Search results for: medical and health

Authors: Maretha Le Roux, Corinna Walsh, Mariette M. Nel

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Introduction: The first 1000 days from conception to 24 months, is a critical period for healthy growth and development. In South Africa, stunting is a major public health issue with significant health consequences. We determined associations between demographic, health and anthropometric indicators of mothers and their infants. Methods: A cross-sectional study was conducted in all districts in the Northern Cape. All mothers with 5-7 week old babies visiting PHC facilities could participate. A questionnaire was completed in a structured interview with each mother. Weight and length of the baby at birth and at 6 weeks were used to determine stunting, while weight and height of the mother were measured for body mass index (BMI). Results: Eight hundred questionnaires were completed in 92 facilities. The median age of mothers was 26 years (range 10-46 years), and 44,9% were married. Almost 40% relied on a government grant as main source of income. Two-thirds (64,9%) had not planned the pregnancy, and 19.4% had a Caesarian section. Although 79% breastfed exclusively, more than a quarter (26,1%) smoked cigarettes or used snuff during pregnancy, while 9,4% drank alcohol. At birth, 17.7% of boys and 13.0% of girls were stunted (height-for-age below -2SD from the WHO reference values), while at 6 weeks this had increased to 30.8% of boys and 14.1% of girls. In terms of mothers, 25,4% were classified as obese and 24,6% as overweight at 6 weeks. Compared to babies that were not stunted, significantly more babies of mothers that were older, overweight, used ART, relied on a grant and smoked/snuffed during pregnancy were stunted. Conclusion: To address stunting, interventions aimed at encouraging healthy lifestyles with the emphasis on maintaining a healthy weight, healthy eating and smoking cessation before pregnancy are urgently required.

Keywords: growth, health, South Africa, stunting

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Authors: Mohammad Mosaddik Rahman

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This study embarks on an exploratory journey to assess the pervasive issue of heavy metal contamination in the water bodies along Chittagong Coast, Bangladesh. Situated along the mesmerizing Bay of Bengal, known for its potential as an emerging tourist haven, economic zone, ship breaking yard, confronts significant environmental hurdles. The core of these challenges lies in the contamination from heavy metals such as lead, cadmium, chromium, and mercury, which detrimentally impact both the ecological integrity and public health of the region. This contamination primarily stems from industrial activities, particularly those involving metallurgical and chemical processes, which release these metals into the environment, leading to their accumulation in soil and water bodies. The study's primary aim is to conduct a thorough assessment of heavy metal pollution levels, alongside an analysis of nutrient variations, focusing on nitrates and nitrites. Methodologically, the study leverages systematic sampling and advanced analytical tools like the Hach 3900 spectrophotometer to ensure precise and reliable data collection. The implications of heavy metal presence are multifaceted, affecting microbial and aquatic life, and posing severe health risks to the local population, including respiratory problems, neurological disorders, and an increased risk of cancer. The results of this study highlight the urgent need for effective mitigation strategies and regulatory measures to address this critical issue. By providing a comprehensive understanding of the environmental and public health implications of heavy metal contamination in Chittagong Coast, this research endeavours to serve as a catalyst for change, emphasising the need for pollution control and advancements in water management policies. It is envisioned that the outcomes of this study will guide stakeholders in collaborating to develop and implement sustainable solutions, ultimately safeguarding the region’s environment and public health.

Keywords: heavy metal, environmental health, pollution control policies, shipbreaking yard

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Authors: Lakmali Anthony, Madeline Gillies

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Background: Colorectal cancer (CRC) is usually managed with surgical resection. Many of the outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO), such as Health-Related Quality of life (HRQoL), provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. HRQoL has previously been shown to be impacted by psychosocial, behavioral and disease-specific characteristics. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods: Consecutive patients who had resection of colorectal cancer in a single regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey instrument designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Demographic and disease-specific data were also collected via medical record review. Results: Forty-six patients completed the survey. Clinically significant levels of fear of recurrence as well as emotional distress, were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for CRC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL; however, the operative approach (laparoscopic vs. open) was associated with HRQoL for these patients. All psychosocial factors measured were associated with HRQoL, including cancer worry, emotional distress, body image and dispositional optimism. Conclusion: HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative colorectal cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: surgery, colorectal, cancer, PRO, HRQoL

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Authors: J. Jarolímek, P. Urban, P. Pavlínek, D. Dzúrová

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The industry constitutes a dominant economic sector in Czechia. The automotive industry represents the most important industrial sector in terms of gross value added and the number of employees. The objective of this study was to analyse the occurrence of occupational diseases (OD) in the automotive industry in Czechia during the 2001-2014 period. Whereas the occurrence of OD in other sectors has generally been decreasing, it has been increasing in the automotive industry, including growing spatial discrepancies. Data on OD cases were retrieved from the National Registry of Occupational Diseases. Further, we conducted a survey in automotive companies with a focus on occupational health services and positions of the companies in global production networks (GPNs). An analysis of OD distribution in the automotive industry was performed (age, gender, company size and its role in GPNs, regional distribution of studied companies, and regional unemployment rate), and was accompanied by an assessment of the quality and range of occupational health services. The employees older than 40 years had nearly 2.5 times higher probability of OD occurrence compared with employees younger than 40 years (OR 2.41; 95% CI: 2.05-2.85). The OD occurrence probability was 3 times higher for women than for men (OR 3.01; 95 % CI: 2.55-3.55). The OD incidence rate was increasing with the size of the company. An association between the OD incidence and the unemployment rate was not confirmed.

