Search results for: general derivative

Authors: Euan Donley

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Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.

Keywords: assessment, emergency, risk, psychiatric

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Authors: Paschal Ohalehi

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Purpose - The purpose of this paper, which is part of a PhD thesis is to examine the role of risk based approach in minimising financial crime in the charity sector as well as offer recommendations to improving the quality of charity regulation whilst still retaining risk based approach as a regulatory framework and also making a case for a new regulatory model. Increase in financial crimes in the charity sector has put the role of regulation in minimising financial crime up for debates amongst researchers and practitioners. Although previous research has addressed the regulation of charities, research on the role of risk based approach to minimising financial crime in the charity sector is limited. Financial crime is a concern for all organisation including charities. Design/methodology/approach - This research adopts a social constructionist’s epistemological position. This research is carried out using semi structured in-depth interviews amongst randomly selected 24 charity trustees divided into three classes: 10 small charities, 10 medium charities and 4 large charities. The researcher also interviewed 4 stakeholders (NFA, Charity Commission and two different police forces in terms of size and area of coverage) in the charity sector. Findings - The results of this research show that reliance on risk based approach to financial crime in the sector is weak and fragmented with the research pointing to a clear evidence of disconnect between the regulator and the regulated leading to little or lack of regulation of trustees’ activities, limited monitoring of charities and lack of training and awareness on financial crime in the sector. Originality – This paper shows how regulation of charities in general and risk based approach in particular can be improved in order to meet the expectations of the stakeholders, the public, the regulator and the regulated.

Keywords: risk, risk based approach, financial crime, fraud, self-regulation

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Authors: Maryam Borjali

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Introduction. Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. e objective of present study was to identify nonmedical determinants related to this abnormality from the mother’s perspectives. Methods. is research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results. Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions. Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers’ prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Keywords: congenital_cou, cultural, social, platform

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Authors: Sonia Nemakallu, Pota Kalima

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Introduction: Vancomycin is a glycopeptide antibiotic, commonly used to treat gram-positive bacteraemia. It has been increasingly used in the critical care setting due to an increased awareness of resistant gram positive organisms. In Edinburgh both tertiary hospitals, The Western General Hospital and The Royal Infirmary Of Edinburgh, commonly use Vancomycin for a variety of infections. Administration of Vancomyicn in these hospitals is by continuous infusion as it is thought to maintain serum concentrations easier and is a simpler monitoring system. Purpose: The aim of the study was to evaluate the efficacy and reliability in which Vancomycin is used. Material and Methods: A retrospective study, over a 6-month period from January 2014 to June 2014. 91 admissions were included, all received Vancomycin by continuous infusion during their critical care stay. Results: The number one use for Vancomycin in critical care settings was in the treatment of ventilator or hospital-acquired pneumonia. Only 3% of population had MRSA. 49% of admissions were not therapeutic on day 1 post loading dose. Of those that were therapeutic on day 1 post loading dose, 39% of admissions showed no organisms in any cultures taken, 42% had organisms sensitive to Vancomycin and 19% had only organisms resistant to Vancomycin. Those that were not therapeutic on day 1 showed similar organism sensitivities. 15% of admissions had Vancomycin levels above 25 (levels should be maintained between 15-25). An increase in creatinine was proportionally seen with an increase in Vancomycin levels. Conclusion: Within Edinburgh Vancomycin is being overused in the critical care setting with only 3% of the population having highly resistant organisms. Continuous infusion have not ruled out the complexity of maintaining therapeutic levels, with a large proportion of patients not being therapeutic on day 1. Further research is also required into the nephrotoxic effects of using higher doses of Vancomycin.

Keywords: Vancomycin, continuous infusion, multi resistant organisms, sepsis, renal toxicity

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Authors: Aida Lamaj

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Death is an inevitable phenomenon in our life, in the same way, are also the ritual of death accompanied by the dirge and the keening performed by men. Keening is a phenomenon common among all peoples, the instances in which the ritual of death and keening coincide, as a special phenomenon of its, are numerous given the fact that keening is an outcome of an extremely special emotional state. However, even during the ritual of death, every people try to display through words its qualities, a multitude of characteristics preserved and transmitted with fanaticism from one generation to the other. The ritual of death constitutes an important element of our tradition and at the same time a material always interesting to be studied in minute details. In this study, we have tried to limit ourselves to the feminine speech, since keening, in general in Albania has been carried out by women. Differences and similarities among keening on the national scale, from the diachronic and synchronic point of view, can be seen clearly if we compare the Albanian creations in different regions. The similarities and differences within the Albanian culture serve as a typical paradigm to study how the ancient elements of outlook that the Albanians have had on death, history, and the social organization in these regions have been preserved and transmitted and above all, in what way these feelings have been clothed from the linguistic point of view, the typologies of keening and of all of the ritual of death, which clearly shows archaic forms as well as new developments. These data have been gathered not only by conducting various surveys but also by observing closely the linguistic behavior of women in Albania during the ritual of death. The study has encompassed the popular lyric poetry as well as new entries, whereas from the geographic point of view we focus mainly in the Southern regions, although examples from other regions where Albanian speaking people live are also present. The main results of the study show that women use much more than men dialect form, peripheral language elements and descriptive elements during their speech in the ritual of death.

