Search results for: motherhood practice

Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Sadiah Baharom, Che Nidzam Che Ahmad, Saipol Barin Ramli, Asmayati Yahaya, Sopia Md Yassin

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The early childhood care and education (ECCE) in Malaysia aspire to develop children who are intellectually, emotionally, physically and spiritually balanced. This aspiration can only materialise if the early childhood program developed comprehensive and is of high quality comparable to international standards. As such, there is a pressing need to assess the quality of the program in an all-encompassing manner. The overall research project aims at developing a comprehensive and integrated model of high-quality Malaysian ECCE. One of the major objectives of this project is to assess and evaluate the scope and quality of the existing ECCE programs in Malaysia. To this end, a specific aspect of this objective is to develop and validate an instrument to assess and evaluate the ECCE curriculum of the country. Thus this paper describes the development and validation of an instrument to explore the quality of early childhood care and education curriculum currently implemented in the country’s ECCE centres. The generation of the constructs and items were based on a set of criteria mapped against existing ECCE practice, document analyses, expert interviews and panel discussions. The items went through expert validation and were field tested on 597 ECCE teachers. The data obtained went through an exploratory factor analysis to validate the constructs of the instrument followed by reliability studies on internal consistency based on the Cronbach Alpha values. The final set of items for the ECCE curriculum instrument, earmarked for the main study, consists of four constructs namely philosophy and core values, curriculum content, curriculum review and unique features. Each construct consists of between 21 to 3 items with a total of 36 items in all. The reliability coefficients for each construct range from 0.65 to 0.961. These values are within the acceptable limits for a reliable instrument to be used in the main study.

Keywords: early childhood and care education, instrument development, reliability studies, validity studies

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Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

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Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: multidisciplinary approach, neuropalliative care, research, quality of life

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Authors: Anne N. Heirman, Lisette van der Molen, Richard Dirven, Gyorgi B. Halmos, Michiel W.M. van den Brekel

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Background: Due to the rising incidence of oropharyngeal squamous cell cancer (OPSCC), many patients are challenged with choosing between transoral(robotic) surgery and radiotherapy, with equal survival and oncological outcomes. Also, functional outcomes are of little difference over the years. With this study, the wants and needs of patients and caregivers are identified to develop a comprehensible patient decision aid (PDA). Methods: The development of this PDA is based on the International Patient Decision Aid Standards criteria. In phase 1, relevant literature was reviewed and compared to current counseling papers. We interviewed ten post-treatment patients and ten doctors from four head and neck centers in the Netherlands, which were transcribed verbatim and analyzed. With these results, the first draft of the PDA was developed. Phase 2 beholds testing the first draft for comprehensibility and usability. Phase 3 beholds testing for feasibility. After this phase, the final version of the PDA was developed. Results: All doctors and patients agreed a PDA was needed. Phase 1 showed that 50% of patients felt well-informed after standard care and 35% missed information about treatment possibilities. Side effects and functional outcomes were rated as the most important for decision-making. With this information, the first version was developed. Doctors and patients stated (phase 2) that they were satisfied with the comprehensibility and usability, but there was too much text. The PDA underwent text reduction revisions and got more graphics. After revisions, all doctors found the PDA feasible and would contribute to regular counseling. Patients were satisfied with the results and wished they would have seen it before their treatment. Conclusion: Decision-making for OPSCC should focus on differences in side-effects and functional outcomes. Patients and doctors found the PDA to be of great value. Future research will explore the benefits of the PDA in clinical practice.

Keywords: head-and-neck oncology, oropharyngeal cancer, patient decision aid, development, shared decision making

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Authors: Celeste Lawson

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Learning to embrace and value teamwork assessment at a university level is critical for students, as graduates enter a real-world working environment where teamwork is likely to occur virtually. Student disdain for teamwork exercises is an area often overlooked or disregarded by academics. This research explored the implementation of an online teamwork assessment approach at a regional Australian university with a significant cohort of Distance Education students. Students had disliked teamwork for three reasons: it was not relevant to their study, the grading was unfair amongst team members, and managing the task was challenging in a virtual environment. Teamwork assessment was modified so that the task was an authentic task that could occur in real-world practice; team selection was based on the task topic rather than randomly; grading was based on the individual’s contribution to the task, and students were provided virtual team management skills as part of a the assessment. In this way, management of the team became an output of the task itself. Data was gathered over three years from student satisfaction surveys, failure rates, attrition figures, and unsolicited student comments. In one unit where this approach was adopted (Advanced Public Relations), student satisfaction increased from 3.6 (out of 5) in 2012 to 4.6 in 2016, with positive comments made about the teamwork approach. The attrition rate for another unit (Public Relations and the Media) reduced from 20.7% in 2012 to 2.2% in 2015. In 2012, criticism of teamwork assessment made up 50% of negative student feedback in Public Relations and the Media. By 2015, following the successful implementation of the teamwork assessment approach, only 12.5% of negative comments on the student satisfaction survey were critical of teamwork, while 33% of positive comments related to a positive teamwork experience. In 2016, students explicitly nominated teamwork as the best part of this unit. The approach is transferable to other disciplines and was adopted by other academics within the institution with similar results.

Keywords: assessment, distance education, teamwork, virtual

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Authors: Ningfei Xiao, Simon Twose, Hannah Hopewell

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In urban settings worldwide, artists and researchers have drawn from shamanic healing, providing insightful responses to the environment. This project is a transdisciplinary creative research project where architecture and art practice draw from shamanic healing and provide the potential to expand knowledge of public space and inspire more aesthetic explorations of public spatial visions. The research started from the encounters with the Ewengki/Evenki shaman tribe in settlement areas of northern China in 2019 and extended through the partnerships with Maori artists in Poneke Aotearoa, New Zealand, in 2023. Based on the learnings and collaborations with female indigenous tradition practitioners and the healing that the researcher received from the land, a spatial installation exhibition was developed in this project. Indigenous practices are intricately woven with contemporary technology, merging visuals, soundscapes, and other non-visual aesthetics influenced by the researcher's personal experiences of embodied shamanic healing with brainwave generative technology. This synthesis seeks to ritualize and reimagine future public spaces, encompassing streetscapes and greenscapes from China to Aotearoa, and fostering connections between urbanized human body, mind, spirit, and land. In doing so, the project presents a feminist posthuman inquiry into how individuals perceive materiality within the context of a future city. Grounded in creative research and embodied methodologies, this paper focuses on the conceptual and autoethnographic aspects of visual-non-visual aesthetics and their creative representation. Through the exploration of aesthetics beyond the visual realm within urban and spatial contexts, this project showcases the spatial installation exhibition as an example of shamanic influence and related response to public space through embodied artistry and transdisciplinary creative inquiry.