Keywords: occupational diseases, automotive industry, health geography, unemployment

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Authors: Hela Ghali, Sihem Ben Fredj, Mohamed Ben Rejeb, Sawssen Layouni, Salwa Khefacha, Lamine Dhidah, Houyem Said Laatiri

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Background: Antimicrobial resistance is a growing threat to public health and motivates to improve prevention and control programs both at international (WHO) and national levels. Despite their low pathogenicity, vancomycin-resistant enterococci (VRE) are common nosocomial pathogens in several countries. The high potential for transmission of VRE between patients and the threat to send its resistance genes to other bacteria such as staphylococcus aureus already resistant to meticilin, justify strict control measures. Indeed, in Europe, the proportion of Enterococcus faecium responsible for invasive infections, varies from 1% to 35% in 2011 and less than 5% were resistant to vancomycin. In addition, it represents the second cause of urinary tract and wound infections and the third cause of nosocomial bacteremia in the United States. The nosocomial outbreaks of VRE have been mainly described in intensive care services, hematology-oncology and haemodialysis. An epidemic of VRE has affected our hospital and the objective of this work is to describe the measures put in place. Materials/Methods: Following the alert given by the service of plastic surgery concerning a patient carrier of VRE, a team of the prevention and healthcare security service (doctor + technician) made an investigation. A review of files was conducted to draw the synoptic table and the table of cases. Results: By contacting the microbiology laboratory, we have identified four other cases of VRE and who were hospitalized in Medical resuscitation department (2 cases, one of them was transferred to the Physical rehabilitation department), and Nephrology department (2 cases). The visit has allowed to detect several malfunctions in professional practice. A crisis cell has allowed to validate, coordinate and implement control measures following the recommendations of the Technical Center of nosocomial infections. In fact, the process was to technically isolate cases in their sector of hospitalization, to restrict the use of antibiotics, to strength measures of basic hygiene, and to make a screening by rectal swab for both cases and contacts (other patients and health staff). These measures have helped to control the situation and no other case has been reported for a month. 2 new cases have been detected in the intensive care unit after a month. However, these are short-term strategies, and other measures in the medium and long term should be taken into account in order to face similar outbreaks. Conclusion: The efforts to control the outbreak were not efficient since 2 new cases have been reported after a month. Therefore, a continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of VRE.

Keywords: hospitals, nosocomial infection, outbreak, vancomycin-resistant enterococci

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Authors: Sara E. Baumann, Megan A. Rabin, Mary Hawk, Bhimsen Devkota, Kajol Upadhyaya, Guna Raj Shrestha, Brigit Joseph, Annika Agarwal, Jessica G. Burke

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In Nepal, prevailing sociocultural norms associated with menstruation prompt adherence to stringent rules that limit participation in daily activities. Chhaupadi is a specific menstrual tradition in Nepal in which women and girls segregate themselves and follow a series of restrictions during menstruation. Despite having numerous physical and mental health implications, extant interventions have yet to sustainably address the harms associated with chhaupadi. In this study, the authors describe insights garnered from a collaboration with community members in Dailekh district, who formulated their own approaches to mitigate the adverse facets of chhaupadi. Envisaged as an entry point to improve women’s menstrual health experiences, this investigation employed an approach that uses Human-centered Design and a community-engaged approach. The authors conducted a four-day design workshop which unfolded in two phases: The Discovery Phase, to uncover chhaupadi context and key stakeholders, and the Design Phase, to design contextually relevant interventions. Diverse community-members, including those with lived experience practicing chhaupadi, developed five intervention concepts: 1) harnessing Female Community Health Volunteers as role models, for counseling, and raising awareness; 2) focusing on mothers and mother’s groups to instigate behavioral shifts; 3) engaging the broader community in behavior change efforts; 4) empowering fathers to effect change in their homes through counseling and education; and 5) training and emboldening youth to advocate for positive change through advocacy in their schools and homes. This research underscores the importance of employing multi-level approaches tailored to specific stakeholder groups, given Nepal’s rich cultural diversity. The engagement of Female Community Health Volunteers emerged as a promising yet underexplored intervention concept for chhaupadi, warranting broader implementation. Crucially, it is also imperative for interventions to prioritize tackling deleterious aspects of the chhaupadi tradition, emphasizing safety considerations, all while acknowledging chhaupadi’s entrenched cultural history; for some, there are positive aspects of the tradition that women and girls wish to preserve.

Keywords: human-centered design, menstrual health, Nepal, community-engagement, intervention development, women's health, rural health

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Authors: Salima Kerai, Muhammad Islam, Uzma Khan, Nargis Asad, Junaid Razzak, Omrana Pasha

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Background: Pre-hospital care providers are exposed to various kinds of stressors. Their daily exposure to diverse critical and traumatic incidents can lead to stress reactions like Post-Traumatic Stress Disorder (PTSD). Consequences of PTSD in terms of work loss can be catastrophic because of its compound effect on families, which affect them economically, socially and emotionally. Therefore, it is critical to assess the association between PTSD and Work performance in Emergency Medical Service (EMS) if exist any. Methods: This prospective observational study was carried out at AMAN EMS in Karachi, Pakistan. EMS personnel were screened for potential PTSD using impact of event scale-revised (IES-R). Work performance was assessed on basis of five variables; number of late arrivals to work, number of days absent, number of days sick, adherence to protocol and patient satisfaction survey over the period of 3 months. In order to model outcomes like number of late arrivals to work, days absent and days late; negative binomial regression was used whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Results: Out of 536 EMS personnel, 525 were found to be eligible, of them 518 consented. However data on 507 were included because 7 left the job during study period. The mean score of PTSD was found to be 24.0 ± 12.2. However, weak and insignificant association was found between PTSD and work performance measures: number of late arrivals (RRadj 0.99; 95% CI 0.98-1.00), days absent (RRadj 0.98; 95% CI 0.96-0.99), days sick (Rradj 0.99; 95% CI 0.98 to 1.00), adherence to protocol (ORadj 1.01: 95% CI 0.99 to 1.04) and patient satisfaction (0.001% score; 95% CI -0.03% to 0.03%). Conclusion: No association was found between PTSD and Work performance in the selected EMS population in Karachi Pakistan. Further studies are needed to explore the phenomenon of resiliency in these populations. Moreover, qualitative work is required to explore perceptions and feelings like willingness to go to work, readiness to carry out job responsibilities.

