A Study on the Relation among Primary Care Professionals Serving the Disadvantaged Community, Socioeconomic Status, and Adverse Health Outcome

During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the United States. The elevated death and disease rates among former slaves were attributable to lack of quality healthcare. To address the paucity of healthcare services, Meharry Medical College, an institution with the mission of educating minority professionals and serving the underserved population, was established in 1876. Purpose: The social ecological framework and partial least squares (PLS) path modeling were used to quantify the impact of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Thus, the study results could demonstrate the accomplishment of the College’s mission of training primary care professionals to serve in underserved areas. Methods: Various statistical methods were used to analyze alumni data from 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates in the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t-test was performed to detect the significant mean differences of respective clustering and criterion variables. Chi-square test was used to test if the proportions of primary care and non-primary care specialists are consistent with those of medical and dental graduates practicing in the designated community clusters. Finally, the PLS path model was constructed to explore the construct validity of analytic model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Results: Approximately 83% (3,192/3,864) of Meharry Medical College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the PLS path modeling demonstrated that alumni served as primary care professionals in communities with significantly lower socioeconomic status and higher adverse health outcome (p < .001). The PLS path modeling exhibited the meaningful interrelation between primary care professionals practicing communities and surrounding environments (socioeconomic statues and adverse health outcome), which yielded model reliability, validity, and applicability. Conclusion: This study applied social ecological theory and analytic modeling approaches to assess the attainment of Meharry Medical College’s mission of training primary care professionals to serve in underserved areas, particularly in communities with low socioeconomic status and high rates of adverse health outcomes. In summary, the majority of medical and dental graduates from Meharry Medical College provided primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcome, which demonstrated that Meharry Medical College has fulfilled its mission. The high reliability, validity, and applicability of this model imply that it could be replicated for comparable universities and colleges elsewhere.

Failure to React Positively to Flood Early Warning Systems: Lessons Learned by Flood Victims from Flash Flood Disasters: The Malaysia Experience

This paper describes the issues relating to the role of the flash flood early warning system provided by the Malaysian Government to the communities in Malaysia, specifically during the flash flood disaster in the Cameron Highlands, Malaysia. Normally, flash flood disasters can occur as a result of heavy rainfall in an area, and that water may possibly cause flooding via streams or narrow channels. The focus of this study is the flash flood disaster which occurred on 23 October 2013 in the Cameron Highlands, and as a result the Sungai Bertam overflowed after the release of water from the Sultan Abu Bakar Dam. This release of water from the dam caused flash flooding which led to damage to properties and also the death of residents and livestock in the area. Therefore, the effort of this study is to identify the perceptions of the flash flood victims on the role of the flash flood early warning system. For the purposes of this study, data were gathered through face-to-face interviews from those flood victims who were willing to participate in this study. This approach helped the researcher to glean in-depth information about their feelings and perceptions of the role of the flash flood early warning system offered by the government. The data were analysed descriptively and the findings show that the respondents of 22 flood victims believe strongly that the flash flood early warning system was confusing and dysfunctional, and communities had failed to response positively to it. Therefore, most of the communities were not well prepared for the releasing of water from the dam which caused property damage, and 3 people were killed in the Cameron Highland flash flood disaster.