Keywords: feminine speech in Albania, linguistic characteristics of the dirge, ritual of death, the typologies of keening

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Authors: Raul G. Angeles

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The Philippine government instituted major reforms in its educational system. The Department of Education pushes the K to 12 program that makes kindergarten mandatory and adds two years of senior high school to the country's basic education. In essence, the students’ stay in basic education particularly those who are supposedly going to college is extended. The majority of the students expressed that they will be taking the Academic Track of the Senior High School curriculum specifically the Science, Technology, Engineering and Mathematics (STEM) and General Academic (GA) strands. Almost certainly, instruction should match the students' styles and thus through this descriptive study a city survey was conducted to explore the teaching strategies preferences of junior high school students and teachers who will be promoted to senior high school during the Academic Year 2016-2017. This study was conducted in selected public and private secondary schools in Metro Manila. Questionnaires were distributed to students and teachers; and series of follow-up interviews were also carried out to generate additional information. Preferences of students are centered on employing innovations such as technology, cooperative and problem-based learning. While the students will still be covered by basic education their interests in science are sparking to a point where the usual teaching styles may no longer work to them and for that cause, altering the teaching methods is recommended to create a teacher-student style matching. Other effective strategies must likewise be implemented.

Keywords: curriculum development, effective teaching strategies, problem-based learning, senior high school, science education, technology

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Authors: Linta Koka

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Aim: The way people with severe mental disorders deal with self-stigma and how it affects their self-esteem is a problem that has gained much attention in recent years. The primary aim of this study was to empirically explore the link between self-stigma and self-esteem of individuals with the presence of a mental illness, offering a novel perspective by exploring the same variables amongst a sample without a mental illness. Methods: This study utilized a cross-sectional study. Participants with (N=85) and without (N=75) a mental health issue were included from Darlingdon's Mind organization. Participants completed two scales, one of Self-Stigma of Mental Illness Scale and one of Self-Esteem, following some demographics questions. Results: According to the primary hypothesis, self-stigma significantly correlates with self-esteem in the clinical population. Furthermore, gender and ethnicity, above all the demographics, positively correlates to the relationship of self-stigma with self-esteem in people who endure a mental health issue. Limitations: A significant limitation is that of the size of the sample of participants conducted in this study. The clinical population was limited to 85 participants, and the control group consisted of 76 participants. Since the sample was not representative. The small size used did not allow any comparisons between the group with mental illness and the control group. There was a restricted time to approach the participants since the online survey was released by the end of May. Conclusions: Individuals suffering from mental illnesses may internalize stigmatizing stereotypes on an explicit level. Efforts should be made to lessen the harmful impact stigma may have on mentally ill people, such as worsening symptoms or delays in receiving care. Further study is needed within this small research topic to improve awareness and regulate mental health among the general population. Undoubtedly, people with mental disorders are stigmatized; therefore, more research is required to explore all factors contributing to mentally ill patients' devaluation.

Keywords: self-stigma, mental illness, self-esteem, clinical population, non-clinical population

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Authors: Amel M. A. Osman, Roy Mahony, Lisa Dann, McKenna S.

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Background: Computed Tomography (CT) is a significant source of radiation in the pediatric population. A new head injury (HI) pathway was introduced in 2021, which altered the previous process of HI being jointly admitted with general pediatrics and surgery to admit these patients under the Emergency Medicine Team. Admitted patients included those with positive CT findings not requiring immediate neurosurgical intervention and those who did not meet current criteria for urgent CT brain as per NICE guidelines but were still symptomatic for prolonged observations. This approach aims to decrease the number of CT scans performed. The main aim is to assess the variation in CT scanning rates since the change in the admitting process. A retrospective review of patients presenting to CHI PECU with HI over 6-month period (01/01/19-31/05/19) compared to a 6-month period post introduction of the new pathway (01/06/2022-31/12/2022). Data was collected from the electronic record databases, symphony, and PACS. Results: In 2019, there were 869 presentations of HI, among which 32 (3.68%) had CT scans performed. 2 (6.25%) of those scanned had positive findings. In 2022, there were 1122 HI presentations, with 47 (4.19%) CT scans performed and positive findings in 5 (10.6%) cases. 57 patients were admitted under the new pathway for observation, with 1 having a CT scan following admission. Conclusion: Quantitative lifetime radiation risks for children are not negligible. While there was no statistically significant reduction in CTs performed amongst HIs presenting to our department, a significant group met the criteria for admission under the PECU consultant for prolonged monitoring. There was also a greater proportion of abnormalities on CT scans performed in 2022, demonstrating improved patient selection for imaging. Further data analysis is ongoing to determine if those who were admitted would have previously been scanned under the old pathway.

