Search results for: GAP year

Authors: Phusit Phukamchanoad, Chutchai Ditchareon, Suwaree Yordchim

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This research was to study on background and social and cultural context of Kamchanoad community for sustainable tourism management. All data was collected through in-depth interview with village headmen, community committees, teacher, monks, Kamchanoad forest field officers and respected senior citizen above 60 years old in the community who have lived there for more than 40 years. Altogether there were 30 participants for this research. After analyzing the data, content from interview and discussion, Kamchanoad has both high land and low land in the region as well as swamps that are very capable of freshwater animals’ conservation. Kamchanoad is also good for agriculture and animal farming. 80% of Kamchanoad’s land are forest, freshwater and rice farms. Kamchanoad was officially set up as community in 1994 as “Baan Nonmuang”. Inhabitants in Kamchanoad make a living by farming based on sufficiency economy. They have rice farm, eucalyptus farm, cassava farm and rubber tree farm. Local people in Kamchanoad still believe in the myth of Srisutto Naga. They are still religious and love to preserve their traditional way of life. In order to understand how to create successful tourism business in Kamchanoad, we have to study closely on local culture and traditions. Outstanding event in Kamchanoad is the worship of Grand Srisutto, which is on the full-moon day of 6th month or Visakhabucha Day. Other big events are also celebration at the end of Buddhist lent, Naga firework, New Year celebration, Boon Mahachart, Songkran, Buddhist Lent, Boon Katin and Loy Kratong. Buddhism is the main religion in Kamchanoad. The promotion of tourism in Kamchanoad is expected to help spreading more income for this region. More infrastructures will be provided for local people as well as funding for youth support and people activities.

Keywords: social and culture area, tourism management, Kamchanoad Community, Udon Thani Province

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Authors: Mitiku Tefera

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Background: Meconium-stained amniotic fluid is one of the primary causes of birth asphyxia. Each year, over five million neonatal deaths occur worldwide due to meconium-stained amniotic fluid, with 90% of these deaths due to birth asphyxia. In Ethiopia meconium-stained amniotic fluid is under investigated, specifically in North Shoa Zone Amhara region Ethiopia. Objective: The aim of this study was to assess the magnitude of meconium-stained amniotic fluid and associated factors among women who gave birth in the North Shoa Zone Hospital’s Amhara Region, Ethiopia, in 2022. Methods: An institutional-based, cross-sectional study was conducted among 628 women who gave birth at North Shoa Zone Hospitals, Amhara, Ethiopia. The study was conducted from 08/June-08/August 2022. Two-stage cluster sampling was used to recruit study participants. The data was collected by using a structured interview-administered questionnaire and chart review. The collected data was entered into Epi-Data Version 4.6 and exported to SPSS Version 25. Logistics regression was employed, and a p-value <0.05 was considered significant. Result: The magnitude of meconium-stained amniotic fluid was 30.3%. Women presented with normal hematocrit level 83% less likely develop meconium-stained amniotic fluid. Women had mid-upper arm circumference value was less than 22.9cm(AOR=1.9; 95% CI;1.18-3.20), obstructed labor(AOR=3.6; 95% CI;1.48-8.83), prolonged labor ≥ 15hr (AOR=7.5; 95% CI ;7.68-13.3), the premature rapture of the membrane (AOR=1.7; 95% CI; 3.22-7.40), fetal tachycardia(AOR=6.2; 95% CI; 2.41-16.3) and Bradycardia (AOR=3.1; 95% CI;1.93-5.28) were significant association with meconium stained amniotic fluid. Conclusion: The magnitude of meconium-stained amniotic fluid, which was high. In this study, MUAC value <22.9 cm, obstructed and prolonged labor, PROM, bradycardia, and tachycardia were factors associated with meconium-stained amniotic fluid. A follow-up study and pooled similar articles will be mentioned for better evidence, enhancing intrapartum services and strengthening early detection of meconium-stained amniotic fluid for the health of the mother and baby.

Keywords: women, meconium-staned amniotic fluid, magnitude, Ethiopia

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Authors: Nada Basset

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Problem Statement: The study examines the important role of leading change inside start-ups and highlights the challenges faced by an entrepreneur during the startup phase of the business. Research Methods/Procedures/Approaches: A qualitative research approach is taken, using the case study analysis method. A comparative study was made between two day care nurseries in Greater Cairo. Non-probability purposive sampling was used and a triangulation of semi-structured interviews, document analysis and participant-observation were applied simultaneously. The in-depth case study analysis took place over a longitudinal study of four calendar months. Results/Findings: Findings demonstrated that leading change in an entrepreneurial setup must be initiated by the entrepreneur, who must also be the owner of the change process. Another important finding showed that the culture of change, although created by the entrepreneur, needs the support and engagement of followers, who should be sharing the same value system and vision of the entrepreneur. Conclusions and Implications: An important implication suggests that during the first year of a start-up lifecycle, special emphasis must be made to the recruitment and selection of personnel, who should play a role into setting the new start-up culture and help it grow or shrink. Another drawn conclusion is that the success of the change must be measured in both quantitative and qualitative terms. Increasing revenues and customer attrition rates -as quantitative KPIs- must be aligned with other qualitative KPIs like customer satisfaction, employee satisfaction, and organizational commitment and business reputation. Originality of Paper: The paper addresses change management in an entrepreneurial concept, with an empirical application on an Egyptian start-up model providing a service to both adults and children. This privileges the research as the constructs measured merged together the level of satisfaction of employees, decision-makers (parents of children), and the users (children).

