Search results for: early exercise

Authors: Zouhair Haddi, Stephane Delliaux, Jean-Francois Pons, Ismail Kechaf, Jean-Claude De Haro, Mustapha Ouladsine

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Atrial fibrillation (AF) has been considered as the most common cardiac arrhythmia, and a major public health burden associated with significant morbidity and mortality. Nowadays, telemedical approaches targeting cardiac outpatients situate AF among the most challenged medical issues. The automatic, early, and fast AF detection is still a major concern for the healthcare professional. Several algorithms based on univariate analysis have been developed to detect atrial fibrillation. However, the published results do not show satisfactory classification accuracy. This work was aimed at resolving this shortcoming by proposing multivariate data analysis methods for automatic AF detection. Four publicly-accessible sets of clinical data (AF Termination Challenge Database, MIT-BIH AF, Normal Sinus Rhythm RR Interval Database, and MIT-BIH Normal Sinus Rhythm Databases) were used for assessment. All time series were segmented in 1 min RR intervals window and then four specific features were calculated. Two pattern recognition methods, i.e., Principal Component Analysis (PCA) and Learning Vector Quantization (LVQ) neural network were used to develop classification models. PCA, as a feature reduction method, was employed to find important features to discriminate between AF and Normal Sinus Rhythm. Despite its very simple structure, the results show that the LVQ model performs better on the analyzed databases than do existing algorithms, with high sensitivity and specificity (99.19% and 99.39%, respectively). The proposed AF detection holds several interesting properties, and can be implemented with just a few arithmetical operations which make it a suitable choice for telecare applications.

Keywords: atrial fibrillation, multivariate data analysis, automatic detection, telemedicine

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Authors: Matei Tudor Berceanu, Hema Viswambharan, Kirti Kain, Chew Weng Cheng

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Background - Obesity parameters, particularly visceral obesity as measured by the waist-to-height ratio (WHtR), correlate with insulin resistance. The metabolic microvascular changes associated with insulin resistance causes increased peripheral arteriolar resistance primarily to the lower limb vessels. We hypothesize that ankle systolic blood pressures (SBPs) are more significantly associated with visceral obesity than brachial SBPs. Methods - 1098 adults enriched in south Asians or Europeans with diabetes (T2DM) were recruited from a primary care practice in West Yorkshire. Their medical histories, including T2DM and cardiovascular disease (CVD) status, were gathered from an electronic database. The brachial, dorsalis pedis, and posterior tibial SBPs were measured using a Doppler machine. Their body mass index (BMI) and WHtR were calculated after measuring their weight, height, and waist circumference. Linear regressions were performed between the 6 SBPs and both obesity parameters, after adjusting for covariates. Results - Generally, the left posterior tibial SBP (P=4.559*10⁻¹⁵) and right posterior tibial SBP (P=1.114* 10⁻¹³ ) are the pressures most significantly associated with the BMI, as well as in south Asians (P < 0.001) and Europeans (P < 0.001) specifically. In South Asians, although the left (P=0.032) and right brachial SBP (P=0.045) were associated to the WHtR, the left posterior tibial SBP (P=0.023) showed the strongest association. Conclusion - Regardless of ethnicity, ankle SBPs are more significantly associated with generalized obesity than brachial SBPs, suggesting their screening potential for screening for early detection of T2DM and CVD. A combination of ankle SBPs with WHtR is proposed in south Asians.

Keywords: ankle blood pressures, body mass index, insulin resistance, waist-to-height-ratio

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Authors: Kidane workelul, Li xu, Xiaoyang Pang, Jiaping Lv

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Dairy products are exceptionally ideal media for the growth of microorganisms because of their high nutritional content. There are several ways that milk might get contaminated throughout the milking process, including how the raw milk is transported and stored, as well as how long it is kept before being processed. Psychrotrophic bacteria are among the one which can deteriorate the quality of milk mainly their heat resistance proteas and lipase enzyme. For this research purpose 8 selected strains of Psychrotrophic bacteria (Entrococcus hirae, Pseudomonas fluorescens, Pseudomonas azotoformans, Pseudomonas putida, Exiguobacterium indicum, Pseudomonas paralactice, Acinetobacter indicum, Serratia liquefacients)are chosen and try to determine their characteristics based on the research methodology protocol. Thus, the 8 selected strains are cultured, plated incubate, extracted their genomic DNA and genome DNA was amplified, the purpose of the study was to identify their Psychrotrophic properties, lipase hydrolysis positive test, their optimal incubation temperature, designed primer using the noble strain P,flourescens conserved region area in target with lipA gene, optimized primer specificity as well as sensitivity and PCR detection for lipase positive strains using the design primers. Based on the findings both the selected 8 strains isolated from stored raw milk are Psychrotrophic bacteria, 6 of the selected strains except the 2 strains are positive for lipase hydrolysis, their optimal temperature is 20 to 30 OC, the designed primer specificity is very accurate and amplifies for those strains only with lipase positive but could not amplify for the others. Thus, the result is promising and could help in detecting the Psychrotrophic bacteria producing heat resistance enzymes (lipase) at early stage before the milk is processed and this will safe production loss for the dairy industry.

Keywords: dairy industry, heat-resistant, lipA, milk, primer and psychrotrophic

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Authors: Miraç Savaş Turhan, Ali Danişman

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Recently scholars of new institutional theory have used institutional logics perspective to explain the contradictory practices in modern western societies. Accordingly, distinct institutional logics are embedded in central institutions such as the market, state, democracy, family, and religion. They guide individual and organizational actors and constraint their behaviors in a particular organizational field. Through this perspective, actors are assumed to have a situated, embedded, boundedly intentional, and adaptive role against the structure in social, cultural and political context. On the other hand, over a decade, there is an emerging attempt focusing on the role of actors on creating, maintaining, and changing the institutions. Such attempts brought out the concept of institutional entrepreneurs to explain the role of individual actors in relation to institutions. Institutional entrepreneurs are individuals, groups of individuals, organizations or groups of organizations that are able to initiate some actions to build, maintain or change institutions. While recent studies on institutional logics perspective have attempted to explain roles of entrepreneurial actors who have resources and skills, little is known about the effects of multiple institutional logics on the ability of institutional entrepreneurs. In this study, we aim to find out that how multiple institutional logics affect the ability of institutional entrepreneurs during the process of institutional change. We examine this issue in the Turkish Education Field. While institutional logics were identified based on the previous studies in the education field, the actions taken by Turkish National Education Ministry from 2003 to 2013 was examined through content analysis The early results indicate that there are remarkable shift and contradictions in the ability of institutional entrepreneur in taking actions to change the field in relationship to balance of power shift among the carriers of institutional logics.

