Search results for: Health Outcomes

Authors: Amean A. Yasir, Zainab Kh. A. Al-Mahdi Al-Amean

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In both developed and developing countries, obesity among women is increasing, but in different patterns and at very different speeds. It may have a negative effect on health, leading to reduced life expectancy and/or increased health problems. This research studied the age distribution among obese women, the types of overweight and obesity, and the extent of the problem of overweight/obesity and the obesity etiological factors among women in Hillah city in central Iraq. A total of 322 overweight and obese women were included in the study, those women were randomly selected. The Body Mass Index was used as indicator for overweight/ obesity. The incidence of overweight/obesity among age groups were estimated, the etiology factors included genetic, environmental, genetic/environmental and endocrine disease. The overweight and obese women were screened for incidence of infection and/or diseases. The study found that the prevalence of 322 overweight and obese women in Hillah city in central Iraq was 19.25% and 80.78%, respectively. The obese women types were recorded based on BMI and WHO classification as class-1 obesity (29.81%), class-2 obesity (24.22%) and class-3 obesity (26.70%), the result was discrepancy non-significant, P value < 0.05. The incidence of overweight in women was high among those aged 20-29 years (90.32%), 6.45% aged 30-39 years old and 3.22% among ≥ 60 years old, while the incidence of obesity was 20.38% for those in the age group 20-29 years, 17.30% were 30-39 years, 23.84% were 40-49 years, 16.92% were 50-59 years group and 21.53% were ≥ 60 years age group. These results confirm that the age can be considered as a significant factor for obesity types (P value < 0.0001). The result also showed that the both genetic factors and environmental factors were responsible for incidents of overweight or obesity (84.78%) p value < 0.0001. The results also recorded cases of different repeated infections (skin infection, recurrent UTI and influenza), cancer, gallstones, high blood pressure, type 2 diabetes, and infertility. Weight stigma and bias generally refers to negative attitudes; Obesity can affect quality of life, and the results of this study recorded depression among overweight or obese women. This can lead to sexual problems, shame and guilt, social isolation and reduced work performance. Overweight and Obesity are real problems among women of all age groups and is associated with the risk of diseases and infection and negatively affects quality of life. This result warrants further studies into the prevalence of obesity among women in Hillah City in central Iraq and the immune response of obese women.

Keywords: Obesity, overweight, Iraq, body mass index.

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Authors: Bolajoko I. Malomo, Maryam O. Yusuf

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Lagos urban mini bus drivers play a critical role in the transportation sector. The current major mode of transportation within Lagos metropolis remains road transportation and this confirms the relevance of urban mini-bus drivers in transporting the populace to their various destinations. Other modes of transportation such as the train and waterways are currently inadequate. Various threats to the well-being of urban bus drivers include congested traffic typical of modern day lifestyles, dwindling financial returns due to long hours in traffic, fewer hours of sleep, inadequate diet, time pressure, and assaults related to fare disputes. Several healthrelated problems have been documented to be associated with urban bus driving. For instance, greater rates of hypertension, obesity and cholesterol level have been reported. Research studies are yet to identify the influence of age and marital status on the well-being of urban mini-bus drivers in Lagos metropolis. A study of this nature is necessary as it is culturally perceived in Nigeria that older and married people are especially influenced by family affiliation and would behave in ways that would project positive outcomes. The study sample consisted of 150 urban mini-bus drivers who were conveniently sampled from six (6) different terminuses where their journey begins and terminates. The well-being questionnaire was administered to participants. The criteria for inclusion in the study included the ability to read in English language and the confirmation that interested participants were on duty and suited to be driving mini-buses. Due to the nature of the job of bus driving, the researcher administered the questionnaires on participants who were free and willing to respond to the survey. All participants were males of various age groups and of different marital statuses. Results of analyses conducted revealed no significant influence of age and marital status on the well-being of urban mini-bus drivers. This indicates that the well-being of urban mini bus drivers is not influenced by age or marital status. The findings of this study have cultural implications. It negates the popularly held belief that older and married people care more about their well-being than younger and single people. It brings to fore the need to also identify and consider other factors when certifying people for the job of urban bus driving.

Keywords: Age, Lagos metropolis, marital status, well-being of urban mini bus drivers.

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Authors: Mustafa M. Donma, Orkide Donma

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Zinc (Zn) is a vital element required for growth and development particularly in children. It exhibits some protective effects against cardiovascular diseases (CVDs). Zn may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis and prognosis of CVDs. The aim of this study is to determine Zn as well as new generation cardiac markers’ profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. 45 MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99 and above 99 for N-BMI, OB and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses including Zn were performed. hs-cTnT and cMyBP-C concentrations were measured by enzyme-linked immunosorbent assay. Data were analyzed by using SPSS software. p < 0.05 was accepted as significant. Four groups were matched for age and gender. Decreased Zn concentrations were measured in Groups 2, 3 and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between Zn and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between Zn and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of Zn accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both Zn and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.

Keywords: Cardiac myosin binding protein-C, cardiovascular diseases, children, high sensitive cardiac troponin T, obesity.

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Authors: Gaofetoge Lenetha, Malerato Moloi, Ntsoaki Malebo

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Microbial contamination of ready-to-eat foods and beverages sold by street vendors has become an important public health issue. In developing countries including South Africa, health risks related to such kinds of foods are thought to be common. Thus, this study assessed knowledge, attitude and practices of street food vendors. Street vendors in the city of Mangaung Metro were investigated in order to assess their knowledge, attitudes and handling practices. A semi-structured questionnaire and checklist were used in interviews to determine the status of the vending sites and associa. ted food-handling practices. Data was collected by means of a face-to-face interview. The majority of respondents were black females. Hundred percent (100%) of the participants did not have any food safety training. However, street vendors showed a positive attitude towards food safety. Despite the positive attitude, vendors showed some non-compliance when it comes to handling food. During the survey, it was also observed that the vending stalls lack basic infrastructures like toilets and potable water that is currently a major problem. This study indicates a need for improvements in the environmental conditions at these sites to prevent foodborne diseases. Moreover, based on the results observed food safety and food hygiene training or workshops for street vendors are highly recommended.