Keywords: trauma, emergency medical service, stress, pakistan

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Authors: Lin Tang, Xiaoxia Guo, Lingling Zhang

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Recent vaccine scandals overshadowed China’s accomplishment of public health, triggering discussions on the causes of vaccine incidents. Through legal interpretation of selected vaccine incidents and analysis of systemic vulnerabilities in vaccine circulation and lot release, a panoramic review of legislative progresses in the vaccine administration sheds the light on this debate. In essence, it is the combination of the lagging legal system and the absence of information technology infrastructure in the process of vaccine administration reform that has led to the recurrence of vaccine incidents. These findings have significant implications for further improvement of vaccine administration and China’s participation in global healthcare.

Keywords: legislation, lot release, public health, reform, vaccine administration, vaccine circulation

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Authors: Adem Rama, Rabiha Seboussi, Mahmoud Muhamadin, Sultan Alzarooni, Fatima Mohamed, Khuloud Al Ali

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To assess public health hazards associated with the occurrence of Antibiotics and AFM1 residues in UHT milk, a survey was carried out in Sharjah, UAE. In the present study, a total of 42 UHT milk samples analyzed were from different commercial brands manufactured in industrial dairy units in the UAE and from foreign producers. Milk samples were collected for four months (January to April 2020). The occurrence and concentration range of Antibiotics (Streptomycin and Gentamycin) and AFM1 in the samples were investigated by applying the ELISA method. According to the methodology used in this study, in total, 2 (5%) out of 42(95%) samples tested positive on the presence of AFM1. While, 1(2.4%) out of 41(97.6%) positive samples were found to contain Streptomycin and Gentamycin, respectively. The positive incidence of AFM1 in the UHT milk samples ranged from 58.8 to 1074 µg/L, for Streptomycin from up to 1004 µg/L, and Gentamycin up to 6909 µg/L. There were no positive samples found in locally produced UHT milk. AFM1 and antibiotic levels in positive samples UHT milk samples exceeded the maximum tolerable limits as set by the European Union - EC guidelines/standards. These levels in the samples show a presence of contaminants that might constitute a human health risk in Sharjah. The results of this study imply that more emphasis should be given to the routine inspection of milk and dairy products in the Sharjah region.

Keywords: milk, contaminant residues, ELISA, public health, Sharjah

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Authors: Charlotte Zamani

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Children's and young people’s (CYP’s) perspectives on using client preference tools are central to understanding youth mental health therapy engagement. This systematic literature review attempts to understand the meanings of CYP using preference tools that may allow greater connection with the therapeutic process. Following a systematic search using PRISMA guidelines, seven studies were identified that reported qualitative feedback on preferred treatment options or activities within therapy. The data were analysed using interpretative phenomenological analysis (IPA). Three group experiential themes were found: ‘Tailor my support’, ‘My autonomy leads to greater engagement’ and ‘Preferences facilitate my authentic self’. CYP is broadly divided into those who thrive in decision-making and those who require more support. Being offered a choice in therapy delivery provides easier access and means more freedom for CYP. Preferences in therapy appeared to enable greater self-knowledge and a deeper connection to the therapeutic process. The therapist is integral in using preference tools in therapy. Youth feedback is currently limited, yet essential and ethical in order to understand critical factors of CYP engagement and for future research.

Keywords: child and adolescent, client preferences, mental health therapy, qualitative

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Authors: Marco Vinicio Félix Lerma, Efrain Rubio Rosas, Fernando Ricardez Rueda, Victor Manuel Castaño Meneses

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This paper reports a spectral analysis of the exposure levels of radiofrequency electromagnetic fields originating from a wide variety of telecommunications sources present in an urban area of Lagos de Moreno, Jalisco, Mexico. The electromagnetic characterization of the urban zone under study was carried out by measurements in 118 sites. Measurements of TETRA,ISM434, LTE800, ISM868, GSM900, GSM1800, 3G UMTS,4G UMTS, Wlan2.4, LTE2.6, DECT, VHF Television and FM radio signals were performed at distances ranging over 10 to 1000m from 87 broadcasting towers concentrated in an urban area of about 3 hectares. The aim of these measurements is the evaluation of the electromagnetic fields power levels generated by communication systems because of their interaction with the human body. We found that in certain regions the general public exposure limits determined by ICNIRP (International Commission of Non Ionizing Radiation Protection) are overpassed from 5% up to 61% of the upper values, indicating an imminent health public hazard, whereas in other regions we found that these limits are not overpassed. This work proposes an electromagnetic pollution classification for urban zones according with ICNIRP standards. We conclude that the urban zone under study presents diverse levels of pollution and that in certain regions an electromagnetic shielding solution is needed in order to safeguard the health of the population that lives there. A practical solution in the form of paint coatings and fiber curtains for the buildings present in this zone is also proposed.

Keywords: electromagnetic field, telecommunication systems, electropollution, health hazards

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Authors: Lidon Lashley

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This paper presents how the social model of disability can be used to reshape inclusive education practices in Guyana. Inclusive education in Guyana is metamorphosizing but still firmly held in the tenets of the Medical Model of Disability which influences the experiences of children with Special Education Needs and/or Disabilities (SEN/D). An ethnographic approach to data gathering was employed in this study. Qualitative data was gathered from the voices of children with and without SEN/D as well as their mainstream teachers to present the interplay of discourses and subjectivities in the situation. The data was analyzed using Adele Clarke's postmodern approach to grounded theory analysis called situational analysis. The data suggest that it is possible but will be challenging to fully contextualize and adopt Loreman's synthesis and Booths and Ainscow's Index in the two mainstream schools studied. In addition, the data paved the way for the presentation of the social model framework specific to Guyana called 'Southern Inclusive Education Framework for Guyana' and its support tool called 'The Inclusive Checker created for Southern mainstream primary classrooms.

