Search results for: chronic health problems

Authors: Manana Lobzhanidze

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Introduction: The paper will argue that labor migration is the most important problem Georgia faces today. The structure of labor migration by age and gender of Georgia is analyzed. The main driving factors of circular labor migration during the last ten years are identified. While studying migration, it is necessary to discuss the interconnection of economic, social, and demographic features, also taking into consideration the policy of state regulations in terms of education and professional training. Methodology: Different research methods are applied in the presented paper: statistical, such as selection, grouping, observation, trend, and qualitative research methods, namely; analysis, synthesis, induction, deduction, comparison ones. Main Findings: Labour migrants are filling the labor market as a low salary worker. The main positive feedback of migration from developing countries is poverty eradication, but this process is accompanied by problems, such as 'Brain Drain'. The country loses an important part of its intellectual potential, and it is invested by households or state itself. Conclusions: Labor migration is characterized to be temporary, but socio-economic problems of the country often push the labor migration in the direction of longterm and illegal migration. Countries with developed economies try to stricter migration policy and fight illegal migration with different methods; circular migration helps solve this problem. Conclusions and recommendations are included about circular labor migration consequences in Georgia and its influence on the reduction of unemployment level.

Keywords: migration, circular labor migration, labor migration employment, unemployment

Procedia PDF Downloads 179

Authors: Thea Werkhoven, Wayne Cotton

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Adult and childhood rates of obesity in Australia are health concerns of high national priority, retaining epidemic status in the populations affected. Attempts to prevent further increases in prevalence of childhood obesity in the population aged below eighteen years have had varied success. A multidisciplinary approach has been used, employing strategies in schools, through established health care system usage and public health campaigns. Over the last decade a plateau in prevalence has been reached in the youth population afflicted by obesity and interest has peaked in school based strategies to prevent and treat overweight and obesity. Of interest to this study is the importance of the tertiary training of future health educators or health professionals destined to be involved in obesity prevention and treatment strategies. Health educators and health professionals are considered instrumental to the success of prevention and treatment strategies, required to possess sufficient and accurate knowledge in order to be effective in their positions. A common influence on the success of school based health promoting activities are the weight based attitudes possessed by health educators, known to be negative and biased towards overweight or obese children during training and practice. Whilst the tertiary training of future health professionals includes minimal nutrition education, there is no mandatory training in health education or nutrition for pre-service health educators in Australian tertiary institutions. This study aimed to assess the impact of a pedagogical intervention on pre-service health educators and health professionals enrolled in a health and wellbeing elective. The intervention aimed to increase nutrition knowledge and decrease weight bias and was embedded in the twelve week elective. Participants (n=98) were tertiary students at a major Australian University who were enrolled in health (47%) and non-health related degrees (53%). A quantitative survey using four valid and reliable instruments was conducted to measured nutrition knowledge, antifat attitudes and weight stereotyping attitudes at baseline and post-intervention. Scores on each instrument were compared between time points to check if they had significantly changed and to determine the effect of the intervention on attitudes and knowledge. Antifat attitudes at baseline were considered low and decreased further over the course of the intervention. Scores representing weight bias did decrease but the change was not significant. Fat stereotyping attitudes became stronger over the course of the intervention and this change was significant. Nutrition knowledge significantly improved from baseline to post-intervention. The design of the nutrition knowledge and attitude amelioration content of the intervention was semi-successful in achieving its outcomes. While the level of nutrition knowledge was improved over the course of the intervention, an unintentional increase was observed in weight based prejudice which is known to occur in interventions that employ stigma reduction methodologies. Further research is required into a structured methodology that increases level of nutrition knowledge and ameliorates weight bias at the tertiary level. In this way training provided would help prepare future health educators with the knowledge, skills and attitudes required to be effective and bias free in their practice.

Keywords: education, intervention, nutrition, obesity

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Authors: Reka Zsuzsanna Mathe

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The globalization and the Europeanization have significantly contributed to a change in the role of the nation-states. The global economic crisis, the climate changes, and the recent refugee crisis, are just a few among many challenges that cannot be effectively addressed by the traditional role of the nation-states. One of the main roles of the states is to solve collective action problems, however due to their changing roles; apparently this is getting more and more difficult. Depending on political culture, collective action problems are solved either through cooperation or conflict. The political culture of Central and Eastern European (CEE) countries is marked by low civic participation and by a weak civil society. In this type of culture collective action problems are likely to be induced through conflict, rather than the democratic process of dialogue and any type of social change is probably to be introduced by social movements. Several studies have been conducted on the social movements of the CEE countries, yet, it is still not clear if the most significant social movements of the region tend to choose rather the cooperative or the conflictual way as action strategy. This study differentiates between a national and a European action field, having different social orders. The actors of the two fields are the broadly understood civil society members, conceptualized as social movements. This research tries to answer the following questions: a) What are the norms that best characterize the CEE countries’ social order? b) What type of actors would prefer a change and in which areas? c) Is there a significant difference between the main actors active in the national versus the European field? The main hypotheses are that there are conflicting norms defining the national and the European action field, and there is a significant difference between the action strategies adopted by social movements acting in the two different fields. In mapping the social order, the study uses data provided by the European Social Survey. Big data of the Global Data on Events, Location and Tone (GDELT) database offers information regarding the main social movements and their preferred type of action. The unit of the analysis is the so called ‘Visegrad 4’ countries: Poland, Czech Republic, Slovakia and Hungary and the research uses data starting from 2005 (after the European accession of these four countries) until May, 2017. According to the data, the main hypotheses were confirmed.