Apoptosis Pathway Targeted by Thymoquinone in MCF7 Breast Cancer Cell Line

Array-based gene expression analysis is a powerful tool to profile expression of genes and to generate information on therapeutic effects of new anti-cancer compounds. Anti-apoptotic effect of thymoquinone was studied in MCF7 breast cancer cell line using gene expression profiling with cDNA microarray. The purity and yield of RNA samples were determined using RNeasyPlus Mini kit. The Agilent RNA 6000 NanoLabChip kit evaluated the quantity of the RNA samples. AffinityScript RT oligo-dT promoter primer was used to generate cDNA strands. T7 RNA polymerase was used to convert cDNA to cRNA. The cRNA samples and human universal reference RNA were labelled with Cy-3-CTP and Cy-5-CTP, respectively. Feature Extraction and GeneSpring softwares analysed the data. The single experiment analysis revealed involvement of 64 pathways with up-regulated genes and 78 pathways with downregulated genes. The MAPK and p38-MAPK pathways were inhibited due to the up-regulation of PTPRR gene. The inhibition of p38-MAPK suggested up-regulation of TGF-ß pathway. Inhibition of p38-MAPK caused up-regulation of TP53 and down-regulation of Bcl2 genes indicating involvement of intrinsic apoptotic pathway. Down-regulation of CARD16 gene as an adaptor molecule regulated CASP1 and suggested necrosis-like programmed cell death and involvement of caspase in apoptosis. Furthermore, down-regulation of GPCR, EGF-EGFR signalling pathways suggested reduction of ER. Involvement of AhR pathway which control cytochrome P450 and glucuronidation pathways showed metabolism of Thymoquinone. The findings showed differential expression of several genes in apoptosis pathways with thymoquinone treatment in estrogen receptor-positive breast cancer cells.

3D Frictionless Contact Case between the Structure of E-Bike and the Ground

China is currently the world's largest producer and distributor of electric bicycle (e-bike). The increasing number of e-bikes on the road is accompanied by rising injuries and even deaths of e-bike drivers. Therefore, there is a growing need to improve the safety structure of e-bikes. This 3D frictionless contact analysis is a preliminary, but necessary work for further structural design improvement of an e-bike. The contact analysis between e-bike and the ground was carried out as follows: firstly, the Penalty method was illustrated and derived from the simplest spring-mass system. This is one of the most common methods to satisfy the frictionless contact case; secondly, ANSYS static analysis was carried out to verify finite element (FE) models with contact pair (without friction) between e-bike and the ground; finally, ANSYS transient analysis was used to obtain the data of the penetration p(u) of e-bike with respect to the ground. Results obtained from the simulation are as estimated by comparing with that from theoretical method. In the future, protective shell will be designed following the stability criteria and added to the frame of e-bike. Simulation of side falling of the improvedsafety structure of e-bike will be confirmed with experimental data.

Antimicrobial Properties of Copper in Gram-Negative and Gram-Positive Bacteria

For centuries humans have used the antimicrobial properties of copper to their advantage. Yet, after all these years the underlying mechanisms of copper mediated cell death in various microbes remain unclear. We had explored the hypothesis that copper mediated increased levels of lipid peroxidation in the membrane fatty acids is responsible for increased killing in Escherichia coli. In this study we show that in both gram positive (Staphylococcus aureus) and gram negative (Pseudomonas aeruginosa) bacteria there is a strong correlation between copper mediated cell death and increased levels of lipid peroxidation. Interestingly, the non-spore forming gram positive bacteria as well as gram negative bacteria show similar patterns of cell death, increased levels of lipid peroxidation, as well as genomic DNA degradation, however there is some difference in loss in membrane integrity upon exposure to copper alloy surface.

Assessment of Health and Safety Item on Construction Sites in Ondo State

The well been of human beings on construction site is very important, many man power had been lost through accidents which kills or make workers physically unfit to carry out construction activities, these in turn have multiple effects on the whole economy. Thus it is necessary to put all safety items and regulations in place before construction activities can commence. This study was carried out in Ondo state of Nigeria to known and analyse the state of health and safety of construction workers in the state. The study was done using first hand observation method, 50 construction project sites were visited in 10 major towns of Ondo state, questionnaires were distributed and the results were analysed. The result show that construction workers are being exposed to a lot of construction site hazards due to lack of inadequate safety programmes and nonprovision of appropriate safety materials for workers on site. From the data gotten for each site visited and the statistical analysis, it can be concluded that occurrence of accident on construction sites depends significantly on the available safety facilities on the sites. The result of the regression statistics show that the level of significant of the dependence of occurrence of accident on the availability of safety items on site is 0.0362 which is less than 0.05 maximum significant level required. Therefore a vital way of sustaining our building strategy is by given a detail attention to provision of adequate health and safety items on construction sites which will reduce the occurrence of accident, loss of man power and death of skilled workers among others.