Keywords: social model of disability, medical model of disability, subjectivities, metamorphosis, special education needs, postcolonial Guyana, inclusion, culture, mainstream primary schools, Loreman's synthesis, Booths and Ainscow's index

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Authors: Senait Belay Adugna, Mirutse Giday, Tsegahun Manyazewal

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Background: The emergence and resurgence of zoonotic diseases have continued to be a major threat to global health and the economy. Developing countries are particularly vulnerable due to agricultural expansions and the domestication of animals by humans. Scientifically sound clinical trials are important to find better ways to prevent, diagnose, and treat zoonotic diseases, while there is a lack of evidence to inform the clinical trials’ capacity and practice in countries highly affected by the diseases. This study aimed to investigate researchers’ perceptions and experiences in conducting clinical trials on zoonotic diseases in Ethiopia. Methods: This study employed a descriptive, qualitative study design. It included major academic and research institutions in Ethiopia that had active engagements in veterinary and public health research. It included the National Veterinary Institute, the National Animal Health Diagnostic and Investigation Center, the College of Veterinary Medicine at Addis Ababa University, the Ethiopian Public Health Institute, the Armauer Hansen Research Institute, and the College of Health Sciences at Addis Ababa University. In-depth interviews were conducted with 14 senior researcher investigators in the institutions who hold a proven exhibit primarily leading research activities or research units. Data were collected from October 2019 to April 2020. Data analysis was undertaken using open code 4.03 for qualitative data analysis. Results: Five major themes, with 18 sub-themes, emerged from the in-depth interview in connection. These were: challenges in the prevention, control, and treatment of zoonotic diseases; One Health approach to mitigate zoonotic diseases; personal and institutional experiences in conducting clinical trials on zoonotic diseases; barriers in conducting clinical trials towards zoonotic diseases; and strategies that promote conducting clinical trials on zoonotic diseases. Conducting clinical trials on zoonotic diseases in Ethiopia is hampered by a lack of clearly articulated ethics and regulatory frameworks, trial experts, financial resources, and good governance. Conclusions: In Ethiopia, conducting clinical trials on zoonotic diseases deserves due attention. Strengthening institutional and human resources capacity is a precondition to harnessing effective implementation of clinical trials on zoonotic diseases in the country. In Ethiopia, where skilled human resource is scarce, the One Health approach has the potential to form multidisciplinary teams to systematically improve clinical trials capacity and outcomes in the country.

Keywords: Ethiopia, clinical triak, zoonoses, disease

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Authors: Asma AlAmri, Ahmed Hassab Errasoul

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Background & Objectives: Psychiatric disorders are common, affecting approximately one of five adults (17.6%) of the population. While most patients can be successfully treated as outpatients, admission to psychiatric wards is required during relapses or as part of crisis intervention. The first 72h of admission could be particularly critical due to increased risk of physical violence, non-medical discharge and absconding. Many patients requiring interventions such as seclusion, physical restrain, PRN psychotropic medications. This study aims to investigate the relationship between demographical, clinical and pharmacological factors in one hand and certain outcomes (physical aggression, use of PRN medications, need for seclusions and non-medical discharges) within the first 72hours of admission to acute psychiatric wards in KKUH/Riyadh Methods: All admissions to psychiatric wards over a 20 month period, between (May 2015- January 2017) were included. Data was collected on demographics, diagnosis, psychotropic medications prescription, documented physical aggression, and seclusion, self-discharge and absconding. Results: 134 males and 171 females were admitted over the study period. Mean age was 34.2 years (SD 11.96).48.9% (n=149) were single and most patients (n=198) were either unemployed or in educations. Bipolar disorder was the most frequent diagnosis recorded on admission (39.3%, n=120); followed by Schizophrenia and related disorders (34.8%; n=106). Most patients (77.4%, n= 236) received regular psychotropic medications on admission. Vis a vis, 223 patients (73%) received PRN medications. Nominal regression model revealed positive relationship between “no psychotropics prescribed on admission” and self-discharge in women but not in men. No statistically significant relationship was found between age, gender, admission diagnosis and use of regular psychotropic medications on admission and need for seclusion, time spent in seclusion, documented physical aggression and use of PRN medications. Conclusion: Contrary to what is expected, our study does not show association between gender, physical aggression and need for seclusion. This could be due to poor documentation practices by nursing staff in male ward comparing with those in the female ward. Use of PRN psychotropics in the first 72 hours of admission was quite high possibly leading to a “ceiling effect”. A limitation of this study is the retrospective data collection.