Keywords: Food hygiene, foodborne illnesses, food safety, street foods.

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Authors: Taruna Katyal Arora, Geeta Kumari, Hari Shankar, Neelima Mishra

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Substandard and counterfeit antimalarials is a major problem in malaria endemic areas. The availability of counterfeit/ substandard medicines is not only decreasing the efficacy in patients, but it is also one of the contributing factors for developing antimalarial drug resistance. Owing to this, a pilot study was conducted to survey quality of drugs collected from different malaria endemic areas of India. Artesunate+Sulphadoxine-Pyrimethamine (AS+SP), Artemether-Lumefantrine (AL), Chloroquine (CQ) tablets were randomly picked from public health facilities in selected states of India. The quality of antimalarial drugs from these areas was assessed by using Global Pharma Health Fund Minilab test kit. This includes physical/visual inspection and disintegration test. Thin-layer chromatography (TLC) was carried out for semi-quantitative assessment of active pharmaceutical ingredients. A total of 45 brands, out of which 21 were for CQ, 14 for AL and 10 for AS+SP were tested from Uttar Pradesh (U.P.), Mizoram, Meghalaya and Gujrat states. One out of 45 samples showed variable disintegration and retension factor. The variable disintegration and retention factor which would have been due to substandard quality or other factors including storage. However, HPLC analysis confirms standard active pharmaceutical ingredient, but may be due to humid temperature and moisture in storage may account for the observed result.

Keywords: Antimalarial medicines, counterfeit, substandard, thin layer chromatography.

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Authors: Ghassan Kbar, Shady Aly, Ibraheem Elsharawy, Akshay Bhatia, Nur Alhasan, Ronaldo Enriquez

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The Smart Help for persons with disability (PWD) is a part of the project SMARTDISABLE which aims to develop relevant solution for PWD that target to provide an adequate workplace environment for them. It would support PWD needs smartly through smart help to allow them access to relevant information and communicate with other effectively and flexibly, and smart editor that assist them in their daily work. It will assist PWD in knowledge processing and creation as well as being able to be productive at the work place. The technical work of the project involves design of a technological scenario for the Ambient Intelligence (AmI) - based assistive technologies at the workplace consisting of an integrated universal smart solution that suits many different impairment conditions and will be designed to empower the Physically disabled persons (PDP) with the capability to access and effectively utilize the ICTs in order to execute knowledge rich working tasks with minimum efforts and with sufficient comfort level. The proposed technology solution for PWD will support voice recognition along with normal keyboard and mouse to control the smart help and smart editor with dynamic auto display interface that satisfies the requirements for different PWD group. In addition, a smart help will provide intelligent intervention based on the behavior of PWD to guide them and warn them about possible misbehavior. PWD can communicate with others using Voice over IP controlled by voice recognition. Moreover, Auto Emergency Help Response would be supported to assist PWD in case of emergency. This proposed technology solution intended to make PWD very effective at the work environment and flexible using voice to conduct their tasks at the work environment. The proposed solution aims to provide favorable outcomes that assist PWD at the work place, with the opportunity to participate in PWD assistive technology innovation market which is still small and rapidly growing as well as upgrading their quality of life to become similar to the normal people at the workplace. Finally, the proposed smart help solution is applicable in all workplace setting, including offices, manufacturing, hospital, etc.

Keywords: Ambient Intelligence, ICT, Persons with disability PWD, Smart application.

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Authors: A. Rezazadeh, B Damari, S. Riazi-Esfahani, M. Hajian

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The consumption of junk food in Iran is alarmingly increasing. This study aimed to investigate the influencing factors of junk food consumption and amendable interventions that are criticized and approved by stakeholders, in order to presented to health policy makers. The articles and documents related to the content of study were collected by using the appropriate key words such as junk food, carbonated beverage, chocolate, candy, sweets, industrial fruit juices, potato chips, French fries, puffed corn, cakes, biscuits, sandwiches, prepared foods and popsicles, ice cream, bar, chewing gum, pastilles and snack, in scholar.google.com, pubmed.com, eric.ed.gov, cochrane.org, magiran.com, medlib.ir, irandoc.ac.ir, who.int, iranmedex.com, sid.ir, pubmed.org and sciencedirect.com databases. The main key points were extracted and included in a checklist and qualitatively analyzed. Then a summarized abstract was prepared in a format of a questionnaire to be presented to stakeholders. The design of this was qualitative (Delphi). According to this method, a questionnaire was prepared based on reviewing the articles and documents and it was emailed to stakeholders, who were asked to prioritize and choose the main problems and effective interventions. After three rounds, consensus was obtained.            Studies revealed high consumption of junk foods in the Iranian population, especially in children and adolescents. The most important affecting factors include availability, low price, media advertisements, preference of fast foods taste, the variety of the packages and their attractiveness, low awareness and changing in lifestyle. Main interventions recommended by stakeholders include developing a protective environment, educational interventions, increasing healthy food access and controlling media advertisements and putting pressure from the Industry and Mining Ministry on producers to produce healthy snacks. According to the findings, the results of this study may be proposed to public health policymakers as an advocacy paper and to be integrated in the interventional programs of Health and Education ministries and the media. Also, implementation of supportive meetings with the producers of alternative healthy products is suggested.

Keywords: Junk foods, situation, qualitative study, Iran.