Keywords: head injury, CT, admission, guidline

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Authors: Domenico M. Mongelli, Michele De Carli, Laura Carnieletto, Filippo Busato

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Europe's dependence on imported fossil fuels has been particularly highlighted by the Russian invasion of Ukraine. Limiting this dependency with a massive replacement of fossil fuel boilers with heat pumps for building heating is the goal of this work. Therefore, with the aim of diversifying energy sources and evaluating the potential use of heat pump technologies for residential buildings with a view to decarbonization, the quantitative reduction in the consumption of fossil fuels was investigated in all regions of Europe through the use of heat pumps. First, a general overview of energy consumption in buildings in Europe has been assessed. The consumption of buildings has been addressed to the different uses (heating, cooling, DHW, etc.) as well as the different sources (natural gas, oil, biomass, etc.). The analysis has been done in order to provide a baseline at the European level on the current consumptions and future consumptions, with a particular interest in the future increase of cooling. A database was therefore created on the distribution of residential energy consumption linked to air conditioning among the various energy carriers (electricity, waste heat, gas, solid fossil fuels, liquid fossil fuels, and renewable sources) for each region in Europe. Subsequently, the energy profiles of various European cities representative of the different climates are analyzed in order to evaluate, in each European climatic region, which energy coverage can be provided by heat pumps in replacement of natural gas and solid and liquid fossil fuels for air conditioning of the buildings, also carrying out the environmental and economic assessments for this energy transition operation. This work aims to make an innovative contribution to the evaluation of the potential for introducing heat pump technology for decarbonization in the air conditioning of buildings in all climates of the different European regions.

Keywords: heat pumps, heating, decarbonization, energy policies

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Authors: Juan Zhou, Lusan Liu, Yanzhong Zhu, Kuixuan Lin, Wenqian Cai, Yu Wang, Xing Wang

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During the past few decades, there has been an increase in the number of coastal land reclamation projects for residential, commercial and industrial purposes in more and more coastal cities of China, which led to the destruction of the wetlands and loss of the sensitive marine habitats. Meanwhile, the influences and nature of these projects attract widespread public and academic concern. For identifying the trend of landscape (esp. Coastal reclamation) and ecological environment changes, understanding of which interacted, and offering a general science for the development of regional plans. In the paper, a case study was carried out in Bohai Bay area, based on the analysis of remote sensing data. Land use maps were created for 1954, 1970, 1981, 1990, 2000 and 2010. Landscape metrics were calculated and illustrated that the degree of reclamation changes was linked to the hydrodynamic environment and macrobenthos community. The results indicated that the worst of the loss of initial areas occurred during 1954-1970, with 65.6% lost mostly to salt field; to 2010, Coastal reclamation area increased more than 200km² as artificial landscape. The numerical simulation of tidal current field in 2003 and 2010 respectively showed that the flow velocity in offshore became faster (from 2-5 cm/s to 10-20 cm/s), and the flow direction seem to go astray. These significant changes of coastline were not conducive to the spread of pollutants and degradation. Additionally, the dominant macrobenthos analysis from 1958 to 2012 showed that Musculus senhousei (Benson, 1842) spread very fast and had been the predominant species in the recent years, which was a disturbance tolerant species.

Keywords: Bohai Bay, coastal reclamation, landscape change, spatial patterns

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Authors: Savin Phoeun

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Long time civil war, economic, infrastructure, social, and political structure were destroyed and everything starts from zero. Transport and communication are the key feature of the national economic growth, especially inland transport and other mode take a complementary role which supported by government and international organization both direct and indirect to private sector and small and medium size enterprises. The objectives of this study are to study the general characteristics, capacity and competitive KPIs of Cambodian Inland Transport Operators. Questionnaire and interview were formed from capacity and competitiveness key performance indicators to take apart in survey to Inland Transport Companies in Phnom Penh capital city of Cambodia. And descriptive statistics was applied to identify the data. The result of this study divided into three distinct sectors: 1). Management ability of transport operators – capital management, financial and qualification are in similar level which can compete between local competitors (moderated level). 2). Ability in operation: customer service providing is better but seemed in high cost operation because mostly they are in family size. 3). Local Cambodian Inland Transport Service Providers are able to compete with each other because they are in similar operation level while Thai competitors mostly higher than. The suggestion and recommendation from the result that inland transport companies should access to new technology, improve strategic management, build partnership (join/corporate) to be bigger size of capital and company in order to attract truthfulness from customers and customize the services to satisfy. Inland Service Providers should change characteristic from only cost competitive to cost saving and service enhancement.

Keywords: assessment, competitiveness, inland transport, operator

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Authors: José Batista de Souza Neto

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This research project has as its theme the implementation of public policies to support micro and small businesses (MSEs). The research problem defined was how public policies for access to markets that drive the entrepreneurial ecosystem of MSEs are implemented. The general objective of this research is to understand the process of implementing a public policy to support the entrepreneurial ecosystem of MSEs by the Support Service for Micro and Small Enterprises of the State of São Paulo (SEBRAESP). Public policies are constituent elements of entrepreneurship ecosystems that influence the creation and development of ventures from the action of the entrepreneur. At the end of the research, it is expected to achieve the results for the following specific objectives: (a) understand how the entrepreneurial ecosystem of MSEs is constituted; (b) understand how market access public policies for MSEs are designed and implemented; (c) understand SEBRAE's role in the entrepreneurship ecosystem; and (d) offer an action plan and monitor its execution up to march, 2023. The field research will be conducted based on Action Research, with a qualitative and longitudinal approach to the data. Data collection will be based on narratives produced since 2019 when the decision to implement Comércio Brasil program, a public policy focused on generating market access for 4280 MSEs yearly, was made. The narratives will be analyzed by the method of document analysis and narrative analysis. It is expected that the research will consolidate the relevance of public policies to market access for MSEs and the role of SEBRAE as a protagonist in the implementation of these public policies in the entrepreneurship ecosystem will be demonstrated. Action research is recognized as an intervention method, it is expected that this research will corroborate its role in supporting management processes.