Keywords: discharge against medical advice, physical aggression, psychotropics, seclusion

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Authors: Simon Mensah Ofosu

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Illicit surface mining activities pollutes agricultural lands and water bodies and results in accumulation of heavy metals in vegetables cultivated in such areas. Heavy metal (HM) accumulation in vegetables is a serious food safety issues due to the adverse effects of metal toxicities, hence the need to investigate the levels of these metals in cultivated vegetables in the eastern region. Cocoyam leaves, cabbage and cucumber were sampled from selected farms in mining areas (Atiwa District) and non -mining areas (Yilo Krobo and East Akim District) of the region for the study. Levels of Cadmium, Lead, Mercury and Arsenic were investigated in the vegetables with Atomic Absorption Spectrometer, and the results statistically analyzed with Microsoft Office Excel (2013) Spread Sheet and ANOVA. Cadmium (Cd) and arsenic (As) were the highest and least concentrated HM in the vegetables sampled, respectively. The mean concentrations of Cd and Pb in cabbage (0.564 mg/kg, 0.470 mg/kg), cucumber (0.389 mg/kg, 0.190 mg/kg), cocoyam leaves (0.410 mg/kg, 0.256 mg/kg) respectively from the mining areas exceeded the permissible limits set by Joint FAO/WHO. The mean concentrations of the metals in vegetables from the mining and non-mining areas varied significantly (P<0.05). The Target Hazard Quotient (THQ) was used to assess the health risk posed to the human population via vegetable consumption. The THQ values of cadmium, mercury, and lead in adults and children through vegetable consumption in the mining areas were greater than 1 (THQ >1). This indicates the potential health risk that the children and adults may be facing. The THQ values of adults and children in the non-mining areas were less than the safe limit of 1 (THQ<1), hence no significant health risk posed to the population from such areas.

Keywords: food safety, risk assessment, illicit mining, public health, contaminated vegetables

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Authors: Zahra Zamanian, Alireza Zamanian, Jafar Hasanzadeh

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Background: Unwanted sound, as one of the most important physical factors in the majority of production units, imposes a great number of problems on the industrial workers. Sound is one of the environmental factors which can cause physical as well as psychological damages and also affects the individuals’ performance and productivity. Therefore, the present study aimed to determine the effect of noise exposure on human performance. Methods: The present study assessed the effect of noise on the performance of 50 students of Shiraz University of Medical Sciences (25 males and 25 females) at the sound pressures of 70, 90, and 110 dB by using two factors of physical features and the creation of different conditions of sound pressure source as well as applying Two-Arm coordination Test. Results: The results of the present study revealed no significant difference between male and female subjects as well as different conditions of creating sound pressure regarding the length of performance (p> 0.05). In addition, as the sound pressure increased, the length of performance increased, as well. According to the results, no significant difference was found between the performance at 70 and 90 dB. On the other hand, the performance at 110 dB was significantly different from the performance at 70 and 90 dB (p<0.05 and p<0.001). Conclusion: In general, as the sound pressure increases, the performance decreases which results in a considerable increase in the individuals’ rate of error.

Keywords: physical factors, two-arm coordination test, Shiraz University of Medical Sciences, noise

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Authors: Davidson E. Egirani, Nanfe R. Poyi, Napoleon Wessey

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This paper would report the environmental challenges faced by stakeholders in the development and management of mineral resources in Mindanao mining region of the Philippines. The paper would proffer solutions via the development and management of integrated mineral resource framework. This is by interfacing the views of government, operating mining companies and the mining host communities. The project methods involved the desktop review of existing local, regional, national environmental and mining legislation. This was followed up with visits to mining sites and discussions were held with stakeholders in the mineral sector. The findings from a 2-year investigation would reveal lack of information, education, and communication campaign by stakeholders on environmental, health, political, and social issues in the mining industry. Small-scale miners lack the professional muscles for a balance shift of emphasis to sustainable and responsible mining to avoid environmental degradation and human health effect. Therefore, there is a need to balance ecological requirements, sustainability of the environment and development of mineral resources. This paper would provide an environmentally friendly mineral resource development framework.

Keywords: ecological requirements, environmental degradation, human health, mining legislation, responsible mining

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Authors: D. Velayadum, P. Sthandiwe , N. Maharaj, T. Munien, S. Ndamase, G. Zulu, S. Xulu, F. Oosthuizen

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Introduction and aims of the study: It is the responsibility of the pharmacist to manage drug-related problems in order to ensure the greatest benefit to the patient. In order to prevent drug-related morbidity, pharmacists should be aware of medicines that may contribute to certain drug-related problems due to their pharmacological action. In an attempt to assist healthcare practitioners to prevent drug-related morbidity (PDRM), indicators for prevention have been designed. There are currently no indicators available for primary health care in developing countries like South Africa, where the majority of the population access primary health care. There is, therefore, a need to develop such indicators, specifically with the aim of assisting healthcare practitioners in primary health care. Methods: A literature study was conducted to compile a comprehensive list of PDRM indicators as developed internationally using the search engines Google Scholar and PubMed. MESH term used to retrieve suitable articles was 'preventable drug-related morbidity indicators'. The comprehensive list of PDRM indicators obtained from the literature study was further evaluated for face validity. Face validity was done in duplicate by 2 sets of independent researchers to ensure 1) no duplication of indicators when compiling a single list, 2) inclusion of only medication available in primary healthcare, and 3) inclusion of medication currently available in South Africa. Results: The list of indicators, compiled from PDRM indicators in the USA, UK, Portugal, Australia, India, and Canada contained 324 PDRM. 184 of these indicators were found to be duplicates, and the duplications were omitted, leaving a final list of 140. The 140 PDRM indicators were evaluated for face-validity, and 97 were accepted as relevant to primary health care in South Africa. 43 indicators did not comply with the criteria and were omitted from the final list. Conclusion: This study is a first step in compiling a list of PDRM indicators for South Africa. It is important to take cognizance to the fact the health systems differ vastly internationally, and it is, therefore, important to develop country-specific indicators.