Keywords: leadership, change management, entrepreneurship, startup business

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Authors: Melissa Mattos, Camila Lima, Ibraim Castro, Augusto Carioca, Saulo Magalhães, Paula Freitas, Keciany Oliveira

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Obesity is a chronic, multifactorial, relapsing disease that has increased dramatically over the years. Its control is considered a public health issue, and more and more treatments and interventions are being studied to reduce its prevalence. When interventions in lifestyle and the use of drugs do not generate lasting results, bariatric procedures emerge as a resource for obesity control. The main guidelines for the treatment of obesity emphasize the need for pre-procedure and post-procedure nutritional monitoring to avoid nutritional deficiencies that may occur. The individual who undergoes bariatric surgery needs to understand the changes that will be necessary for life in view of the intense anatomical and metabolic changes that result from surgical techniques. To assess the nutritional profile of patients who undergo bariatric surgery, we analyzed data from the medical records of all people who underwent sleeve-type bariatric surgery from January to June 2022 at a clinic in the City of Fortaleza. 38 patients were analyzed, 32 women and 6 men in the pre-surgical period, 6 and 12 months after surgery. The data showed an average weight loss of 24.45% at 6 months and 30.85% at 12 months, with a reduction of 21.32% and 30.41%, respectively, in the fat percentage, also indicating that 13.15% used drugs for weight loss during this period, leading to reflection on the isolated long-term efficacy of bariatric surgery, requiring multidisciplinary follow-up for a change in lifestyle. Only 12 individuals, corresponding to 31.57%, reached eutrophic BMI 12 months after surgery, 20 individuals remained overweight, corresponding to 52.63% of the sample, and 6 individuals (15.78%) remained in the BMI obese class I. As for body composition, there was a 52.39% reduction in fat mass and a 12.82% reduction in muscle mass, and 21% of individuals underwent cholecystectomy. Sleeve-type bariatric surgery promoted significant weight loss after 1 year of the procedure, with a reduction in body fat percentage and fat mass. Most patients were still overweight and had a significant reduction in muscle mass.

Keywords: bariatric surgery, sleeve gastrectomy, obesity, sleeve

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Authors: Rudra Prasad Khanal

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Introduction: Non-communicable disease, such as cancer, has spread all over the world for some last decades. However, every nation has experienced a burden from the development of technology. In the context of Nepal, 10 to 15 thousand new cancer incidences are being registered in different hospitals for treatment. Since the date of starting nuclear medicine at Bir Hospital in 1998, cancer patients have been getting treatment regularly. According to the data of the population-based cancer registry, approximately 60% of the population having a middle-class income is being affected by cancer in Nepal. Methods and Materials: The study is aimed to find out the particular place where the population density of new cancer incidence is highest in Nepal and to inform the concerned regulatory body that is working on cancer screening and early detection for the proper treatment from the beginning. In order to identify the areas with the highest population density of new cancer incidence, all the data of cancer patients were collected from five different renowned hospitals and also from the population-based cancer registry center and then analyzed the data. The history of cancer patients was studied from 2003 to 2020, but here the data are analyzed from 2015 to 2020 only to find the latest trend in cancer incidence. Results: In the five major hospitals in Nepal, the total new cancer incidence was 61783 from 2015 to 2020. Out of those, 34617 were female, and 27176 were male. This research shows that female cancer patients were more every year. In the male, lung cancer patients more than cancer of other organs, but in females, the number of breast cancer patients was greatest. The age-adjusted mortality rate for males in Kathmandu valley was 36.3, and for females was 27.0 per 100,000 population. The cancer incidence and mortality rate were slightly lesser in other districts of Nepal. This rate increased with the increase in the age of people. Over 60 years, cancer incidence and mortality rates have been found to increase rapidly. Conclusion: This research supports conducting the program of cancer screening and early detection at Kathmandu valley with high priority and then Morang, Rukum, SSDM, etc., to control cancer.