Keywords: big data, Central and Eastern Europe, civil society, GDELT, social movements

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Authors: Bryana Woodard, Monica Mitchell, Kasey Harry, Ebony Washington, Megan Harris, Marcia Boyd, Regina Lynch, Daphene Baines, Surbi Bankar

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Introduction: African Americans experience mental health illnesses (i.e., depression, anxiety, etc.) at higher rates than their white counterparts. Despite this, they utilize mental health resources less and have lower mental health literacy, perhaps due to cultural barriers- including but not limited to mistrust. Research acknowledges African Americans’ close ties to community networks, identifying these linkages as key to establishing comfort and trust. Similarly, the church has historically been a space that creates unity and community among African Americans. Studies show that longstanding academic-community partnerships with organizations, such as churches and faith-based entities, have the capability to effectively address health and mental health barriers and needs in African Americans. The importance of implementing faith-based approaches is supported in the literature, however few empirical studies exist. This project describes the First Ladies for Health and Cincinnati Children's Hospital Medical Center (CCHMC) Partnership (FLFH-CCHMC Partnership) and the implementation and assessment of an annual Mental Health Symposium, the overall aim of which was to increase mental health awareness and decrease stigma in African American communities. Methods: The specific goals of the FLFH Mental Health Symposium were to (1) Collaborate with trusted partners to build trust with community participants; (2) Increase mental health literacy and decrease mental health stigma; (3) Understand the barriers to improving mental health and improving trust; (4) Assess the short-term outcomes two months following the symposium. Data were collected through post-event and follow-up surveys using a mixed methods approach. Results: More than 100 participants attended each year with over 350 total participants over three years. 98.7% of participants were African American, 86.67% female, 11.6% male, and 11.6% LGBTQ+/non-binary; 10.5% of participants were teens, with the remainder aged 20 to 80 plus. The event was successful in achieving its goals: (1a) Eleven different speakers from 8 community and church organizations presented; (1b) 93% of participants rated the overall symposium as very good or excellent (2a) Mental health literacy significantly increased each year with over 90% of participants reporting improvement in their “understanding” and “awareness of mental health (2b) Participants 'personal stigma surrounding mental health illness decreased each year with 92.3% of participants reporting changes in their “willingness to talk about and share” mental health challenges; (3) Barriers to mental health care were identified and included social stigma, lack of trust, and the cost of care. Data were used to develop priorities and an action plan for the FLFH-CCHMC Mental Health Partnership; (4) Follow-up data showed that participants sustained benefits of the FLFH Symposium and took actionable steps (e.g., meditation, referrals, etc.). Additional quantitative and qualitative data will be shared. Conclusions: Lower rates of mental health literacy and higher rates of stigma among participants in this initiative demonstrate the importance of mental health providers building trust and partnerships in communities. Working with faith-based entities provides an opportunity to mitigate and address mental health equity in African American communities.

Keywords: community psychology, faith-based, african-american, culturally competent care, mental health equity

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Authors: Amin Banae Babazadeh

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In the contemporary world, NGOs are considered as important tool for motivating the community. So they committed their true mission and the promotion of civic participation and strengthen social identities. Functional characteristics of non-governmental organizations are the element to leverage the centers of political and social development of powerful governments since they are concrete and familiar with the problems of society and the operational strategies which would facilitate this process of mutual trust between the people and organizations. NGOs on the one hand offer reasonable solutions in line with approved organizations as agents to match between the facts and reality of society and on the other hand changes to a tool to have true political, social and economic behavior. However, the NGOs are active in the formulation of national relations and policy formulation in an organized and disciplined based on three main factors, i.e., resources, policies, and institutions. Organizations are not restricted to state administration in centralized system bodies and this process in the democratic system limits the accumulation of desires and expectations and at the end reaches to the desired place. Hence, this research will attempt to emphasis on field research (questionnaire) and according to the development evolution and role of NGOs analyze the effects of this center on youth. Therefore, the hypothesis is that there is a direct relationship between the Enlightenment and the effectiveness of policy towards NGOs and solving social damages.

Keywords: civic participation, community vulnerability, insightful, NGO, urmia

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Authors: Supunmali Ahangama, Danny Chiang Choon Poo

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Health analytics (HA) is used in healthcare systems for effective decision-making, management, and planning of healthcare and related activities. However, user resistance, the unique position of medical data content, and structure (including heterogeneous and unstructured data) and impromptu HA projects have held up the progress in HA applications. Notably, the accuracy of outcomes depends on the skills and the domain knowledge of the data analyst working on the healthcare data. The success of HA depends on having a sound process model, effective project management and availability of supporting tools. Thus, to overcome these challenges through an effective process model, we propose an HA process model with features from the rational unified process (RUP) model and agile methodology.