Keywords: entrepreneurship, entrepreneurship ecosystem, public policies, SEBRAE, action research

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Authors: Vedat Kurt, Tansel Koyunoglu, Gamze Kurt, Ozgen Aras

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Low back pain is one of the most common health problem in public. Common symptoms that can be associated with low back pain include; pain, functional disability, gait disturbances. The aim of the study was to investigate the differences between disability scores and gait parameters in subjects with low back pain. Sixty participants are included in our study, (35 men, 25 women, mean age: 37.65±10.02 years). Demographic characteristics of participants were recorded. Pain (visual analog scale) and disability level (Oswestry Disability Index(ODI)) were evaluated. Gait parameters were measured with Zebris-FDM-2 platform. Independent samples t-test was used to analyse the differences between subjects with under 40 points (n=31, mean age:35.8±11.3) and above 40 points (n=29, mean age:39.6±8.1) of ODI scores. Significant level in statistical analysis was accepted as 0.05. There was no significant difference between the ODI scores and groups’ ages. Statistically significant differences were found in step width between subjects with under 40 points of ODI and above 40 points of ODI score(p < 0.05). But there were non-significant differences with other gait parameters (p > 0.05). The differences between gait parameters and pain scores were not statistically significant (p > 0.05). Researchers generally agree that individuals with LBP walk slower and take shorter steps and have asymmetric step lengths when compared with than their age-matched pain-free counterparts. Also perceived general disability may have moderate correlation with walking performance. In the current study, the patients classified as minimal/moderate and severe disability level by using ODI scores. As a result, a patient with LBP who have higher disability level tends to increase support surface. On the other hand, we did not find any relation between pain intensity and gait parameters. It may be caused by the classification system of pain scores. Additional research is needed to investigate the effects of functionality level and pain intensity on gait in subjects with low back pain under different classification types.

Keywords: functionality, low back pain, gait, pain

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Authors: Maria Ukolova

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Social and cultural processes over the past decades have largely affected the understanding of conventional female beauty all over the world. Fine arts and design tendencies could not remain unchanged and show a dynamic interplay with female rights, gender equality, and other social processes. As of now, the area lacks comprehensive academic research on the tendencies of understanding female beauty in contemporary art. This article makes an attempt to outline and analyse the main tendencies of contemporary works of art that turn to the image of a woman, including photography, digital art, and various forms of design. The research bases itself on paintings, performing arts, photography, digital art, and various forms of design, mainly on the principle of the most broadly resonated in society, as an empirical basis, and on existing researches in the sphere. The results of the research show a general trend that the concept of female beauty in art is either challenged as such or its understanding has shifted to individuality, diversity, and the state of mental health. However, some categories of art, such as digital art in the gaming industry, remain resistant to change and retain the appearance-based understanding of beauty. Specific tendencies are, firstly, aestheticization of all types of appearances; secondly, a ubiquitous interest in mental health issues and understanding the state of mental health as a part of beauty; thirdly, a certain infantilization of the image of the woman is observed as compared to previous decades. The significance of the findings of the research is to contribute to a scientific understanding of the concept of beauty in contemporary art and to give ground for prospective further related research in sociology, phycology, etc. The findings might be perceived not only by academics but also by artists and practitioners in the spheres of art and society.

Keywords: fine arts, history of art, contemporary art, concept of beauty

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Authors: Marcelus U. Ajonina, Deodata B. Ngonga, Kenric B. Ware, Carine K. Nfor

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Background: Lack of knowledge of rational use of antimalarial drugs among dispensers is a serious problem, especially in areas of intense transmission, thus increasing the risk of resistance and adverse drug reactions. This study was aimed at assessing the knowledge of malaria as well as perception and dispensing practices of antimalarials among vendors in Buea community. Methods: A community-based cross-sectional survey of a random sample of 140 drug vendors living within the Buea community was conducted between March and June 2017. A questionnaire was designed to obtain information from drug vendors on the general knowledge of malaria as well as dispensing practices. Data were analyzed using SPSS Statistics 20.0 and were considered significant at p ≤ 0.05. Results: Knowledge of malaria symptoms, transmission, and prevention was reasonable among 55.8% (77) of the respondents. Only 33.6% (47) of the respondents could attribute the cause of malaria to protozoan of genus Plasmodium species. Of the 140 vendors, 115 (82.7%) prescribe antimalarial drugs. The knowledge of the national protocol was malaria case management among dispensers was 35.0%. Vendors in hospital/community pharmacies were 2.4 times (OR = 3.14, 95% CI: 4.14 - 8.74, p < 0.001) more knowledgeable about malaria treatment protocol than those of in drugstores. The prevalence of self-prescription of antimalarials was 39.3%. Self-prescription was significantly higher in drugstores than hospital/community pharmacies (p=0.004). In all, 56 (40.6%) of vendors showed good practices regarding antimalarial drug dispensing with the majority (51.7%) from community pharmacies (OR=2.27,95% CI: 1.13-4.56). Conclusion: Findings reveal moderate knowledge of malaria but poor prescription and dispensing practices of antimalarial drugs among vendors, thus indicating a need for routine monitoring and evaluation to prevent the emergence of resistant strains to current efficacious antimalarials.