Keywords: cancer incidence, research scholar, Tribhuvan University, Bhaktapur Cancer Hospital, Nepal

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Authors: Umashankar Morya, Somnath Basu

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Metalloids like arsenic are often present as contaminants in industrial effluents. Removal of the same is essential before the safe discharge of the wastewater into the environment. Otherwise, these pollutants tend to percolate into aquifers over a period of time and contaminate drinking water sources. Several adsorbents, including metal powders, carbon nanotubes and zeolites, are being used for this purpose, with varying degrees of success. However, most of these solutions are not only costly but also not always readily available. This restricts their use, especially among financially weaker communities. Slag generated globally from primary steelmaking operations exceeds 200 billion kg every year. Some of it is utilized for applications like road construction, filler in reinforced concrete, railway track ballast and recycled into iron ore agglomeration processes. However, these usually involve low-value addition, and a significant amount of the slag still ends up in a landfill. However, there is a strong possibility that the constituents in the steelmaking slag may immobilize metalloid contaminants present in wastewater through a combination of adsorption and precipitation of insoluble product(s). Preliminary experiments have already indicated that exposure to basic oxygen steelmaking slag does reduce pollutant concentration in wastewater. In addition, the slag is relatively inexpensive and available in large quantities and in several countries across the world. Investigations on the mechanism of interactions at the water-solid interfaces have been in progress for some time. However, at the same time, there are concerns about the possibility of leaching of metal ions from the slag particles in concentrations greater than what exists in the water bodies where the “treated” wastewater would eventually be discharged. The effect of such leached ions on the aquatic flora and fauna is yet uncertain. This has prompted the present investigation, which focuses on the leaching of metal ions from steelmaking slag particles in contact with wastewater, and the influence of these ions on the removal of contaminant species. Experiments were carried out to quantify the leaching behavior of different ionic species upon exposure of the slag particles to simulated wastewater, both with and without specific metalloid contaminants.

Keywords: slag, water, metalloid, heavy metal, wastewater

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Authors: Basave Gowda, Lokesh K., Prasanth S. M., Bellad S. B., Radha J., Lokesh G. Y., Patil S. B., Vijayakumar D. K., Ganigar B. S., Rakesh C. Mathad

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Quality seed plays an important role in enhancing the crop productivity. It was reported and confirmed by large scale verification research trials that by use of quality seeds alone, the crop yield can be enhanced by 15 to 20 per cent. At present, the quality seed production and distribution through organised sectors comprising both public and private seed sector was only 20-25% of the requirement and the remaining quantity is met through unorganised sector which include the farmer to farmers saved seeds. With an objective of developing an alternative seed system, the University of Agricultural Sciences, Raichur in Karnataka state has implemented Seed Village Programme in more than 100 villages covering around 5000 farmers every year since 2009-10 and in the selected seed villages, a group of 50-150 farmers were supplied the foundation seeds of new varieties to an extent of 0.4 ha at 50 % subsidy. And two to three training programmes were conducted in the targeted villages for quality seed production and the seed produced in the target group was processed locally in the university seed processing units and arranged for distribution in the local villages by the seed growers themselves. By this new innovative and modified seed system, the university can able to replace old varieties of pigeon pea and green gram by producing 1482, 2978, 2729, 2560, and 4581 tonnes of seeds of new varieties on large scale under farmers and scientists participatory seed village programmes respectively during 2009-10, 2010-11, 2011-12, 2012-13 and 2013-14. From this new alternate model of seed system, there should be large scale promotion of regional seed system involving farmers, NGO and voluntary organisation for quick and effective replacement of old, low yielding, disease susceptible varieties with new high yielding, disease resistant for enhanced food production and food security.

Keywords: seed system, seed village, seed replacement, varietal replacement

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Authors: Shraddha Jadhav

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We are entering a new age in the built environment where we expect our buildings to deliver far more than just a place to work or live. It is widely believed that sustainable building design strategies create improved occupants’ comfort & satisfaction with respect to thermal comfort & indoor environmental quality. Yet this belief remains a hypothesis with little empirical support. IT buildings cater to more than 3000 users at a time. Nowadays people spend 90% of the time inside offices. These sustainable IT office buildings should provide the occupants with maximum comfort for better work productivity. Such green rated buildings fulfill all the criteria at the designing stage, but do they really work as expected at the occupancy stage. The aim of this paper is to evaluate whether green IT buildings provide the required comfort level as expected at the design stage. Building Occupants are a rich source of information for evaluating their comfort level in the building and to find out the solutions for their discomfort. This can be achieved by carrying out Post Occupancy Evaluation after the building has been occupied for more than a year or two. The technique consists of qualitative methods like questionnaire surveys & observations and quantitative methods like field measurements, photographs. Post Occupancy Evaluation was carried out in a Green (Platinum rated) IT building in Pune. 30 samples per floor were identified for the questionnaire survey. The core questions access occupant satisfaction with thermal comfort in the work area and measures adopted for making it comfortable were identified. The Mean Radiant Temperature of the same samples was taken to compare the quantitative and qualitative results. The survey was used to evaluate the occupant thermal comfort in a green office building and identify areas needing improvement. The survey has been designed in reference to ASHRAE standard 55-2010 & ISHRAE 10001:2017 IEQ and was further refined to suit the user of the building.