Keywords: drug-related morbidity, primary healthcare, South Africa, developing countries

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Authors: M. Card

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Working with anorexia patients can be a challenging experience for mental and health care professionals. The reasons for not wanting to work with this patient population stems from the numerous concerns surrounding the patient’s health – physically and mentally. Many health care professionals reported having strong negative feelings, such as; anger, hopelessness and helplessness when working with anorexia patients. These feelings often impaired their judgement to treatment and affected how they related to the patient. This research focused on psychotherapists who preferred to work with anorexia patients; what countertransference feelings were evoked in them during sessions with patients and most importantly, how they managed the feelings. The research used interpretative phenomenological analysis (IPA) as the theoretical framework and data analysis method. Semi-structured interviews were used with ten experienced psychotherapists to obtain their countertransference experiences with anorexia patients and how they manage it. There were three main themes discovered; (1) the use of supervision, (2) their own personal therapy and finally (3) experience and evolution. The research unearthed that experienced psychotherapists also experienced strong countertransference feelings towards their patients; some positive and some negative. However, these feelings could actually be interpreted as co-transference with their anorexia patients. The psychotherapists were able to own their part in the evocative unconscious nature of a relational therapeutic space, where their personal issues may be entangled in their anorexia patient’s symptomatology.

Keywords: anorexia nervosa, countertransference, co-transference, psychotherapy, relational psychotherapy

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Authors: Subham Ghosh, Arnab Nandi

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Background: The proliferation of Wireless Body Area Networks (WBAN) and Internet of Things (IoT) applications demonstrates the potential for continuous monitoring of physical changes in the body. These technologies are vital for health monitoring tasks, such as identifying coughing and breathing activities, which are necessary for disease diagnosis and management. Monitoring activities such as coughing and deep breathing can provide valuable insights into a variety of medical issues. Wearable radio-based antenna sensors, which are lightweight and easy to incorporate into clothing or portable goods, provide continuous monitoring. This mobility gives it a substantial advantage over stationary environmental sensors like as cameras and radar, which are constrained to certain places. Furthermore, using compressive techniques provides benefits such as reduced data transmission speeds and memory needs. These wearable sensors offer more advanced and diverse health monitoring capabilities. Methodology: This study analyzes the feasibility of using a semi-flexible antenna operating at 2.4 GHz (ISM band) and positioned around the neck and near the mouth to identify three activities: coughing, deep breathing, and idleness. Vector network analyzer (VNA) is used to collect time-varying complex reflection coefficient data from perturbed antenna nearfield. The reflection coefficient (S11) conveys nuanced information caused by simultaneous variations in the nearfield radiation of three activities across time. The signatures are sparsely represented with gaussian windowed Gabor spectrograms. The Gabor spectrogram is used as a sparse representation approach, which reassigns the ridges of the spectrogram images to improve their resolution and focus on essential components. The antenna is biocompatible in terms of specific absorption rate (SAR). The sparsely represented Gabor spectrogram pictures are fed into a lightweight deep learning (DL) model for feature extraction and classification. Two antenna locations are investigated in order to determine the most effective localization for three different activities. Findings: Cross-validation techniques were used on data from both locations. Due to the complex form of the recorded S11, separate analyzes and assessments were performed on the magnitude, phase, and their combination. The combination of magnitude and phase fared better than the separate analyses. Various sliding window sizes, ranging from 1 to 5 seconds, were tested to find the best window for activity classification. It was discovered that a neck-mounted design was effective at detecting the three unique behaviors.

Keywords: activity recognition, antenna, deep-learning, time-frequency

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Authors: Sithandazile Masuku

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Introduction: Public health approaches to offender mental health are driven by international policies and frameworks in response to the disproportionately large representation of people with mental health problems within the offender pathway compared to the general population. Public health service innovations include mental health courts in the US, restorative models in Singapore and, liaison and diversion services in Australia, the UK, and some other European countries. Mental health nurses are at the forefront of offender health service innovations. In the U.K. context, police custody has been identified as an early point within the offender pathway where nurses can improve outcomes by offering assessments and share information with criminal justice partners. This scope of nursing practice has introduced challenges related to skills and support required for nurses working at the interface of health and the criminal justice system. Parallel literature exploring experiences of nurses working in forensic settings suggests the presence of compassion fatigue, burnout and vicarious trauma that may impede risk harm to the nurses in these settings. Published research explores mainly service-level outcomes including monitoring of figures indicative of a reduction in offending behavior. There is minimal research exploring the experiences of liaison and diversion nurses who are situated away from a supportive clinical environment and engaged in complex autonomous decision-making. Aim: This paper will share qualitative findings (in progress) from a PhD study that aims to explore the experiences of liaison and diversion nurses in one service in the U.K. Methodology: This is a qualitative interview study conducted using an Interpretative Phenomenological Analysis to gain an in-depth analysis of lived experiences. Methods: A purposive sampling technique was used to recruit n=8 mental health nurses registered with the UK professional body, Nursing and Midwifery Council, from one UK Liaison and Diversion service. All participants were interviewed online via video call using semi-structured interview topic guide. Data were recorded and transcribed verbatim. Data were analysed using the seven steps of the Interpretative Phenomenological Analysis data analysis method. Emerging Findings Analysis to date has identified pertinent themes: • Difficulties of meaning-making for nurses because of the complexity of their boundary spanning role. • Emotional burden experienced in a highly emotive and fast-changing environment. • Stress and difficulties with role identity impacting on individual nurses’ ability to be resilient. • Challenges to wellbeing related to a sense of isolation when making complex decisions. Conclusion Emerging findings have highlighted the lived experiences of nurses working in liaison and diversion as challenging. The nature of the custody environment has an impact on role identity and decision making. Nurses left feeling isolated and unsupported are less resilient and may go on to experience compassion fatigue. The findings from this study thus far point to a need to connect nurses working in these boundary spanning roles with a supportive infrastructure where the complexity of their role is acknowledged, and they can be connected with a health agenda. In doing this, the nurses would be protected from harm and the likelihood of sustained positive outcomes for service users is optimised.