Keywords: antimalarials, drug retail outlets, dispensing, drug resistance, prescription

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Authors: Marko Batic, Nikola Tomasevic, Sanja Vranes

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One of the strongholds in the ubiquitous efforts related to the energy conservation and energy efficiency improvement is represented by the retrofit of high energy consumers in buildings. In general, HVAC systems represent the highest energy consumers in buildings. However they usually suffer from mal-operation and/or malfunction, causing even higher energy consumption than necessary. Various Fault Detection and Diagnosis (FDD) systems can be successfully employed for this purpose, especially when it comes to the application at a single device/unit level. In the case of more complex systems, where multiple devices are operating in the context of the same building, significant energy efficiency improvements can only be achieved through application of comprehensive FDD systems relying on additional higher level knowledge, such as their geographical location, served area, their intra- and inter- system dependencies etc. This paper presents a comprehensive FDD system that relies on the utilization of common knowledge repository that stores all critical information. The discussed system is deployed as a test-bed platform at the two at Fiumicino and Malpensa airports in Italy. This paper aims at presenting advantages of implementation of the knowledge base through the utilization of ontology and offers improved functionalities of such system through examples of typical queries and reasoning that enable derivation of high level energy conservation measures (ECM). Therefore, key SPARQL queries and SWRL rules, based on the two instantiated airport ontologies, are elaborated. The detection of high level irregularities in the operation of airport heating/cooling plants is discussed and estimation of energy savings is reported.

Keywords: airport ontology, knowledge management, ontology modeling, reasoning

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Authors: Ameen Alshugaa, Abul Mansur Masih

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This paper sheds light on the economic impacts of political uncertainty caused by the civil uprisings that swept the Arab World and have been collectively known as the Arab Spring. Measuring documented effects of political uncertainty on regional stock market indices, we examine the impact of the Arab Spring on the volatility of stock markets in eight countries in the Middle East and North Africa (MENA) region: Egypt, Lebanon, Jordon, United Arab Emirate, Qatar, Bahrain, Oman and Kuwait. This analysis also permits testing the existence of financial contagion among equity markets in the MENA region during the Arab Spring. To capture the time-varying and multi-horizon nature of the evidence of volatility and contagion in the eight MENA stock markets, we apply two robust methodologies on consecutive data from November 2008 to March 2014: MGARCH-DCC, Continuous Wavelet Transforms (CWT). Our results indicate two key findings. First, the discrepancies between volatile stock markets of countries directly impacted by the Arab Spring and countries that were not directly impacted indicate that international investors may still enjoy portfolio diversification and investment in MENA markets. Second, the lack of financial contagion during the Arab Spring suggests that there is little evidence of cointegration among MENA markets. Providing a general analysis of the economic situation and the investment climate in the MENA region during and after the Arab Spring, this study bear significant importance for policy makers, local and international investors, and market regulators.

Keywords: Portfolio Diversification , MENA Region , Stock Market Indices, MGARCH-DCC, Wavelet Analysis, CWT

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

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Authors: Mai Alshareef

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The Saudi government considers the modernisation of the education system as a critical component of the national development plan, Saudi Vision 2030; however, this sudden reform creates tension amongst Saudis. This study examines first the reflection of the social and digital education reform on stakeholders and the general Saudi public, and second, the influence of information and communication technologies (ICTs) on the ethnoreligious conflict in Saudi Arabia. This study employs Cyberconflict theory to examine conflicts in the real world and cyberspace. The findings are based on a qualitative case study methodology that uses netnography, an analysis of 3,750 Twitter posts and semi-structural interviews with 30 individuals, including key actors in the Saudi education sector and Twitter activists during 2019\2020. The methods utilised are guided by thematic analysis to map an understanding of factors that influence societal conflicts in Saudi Arabia, which in this case include religious, national, and gender identity. Elements of Cyberconflict theory are used to better understand how conflicting groups build their identities in connection to their ethnic/religious/cultural differences and competing national identities. The findings correspond to the ethnoreligious components of the Cyberconflict theory. Twitter became a battleground for liberals, conservatives, the Saudi public and elites, and it is used in a novel way to influence public opinion and to challenge the media monopoly. Opposing groups relied heavily on a discourse of exclusion and inclusion and showed ethnic and religious affiliations, national identity, and chauvinism. The findings add to existing knowledge in the cyberconflict field of study, and they also reveal outcomes that are critical to the Saudi Arabian national context.

Keywords: education, cyberconflict, Twitter, national identity

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Authors: A. Cheriguene, F. Chougrani