Keywords: green office building, building occupant, thermal comfort, POE, user satisfaction, survey

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Authors: Julia Zimmerman, Gaurav Savant

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This study aims to evaluate the efficacy of the U.S. Army Corp of Engineers’ River Analysis System (HEC-RAS) application to modeling the hydraulics of estuaries. HEC-RAS has been broadly used for a variety of riverine applications. However, it has not been widely applied to the study of circulation in estuaries. This report details the model development and validation of a combined 1D/2D unsteady flow hydraulic model using HEC-RAS for estuaries and they are associated with tidally influenced rivers. Two estuaries, Galveston Bay and Delaware Bay, were used as case studies. Galveston Bay, a bar-built, vertically mixed estuary, was modeled for the 2005 calendar year. Delaware Bay, a drowned river valley estuary, was modeled from October 22, 2019, to November 5, 2019. Water surface elevation was used to validate both models by comparing simulation results to NOAA’s Center for Operational Oceanographic Products and Services (CO-OPS) gauge data. Simulations were run using the Diffusion Wave Equations (DW), the Shallow Water Equations, Eulerian-Lagrangian Method (SWE-ELM), and the Shallow Water Equations Eulerian Method (SWE-EM) and compared for both accuracy and computational resources required. In general, the Diffusion Wave Equations results were found to be comparable to the two Shallow Water equations sets while requiring less computational power. The 1D/2D combined approach was valid for study areas within the 2D flow area, with the 1D flow serving mainly as an inflow boundary condition. Within the Delaware Bay estuary, the HEC-RAS DW model ran in 22 minutes and had an average R² value of 0.94 within the 2-D mesh. The Galveston Bay HEC-RAS DW ran in 6 hours and 47 minutes and had an average R² value of 0.83 within the 2-D mesh. The longer run time and lower R² for Galveston Bay can be attributed to the increased length of the time frame modeled and the greater complexity of the estuarine system. The models did not accurately capture tidal effects within the 1D flow area.

Keywords: Delaware bay, estuarine hydraulics, Galveston bay, HEC-RAS, one-dimensional modeling, two-dimensional modeling

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Authors: Rahma Saleh Hussein Al Balushi

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Oman Electricity Transmission Company's (OETC) vision is to be a renowned world-class transmission grid by 2025, and one of the indications of achieving the vision is obtaining Asset Management ISO55001 certification, which required setting out a documented Standard Operating Procedures (SOP). Hence, documented SOP for the Geographical information system data process has been established. Also, to effectively manage and improve OETC power transmission, asset data and information need to be governed as such by Asset Information & GIS department. This paper will describe in detail the current GIS data submission process and the journey for developing it. The methodology used to develop the process is based on three main pillars, which are system and end-user requirements, Risk evaluation, data availability, and accuracy. The output of this paper shows the dramatic change in the used process, which results subsequently in more efficient, accurate, and updated data. Furthermore, due to this process, GIS has been and is ready to be integrated with other systems as well as the source of data for all OETC users. Some decisions related to issuing No objection certificates (NOC) for excavation permits and scheduling asset maintenance plans in Computerized Maintenance Management System (CMMS) have been made consequently upon GIS data availability. On the Other hand, defining agreed and documented procedures for data collection, data systems update, data release/reporting and data alterations has also contributed to reducing the missing attributes and enhance data quality index of GIS transmission data. A considerable difference in Geodatabase (GDB) completeness percentage was observed between the years 2017 and year 2022. Overall, concluding that by governance, asset information & GIS department can control the GIS data process; collect, properly record, and manage asset data and information within the OETC network. This control extends to other applications and systems integrated with/related to GIS systems.

Keywords: asset management ISO55001, standard procedures process, governance, CMMS

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Authors: Maria Lucia G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Isosporiasis is an affliction caused by coccidial protozoa belonging to genera Isospora spp. or Cystoisospora spp., which may parasitize the small and large intestines of dogs, of which neonates and young animals present higher risk of infection. This study aims at reporting a case of isosporiasis in neonate Pitbull dogs, as well as the diagnosis and treatment. Seven Pitbull puppies were admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil, with history of yellowish diarrhea without mucus or blood for the past two days. The animals were five days old. The history of the mother, a primiparous two-year-old, revealed that she was properly vaccinated, not de-wormed and did not present diarrhea. The clinical examination revealed that the neonates weighted between 308 and 360 grams, and presented normal reflexes, moderate dehydration, body temperatures between 36.8 and 37.2 ºC, blood sugar between 103 and 124 mg/dL and normal appetite. A full blood count and a parasitology assay were performed to aid in the diagnosis. The full blood count detected eosinophilia, without any other relevant alterations. The parasitology assay (Willis-Molly & Faust) revealed the presence of Cystoisospora spp. The treatment was instituted with heated fluid therapy with Ringer’s Lactate (4 mL/100 g, subcutaneous) and antibiotic therapy with sulfamethoxazole-trimethoprim (15 mg/kg, orally) every 12 hours for ten days. The mother and other dogs that came in contact with the newborns were also treated. The environment was disinfected for 10 minutes with 1.6% quaternary ammonium. After 10 days, the newborns presented normal clinical signs and no alterations in the full blood count. Isosporiasis is an affliction with high mortality rates in litters that should be diagnosed and treated as soon as possible to increase the survival rates in these patients.