Keywords: aesthetic, embodiment, visual and/or non-visual, spatial installation, shamanic healing, public space

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Authors: Sher Ali

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Organic agriculture has gained significant momentum globally as a sustainable and environmentally friendly farming practice. In Pakistan, amidst growing concerns about food security, environmental degradation, and health issues related to conventional farming methods, the adoption of organic agriculture presents a promising pathway for agricultural development. This abstract aims to provide an overview of the status, opportunities, challenges, and future directions of organic agriculture in Pakistan. It delves into the current state of organic farming practices, including the extent of adoption, key crops cultivated, and the regulatory framework governing organic certification. Furthermore, the abstract discusses the unique opportunities that Pakistan offers for organic agriculture, such as its diverse agro-climatic zones, rich biodiversity, and traditional farming knowledge. It highlights successful initiatives and case studies that showcase the potential of organic farming to improve rural livelihoods, enhance food security, and promote sustainable agricultural practices. However, the abstract also addresses the challenges hindering the widespread adoption of organic agriculture in Pakistan, ranging from limited awareness and technical know-how among farmers to inadequate infrastructure and market linkages. It emphasizes the need for supportive policies, capacity-building programs, and investment in research and extension services to overcome these challenges and promote the growth of the organic agriculture sector. Lastly, the abstract outlines future directions and recommendations for advancing organic agriculture in Pakistan, including strategies for scaling up production, strengthening certification mechanisms, and fostering collaboration among stakeholders. By shedding light on the opportunities, challenges, and potential of organic agriculture in Pakistan, this abstract aims to contribute to the discourse on sustainable farming practices at the upcoming Agro Conference in the USA. It invites participants to engage in dialogue, share experiences, and explore avenues for collaboration toward promoting organic agriculture for a healthier, more resilient food system.

Keywords: agriculture, challenges, organic, Pakistan

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Authors: Canan Duzan

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For most language learners, mastery of the speaking skill is the proof of the mastery of the foreign language. On the other hand, the speaking skill is considered as the most difficult aspect of language learning to develop for both learners and teachers. Especially in countries like Turkey where exposure to the target language is minimum and resources and opportunities provided for language practice are scarce, teaching and learning to speak the language become a real struggle for teachers and learners alike. Data collected from students, instructors, faculty members and the business sector in needs analysis studies conducted previously at Middle East Technical University (METU) consistently revealed the need for addressing the problem of lack of confidence in speaking English. Action was taken during the design of the only EAP speaking course offered in Modern Languages Department since lack of confidence is considered to be a serious barrier for effective communication and causes learners to suffer from insecurity, uncertainty and fear. “Confidence building” served as the guiding principle in the syllabus design, nature of the tasks created for the course and the assessment procedures to help learners become more confident speakers of English. In order to see the effectiveness of the decisions made during the design phase of the course and whether students become more confident speakers upon completion of the course, a case study was carried out with 100 students at METU. A questionnaire including both Likert-Scale and open-ended items were administered to students to collect data and this data were analyzed using the SPSS program. Group interviews were also carried out to gain more insight into the effectiveness of the course in terms of building speaking confidence. This presentation will explore the specific actions taken to develop students’ confidence based on the findings of program evaluation studies and to what extent the students believe these actions to be effective in improving their confidence. The unique design of this course and strategies adopted for confidence building are highly applicable in other EAP contexts and may yield similar positive results.

Keywords: confidence, EAP, speaking, strategy

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Authors: Eva Kirzner

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Based on outcome studies published over the past two decades, in 2018, the ACC/AHA published new guidelines for the management of hypercholesterolemia that incorporate the use of coronary artery calcium (CAC) scanning as a decision tool for ascertaining which patients may benefit from statin therapy. This use is based on the recognition that the absence of calcium on CAC scanning (i.e., a CAC score of zero) usually signifies the absence of significant atherosclerotic deposits in the coronary arteries. Specifically, in patients with a high risk for atherosclerotic cardiovascular disease (ASCVD), initiation of statin therapy is generally recommended to decrease ASCVD risk. However, among patients with intermediate ASCVD risk, the need for statin therapy is less certain. However, there is a need for new outcome studies that provide evidence that the management of hypercholesterolemia based on these new ACC/AHA recommendations is safe for patients. Based on a Pub-Med and Google Scholar literature search, four relevant population-based or patient-based cohort studies that studied the relationship between CAC scanning, risk assessment or mortality, and statin therapy that were published between 2017 and 2021 were identified (see references). In each of these studies, patients were assessed for their baseline risk for atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohorts Equation (PCE), an ACC/AHA calculator for determining patient risk based on assessment of patient age, gender, ethnicity, and coronary artery disease risk factors. The combined findings of these four studies provided concordant evidence that a zero CAC score defines patients who remain at low clinical risk despite the non-use of statin therapy. Thus, these new studies confirm the use of CAC scanning as a safe tool for reducing the potential overuse of statin therapy among patients with zero CAC scores. Incorporating these new data suggest the following best practice: (1) ascertain ASCVD risk according to the PCE in all patients; (2) following an initial attempt trial to lower ASCVD risk with optimal diet among patients with elevated ASCVD risk, initiate statin therapy for patients who have a high ASCVD risk score; (3) if the ASCVD score is intermediate, refer patients for CAC scanning; and (4) and if the CAC score is zero among the intermediate risk ASCVD patients, statin therapy can be safely withheld despite the presence of an elevated serum cholesterol level.

