The CANON process is a promising method for nitrogen removal in wastewaters with low organic carbon content like reject water. This study investigated the effect of important factors for optimization of the CANON process through inhibition of nitrite-oxidizing bacteria (NOB). In the acclimation period, complete ammonium removal and 43.3% total N removal were obtained at hydraulic retention time of 12 h, temperature of 30°C ± 0.5°C and DO equal to 7-9 mg/L. The effects of air flow rate (AFR) (representative of DO), SRT and C/N were evaluated. Air flow rate was the most important factor for controlling the process, but the effect of SRT was negligible. When AFR was increased from 100 to 500 mL/min, both ammonium removal efficiency (33-43% to 81-83%) and nitrite accumulation (nitritation, 40 mgN/L to 100-120 mgN/L) were increased, but with increasing AFR to 1000 mL/min only ammonium removal efficiency was increased and because of better condition (high DO) for NOBs, nitritation was decreased. C/N had an effect like AFR of 1000 and only increased ammonium removal efficiency and total N removal. With increasing AFR and C/N, both OUR and AUR were increased, but SVI was decreased.
Malaysian healthcare institutions still use ineffective paper-based vaccination systems to manage childhood immunization schedules. This may lead to missed appointments, incomplete vaccinations, and outbreaks of preventable diseases among infants. To address this issue, a text messaging vaccination reminder and recall system named Virtual Health Connect (VHC) was studied. VHC simplifies and accelerates immunization administration for nurses, which may result in improving the completion and timeliness of immunizations among infants. Considering the limited research on the acceptance of these systems in the healthcare sector, we examined the factors influencing nurses' attitudes and intentions to use VHC using the extended technology acceptance model (TAM). The novelty of the conceptual model is the incorporation of new predictors of attitude, namely, perceived compatibility and perceived privacy and security issues. We conducted a survey among 121 nurses in Malaysian government hospitals and clinics to test the model. We analyzed the collected data using partial least squares structural equation modeling (PLS-SEM) to examine the significant factors influencing nurses' attitudes and intentions to use VHC. Moreover, we applied an artificial neural network (ANN) to determine the most significant factors of acceptance with higher accuracy. Therefore, we could offer more accurate insights to decision-makers in the healthcare sector for the advancement of health services. Our results highlighted that the compatibility of VHC with the current work setting of nurses developed their positive perspectives on the system. Moreover, the nurses felt optimistic about the system when they considered it useful and easy to use in the workplace. Finally, their attitude toward using VHC played a pivotal role in increasing their intention to use it. Based on the ANN models, we also found that perceived compatibility was the most significant factor influencing nurses' attitudes towards using VHC, followed by perceived ease of use and perceived usefulness.
BACKGROUND: Fall is a worldwide health problem among elderly people and a known leading cause of disabilities. Fall prevention programs have been implemented in various forms. The Otago exercise program (OEP) is one of the most recent home-base exercise training program.
OBJECTIVES: This study was conducted to examine the effectiveness of OEP to reduce falls among elderly people in Shahroud, IR Iran.
MATERIALS AND METHODS: This randomised control trial was conducted among the elderly community dwellers in Shahroud city of the Semnan province, IR Iran, with experience of falls in the last 12 months. Subjects of the study (n = 317) were recruited from elderly senior citizens at public health centers. Block systematic random sampling was applied to categorize the subjects in experimental and control groups. The experimental group (n = 160) received OEP for six months and was compared with the control group (n = 157) who received general health training. This study was registered with the following ID, IRCT2014012016285N1.
RESULTS: The findings of the study showed that OEP improved physical performance (Berg-Balance-Score with P > 0.025, and Timed-Up-Go-Test with P > 0.017) and functional capacity (Arm-Curl-Test with P > 0.00 and Chair-Stand-Test with P > 0.01). In addition, OEP significantly reduced the incidence of falls (P ≤ 0.00) among senior citizens in the experimental group.
DISCUSSION: The OEP as a home-based exercise is effective for the reduction of the incidence of falls among senior citizens with a history of falls. The OEP can be recommended for elderly homebound people who do not have access to facilities.
KEYWORDS: Community; Elderly; Falls; Otago Exercise