Search results for: post disasters

Authors: S. Khakurel, R. P. Dhakal, T. Z. Yeow

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Downtime is one of the major sources (alongside damage and injury/death) of financial loss incurred by a structure in an earthquake. The length of downtime associated with a building after an earthquake varies depending on the time taken for the reaction (to the earthquake), decision (on the future course of action) and execution (of the decided course of action) phases. Post-earthquake assessment of buildings is a key step in the decision making process to decide the appropriate safety placarding as well as to decide whether a damaged building is to be repaired or demolished. The aim of the present study is to develop a model to quantify downtime associated with the post-earthquake building-assessment phase in terms of two parameters; i) duration of the different assessment phase; and ii) probability of different colour tagging. Post-earthquake assessment of buildings includes three stages; Level 1 Rapid Assessment including a fast external inspection shortly after the earthquake, Level 2 Rapid Assessment including a visit inside the building and Detailed Engineering Evaluation (if needed). In this study, the durations of all three assessment phases are first estimated from the total number of damaged buildings, total number of available engineers and the average time needed for assessing each building. Then, probability of different tag colours is computed from the 2010-11 Canterbury earthquake Sequence database. Finally, a downtime model for the post-earthquake building inspection phase is proposed based on the estimated phase length and probability of tag colours. This model is expected to be used for rapid estimation of seismic downtime within the Loss Optimisation Seismic Design (LOSD) framework.

Keywords: assessment, downtime, LOSD, Loss Optimisation Seismic Design, phase length, tag color

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Authors: Aminul Haque, Quazi Zahangir Hossain, Dilshad Sharmin Chowdhury

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The human migration is getting growing concern around the world, and recurrent disasters and climate change impact have great influence on migration. Bangladesh is one of the disaster prone countries that/and has greater susceptibility to stress migration by recurrent disasters and climate change. The study was conducted to investigate the factors that have a strong influence on current migration and changing pattern of life and livelihood means of the southwest coastal part of Bangladesh. Moreover, the study also revealed a strong relationship between disasters and migration and appropriate policy concern. To explore this relation, both qualitative and quantitative methods were applied to a questionnaire survey at household level and simple random sampling technique used in the sampling process along with different secondary data sources for understanding policy concern and practices. The study explores the most influential driver of migration and its relationship with social, economic and environmental drivers. The study denotes that, the environmental driver has a greater effect on the intention of permanent migration (t=1.481, p-value=0.000) at the 1 percent significance level. The significant number of respondents denotes that abrupt pattern of cyclone, flood, salinity intrusion and rainfall are the most significant environmental driver to make a decision on permanent migration. The study also found that the temporary migration pattern has 2-fold increased compared to last ten (10) years. It also appears from the study that environmental factors have a great implication on the changing pattern of the occupation of the study area and it has reported that about 76% of the respondent now in the changing modality of livelihood compare to their traditional practices. The study bares that the migration has foremost impact on children and women by increasing hardship and creating critical social security. The exposure-route of permanent migration is not smooth indeed, these migrations creating urban and conflict in Chittagong hill tracks of Bangladesh. The study denotes that there is not any safeguard of the stress migrant on existing policy and not have any measures for safe migration and resettlement rather considering the emergency response and shelter. The majority of (98%) people believes that migration is not to be the adoption strategies, but contrary to this young group of respondent believes that safe migration could be the adaptation strategy which could bring a positive result compare to the other resilience strategies. On the other hand, the significant number of respondents uttered that appropriate policy measure could be an adaptation strategy for being the formation of a resilient community and reduce the migration by meaningful livelihood options with appropriate protection measure.

Keywords: environmental driver, livelihood, migration, resilience

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Authors: Summer Jackson

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September 11, 2001 terrorist attacks exposed weaknesses in federal law enforcement’s ability to proactively counter threats to American homeland security. Following the attacks, legislative reforms and policy changes cleared both bureaucratic and legal obstacles to anti-terrorism efforts. The Federal Bureau of Investigation (FBI) transformed into a domestic intelligence agency responsible for preventing future terrorist attacks. Likewise, the passage of the 2001 USA Patriot Act gave federal agents new discretionary powers to more easily collect intelligence on those suspected of supporting terrorism. Despite these changes, there has been only limited scholarly attention paid to terrorism responses by the federal criminal justice system. This study sought to examine the investigative and prosecutorial changes made in the Post-9/11 era. The methodology employed bivariate and multivariate statistics using data from the American Terrorism Study (ATS). This analysis examined how policy changes are reflected in the nature of terrorism investigations, the handling of terrorist defendants by federal prosecutors, and the outcomes of terrorism cases since 2001. The findings indicate significant investigative and prosecutorial changes in the Post-9/11 era. Specifically, this study found terrorism cases involved younger defendants, fewer indictees per case, less use of human intelligence, less complicated attacks, less serious charges, and more plea bargains. Overall, this study highlights the important shifts in responses to terrorism following the 9/11 attacks.