Keywords: cholesterol, cardiovascular disease, statin therapy, coronary calcium

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Authors: Laïd Boukraâ

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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.

Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds

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Authors: Oyuntsetseg Sandag, Lkhagvadorj Khosbayar, Naidansuren Tsendeekhuu, Densenbal Dansran, Bandi Solongo

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Introduction: Obstructive sleep apnea (OSA) is a common disorder affecting at least 2% to 4% of the adult population. It is estimated that nearly 80% of men and 93% of women with moderate to severe sleep apnea are undiagnosed. A number of screening questionnaires and clinical screening models have been developed to help identify patients with OSA, also it’s indeed to clinical practice. Purpose of study: Determine dependence of obstructive sleep apnea between for severe risk and risk factor. Material and Methods: A cross-sectional study included 114 patients presenting from theCentral state 3th hospital and Central state 1th hospital. Patients who had obstructive sleep apnea (OSA)selected in this study. Standard StopBang questionnaire was obtained from all patients.According to the patients’ response to the StopBang questionnaire was divided into low risk, intermediate risk, and high risk.Descriptive statistics were presented mean ± standard deviation (SD). Each questionnaire was compared on the likelihood ratio for a positive result, the likelihood ratio for a negative test result of regression. Statistical analyses were performed utilizing SPSS 16. Results: 114 patients were obtained (mean age 48 ± 16, male 57)that divided to low risk 54 (47.4%), intermediate risk 33 (28.9%), high risk 27 (23.7%). Result of risk factor showed significantly increasing that mean age (38 ± 13vs. 54 ± 14 vs. 59 ± 10, p<0.05), blood pressure (115 ± 18vs. 133 ± 19vs. 142 ± 21, p<0.05), BMI(24 IQR 22; 26 vs. 24 IQR 22; 29 vs. 28 IQR 25; 34, p<0.001), neck circumference (35 ± 3.4 vs. 38 ± 4.7 vs. 41 ± 4.4, p<0.05)were increased. Results from multiple logistic regressions showed that age is significantly independently factor for OSA (odds ratio 1.07, 95% CI 1.02-1.23, p<0.01). Predictive value of age was significantly higher factor for OSA (AUC=0.833, 95% CI 0.758-0.909, p<0.001). Our study showing that risk of OSA is beginning 47 years old (sensitivity 78.3%, specifity74.1%). Conclusions: According to most of all patients’ response had intermediate risk and high risk. Also, age, blood pressure, neck circumference and BMI were increased such as risk factor was increased for OSA. Especially age is independently factor and highest significance for OSA. Patients’ age one year is increased likelihood risk factor 1.1 times is increased.

Keywords: obstructive sleep apnea, Stop-Bang, BMI (Body Mass Index), blood pressure

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Authors: Anu S. Nair, V. Anantha Subramanian

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This paper presents a surface development and fairing technique combining the features of a modern computer-aided design tool namely the Non-Uniform Rational Basis Spline (NURBS) with an algorithm to obtain a rapidly faired hull form. Some of the older series based designs give sectional area distribution such as in the Wageningen-Lap Series. Others such as the FORMDATA give more comprehensive offset data points. Nevertheless, this basic data still requires fairing to obtain an acceptable faired hull form. This method uses the input of sectional area distribution as an example and arrives at the faired form. Characteristic section shapes define any general ship hull form in the entrance, parallel mid-body and run regions. The method defines a minimum of control points at each section and using the Golden search method or the bisection method; the section shape converges to the one with the prescribed sectional area with a minimized error in the area fit. The section shapes combine into evolving the faired surface by NURBS and typically takes 20 iterations. The advantage of the method is that it is fast, robust and evolves the faired hull form through minimal iterations. The curvature criterion check for the hull lines shows the evolution of the smooth faired surface. The method is applicable to hull form from any parent series and the evolved form can be evaluated for hydrodynamic performance as is done in more modern design practice. The method can handle complex shape such as that of the bulbous bow. Surface patches developed fit together at their common boundaries with curvature continuity and fairness check. The development is coded in MATLAB and the example illustrates the development of the method. The most important advantage is quick time, the rapid iterative fairing of the hull form.

Keywords: computer-aided design, methodical series, NURBS, ship design

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Authors: Hamed Seddighi Khavidak

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Voluntary work has a lot of economic and social benefits for a country, but the economic value is ignored because it is voluntary. The aim of this study is reviewing Monetary Value of Voluntary Work methods and comparing opportunity cost method and replacement cost method both in theory and in practice. Beside monetary value, in this study, we discuss cost-benefit analysis of health and safety plan in the New Year that conducted by young volunteers of Red Crescent society of Iran. Method: We discussed eight methods for monetary value of voluntary work including: Alternative-Employment Wage Approach, Leisure-Adjusted OCA, Volunteer Judgment OCA, Replacement Wage Approach, Volunteer Judgment RWA, Supervisor Judgment RWA, Cost of Counterpart Goods and Services and Beneficiary Judgment. Also, for cost benefit analysis we drew on 'value audit and volunteer investment' (VIVA) technique that is used widely in voluntary organizations like international federation of Red Cross and Red Crescent societies. Findings: In this study, using replacement cost approach, voluntary work by 1034 youth volunteers was valued 938000000 Riyals and using Replacement Wage Approach it was valued 2268713232 Riyals. Moreover, Yazd Red Crescent Society spent 212800000 Riyals on food and other costs for these volunteers. Discussion and conclusion: In this study, using cost benefit analysis method that is Volunteer Investment and Value Audit (VIVA), VIVA rate showed that for every Riyal that the Red Crescent Society invested in the health and safety of New Year's travelers in its volunteer project, four Riyals returned, and using the wage replacement approach, 11 Riyals returned. Therefore, New Year's travelers health and safety project were successful and economically, it was worthwhile for the Red Crescent Society because the output was much bigger than the input costs.