Keywords: Cystoisospora spp., neonatal infection, puppies, diarrhea,

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Authors: Anik Sarminingsih, Krishna V. Pradana

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The failure of flood control system can be caused by various factors, such as not considering the uncertainty of designed flood causing the capacity of the flood control system is exceeded. The presence of the uncertainty factor is recognized as a serious issue in hydrological studies. Uncertainty in hydrological analysis is influenced by many factors, starting from reading water elevation data, rainfall data, selection of method of analysis, etc. In hydrological modeling selection of models and parameters corresponding to the watershed conditions should be evaluated by the hydraulic model in the river as a drainage channel. River cross-section capacity is the first defense in knowing the reliability of the flood control system. Reliability of river capacity describes the potential magnitude of flood risk. Case study in this research is Wulan River in Central Java. This river occurring flood almost every year despite some efforts to control floods such as levee, floodway and diversion. The flood-affected areas include several sub-districts, mainly in Kabupaten Kudus and Kabupaten Demak. First step is analyze the frequency of discharge observation from Klambu weir which have time series data from 1951-2013. Frequency analysis is performed using several distribution frequency models such as Gumbel distribution, Normal, Normal Log, Pearson Type III and Log Pearson. The result of the model based on standard deviation overlaps, so the maximum flood discharge from the lower return periods may be worth more than the average discharge for larger return periods. The next step is to perform a hydraulic analysis to evaluate the reliability of river capacity based on the flood discharge resulted from several methods. The selection of the design flood discharge of flood control system is the result of the method closest to bankfull capacity of the river.

Keywords: design flood, hydrological model, reliability, uncertainty, Wulan river

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Authors: Etleva Hamzaraj, Eva Kica, Anila Paparisto, Pranvera Lazo

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Worldwide demographic developments of recent decades have been associated with negative environmental consequences. For this reason, there is a growing interest in assessing the state of natural ecosystems or assessing human impact on them. In this respect, this study aims to evaluate the change in water quality of the Mat River for a period of about ten years to highlight human impact. In one year, period of study, several biological and environmental parameters are determined to evaluate river water quality, and the data collected are compared with those of a similar study in 2007. Samples are collected every month in five stations evenly distributed along the river. Total coliform bacteria, the number of heterotrophic bacteria in water, and benthic macroinvertebrates are used as biological parameters of water quality. The most probable number index is used for evaluation of total coliform bacteria in water, while the number of heterotrophic bacteria is determined by counting colonies on plates with Plate Count Agar, cultivated with 0.1 ml sample after series dilutions. Benthic macroinvertebrates are analyzed by the number of individuals per taxa, the value of biotic index, EPT Richness Index value and tolerance value. Environmental parameters like pH, temperature, and electrical conductivity are measured onsite. As expected, the bacterial load was higher near urban areas, and the pollution increased with the course of the river. The maximum concentration of fecal coliforms was 1100 MPN/100 ml in summer and near the most urbanized area of the river. The data collected during this study show that after about ten years, there is a change in water quality of Mat River. According to a similar study carried out in 2007, the water of Mat River was of ‘excellent’ quality. But, according to this study, the water was classified as of ‘excellent’ quality only in one sampling site, near river source, while in all other stations was of ‘good’ quality. This result is based on biological and environmental parameters measured. The human impact on the quality of water of Mat River is more than evident.

Keywords: water quality, coliform bacteria, MPN index, benthic macroinvertebrates, biotic index

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Authors: Shang-Hsin Ou, Yang-Chun Lin, Ke-Hao Cheng

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The year 2021 marked a historic drought in Taiwan, posing unprecedented challenges due to record-low rainfall and inadequate reservoir storage. The central region experienced water scarcity, leading to the implementation of "Groundwater Utilization at Construction Sites" for drought-resilient livelihood water supply. This study focuses on the establishment process of temporary groundwater treatment plants at construction sites in Taichung City, serving as a reference for future emergency response and the utilization of construction site groundwater. To identify suitable sites for groundwater reuse projects, site selection operations were carried out based on relevant water quality regulations and assessment principles. Subsequently, the planning and design of temporary water treatment plants were conducted, considering the water quality, quantity, and on-site conditions of groundwater wells associated with construction projects. The study consolidates the major water treatment facilities at each site and addresses encountered challenges during the establishment process. Practical insights gained from operating temporary groundwater treatment plants are presented, including improvements related to stable water quality, water quantity, equipment operation, and hydraulic control. In light of possible future droughts, this study provides an outlook and recommendations to expedite and improve the setup of groundwater treatment plants at construction sites. This includes considering on-site water abstraction, treatment, and distribution conditions. The study's results aim to offer practical guidelines for effectively establishing and managing such treatment plants, while offering experiences and recommendations for other regions facing similar emergencies, water shortages, and drought situations. These endeavors contribute to ensuring sustainable water supply for drought-resilient livelihoods and maintaining societal stability.