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A total of 153 wild lactic acid bacteria were isolated from goat’s milk collected from different areas in Western Algeria. The strains were identified using phenotypical, biochemical and physiological properties. API system and SDS-PAGE technique was also used in identification of the strains. Six genera were found Enterococcus (41.83%), Lactobacillus (29.40%), Lactococcus (19.60%), Leuconostoc (4.57%), Streptococcus thermophilus (3.26%) and Pediococcus (1.30%). The most abundant species were Enterococcus faecium (24 isolates), Enterococcus durans (22 isolates), Lactococcus lactis subsp. lactis (25 isolates), Lactobacillus rhamnosus (09 isolates) and Lactobacillus delbrueckii subsp. bulgaricus (07 isolates). The strains were screened for production and technological properties such as acid production, aminopeptidase activity, autolytic properties, antimicrobial activity and exopolysaccharide production. In general most tested isolates showed a good biomass separation when collected by centrifugation; as for the production of the lactic acid, results revealed that our strains are weakly acidifying; nevertheless, lactococci showed a best acidifying activity compared to lactobacilli. Aminopeptidase activity was also weak in most strains; but, it was generally higher for lactobacilli compared to lactococci, where we recorded 30 units for Lactobacillus delbrueckii subsp. bulgaricus M14. Autolytic activity was generally higher for most strains, more particularly lactobacilli where we recorded values of 71.13% and 70% of autolysis rate respectively in Lactobacillus rhamnosus strains 9S10 and 9S7. Antimicrobial activity was detected in 50% of the isolates, particularly in lactobacilli where 80% of strains tested were able to inhibit the growth of other strains. Two strains could produce exopolysaccharides, E. faecium 8M6 and E. durans 7S8. Some strains were able to maintain two or three technological characteristics together.

Keywords: lactic acid bacteria, technological properties, acidification, aminopeptidase acivity (AP), autolysis

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Authors: Yolanda Havenga

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Being a competent nurse requires clinical, general, and moral competencies. Moral competence is a culmination of moral perceptions, moral judgment, moral behaviour, and moral identity. Moral identity is the values, images, and fundamental principles held in the collective minds and memories of nurses about what it means to be a ‘good nurse’. It is important to explore and describe South African nurses’ moral identities and excavate the post-colonial counter-narrative to nurses moral identities as a better understanding of these identities will enable means to positively address nurses’ moral behaviours. This study explored the moral identity of nurses within the South African context. A qualitative approach was followed triangulating with phenomenological and narrative designs with the same purposively sampled group of professional nurses. In-depth interviews were conducted until saturation of data occurred about the sampled nurses lived experiences of being a nurse in South Africa. They were probed about their core personal-, social-, and professional values. Data were analysed based on the steps used by Colaizzi. These nurses were then asked to write a narrative telling a personal story that portrayed a significant time in their professional career that defines their identity as a nurse. This data were analysed using a critical narrative approach and findings of the two sets of data were merged. Ethical approval was obtained and approval from all relevant gate keepers. In the findings, themes emerged related to personal, social and professional values, images and fundamental principles of being a nurse within the South African context. The findings of this study will inform a future national study including a representative sample of South African nurses.

Keywords: moral behaviour, moral identity, nurses, qualitative research

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Authors: Asma Batool

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Immigrant families raising a child with developmental disabilities in Canada encounter many challenges during the process of disability care. Starting from the early screening of their child for diagnosis followed by challenges associated with treatment, access and service utilization. A substantial amount of research focuses on identifying barriers. However, the functional aspects of barriers in terms of their potential influences on parents and children with disabilities are unexplored yet. This paper presents functional analysis of barriers in disability care research by adopting a method of integrated approach. Juxtaposition of two developmental approaches, Bronfenbrenner’s ecological model and parents ‘transformational process model is generating multiple hypotheses to be considered while empirically investigating causal relationships and mediating or moderating factors among various variables related with disability care research. This functional analysis suggests that barriers have negative impacts on the physical and emotional development of children with disabilities as well as on the overall quality of family life (QOFL). While, barriers have facilitating impacts on parents, alternatively, the process of transformation in parents expedite after experiencing barriers. Consequently, parents reconstruct their philosophy of life and experience irreversible but continuous developmental change in terms of transformations simultaneously with their developing child and may buffer the expected negative impacts of barriers on disabled child and QOFL. Overall, this paper is suggesting implications for future research and parents’ transformations are suggesting potential pathways to minimize the negative influences of barriers that parents experience during disability care, hence improving satisfaction in QOFL in general.

Keywords: barriers in disability care, developmental disabilities, parents’ transformations, quality of family life

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Authors: Yeşim Özer Özkan, Fatma Büşra Fincan

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Biased sample is a regression of an observation, design process and all of the specifications lead to tendency of a side or the situation of leaving from the objectivity. It is expected that, test items are answered by the students who come from different social groups and the same ability not to be different from each other. The importance of the expectation increases especially during student selection and placement examinations. For example, all of the test items should not be beneficial for just a male or female group. The aim of the research is an investigation of item bias whether or not the exam included in 2014 free boarding and scholarship examination in terms of gender variable. Data which belong to 5th, 6th, and 7th grade the secondary education students were obtained by the General Directorate of Measurement, Evaluation and Examination Services in Turkey. 20% students were selected randomly within 192090 students. Based on 38418 students’ exam paper were examined for determination item bias. Winsteps 3.8.1 package program was used to determine bias in analysis of data, according to Rasch Model in respect to gender variable. Mathematics items tests were examined in terms of gender bias. Firstly, confirmatory factor analysis was applied twenty-five math questions. After that, NFI, TLI, CFI, IFI, RFI, GFI, RMSEA, and SRMR were examined in order to be validity and values of goodness of fit. Modification index values of confirmatory factor analysis were examined and then some of the items were omitted because these items gave an error in terms of model conformity and conceptual. The analysis shows that in 2014 free boarding and scholarship examination exam does not include bias. This is an indication of the gender of the examination to be made in favor of or against different groups of students.

