Examining the impact of urban canyons morphology on outdoor environmental conditions in city centres with a temperate climate

The concept of future-proofing cities seeks to minimize environmental impacts and achieve sustainability by utilising various mitigation and adaptation techniques, specifically by improving urban fabric. Different urban forms and parameters have been extensively investigated in hot, arid and humid climates, however, it is less in temperate climates. In the UK, the current local urban design guides meet the needs of designers and urban planners, however, these guides are still considered descriptive and lack in-depth environmental assessment. This study aims to investigate the recommended threshold values in the National Model Design Code against real sites with different urban canyons morphologies to examine their impact on outdoor environmental conditions. The study used quantitative methods by conducting a review study, a survey of UK urban design guides and modelling using simulation via RayMan and IESVE. The study targeted pre-selected sites in Cardiff and Bristol that were identified as zones with urban heat stress. The results showed that the Aspect Ratio and Sky View Factor in two cities have significantly impacted outdoor environmental conditions in urban areas subsequently affecting the Physiological Equivalent Temperature (PET). The results showed that the recommended values have a significant impact on the outdoor thermal performance of the pre-selected urban canyons. The findings demonstrated that modifying the width of streets and changing the Aspect Ratio and SVF resulted in achieving a positive impact during summer when both factors have a direct relationship. However, when the Aspect Ratio and SVF have an inverse relationship, the results showed extreme cold stress during winter. Therefore, maintaining a direct relationship between the Aspect Ratio and SVF would help to improve outdoor conditions

Strategic job market-guided development of pharmacy Bachelor‘s curriculum and its importance in maintaining the profession viability in the Middle Eastern countries: Colleges of pharmacy in the UAE as a model

The Middle East has high youth population; however, it is challenged by uncertain economic situation. Higher education plays a crucial role in the development of nations by equipping generations with the knowledge and skill through cumulative curriculum development. Like other professions, pharmacy is a dynamic field of study where continuous improvements are required to keep the viability of the profession and endow future generations with up to date skills. This article describes a strategy for pharmacy curriculum development considering four layers. The strategy starts from the understanding of the current situation in a university, looking into national, international accreditations and job market. The strategy covers development from program to subject’s level. The strategy is applied to pharmacy programs in the UAE. Upon analysis, several recommendations were obtained for curriculum improvements. At individual university level, there is a need to work on clinical oriented topics in the curriculum to fit with international accreditation and country’s vision. Details on this can be taken form deeper analysis of job market and stakeholders in the UAE. On the national level, unifications of total credit hours for the degree across universities needs to be envisaged with limits on contact experiential hours. The strategy has the potential of extrapolating to other Middle Eastern countries

The Role of Urinary N-acetyl Beta-D-glucosaminidase in Children with Urological Problems

Objectives: To assess urinary NAG/ urinary creatinine (NAG/ Cr) ratio in patients with urological abnormalities (normal and abnormal ultrasonography) and compare it with normal healthy children. Methods: A prospective study was conducted from November 2012 to April 2013. Urine samples were collected from 70 patients with various urological abnormalities, and from 40 healthy control groups, their age range (1 month-13 years). Children who were admitted to Emergency Pediatric department, Children Welfare Teaching Hospital / Medical City Complex, Baghdad, Iraq. The Glomerular filtration rate was in normal range in all of them. Urine samples were tested for NAG by (ELISA, Cusabio, China) while, both Serum creatinine (S-Cr) and urine creatinine (U-Cr) were estimated by Jaffe’s kinetic method. Results: In this study 29% of the patients had normal ultrasonography and 72% abnormal ultrasonography. The current results revealed that NAG/creatinine index was significantly higher in all patients with (vesicoureteral reflux, hydronephrosis and pyelonephritis) in comparison with cystitis. Conclusion: The assessment of urinary NAG could be considered as a useful marker in prediction of the (vesicoureteral reflux, hydronephrosis) .Urinary NAG is elevated in children with pyelonephritis and it can be considered as a further criterion in the diagnosis of upper urinary tract infection

Self-Medication with Antibiotics during COVID-19 in the Eastern Mediterranean Region Countries:A Review

Self-treatment with medicines including treatment with antibiotics is a growing global concern, as it can cause public health problems, such as antibiotic resistance and drug toxicity. Therefore, the significance of the self-medication impact of COVID-19 in any region can have an influence on the prevalence of such problems. The review aimed to investigate the self-treatment with antibiotics among the general population in Eastern Mediterranean region countries during COVID-19 pandemic. A comprehensive review of literature in four databases was conducted for the pandemic period from January 2020 to the end of March 2022. Nine studies related to self-treatment with antibiotics were found. The studies were homogeneous in terms of assessing the antibiotic self-treatment usage during the COVID-19 pandemic among the general population and among community pharmacies. The prevalence of self-treatment with antibiotics ranged from 20.8% to 45.8% between the studies. The main reasons for that were cost-saving, fear of COVID-19 infection, quarantine, and ease of accessibility without time limits. Antibiotic self-treatment has been high during the COVID-19 pandemic; however, it was less reported during the study period than before the time of the pandemic. There is a need for more restrictions on dispensing antibiotics from community pharmacies. In addition, there is a need to raise awareness among the population regarding self-treatment with antibiotics

COVID-19 Treatment Guidelines: Do They Really Reflect Best Medical Practices to Manage the Pandemic?