Keywords: institutional theory, institutional logics, institutional entrepreneurs, Turkish national education

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Authors: Pamela E. Mukaire

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Anemia and chronic energy deficiency are significant manifestations of poor nutritional health. Anaemia and nutritional status screening are practical ways for assessing the prevalence of iron deficiency anemia in the food insecure populations with large groups of childbearing women and children. The objective of the study was to assess anemia prevalence and other clinical manifestations of malnutrition among pairs of mothers and young children in rural Uganda. This community cross-sectional study used consecutive sampling to select 214 mothers and 214 children for the study. Data was generated using structured questionnaire, anthropometric measurements and on site analysis for anemia. Bivariable and multivariable analyses were used to assess the effect of different factors on anaemia. Of the 214 mothers, 54.2% were 25-34 years of age, 76.7% unmarried, 63% low income, and 55% had more than four children. Of the 214 children, 57% were female, 50% between 1 to 3 years of age and 35% under one year, and. Overall, 38% of the households had more 4 children under the age of 12. The prevalence of anemia was 48% for mothers and 72% for children; 20.6% of mothers had moderate to severe chronic energy deficiency, 39% had moderately-severe anaemia (10 to 7.1 g/dL). Among children, 53% had moderately-severe anaemia, and 18.2% had severe anaemia. Parity X2 =20, p < .037, number of children under 12 years living in a household X2 =10, p < .015, and child’s gender X2 =6.5, p < .038, had a significant relationship with maternal anaemia. There was a significant relationship between household income X2 =10, p < .005, marital status X2 =9, p < .011, owing a piece of land X2 =18, p < .000, owing home X2 =7, p < .036, and anaemia in children. The prevalence of anemia was high in both mothers and children. Income, marital status, owing a piece of land, owing home, number of children under age 12 in a household were associated with anaemia. Hence, efforts should be made for early diagnosis and management of anaemia deficiencies with special emphasis on those households with large number of children under age 12.

Keywords: anemia, maternal-child, nutrition, rural population

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Authors: Seyed Reza Aghili, Tahereh Shokohi, Lotfollah Davoodi, Zahra Kashi, Azam Moslemi, Mahdi Abastabar, Iman Haghani, Sabah Mayahi, Asoudeh A.

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Introduction: In diabetic foot ulcers, if fungal agents such as Candida species penetrate into the cutaneous or depth of ulcer, can increase the degree of the wound and cause Candia infection and make it more difficult to heal. Material & Methods: A cross-sectional study was performed on 100 diabetic foot ulcer patients in 2020 in Sari, Iran. patient's data and wound grade were recorded in a questionnaire. Candida infection was diagnosed with direct microscopic examination and culture of samples. Colony-PCR molecular method was used for ITS region of DNA and then PCR-RFLP with Msp1 enzyme and using HWP1 specific gene to determine species of Candida agent. Results: Of 100 patients, the mean age 62.1 ± 10.8 years, 95% type 2 diabetes, 83%>10 years duration diabetes, 59% male, 66%> poor education level, 99% married, 52% rural, 95% neuropathic symptoms, 88% using antibiotics, 69%HbA1C >9%, and mean ulcer degree 2.6±1.05 were. Candida infection was seen in 13% of the deep tissue of the wound and 7% cutaneous around the wound. The predominant Candida isolated was C. parapsilosis (71.5%), C .albicans (14.3%). Fungal infections caused by mold fungi were not detected. There was a statistically significant relationship between yeast infection and gender, rural, HbA1C and ulcer degree. Conclusion: Mycological evaluations often are ignored. Candida parapsilosis is the most common infectious agent in these patients and may require specific treatment. Therefore, more attention of physicians to Candida infections particularly, early diagnosis and effective treatment can help faster recovery and prevent amputation.

Keywords: diabetic foot ulcer, candida infection, risk factors, c. parapsilosis

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Authors: Nguyen Dang Duc, Nguyen Phuong Sinh, Lam Nguyen Hong Anh

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Superior mesenteric artery (SMA) syndrome is a rare cause of high-section intestinal obstruction. SMA syndrome is characterized by compression of the third segment of the duodenum due to the narrowing of the distance between the superior mesenteric artery and the abdominal aorta. The main clinical signs of SMA syndrome are high intestinal obstruction, such as postprandial vomiting, epigastric pain, early feeling of abdominal fullness, and indigestion. Abdominal computed tomography plays an important role in diagnosis. There are two main methods of treating SMA syndrome that are conservative and surgical treatment. We report a clinical case of an 18-year-old male patient admitted to the hospital because of a Bungarus snake bit in the second hour, to the twelfth day of treatment, the patient developed diarrhea that lasted until the twenty-fourth day of treatment. On the twenty-fifth day of treatment, the patient lost 16 kilograms (from 56 down to 40). The patient had symptoms of vomiting after eating, indigestion, and epigastric pain. On abdominal computed tomography, the angle created by the superior mesenteric artery and the abdominal aorta was 17 degrees, the distance between the two arteries was 3.8 millimeters, light dilation and stagnation of the D1 and D2 segment of the duodenum with gas and watery level inside segment D3 and D4 of the duodenum and this segment was constricted. This patient was diagnosed with superior mesenteric artery syndrome with the Bungarus snake bites. Currently, the patient was treated with feeding through a jejunal tube each other intravenous nutrition. Finally, The patient was discharged and returned to his house on the forty-fifth day of treatment. We reported this clinical case to introduce clinical and paraclinical signs, diagnose, and methods treated for patient having SMA syndrome.