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Authors: Manish Kumar, Pradeep Rout Aditya Kumar Jha, Pankaj Gupta

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Wings are structural components of an aeroplane that are used to produce lift while the aircraft is in flight. The initial assault angle of the wing is definite. Due to the pressure difference at the top and bottom surfaces of the wing, lift force is produced when the flow passes over it. This paper explains the fundamental concept of the structural behaviour of a wing threatened by flowing loads during the voyage. The study comprises the use of concepts and analysis with the help of finite element analysis. Wing assembly is the first stage of wing model and design, which are determined by fascinating factual features. The basic gathering wing consists of a thin membrane, two poles, and several ribs. It has two spars, the major spar and the secondary spar. Here, NACA 23015 is selected as the standard model for all types of aerofoil structures since it is more akin to the custom aerofoil utilized in large aircraft, specifically the Airbus A320. Two rods mostly endure the twisting moment and trim strength, which is finished with titanium contamination to ensure enough inflexibility. The covering and wing spars are made of aluminium amalgam to lessen the structural heaviness. Following that, a static underlying examination is performed, and the general contortion, equivalent flexible strain, and comparing Von-Mises pressure are obtained to aid in investigations of the mechanical behaviour of the wing. Moreover, the modular examination is being upheld to decide the normal pace of repetition as well as the modular state of the three orders, which are obtained through the pre-stress modular investigation. The findings of the modular investigation assist engineers in reducing their excitement about regular events and turning away the wing from the whirlwind. Based on the findings of the study, planners can prioritise union and examination of the pressure mindfulness range and tremendous twisting region. All in all, the entertainment outcomes demonstrate that the game plan is feasible and further develop the data grade of the lifting surface.

Keywords: FEM, Airbus, NACA, modulus of elasticity, aircraft wing.

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Authors: W. Kongnoo, J. Loysongkroa, S. Chotivichien, N. Viriyautsahakul, N. Saiwongse

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Obesity, stunting and wasting problems among Thai school-aged children are increasing due to inappropriate food consumption behavior and poor environments for desirable nutritional behavior. Because of a low school lunch budget of only 0.40 USD per person per day, food quality is not up to nutritional standards. Therefore, the Health Department with the Education Ministry and the Thai Health Promotion Foundation have developed a quality school lunch project during 2009–2013. The program objectives were development and management of public policy to increase school lunch budget. The methods used a healthy public policy motivation process and movement in 241 local administrative organizations and 538 schools. The problem and solution research was organized to study school food and nutrition management, create a best practice policy mobilization model and hold a public hearing to motivate an increase of school meal funding. The results showed that local public policy has been motivated during 2009-2011 to increase school meal budget using local budgets. School children with best food consumption behavior and exercise increased from 13.2% in 2009 to 51.6% in 2013 and stunting decreased from 6.0% in 2009 to 4.7% in 2013. As the result of national policy motivation (2012-2013), the cabinet meeting on October 22, 2013 has approved an increase of school lunch budget from 0.40 USD to 0.62 USD per person per day. Thus, 5,800,469 school children nationwide have benefited from the budget increase.

Keywords: Public policy, Quality school lunch, Thailand.

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Authors: Berceste Gülçin Özdemir

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The representation of women characters in cinema has been discussed for centuries. In cinema where dominant narrative codes prevail and scopophilic views exist over women characters, passive stereotypes of women are observed in the representation of women characters. In films shot from a woman’s point of view in Turkish Cinema and even in the films outside the main stream in which the stories of women characters are told, the fact that women characters are discussed on the basis of feminist film theories triggers the question: ‘Are feminist films produced in Turkish Cinema?’ The spaces that are used in the representation of women characters are observed to be used as spaces that convert characters into passive subjects on the basis of the space factor in the narrative. The representation of women characters in the possible surveillance spaces integrates the characters and compresses them in these spaces. In this study, narrative analysis was used to investigate women characters representation in the surveillance spaces. For the study framework, firstly a case study films are selected, and in the second level, women characters representations in surveillance spaces are argued by narrative analysis using feminist film theories. Two questions are argued with feminist film theories: ‘Why do especially women directors represent their female characters to viewers by representing them in surveillance spaces?’ and ‘Can this type of presentation contribute to the feminist film practice and become important with regard to feminist film theories?’ The representation of women characters in a passive and observed way in surveillance spaces of the narrative reveals the questioning of also the discourses of films outside of the main stream. As films that produce alternative discourses and reveal different cinematic languages, those outside the main stream are expected to bring other points of view also to the representation of women characters in spaces. These questionings are selected as the baseline and Turkish films such as Watch Tower and Mustang, directed by women, were examined. This examination paves the way for discussions regarding the women characters in surveillance spaces. Outcomes can be argued from the viewpoint of representation in the genre by feminist film theories. In the context of feminist film theories and feminist film practice, alternatives should be found that can corporally reveal the existence of women in both the representation of women characters in spaces and in the usage of the space factor.

Keywords: Feminist film theory, representation, space, women filmmaker, women characters.