Keywords: agile methodology, health analytics, unified process model, UML

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Authors: Sahar Esmaeili, Ramezanali Ghaderi sanavi, Masoomeh Maarefvand, Samaneh Hosseinzadeh

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Introduction: Conducted researches reveal that nowadays, 60 percent of women around the world are the households. The adverse economic condition causes female-headed households and their children to be the most vulnerable people against social harm. Mainly a symptoms of mental illness such as depression, anxiety, obsession and aggression can be seen in female-headed households and their children are potentially exposed to issues such as crime-work, child labor in the black and informal jobs, education deprivation and malnutrition. The aim of this study is to evaluate the effect of Orem self-care education with the FGC technique on the public health of female-headed households. Methods: Sixty-four Female-headed householders who were supported by Saleh Foundation participated in a clinical trial study and were assigned to the case (n=32) and control (n=32) groups. The case group received 4-session Orem’s self-care education with family group conferencing technique. Data were collected using the demographic questionnaire and General Health Questionnaire (GHQ-28) prior to intervention and post-intervention. ANOVA was used to evaluate outcomes. Results: The results showed significant improvement of the intervention group in GHQ (P<0.001) and subscales of Physical Health (P<0.001) Agitation and Insomnia (P<0.001) and Social disorder (P<0.001) and Depression (P<0.001) compared with the control group after the intervention. Conclusion: The intervention of Orem’s self-care education with family group conferencing technique was effective in improving the General Health of Female-headed households

Keywords: orem’s self-care, female-headed households, general health, group

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Authors: Meng-Na Dai, Bao-Fang Wen, Gao-Pei Zhu, Chen-Xi Zhang, Jing Sun, Chang-Hai Tang, Zhi-Qiang Feng, Wen-Qiang Yin

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Based on the analysis of literature in the health emergency management in China with recent 10 years, this paper discusses the Chinese current research hotspots, development trends and shortcomings in this field, and provides references for scholars to conduct follow-up research. CNKI(China National Knowledge Infrastructure), Weipu, and Wanfang were the databases of this literature. The key words during the database search were health, emergency, and management with the time from 2009 to 2018. The duplicate, non-academic, and unrelated documents were excluded. 901 articles were included in the literature review database. The main indicators of abstraction were, the number of articles published every year, authors, institutions, periodicals, etc. There are some research findings through the analysis of the literature. Overall, the number of literature in the health emergency management in China has shown a fluctuating downward trend in recent 10 years. Specifically, there is a lack of close cooperation between authors, which has not constituted the core team among them yet. Meanwhile, in this field, the number of high-level periodicals and quality literature is scarce. In addition, there are a lot of research hotspots, such as emergency management system, mechanism research, capacity evaluation index system research, plans and capacity-building research, etc. In the future, we should increase the scientific research funding of the health emergency management, encourage collaborative innovation among authors in multi-disciplinary fields, and create high-quality and high-impact journals in this field. The states should encourage scholars in this field to carry out more academic cooperation and communication with the whole world and improve the research in breadth and depth. Generally speaking, the research in health emergency management in China is still insufficient and needs to be improved.

Keywords: health emergency management, research situation, bibliometrics, literature

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Authors: Mariam Badmus, Bothina Manasreh

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Transition metal dichalcogenides (TMDs) have gained significant attention as two-dimensional (2D) materials due to their intrinsic band gaps and unique properties, which make them ideal candidates for electronic and photonic applications. Unlike graphene, which lacks a band gap, TMDs (MX₂, where M is a transition metal and X is a chalcogen such as sulfur, selenium, or tellurium) exhibit semiconductor behavior and can be exfoliated into monolayers, enhancing their properties. The properties of these materials are investigated using density functional theory, a quantum mechanical computational method to solve Schrodinger equation for many body problems to calculate electron density of the atoms involved on which the energy and properties of a system depend. They show promise for use in photodetectors, biosensors, memory devices, and other technologies in communications, health, and energy sectors. In particular, metallic TMDs, which lack an intrinsic band gap, benefit from doping with transition metals, this improves their electronic and optical properties. Doping monolayer TMDs yields more significant improvements than doping bulk materials. Notably, doping with metals such as vanadium enhances the magnetization of TMDs, expanding their potential applications in spintronics. This work highlights the effects of doping on TMDs and explores strategies for optimizing their performance for advanced technological applications.

Keywords: concentration, doping, magnetization, monolayer

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Authors: Bruno de Almeida Vilela, Heinz Ahn, Ana Lúcia Miranda Lopes, Marcelo Azevedo Costa

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Benchmarking public utilities such as transmission system operators (TSOs) is one of the main strategies employed by regulators in order to fix monopolistic companies’ revenues. Since 2007 the Brazilian regulator has been utilizing Data Envelopment Analysis (DEA) to benchmark TSOs. Despite the application of DEA to improve the transmission sector’s efficiency, some problems can be pointed out, such as the high price of electricity in Brazil; the limitation of the benchmarking only to operational expenses (OPEX); the absence of variables that represent the outcomes of the transmission service; and the presence of extremely low and high efficiencies. As an alternative to the current concept of benchmarking the Brazilian regulator uses, we propose a goal-oriented approach. Our proposal supports input/output selection by taking traditional organizational goals and measures as a basis for the selection of factors for benchmarking purposes. As the main advantage, it resolves the classical DEA problems of input/output selection, undesirable and dual-role factors. We also provide a demonstration of our goal-oriented concept regarding service quality. As a result, most TSOs’ efficiencies in Brazil might improve when considering quality as important in their efficiency estimation.