Keywords: superior mesenteric artery syndrome, Bungarus snake bites, loss weight

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Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

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This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: awareness, knowledge, osteoporosis, practices

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Authors: Muhammad Izzam Bin Mohd Khazar, Nur Adibah Binti Zainudin

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Islamic banking as one of the financial institutions is highly required to maintain a prudent approach to ensure that any financing given is able to generate income to their respective shareholders. As the default payment of customers is probably occurred in the financing, having a prudent approach in the recovery process is a must to ensure that financing losses are within acceptable limits. The objective of this research is to provide the best practice of recovery which is anticipated to benefit both bank and customers. This study will address arising issue on the current practice of recovery process and followed by providing humanising recovery solutions in the light of the Maqasid Shariah. The study identified main issues pertaining to Islamic recovery process which can be categorized into knowledge crisis, process issues, specific treatment cases and system issues. Knowledge crisis is related to direct parties including judges, solicitors and salesperson, while the recovery process issues include the process of issuance of reminder, foreclosure and repossession of asset. Furthermore, special treatment for particular cases also should be observed since different contracts in Islamic banking products will need different treatment. Finally, issues in the system used in the recovery process are still unresolved since the existing technology is still young in this area to embraced Islamic finance requirements and nature of calculation. In order to humanize the financial services in Islamic banking recovery process, we have highlighted four main recommendation to be implemented by Islamic Financial Institutions namely; 1) early deterrent by improving the awareness, 2) improvement of the internal process, 3) reward mechanism, and 4) creative penalty to provide awareness to all stakeholders.

Keywords: humanizing financial services, Islamic Finance, Maqasid Syariah, recovery process

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Authors: Torsten Schwan, Rene Unger

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Simulation of thermal and electrical building performance more and more becomes part of an integrative planning process. Increasing requirements on energy efficiency, the integration of volatile renewable energy, smart control and storage management often cause tremendous challenges for building engineers and architects. This mainly affects commercial or non-residential buildings. Their energy consumption characteristics significantly distinguish from residential ones. This work focuses on the many-objective optimization problem indoor air quality and comfort, especially in non-residential buildings. Based on a brief description of intermediate dependencies between different requirements on indoor air treatment it extends existing Modelica-based building physics models with additional system states to adequately represent indoor air conditions. Interfaces to corresponding HVAC (heating, ventilation, and air conditioning) system and control models enable closed-loop analyzes of occupants' requirements and energy efficiency as well as profitableness aspects. A complex application scenario of a nearly-zero-energy school building shows advantages of presented evaluation process for engineers and architects. This way, clear identification of air quality requirements in individual rooms together with realistic model-based description of occupants' behavior helps to optimize HVAC system already in early design stages. Building planning processes can be highly improved and accelerated by increasing integration of advanced simulation methods. Those methods mainly provide suitable answers on engineers' and architects' questions regarding more exuberant and complex variety of suitable energy supply solutions.

Keywords: indoor air quality, dynamic simulation, energy efficient control, non-residential buildings

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Authors: Ming Fang Hsieh

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The purpose of this study was to investigate the reading responses of infants and toddlers across different contexts in nursery centers. The study adopted Sipe’s framework for children’s literacy education to explore the reading behavior of infants and toddlers. The study was conducted at two nurseries. The sample comprised 46 infants and toddlers and 6 caregivers. The methods of data collection included observation of various reading activities, including shared reading in a group, one-on-one reading, and unstructured reading activities, as well as interviews with caregivers. The data obtained through observations and interviews were transcribed and analyzed. The caregivers and the children’s parents signed an informed consent form before the start of the study. There was no risk anticipated during the course of the study. The analysis revealed five types of reading responses exhibited by the infants and toddlers: (1) linguistic- verbally responding to reading, repeating vocabulary, and answering questions; (2) affective- concentrating on reading or requesting for repeated reading, leaning on books, and gazing at caregivers; (3) explosive- children under 18 months were observed manipulating books through their bodies or different movements like flipping, rotating, or tapping on books; (4) social- during unstructured reading context, children were seen interacting with peers or following the rules of reading, sitting properly, and choosing one book at a time; and (5) distracted responses- paying attention to something else instead of reading, walking around, and playing, which was usually observed during shared reading in a group. The study concluded that children’s distraction and explosive reading behaviors may be a part of the process of their emergent reading behavior. As children develop, they demonstrate an increase in verbal responses, improved concentration, and better behavior. The study suggests that adults should continue to provide appropriate reading opportunities beginning from infancy to nurture children’s reading behaviors.

Keywords: reading response, infants and toddlers, early reading, picture books

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Authors: Gordon James Knowles

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Historically the Chinatown district in Sandwich Islands has been plagued with the traditional vice crimes of illegal drugs, gambling, and prostitution since the early 1800s. However, a new form of psychologically addictive arcade style table gambling machines has become the dominant form of illegal revenue made in Honolulu, Hawaii. This study attempts to document the drive, desire, or will to play and wager with arcade style video gaming and understand the role of illegal game rooms in facilitating pathological gambling addiction. Indicators of police corruption by Chinese organized crime syndicates related to protection rackets, bribery, and pay-offs were revealed. Information fusion from a police science and sociological intelligence perspective indicates insurgent warfare is being waged on the streets of Honolulu by the People’s Republic of China. This state-sponsored communist terrorism in the Hawaiian Islands used “contactless” irregular warfare entailing: (1) the deployment of psychologically addictive gambling machines, (2) the distribution of the physically addictive fentanyl drug as a lethal chemical weapon, and (3) psychological warfare by circulating pro-China anti-American propaganda newspapers targeted at the small island populace.

