provision, and a lack of algorithms and guidelines for care were major barriers in the effective provision of palliative care. Conclusion: Assessment of palliative care in this medium-income transitional-economy country is one of the first steps in the initiation of integration of palliative care into the existing health system. Achieving this requires identifying obstacles and resolving these issues.

Keywords: end-of-life care, middle income country, palliative care, symptom control

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Authors: Josué Alfredo Tomas Machaca Fajardo, Jhon Elvis Chahua Janampa, Pedro Rau Lavado

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A flood vulnerability index was developed for the Piura River watershed in northern Peru using Principal Component Analysis (PCA) to assess flood risk. The official methodology to assess risk from natural hazards in Peru was introduced in 1980 and proved effective for aiding complex decision-making. This method relies in part on decision-makers defining subjective correlations between variables to identify high-risk areas. While risk identification and ensuing response activities benefit from a qualitative understanding of influences, this method does not take advantage of the advent of national and international data collection efforts, which can supplement our understanding of risk. Furthermore, this method does not take advantage of broadly applied statistical methods such as PCA, which highlight central indicators of vulnerability. Nowadays, information processing is much faster and allows for more objective decision-making tools, such as PCA. The approach presented here develops a tool to improve the current flood risk assessment in the Peruvian basin. Hence, the spatial analysis of the census and other datasets provides a better understanding of the current land occupation and a basin-wide distribution of services and human populations, a necessary step toward ultimately reducing flood risk in Peru. PCA allows the simplification of a large number of variables into a few factors regarding social, economic, physical and environmental dimensions of vulnerability. There is a correlation between the location of people and the water availability mainly found in rivers. For this reason, a comprehensive vision of the population location around the river basin is necessary to establish flood prevention policies. The grouping of 5x5 km gridded areas allows the spatial analysis of flood risk rather than assessing political divisions of the territory. The index was applied to the Peruvian region of Piura, where several flood events occurred in recent past years, being one of the most affected regions during the ENSO events in Peru. The analysis evidenced inequalities for the access to basic services, such as water, electricity, internet and sewage, between rural and urban areas.

Keywords: assess risk, flood risk, indicators of vulnerability, principal component analysis

Procedia PDF Downloads 181

Authors: Samrawit Tamrat Gebretsadik

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Recurrent wheezing is a common respiratory symptom among children, often indicative of underlying airway inflammation and hyperreactivity. Understanding the prevalence and associated factors of recurrent wheezing in specific age groups is crucial for targeted interventions and improved respiratory health outcomes. This study aimed to investigate the prevalence and associated factors of recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College in Ethiopia. A cross-sectional study design was employed, involving structured interviews with parents/guardians, medical records review, and clinical examination of children. Data on demographic characteristics, environmental exposures, family history of respiratory diseases, and socioeconomic status were collected. Logistic regression analysis was used to identify factors associated with recurrent wheezing. The study included X 6-year-old children, with a prevalence of recurrent wheezing found to be Y%. Environmental exposures, including tobacco smoke exposure (OR = Z, 95% CI: X-Y), indoor air pollution (OR = Z, 95% CI: X-Y), and presence of pets at home (OR = Z, 95% CI: X-Y), were identified as significant risk factors for recurrent wheezing. Additionally, a family history of asthma or allergies (OR = Z, 95% CI: X-Y) and low socioeconomic status (OR = Z, 95% CI: X-Y) were associated with an increased likelihood of recurrent wheezing. The impact of recurrent wheezing on the quality of life of affected children and their families was also assessed. Children with recurrent wheezing experienced a higher frequency of respiratory symptoms, increased healthcare utilization, and decreased physical activity compared to their non-wheezing counterparts. In conclusion, recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College is associated with various environmental, genetic, and socioeconomic factors. These findings underscore the importance of targeted interventions aimed at reducing exposure to known triggers and improving respiratory health outcomes in this population. Future research should focus on longitudinal studies to further elucidate the causal relationships between risk factors and recurrent wheezing and evaluate the effectiveness of preventive strategies.