Keywords: decision making, goal-oriented benchmarking, input/output factor determination, TSO regulation

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Authors: Victor Arokia Doss, Kuberapandian Dharaniyambigai, K. Julia Rose Mary

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Advanced Glycation End (AGE) products are the end products due to the reaction between excess reducing sugar present in diabetes and free amino group in protein lipids and nucleic acids. Thus, non-enzymic glycation of molecules such as hemoglobin, collagen, and other structurally and functionally important proteins add to the pathogenic complications such as diabetic retinopathy, neuropathy, nephropathy, vascular changes, atherosclerosis, Alzheimer's disease, rheumatoid arthritis, and chronic heart failure. The most common non-cross linking AGE, carboxymethyl lysine (CML) is formed by the oxidative breakdown of fructosyllysine, which is a product of glucose and lysine. CML is formed in a wide variety of tissues and is an index to assess the extent of glycoxidative damage. Thus we have constructed a mathematical and computational model that predicts the effect of temperature differences in vivo, on the formation of CML, which is now being considered as an important intracellular milieu. This hybrid model that had been tested for its parameter fitting and its sensitivity with available experimental data paves the way for designing novel laboratory experiments that would throw more light on the pathological formation of AGE adducts and in the pathophysiology of diabetic complications.

Keywords: advanced glycation end-products, CML, mathematical model, computational model

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Authors: Abraham Castro-Alvarez, Luisaldo Sandate-Flores, Roberto Parra-Saldivar

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The losing of crops during the whole production process is a problem that is affecting farmers in the whole world, as climate change affects the weather behavior. Stenocereus spp. is a tropical, exotic and endemic columnar cacti, it produces a colored and expensive fruit known how “pitaya”. The quality and value of the fruit, these species represent an attractive option for economical development in arid and semi-arid regions. This fruits are produced in Mexico, mainly in 4 regions, Mixteca Oaxaca-Puebla, Michoacan, Sinaloa-Sonora, Jalisco-Zacatecas. Pitaya can be an option to try mixed crop in this states due to the resistance to hard weather conditions. And also because of the marginalization problems that exist in these townships. As defined by the Population National Council it consists in the absence of development opportunities and the lack of capacity to get them. According to an analysis done in EsriPress ArcGis 10.1 the potential area in the country is almost the half of the territory being the total area of Mexico 1,965,249 km2 and the area with potential to produce pitaya 960,527 km2. This area covers part of the most affected townships that also have a few options of maize varieties making even harder the production of maize and exposing farmers to crop losing if conditions are good enough. Making pitaya a good option for these farmers to have an economic backup in their productions.

Keywords: maize, pitaya, rain fed, Stenocereus

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Authors: Shatha Ahmad Alharthi

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Prior research suggests that reduced social interaction can negatively affect well-being and impair mental health (e.g., depression and anxiety), resulting in lower academic performance. The COVID-19 pandemic has significantly limited social interaction among Saudi Arabian school children since the government closed schools and implemented lockdown restrictions to reduce the spread of the disease. These restrictions have resulted in prolonged remote learning for middle school students with unknown consequences for perceived academic performance, mental health, and well-being. This research project explores how middle school Saudi students’ current remote learning practices affect their mental health (e.g., depression and anxiety) and well-being during the lockdown. Furthermore, the study will examine the association between social interaction, mental health, and well-being pertaining to students’ perceptions of their academic achievement. Research findings could lead to a better understanding of the role of lockdown on depression, anxiety, well-being and perceived academic performance. Research findings may also inform policy-makers or practitioners (e.g., teachers and school leaders) about the importance of facilitating increased social interactions in remote learning situations and help to identify important factors to consider when seeking to re-integrate students into a face-to-face classroom setting. Potential implications for future educational research include exploring remote learning interventions targeted at bolstering students’ mental health and academic achievement during periods of remote learning.

Keywords: depression, anxiety, academic performance, social interaction

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Authors: Peter Fedichev

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We studied fundamental aspects of aging to develop a mathematical model of gene regulatory network. We show that aging manifests itself as an inherent instability of gene network leading to exponential accumulation of regulatory errors with age. To validate our approach we studied age-dependent omic data such as transcriptomes, metabolomes etc. of different model organisms and humans. We build a computational platform based on our model to identify the targets and biomarkers of aging to design new drugs against aging and age-related diseases. As biomarkers of aging, we choose the rate of aging and the biological age since they completely determine the state of the organism. Since rate of aging rapidly changes in response to an external stress, this kind of biomarker can be useful as a tool for quantitative efficacy assessment of drugs, their combinations, dose optimization, chronic toxicity estimate, personalized therapies selection, clinical endpoints achievement (within clinical research), and death risk assessments. According to our model, we propose a method for targets identification for further interventions against aging and age-related diseases. Being a biotech company, we offer a complete pipeline to develop an anti-aging drug-candidate.

Keywords: aging, longevity, biomarkers, senescence

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Authors: Aftab Yusuf Raj

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Human milk oligosaccharides (HMOs) are complex carbohydrates. They are 3rd most abundant solid component found in breast milk, after lactose and lipids. HMO has profound beneficial health benefit effects on infants and toddlers. They have diverse roles, in immuno-modulation, development of neonatal gut, influencing the commensal microbiota of developing gut, and anti-inflammatory functions. HMOs, gut and commensal microbiota of the gut work synergistically to bring positive impact on infant and toddler health. HMO influences the gut-brain axis, maintains good mental health and cognitive function and inhibits neuronal inflammation. HMOs are now applied in infant nutrition, and supplementation of HMOs in infant formula is a promising innovation for infant nutrition.