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Authors: Saeed Rezaeian, M. Rezaee Boroon

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Nitrogen accumulates in soils during the process of fertilizer addition to promote the plant growth. When the organic matter decomposes, the form of available nitrogen produced is in the form of nitrate, which is highly mobile. The most significant health effect of nitrate ingestion is methemoglobinemia in infants under six months of age (blue baby syndrome). The mobile nutrients, like nitrate nitrogen, are not stored in the soil as the available forms for the long periods and in large amounts. It depends on the needs for the crops such as vegetables. On the other hand, the vegetables will compete actively for nitrate nitrogen as a mobile nutrient and water. The mobile nutrients must be shared. The fewer the plants, the larger this share is for each plant. Also, this nitrate nitrogen is poisonous for the people who use these vegetables. Nitrate is converted to nitrite by the existing bacteria in the stomach and the Gastro-Intestinal (GI) tract. When nitrite is entered into the blood cells, it converts the hemoglobin to methemoglobin, which causes the anoxemia and cyanosis. The increasing use of pesticides and chemical fertilizers, especially the fertilizers with nitrates compounds, which have been common for the increased production of agricultural crops, has caused the nitrate pollution in the (soil, water, and environment). They have caused a lot of damage to humans and animals. In this research, the nitrate accumulation in different kind of vegetables such as; green pepper, tomatoes, egg plants, watermelon, cucumber, and red pepper were observed in the suburbs of Mashhad, Neisabour, and Sabzevar cities. In some of these cities, the information forms of agronomical practices collected were such as; different vegetable crops fertilizer recommendations, varieties, pesticides, irrigation schedules, etc., which were filled out by some of our colleagues in the research areas mentioned above. Analysis of the samples was sent to the soil and water laboratory in our department in Mashhad. The final results from the chemical analysis of samples showed that the mean levels of nitrates from the samples of the fruit crops in the mentioned cities above were all lower than the critical levels. These fruit crop samples were in the order of: 35.91, 8.47, 24.81, 6.03, 46.43, 2.06 mg/kg dry matter, for the following crops such as; tomato, cucumber, eggplant, watermelon, green pepper, and red pepper. Even though, this study was conducted with limited samples and by considering the mean levels, the use of these crops from the nutritional point of view will not cause the poisoning of humans.

Keywords: Environmental pollution, human health, nitrate accumulations, nitrate fertilizers.

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Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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Authors: Magdalena Escamilla Quintal, Thelma Cetina Canto, Cecilia Aguilar Ortega

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Due to the importance that people represent for companies, the setting of a clear control of the risks that threaten the health and the material and financial resources of workers is essential. It is irrelevant if the company is a small and medium-sized enterprise (SME) or a large multinational, or if it is in the construction or service sector. The risk prevention importance is related to a constitutional and human right that all people have; working in a risk-free environment to prevent accidents or illnesses that may influence their quality of life and the tranquility of their family. Therefore, the objective of this study was to determine the level of psychosocial risks (physical and emotional) of the employees of an SME. The participants of this study were 186 employees of a productive sector SME; 151 men and 35 women, all with an average age of 31.77 years. Their seniority inside the SME was between one month and 19.91 years. Ninety-six workers were from the production area, 28 from the management area, as well as 25 from the sales area and 40 from the supplies area. Ninety-three workers were found in Uman, 78 in Playa del Carmen, 11 in Cancun and seven in Cd. del Carmen. We found a statistically significant relationship between the burnout variable and the engagement and psychosomatic complaints as well as between the variables of sex, burnout and psychosomatic complaints. We can conclude that, for benefit of the SME, that there are low levels of burnout and psychosomatic complaints, the women experience major levels of burnout and the men show major levels of psychosomatic complaints. The findings, contributions, limitations and future proposals will be analyzed.

Keywords: Psychosocial risks, SME, burnout, engagement, psychosomatic complaints.

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Authors: M. Adamczak-Retecka, O. Hołub-Śniadach

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Dangerous of climate change is now global problem and as such has a strategic priority also for the European Union. Europe and European citizens try to do their best to cut greenhouse gas emissions, moreover they substantially encourage other nations and regions to follow the same way. The European Commission and a number of Member States have developed adaptation strategies in order to help strengthen EU's resilience to the inevitable impacts of climate change. The EU has long been a driving force in international negotiations on climate change and was instrumental in the development of the UN Framework Convention on Climate Change. As the world's leading donor of development aid, the EU also provides substantial funding to help developing countries tackle climate change problem. Global warming influences human health, biodiversity, ecosystems but also many social and economic sectors. The aim of this paper is to focus on impact of claimant change on for food security. Food security challenges are directly related to globalization, climate change. It means that current and future food policy is exposed to all cross-cutting and that must be linked with environmental and climate targets, which supposed to be achieved. In the 7th EAP —The new general Union Environment Action Program to 2020, called “Living well, within the limits of our planet” EU has agreed to step up its efforts to protect natural capital, stimulate resource efficient, low carbon growth and innovation, and safeguard people’s health and wellbeing– while respecting the Earth’s natural limits.

Keywords: Climate change, EU law, food policy, food security.

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Authors: Bill D. Geis, Frederick Newman

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Suicide and wrongful death forensic cases are the fastest rising tort in mental health law. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from US state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. But suicide ideation, in the matter of suicide risk determination, may be a necessary but insufficient target of lethal suicide risk assessment. Assessment of near-term suicide risk—assessment that goes beyond verbalized suicide ideation and relates to acute crisis variables—is likely needed. Specifically, such other or additional suicide risk variable assessment may be required in the context of lethal suicide risk situations, as opposed to the discernment of general, nonlethal suicide behavior as a standard of practice (whether a patient is having suicidal thoughts or exhibiting an ambivalent suicide attempt potential). In the current study, verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The Lethal Suicide Risk Assessment, Acute Model, and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training and become the legal standard of care for expected clinical behavior. Without this expanded clinical assessment perspective, the standard of care for suicide assessment is out of sync with current knowledge—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: Forensic evaluation, standard of care, suicide, suicide assessment, wrongful death.