Keywords: Chinese and Polynesian organized crime, china daily newspaper, electronic arcade style table games, gaming technology addiction, illegal compulsive gambling, and police intelligence

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Authors: Aparna Bandyopadhyay

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The proposed paper will examine how prostitution produced a vast corpus of literature in colonial Bengal. This corpus included autobiographical accounts by prostitutes themselves. While the authenticity of some of these has, at times, been doubted by contemporary observers, the sheer magnitude of such narrative prose demands critical attention. Many of these autobiographical narratives focused on the prostitute’s early life within respectable society and then proceeded to delineate the transgressions and the inescapable chain of circumstances that eventually rendered her a prostitute. Significantly, these serve to corroborate the findings of official investigations regarding the circumstances that led upper-caste Hindu women in Bengal to embrace prostitution in this period. The literary corpus that dwelt on prostitution also included a vast volume of fiction penned by celebrated writers. These foregrounded a prostitute as the central protagonist, telling the life-stories of prostitutes and the circumstances that made them what they were. Novels and short stories often represented the prostitute as an affective being – an individual capable of deep emotions despite her profession. She was seldom a person who had voluntarily embraced prostitution. She was always a figure of helplessness and suffering, a woman whose desire to love and be loved transcended the carnality of her livelihood. She was an outcast, but she experienced the entire repertoire of emotions experienced by her respectable counterparts. The proposed paper will examine the trends and characteristics of the available repertoire of prostitute-oriented literature in late colonial Bengal. It will begin by focusing on the existing perspectives on the origins of prostitution in late colonial Bengal. It will proceed to discuss the literary corpus supposedly penned by prostitutes themselves and then focus on the manner in which some of the stalwarts of high literature represented the prostitute in their literary creations.

Keywords: emotions, literature, prostitution, transgression

Procedia PDF Downloads 116

Authors: Lizinis Cassendra Frederick Dony, Dewi Binti Tajuddin, Jirom Jeremy Frederick Dony, Andrew Nicholas

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Unemployed graduates have become among the world major concerns lately. 70% of Malaysian graduates are jobless. Due to this concerns, this paper aims to identify major factors influencing Sabah minority ethnic favorable in the entrepreneurialism business interest. Hence, extensive introductory entrepreneurship syllabus clusters development beginning from the early childhood, primary, secondary and university students. This may induce interest appeal and to develop focus group of self-employment. The study focus on 7 indicators consist of demographic profiles variable (DP), social norms (SN), attitude (A), self-efficacy (SE) and business management skills (BMS) with reference to university students’ entrepreneurial intention. This study also partially mediates the relationship between product attractiveness (PA) and the minority ethnic entrepreneurialism business interest (MEEBI), by testifying their direct and indirect relationships. Hence, this study provides new perception towards improving the graduates’ characteristic, capabilities to exploit the business opportunities in the market. Furthermore, this paper will assess the relationship with the product attractiveness(PA) as a mediator. The study encompasses on the type of Sabah minority ethnic (ME) and nature of family own business (FOB) background with the 280 samples students in UiTM Sabah and UMS. The descriptive and random sampling method of research which revealed that majority of the respondents agreed that FOB and entrepreneurship education had positively influenced the ethnic students’ involvement in the entrepreneurial process and career development either full-time or part-time basis.

Keywords: Demographic profile (DP), soci, unemployed graduates, Malaysian minority

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Authors: Anna Słupik, Krzysztof Jaworski, Anna Mosiołek, Dariusz Białoszewski

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Background: Maintaining the correct body balance is essential in the prevention of falls in the elderly, which is especially important for women because of postmenopausal osteoporosis and the serious consequences of falls. One of the exercise methods which is very popular among adults, and which may affect body balance in a positive way is the pilates method. The aim of the study was to evaluate the effect of regular pilates exercises on the ability to maintain body balance in static conditions in adult healthy women. Material and methods: The study group consisted of 20 healthy women attending pilates twice a week for at least 1 year. The control group consisted of 20 healthy women physically inactive. Women in the age range from 35 to 50 years old without pain in musculoskeletal system or other pain were only qualified to the groups. Body balance was assessed using MatScan VersaTek platform with Sway Analysis Module based on Matscan Clinical 6.7 software. The balance was evaluated under the following conditions: standing on both feet with eyes open, standing on both feet with eyes closed, one-leg standing (separately on the right and left foot) with eyes open. Each test lasted 30 seconds. The following parameters were calculated: estimated size of the ellipse of 95% confidence, the distance covered by the Center of Gravity (COG), the size of the maximum shift in the sagittal and frontal planes and load distribution between the left and right foot, as well as between rear- and forefoot. Results: It was found that there is significant difference between the groups in favor of the study group in the size of the confidence ellipse and maximum shifts of COG in the sagittal plane during standing on both feet, both with the eyes open and closed (p < 0.05). While standing on one leg both on the right and left leg, with eyes opened there was a significant difference in favor of the study group, in terms of the size of confidence ellipse, the size of the maximum shifts in the sagittal and in the frontal plane (p < 0.05). There were no differences between the distribution of load between the right and left foot (standing with both feet), nor between fore- and rear foot (in standing with both feet or one-leg). Conclusions: 1. Static balance in women exercising regularly by pilates method is better than in inactive women, which may in the future prevent falls and their consequences. 2. The observed differences in maintaining balance in frontal plane in one-leg standing may indicate a positive impact of pilates exercises on the ability to maintain global balance in terms of the reduced support surface. 3. Pilates method can be used as a form preventive therapy for all people who are expected to have problems with body balance in the future, for example in chronic neurological disorders or vestibular problems. 4. The results have shown that further prospective randomized research on a larger and more representative group is needed.

Keywords: balance exercises, body balance, pilates, pressure distribution, women

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Authors: P. M. Natarajan, Shambhu Kallolikar, S. Ganesh