Keywords: HMO’s, gut, epigenetic modulation, bacteria

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Authors: Olaf Visker, Arnout De Vries, Lambert Schomaker

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Predictive policing refers to the usage of analytical techniques to identify potential criminal activity. It has been widely implemented by various police departments. Being a relatively new area of research, there are, to the author’s knowledge, no absolute tried, and true methods and they still exhibit a variety of potential problems. One of those problems is closely related to the lack of understanding of how acting on these prediction influence crime itself. The goal of law enforcement is ultimately crime reduction. As such, a policy needs to be established that best facilitates this goal. This research aims to find such a policy by using adversarial agent-based modeling in combination with modern reinforcement learning techniques. It is presented here that a baseline model for both law enforcement and criminal agents and compare their performance to their respective reinforcement models. The experiments show that our smart law enforcement model is capable of reducing crime by making more deliberate choices regarding the locations of potential criminal activity. Furthermore, it is shown that the smart criminal model presents behavior consistent with popular crime theories and outperforms the baseline model in terms of crimes committed and time to capture. It does, however, still suffer from the difficulties of capturing long term rewards and learning how to handle multiple opposing goals.

Keywords: adversarial, agent based modelling, predictive policing, reinforcement learning

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Authors: Hamida Hamed Said Al Harthi

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Background: Illegal drug use is a rising problem that affects Omani youth. This research aimed to study a group of young Omani men who were imprisoned more than once for illegal drug use, focusing on exploring their lifestyle experiences inside and outside the prison and whether these contributed to their early relapse and re-imprisonment. This is the first study of its kind from Oman conducted in a prison setting. Methods: 19 Omani males aged 18–35 years imprisoned in Oman Central Prison were recruited using purposive sampling. Focused ethnography was conducted over 8 months to explore the drug-related experiences outside the prison and during imprisonment. Face-to-face semi-structured interviews with the participants yielded detailed transcripts and field notes. These were thematically analyzed, and the results were compared with the existing literature. Results: The participants’ voices yielded new insights into the lives of young Omani men imprisoned for illegal drug use, including their sufferings and challenges in prison. These included: entry shock, timing and boredom, drug trafficking in prison, as well as physical and psychological health issues. Overall, imprisonment was reported to have negatively impacted the participants’ health, personality, self-concept, emotions, attitudes, behavior and life expectations. The participants reported how their efforts to reintegrate into the Omani community after release from prison were rebuffed due to stigmatization and rejection from society and family. They also experienced frequent unemployment, police surveillance, accommodation problems and a lack of rehabilitation facilities. The immensity of the accumulated psychophysiological trauma contributed to their early relapse and re-imprisonment. Conclusion: This thesis concludes that imprisonment is largely ineffective in controlling drug use in Oman. Urgent action is required across multiple sectors to improve the lives and prospects of users of illegal drugs within and outside the prison to minimize factors contributing to early relapse. Key Words: illegal drugs, drug users, Oman, addiction, Omani culture, prisoners, relapse, re-imprisonment, qualitative research, ethnography.

Keywords: illigal drugs, Prison, Omani culture lifestyle, post prison life

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Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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Authors: Behnoush Sabayan, Ali Alidadi, Saeid Ebarhimi, N. M. Bakhshani

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Hemodialysis (HD) patients are at a high risk of atherosclerotic and vascular disease; also little information is available for the HD impact on brain structure of these patients. We studied the brain abnormalities in HD patients. The aim of this study was to investigate the effect of long term HD on brain structure of HD patients. Non-contrast MRI was used to evaluate imaging findings. Our study included 80 HD patients of whom 39 had less than six months of HD and 41 patients had a history of HD more than six months. The population had a mean age of 51.60 years old and 27.5% were female. According to study, HD patients who have been hemodialyzed for a long time (median time of HD was up to 4 years) had small vessel ischemia than the HD patients who underwent HD for a shorter term, which the median time was 3 to 5 months. Most of the small vessel ischemia was located in pre-ventricular, subcortical and white matter (1.33± .471, 1.23± .420 and 1.39±.490). However, the other brain damages like: central pons abnormality, global brain atrophy, thinning of corpus callosum and frontal lobe atrophy were found (P<0.01). The present study demonstrated that HD patients who were under HD for a longer time had small vessel ischemia and we conclude that this small vessel ischemia might be a causative mechanism of brain atrophy in chronic hemodialysis patients. However, additional researches are needed in this area.

Keywords: Hemodialysis Patients, Duration of Hemodialysis, MRI, Zahedan

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Authors: Yen-Hsia Lin, Ya-Fang Cheng, Hui-Zhu Chen, Chi-Hui Tiao

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This is a case study of a 70-year-old man suffering from Type 2 diabetes mellitus and hyperglycemia hyperosmolarity state. He was admitted into the intensive care unit from the 20th to 26th of October, 2015. After receiving relevant information through open-ended conversations, observation, and physical assessment, as well as the psychological, social and spiritual holistic nursing assessment, several clinical health problems such as unstable blood sugar, impaired skin integrity and lack of self-care management knowledge were identified by the author. During the period of care, the patient was encouraged to share and express his feelings, an active listening and initiating approach from the nursing team had led to the understanding of why the patient refused to use insulin. This knowledge enabled the nursing team to manage patient care by educating the patient with self-care management skills, such as foot wound care and insulin injection skills to slow the deterioration of complications. Also, the implementation of appropriate diet and exercise routine to improve patients’ style. By enhancing self-care ability in diabetic patients, they are able to return home with the skill to improve better quality life style.