Keywords: gender, item bias, placement test, Rasch model

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Authors: R. Morbidelli, C. Saltalippi, A. Flammini, A. Garcia-Marin, J. L. Ayuso-Munoz

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The climate change, mainly due to greenhouse gas emissions associated to human activities, has been modifying hydrologic processes with a direct effect on air surface temperature that has significantly increased in the last century at global scale. In this context the Mediterranean area is considered to be particularly sensitive to the climate change impacts on temperature indices. An analysis finalized to study the evolution of temperature indices and to check the existence of significant trends in the Umbria Region (Italy) is presented. Temperature data were obtained by seven meteorological stations uniformly distributed in the study area and characterized by very long series of temperature observations (at least 60 years) spanning the 1924-2015 period. A set of 39 temperature indices represented by monthly and annual mean, average maximum and average minimum temperatures, has been derived. The trend analysis was realized by applying the non-parametric Mann-Kendall test, while the non-parametric Pettit test and the parametric Standard Normal Homogeneity test (SNHT) were used to check the presence of breakpoints or in-homogeneities due to environmental changes/anthropic activity or climate change effects. The Umbria region, in agreement with other recent studies exploring the temperature behavior in Italy, shows a general increase in all temperature indices, with the only exception of Gubbio site that exhibits very light negative trends or absence of trend. The presence of break points and in-homogeneity was widely explored through the selected tests and the results were checked on the basis of the well-known metadata of the meteorological stations.

Keywords: reception theory, reading, literary translation, horizons of expectation, reader

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Authors: Yepeng Cheng, Yasuhiko Morimoto

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Customer relationship analysis is vital for retail stores, especially for supermarkets. The point of sale (POS) systems make it possible to record the daily purchasing behaviors of customers as an identification point of sale (ID-POS) database, which can be used to analyze customer behaviors of a supermarket. The customer value is an indicator based on ID-POS database for detecting the customer loyalty of a store. In general, there are many supermarkets in a city, and other nearby competitor supermarkets significantly affect the customer value of customers of a supermarket. However, it is impossible to get detailed ID-POS databases of competitor supermarkets. This study firstly focused on the customer value and distance between a customer's home and supermarkets in a city, and then constructed the models based on logistic regression analysis to analyze correlations between distance and purchasing behaviors only from a POS database of a supermarket chain. During the modeling process, there are three primary problems existed, including the incomparable problem of customer values, the multicollinearity problem among customer value and distance data, and the number of valid partial regression coefficients. The improved customer value, Huff’s gravity model, and inverse attractiveness frequency are considered to solve these problems. This paper presents three types of models based on these three methods for loyal customer classification and competitors’ influence analysis. In numerical experiments, all types of models are useful for loyal customer classification. The type of model, including all three methods, is the most superior one for evaluating the influence of the other nearby supermarkets on customers' purchasing of a supermarket chain from the viewpoint of valid partial regression coefficients and accuracy.

Keywords: customer value, Huff's Gravity Model, POS, Retailer

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Authors: Ekin Ece Gürer, Tarık Onur Tiryaki, Sevgi Kalayoğlu Beşışık, Fatma Savran Oğuz, Uğur Sezerman, Fatma Erdem, Gülşen Günel, Dürdane Serap Kuruca, Zerrin Aktaş, Oral Öncül

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Aim: Chemotherapytreatment in HodgkinLymphomaandNon-HodgkinLymphoma (NHL) diseasescausesgastrointestinalepithelialdamage, disruptstheintestinalmicrobiotabalanceandcausesdysbiosis. Inourstudy, it wasaimedtoshowtheeffect of thedamagecausedbychemotherapy on themicrobiotaandtheeffect of thechangingmicrobiota flora on thecourse of thedisease. Materials And Methods: Seven adult HL and seven adult HL patients to be treatedwithchemotherapywereincluded in the study. Stoolsamplesweretakentwice, beforechemotherapytreatmentandafterthe 3th course of treatment. SamplesweresequencedusingNextGenerationSequencing (NGS) methodafternucleicacidisolation. OTU tableswerepreparedusing NCBI blastnversion 2.0.12 accordingtothe NCBI general 16S bacterialtaxonomyreferencedated 10.08.2021. Thegenerated OTU tableswerecalculatedwith R Statistical Computer Language version 4.04 (readr, phyloseq, microbiome, vegan, descrand ggplot2 packages) to calculate Alpha diversityandtheirgraphicswerecreated. Statistical analyzeswerealsoperformedusing R Statistical Computer Language version 4.0.4 and studio IDE 1.4 (tidyverse, readr, xlsxand ggplot2 packages). Expression of IL-12 and IL-17 cytokineswasperformedbyrtPCRtwice, beforeandaftertreatment. Results: InHL patients, a significantdecreasewasobserved in themicrobiota flora of Ruminococcaceae_UCG-014 genus (p:0.036) andUndefined Ruminococcaceae_UCG-014 species (p:0.036) comparedtopre-treatment. When the post-treatment of HL patientswerecomparedwithhealthycontrols, a significantdecreasewasfound in themicrobiota of Prevotella_7 genus (p:0.049) andButyricimonas (p:0.006) in the post-treatmentmicrobiota of HL patients. InNHL patients, a significantdecreasewasobserved in themicrobiota flora of Coprococccus_3 genus (p:0.015) andUndefined Ruminoclostridium_5 (p:0.046) speciescomparedtopre-treatment. When post-treatment of NHL patientswerecomparedwithhealthycontrols, a significantabundance in theBacilliclass (p:0.029) and a significantdecrease in theUndefinedAlistipesspecies (p:0.047) wereobserved in the post-treatmentmicrobiota of NHL patients. While a decreasewasobserved in IL-12 cytokineexpressionuntilbeforetreatment, an increase in IL-17 cytokineexpressionwasdetected. Discussion: Intestinal flora monitoringafterchemotherapytreatmentshowsthat it can be a guide in thetreatment of thedisease. It is thoughtthatincreasingthediversity of commensalbacteria can alsopositivelyaffecttheprognosis of thedisease.