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By size and volume of water, Ganges River basin is the biggest among the fourteen major river basins in India. By Hindu’s faith, it is the main ‘holy river’ in this nation. But, of late, the pollution load, both domestic and industrial sources are deteriorating the surface and groundwater as well as land resources and hence the environment of the Ganges River basin is under threat. Seeing this scenario, the Indian government began to reclaim this river by two Ganges Action Plans I and II since 1986 by spending Rs. 2,747.52 crores ($457.92 million). But the result was no improvement in the water quality of the river and groundwater and environment even after almost three decades of reclamation, and hence now the New Indian Government is taking extra care to rejuvenate this river and allotted Rs. 2,037 cores ($339.50 million) in 2014 and Rs. 20,000 crores ($3,333.33 million) in 2015. The reasons for the poor water quality and stinking environment even after three decades of reclamation of the river are either no treatment/partial treatment of the sewage. Hence, now the authors are suggesting a tertiary level treatment standard of sewages of all sources and origins of the Ganges River basin and recycling the entire treated water for nondomestic uses. At 20million litres per day (MLD) capacity of each sewage treatment plant (STP), this basin needs about 2020 plants to treat the entire sewage load. Cost of the STPs is Rs. 3,43,400 million ($5,723.33 million) and the annual maintenance cost is Rs. 15,352 million ($255.87 million). The advantages of the proposed exercise are: we can produce a volume of 1,769.52 million m³ of biogas. Since biogas is energy, can be used as a fuel, for any heating purpose, such as cooking. It can also be used in a gas engine to convert the energy in the gas into electricity and heat. It is possible to generate about 3,539.04 million kilowatt electricity per annum from the biogas generated in the process of wastewater treatment in Ganges basin. The income generation from electricity works out to Rs 10,617.12million ($176.95million). This power can be used to bridge the supply and demand gap of energy in the power hungry villages where 300million people are without electricity in India even today, and to run these STPs as well. The 664.18 million tonnes of sludge generated by the treatment plants per annum can be used in agriculture as manure with suitable amendments. By arresting the pollution load the 187.42 cubic kilometer (km³) of groundwater potential of the Ganges River basin could be protected from deterioration. Since we can recycle the sewage for non-domestic purposes, about 14.75km³ of fresh water per annum can be conserved for future use. The total value of the water saving per annum is Rs.22,11,916million ($36,865.27million) and each citizen of Ganges River basin can save Rs. 4,423.83/ ($73.73) per annum and Rs. 12.12 ($0.202) per day by recycling the treated water for nondomestic uses. Further the environment of this basin could be kept clean by arresting the foul smell as well as the 3% of greenhouse gages emission from the stinking waterways and land. These are the ways to reclaim the waterways of Ganges River basin from deterioration.

Keywords: Holy Ganges River, lifeline of India, wastewater treatment and management, making Ganges permanently holy

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Authors: Behrang Ekrami, Amin Tamadon

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Persian fallow deer (Dama dama mesopotamica) is belonging to the family Cervidae and is only found in a few protected areas in the northwest, north, and southwest of Iran. The aims of this study were analysis of inbreeding and morphometric parameters of semen in male Persian fallow deer to investigate the cause of reduced fertility of this endangered species in Dasht-e-Naz National Refuge, Sari, Iran. The Persian fallow deer semen was collected from four adult bucks randomly during the breeding and non-breeding season from five dehorned and horned deer's BY an artificial vagina. Twelve blood samples was taken from Persian fallow deer and mitochondrial DNA was extracted, amplified, extracted, sequenced, and then were considered for genetic analysis. The Persian fallow deer semen, both with normal and abnormal spermatozoa, is similar to that of domestic ruminants but very smaller and difficult to observe at the primary observation. The post-mating season collected ejaculates contained abnormal spermatozoa, debris and secretion of accessory glands in horned bucks and accessory glands secretion free of any spermatozoa in dehorned or early velvet budding bucks. Microscopic evaluation in all four bucks during the mating season showed the mean concentration of 9×106 spermatozoa/ml. The mean ±SD of age, testes length and testes width was 4.60±1.52 years, 3.58±0.32 and 1.86±0.09 cm, respectively. The results identified 1120 loci (assuming each nucleotide as locus) in which 377 were polymorphic. In conclusion, reduced fertility of male Persian fallow deer may be caused by inbreeding of the protected herd in a limited area of Dasht-e-Naz National Refuge.

Keywords: Persian fallow deer, spermatozoa, reproductive characteristics, morphometric parameters

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Authors: Viktor Novikov, Yuri Ruzhin

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The studies completed to-date on a relation of the Earth's seismicity and solar processes provide the fuzzy and contradictory results. For verification of an idea that solar flares can trigger earthquakes, we have analyzed a case of a powerful surge of solar flash activity early in September 2017 during approaching the minimum of 24th solar cycle was accompanied by significant disturbances of space weather. On September 6, 2017, a group of sunspots AR2673 generated a large solar flare of X9.3 class, the strongest flare over the past twelve years. Its explosion produced a coronal mass ejection partially directed towards the Earth. We carried out a statistical analysis of the catalogs of earthquakes USGS and EMSC for determination of the effect of solar flares on global seismic activity. New evidence of earthquake triggering due to the Sun-Earth interaction has been demonstrated by simple comparison of behavior of Earth's seismicity before and after the strong solar flare. The global number of earthquakes with magnitude of 2.5 to 5.5 within 11 days after the solar flare has increased by 30 to 100%. A possibility of electric/electromagnetic triggering of earthquake due to space weather disturbances is supported by results of field and laboratory studies, where the earthquakes (both natural and laboratory) were initiated by injection of electrical current into the Earth crust. For the specific case of artificial electric earthquake triggering the current density at a depth of earthquake, sources are comparable with estimations of a density of telluric currents induced by variation of space weather conditions due to solar flares. Acknowledgment: The work was supported by RFBR grant No. 18-05-00255.

Keywords: solar flare, earthquake activity, earthquake triggering, solar-terrestrial relations

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Authors: Mohd Najib Mansor, Nur Syamilah Md. Noor, Abdul Rahim Anuar, Shazida Jan Mohd Khan, Ahmad Zubir Ibrahim, Badariah Hj Din, Abu Sufian Abu Bakar, Kalsom Kayat, Wan Nurmahfuzah Jannah Wan Mansor

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This study aimed and focused on the behavior of youth entrepreneurs’ especially entrepreneurial self-efficacy and the performance in micro SMEs in Malaysia. Entrepreneurship development calls for support from various quarters, and mostly the need exists to initiate a youth entrepreneurship culture and drive amongst the youth in the society. Although backed up by the government and non-government organizations, micro-entrepreneurs are still facing challenges which greatly delay their progress, growth and consequently their input towards economic advancement. Micro-entrepreneurs are confronted with unique difficulties such as uncertainty, innovation, and evolution. Reviews on the development of entrepreneurial characteristics such as need for achievement, internal locus of control, risk-taking and innovation and have been recognized as highly associated with entrepreneurial behavior. The data in this study was obtained from the Department of Statistics, Malaysia. A random sampling of 830 respondents was distributed to 14 states that involve of micro-entrepreneurs. The study adopted a quantitative approach whereby a set of questionnaire was used to gather data. Multiple regression analysis was chosen as a method of analysis testing. The result of this study is expected to provide insight into the factor affecting entrepreneurial behavior and performance of youth entrepreneurs in micro SMEs. The finding showed that the Malaysian youth entrepreneurs do not have the entrepreneurial self-efficacy within themselves in order to accomplish greater success in their business venture. The establishment of entrepreneurial schools to allow our youth to be exposed to entrepreneurship from an early age and the development of special training focuses on the creation of business network so that the continuous entrepreneurial culture is crafted.