Keywords: terrorism, law enforcement, post-9/11, federal policy

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Authors: Amanda Coleman, Estefanía Gonzalez

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Empathy is considered an essential skill for engaging with social work clients. Drawing from developments in medical education, researchers will conduct and evaluate a three-part pilot theatre workshop with master level social work students (n ≈ 30) to evaluate the workshop's ability to enhance empathy among participants. Outcomes will be measured using semi-structured post-intervention interviews with a subset of participants (n ≈ 10) as well post-intervention written reflections and pre-and-post intervention quantitative evaluation of empathy using King and Holosko’s 2011 Empathy Scale for Social Workers. The content of the workshop will differ from traditional role plays, which are common in social work education, in that it will draw from role theory and research on creative empathy to emphasize role reversal with clients. Workshops will be held February and March of 2017 with preliminary findings available by April.

Keywords: education, empathy, social work, theatre

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Authors: Ashwini Patil

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Caudal block is one of the most commonly used regional anesthetic techniques in children. Currently, fentanyl is used as an adjuvant to bupivacaine to prolong analgesia but fentanyl is a narcotic. Dexamethasone, a glucocorticoid with strong anti-inflammatory effects provides improvement in post-operative analgesia and post-operative side effects. However, its analgesic efficacy and safety in comparison with fentanyl has not been extensively studied. So the objective of this randomized controlled study is to compare dexamethasone with fentanyl as an adjuvant to bupivacaine for caudal block in children in relation to the duration of caudal analgesia, post-operative analgesic requirement and incidence of post-operative nausea and vomiting. This study included 100 children, aged 1–6 years, undergoing lower abdominal surgeries. Patients were randomized into two groups, 50 each to receive a combination of dexamethasone 0.2 mg/kg along with 1 ml/kg bupivacaine 0.25% (group A) or combination of fentanyl (1 ug/kg) along with 1ml/kg bupivacaine 0.25% (group B). In the post-operative period, pain was assessed using a Modified Objective Pain Scale (MOPS) until 12 hr after surgery and rescue analgesia is administered when MOPS score 4 or more is recorded. Residual motor block, number of analgesic doses required within 24 hr after surgery, sedation scores, intra-operative and post-operative hemodynamic variables, post-operative nausea and vomiting (PONV), and other adverse effects were recorded. Data is analysed using unpaired t test and Significance level of P< 0.05 is considered statistically significant. Group A showed a significantly longer time to first analgesic requirement than group B (p<0.05). The number of rescue analgesic doses required in the first 24 h was significantly less in group A (p<0.05). Group A showed significantly lower MOPS scores than group B(p<0.05). Intra-operative and post-operative hemodynamic variables, Modified Bromage Scale scores, and sedation scores were comparable in both the groups. Group A showed significantly fewer incidences of PONV compared with group B(p<0.05). This study reveals that adding dexamethasone to bupivacaine prolongs the duration of postoperative analgesia and decreases the incidence of PONV as compared to combination of fentanyl to bupivacaine after a caudal block in pediatric patients.

Keywords: bupivacaine, caudal analgesia, dexamethasone, pediatric

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Authors: Anjali Kanagali, Astha Sinha

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Climate change is the greatest threat being faced by mankind in the 21st century. It no longer is merely an environmental, scientific or economic issue but is a humanitarian issue as well. Paris Agreement put great pressure on the businesses to reduce carbon emissions and mitigate the impact of climate change. However, the already increased climate variability and extreme weather are aggravating emergency humanitarian needs. According to the Intergovernmental Panel on Climate Change (IPCC), if efficient policy changes are not made in time to combat the climate change issues, the situation will deteriorate with an estimated global temperature rise of 4 degrees. The existing international network of Humanitarian system is not adequately structured to handle the projected natural disasters and climate change crisis. The 2030 Agenda which embraces the 17 Sustainable Development Goals (SGDs) discussed the relationship between the climate change and humanitarian assistance. The Humanitarian law aims to protect, amongst other things, ‘internally displaced persons’ which includes people displaced due to natural hazard related disasters engulfing the hazards of climate change. ‘Legal protection’ of displaced people to protect their rights is becoming a pressing need in such times. In this paper, attempts will be made to analyze the causes of the displacement, identify areas where the effect of the climate change is most likely to occur and to examine the character of forced displacement triggering population movement. We shall discuss the pressure on the Humanitarian system and assistance due to climate change issues and the need for vesting powers to the local communities or local government players to deal with the climate changes. We shall also discuss the possibility of setting up a new framework where non-state actors could be set up for climate change impact and its governance.

Keywords: humanitarian assistance to climate change, humanitarian crisis, internally displaced person, legal framework for climate migrants, non-state actors

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Authors: Hania Pasandi

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Over his first three films, Abdellatif Kechiche established himself as one of the most celebrated directors at work in twenty-first-century French cinema. While his first three movies, La Faute à Voltaire (2000), L’Esquive (2003), and La Graine et le mulet (2007) tell stories about individuals of the Maghrebi origin or descent struggling to find their place in the contemporary French Republic, his 2010’s movie, Vénus noire (2010) recounts the true story of the so-called ‘Hottentot Venus’, Saartjie Baartman, who became famous after her stage appearances in London and Paris in the early eighteenth century. The movie shows the complex ways in which gender and ethnicity can combine in exclusionary discourse. This paper studies gender and racial identities, the irony of science theorisation about ethnicities through the male colonial gaze on a heavily exhibited woman. This paper explores how Vénus Noire engages the spectator’s own corporeal awareness of violence and calls attention to the othering practices of (post)colonial times.