Fetal and Infant Mortality in Botucatu City, São Paulo State, Brazil: Evaluation of Maternal - Infant Health Care

In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Targeting the Life Cycle Stages of the Diamond Back Moth (Plutella xylostella) with Three Different Parasitoid Wasps

A continuous time model of the interaction between crop insect pests and naturally beneficial pest enemies is created using a set of simultaneous, non-linear, ordinary differential equations incorporating natural death rates based on the Weibull distribution. The crop pest is present in all its life-cycle stages of: egg, larva, pupa and adult. The beneficial insects, parasitoid wasps, may be present in either or all parasitized: eggs, larva and pupa. Population modelling is used to estimate the quantity of the natural pest enemies that should be introduced into the pest infested environment to suppress the pest population density to an economically acceptable level within a prescribed number of days. The results obtained illustrate the effect of different combinations of parasitoid wasps, using the Pascal distribution to estimate their success in parasitizing different pest developmental stages, to deliver pest control to a sustainable level. Effective control, within a prescribed number of days, is established by the deployment of two or all three species of wasps, which partially destroy pest: egg, larvae and pupae stages. The selected scenarios demonstrate effective sustainable control of the pest in less than thirty days.

Transcriptional Evidence for the Involvement of MyD88 in Flagellin Recognition: Genomic Identification of Rock Bream MyD88 and Comparative Analysis

The MyD88 is an evolutionarily conserved host-expressed adaptor protein that is essential for proper TLR/ IL1R immune-response signaling. A previously identified complete cDNA (1626 bp) of OfMyD88 comprised an ORF of 867 bp encoding a protein of 288 amino acids (32.9 kDa). The gDNA (3761 bp) of OfMyD88 revealed a quinquepartite genome organization composed of 5 exons (with the sizes of 310, 132, 178, 92 and 155 bp) separated by 4 introns. All the introns displayed splice signals consistent with the consensus GT/AG rule. A bipartite domain structure with two domains namely death domain (24-103) coded by 1st exon, and TIR domain (151-288) coded by last 3 exons were identified through in silico analysis. Moreover, homology modeling of these two domains revealed a similar quaternary folding nature between human and rock bream homologs. A comprehensive comparison of vertebrate MyD88 genes showed that they possess a 5-exonic structure.In this structure, the last three exons were strongly conserved, and this suggests that a rigid structure has been maintained during vertebrate evolution.A cluster of TATA box-like sequences were found 0.25 kb upstream of cDNA starting position. In addition, putative 5'-flanking region of OfMyD88 was predicted to have TFBS implicated with TLR signaling, including copies of NFkB1, APRF/ STAT3, Sp1, IRF1 and 2 and Stat1/2. Using qPCR technique, a ubiquitous mRNA expression was detected in liver and blood. Furthermore, a significantly up-regulated transcriptional expression of OfMyD88 was detected in head kidney (12-24 h; >2-fold), spleen (6 h; 1.5-fold), liver (3 h; 1.9-fold) and intestine (24 h; ~2-fold) post-Fla challenge. These data suggest a crucial role for MyD88 in antibacterial immunity of teleosts.

The Impact of Web Based Education on Cancer Patients’ Clinical Outcomes

Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

The Impact of E-Learning on Medication Administration of Nursing Students: What Recent Studies Say?

Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

A Narrative of Monks: Culture Heroes in Songkhla Province

This study aimed to look into roles of culture heroes of monks in Buddhism in Songkhla province during the last 50 years. Qualitative study, in-depth interviews, participatory observation and non-participatory observation were employed for this study. The results of the study indicated that culture heroes in Songkhla province would act as the followings. 1) For secular matters, monks would do something beneficial to the community. 2) For religious matters, monks would behave to follow Buddhism discipline strictly and unambitiously. At the same time, monks would not neglect to teach Buddhists to give respect to Lord Buddha by doing meditation and praying. However, when some of those culture heroes passed away, villagers in the community would show gratitude and appreciation by arranging a religious death anniversary ceremony, having icon, or having narrative to recognize those, continuously.