SARS-CoV-2 (COVID-19) has been changing the world since December 2019. A comprehensive search into many COVID-19 treatment guidelines was conducted and reported in this article. This is a review paper to probe differences in COVID-19 managing strategies and explore the most common treatment plans among countries. Published guidelines from 23 countries and three references guidelines—until the end of 2020—were included in this article. The majority of COVID-19 treatment options were reported in this review and it includes antiviral drugs, antimalarial drugs, antibiotics, corticosteroids, immunotherapy, anticoagulants, and other pharmacological treatment. The presence of such information from different countries in a single comprehensive review article could help in understanding and speculation of variation in the recommended treatment in each country. This might be related to the cost of medications, the access to the medications, availability of medication that could potentially be useful in managing COVID-19 cases, and the availability/capacity of healthcare facilities. Finally, although there are various treatment groups listed in the published therapeutic guidelines worldwide, unfortunately, there is no evidence for effectiveness of most of these medications in reducing the COVID-19 mortality curve over more than one year of this global pandemic

Telecare Service Use in Northern Ireland: Exploratory Retrospective Cohort Study

BACKGROUND: Telecare is a health service that involves the home installation of a number of information technology support systems for individuals with complex needs, such as people with reduced mobility or disabilities and the elderly. It involves the use of sensors in patients’ homes to detect events, such as smoke in the kitchen, a front door left open, or a patient fall. In Northern Ireland (NI), outputs from these sensors are monitored remotely by the telecare team, who can provide assistance as required by telephone or through the emergency services. The facilitation of such rapid responses has the aim of promoting early intervention and therefore maintaining patient well-being. OBJECTIVE: The aims of this study were to construct a descriptive summary of the telecare program in NI and evaluate hospital-based service use by telecare patients before and after the installation of telecare equipment. METHODS: An exploratory retrospective cohort study was conducted involving more than 2000 patients. Data analysis included the evaluation of health care use before and after the telecare service was initiated for individual participants. Individuals with data for a minimum of 6 months before and after the installation of the telecare service were included in this analysis. RESULTS: A total of 2387 patients were enrolled in the telecare service during the observation period (February 26, 2010-February 22, 2016). The mean age was 78 years (median 81 years). More women (1623/2387, 68%) were enrolled in the service. Falls detectors were the most commonly deployed detectors in the study cohort (824/1883, 43.8% of cases). The average number of communications (calls and/or alarms) between participants and the coordinating center was the highest for patients aged ≥85 years (mean 86 calls per year). These contacts were similarly distributed by gender. The mortality rate over the study period was higher in men than women (98/770, 14.4% in men compared to 107/1617, 6.6% in women). The number of nonelective hospital admissions, emergency room visits, and outpatient clinic visits and the length of hospital stays per year were significantly higher (P<.001) after the installation of the telecare equipment than during the period before installation. CONCLUSIONS: Despite the likely benefits of the telecare service in providing peace of mind for patients and their relatives, hospital-based health care use significantly increased after enrollment in the service. This likely reflects the increasing health care needs over time in an aging population

Knowledge, Attitude, and Behavior about Antimicrobial Use and Resistance among Medical, Nursing and Pharmacy Students in Jordan:A Cross Sectional Study

The present study aimed to survey medical, nursing and pharmacy students’ knowledge, attitude and practice regarding antimicrobial use and resistance. Additionally, the study assessed the teaching and assessment activities received regarding antibiotic use. A cross sectional online survey was distributed to undergraduate students currently in clinical studies in their degree program. A total of 716 medicine, nursing and pharmacy undergraduate students were included. Respondents scored more than 76% on knowledge on effective use, unnecessary use and associated side effects of antibiotics, and 65.2% regarding knowledge on the spread of antibiotic resistance. Some participants (21.0%) agreed or strongly agreed that there has been good promotion of prudent antimicrobial use. Students were aware (13.1%), unaware (29.1%), or unsure (57.8%) that there is a national action plan relating to antimicrobial resistance. A total of 62.8% of the respondents strongly agreed or agreed that they have a key role in helping control antibiotic resistance. Participants reported that they require more information about resistance to antibiotics (53.9%), medical conditions for which antibiotics are used (51.7%) and how to use antibiotics (51.0%). Discussion of clinical cases and vignettes and small group teaching were reported as very useful or useful teaching strategies (79.9% and 74.2%, respectively). The findings from this study determined the current situation in relation to education on prudent antimicrobial use for undergraduates and highlighted areas for informing better curriculum design

Assessment of Knowledge, Awareness of Stroke, and the Factors Associated with Among Jordanian Population: A Cross-Sectional Study

This study aims to assess the knowledge and awareness about stroke among the Jordanian population and determine factors associated with stroke awareness