Keywords: gender, (post)colonial gaze, other, violence

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Authors: Siddarth Kannan

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Objectives: Deep Brain Stimulation (DBS) and Motor Cortex stimulation (MCS) are innovative interventions in order to treat various neuropathic pain disorders such as post-stroke pain. While each treatment has a varying degree of success in managing pain, comparative analysis has not yet been performed, and the success rates of these techniques using validated, objective pain scores have not been synthesised. The aim of this study was to compare the effect of pain relief offered by MCS and DBS on patients with post-stroke pain and to assess if either of these procedures offered better results. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPEROID CRD42021277542). Three databases were searched, and articles published from 2000 to June 2023 were included (last search date 25 June 2023). Meta-analysis was performed using random effects models. We evaluated the performance of DBS or MCS by assessing studies that reported pain relief using the Visual Analogue Scale (VAS). Data analysis of descriptive statistics was performed using SPSS (Version 27; IBM; Armonk; NY; USA). R statistics (Rstudio Version 4.0.1) was used to perform meta-analysis. Results: Of the 478 articles identified, 27 were included in the analysis (232 patients- 117 DBS & 115 MCS). The pooled number of patients who improved after DBS was 0.68 (95% CI, 0.57-0.77, I2=36%). The pooled number of patients who improved after MCS was 0.72 (95% CI, 0.62-0.80, I2=59%). Further sensitivity analysis was done to include only studies with a minimum of 5 patients in order to assess if there was any impact on the overall results. Nine studies each for DBS and MCS met these criteria. There seemed to be no significant difference in results. Conclusions: The use of surgical interventions such as DBS and MCS is an upcoming field for the treatment of post-stroke pain, with limited studies exploring and comparing these two techniques. While our study shows that MCS might be a slightly better treatment option, further research would need to be done in order to determine the appropriate surgical intervention for post-stroke pain.

Keywords: post-stroke pain, deep brain stimulation, motor cortex stimulation, pain relief

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Authors: Samuel Quashie

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Ph.D. Construction Management methodology and mixed methods are organized to guide the researcher to assemble and assess data in the research activities. Construction management research is close to business management and social science research. It also contributes to researching the phenomenon and answering the research question, generating an integrated management system for post-disaster reconstruction in construction and related industries. Research methodology and methods drive the research to achieve the goal or goals, contribute to knowledge, or increase knowledge. This statement means the research methodology, mixed methods, aim, objectives, and processes address the research question, facilitate its achievement and foundation to conduct the study. Mixed methods use project-based case studies, interviews, observations, literature and archival document reviews, research questionnaires, and surveys, and evaluation of integrated systems used in the construction industry and related industries to address the research work. The research mixed methods (qualitative, quantitative) define the research topic and establish a more in-depth study. The research methodology is action research, which involves the collaboration of participants and service users to collect and evaluate data, studying the phenomenon, research question(s) to improve the situation in post-disaster reconstruction phase management.

Keywords: methodology, Ph.D. research, post-disaster reconstruction, mixed-methods qualitative and quantitative

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Authors: Shahzad Ali

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This article expounds the coverage of Pak-US relations in the context of Osama Bin Laden killing in four selected leading newspapers of UK and the US viz The Telegraph, The Guardian, The New York Times and The Washington Post during the specific time period of three months, i.e., April-June, 2011. The study is scrutinized on the basis of Operation Neptune Spear. The research study is theoretically linked with the propaganda model of Herman and Chomsky and the Shoemaker and Reeve‘s theory of content effect, specifically the impact of foreign policy as a driving instrument influencing the nature and treatment of the coverage of Pak-US relations. The relations between Pakistan and USA are of great importance in the context of Bin Laden. The Pak-US relations were less aggravated and hostile in pre OBL period but post OBL period worsened these relations. It is also interesting to mention that the policies of these newspapers were dependent on the foreign policy of their countries. It was explored that the news coverage was found favorable as and when the relations Pakistan and the US or UK were cordial and smooth. And it turned into negative and unfavorable when the relations were in strain and deteriorating and endorsed various studies that the Western mainstream media tried to be more nationalistic in projecting official stance while covering foreign coverage instead of adhering to universal cannon of journalism, i.e., objectivity, fairness, and neutrality, etc. Overall 219 news items of these four selected newspapers regarding Pak-US relations in the context of pre and post OBL’s killing operation were undertaken for analysis. The ratio of negative slants was found higher as compared to the positive and neutral slants. Besides, the ratio of news items with unfavorable frames was found higher in post OBL operation in comparison of pre-era of the coverage related to Pak-US relations in the leading British and American newspapers.

Keywords: Osama Bin Laden, Pakistan, USA, UK, relations, Guardian, Washington Post, Telegraph, New York Times, Operation Neptune Spear

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Authors: Henry Wilde, Thiravat Hemachudha

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Human rabies deaths are underreported worldwide at 55,000 annual cases; more than of dengue and Japanese encephalitis. Almost half are children. A recent study from the Philippines of nearly 2,000 rabies deaths revealed that none of had received incomplete or no post exposure prophylaxis. Coming from a canine rabies endemic country, this is not unique. There are two major barriers to reducing human rabies deaths: 1) the large number of unvaccinated dogs and 2) post-exposure prophylaxis (PEP) that is not available, incomplete, not affordable, or not within reach for bite victims travel means. Only the first barrier, inadequate vaccination of dogs, is now being seriously addressed. It is also often not done effectively or sustainably. Rabies PEP has evolved as a complex, prolonged process, usually delegated to centers in larger cities. It is virtually unavailable in villages or small communities where most dog bites occur, victims are poor and usually unable to travel a long distance multiple times to receive PEP. Reseacrh that led to better understanding of the pathophysiology of rabies and immune responses to potent vaccines and immunoglobulin have allowed shortening and making PEP more evidence based. This knowledge needs to be adopted and applied so that PEP can be rendered safely and affordably where needed the most: by village health care workers who have long performed more complex services after appropriate training. Recent research makes this an important and long neglected goal that is now within our means to implement.