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Authors: Niwatchai Namwichisirikul

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Due to the emergence of “Humanized Healthcare" introduced by Professor Dr. Prawase Wasi in 2003[1], the development of this paradigm tends to be widely implemented. The organizations included Healthcare Accreditation Institute (public organization), National Health Foundation, Mahidol University in cooperation with Thai Health Promotion Foundation, and National Health Security Office (Thailand) have selected the hospitals or infirmaries that are qualified for humanized healthcare since 2008- 2010 and 35 of them are chosen to be the outstandingly navigating organizations for the development of humanized healthcare, humanized healthcare award [2]. The research aims to study the current issue, characteristics and patterns of hospital administration contributing to humanized healthcare system in Thailand. The selected case studies are from four hospitals including Dansai Crown Prince Hospital, Leoi; Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and Prathai Hospital, Nakhonrachasima. The methodology is in-depth interviewing with 10 staffs working as hospital executive directors, and representatives from leader groups including directors, multidisciplinary hospital committees, personnel development committees, physicians and nurses in each hospital. (Total=40) In addition, focus group discussions between hospital staffs and general people (including patients and their relatives, the community leader, and other people) are held by means of setting 4 groups including 8 people within each group. (Total=128) The observation on the working in each hospital is also implemented. The findings of the study reveal that there are five important aspects found in each hospital including (1) the quality improvement under the mental and spiritual development policy from the chief executives and lead teams, leaders as Role model and they have visionary leadership; (2) the participation hospital administration system focusing on learning process and stakeholder- needs, spiritual human resource management and development; (3) the relationship among people especially staffs, team work skills, mutual understanding, effective communication and personal inner-development; (4) organization culture relevant to the awareness of patients- rights as well as the participation policy including spiritual growth achieving to the same goals, sharing vision, developing public mind, and caring; and (5) healing structures or environment providing warmth and convenience for hospital staffs, patients and their relatives and visitors.

Keywords: Hospital administration, Humanized healthcare.

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Authors: M. Farzadkia, S. Jorfi

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Hospital waste is a category of waste consisting of infectious and non-infectious waste, which pose environmental and health risks. Therefore, special planning and management is required, due to the potential hazards of them. The lack of valid and comprehensive information regarding the generation and management of hospital waste in Iran is one of the most important problems in this field. This research aimed to evaluate hospital waste management efficiency in Karaj city, Iran. The four greatest hospitals in Karaj city had been selected in this cross-sectional study. Site observations and interviews with employees were implemented. The data was gathered based on the hospital waste management questionnaire which was designed by World Health Organization for developing countries. Collected Data had been analyzed using SPSS software. The average of solid waste which was generated per bed was 2.78 kg, which included 90% of domestic waste and 10% of infectious waste. Based on the quantitative analysis of general and infectious waste in these hospitals, the highest contributors of general waste were consisting of food waste (37.39%), while textile (28.06%) were the highest contributors of the infectious waste. According to the information contained in the questionnaires, the main defects of waste management in these hospitals were; inadequate staff in waste management sector, poorly disinfection of solid waste containers and temporary storage locations, and a lack of proper infectious waste treatment. According to the results of this research, waste management in these hospitals were far from optimum conditions. In order to improve the existing conditions, mentioned problems must be solved quickly, and planning for continuous monitoring in the waste management field in these hospitals should be established.

Keywords: Waste management, hospital wastes, solid wastes, Iran.

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Authors: Jay Patel

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This research is about investigating the ‘image’ of the city, and asks whether this ‘image’ holds any significance that can be changed. Kevin Lynch in the book ‘The Image of the City’ develops a framework that breaks down the city’s image into five physical elements. These elements (Paths, Edge, Nodes, Districts, and Landmarks), according to Lynch assess the legibility of the urbanscapes, that emerged from his perception-based study in three different cities (New Jersey, Los Angeles, and Boston) in the USA. The aim of this research is to investigate whether Lynch’s framework can be applied within an Indian context or not. If so, what are the possibilities and whether the imageability of Indian cities can be depicted through the Lynch’s physical elements or it demands an extension to the framework by either adding or subtracting a physical attribute. For this research project, the walled city of Jaipur was selected, as it is considered one of the futuristic designed cities of all time in India. The other significant reason for choosing Jaipur was that it is a historically planned city with solid historical, touristic and local importance; allowing an opportunity to understand the application of Lynch's elements to the city's image. In other words, it provides an opportunity to examine how the disadvantages of a city's implicit program (its relics of bygone eras) can be converted into assets by improving the imageability of the city. To obtain data, a structured semi-open ended interview method was chosen. The reason for selecting this method explicitly was to gain qualitative data from the users rather than collecting quantitative data from closed-ended questions. This allowed in-depth understanding and applicability of Kevin Lynch’s framework while assessing what needs to be added. The interviews were conducted in Jaipur that yielded varied inferences that were different from the expected learning outcomes, highlighting the need for extension on Lynch’s physical elements to achieve city’s image. Whilst analyzing the data, there were few attributes found that defined the image of Jaipur. These were categorized into two: a Physical aspect (streets and arcade entities, natural features, temples and temporary/informal activities) and Associational aspects (History, culture and tradition, medium of help in wayfinding, and intangible aspects).

Keywords: Imageability, Kevin Lynch, People’s Perception, associational aspects, physical aspects.

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Authors: Kyu Jin Kim, Byung Kwan Oh, Hyo Seon Park

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The seismic responses-based structural health monitoring system has been performed to prevent seismic damage. Structural seismic damage of building is caused by the instantaneous stress concentration which is related with dynamic characteristic of earthquake. Meanwhile, seismic response analysis to estimate the dynamic responses of building demands significantly high computational cost. To prevent the failure of structural members from the characteristic of the earthquake and the significantly high computational cost for seismic response analysis, this paper presents an artificial neural network (ANN) based prediction model for dynamic responses of building considering specific time length. Through the measured dynamic responses, input and output node of the ANN are formed by the length of specific time, and adopted for the training. In the model, evolutionary radial basis function neural network (ERBFNN), that radial basis function network (RBFN) is integrated with evolutionary optimization algorithm to find variables in RBF, is implemented. The effectiveness of the proposed model is verified through an analytical study applying responses from dynamic analysis for multi-degree of freedom system to training data in ERBFNN.