Keywords: voluntary work, monetary value, youth, red crescent society

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Authors: Miriam Colleran, Barbara Sheehy-Skeffington

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Background: To explore if there are unique features in the palliative care needs of patients with intellectual disability that may impact on planning for resource and service provision for them. Aim: The purpose of this practice review is to assess the indications for, numbers of and outcomes of care for adults with intellectual disabilities referred to a specialist palliative care service over a twoyear period. Service utilization aspects considered included the frequency of home visits by a specialist palliative care doctor or clinical nurse specialist and the number of hospice admissions that occurred for the patients. Method: A retrospective review was carried out of persons 18 years and older with intellectual disabilities referred to a specialist palliative care service over a 5-year period from 30.11.3018 to 29.11.2023. A manual review was carried out of the register using key terms, namely, known residential care and community dwelling places of service providers for persons with intellectual disabilities in the area and registered diagnoses in addition to the patients known to the clinicians who had intellectual disabilities. Results: 25 referrals were made to the specialist palliative care service of 23 persons with intellectual disabilities during that time. However, this may be an underestimate. 15 women and 8 men were referred with an age range of 19 to 86 years of age. The majority had a diagnosis of Down’s syndrome or Trisomy 21. 5 patients referred did not have home visits from the specialist palliative care team. A range of 2 to 48 phone calls per person occurred by the specialist palliative care team regarding this cohort of patients. The outcomes for the patients included discharge and death. The majority of patients that died, did so in the community. One person however died in hospital. Another person died in a hospice out of area. Conclusion: Providing specialist palliative care for adults with intellectual disabilities is an important element of palliative care. The dominance of the community as the place of death for these patients and the limited number of patients dying in either hospice or hospital are noteworthy. Further research is necessary and education to inform, support, and empower specialist palliative care professionals in optimizing palliative and end-of-life care for persons with intellectual disabilities and to inform service development and provision.

Keywords: about intellectual disability, palliative care

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Authors: Hadas Hirsch

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Clothing is aimed at concealing and revealing the body, protecting it, and manifesting religious, political, and social declarations. The material and symbolic meanings of clothing and its raw materials are evaluated through the context of their social, cultural, and religious systems. The raw materials for clothing that were frequent and familiar in the 7th century Arab Peninsula were wool, leather, cotton, and some kinds of silk. The spread of the Muslim empire and the intersections with other religions and cultures enable the trickling of new raw materials that were unknown to Muslims or unaccepted. The sources for this research are hadith collections that discuss in details various kinds of textiles and their origin, together with a legal explanation that permits or prohibits its use. The paper will describe and analyze this discussion by contextualizing it in social, religious, and cultural reality that creates a structure of socio-religious dependency. The aim is not to identify, catalogue, and technically analyze fabrics but to reveal their role in Muslims’ life as a means of creating dependency for the community and setting borders inside and outside. The analysis is built upon a scale that starts with the most recommended raw materials, then comes the permitted ones and, in the end, the prohibited raw materials. This mapping will provide an insight into the ways textiles, as a cultural medium, help to shape and redefine identities and, at the same time, enable a sphere for creative expression within socio-cultural and religious limits and context. To sum up, hadith literature has the main role is characterizing Muslim clothing, from garments to textiles and colors, including multiple variations and contradicting aspects. The Muslim style of clothing and, in particular, textiles is a manifestation of the socio-religious structure of dependency that creates differentiated Muslim identity together with subdivision of gendered groups. Some other aspects are the tension between authenticity and imitation and the jurists’ pragmatic and practice attitude that enables an individual sphere of expression within the limits of jurisprudence.

Keywords: Hadith, jurisprudence, medieval Islam, material culture

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Authors: Md. Rezaul Karim, Andreas Thiel

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Bangladesh is known as one of the most climate vulnerable countries in the world. Innovative technologies are always the key responses to the management of climate impacts. The objectives of this study are to determine the farmer’s perception of climate variability, to compare farmers’ perceptions with metrological data, and to explore the determinants that affect the likelihood of adoption of the selected Climate Smart Agricultural (CSA) technologies. Data regarding climate change perception, determinants and adoption were collected based on the household survey from stratified and randomly selected 365 farmers of the Biral sub-district under Dinajpur district in drought-prone northern Bangladesh. The likelihood of adoption of CSA technologies was analyzed following a multivariate probit model. The findings show that about 82.5% of the farmers perceived increasing temperature, and 75.1 % of farmers perceived decreasing dry season rainfall over the years, which is similarly relevant to metrological data. About 76.4.7% and 80.85% of farmers were aware of the drought tolerance crops and vermicompost, respectively; more than half of the farmers adopted these practices. Around 70.7% of farmers were aware of perching for insect control, but 46.3% of farmers adopted this practice. Although two-thirds of farmers were aware of crop diversification and pheromone trap, adoption was lower compared to the other three CSAs. Results also indicate that the likelihood of adoption of the selected CSAs is significantly influenced by different factors such as socio-economic characteristics, institutional factors and perceived technological or innovation attributes. The likelihood of adopting drought tolerance crops is affected by 11, while crop diversification and perching method by 7, pheromone trap by 9 and vermicompost by 8 determining factors. Lack of information and unavailability of input appear to be major obstacles to the non-adoption of CSA technologies. This study suggests that policy implications are necessary to promote extension services and overcome the obstacles to the non-adoption of individual CSA technologies. It further recommends that the research study should be conducted in a diverse context, nationally or globally.

Keywords: determinants, adoption, climate smart agriculture, northern Bangladesh

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Authors: Amol Rakhunde, Namdeo Hedaoo

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Cold bituminous emulsion mixes (CBEM) are preferred due to their low cost for the construction of low volume roads in India. Due to the low strength of CBEM’s, the strength is generally increased by the addition of Ordinary Portland Cement (OPC) and hydrated lime. To improve the performance of CBEM’s, the use of industrial waste material is also an alternative. Steel slag is by product of steel industry which is sustainable construction material. Due to limited modes of practice of utilization steel slag, huge amount of steel slag dumped in yards of each steel industry and engaging of important agricultural land and gave pollution to whole environment. The effective use of steel slag as additives in CBEM’s has ultimate benefits such improvement in strength of CBEM’s, waste disposal steel slag, saving natural aggregate and lowering cost of roadways. Studies carried out in the past have shown a significant improvement in the strength of CBEM’s prepared with the replacement of natural aggregate with industrial waste materials such as fly ash and ground granulated blast furnace slag. In this study, effect of modified mix which is mixes prepared with steel slag compared with the control mix and the mixes prepared with OPC. Experimental work was carried out on the sample of control mix, OPC mix, and modified mix. For modified mix, aggregate was replaced with steel slag by 10%, 20%, 30% and 40% of weight of aggregate of same size as of steel slag in aggregate gradation. For OPC mix, filler was replaced by 1%, 2% and 3% of weight of total aggregate with OPC. Optimum emulsion content of each mix obtained by using Marshall stability test and comparison of stability values were carried out. Marshall stability, indirect tensile strength test, and retained stability tests are performed on control mixes, OPC mixes and modified mixes. Significant improvement in Marshall stability retained stability and indirect tensile strength of modified mix compared to control mix and OPC mix.