Prediction of Road Accidents in Qatar by 2022

There is growing concern over increasing incidences of road accidents and consequent loss of human life in Qatar. In light to the future planned event in Qatar, World Cup 2022; Qatar should put into consideration the future deaths caused by road accidents, and past trends should be considered to give a reasonable picture of what may happen in the future. Qatar roads should be arranged and paved in a way that accommodate high capacity of the population in that time, since then there will be a huge number of visitors from the world. Qatar should also consider the risk issues of road accidents raised in that period, and plan to maintain high level to safety strategies. According to the increase in the number of road accidents in Qatar from 1995 until 2012, an analysis of elements affecting and causing road accidents will be effectively studied. This paper aims to identify and criticize the factors that have high effect on causing road accidents in the state of Qatar, and predict the total number of road accidents in Qatar 2022. Alternative methods are discussed and the most applicable ones according to the previous researches are selected for further studies. The methods that satisfy the existing case in Qatar were the multiple linear regression model (MLR) and artificial neutral network (ANN). Those methods are analyzed and their findings are compared. We conclude that by using MLR the number of accidents in 2022 will become 355,226 accidents, and by using ANN 216,264 accidents. We conclude that MLR gave better results than ANN because the artificial neutral network doesn’t fit data with large range varieties.

Modelling Sudden Deaths from Myocardial Infarction and Stroke

Death within 30 days is an important factor to be looked into, as there is a significant risk of deaths immediately following or soon after, myocardial infarction (MI) or stroke. In this paper, we will model the deaths within 30 days following a myocardial infarction (MI) or stroke in the UK. We will see how the probabilities of sudden deaths from MI or stroke have changed over the period 1981-2000. We will model the sudden deaths using a generalized linear model (GLM), fitted using the R statistical package, under a Binomial distribution for the number of sudden deaths. We parameterize our model using the extensive and detailed data from the Framingham Heart Study, adjusted to match UK rates. The results show that there is a reduction for the sudden deaths following a MI over time but no significant improvement for sudden deaths following a stroke.

Particle Image Velocimetry for Measuring Water Flow Velocity

Floods are natural phenomena, which may turn into disasters causing widespread damage, health problems and even deaths. Nowadays, floods had become more serious and more frequent due to climatic changes. During flooding, discharge measurement still can be taken by standing on the bridge across the river using portable measurement instrument. However, it is too dangerous to get near to the river especially during high flood. Therefore, this study employs Particle Image Velocimetry (PIV) as a tool to measure the surface flow velocity. PIV is a image processing technique to track the movement of water from one point to another. The PIV codes are developed using Matlab. In this study, 18 ping pong balls were scattered over the surface of the drain and images were taken with a digital SLR camera. The images obtained were analyzed using the PIV code. Results show that PIV is able to produce the flow velocity through analyzing the series of images captured.

Security Model of a Unified Communications and Integrated Collaborations System in the Health Sector Environment of Developing Countries: A Case of Uganda

Access to information holds the key to the empowerment of everybody despite where they are living. This research has been carried out in respect of the people living in developing countries, considering their plight and complex geographical, demographic, social-economic conditions surrounding the areas they live, which hinder access to information and of professionals providing services such as medical workers, which has led to high death rates and development stagnation. Research on Unified Communications and Integrated Collaborations (UCIC) system in the health sector of developing countries aims at creating a possible solution of bridging the digital canyon among the communities. The system is meant to deliver services in a seamless manner to assist health workers situated anywhere to be accessed easily and access information which will enhance service delivery. The proposed UCIC provides the most immersive telepresence experience for one-to-one or many-to-many meetings. Extending to locations anywhere in the world, the transformative platform delivers Ultra-low operating costs through the use of general purpose networks and using special lenses and track systems. The essence of this study is to create a security model for the deployment of the UCIC system in the health sector of developing countries. The model approach used for building the UCIC system security carefully considers the specific requirements for the health sector environment organization such as data centre, national, regional and district hospitals, and health centers IV, III, II and I and then builds the single best possible secure network to meet their needs. The security model demonstrates on how the components of the UCIC system will be protected physically and logically in the health sector environment. The UCIC system once adopted and implemented correctly will bring enhancement to the speed and quality of services offered by health workers. The capacities of UCIC will help health workers shorten decision cycles, accelerate service delivery and save lives by speeding access to information and by making it possible for all health workers and patients to collaborate ubiquitously.