Keywords: hyperglycemia hyperosmolar state, type2 diabetes Mellitu, diabetes Mellitu foot care, intensive care

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Authors: Babak Nemat Shahrbabaki, Arezo Fallahi, Masoomeh Hashemian

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Introduction: Health and safety are basic components of civil right. Health care systems in different countries were influenced by political, economic and cultural circumstances. In order to health services to people, these systems are organized with different forms, methods such as: prevention, treatment and rehabilitation and in this among, public satisfaction with the services provided is important. This study aimed to determine client satisfaction with family physician and relationship with physician’ demographic variables in health care centers of Jiroft county, Iran. Methods: This is a descriptive-analytical study. The collective data tool was a self-made questionnaire with two parts. The first part comprised demographic characteristics, and the second part contained 11 items for the assessment of satisfaction with family physician from different aspects. In addition, questionnaire, reliability and validity were confirmed. Random simple sampling method was used to determine samples. 234 people referred to the health centers filled questionnaire. The data were analyzed using SPSS software, and inferential statistical analysis was performed. Findings: The majority of the study population were women, married, and aged between 18 and 62 years (mean= 30.09±10.71). Total average satisfaction score was 42.63±3.68. Overall satisfaction averages were 9.47% very high, 30.04% high, 33.09% moderate, 15.12% low, and 12.28% very low. Except lodge on of family physician none of physician’ demographic variables did not effect on satisfaction index. Discussion & Conclusion: The Results showed that mean of satisfaction indexes of family physicians was high and lodge on of family physician effected on this index. Informing people about the main goals of family-doctor program will help to promote the quality of program and increase people satisfaction.

Keywords: family physician program, satisfaction, health-care centers, client

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Authors: Moez Yeddes

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The property of opacity is widely used in the formal verification of security in computer systems and protocols. Opacity is a general language-theoretic scheme of many security properties of systems. Opacity is parametrized with framework in which several security properties of a system can be expressed. A secret behaviour of a system is opaque if a passive attacker can never deduce its occurrence from the system observation. Instead of considering the case of static observability where the set of observable events is fixed off-line or dynamic observability where the set of observable events changes over time depending on the history of the trace, we introduce Orwellian partial observability where unobservable events are not revealed provided that downgrading events never occurs in the future of the trace. Orwellian partial observability is needed to model intransitive information flow. This Orwellian observability is knwon as ipurge function. We show in previous work how to verify opacity for regular secret is opaque for a regular language L w.r.t. an Orwellian projection is PSPACE-complete while it has been proved undecidable even for a regular language L w.r.t. a general Orwellian observation function. In this paper, we address two problems of opacification of a regular secret ϕ for a regular language L w.r.t. an Orwellian projection: Given L and a secret ϕ ∈ L, the first problem consist to compute some minimal regular super-language M of L, if it exists, such that ϕ is opaque for M and the second consists to compute the supremal sub-language M′ of L such that ϕ is opaque for M′. We derive both language-theoretic characterizations and algorithms to solve these two dual problems.

Keywords: security policies, opacity, formal verification, orwellian observation

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Authors: Ching-Ling Lin, Li-Chi Huang, Yao-Tsung Chang, Ruey-Yu Chen, Shwu-Huey Yang

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Introduction & Purpose: Diabetes and its related complications always been a major part of medical cost in Taiwan. To patient with diabetes, self-management blood sugar, improving a healthy lifestyle are the most important thing to avoid getting worse. The aim of this study was to explore the trend of the changing in blood glucose within intervention and followed-up periods of patients who participated in the health coaching program between 2017 and 2020. Design & Methods: The data was combined from two diabetes health coaching program. The intervention group had health coaching and usual care for 6 months, whereas the control had usual care only. The main outcome variables were HbA1c level at baseline, 3, 6, 9, and 12 months. Results: In total, the data were available for 99 patients in the coaching intervention group and for 88 patients in the control group, the dropout rate during the follow-up period is about 18%. Of 187 participants, 54% were female, mean age was 61.5 years (SD=10.19), only 32.1% had a bachelor’s degree or higher, and the mean duration of diabetes treatment at Cathay General Hospital was 9.9 years. Within 12 months, the intervention group had a significant decrease of 0.65% (SD=1.05) in HbA1c level, and a non-significant decrease of 0.13%(SD=0.96) was observed in the control group. The figure showed the effect was the most significant in the first three months of the intervention and can be maintained for up to six months after the intervention was over. The HbA1c values of the two groups at each follow-up point are significantly different. In addition, there were non-significant correlation between HbA1c and gender, age, and educational level. Conclusion: Health coaching might be an effective way to enhance self-management for patients with diabetes and improving their blood sugar control in Taiwan.

Keywords: diabetes, health coaching, HbA1c, self-management

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Authors: Neşe Işık, Şenol Altıok, Galip Devrim Eryılmaz, Aydın durukan, Hasan Özgür Daş

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In this study, an active landslide zone affecting the road alignment on the Tortum-Uzundere (Erzurum/Turkey) highway was investigated. Due to the landslide movement, problems have occurred in the existing road pavement, which has caused both safety problems and reduced driving comfort in the operation of the road. In order to model the landslide, drilling, geophysical and inclinometer studies were carried out in the field within the scope of ground investigation. Laboratory tests were carried out on soil and rock samples obtained from the borings. When the drilling and geophysical studies were evaluated together, it was determined that the study area has a complex geological structure. In addition, according to the inclinometer results, the direction and speed of movement of the landslide mass were observed. In order to create an idealized geological profile, all field and laboratory studies were evaluated together and then the sliding surface of the landslide was determined by back analysis method. According to the findings obtained, it was determined that the landslide was massively large, and the movement occurred had a deep sliding surface. As a result of the numerical analyses, it was concluded that the Slope angle reduction is the most economical and environmentally friendly method for the control of the landslide mass.