Keywords: CBEM, indirect tensile strength test, Marshall stability test, OPC, optimum emulsion content, retained stability test, steel slag

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Authors: Li-Fang CHou, Chun-Jung Tseng, Sung-Chun Tsai

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Zhong-Yong represents unique values and cognitive beliefs of Chinese culture. Zhong-Yong thinking emphasizes (a) holistic thinking and perspective taking, (b) tolerance of contradictions, and (c) pursuance of a person’s interpersonal and inner harmony. With a unique way of naïve dialectical thinking based on Chinese culture, previous studies have found that people with higher Zhong-Yong thinking have more cognitive resources and resilience to make decision for dilemmas and cope stresses. Creativity is defined as the behavior to create novel and value products and viewed as the most important capital for individuals and enterprises. However, the relationship between Zhong-Yong thinking and creativity is still remaining to be unexplored. Three studies were conducted to explore the effects of Zhong-Yong thinking on creativity. In Study1, with 87 undergraduate students from a university in southern Taiwan as participants, we used questionnaire to measure Zhong-Yong thinking and processed creative task (unusual uses task) to get indicators of fluency and flexibility. After controlling background and openness to experience of Big five, the results showed that Zhong-Yong thinking had significant positive effects on fluency and flexibility. In Study 2, 97 undergraduate students were recruited to do Zhong-Yong thinking task and creative task. The result showed that, compared with control group, the participants had higher creative performance after being primed with Zhong-Yong thinking. In Study 3, we adopted questionnaire survey and took 397 employees from private enterprises in Taiwan as sample. Besides the main effects of Zhong-Yong thinking, the moderating effects on the relationship between leadership behavior and employee’s creative performance were also investigated. We found that (a) Zhong-Yong thinking was positively associated to creative performance; (b) Zhong-Yong thinking strengthened the positive effects of transformational and authoritative leadership on creative performance. Finally, the implications of theory/practice and limitations/future directions were also discussed.

Keywords: Zhong-Yong thinking, creativity and creative performance, unusual uses task, transformational leadership, authoritative leadership

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Authors: Jeffrey Chase

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Historically the profession of Occupational Therapy was closely tied to the treatment of those suffering from mental illness; more recently, and especially in the U.S., the percentage of OTs identifying as working in the mental health area has declined significantly despite the estimate that by 2020 behavioral health disorders will surpass physical illnesses as the major cause of disability worldwide. In the U.S. less than 10% of OTs identify themselves as working with the mentally ill and/or practicing in mental health settings. Such a decline has implications for both those suffering from mental illness and the profession of Occupational Therapy. One reason cited for the decline of OT in mental health has been the limited research in the discipline addressing mental health practice. Despite significant advances in technology and growth in the field of neuroscience, major institutions and funding sources such as the National Institute of Mental Health (NIMH) have noted that research into the etiology and treatment of mental illness have met with limited success over the past 25 years. One major reason posited by NIMH is that research has been limited by how we classify individuals, that being mostly on what is observable. A new classification system being developed by NIMH, the Research Domain Criteria (RDoc), has the goal to look beyond just descriptors of disorders for common neural, genetic, and physiological characteristics that cut across multiple supposedly separate disorders. The hope is that by classifying individuals along RDoC measures that both reliability and validity will improve resulting in greater advances in the field. As a result of this change NIH and NIMH will prioritize research funding to those projects using the RDoC model. Multiple disciplines across many different setting will be required for RDoC or similar classification systems to be developed. During this shift in research methodology OT has an opportunity to reassert itself into the research and treatment of mental illness, both in developing new ways to more validly classify individuals, and to document the legitimacy of previously ill-defined and validated disorders such as sensory integration.

Keywords: global mental health and neuroscience, research opportunities for ot, greater integration of ot in mental health research, research and funding opportunities, research domain criteria (rdoc)

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Authors: Nizamuddin Khan

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Integrated livestock and cropping system is very old agricultural practice since antiquity. It is an eco-friendly and sustainable farming system in which both the resources are optimally and rationally utilized through the recycling and re-utilization of their by-products. Indian farmers follow in- farm integrated farming system unlike in developed countries where both farm and off-farm system prevailed. The data on different components of the integrated farming system is very limited and that too is not widely available in published form. The primary source is the only option for understanding the mechanism, process, evaluation and performance of integrated livestock cropping system. Researcher generated data through the field survey of sampled respondents from sampled villages from Bulandshahr district of Uttar Pradesh. The present paper aims to understand the component group of system, degree, and level of integration, level of generation of employment, income, improvement in farm ecology, the economic viability of farmers and check in rural-urban migration. The study revealed that area witnessed intra farm integration in which both livestock and cultivation of crops take place on the same farm. Buffalo, goat, and poultry are common components of integration. Wheat, paddy, sugarcane and horticulture are among the crops. The farmers are getting 25% benefit more than those who do not follow the integrated system. Livestock husbandry provides employment and income through the year, especially during agriculture offseason. 80% of farmers viewed that approximately 35% of the total expenditure incurred is met from the livestock sector. Landless, marginal and small farmers are highly benefited from agricultural integration. About 70% of farmers acknowledged that using wastes of animals and crops the soil ecology is significantly maintained. Further, the integrated farming system is helpful in reducing rural to urban migration. An incentive with credit facilities, assured marketing, technological aid and government support is urgently needed for sustainable development of agriculture and farmers.