Keywords: Structural health monitoring, dynamic response, artificial neural network, radial basis function network, genetic algorithm.

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Authors: George Leventakis, George Kokkinis, Nikos Moustakidis, George Papalexandratos, Ioanna Vasiliadou

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Enhancing the feeling of public safety and crime prevention are tasks customarily assigned to the Police. Police departments have, however, recognized that traditional ways of policing methods are becoming obsolete; Community Policing (CP) philosophy; however, when applied appropriately, leads to seamless collaboration between various stakeholders like the Police, NGOs and the general public and provides the opportunity to identify risks, assist in solving problems of crime, disorder, safety and crucially contribute to improving the quality of life for everyone in a community. Social Media, on the other hand, due to its high level of infiltration in modern life, constitutes a powerful mechanism which offers additional and direct communication channels to reach individuals or communities. These channels can be utilized to improve the citizens’ perception of the Police and to capture individual and community needs, when their feedback is taken into account by Law Enforcement Agencies (LEAs) in a structured and coordinated manner. This paper presents research conducted under INSPEC²T (Inspiring CitizeNS Participation for Enhanced Community PoliCing AcTions), a project funded by the European Commission’s research agenda to bridge the gap between CP as a philosophy and as an organizational strategy, capitalizing on the use of Social Media. The project aims to increase transparency, trust, police accountability, and the role of civil society. It aspires to build strong, trusting relationships between LEAs and the public, supporting two-way, contemporary communication while at the same time respecting anonymity of all affected parties. Results presented herein summarize the outcomes of four online multilingual surveys, focus group interviews, desktop research and interviews with experts in the field of CP practices. The above research activities were conducted in various EU countries aiming to capture requirements of end users from diverse backgrounds (social, cultural, legal and ethical) and determine public expectations regarding CP, community safety and crime prevention.

Keywords: Community partnerships, next generation community policing, public safety, social media.

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Authors: Edward A. Osifodunrin, Jose Manuel Dias Lopes

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In Nigeria, enormous efforts/resources had, over the years, been expended on promoting financial inclusion (FI); however, it is seemingly discouraging that many of its self-declared targets on FI remained unachieved, especially amongst the Rural Dwellers and Actors in the Informal Sectors (RDAIS). Expectedly, many reasons had been earmarked for these failures: low literacy level, huge informal/rural sectors etc. This study posits that in spite of these truly-debilitating factors, these FI policy failures could have been avoided or mitigated if the principles of active and better-managed citizens’ participation had been strictly followed in the (re)design/implementation of its FI policies. In other words, in a bid to mitigate the prevalent financial exclusion (FE) in Nigeria, this study hypothesizes the significant positive impact of involving the RDAIS in policy-wide decision making in the FI domain, backed by a preliminary empirical validation. Also, the study introduces the RDAIS-focused Participatory Financial Inclusion Policy (PFIP) as a major FI policy regeneration/improvement tool. The three categories of respondents that served as research subjects are FI experts in Nigeria (n = 72), RDAIS from the very rural/remote village of Unguwar Dogo in Northern Nigeria (n = 43) and RDAIS from another rural village of Sekere (n = 56) in the Southern region of Nigeria. Using survey design (5-point Likert scale questionnaires), random/stratified sampling, and descriptive/inferential statistics, the study often recorded independent consensus (amongst these three categories of respondents) that RDAIS’s active participation in iterative FI policy initiation, (re)design, implementation, (re)evaluation could indeed give improved FI outcomes. However, few questionnaire items also recorded divergent opinions and various statistically (in)significant differences on the mean scores of these three categories. The PFIP (or any customized version of it) should then be carefully integrated into the NFIS of Nigeria (and possibly in the NFIS of other developing countries) to truly/fully provide FI policy integration for these excluded RDAIS and arrest the prevalence of FE.

Keywords: Citizens’ participation, development, financial inclusion, formal financial services, national financial inclusion strategy, participatory financial inclusion policy, rural dwellers and actors in the informal sectors.

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Authors: A. Chowdhury, P. Egodawatta, J. M. McGree, A. Goonetilleke

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Hydrologic models are increasingly used as tools to predict stormwater quantity and quality from urban catchments. However, due to a range of practical issues, most models produce gross errors in simulating complex hydraulic and hydrologic systems. Difficulty in finding a robust approach for model calibration is one of the main issues. Though automatic calibration techniques are available, they are rarely used in common commercial hydraulic and hydrologic modelling software e.g. MIKE URBAN. This is partly due to the need for a large number of parameters and large datasets in the calibration process. To overcome this practical issue, a framework for automatic calibration of a hydrologic model was developed in R platform and presented in this paper. The model was developed based on the time-area conceptualization. Four calibration parameters, including initial loss, reduction factor, time of concentration and time-lag were considered as the primary set of parameters. Using these parameters, automatic calibration was performed using Approximate Bayesian Computation (ABC). ABC is a simulation-based technique for performing Bayesian inference when the likelihood is intractable or computationally expensive to compute. To test the performance and usefulness, the technique was used to simulate three small catchments in Gold Coast. For comparison, simulation outcomes from the same three catchments using commercial modelling software, MIKE URBAN were used. The graphical comparison shows strong agreement of MIKE URBAN result within the upper and lower 95% credible intervals of posterior predictions as obtained via ABC. Statistical validation for posterior predictions of runoff result using coefficient of determination (CD), root mean square error (RMSE) and maximum error (ME) was found reasonable for three study catchments. The main benefit of using ABC over MIKE URBAN is that ABC provides a posterior distribution for runoff flow prediction, and therefore associated uncertainty in predictions can be obtained. In contrast, MIKE URBAN just provides a point estimate. Based on the results of the analysis, it appears as though ABC the developed framework performs well for automatic calibration.