Keywords: landslide, geotechnical methods, geophysics, monitoring, highway

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Authors: Laleh Behboudi Tabrizi, Melika Naserzare

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Accumulating experimental and epidemiologic data smoker individuals are more prone to systemic inflammation than non-smokers. In this study we aimed to determine serum TNF-α and C-reactive protein (CRP) as pro-inflammatory cytokines in response to 3 months aerobic training in smoker men. A total 30 middle-aged healthy smokers selected for participate in this study and were divided into either control or exercise groups. The subjects in exercise group were completed a 3 months aerobic training program for 3 sessions per week at 60 – 80 % of maximal heart rate. Those in control group did nit participated in exercise training. Pre and post-training of CRP and TNF-α were measured in two groups. Student’s t-tests for paired samples were performed to determine whether there were signigcant within-group changes in the outcomes. P value of <0.05 was accepted as significant. No significant differences were found in anthropometrical and biochemical markers between two groups at baseline. Aerobic training program resulted in a significant decrease in anthropometrical markers and serum TNF-α but not in serum CRP in exercise group. All variables remained without changes in control groups. Based on these finding, it is concluded that aerobic training can be improve inflammatory cytokine with emphasis on TNF-α in smokers.

Keywords: cigarette, cytokine, chronic training, inflammation

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Authors: Narendra Kumar

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In developing countries, the majority of people with diabetes are in the age range of 45-64 years and more women than men. As in many areas of the India, non-insulin dependent diabetes mellitus has become major problems. Now it is spreading among the middle class and poor at an alarming stage in India and Kerala is turning to be the world capital of diabetes. This study uses two round NSS data from the ‘National Sample Survey Organization, India’ to investigate the predictors of diabetes in Kerala. The overall estimates for diabetes prevalence among elderly show that higher in men than women, but there are more women with diabetes than men. Education of respondent has been found a significant characteristics, further respondent working status, caste/tribe have substantial impact on diabetes in Kerala. The disease is more common for people who are mostly physically inactive. This whole picture is very much prominent in the urban areas compared with the rural ones. Not working elderly have significantly higher with diabetes than for those working in elderly. Socioeconomic status was inversely associated with diabetes prevalence. For men and women, the prevalence of diabetes and hypertension were significantly higher in the urban population while smoking, smokeless tobacco consumption was more prevalent in the rural population. High alcohol intake increases diabetes risk among elderly. Finally these findings specified that an increase improve health care services and changing life style of elderly which should in turn raise diabetes patient survival and should decrease comorbidities due to diabetes in Kerala.

Keywords: elderly, diabetes, prevalence, Kerala

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Authors: E. Isaac, I. Jalo, Y. Alkali, A. Ajani, A. Rasaki, Y. Jibrin, K. Mustapha, A. Ayuba, S. Charanchi, H. Danlami

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Introduction: Hepatitis B infection continues to be a serious global health problem with about 2 billion people infected worldwide, many of these in sub-Saharan Africa. Nigeria is one of the countries with the highest incidence, with a prevalence of 10-15%. Methods: Records of Hepatitis B surface and envelope antigen test results in adults in Federal Teaching Hospital, Gombe between May 2000 and May 2015 were retrieved and analyzed. Findings: Adult out-patient consultations and in-patient admissions were 343,083 and 67,761 respectively, accounting for 87% of total. Hepatitis B surface antigenaemia was tested for in 23,888 adults and children. 88.9% (21240) were adults. Males constituted 56% (11902/21240) and females 44% (9211/21240). 5104 (24.0%) of tested individuals were 19-25years; 12,039 (56.7%) 26-45years; 21119 (9.0%) 46-55years; 2.8% (590/21240) and 766 (3.6%) >65years. Among adult males, 17% (2133/11902) was contributed by ages 19-25. 58% (7017/11902), 11.9% (1421/11902), 6.4% (765/11902) and 4.7% (563/11902) of males were 26-45 years old, 46-55 years old and 56-65 years and >65year old respectively. Adults aged 19-25years, 26-45 years, 46-55years, 56-65 and > 65years each constituted 32% (2966/9211); 54.4% (5009/9211); 7.4% (684/9211), 3.8% (350/9211) and 2.2% (201/9211) of females respectively. 16.2% (3431/21,240) demonstrated Hepatitis B surface antigenaemia. The sero-positivity rate was 16.9% (865//5104) between 19-25years, 21.2% (2559/12,039) among 26-45year old individuals. 17.9% (377/2111); 14.1% (83/590) and 7.3% (56/766) of 46-55year old, 56-65year old and >65year old individuals screened were seropositive. The highest sero-positivity rate was found in male young adults aged 19-25years 27.9% (398/1426) and lowest in elderly males 7.4% (28/377). HBe antigen testing rate among HbSAg seropositive individuals was 97.3% (3338/3431). Males constituted 59.7% (1992/3338) and females 40.3% (1345/3338). 25.3% (844/3338) were aged 19-25years; 61.1% (2039/3338) 26-45years; 10.2% (340/3338) 46-55years; 2.7% (90/3338) 56-65years and 0.7% >65years old. HB e antigenaemia was positive in 8.2% (275/3338) of those tested. 41% (113/275); 50.2% (138/275); 5.4% (15/275); 1.8% (5/275) and 1.1 (3/275) of HB e sero-positivity was among age groups 19-25, 26-45, 46-55, 56-65 and > 65year old individuals. Dual sero-positivity rate was highest 13% (113/844) in young adults 19-25years and lowest between 46-55years; 15/340 (4.4%). 4.2% (15/360); 13.5% (69/512); 6.7% (90/1348); 4.6% (10/214); 5% (2/40) and 6.7% (1/15) of males aged 19-25; 26-45; 46-55; 56-65; and >65years had HB e antigenaemia respectively. Among females - 27/293 (9.2%) aged 19-25; 26/500 (5.2%) 26-45; 2/84 (2.4%) 46-55; 1/12 (8.3%) 56-65 and 1/9(11.1%) >65years had dual antigenaemia. In women of childbearing age, 6.9% (53/793) had a dual carriage. Conclusion: Dual hepatitis B surface and envelope antigenaemia are highest in young adult males. This will have significant implications for the development of chronic liver disease and hepatocellular carcinoma.