Keywords: drought resilience, groundwater treatment, construction site, water supply

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Authors: P. Phenpun, S. Wareewan

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This qualitative study aimed to describe the opinions in relation to humanized care emerging from the volunteer activities of nursing students at Boromarajonani College of Nursing, Chonburi, Thailand. One hundred and twenty-seven second-year nursing students participated in this study. The volunteer activity model was composed of preparation, implementation, and evaluation through a learning log, in which students were encouraged to write their daily activities after completing practical training at the healthcare center. The preparation content included three main categories: service minded, analytical thinking, and client participation. The preparation process took over three days that accumulates up to 20 hours only. The implementation process was held over 10 days, but with a total of 70 hours only, with participants taking part in volunteer work activities at a healthcare center. A learning log was used for evaluation and data were analyzed using content analysis. The findings were as follows. With service minded, there were two subcategories that emerged from volunteer activities, which were service minded towards patients and within themselves. There were three categories under service minded towards patients, which were rapport, compassion, and empathy service behaviors, and there were four categories under service minded within themselves, which were self-esteem, self-value, management potential, and preparedness in providing good healthcare services. In line with analytical thinking, there were two components of analytical thinking, which were analytical skill for their works and analytical thinking for themselves. There were four subcategories under analytical thinking for their works, which were evidence based thinking, real situational thinking, cause analysis thinking, and systematic thinking, respectively. There were four subcategories under analytical thinking for themselves, which were comparative between themselves, towards their clients that leads to the changing of their service behaviors, open-minded thinking, modernized thinking, and verifying both verbal and non-verbal cues. Lastly, there were three categories under participation, which were mutual rapport relationship; reconsidering client’s needs services and providing useful health care information.

Keywords: humanized care service, volunteer activity, nursing student, learning log

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Authors: Kwasi Sarfo, Bernard Okoampah Otu

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The 1992 constitution of the Republic of Ghana recognises the authority and roles of traditional leaders and considers them as being entrusted with fiduciary responsibility over land in their respective territories. The new land act, Act 1036 of 2020, in buttressing the fiduciary role of traditional leaders in land matters, inserted the traditional leaders’ accountability clause. Many traditional leaders have expressed their misgivings about the insertion of this clause. Therefore, there appears to be a misunderstanding of the concept of fiduciary in land management in Ghana. The objective of this study is to examine the concept of fiduciary in respect of allodial rights holders in land management and administration and how this concept is perceived and applied by traditional leaders. The study seeks to provide insights into the discrepancy between fiduciary theory and its practical implementation in Ghana. The study is based on a qualitative empirical research approach and adopts in-depth interviews as a primary method of data collection. The study also adopts the theory of New Institutionalism of social anthropology in analysing and interpreting the findings. The data for this study was collected over a period of one year, from July 2022 to July 2023, as part of one of the author's PhD dissertation. The collected data were carefully analysed using the principles of thematic analysis, identifying key themes and patterns. This study does not seek to pursue the discussions from a legal standpoint but from a social anthropological perspective and argues that the concept of fiduciary in theory is far different from what pertains in practice and that traditional leaders’ assumptions and application of this concept contribute to the alienation of customary and communal land at the expense of their subjects. This study deepens our understanding of the continuous expropriation of communal landholders in many rural communities in Africa in the era of global land grabbing, which worsens their poverty levels. It also explains further the theory of new institutionalism of social anthropology by highlighting how the theory manifests in practice in the case of Ghana.

Keywords: fiduciary, customary land tenure, allodial rights, land alienation, communal land, Ghana

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Authors: Okan Cakir, Okan Tatli

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Acute motor and sensory axonal neuropathy (AMSAN) syndrome usually occurs following a postviral infection in two to four weeks and is a polyneuropathy characterized by axonal and sensorial degeneration as a rare variant of Gullian-Barre syndrome. In our case, we wanted to mention that a rare case of AMSAN Syndrome due to prior surgery. A 61-year-old male case admitted to emergency department with complaints of weakness in feet, numbness and incapability to walk. In his history, it was learned that endovascular aneurysm repair (EVAR) had applied for abdominal aort aneurysm two weeks ago before admission, his complaints had been for a couple of days increasingly and bilaterally, and there had been no infection disease history for four weeks. In physical examination, general status was good, vital signs were stable, and there was a mild paresis in dorsal flexion of feet in bilaterally lower extremities. No nuchal rigidity was determined. Other system examinations were normal. Urea:52 mg/dL (normal range: 15-44 mg/dL), creatinine: 1,05 mg/dL (normal range: 0,81-1,4 mg/dL), potassium: 3,68 mmol/L (normal range: 3,5-5,5 mmol/L), glycaemia: 142 mg/dL, calcium: 9,71 mg/dL (normal range: 8,5-10,5 mg/dL), erythrocyte sedimentation rate (ESR): 74 mm/h (normal range: 0-15 mm/h) were determined in biochemical tests. The case was consulted to neurology department and hospitalized. In performing electromyography, it was reported as a bilateral significant axonal degeneration with sensory-motor polyneuropathy. Normal ranges of glycaemia and protein levels were detected in lumbal punction. Viral markers and bucella, toxoplasma, and rubella markers were in normal range. Intravenous immunoglobulin (IVIG) was applied as a treatment, physical treatment programme was planned and the case discharged from neurology department. In our case, we mentioned that it should be considered polyneuropathy as an alternative diagnosis in cases admitting symptoms like weakness and numbness had a history of prior surgery.