Keywords: integrated, recycle, employment, soil ecology, sustainability

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Authors: Anshar Ajatasatru

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The decline of coal prices over past years have been significantly increasing the awareness of effective mining operation. A viable step must be undertaken in becoming more cost competitive while striving for best mining practice especially at Melak Coal Mine in East Kalimantan, Indonesia. This paper aims to show how effective dozer push measurement method can be implemented as it is controlled by contract rate on the unit basis of USD ($) per bcm. The method emerges from an idea of daily dozer push activity that continually shifts the overburden until final target design by mine planning. Volume calculation is then performed by calculating volume of each time overburden is removed within determined distance using cut and fill method from a high precision GNSS system which is applied into dozer as a guidance to ensure the optimum result of overburden removal. Accumulation of daily to weekly dozer push volume is found 95 bcm which is multiplied by average sell rate of $ 0,95, thus the amount monthly revenue is $ 90,25. Furthermore, the payment mechanism is then based on push distance and push grade. The push distance interval will determine the rates that vary from $ 0,9 - $ 2,69 per bcm and are influenced by certain push slope grade from -25% until +25%. The amount payable rates for dozer push operation shall be specifically following currency adjustment and is to be added to the monthly overburden volume claim, therefore, the sell rate of overburden volume per bcm may fluctuate depends on the real time exchange rate of Jakarta Interbank Spot Dollar Rate (JISDOR). The result indicates that dozer push measurement can be one of the surface mining alternative since it has enabled to refine method of work, operating cost and productivity improvement apart from exposing risk of low rented equipment performance. In addition, payment mechanism of contract rate by dozer push operation scheduling will ultimately deliver clients by almost 45% cost reduction in the form of low and consistent cost.

Keywords: contract rate, cut-fill method, dozer push, overburden volume

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Authors: Ana Cristina Lindsay, Sherrie Wallington, Faith Lees, Mary Greaney

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Purpose: Latino children in low-income families are at elevated risk of becoming overweight or obese. The purpose of this study was to examine low-income Latino parents’ beliefs, parenting styles and practices related to their children’s eating and physical activity behaviors while at home. Design and Methods: Qualitative study using focus group discussions with 33 low-income Latino parents of preschool children 2 to 5 years of age. Transcripts were analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and physical activity for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment influences low-income Latino preschool children’s eating and physical activity habits. This information is useful for pediatric nurses in their health promotion and disease prevention efforts with low-income Latino families with young children, and for the development of home-based and parenting interventions to prevent and control childhood obesity among this population group. Practice Implications: Pediatric nurses can facilitate communication, provide education, and offer guidance to low-income Latino parents that support their children’s development of early healthy eating and physical activity habits, while taking into account daily life barriers faced by families. Moreover, nurses can play an important role in the integration and coordination of home-visitation to complement office-based visits and provide a continuum of care to low-income Latino families.

Keywords: home environment, Latino, obesity, parents, healthy eating, physical activity

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Authors: Saima Murtaza

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Ethics and aesthetics have invariably remained the two closely integrated artistic appurtenances for the production of any work of art. These artistic devices configure themselves into a complex synthesis in our contemporary literature. The labyrinthine integration of ethics and aesthetics, operating in the lives of human characters, to the extent of transcending all limits has resulted in an artistic puzzle for the readers. Art, no doubt, is an extrinsic expression of the intrinsic life of man. The use of aesthetics in literature pertaining to human existence; aesthetic solipsism, has resulted in the artistic objectification of these characters. The practice of the like aestheticism deprives the characters of their souls, rendering them as mere objects of aesthetic gaze at the hands of their artists-creators. Artists orchestrate their lives founding it on a plot which deviates from normal social and ethical standards. Their perverse attitude can be seen in dealing with characters, their feelings and the incidents of their lives. Morality is made to appear not as a religious construct but as an individual’s private affair. Furthermore, the idea of beauty incarnated, in other words hedonistic aesthetic does not placate a true aesthete. Ethics and aesthetics are the two most recurring motifs of our contemporary literature, especially of Nabokov’s world. The purpose of this study is to peruse these aforementioned motifs in Nabokov’s most enigmatic novel Lolita, a story of pedophilia, which is in fact reflective of our complex individual psychic and societal patterns. The narrative subverts all the traditional and hitherto known notions of aesthetics and ethics. When applied to literature, aesthetic does not simply mean ‘beautiful’ in the text. It refers to an intricate relationship between feelings and perception and also incorporates within its range wide-ranging emotional reactions to text. The term aesthetics in literature is connected with the readers whose critical responses to the text determine the merit of any work to be really a piece of art. Aestheticism is the child of ethics. Morality sets the grounds for the production of any work and the idea of aesthetics gives it transcendence.

Keywords: ethics, aesthetics and hedonistic aesthetic, nymphet syndrome, pedophilia

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Authors: Chen ChihYu, Tang Wen Tzu, Chen Kuang Hui

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Aim —To compare the dismount skill between Taiwanese and elite international gymnastics in parallel bars following the 2017-2020 code of points. Methods—The gymnasts who advanced to the parallel bars event finals of these four competitions including World Championships, Universiade, the National Games of Taiwan, and the National Intercollegiate Athletic Games of Taiwan both 2017 and 2019 were selected in this study. The dismount skill of parallel bars was analyzed, and the average difficulty score was compared by one-way ANOVA. Descriptive statistics were applied to present the type of dismount skill and the difficulty of each gymnast in these four competitions. The data from World Championships and Universiade were combined as the international group (INT), and data of Taiwanese National Games and National Intercollegiate Athletic Games were also combined as the national group (NAT). The differences between INT and NAT were analyzed by the Chi-square test. The statistical significance of this study was set at α= 0.05. Results— i) There was a significant difference in the mean parallel bars dismount skill in these four competitions analyzed by one-way ANOVA. Both dismount scores of World Championships and Universiade were significantly higher than in Taiwanese National Games and National Intercollegiate Athletic Games (0.58±0.08 & 0.56±0.08 > 0.42±0.06 & 40±0.06, p < 0.05). ii) Most of the gymnasts in World Championships and Universiade selected the 0.6-point skill as the parallel bars dismount element, and for the Taiwanese National Games and the National Intercollegiate Athletic Games, most of the gymnasts performed the 0.4-point dismount skill. iii) The result of the Chi-square test has shown that there was a significant difference in the selection of parallel bars dismount skill. The INT group used the E or E+ difficulty element as the dismount skill, and the NAT group selected the D or D- difficulty element. Conclusion— The level of parallel bars dismount in Taiwanese gymnastics is inferior to elite international gymnastics. It is suggested that Taiwanese gymnastics must try to practice the F difficulty dismount (double salto forward tucked with half twist) in the future.