Keywords: rabies, post-exposure prophylaxis, availability, immunoglobulin

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Authors: Hong Zhang

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The main purpose of this study is to show that machine translation (MT) post-editing (PE) training can help our Chinese students learn Spanish as a second language. Our hypothesis is that they might make better use of it by learning PE skills specific for foreign language learning. We have developed PE training materials based on the data collected in a previous study. Training material included the special error types of the output of MT and the error types that our Chinese students studying Spanish could not detect in the experiment last year. This year we performed a pilot study in order to evaluate the PE training materials effectiveness and to what extent PE training helps Chinese students who study the Spanish language. We used screen recording to record these moments and made note of every action done by the students. Participants were speakers of Chinese with intermediate knowledge of Spanish. They were divided into two groups: Group A performed PE training and Group B did not. We prepared a Chinese text for both groups, and participants translated it by themselves (human translation), and then used Google Translate to translate the text and asked them to post-edit the raw MT output. Comparing the results of PE test, Group A could identify and correct the errors faster than Group B students, Group A did especially better in omission, word order, part of speech, terminology, mistranslation, official names, and formal register. From the results of this study, we can see that PE training can help Chinese students learn Spanish as a second language. In the future, we could focus on the students’ struggles during their Spanish studies and complete the PE training materials to teach Chinese students learning Spanish with machine translation.

Keywords: machine translation, post-editing, post-editing training, Chinese, Spanish, foreign language learning

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Authors: Amaefule, Leonard Ifeanyi

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The study evaluated the disruptions in Nigeria’s domestic economic activities occasioned by the COVID-19 pandemic: a pre and post-pandemic investigation approach. Domestic economic activities were measured with composite manufacturing purchasing managers index (PMI) and composite non-manufacturing PMI. Production and employment levels indices were proxies for composite manufacturing PMI, while business activities and employment level indices were proxies for non-manufacturing PMI. Data for these indices were sourced from monthly and quarterly publications of the Central Bank of Nigeria for periods covering fifteen (15) months before and 15 months after the outbreak of the virus in Nigeria. Test of equality of means was employed in establishing the significance of the difference of means between the pre and post-pandemic domestic economic activities. Results from the analysis indicated that a significant negative difference exists in each of the measures of domestic economic activities between the pre and post-pandemic periods. These findings, therefore, offer empirical evidence that the COVID-19 pandemic has disrupted domestic economic activities in Nigeria; thus, it exerts a negative influence on the measures of the nation’s domestic economic activities. The study thus recommended (among other things) that the Nigerian government should focus on policies that would enhance domestic production, employment and enhance business activities.

Keywords: COVID-19, domestic economic activities, composite manufacturing indices, composite non-manufacturing indices

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Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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Authors: Mohamad Sukeri Khalid, Che Su Mustaffa, Mohd Najib Marzuki, Mohd Fo’ad Sakdan, Sapora Sipon, Mohd Taib Ariffin, Shazwani Shafiai

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

Keywords: communities affected, disaster management, early warning system, flash flood disaster

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Authors: Ricardo Chaves, Carlos Vasconcelos

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Candidates to join the Naval Academy have to take a set of physical tests, which is crucial for a high level of physical fitness. Thus, the planning of physical exercises for candidates to the Naval School must take into account the improvement of their physical fitness. The aim of this study was to investigate the impact of a 6-month exercise program to improve the physical fitness of an individual who will apply for the Naval Academy. This was a non-experimental pre-post-evaluation study. The patient was male, had 18 years old, and a body mass index of 21.1 kg.m². The patient participated in a 6-month aerobic and strength exercise program (3 sessions per week, 75 minutes duration each session). Physical fitness tests were performed according to the physical fitness requirements for entry into the Naval academy (muscle strength [maximum number of lifts and maximum number of sit-ups for 1 minute]; aerobic fitness [2.4 km run and 200 m swimming test]) before (baseline) and after the exercise intervention (6 months). Regarding muscle strength, in the abdominal test, the improvements between the pre-test (39 abdominals.) and post-test (61 abdominals) were 56.4%. For elevations, there was an increase in its number by 150% between the pre-test (4 elevations) and post-test (10 elevations). With regard to aerobic fitness, in the 2.4 km race, there was an evolution of 32.0% between the pre-test (16.46 min.) and the post-test (12.42 min.). For the 200-meter swimming test, there was a negative variation of 2% between the pre-test (2.25 min.) and post-test (2.28 min). A 6-month aerobic and strength exercise program leads to a positive evolution in the muscular strength of the patient. Regarding aerobic fitness, opposite results were found, with a positive evolution in the 2.4 km running test and a negative evolution in the swimming test. In future exercise programs for the improvement of the physical fitness of candidates for the Naval Academy, more emphasis has to be done on specific swimming training.