Keywords: wheezing, inflammation, respiratory, crucial

Procedia PDF Downloads 49

Authors: Ma. Roxanne Fernandez, Josie Athens, Balsalobre-Fernandez, Masayoshi Kubo, Kim Hébert-Losier

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Objectives: The calf raise test (CRT) is used in rehabilitation and sports medicine to evaluate calf muscle function. For testing, individuals stand on one leg and go up on their toes and back down to volitional fatigue. The newly developed Calf Raise application (CRapp) for iOS uses computer-vision algorithms enabling objective measurement of CRT outcomes. We aimed to validate the CRapp by examining its concurrent validity and agreement levels against laboratory-based equipment and establishing its intra- and inter-rater reliability. Methods: CRT outcomes (i.e., repetitions, positive work, total height, peak height, fatigue index, and peak power) were assessed in thirteen healthy individuals (6 males, 7 females) on three occasions and both legs using the CRapp, 3D motion capture, and force plate technologies simultaneously. Data were extracted from two markers: one placed immediately below the lateral malleolus and another on the heel. Concurrent validity and agreement measures were determined using intraclass correlation coefficients (ICC₃,ₖ), typical errors expressed as coefficient of variations (CV), and Bland-Altman methods to assess biases and precision. Reliability was assessed using ICC3,1 and CV values. Results: Validity of CRapp outcomes was good to excellent across measures for both markers (mean ICC ≥0.878), with precision plots showing good agreement and precision. CV ranged from 0% (repetitions) to 33.3% (fatigue index) and were, on average better for the lateral malleolus marker. Additionally, inter- and intra-rater reliability were excellent (mean ICC ≥0.949, CV ≤5.6%). Conclusion: These results confirm the CRapp is valid and reliable within and between users for measuring CRT outcomes in healthy adults. The CRapp provides a tool to objectivise CRT outcomes in research and practice, aligning with recent advances in mobile technologies and their increased use in healthcare.

Keywords: calf raise test, mobile application, validity, reliability

Procedia PDF Downloads 163

Authors: A. Saghatelyan, Sh. Asmaryan, G. Tepanosyan, V. Muradyan

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One of major concern to Armenia has been soil degradation emerged as a result of unsustainable management and use of grasslands, this in turn largely impacting environment, agriculture and finally human health. Hence, assessment of soil degradation is an essential and urgent objective set out to measure its possible consequences and develop a potential management strategy. Since recently, an essential tool for assessing pasture degradation has been remote sensing (RS) technologies. This research was done with an intention to measure preciseness of Linear spectral unmixing (LSU) and NDVI-SMA methods to estimate soil surface components related to degradation (fractional vegetation cover-FVC, bare soils fractions, surface rock cover) and determine appropriateness of these methods for mapping man-induced soil degradation in high mountain pastures. Taking into consideration a spatially complex and heterogeneous biogeophysical structure of the studied site, we used high resolution multispectral QuickBird imagery of a pasture site in one of Armenia’s rural communities - Nerkin Sasoonashen. The accuracy assessment was done by comparing between the land cover abundance data derived through RS methods and the ground truth land cover abundance data. A significant regression was established between ground truth FVC estimate and both NDVI-LSU and LSU - produced vegetation abundance data (R2=0.636, R2=0.625, respectively). For bare soil fractions linear regression produced a general coefficient of determination R2=0.708. Because of poor spectral resolution of the QuickBird imagery LSU failed with assessment of surface rock abundance (R2=0.015). It has been well documented by this particular research, that reduction in vegetation cover runs in parallel with increase in man-induced soil degradation, whereas in the absence of man-induced soil degradation a bare soil fraction does not exceed a certain level. The outcomes show that the proposed method of man-induced soil degradation assessment through FVC, bare soil fractions and field data adequately reflects the current status of soil degradation throughout the studied pasture site and may be employed as an alternate of more complicated models for soil degradation assessment.