Keywords: Artistic Gymnastics World Championships, dismount, difficulty score, element

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Authors: Armando T. Zúñiga

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As the number of English Language Learners (ELLs) in public schools continues to grow, so does the achievement gap between ELLs and other student populations. In an effort to support classroom teachers with effective instructional strategies for this student population, many districts have created instructional coaching positions specifically to support classroom teachers of ELLs—ELL Teachers on Special Assignment (ELL TOSAs). This study employed a gap analysis framework to the ELL TOSA professional support program in one California school district to examine knowledge, motivation, and organizational influences (KMO) on the ELL TOSAs’ goal of supporting classroom teachers of ELLs. Three themes emerged as a result of data analysis. First, there was evidence to illustrate the interaction between knowledge and the organization. Data from ELL TOSAs indicated an understanding of the role that collaboration plays in coaching and how to operationalize it in their support of teachers. Further, all of the ELL TOSAs indicated they have received professional development on effective strategies for instructional coaching. Additionally, a large percentage of the ELL TOSAs indicated a knowledge of modeling as an effective coaching practice. Accordingly, all of the ELL TOSAs indicated that they had knowledge of feedback as an effective coaching strategy. However, there was not sufficient evidence to support that they learned the latter two strategies through professional development. A second theme surfaced as there was evidence to illustrate an interaction between motivation and the organization. Some ELL TOSAs indicated that their sense of self-efficacy was affected by conflicting roles and expectations for the job. Most of the ELL TOSAs indicated that their sense of self-efficacy was affected by an increased workload brought about by fiscal decision making. Finally, there was evidence illustrating the interaction between the organization and motivation. The majority of the of ELL TOSAs indicated that there is confusion about how their roles are perceived, leaving the ELL TOSAs to feel that their actions did not contribute to instructional change. In conclusion, five research-based recommendations to support ELL TOSA goal attainment and considerations for future research on instructional coaches for classroom teachers of ELLs are provided.

Keywords: English language development, English language acquisition, language and leadership, language coaching, English language learners, second language acquisition

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Authors: Erinma Chibuzo Nwandu

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Graduates unemployment has risen astronomically in spite of the emphasis on teaching of small scale business and Entrepreneurship in schools. This study sets out to evaluate the effect of teaching small scale business and Entrepreneurship on graduates’ unemployment in Nigeria. This study adopted the survey research design. Thus the nature of data for this study is primary, sourced by the use of a questionnaire administered to a sample of two thousand and sixty-five (2065) respondents drawn from groups of graduates who are employed, unemployed and self-employed in South East Nigeria. Simple percentages, Chi-square and regression analysis were used to derive useful and meaningful information and test the hypotheses respectively. Findings from the study suggest that Nigeria graduates are ill prepared to embark on small-scale business and entrepreneurship after graduation, and that teaching of small scale business and entrepreneurship in Nigeria tertiary institutions is ineffective on graduate unemployment reduction. Findings also suggest that while a lot of graduates agreed that they have taken a class(s) on small scale or entrepreneurship, they received more theoretical teachings than practical, more so while teachings on small scale business or entrepreneurship motivated graduates to think of self-employment, most of them cannot do a good business plan and hence could not benefit from some kind of Government assisted program for small-scale business and bank loan for the sake of small scale business. Thus, so many graduates are not interested in small scale business or entrepreneurship development as a result of lack of startup capital. The study thus recommends that course content and teaching method of entrepreneurship education needs to be reviewed and re-structured to constitute more practical teachings than theoretical teachings. Also, graduates should be exposed to seminar /workshop for self-employment at least once every semester. There should be practical teaching and practice of developing a business plan that will be viable to attract government or private sponsorship as well for it to be viable to attract financing from financing institutions. Government should provide a fund such as venture capital financing arrangement to empower business startups in Nigeria by graduates’.

Keywords: entrepreneurship, small scale business, startup capital, unemployment

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Authors: Maria Inês Faria, João Miguel Simão

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Frequently, the Sustainable Development paradigm is considered the contemporary societies flag and is has been assuming different nuances on local and global dialogues. This reveals the ambivalent character associated to its implementation due, namely, to the kind of synergies that political institutions, social organizations and citizenry can actually create. The Sustainable Development concept needs further discussion so that it can be useful in decision-making processes. In fact, the polysemic nature of this concept has consistently undermined its credibility leading, among other factors, to the talk and action gap, as well as to misappropriations of this notion. The present study focuses on the importance in questioning the sustainable development operationalization, "To walk the talk", and intends, in a broad sense, identify prospects and the elements of sustainability that are included in strategic plans (global, national and local) and, in the strict sense, confront discourse and practice in the context of local public policies for sustainable development, in particular with regard to the implementation of Local Agenda 21 in the municipality of Beja (Portugal) in order to analyze at what extent the strategies adopted and implemented are aligned with the paradigm of sustainable development. The method is based on critical analysis of literature and official documentation, using three complementary approaches: a) exploratory review of literature in order to identify publications on sustainability and sustainable development; b) this second approach complements the first, focused on the official documentation for the adoption and implementation of sustainable development, which is produced in the global plan, regional, national and local levels; c) and the approach which is focused on official documentation that expresses the policy options, the strategic lines and actions for sustainable development implementation Beja´s Municipality. The main results of this study highlight the type of alignment of the Beja´s Municipality sustainable policies, concerning the officially stipulated for the promotion of sustainable development on the international agenda, stressing the potentialities, constraints and challenges of Agenda 21 Local implementation.