Keywords: case study, exercise program, Naval Academy, physical fitness

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Authors: Pronob Kumar Mozumder, M. Abdur Rob Mollah

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This research was conducted in two coastal locations of Bangladesh from February, 2013 to January, 2014.The objective of this research was to assess the potential vulnerabilities of climate change on local ecosystem and people and to identify and recommend local level adaptation strategies to climate change. Focus group discussions, participatory rural appraisal, interviewing local elderly people were conducted. Perceptions about climate change indicate that local people are experiencing impacts of climate change. According to local people, temperature, cyclone, rain, water-logging, siltation, salinity, erosion, and flash flood are increasing. Vulnerability assessment revealed that local people are variously affected by abnormal climate related disasters. This is jeopardizing their livelihoods, risking their lives, health, and their assets. This prevailing climatic situation in the area is also impacting their environmental conditions, biodiversity and natural resources, and their economic activities. The existing adaptation includes using traditional boat and mobile phone while fishing and making house on high land and lower height. Proposed adaptation for fishing boat are using more than 60 feet length with good timber, putting at least 3 longitudinal bar along upper side, using enough vertical side bars. The homestead measures include use of cross bracing of wall frame, roof tying with extra-post by ropes and plantation of timber tree against wind.

Keywords: community level vulnerabilities, climate change, Cox’s Bazar-Teknaf Coastal Area, Bangladesh

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Authors: Hameed Ullah, Karim Elakabawi, Han KE, Najeeb Ullah, Habib Ullah, Sardar Ali Shah, Hamad Haider Khan, Muhammad Asad Khan, Ning Guo, Zuyi Yuan

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Background: Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low Fractional flow reserve (FFR) at coronary artery (LCx) and the possible treatment strategies for the compromised LCx-together with their long term outcomes. Methods: A total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesions. The enrolled patients underwent single-stent cross-over PCI under IVUS guidance with further LCx intervention as indicated by measured FFR. Results: The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR <0.8. The 3-year composite MACE rates were comparable between the high and low FFR groups (16.8% vs. 15.5%, respectively; P=0.744). In a multivariable analysis, a low FFR in the LCx was associated with post-stenting MLA of the LCx (OR: 0.032, P <0.001), post-stenting LCx-plaque burden (OR: 1.166, P <0.001), post-stenting LM-MLA (OR: 0.821, P =0.038) and pre-stenting LCx-MLA (OR: 0.371, P =0.044). In patients with low FFR, management of compromised LCx with DEB had the lowest 3-year MACE rate (8.1%) as compared to either KBI (17.5%) or stenting group (20.5%), P =0.299. Conclusion: FFR-guided LCx intervention can avoid unnecessary LCx intervention. The post-stenting predictors of low FFR include post-stenting MLA and plaque burden of the LCx and MV stent length. The 3-year MACE rates were comparable between high FFR patients and patients who had low FFR and were adequately managed.

Keywords: fractional flow reserve, left main stem, percutaneous coronary interventions, intravascular ultrasound

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Authors: Fuad Alzahrani, Yiannis Kyratsis

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Although emergency nurses, being the frontline workers in mass-gatherings, are essential for providing an effective public health response, little is known about the skills that emergency nurses have, or require, in order to respond effectively to a disaster event. This paper is designed to address this gap in the literature by conducting an empirical study on emergency nurses’ preparedness at the mass-gathering event of Hajj in Mecca city. To achieve this aim, this study conducted a cross-sectional survey among 106 emergency department nurses in all the public hospitals in Mecca in 2014. The results revealed that although emergency nurses’ role understanding is high; they have limited knowledge and awareness of how to respond appropriately to mass-gathering disaster events. To address this knowledge gap, the top three most beneficial types of education and training courses suggested are: hospital education sessions, the Emergency Management Saudi Course and workshop; and short courses in disaster management. Finally, recommendations and constructive strategies are developed to provide the best practice in enhancing disaster preparedness. This paper adds to the body of knowledge regarding emergency nurses and mass gathering disasters. This paper measures the level of disaster knowledge, previous disaster response experience and disaster education and training amongst emergency nurses in Mecca, Saudi Arabia. It is anticipated that this study will provide a foundation for future studies aimed at better preparing emergency nurses for disaster response. This paper employs new strategies to improve the emergency nurses’ response during mass gatherings for the Hajj. Increasing the emergency nurses’ knowledge will develop their effective responses in mass-gathering disasters.