Keywords: adult, Hepatitis B, Nigeria, dual carriage

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Authors: Gayathri Nagarajan, L. D. Dhinesh Babu

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Health care is one of the prominent industries that generate voluminous data thereby finding the need of machine learning techniques with big data solutions for efficient processing and prediction. Missing data, incomplete data, real time streaming data, sensitive data, privacy, heterogeneity are few of the common challenges to be addressed for efficient processing and mining of health care data. In comparison with other applications, accuracy and fast processing are of higher importance for health care applications as they are related to the human life directly. Though there are many machine learning techniques and big data solutions used for efficient processing and prediction in health care data, different techniques and different frameworks are proved to be effective for different applications largely depending on the characteristics of the datasets. In this paper, we present a framework that uses ensemble machine learning technique gradient boosted trees for data classification in health care big data. The framework is built on Spark platform which is fast in comparison with other traditional frameworks. Unlike other works that focus on a single technique, our work presents a comparison of six different machine learning techniques along with gradient boosted trees on datasets of different characteristics. Five benchmark health care datasets are considered for experimentation, and the results of different machine learning techniques are discussed in comparison with gradient boosted trees. The metric chosen for comparison is misclassification error rate and the run time of the algorithms. The goal of this paper is to i) Compare the performance of gradient boosted trees with other machine learning techniques in Spark platform specifically for health care big data and ii) Discuss the results from the experiments conducted on datasets of different characteristics thereby drawing inference and conclusion. The experimental results show that the accuracy is largely dependent on the characteristics of the datasets for other machine learning techniques whereas gradient boosting trees yields reasonably stable results in terms of accuracy without largely depending on the dataset characteristics.

Keywords: big data analytics, ensemble machine learning, gradient boosted trees, Spark platform

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Authors: Deepa Gandhi, Pravin K. Naoghare, Amit Bafana, Krishnamurthi Kannan, Saravanadevi Sivanesana

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Oxidative stress is known to depreciate normal functioning of osteoblast cells. Present study reports oxidative/inflammatory signatures in fluoride exposed human osteosarcoma (HOS) cells and its possible association with the genes involved in bone developmental pathway. Microarray analysis was performed to understand the possible molecular mechanisms of stress-mediated bone lose in HOS cells. Cells were chronically exposed with sub-lethal concentration of fluoride. Global gene expression is profiling revealed 34 up regulated and 2598 down-regulated genes, which were associated with several biological processes including bone development, osteoblast differentiation, stress response, inflammatory response, apoptosis, regulation of cell proliferation. Microarray data were further validated through qRT-PCR and western blot analyses using key representative genes. Based on these findings, it can be proposed that chronic exposure of fluoride may impair bone development via oxidative and inflammatory stress. The present finding also provides important biological clues, which will be helpful for the development of therapeutic targets against diseases related bone.

Keywords: bone, HOS cells, microarray, stress

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Authors: Catherine Portelli

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Felines, such as Panthera tigris, Panthera leo and Puma concolor, have become common residents in animal parks and zoos. They often sustain injuries from other felines within the same, or adjacent enclosures and from playing with items of enrichment and structures of the enclosure itself. These open wounds, and their treatments, are often challenging in the veterinary practice, where feline-specific studies are lacking. This study is based on the author’s clinical experience gained while working at local animal parks in the past five years, and current evidence of hydrocolloid dressing applied to other species. Hydrocolloid dressing is used for secondary healing of chronic and acute wounds, where there is a considerable amount of tissue loss. The patients included in this study were sedated using medetomidine and ketamine every three to four days, for wound treatment and bandage change. Comparative studies of different techniques of open wound management will improve the healing process of exotic felines in the future by decreasing the time of recovery and incidence of other complications. Such studies will also aid with treatment of injuries sustained in wild felines, such as trap and bite wounds, found in natural conservation areas and wild animal sanctuaries.

Keywords: felines, hydrocolloid dressing, open wound, secondary healing

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