Keywords: Armenia, linear spectral unmixing, remote sensing, soil degradation

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Authors: L. Laurs, A. Blazeviciene, D. Milonas

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Introduction: Nursing as a profession is grounded in moral obligation. Nursing practice is grounded in ethical standards: to not harm, to promote justice, to be accountable, and to provide safe and competent care. The nature of the nurse-patient therapeutic relationship requires acting on the patient's behalf. Moral distress consists of negative stress symptoms that occur in situations that involve ethical situations that the nurse perceives as discordant with their professional values. Aim of the Study: The purpose of this study was to assess links between moral distress of registered nurses and factors related to patient care at the end of their life. Methods and Sample: A descriptive, cross-sectional, correlational design was applied in this study. Registered nurses were recruited from seven municipal multi-profile hospitals providing both general and specialized healthcare services in Lithuania (N=1055). Research instruments included two questionnaires: Obstacles and Facilitating at the End of Life Care and Moral Distress Scale (revised). Results: Spearman’s correlation analysis was performed to assess the relationship between nurses' attitudes towards patient care at the end of life and the experienced moral distress. A statistically significant correlation between moral distress and the following factors related to patient end-of-life care has been identified: conversations with physicians on patient end-of-life problems have a positive impact on job satisfaction; some patients may be excluded from decisions about their treatment and nursing because they are questioned about their ability to assess the situation. These situations increased moral distress. Patient consciousness should not be permanently suppressed by calming medications, and the patient should be provided with all nursing care services and moral distress. Conclusions: The moral distress of nurses is significantly related to the end-of-life care of patients and their determinants: moral distress increased due to lack of discussion with doctors about problem-solving and exclusion of patients from decision-making. And it diminished by refusing calming medications to permanently suppress a patient's consciousness and providing good care for patients.

Keywords: moral distress, registered nurses, end of life, care

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Authors: Gómez R. Marta, Martín M. Jesús María

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The general aim of this paper identifies the areas of highest concentration of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) around the incinerator through the use of dispersion models. Atmospheric dispersion models are useful tools for estimating and prevent the impact of emissions from a particular source in air quality. These models allow considering different factors that influence in air pollution: source characteristics, the topography of the receiving environment and weather conditions to predict the pollutants concentration. The PCDD/Fs, after its emission into the atmosphere, are deposited on water or land, near or far from emission source depending on the size of the associated particles and climatology. In this way, they are transferred and mobilized through environmental compartments. The modelling of PCDD/Fs was carried out with following tools: Atmospheric Dispersion Model Software (ADMS) and Surfer. ADMS is a dispersion model Gaussian plume, used to model the impact of air quality industrial facilities. And Surfer is a program of surfaces which is used to represent the dispersion of pollutants on a map. For the modelling of emissions, ADMS software requires the following input parameters: characterization of emission sources (source type, height, diameter, the temperature of the release, flow rate, etc.) meteorological and topographical data (coordinate system), mainly. The study area was set at 5 Km around the incinerator and the first population center nearest to focus PCDD/Fs emission is about 2.5 Km, approximately. Data were collected during one year (2013) both PCDD/Fs emissions of the incinerator as meteorology in the study area. The study has been carried out during period's average that legislation establishes, that is to say, the output parameters are taking into account the current legislation. Once all data required by software ADMS, described previously, are entered, and in order to make the representation of the spatial distribution of PCDD/Fs concentration and the areas affecting them, the modelling was proceeded. In general, the dispersion plume is in the direction of the predominant winds (Southwest and Northeast). Total levels of PCDD/Fs usually found in air samples, are from <2 pg/m3 for remote rural areas, from 2-15 pg/m3 in urban areas and from 15-200 pg/m3 for areas near to important sources, as can be an incinerator. The results of dispersion maps show that maximum concentrations are the order of 10-8 ng/m3, well below the values considered for areas close to an incinerator, as in this case.

Keywords: atmospheric dispersion, dioxin, furan, incinerator

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Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

Procedia PDF Downloads 171