Keywords: emergency nurses, mass-gatherings, hajj, disaster preparedness, disaster knowledge, perceived role, disaster training, previous disaster response experience

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Authors: Michael Oppong, Stephanie Owusu Ansah, Daniel Ofori

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The study investigated students’ post-covid-19 experiences with e-learning platforms among undergraduate students of public universities in the Ashanti region of Ghana. The study respectively drew 289 respondents from two public universities, i.e., Kwame Nkrumah University of Science and Technology (KNUST) Business School and the Kumasi Technical University (KsTU) Business School in Ghana. Given that the population from the two public universities was fairly high, sampling had to be done. The overall population of the study was 480 students randomly sampled from the two public universities using the sampling ratio given by Alreck and Settle (2004). The population constituted 360 students from the Kwame Nkrumah University of Science and Technology (KNUST) Business School and 120 from the Kumasi Technical University Business School (KsTU). The study employed questionnaires as a data collection tool. The data gathered were 289 responses out of 480 questionnaires administered, representing 60.2%. The data was analyzed using pie charts, bar charts, percentages, and line graphs. Findings revealed that the e-learning platforms were still useful. However, the students used it on a weekly basis post-COVID-19, unlike in the COVID-19 era, where it was used daily. All other academic activities, with the exception of examinations, are still undertaken on the e-learning platforms; however, it is underutilized in the post-COVID-19 experience. The study recommends that universities should invest in infrastructure development to enable all academic activities, most especially examinations, to be undertaken using the e-learning platforms to curtail future challenges.

Keywords: e-learning platform, undergraduate students, post-COVID-19 experience, public universities

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Authors: Kuniko Muramoto, Tadashi Nakamura, Shiro Dan

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On March 11, 2011 the Great East Japan Disaster caused widespread damage. In the aftermath, we searched for ways to provide long-term support and enhanced resilience to affected areas, arriving at the Family Manga Exhibition: an art collection portraying family life. It became a tool for community outreach and intervention, and we implemented support programs by collaborating with local support agencies. This 10-year project has been touring through four prefectures in Tohoku since the disaster struck, bearing witness to the effects of disaster and recovery alike. At this five-year mark, we use a narrative perspective to present our findings and reflect on post-disaster community support. It is important to note that the exhibition’s art does not directly depict the disaster; it portrays stories of anonymous families instead. They stimulate viewers’ memories and remind them of their own family stories. We analyzed viewers' oral and written responses to the exhibition and discovered that family manga as an art form enhances the viewer’s sense of connection to people close to them. We also discovered that the viewers gained more universal perspective on their own situations by viewing the exhibition. Manga, we found, offered a certain safety by enabling the viewers to control how they would interact with the exhibition's content and themes. In addition, the purpose of the project was for us to become witnesses of the disaster and recovery. Supporters of the project became active listeners, functioning as interactive agents who helped forming stories. Voices of the story tellers and the listeners layered upon each other and, as a result, converged into brand new narratives. The essence of traumatic experience is ‘the sense of overwhelming powerlessness and isolation’. When we redefine trauma as ‘broken relationships’, we can say that ‘enhancing relationships’ and ‘weaving relationships’ are what strengthen our resilience. This project used narrative as a modality to fortify the resilience of people involved by enhancing the social capital of bonding, bridging, and linking. The manga exhibition functioned as a tool to achieve this end, suggesting that similar applications are possible. Programs we held in-between manga exhibitions also served to enhance narratives of resiliency in the regions. However, we will save that story for another time. We hope to continue collecting the precious and polyphonic voices of people to present as stories born out of the Great East Japan Disaster. This effort extends beyond the immediately affected area by helping us prepare our resilience for future disasters.

Keywords: community, manga, narrative, resilience

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Authors: Lindy Adoma Dampare, Marina Aferiba Tandoh

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Sickle cell disease (SCD) is an inherited blood disorder that mostly affects individuals in sub-Saharan Africa. Nutritional deficiencies have been well established in SCD patients. In Ghana, studies have revealed the prevalence of malnutrition, especially amongst children with SCD and hence the need to develop an evidence-based comprehensive nutritional therapy for SCD to improve their nutritional status. The aim of the study was to develop and assess the effect of a nutrition education material on the nutritional status of SCD patients in Ghana. This was a pre-post interventional study. Patients between the ages of 2 to 60 years were recruited from the Tema General Hospital. Following a baseline nutrition knowledge (NK), beliefs, sanitary practice and dietary consumption pattern assessment, a twice-monthly nutrition education was carried out for 3 months, followed by a post-intervention assessment. Nutritional status of SCD patients was assessed using a 3-days dietary recall and anthropometric measurements. Nutrition education (NE) was given to SCD adults and caregivers of SCD children. Majority of the caregivers (69%) and SCD adult (82%) at baseline had low NK. The level of NK improved significantly in SCD adults (4.18±1.83 vs. 10.00±1.00, p<0.001) and caregivers (5.58 ± 2.25 vs.10.44± 0.846, p<0.001) after NE. Increase in NK improved dietary intake and dietary consumption pattern of SCD patients. Significant increase in weight (23.2±11.6 vs. 25.9±12.1, p=0.036) and height (118.5±21.9 vs. 123.5±22.2, p=0.011) was observed in SCD children at post intervention. Stunting (10.5% vs. 8.6%, p=0.62) and wasting (22.1% vs. 14.4%, p=0.30) reduced in SCD children after NE although not statistically significant. Reduction (18.2% vs. 9.1%) in underweight and an increase (18.2% vs. 27.3%) in overweight SCD adults was recorded at post intervention. Fat mass remained the same while high muscle mass increased (18.2% vs. 27.3%) at post intervention in SCD adult. Anaemic status of SCD patients improved at post intervention and the improvement was statistically significant amongst SCD children. Nutrition education improved the NK of SCD caregivers and adults hence, improving the dietary consumption pattern and nutrient intake of SCD patients. Overall, NE improved the nutritional status of SCD patients. This study shows the potential of nutrition education in improving the nutritional knowledge, dietary consumption pattern, dietary intake and nutritional status of SCD patients, and should be further explored.