Keywords: youth entrepreneurs, micro entrepreneurs, entrepreneurial self-efficacy, entrepreneurial performance

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Authors: Alexandre Chagnes

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Lithium-ion battery is the technology of choice in the development of electric vehicles. This technology is now mature, although there are still many challenges to increase their energy density while ensuring an irreproachable safety of use. For this goal, it is necessary to develop new cathodic materials that can be cycled at higher voltages and electrolytes compatible with these materials. But the challenge does not only concern the production of efficient batteries for the electrochemical storage of energy since lithium-ion battery technology relies on the use of critical and/or strategic value resources. It is, therefore, crucial to include Lithium-ion batteries development in a circular economy approach very early. In particular, optimized recycling and reuse of battery components must both minimize their impact on the environment and limit geopolitical issues related to tensions on the mineral resources necessary for lithium-ion battery production. Although recycling will never replace mining, it reduces resource dependence by ensuring the presence of exploitable resources in the territory, which is particularly important for countries like France, where exploited or exploitable resources are limited. This conference addresses the development of a new hydrometallurgical process combining leaching of cathodic material from spent lithium-ion battery in acidic chloride media and solvent extraction process. Most of recycling processes reported in the literature rely on the sulphate route, and a few studies investigate the potentialities of the chloride route despite many advantages and the possibility to develop new chemistry, which could get easier the metal separation. The leaching mechanisms and the solvent extraction equilibria will be presented in this conference. Based on the comprehension of the physicochemistry of leaching and solvent extraction, the present study will introduce a new hydrometallurgical process for the production of cobalt, nickel, manganese and lithium from spent cathodic materials.

Keywords: lithium-ion battery, recycling, hydrometallurgy, leaching, solvent extraction

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Authors: Luís Marques, João Rocha, Andreia Fernandes, Maria Moura, Cláudia Caseiro, Filipa Figueiredo, João Nunes

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The implementation of circularity strategies other than recycling, such as reducing the amount of raw material, as well as reusing or sharing existing products, remains marginal. The European Commission announced that the transition towards a more circular economy could lead to the net creation of about 700,000 jobs in Europe by 2030, through additional labour demand from recycling plants, repair services and other circular activities. Efforts to create new circular business models in accordance with completely circular processes, as opposed to linear ones, have increased considerably in recent years. In order to create a societal Circular Economy transition model, it is necessary to include innovative solutions, where startups play a key role. Early-stage startups based on new business models according to circular processes often face difficulties in creating enough impact. The StartUp Zero Program designs a model and approach to increase the flow of startups in the Circular Economy field, focusing on a systemic decision analysis and multi-generational approach, considering Multi-Criteria Decision Analysis to support a decision-making tool, which is also supported by the use of a combination of an Analytical Hierarchy Process and Multi-Attribute Value Theory methods. We define principles, criteria and indicators for evaluating startup prerogatives, quantifying the evaluation process in a unique result. Additionally, this entrepreneurship program spanning 16 months involved more than 2400 young people, from ages 14 to 23, in more than 200 interaction activities.

Keywords: circular economy, entrepreneurship, startups;, multi-criteria decision analysis

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Authors: Ash Ahmed, Fraser Hyndman, Heni Fitriani, John Kamau

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The highway pavement is the biggest structural asset a government can construct and maintain. Concrete rigid pavements are used to carry traffic in large volumes across countries safely and efficiently. Pavement quality concrete mixes have high levels of cement which contribute to up to 10% of global CO₂ emissions. Currently the UK specifies (ground granulated blastfurnace slag) GGBS and (pulverised fuel ash) PFA to reduce the quantity of cement used in pavement construction. GGBS and PFA come from heavy industry that should not be relied upon to improve the sustainability of construction materials. This report shows that cement in pavement quality concrete can be replaced with rice husk ash (RHA) without causing adverse effects to the mechanical properties required for highways. RHA comes from the food production industry and is vital for the growing global population. It is thus a socially responsible objective to use a pozzolan in highway pavement construction that is sourced from an environmentally friendly industry. The report investigates the properties of RHA mixes and compares them to existing pavement quality mixes already used and specified. The report found that sieving RHA and not grinding it gives the best performance. Due to the low density of RHA the investigation found that replacing cement by volume rather than weight provided the best results. Findings showed that CEM II mixed with 20% RHA meets the required specification for pavement quality concrete and mitigates using the comparative CEM I. The investigation also notes that RHA is observed to be more reactive with CEM II rather than CEM I and suits early strength gains required for pavement construction. The report concludes that RHA is a sustainable material that reduces the embodied CO₂ of pavement quality concrete, which is well suited for UK highway specifications and has the potential to improve the lives of people living in the developing countries.