Aged Society: A Pitfall

The aging of the workforce is occurring globally and has significant impact on organizations. The Malaysian population is ageing. Although, not as quickly as the populations of a number of Asian nations, or of parts of Europe; the rate is sufficient to cause a concern. The life expectancy of Malaysians has increased in year 2012 with an average of 73.8 years or equal to 71.1 years for males and 76.7 years for females. The birth and death rates are 26.05 births/1,000 population and 5.29 deaths/1,000 population respectively. These figures have placed a greater liability on the government’s shoulder, and have become a push factor for the country to revise a new retirement age for the public servants. The ‘aged population’ impinged on the new challenges faced by the Malaysian government, which had to deal with an unproductive aged workforce. A new retirement age from 58 to 60 years old has been introduced and this could have a positive effect on this cohort, in maintaining financial security. However, keeping older employees might affect organizations’ performance and productivity. The organizations need to pay more attention on them, since they are less effective and might be affected by numerous health problems. An innovative culture should be introduced and this could be a good indicator for organizations that deal with these ‘expensive’ workers.

Pulse Oximeter Concept for Vascular Occlusion Test

Microcirculatory dysfunction is very common in sepsis and may results in organ failure and increased risk of death. Analyzing oxygen utilization can potentially assess microcirculation function of an individual. In this study, a modified pulse oximeter is used to extract information signals due to absorption of red (R) and infrared (IR) light. IR and R signal are related to the overall blood volume and reduced hemoglobin, respectively. Differences between these two signals thus represent the amount of oxygenated hemoglobin. Avascular occlusion test has been conducted on healthy individuals to validate the pulse oximeter concept. In this test, both R and IR signals rapidly changed according to the occlusion process. The pulse oximeter concept presented is capable of extracting valuable information to assess microcirculation condition. Implementing this concept on ICU patients has the potential to aid sepsis diagnosis and provide more accurate tracking of patient state and sepsis status.

Comparison of Mamdani and Sugeno Fuzzy Interference Systems for the Breast Cancer Risk

Breast cancer is a major health burden worldwide being a major cause of death amongst women. In this paper, Fuzzy Inference Systems (FIS) are developed for the evaluation of breast cancer risk using Mamdani-type and Sugeno-type models. The paper outlines the basic difference between Mamdani-type FIS and Sugeno-type FIS. The results demonstrated the performance comparison of the two systems and the advantages of using Sugeno- type over Mamdani-type.

Regional Development Programs: A Reason for Them Failing

This paper contributes to the analysis of the design of regional development programs. This is a case study the birth, life, death and afterlife of a stately development program in Norway, supporting diffusion of innovations by promoting e-business in SMEs (small and medium sized enterprises). The study shows that joint projects like regional development programs have to be designed such that the present value of the future benefits always exceeds the present value of the future effort for all stakeholders vital for the survival of the project. The study also indicate that a development program not always have one common goal which all the stakeholders agree upon. There are several stakeholders who may have different goals by playing a part in the realization of the program. Even if some parties evaluate the results of a development program as a failure, other may have attained their goals. The lessons learned from this study may advise the designers of development programs involving many independent stakeholders. There is a lack of research examining failing development programs, investigating the reasons for it to be considered a failure. This paper shows why a development program was terminated and gives hint to how joint programs could be designed in order for the program to deliver the wanted results to all the key stakeholders.