Keywords: sickle cell disease, nutrition education, dietary intake, nutritional status

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Authors: Radwa R. El-Saadany , Medhat Abu Zeid, Tarek Omar, Marwa S. Maqsoud

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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders characterized by attention deficit, hyperactivity, and impulsivity. Neurofeedback (NF) is one of the neurotherapy treatments that cause brain wave changes. Method: The current pseudo-experimental study with a pre–post-test design was conducted on a population of children with attention deficit hyperactivity disorder (ADHD).The sample size comprised of (30) children selected by random sampling method and assigned to two therapeutic groups: First therapeutic group received a neurofeedback program. Based on QEEG, it reached (10) children. The second therapeutic group received an organization skills training program, it reached (10) and the control group that did not receive programs, it reached (10) children. Results: There are significant differences between pre- and post-assessments among therapeutic groups in reducing the three core symptoms of ADHD in favor of post measurement. There are no significant differences between post-assessment and follow up measurement of the therapeutic groups.

Keywords: QEEG-based neurofeedback therapy program, organizational skills training program, attention deficit hyperactivity disorder

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Authors: Pricillia Priska Sianita

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An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.

Keywords: cephalometric evaluation, class II division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems

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Authors: Sajadian Akram, Tavasoli F.

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Breast cancer is the second most common cancer in the world and certainly the most frequent cancer mostly among women. This study was aimed to compare the effectiveness of individual counseling and group narrative therapy on female patients' life expectancy afflicted by breast cancer. The present study is a pre-test-post-test clinical trial. Fifty-five patients with breast cancer were randomly selected in the follow-up period and after their active medical treatment completion. Then, they were randomly divided into two groups: individual counseling and group counseling. Herth hope index (HHI) was used to measure the patients' hope level. Data were analyzed using t-test and SPSS software. hope rate was statistically significant in both groups receiving individual and group narrative therapy in the post-test compared to the pre-test (P <00000). Moreover, the comparative evaluation of hope in both groups (individual & group counseling) in the post-test showed that group narrative counseling is more effective than individual narrative counseling (P <00000). Conclusion: Narrative therapy promotes hope in breast cancer patients effectively. Due to the nature of breast cancer and its psychological effects in the post-treatment period, providing narrative group therapy can improve life quality. Patients' life quality changes in tandem with changes in hope.

Keywords: hope, narrative therapy, counseling, breast cancer

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Authors: Balakumar Pitchai, Xiang Llan Ang, Sunil Prajapati, Varatharajan Rajavel, Sundram Karupiah, Mohd Baidi Bahari

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The study examined the pretreatment and post-treatment effects of low-doses of fenofibrate and rosuvastatin in gentamicin-induced acute nephrotoxicity in rats. Gentamicin (100 mg/kg/day, i.p.) was administered to rats for 8 days. In the pretreatment protocol, low-dose fenofibrate (30 mg/kg/day, p.o.) or low-dose rosuvastatin (2 mg/kg/day, p.o.) treatments were started a day before the administration of gentamicin and continued for 8 days. In the post-treatment protocol, rats administered gentamicin were treated with low-dose fenofibrate (30 mg/kg/day, p.o.) or low-dose rosuvastatin (2 mg/kg/day, p.o.) for 6 days after the completion of 8 days protocol of gentamicin administration. Gentamicin-associated acute nephrotoxicity in rats was assessed in terms of biochemical analysis and renal histopathological studies. Gentamicin-administered rats showed marked renal functional changes as assessed in terms of a significant increase in serum creatinine and urea levels as compared to normal rats. The renal dysfunction noted in gentamicin administered rats was accompanied with elevated serum uric acid level as compared to normal rats while there was no significant change in lipid profile. Low-dose fenofibrate pretreatment in gentamicin-administered rats afforded a significant renal functional improvements and renoprotection while its post-treatment showed no significant renoprotection. On the other hand, pretreatment with low-dose rosuvastatin partially reduced gentamicin-induced increase in serum creatinine level, but its post-treatment did not afford renal functional improvements in gentamicin-administered rats. However, all pre and post-treatments with low-doses of fenofibrate or rosuvastatin significantly reduced the elevated serum uric acid concentration in gentamicin-administered rats. Renal histopathological analysis showed a discernible incidence of acute tubular necrosis in gentamicin-administered rats which were markedly reduced by low-dose fenofibrate or low-dose rosuvastatin pretreatments; but, not by their post-treatments. In conclusion, low-dose fenofibrate pretreatment considerably prevented gentamicin-induced acute tubular necrosis and renal functional abnormalities in rats while its post-treatment resulted in no significant renoprotective action. In spite of effective prevention of gentamicin-induced acute tubular necrosis, the pretreatment with low-dose rosuvastatin had only a partial and fractional protection on renal functional abnormalities. The post-treatment with low-dose rosuvastatin was ineffective in affording a renoprotection in gentamicin-administered rats.