Keywords: pavement, pozzolan, rice husk ash, sustainable concrete

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Authors: M. M. S. Prahastomi, M. Muhajir Saputra, Axel Derian

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Lapindo mud (LUSI ) phenomenon which occurred in Sidoarjo 2006 is a national scale of the geological phenomenon. This mudflow forms a mud volcano that spreads by time is in the need of serious treatment. Some further research has been conducted either by the application method of geodesy, geophysics, and subsurface geology, but still remains a mystery to this phenomenon. Sidoarjo Physiographic regions are included in the Kendeng zone flanked by Rembang zones in northern and Solo zones in southern. In this region revealed Kabuh formation, Jombang formation, and alluvium. In general, in the northern part of the area is composed of sedimentary rocks Sidoarjo klastika, epiklastic, pyroclastics, and older alluvium of the Early Pleistocene to Resen. The study was conducted with the literature study of the stratigraphy and regional geology as well as secondary data from observations coupled gravity method (Anomaly Bouger). The aim of the study is to reveal the subsurface geology structure pattern and the changes in mass flow. Gravity anomaly data were obtained from the calculation of the value of gravity and altitude, then processed into gravity anomaly contours which reflect changes in density of each group observed gravity. The gravity data could indicate a bottom surface which deformation occur the stronger or more intense to the south. Deformation in the form of gravity impairment was associated with a decrease in future density which is indicated by the presence of gas, water and gas bursts. Sectional analysis of changes in the measured value of gravity at different times indicates a change in the value of gravity caused by the presence of subsurface subsidence. While the gravity anomaly section describes the fault zone causes the zone to be unstable.

Keywords: mud volcano, Lumpur Sidoarjo, Bouger anomaly, Indonesia

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Authors: Alexander S. Burnasov, Anatoly V. Stepanov, Maria Y. Ilyushkina

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In the conditions of transition to the digital economy, the digital environment of the city becomes one of the key factors of its tourism attractiveness. Modern digital environment makes travelling more accessible, improves the quality of travel services and the attractiveness of many tourist destinations. The digitalization of the industry allows to use resources more efficiently, to simplify business processes, to minimize risks, and to improve travel safety. The city promotion as a tourist destination in the foreign market becomes decisive in the digital environment. Information technologies are extremely important for the functioning of not only any tourist enterprise but also the city as a whole. In addition to solving traditional problems, it is also possible to implement some innovations from the tourism industry, such as the availability of city services in international systems of booking tickets and booking rooms in hotels, the possibility of early booking of theater and museum tickets, the possibility of non-cash payment by cards of international payment systems, Internet access in the urban environment for travelers. The availability of the city's digital services makes it possible to reduce ordering costs, contributes to the optimal selection of tourist products that meet the requirements of the tourist, provides increased transparency of transactions. The users can compare prices, features, services, and reviews of the travel service. The ability to share impressions with friends thousands of miles away directly affects the image of the city. It is possible to promote the image of the city in the digital environment not only through world-scale events (such as World Cup 2018, international summits, etc.) but also through the creation and management of services in the digital environment aimed at supporting tourism services, which will help to improve the positioning of the city in the global tourism market.

Keywords: competitiveness, digital environment, travelling, Yekaterinburg

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Authors: Paola Montenegro, Maria de los Angeles Balaguera Villa

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Contraceptive methods play a fundamental role in preventing unwanted pregnancies and protecting users from sexually transmitted infections (STIs). Despite being known to almost the entire population of reproductive age living in Colombia, there are barriers, practices and complex notions about contraceptives that affect their desired mass use and effectiveness. This work aims to analyse some of the perceptions and practices discussed with young people (13-28 years old) living in Colombia regarding the use of contraceptives in their daily lives, preferences, needs and perceived side effects. This research also examines the perceived paradox in autonomy that young people experience regarding contraceptive use: in one hand, its use (or lack of it) is interpreted as an act of self-determination and primary example of reproductive agency, on the other hand, it was frequently associated with coercion and limited autonomy derived from the gaps in reliable information available for young people, the difficulty of accessing certain preferred methods, and sometimes the experienced coercion exercise by doctors, partners and/or family members. The data and analysis discussed in this work stems from a research project whose objective was to provide information about needs and preferences in sexual and reproductive health of young people living in Colombia in relation to a possible telehealth service that could close the gap in access to quality care and safe information. Through a mixed methods approach, this study collected 5.736 responses to a virtual survey disseminated nationwide in Colombia and 47 inperson interviews (24 of them with people who were assigned female at birth and 21 with local key stakeholders in the abortion ecosystem). Quantitative data was analyzed using Stata SE Version 16.0 and qualitative analysis was completed through NVivo using thematic analysis. Key findings on contraception use in young people living in Colombia reveal that 85,8% of participants had used a contraceptive method in the last two years, and that the most commonly used methods were condoms, contraceptive pills, the morning-after pill and the method of interruption. The remaining 14,2% of respondents who declared to not have used contraceptives in the last two years expressed that the main four barriers to access were: "Lack of knowledge about contraceptive methods and where to obtain information and/or access them (13.9%)", "Have had sex with people who have vaginas (10.2%)", "Cost of contraceptive method (8.4%)" and "Difficulties in obtaining medical authorisations (7.6%)". These barriers coincided with the ones used to explain the non-use of contraceptives in young people, which reveals that limitations in information, cost, and quality care represent structural issues that need to be address in programmes, services, and public policy. Finally, interviews showed that young people perceive contraceptive use and non-use as an example of reaffirming reproductive agency and limitations to this can be explained through the widespread incomplete knowledge about how methods work and the prevalence of other social representations of contraception associated with trust, fidelity, and partner preferences, that in the end create limitations to young people’s autonomy.

Keywords: contraception, family planning, premarital fertility, unplanned pregnancy

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Authors: G. Iacoviello, A. Lazzini