Keywords: hodgkin lymphoma, non-hodgkin, microbiota, cytokines

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Authors: Miranda I. Dosunmu, Orok E. Oyo-Ita, Inyang O. Oyo-Ita

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Polycyclic aromatic hydrocarbons (PAHs) are a class of priority listed organic pollutants due to their carcinogenicity, mutagenity, acute toxicity and persistency in the environment. The distribution and historical changes of PAHs contamination in recent sediment cores from the Imo River were investigated using gas chromatography coupled with mass spectrometer. The concentrations of total PAHs (TPAHs) ranging from 402.37 ng/g dry weight (dw) at the surface layer of the Estuary zone (ESC6; 0-5 cm) to 92,388.59 ng/g dw at the near surface layer of the Afam zone (ASC5; 5-10 cm) indicate that PAHs contamination was localized not only between sample sites but also within the same cores. Sediment-depth profiles for the four (Afam, Mangrove, Estuary and illegal Petroleum refinery) cores revealed irregular distribution patterns in the TPAH concentrations except the fact that these levels became maximized at the near surface layers (5-10 cm) corresponding to a geological time-frame of about 1996-2004. This time scale coincided with the period of intensive bunkering and oil pipeline vandalization by the Niger Delta militant groups. Also a general slight decline was found in the TPAHs levels from near the surface layers (5-10 cm) to the most recent top layers (0-5 cm) of the cores, attributable to the recent effort by the Nigerian government in clamping down the illegal activity of the economic saboteurs. Therefore, the recent amnesty period granted to the militant groups should be extended. Although mechanism of perylene formation still remains enigmatic, examination of its distributions down cores indicates natural biogenic, pyrogenic and petrogenic origins for the compound at different zones. Thus, the characteristic features of the Imo River environment provide a means of tracing diverse origins for perylene.

Keywords: perylene, historical trend, distribution, origin, Imo River

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Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

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Authors: Rajrupa Ghosh, Abhijit Mitra

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Future use of animal protein sources in prawn feeds is expected to be considerably reduced as a consequence of increasing economical, environmental and safety issues. Of main concern has been the use of expensive marine protein sources, such as fish meal which often results in fouling of water quality and disease outbreak in cultured species. To determine prawn capacity to use practical feeds with plant proteins as replacement ingredients to animal protein sources, 8-months growth trial was conducted in two sets of ponds using juvenile (0.02 gm) Macrobrachium rosenbergii. Among the two sets, one set (comprising of three ponds) is experimental pond included formulated feed prepared with 30% Porteresia coarctata dust along with other general ingredients and another set (comprising of another three ponds) is control pond with commercial feed. Mean final weight, percent weight gain, final net yield, feed conversion ratio and survival were evaluated. Higher condition index values, survival rate and gain in prawn weight were observed in experimental pond compared to control pond. Low FCR values were observed in the experimental pond than the control pond. Evaluation of production parameters at the end of the study demonstrated significant differences (P ≥ 0.05) among two ponds. The variation may be attributed to specially formulated plant based feed that not only boosted up the growth of prawns, but also upgraded the ambient aquatic health. These results indicate that fish meal can be replaced with algal protein sources in diets without affecting prawn growth and production.

Keywords: macrobrachium rosenbergii, porteresia coarctata, Indian sundarbans, feed

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Authors: Odunayo Olawuyi Fadodun

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Dielectric elastomers (DEs) are a type of intelligent materials with salient features like electromechanical coupling, lightweight, fast actuation speed, low cost and high energy density that make them good candidates for numerous engineering applications. This paper adopts a new nonlinear electroelastic constitutive theory to examine radial deformation of a pressurized thick-walled spherical shell of soft dielectric material with compliant electrodes on its inner and outer surfaces. A general formular for the internal pressure, which depends on the deformation and a potential difference between boundary electrodes or uniform surface charge distributions, is obtained in terms of special function. To illustrate the effects of an applied electric field on the mechanical behaviour of the shell, three different energy functions with distinct mechanical properties are employed for numerical purposes. The observed behaviour of the shells is preserved in the presence of an applied electric field, and the influence of the field due to a potential difference declines more slowly with the increasing deformation to that produced by a surface charge. Counterpart results are then presented for the thin-walled shell approximation as a limiting case of a thick-walled shell without restriction on the energy density. In the absence of internal pressure, it is obtained that inflation is caused by the application of an electric field. The resulting numerical solutions of the theory presented in this work are in agreement with those predicted by the generally adopted Dorfmann and Ogden model.

Keywords: constitutive theory, elastic dielectric, electroelasticity, finite deformation, nonlinear response, spherical shell

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