Keywords: Automatic calibration framework, approximate Bayesian computation, hydrologic and hydraulic modelling, MIKE URBAN software, R platform.

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Authors: Gülden Küçükakça, Şefika Dilek Güven, Rahşan Kolutek, Seçil Taylan

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Objective: Nursing students face with stress factors affecting academic performance and quality of life as from first moments of their educational life. Stress causes health problems in students such as physical, psycho-social, and behavioral disorders and might damage formation of professional identity by decreasing efficiency of education. In addition to determination of stress experienced by nursing students during their education, it was aimed to help review theoretical and clinical education settings for bringing stress of nursing students into positive level and to raise awareness of educators concerning their own professional behaviors. Methods: The study was conducted with 315 students studying at nursing department of Semra and Vefa Küçük Health High School, Nevşehir Hacı Bektaş Veli University in the academic year of 2015-2016 and agreed to participate in the study. “Personal Information Form” prepared by the researchers upon the literature review and “Nursing Education Stress Scale (NESS)” were used in this study. Data were assessed with analysis of variance and correlation analysis. Results: Mean NESS Scale score of the nursing students was estimated to be 66.46±16.08 points. Conclusions: As a result of this study, stress level experienced by nursing undergraduate students during their education was determined to be high. In accordance with this result, it can be recommended to determine sources of stress experienced by nursing undergraduate students during their education and to develop approaches to eliminate these stress sources.

Keywords: Stress, nursing education, nursing student, nursing education stress.

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Authors: Ilelabayo I. Adebisi, Yetunde R. Okeyinka, Abdulrasaq K. Ayinla

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Architectural design is a complex process especially when the issue of user’s comfort, building sustainability and energy efficiency needs to be addressed. The current energy challenge and the seek for an environment where users will have a more physiological and psychological comfort in this part of the world have led various researchers to constantly explore the concept of passive design techniques. Passive techniques are design strategies used in regulating building indoor climates and improving users comfort without the use of energy driven devices. This paper describes and analyses the significance of passive techniques on indoor climates and their impact on thermal comfort of building users using LAUTECH College of health sciences Ogbomoso as a case study. The study aims at assessing the appropriateness of the passive strategies used in achieving comfort in their buildings with a view to evaluate their adequacy and effectiveness and suggesting how comfortable their building users are. This assessment was carried out through field survey and questionnaires and findings revealed that strategies such as Orientation, Spacing, Courtyards, window positioning and choice of landscape adopted are inadequate while only fins and roof overhangs are adequate. The finding also revealed that 72% of building occupants feel hot discomfort in their various spaces and hence have the urge to get fresh air from outside during work hours. The Mahoney table was used to provide appropriate architectural design recommendations to guide future designers in the study area.

Keywords: Energy challenge, passive cooling, techniques, thermal comfort, users comfort.

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Authors: E. Grochowska-Niedworok, K. Brukało, M. Hadasik, M. Kardas

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Consumption of vegetables by school children and adolescents is essential for their normal growth, development and health, but a significant minority of the world's population consumes the right amount of these products. The aim of the study was to evaluate the preferences and frequency of consumption of vegetables by school children and adolescents. It has been assumed that effectively implemented nutrition education programs should have an impact on increasing the frequency of vegetable consumption among the recipients. The study covered 514 students of five schools in the Opole Voivodeship aged 9 years to 22 years. The research tool was an author's questionnaire, which consisted of closed questions on the frequency of vegetable consumption and the use of 10 ways to treat them. Preferences and frequencies are shown in percentages, while correlations were estimated on the basis of Cramer`s V and gamma coefficients. In each of the examined age groups, the relationship between sex and vegetable consumption (the Cramer`s V coefficient value was 0.06 to 0.38) was determined and the various methods of culinary processing were used (V Craméra was 0.08 to 0.34). For both sexes, the relationship between age and frequency of vegetable consumption was shown (gamma values ranged from ~ 0.00 to 0.39) and different cooking methods (gamma values were 0.01 to 0.22). The most important determinant of nutritional choices is the taste and availability of products. The fact that they have a positive effect on their health is only in third position. As has been shown, obesity prevention programs can not only address nutrition education but also teach about new flavors and increase the availability of healthy foods. In addition, the frequency of vegetable consumption can be a good indicator reflecting the healthy behaviors of children and adolescents.

Keywords: Children and adolescents, frequency, welfare rate, vegetables.

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Authors: Dalyah Y. Al-Jamal, Maryam H. Eshtaiwi, Liyakathunisa Syed

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Connecting health services with technology has a huge demand as people health situations are becoming worse day by day. In fact, engaging new technologies such as Internet of Things (IOT) into the medical services can enhance the patient care services. Specifically, patients suffering from chronic diseases such as cardiac patients need a special care and monitoring. In reality, some efforts were previously taken to automate and improve the patient monitoring systems. However, the previous efforts have some limitations and lack the real-time feature needed for chronic kind of diseases. In this paper, an improved process model for patient monitoring system specialized for cardiac patients is presented. A survey was distributed and interviews were conducted to gather the needed requirements to improve the cardiac patient monitoring system. Business Process Model and Notation (BPMN) language was used to model the proposed process. In fact, the proposed system uses the IOT Technology to assist doctors to remotely monitor and follow-up with their heart patients in real-time. In order to validate the effectiveness of the proposed solution, simulation analysis was performed using Bizagi Modeler tool. Analysis results show performance improvements in the heart monitoring process. For the future, authors suggest enhancing the proposed system to cover all the chronic diseases.