Keywords: liaison and diversion, nurse experiences, offender health, staff wellbeing

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Authors: Syue-Wen Lin

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Objective: This article explores the nursing experience of an 84-year-old male lung cancer patient who underwent a thoracoscopic right lower lobectomy and treatment. The patient has multiple medical histories, including hypertension and diabetes. The nursing process involved cancer treatment, postoperative pain management, as well as wound care and healing. Methods: The nursing period is from February 10 to February 17, 2024. During the nursing process, pain management strategies are implemented, including morphine drugs and non-drug methods, and music therapy, essential oil massage, and extended reception time are used to make patients feel physically and mentally comfortable so as to reduce postoperative pain and encourage active participation in rehabilitation. Strict sterile wound dressing procedures and advanced wound care techniques are used to promote wound healing and prevent infection. Due to septic shock, dialysis is used to relieve worsening symptoms. Taking into account the patient's cancer status, the nursing team provides comprehensive cancer care based on the patient's physical and psychological needs. Given the complexity of the patient's condition, including advanced cancer, palliative care is also incorporated throughout the care process to relieve discomfort and provide psychological support. Results: Through comprehensive health assessment, the nursing team fully understood the patient's condition and developed a personalized care plan based on the patient's condition. The interprofessional critical care team provides respiratory therapy and lung expansion exercises to reduce muscle loss while addressing the patient's psychological status, pain management, and vital sign stabilization needs, resulting in a comprehensive approach to care. Lung expansion exercises and the use of a high-frequency chest wall oscillation vest successfully improved sputum drainage and facilitated weaning from mechanical ventilation. In addition, helping patients stabilize their vital signs and the integration of cancer care, pain management, wound care and palliative care helps the patient be fully supported throughout the recovery process, ultimately improving his quality of life. Conclusion: Lung cancer and septic shock present significant challenges to patients, and the nursing team not only provides critical care but also addresses the unique needs of patients through comprehensive infection control, cancer care, pain management, wound care, and palliative care interventions. These measures effectively improve patients' quality of life, promote recovery, and provide compassionate palliative care for terminally ill patients. Nursing staff work closely with family members to develop a comprehensive care plan to ensure that patients receive high-quality medical care as well as psychological support and a comfortable recovery environment.

Keywords: septic shock, lung cancer, palliative care, nursing experience

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Authors: S. Abed, S. O’Neill

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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: health care, nurse education, nursing in Iraq, nurse leadership

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Authors: Mammar Khames, Mustapha Oumouna

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Brucellosis is one of the most common zoonoses in the world. It represents a serious threat to human health; the existence of brucellosis in Algeria dates back to the beginning of the 19th century. Its transmission to humans is through coccobacilli of the genus Brucella following direct contact with contaminated animals or indirectly through the consumption of their unpasteurized dairy products. The present investigation covers a retrospective study on human brucellosis in the district of Medea over a period from 2011 to 2021 at the level of two public health establishments. In the first place, it is at the level of the Directorate of Public Health and in the infectious department level at Medea Hospital, and at the level of the directorate of agricultural services in the third place. The results showed that during these eleven years of study, 795 cases were collected from the department of health and population, and 141 cases were collected from the infectious department of the district of Medea. A total of 56 cases of bovine brucellosis were obtained from the directorate of agricultural services of the district of Medea. Human brucellosis affects all age groups with different percentages, but the rate has been higher in the 20-44 age group, with a predominance of men. However, the geographic distribution map of the cases shows that the western part of the district was the most affected. A cohort of 141 cases was hospitalized at the infectious service level of Medea Hospital. They were 89 men and 52 women. The most common age reached is [20-44] years. The majority were of rural origin. Two serological reactions were performed for diagnosis: the buffered antigen test and Wright's serodiagnosis. Bovine brucellosis affects all age groups with different percentages, but the rate was higher in the 2-to-4-year age group, with a predominance of females. From these data, we conclude that brucellosis has a strong spread in the region studied.

Keywords: human brucellosis, serology, Medea, Algeria

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Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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Authors: Amina Merghad, Cherif Abdennour

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Solvents are widely used in paint industry, where humans are highly exposed, especially from inhalation. A case report describes how paint affects reproductive markers and the health of workers. Sixty four subjects were chosen and divided into two groups; a control and an exposed group. A questionnaire was given to male workers from similar socio-economic status in order to know their ages, working conditions, clinical symptoms, working period, smoking history, shift, medical history and nutrition. Blood was withdrawn in the morning from volunteers. The measurement of blood testosterone and prolactin concentrations was then carried out. Results showed that the ages of the two groups were almost similar and were up to 47 and 43 years. The period of employment was 17 years and 14 years for the control and the exposed workers, respectively. Concerning clinical symptoms, the frequency of neuropsychological symptoms of the two groups are presented. It is clear that the symptom of memory loss, headaches are the highest among exposed workers followed by poor coordination, poor concentration and insomnia. On the other hand, the symptoms’ frequency in the control was less than that of the exposed group. Testosterone concentration has significantly decreased in group 2 (4.61±2,005 ng/ml) and group 3 (4.25±1.67 ng/ml) of exposed workers. On the other hand, prolactin concentration was higher in group 3 compared to other groups. To conclude, paint industry has disturbed reproductive markers and created high frequency of neuropsychological symptoms.