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This paper focuses on the development of the study of accounting in the Italian education system between the 19th and 20th centuries. It also focuses on the subsequent formation of a scientific and experimental forma mentis that would prepare students for administrative and managerial activities in industry, commerce and public administration. From a political perspective, the period was characterized by two dominant movements - liberalism (1861-1922) and fascism (1922-1945) - that deeply influenced accounting practices and the entire Italian education system. The materials used in the study include both primary and secondary sources. The primary sources used to inform this study are numerous original documents issued from 1890-1935 by the government and maintained in the Historical Archive of the State in Rome. The secondary sources have supported both the development of the theoretical framework and the definition of the historical context. This paper assigns to the educational system the role of cultural producer. Foucauldian analysis identifies the problem confronted by the critical intellectual in finding a way to deploy knowledge through a 'patient labour of investigation' that highlights the contingency and fragility of the circumstances that have shaped current practices and theories. Education can be considered a powerful and political process providing students with values, ideas, and models that they will subsequently use to discipline themselves, remaining as close to them as possible. It is impossible for power to be exercised without knowledge, just as it is impossible for knowledge not to engender power. The power-knowledge relationship can be usefully employed for explaining how power operates within society, how mechanisms of power affect everyday lives. Power is employed at all levels and through many dimensions including government. Schools exercise ‘epistemological power’ – a power to extract a knowledge of individuals from individuals. Because knowledge is a key element in the operation of power, the procedures applied to the formation and accumulation of knowledge cannot be considered neutral instruments for the presentation of the real. Consequently, the same institutions that produce and spread knowledge can be considered part of the ‘power-knowledge’ interrelation. Individuals have become both objects and subject in the development of knowledge. If education plays a fundamental role in shaping all aspects of communities in the same way, the structural changes resulting from economic, social and cultural development affect the educational systems. Analogously, the important changes related to social and economic development required legislative intervention to regulate the functioning of different areas in society. Knowledge can become a means of social control used by the government to manage populations. It can be argued that the evolution of Italy’s education systems is coherent with the idea that power and knowledge do not exist independently but instead are coterminous. This research aims to reduce such a gap by analysing the role of the state in the development of accounting education in Italy.

Keywords: education system, government, knowledge, power

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Authors: Kristiina Teiss

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Estonians and children having Estonian as a one of their languages have lately become the fastest growing minority or bilingual group in Finland which underlines the importance of studying this target group. The acquisition of bilingualism by an infant is affected by many different issues like the child’s personal traits, language differences, and different environmental factors such as people´s attitudes towards languages and bilingualism. In the early years the most important factor is the children’s interaction with their parents and siblings. This poster gives an overview to the material and some preliminary findings of ongoing PhD study concerning code-mixing, code-switching and language attitudes of two bilingual 10-11 year old children. Data was collected from two different bilingual families, one of them living in Tampere, Finland and one of them moved during the study to Tallinn, Estonia. The data includes audio recordings of the families’ interactions with their children when they were aged 2-3 years old and then when they were 10-11 years old. The data also includes recorded semi-structured queries of the parents, as well as recorded semi-structured queries of the children when they were in the age of 10-11 years. The features of code-mixing can vary depending on norms or models in the families, or even according to its use by two parents in same family. The practices studied in the ongoing longitudinal case study, based on a framework of ethnography, contain parental conversational strategies and family attitudes as well as CS (code-switching and code-mixing) cases occurring both in children and adult language. The aim of this paper is to find out whether there is a connection between children’s attitudes and their daily language use. It would be also interesting to find some evidence, as to whether living in different countries has different impacts on using two languages. The results of dissertation maid give some directional suggestions on how language maintenance of Estonian-Finnish bilinguals could be supported, although generalizations on the base of case study could not be done.

Keywords: code switching, Estonian, Finnish, language attitudes

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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Authors: Célia Barreto Carvalho, Carolina da Motta, José Pinto-Gouveia, Ermelindo Bernardo Peixoto

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Auditory hallucinations among the most invalidating and distressing experiences reported by patients diagnosed with schizophrenia, leading to feelings of powerlessness and helplessness towards their illness. In more severe cases, these auditory hallucinations can take the form of commanding voices, which are often related to high suicidality rates in these patients. Several authors propose that the meanings attributed to the hallucinatory experience, rather than characteristics like form and content, can be determinant in patients’ reactions to hallucinatory activity, particularly in the case of voice-hearing experiences. In this study, 48 patients diagnosed with paranoid schizophrenia presenting auditory hallucinations were studied. Multiple regression analyses were computed to study the influence of several developmental aspects, such as family and social dynamics, bullying, depression, and socio-cognitive variables on the auditory hallucinations, on patients’ attributions and relationships with their voices, and on the resulting invalidation of hallucinatory experience. Overall, results showed how relationships with voices can mirror several aspects of interpersonal relationship with others, and how self-schemas, depression and actual social relationships help shaping the voice-hearing experience. Early experiences of victimization and submission help predict the attributions of omnipotence of the voices, and increased hostility from parents seems to increase the malevolence of the voices, suggesting that socio-cognitive factors can significantly contribute to the etiology and maintenance of auditory hallucinations. The understanding of the characteristics of auditory hallucinations and the relationships patients established with their voices can allow the development of more promising therapeutic interventions that can be more effective in decreasing invalidation caused by this devastating mental illness.

Keywords: auditory hallucination, beliefs, life events, schizophrenia

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Authors: Siti Rajaah Binti Sayed Sultan

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Managing the code blue event is stressful for nurses, the patient, and the patient's families. The rapid response from the first and second responders in the code blue event will improve patient outcomes and prevent tissue hypoxia that leads to brain injury and other organ failures. Providing 1 minute for the cardiac massage and 2 minutes for defibrillation will significantly improve patient outcomes. As we know, the American Heart Association came out with guidelines for managing cardiac arrest patients. The hospital must provide competent staff to manage this situation. It can be achieved when the staff is well equipped with the skill, attitude, and knowledge to manage this situation with well-planned strategies, i.e., clear guidelines for managing the code blue event, competent staff, and functional equipment. The code blue simulation (CBS) was chosen in the training program for code blue management because it can mimic real scenarios. Having the code blue simulation module will allow the staff to appreciate what they will face during the code blue event, especially since it rarely happens in that area. This CBS module training will help the staff familiarize themselves with the activities that happened during actual events and be able to operate the equipment accordingly. Being challenged and independent in managing the code blue in the early phase gives the patient a better outcome. The CBS module will help the assessor and the hospital management team with the proper tools and guidelines for managing the code blue drill accordingly. As we know, prompt action will benefit the patient and their family. It also indirectly increases the confidence and job satisfaction among the nurses, increasing the standard of care, reducing the complication and hospital burden, and enhancing cost-effective care.

Keywords: code blue simulation module, development of code blue simulation module, code blue response time, code blue drill, cardiorespiratory arrest, managing code blue

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