Keywords: Business process model and notation, cardiac patient, cardiac monitoring, heart monitoring, healthcare, internet of things, remote patient monitoring system, process model, telemedicine, wearable sensors.

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Authors: Libor Zachoval, Daire O Broin, Oisin Cawley

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E-learning platforms, such as Blackboard have two major shortcomings: limited data capture as a result of the limitations of SCORM (Shareable Content Object Reference Model), and lack of incorporation of Artificial Intelligence (AI) and machine learning algorithms which could lead to better course adaptations. With the recent development of Experience Application Programming Interface (xAPI), a large amount of additional types of data can be captured and that opens a window of possibilities from which online education can benefit. In a corporate setting, where companies invest billions on the learning and development of their employees, some learner behaviours can be troublesome for they can hinder the knowledge development of a learner. Behaviours that hinder the knowledge development also raise ambiguity about learner’s knowledge mastery, specifically those related to gaming the system. Furthermore, a company receives little benefit from their investment if employees are passing courses without possessing the required knowledge and potential compliance risks may arise. Using xAPI and rules derived from a state-of-the-art review, we identified three learner behaviours, primarily related to guessing, in a corporate compliance course. The identified behaviours are: trying each option for a question, specifically for multiple-choice questions; selecting a single option for all the questions on the test; and continuously repeating tests upon failing as opposed to going over the learning material. These behaviours were detected on learners who repeated the test at least 4 times before passing the course. These findings suggest that gauging the mastery of a learner from multiple-choice questions test scores alone is a naive approach. Thus, next steps will consider the incorporation of additional data points, knowledge estimation models to model knowledge mastery of a learner more accurately, and analysis of the data for correlations between knowledge development and identified learner behaviours. Additional work could explore how learner behaviours could be utilised to make changes to a course. For example, course content may require modifications (certain sections of learning material may be shown to not be helpful to many learners to master the learning outcomes aimed at) or course design (such as the type and duration of feedback).

Keywords: Compliance Course, Corporate Training, Learner Behaviours, xAPI.

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Authors: Lucy Ampaw-Asiedu, Terri R. Norton

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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: Disaster management, safe spaces, structural design, tornado, vulnerability.

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Authors: M. A. Abou Donia, A. A. K. Abou-Arab, Nevin E. Sharaf, A. K. Enab, Sherif R. Mohamed

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Lead (Pb) poisoning is one of the most common and preventable environmental health problems. There are different sources of environmental pollution with lead as lead alkyl additives in petrol and manufacturing processes. Pb in the atmosphere can be deposited in urban soils, and may then be re-suspended to re-enter the atmosphere. This could increase human exposure to Pb and cause long-term health effects. Thus, monitoring Pb pollution is considered one of the major tasks in controlling pollution. Scalp hair can be utilized for the determination of lead (Pb) concentration. It provides a lasting record of metal intakes of weeks or even months, and for most metals, their accumulation in hair reflects their accumulation in the whole body. This work was conducted to investigate the concentration of lead in male scalp hair of Cairo (residential-traffic and residential-industrial) and rural residents after twenty years of phasing out of leaded gasoline. Results indicated that the mean concentration of lead in hair of residential-traffic (9.7552 μg/g ±0.71) and residential-industrial (12.3288 μg/g ±1.13) was significantly higher than that in rural residents (4.7327 μg/g ±0.67). The mean concentration of lead in hair of resident’s industrial areas was the highest among Cairo residents and not the traffic areas as it was before phasing out of leaded gasoline. Twenty years of phasing out of leaded gasoline in Cairo has greatly improved the lead pollution among residents of traffic areas, but industrial areas residents were still suffering from lead pollution, which needs more efforts to control the sources of lead pollution.

Keywords: Heavy metals, lead, hair, biological sample, urban pollution, rural pollution.

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Authors: V. K. Bansal, M. Kumar, P. P. Bansal, A. Batish

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This paper presents the results of an experimental investigation carried out to evaluate the effects of partial replacement of cement and fine aggregate with industrial waste by-products on concrete strength properties. The Grey Taguchi approach has been used to optimize the mix proportions for desired properties. In this research work, a ternary combination of industrial waste by-products has been used. The experiments have been designed using Taguchi's L9 orthogonal array with four factors having three levels each. The cement was partially replaced by ladle furnace slag (LFS), fly ash (FA) and copper slag (CS) at 10%, 25% and 40% level and fine aggregate (sand) was partially replaced with electric arc furnace slag (EAFS), iron slag (IS) and glass powder (GP) at 20%, 30% and 40% level. Three water to binder ratios, fixed at 0.40, 0.44 and 0.48, were used, and the curing age was fixed at 7, 28 and 90 days. Thus, a series of nine experiments was conducted on the specimens for water to binder ratios of 0.40, 0.44 and 0.48 at 7, 28 and 90 days of the water curing regime. It is evident from the investigations that Grey Taguchi approach for optimization helps in identifying the factors affecting the final outcomes, i.e. compressive strength and split tensile strength of concrete. For the materials and a range of parameters used in this research, the present study has established optimum mixes in terms of strength properties. The best possible levels of mix proportions were determined for maximization through compressive and splitting tensile strength. To verify the results, the optimal mix was produced and tested. The mixture results in higher compressive strength and split tensile strength than other mixes. The compressive strength and split tensile strength of optimal mixtures are also compared with the control concrete mixtures. The results show that compressive strength and split tensile strength of concrete made with partial replacement of cement and fine aggregate is more than control concrete at all ages and w/c ratios. Based on the overall observations, it can be recommended that industrial waste by-products in ternary combinations can effectively be utilized as partial replacements of cement and fine aggregates in all concrete applications.

Keywords: Analysis of variance, ANOVA, compressive strength, concrete, grey Taguchi method, industrial by-products, split tensile strength.

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