Keywords: gentamicin-nephrotoxicity, low-dose fenofibrate, low-dose rosuvastatin, renoprotection

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Authors: Manee Hasap, Mongkolchai Hasap, Tasanee Nasae

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The purpose of this study was to evaluate the primary caregivers’ knowledge and capabilities for providing quality care to be hospitalized post-hip fracture surgery elderly patients. The theoretical framework of the study was derived from the concepts of dependent care agency in Orem’s Self-Care theory, and family care provision for the elderly and chronically ill patients. 59 subjects were purposively selected. The subjects were primary caregivers of post-operated hip fracture elderly patients who had been admitted to the Orthopaedic Ward of Songklanagarind Hospital. Demographic data of the caregivers and patients were collected by non-participant observation using the evaluation and recording forms. The reliability of caregivers’ knowledge measurement (0.86) was obtained by KR-20 and that of caregivers’ capabilities for post-operative care evaluation form (0.97) obtained from 2 observers by interrater reliability. The data were analyzed using descriptive statistic, which were frequency, percentage, mean, and standard deviation. The result of this study indicated that elderly patients with post-hip fracture surgery had many pre-discharge self care limitations. Approximately, 75% of the caregivers had knowledge to respond to patient’s essential needs at a high level, while the rest (25%) had this knowledge a moderate level. For observation, 57.63% of the subjects had capabilities in care practice at a moderate level; 28.81% had capabilities in care practice at a high level, while 13.56% had at a low level. The result of this study can be used as basic information for patients and caregivers capabilities developing plan especially, providing patients’ activities, accident surveillance and complications prevention for a good life quality of elderly patients after hip surgery both hospitalization and rehabilitation at home.

Keywords: care givers’ knowledge, care givers’ capabilities, elderly hip fracture patients, patients

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Authors: Kate Crinion, Martin Haran, Stanley McGreal, David McIlhatton

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Past research has demonstrated that disasters are continuing to escalate in frequency and magnitude worldwide, representing a key concern for the global community. Understanding and responding to the increasing risk posed by disaster events has become a key concern for disaster managers. An emerging trend within literature, acknowledges the need to move beyond a state of coping and reinstatement of the status quo, towards incremental adaptive change and transformational actions for long-term sustainable development. As such, a growing interest in research concerns the understanding of the change required to address ever increasing and unpredictable disaster events. Capturing transformational capacity and resilience, however is not without its difficulties and explains the dearth in attempts to capture this capacity. Adopting a case study approach, this research seeks to enhance an awareness of transformational resilience by identifying key components and indicators that determine the resilience of flood-affected communities within Cumbria. Grounding and testing a theoretical resilience framework within the case studies, permits the identification of how perceptions of risk influence community resilience actions. Further, it assesses how levels of social capital and connectedness impacts upon the extent of interplay between resources and capacities that drive transformational resilience. Thus, this research seeks to expand the existing body of knowledge by enhancing the awareness of resilience in post-disaster affected communities, by investigating indicators of community capacity building and resilience actions that facilitate transformational resilience during the recovery and reconstruction phase of a flood disaster.

Keywords: capacity building, community, flooding, transformational resilience

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Authors: Gaurav Sancheti

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This study presents an impacting approach of Artificial Neural Networks (ANNs) in determining the quantity of High Tensile Steel (HTS) strands required in post-tensioned (PT) slabs. Various PT slab configurations were generated by varying the span and depth of the slab. For each of these slab configurations, quantity of required HTS strands were recorded. ANNs with backpropagation algorithm and varying architectures were developed and their performance was evaluated in terms of Mean Square Error (MSE). The recorded data for the quantity of HTS strands was used as a feeder database for training the developed ANNs. The networks were validated using various validation techniques. The results show that the proposed ANNs have a great potential with good prediction and generalization capability.

Keywords: artificial neural networks, back propagation, conceptual design, high tensile steel strands, post tensioned slabs, validation techniques

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Authors: Mohammed Masum, Mohammad Omer Faruk Khan, Md. Nazwanul Haque, Anwar Sadat Md. Sayem, Md. Azhar Hossain

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The study area is the Hakaluki Haor which is the second largest wet land of Bangladesh. It spans over the districts of Moulvibazar and Sylhet in southeast Bangladesh. The study was focused in the exploration of peat reserve, reconstruction of the paleo-environment as well as the utilization of the peat resources. Peat is found randomly from 0.5 m to 7 m below the surface and 1 m to 11 m thickness at over 40 beels as well as small plain lands of 90 km2 area of Hakaluki Haor. The total reserve of peat is 282 million ton in wet condition and 112 million ton in dry condition. The peat deposits of Hakaluki Haor area is the largest peat reserves of the Bangladesh. Peat bearing Hakaluki Haor is a low-lying wet land which geological term is synclinal depression. It may be a syncline between two anticlines which was filled with sediments as well as various plant materials derived from the hilly region (anticline) on both sides (west and east) of the Haor. The transportation may be triggered by large natural disasters or any tectonic reason. On the other hand vegetation occurred in this depression as aquatic plants which might have been destroyed by large natural disasters or any tectonic reason. As environment dictates the characteristics and the source of sediments, various aspects of the sediment are indicators of the environment. Peat has mainly industrial importance as a fuel for power production, traditionally used for cooking, domestic heating and in brick fields, also used as insulator in many industries, agricultural purposes, retaining moisture in soil, raw material in horticulture and colour industries etc. Power plants of about 100 MW capacities may be established in this region based on peat of Hakaluki Haor which may be continued more than one hundred years.

Keywords: peat, pale environment, Hakaluki Haor, beel, syncline, anticline

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