Keywords: AMSAN Syndrome, emergency department, prior surgery, weakness

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Authors: M. Shivakumar, S. R. Somashekhar, C. V. Raju

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Secondary salinization of agricultural lands in any command areas of the world is the major issue in the recent past. Currently, it is estimated that the 954 mh of saline and alkaline soil is present in the world. Thousands of hectares of land, getting added every year. Argentina, Bangladesh and Australia are most affected countries. In India, out of 142.80 million hectare (mh) cropped area, 56 mh is irrigated area. Of which, more than 9 mh (about 16.%) of land is found to be alkaline/saline. Due to continuous utilization of same land for same agricultural activities, excessive usage of fertilizers and water, most of the soils have become alkaline, saline or water logged. These lands are low productive and at times totally unfit for agricultural activities. These soils may or may not posses good physical condition, but plants may suffer from its inability to absorb water from salty solution. Plants suffer from dehydration and loose water to the soil, shrink, resulting death of plant. This process is called plasmolysis. It is the fact that soil is an independent, organic body of nature that acquires properties in accordance with forces which act upon it. Aquaculture is one of the solutions to utilize such problematic soils for food production. When the impoundments are constructed in an area 10-15% of the affected areas, the excess water along with the salts gets into impoundments and management of salt is easier in water than in the soil. Due to high organic input in aquaculture such as feed, manure and continuous deposition of fecal matter, pH of the soil gets reduced and over the period of time such soils can be put back into the original activity. Under National Agricultural Development Program (NADP), the project was implemented in 258 villages of Mandya District, Karnataka State, India and found that these lands can be effectively utilized for fish culture and increase the proteinacious food production by many folds while conserving the soils. The findings of the research can be adopted and up scaled in any country.

Keywords: saline and alkaline soils, Aquaculture, Problematic soils, Reclamation

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Authors: Toufic Sarieddine

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As the belt and road Initiative (henceforth, BRI) enters its 9th year, Iran and China are forging stronger ties on economic and military fronts, a development which has not only caused alarm in Washington but also risks staining China’s relationships with the oil-rich Gulf monarchies. World-systems theory has been used to examine the impact of the BRI on the current world order, with scholarship split on the capacity of China to emerge as a hegemon contending with the US or even usurping it. This paper argues the emergence of a new China-centered world-system comprised of states/areas and processes participating in the BRI and overlapping with the global world-system under (shaky) US hegemony. This world-system centers around China as core and hegemon via economic domination, capable new institutions (Shanghai Cooperation Council), legal modi operandi, the common goal of infrastructure development to rally support among developing states, and other indicators of hegemony outlined in world-systems theory. In this regard, while states like Pakistan could become peripheries to China in the BRI-bound world-system via large-scale projects such as the China-Pakistan Economic Corridor, Iran has greater capacities and influence in the Middle East, making it superior to a periphery. This paper thus argues that the increasing proximity between Iran and China sees the former becoming a semi-periphery with respect to China within the BRI-bound world-system, having economic dependence on its new core and hegemon while simultaneously wielding political and military influence on weaker states such as Iraq, Lebanon, Yemen, and Syria. The indicators for peripheralization as well as the characteristics of a semi-periphery outlined in world-systems theory are used to examine the current economic, political, and militaristic dimensions of Iran and China’s growing relationship, as well as the trajectory of these dimensions as part of the BRI-bound world-system.