Keywords: blood, paint, prolactin, occupational exposure, organic solvent, reproductive toxicity, testosterone

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Authors: Nastja Utrosa, Matevz Juvancic

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Hospital buildings are complex public environments characterized by intricate functional arrangements and architectural layouts. Effective wayfinding is essential for patients, visitors, students, and staff. However, spatial orientation planning is often overlooked until after construction. While these environments meet functional needs, they frequently neglect the psychological aspects of user experience. This study investigates wayfinding within complex urban healthcare environments, focusing on the influences of spatial design, spatial cognition, and user experience. The inherent complexity of these environments, with extensive spatial dimensions and dispersed buildings, exacerbates the problem. Gradual expansions and additions contribute to disorientation and navigational difficulties for users. Effective route guidance in urban healthcare settings has become increasingly crucial. However, research on the environmental elements that influence wayfinding in such environments remains limited. To address this gap, we conducted a study at the University Medical Centre Ljubljana (UMCL), Slovenia's largest university hospital. Using a questionnaire, we assessed how individuals' perceptions and use of outdoor hospital spaces with a diverse sample (n=179). We evaluated the area’s usability by analyzing visit frequency, stops, modes of arrival, and parking patterns and examined the visitors' age distribution. Additionally, we investigated spatial aids and the use of color as an orientation element at three specific locations within the medical center. Our study explored the impact of color on entrance selection and the effectiveness of warm versus cool colors for wayfinding. Our findings highlight the significance of graphic adjustments in shaping perceptions of hospital outdoor spaces. Most participants preferred visually organized entrances, underscoring the importance of effective visual communication. Implementing these adaptations can substantially enhance the user experience, reducing stress and increasing satisfaction in hospital environments.

Keywords: hospital layout design, healthcare facilities, wayfinding, navigational aids, spatial orientation, color, signage

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Authors: Tsung Chin Wu, Yu Chen Tsai, Rhay Hung Weng, Weir Sen Lin

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In recent years, nursing staff’s lower job satisfaction has led to higher turnover rates, and high turnover rates not only cause medical institution costs to increase but also the quality of medical care to decrease. From the perspective of internal marketing, institution staffs are internal customers, and institutions should focus and meet the needs of staff, so that staff will strive to meet the needs of external customers and provide them with the required care. However, few previous studies have investigated the impact of internal staff satisfaction on external customers. Therefore, this study aimed to conduct job satisfaction surveys on internal staff to investigate the relationship between job satisfaction and quality of medical care through statistical analysis of the study results. The related study results may serve as a reference for healthcare managers. This study was conducted using a questionnaire and the subjects were nursing staff from four hospitals. A total of 600 questionnaires were distributed and 577 valid questionnaires were returned with a response rate of 96.1%. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The impact of internal marketing and job satisfaction on turnover intention of nursing staff was analyzed using descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. The study results showed that there was a significant difference between nursing staff’s job title and ‘professional participation’ and ‘shifts’. There was a significant difference between salary and ‘shifts’ and ‘turnover intention’, as well as between marriage and ‘remuneration’ and ‘turnover intention’. A significant difference was found between professional advancement and ‘professional growth’ and ‘type of leave’, as well as between division of service and ‘shifts’ and ‘turnover intention’. Pearson correlation analysis revealed a significant negative correlation between turnover intention and ‘internal marketing’, ‘interaction’, ‘professional participation’, ‘grasp of environment’, ‘remuneration’ and ‘shifts’, meaning that the higher the satisfaction, the lower the turnover intention. It is recommended that hospitals establish a comprehensive internal marketing mechanism to enhance staff satisfaction and in turn, reduce intention to resign, and the key to increasing job satisfaction is by establishing effective methods of internal communication.

Keywords: internal marketing, job satisfaction, turnover intention, nursing staff

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Authors: Asharaf Abdul Salam, Ibrahim Elsegaey, Rshood Khraif, Abdullah AlMutairi, Ali Aldosari

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Arab World that comprises of 22 member states of Arab League undergoes rapid transition in demographic front - fertility, mortality and migration. A distinctive geographic region spread across West Asia and North East Africa unified by Arabic language shares common values and characteristics even though diverse in economic and political conditions. Demographic lag that characterizes Arab World is unique but the present trend of declining fertility combined with the existing relatively low mortality undergoes significant changes in its population size. The current research aimed at (i) assessing the growth of population, over a period of 3 decades, (ii) exploring the components and (iii) understanding the public health impact. Based on International Data Base (IDB) of US Census Bureau, for 3 time periods – 1992, 2002 and 2012; 21 countries of Arab World have been analyzed by dividing them into four geographic sectors namely Gulf Cooperation Council (GCC), West Asia, Maghreb and Nile Valley African Horn. Population of Arab World grew widely during the past both through natural growth and migration. Immigrations pronounced especially in the resource intensive GCC nations not only from East Asian and central African countries but also from resource thrifty Arab nations. Migrations within the Arab World as well as outside of the Arab World remark an interesting demographic phenomenon that requires further research. But the transformations on public health statistics – impact of demographic change – depict a new era in the Arab World.

Keywords: demographic change, public health statistics, net migration, natural growth, geographic sectors, fertility and mortality, life expectancy

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Authors: R. R. Ramsheeja, R. Sreeraj

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For view the internal structures of the human body such as liver, brain, kidney etc have a wide range of different modalities for medical images are provided nowadays. Computer Tomography is one of the most significant medical image modalities. In this paper use CT liver images for study the use of automatic computer aided techniques to calculate the volume of the liver tumor. Segmentation method is used for the detection of tumor from the CT scan is proposed. Gaussian filter is used for denoising the liver image and Adaptive Thresholding algorithm is used for segmentation. Multiple Region Of Interest(ROI) based method that may help to characteristic the feature different. It provides a significant impact on classification performance. Due to the characteristic of liver tumor lesion, inherent difficulties appear selective. For a better performance, a novel proposed system is introduced. Multiple ROI based feature selection and classification are performed. In order to obtain of relevant features for Support Vector Machine(SVM) classifier is important for better generalization performance. The proposed system helps to improve the better classification performance, reason in which we can see a significant reduction of features is used. The diagnosis of liver cancer from the computer tomography images is very difficult in nature. Early detection of liver tumor is very helpful to save the human life.

Keywords: computed tomography (CT), multiple region of interest(ROI), feature values, segmentation, SVM classification

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