Keywords: sustainable development, Local Agenda 21, sustainable local public policies, Beja

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Authors: Jodie Bradshaw, Rebecca Dooley, Habib Kadiri, Holly Bird, Aaliyah Felix-West, Udit Mahalingam, Ella Thomson

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The sharp rise of civil orders has led to an expansion of police powers, particularly in the realm of stop and search activities. The broad scope and objectives of these civil orders –addressing issues as varied as public safety, crime prevention, and counter-terrorism – has led to ‘mission-creep’, whereby orders were being imposed in a wider range of contexts than initially intended. The ever-widening purview of civil orders in practice necessitates proactive measures by law enforcement which often rely heavily on the utilisation of stop and search, leading to an expansion of stop and search practices and the regulation of public space. Civil liberties organisations, criminal justice and legal practitioners, activist groups, and researchers have argued that civil orders dilute and undermine foundational legal principles, pose a threat to our basic rights and freedoms, facilitate dangerous criminal justice net-widening, and disproportionately target young, working-class people of colour. Many of the provisions in these orders are potentially incompatible with the right to liberty and security. The conditions of an order (whether negative restrictions or positive obligations) tend to be extremely easy to breach –and in some cases, almost impossible for the person subject to the order not to breach. When the conditions of an order are breached, the result is criminal punishment – often in the form of imprisonment. This paper argues that civil orders set people up to fail, sending them down a path towards incarceration and the ultimate deprivation of liberty. The proclaimed intentions underpinning these civil orders – to tackle purportedly ‘undesirable’ behaviour (which in and of itself is not a crime) committed by ‘undesirable’ people – paves the way for justifying violent and racially disproportionate policing practices.

Keywords: civil orders, policing, stop and search, crime, civil liberties, criminal punishment, anti-social behaviour

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Authors: Fariha Salman, Helmet Steinberg, Hiba Al-Zubeidi

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OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common cause of infertility, with a prevalence of 5-10 % in women of reproductive age. There is evidence for differences between adult and pediatric endocrinologists and other specialists in their approach to the diagnosis and management of PCOS. METHODS: A survey consisting of 37 questions was distributed among adult and pediatric endocrinologists, aiming to understand the current practice for the diagnosis and management of PCOS. A total of 100 responses were available for final analysis; 36 % from adult endocrinologists (AE) and 64 % from pediatric endocrinologists(PE). RESULTS: The majority (64%) of respondents to the survey were endocrinologists from a multispecialty group. For both adults and adolescents with PCOS, the most commonly reported presenting symptoms were menstrual irregularities, obesity and hirsutism. The most common features used for diagnostic criteria were clinical or biochemical hyperandrogenism and ovulatory dysfunction. Most AE and PE screened for PCOS with total testosterone (83%) and free Testosterone (71%), screening for prolactin excess in 70 % and congenital adrenal hyperplasia (83 %), 66 % of AE will obtain pelvic US for evaluation vs 45 % of PE. Only 20 % of all respondents will obtain a midluteal progesterone for documentation of anovulation. In terms of treatment of hyperandrogenism and menstrual irregularities in adolescents, the most common form used is oral contraceptive pills, followed by metformin, then spironolactone. A similar approach was used in adults however the use of spironolactone was higher, 53 % vs 21 % in adolescents. The most common modality used for infertility was lifestyle interventions followed by metformin and clomiphene citrate. Screening of OSA and depression was not done by most of the endocrinologists (never + sometimes), 72 % and 76 %, respectively. Though screening for diabetes/metabolic syndrome and insulin resistance was done by most of the endocrinologists (always+often), 95 and 68 %, respectively. DISCUSSION: There are multiple diagnostic criteria used for PCOS diagnosis, however, given the wide variation in presentation and approach to diagnosis in adults and adolescents, there has not been a consensus on which is the gold standard criteria. CONCLUSION: Our survey showed the most common trends in diagnosing and treating PCOS among adult and pediatric endocrinologists. Further studies and trials need to be conducted to compare different treatment modalities used for hyperandrogenism, menstrual irregularities and infertility, as PCOS, if not treated earlier, can lead to long-term complications.

Keywords: PCOS, adolescents, diagnosis, treatment

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Authors: Pavel Borodkin, Nikolay Khrennikov, Azamat Gazetdinov

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The problem of ensuring of VVER type reactor equipment integrity is now most actual in connection with justification of safety of the NPP Units and extension of their service life to 60 years and more. First of all, it concerns old units with VVER-440 and VVER-1000. The justification of the VVER equipment integrity depends on the reliability of estimation of the degree of the equipment damage. One of the mandatory requirements, providing the reliability of such estimation, and also evaluation of VVER equipment lifetime, is the monitoring of equipment radiation loading parameters. In this connection, there is a problem of justification of such normative parameters, used for an estimation of the pressure vessel metal embrittlement, as the fluence and fluence rate (FR) of fast neutrons above 0.5 MeV. From the point of view of regulatory practice, a comparison of displacement per atom (DPA) and fast neutron fluence (FNF) above 0.5 MeV has a practical concern. In accordance with the Russian regulatory rules, neutron fluence F(E > 0.5 MeV) is a radiation exposure parameter used in steel embrittlement prediction under neutron irradiation. However, the DPA parameter is a more physically legitimate quantity of neutron damage of Fe based materials. If DPA distribution in reactor structures is more conservative as neutron fluence, this case should attract the attention of the regulatory authority. The purpose of this work was to show what radiation load parameters (fluence, DPA) on all VVER equipment should be under control, and give the reasonable estimations of such parameters in the volume of all equipment. The second task is to give the conservative estimation of each parameter including its uncertainty. Results of recently received investigations allow to test the conservatism of calculational predictions, and, as it has been shown in the paper, combination of ex-vessel measured data with calculated ones allows to assess unpredicted uncertainties which are results of specific unique features of individual equipment for VVER reactor. Some results of calculational-experimental investigations are presented in this paper.

Keywords: equipment integrity, fluence, displacement per atom, nuclear power plant, neutron activation measurements, neutron transport calculations

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