Keywords: belt and road initiative, China, China-Middle East relations, Iran, world-systems analysis

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Authors: A. Gagat-Matuła

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There is a definite lack – in Poland, as well as around the world – of empirical studies of families raising handicapped child, in which one parent migrates. In diagnostics of the functioning of such families emphasis should be placed not only on the difficulties, but most of all it should be indicated what possibilities are there for the family and how it overcomes the difficulties. Migration of a parent on the one hand is a chance to improve the family’s material situation. In certain circumstances this may only be an “escape” into work from the issues associated with the upbringing and rehabilitation of a handicapped child. The aim of the study was to learn the functioning of a temporarily single parent family system as a result of migration of a parent from the perspective of adolescents with cerebral palsy. The study was conducted in the year 2013 in the area of Eastern Poland. It involved an analysis of 70 persons (with cerebral palsy in an intellectual capacity) from families in which at least one of the parents migrates. The study incorporated the diagnostic survey method. These tools were used: Family Evaluation Scales (SOR) adapted for Poland by Andrzej Margasiński. The explorations in this study indicate, that 47% of studied temporarily single parent families are balanced models. This is evidence of the resources at the disposal of the family which, despite the disability of the child and temporary separation, is able to function properly. The conducted studies show, that 37% of temporarily single parent families are imbalanced models in the perception of adolescents with cerebral palsy. These families experience functional difficulties and require psychological and pedagogical support. There is a need for building skills related to effective coping with family stress. Especially considering, that families of an imbalanced type do not use the internal and external resources of the family system. Such a situation may deepen the disarrangement of family life. In intermediate families (16%) there are also temporary difficulties in functioning. Separation anxiety experienced by mothers may disrupt relations and introduce additional stress factors. For that reason it is important to provide support for women with difficulties coping with the emotions associated with raising handicapped adolescents and migratory separation.

Keywords: child with cerebral palsy, family, migration, parents

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Authors: Jeounghee Kim

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

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Monika Benedek

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Improvisation is an integral part of music education programmes worldwide since teachers recognize that improvisation helps to broaden stylistic knowledge, develops creativity and various musical skills, in particular, aural skills, and also motivates to learn music theory. In Hungary, where Kodály concept is a core element of music teacher education, improvisation has been relatively neglected subject in both primary school and classical music school curricula. Therefore, improvisation was an important theme of a one-year-long research project carried out at the Liszt Academy of Music in Budapest. The project aimed to develop the music teacher training programme, and among others, focused on testing how improvisation could be used as a teaching tool to improve students’ musical reading and writing skills and creative musical skills. Teacher-researchers first tested various teaching approaches of improvisation with numerous teaching modules in music lessons at public schools and music schools. Data were collected from videos of lessons and from teachers’ reflective notes. After analysing data and developing teaching modules, all modules were tested again in a pilot course in 30 contact lessons for music teachers. Teachers gave written feedback of the pilot programme, tested two modules by their choice in their own teaching and wrote reflecting comments about their experiences in applying teaching modules of improvisation. The overall results indicated that improvisation could be an innovative approach to teaching various musical subjects, in particular, solfege, music theory, and instrument, either in individual or in group instruction. Improvisation, especially with the application of relative solmisation and singing, appeared to have been a beneficial tool to develop various musicianship skills of students and teachers, in particular, the aural, musical reading and writing skills, and creative musical skills. Furthermore, improvisation seemed to have been a motivating teaching tool to learn music theory by creating a bridge between various musical styles. This paper reports on the results of the research project.

Keywords: improvisation, Kodály concept, music school, public school, teacher training

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Authors: Abdulmajeed Almansour

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Learning a foreign language with the assistant of technological tools has become an interest of learners and educators. Increased use of smartphones among undergraduate students has made them popular for not only social communication but also for entertainment and educational purposes. Smartphones have provided remarkable advantages in language learning process. Learning vocabulary is an important part of learning a language. The use of smartphone applications for English vocabulary learning provides an opportunity for learners to improve vocabulary knowledge beyond the classroom wall anytime anywhere. Recently, various smartphone applications were created specifically for vocabulary learning. This paper aims to explore the use of smartphone application Memrise designed for vocabulary learning to enhance academic vocabulary among undergraduate students. It examines whether the use of a Memrise smartphone application designed course enhances the academic vocabulary learning among ESL learners. The research paradigm used in this paper followed a mixed research model combining quantitative and qualitative research. The study included two hundred undergraduate students randomly assigned to the experimental and controlled group during the first academic year at the Faculty of English Language, Imam University. The research instruments included an attitudinal questionnaire and an English vocabulary pre-test administered to students at the beginning of the semester whereas post-test and semi-structured interviews administered at the end of the semester. The findings of the attitudinal questionnaire revealed a positive attitude towards using smartphones in learning vocabulary. The post-test scores showed a significant difference in the experimental group performance. The results from the semi-structure interviews showed that there were positive attitudes towards Memrise smartphone application. The students found the application enjoyable, convenient and efficient learning tool. From the study, the use of the Memrise application is seen to have long-term and motivational benefits to students. For this reason, there is a need for further research to identify the long-term optimal effects of learning a language using smartphone applications.

Keywords: second language vocabulary learning, academic vocabulary, mobile learning technologies, smartphone applications

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Authors: Kanik Sharma

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In the year of 2011, the global production of carbon nano-materials (CNMs) was around 3,500 tons, and it is projected to expand at a compound annual growth rate of 30.6%. Expanding markets for applications of CNMs, such as carbon nano-tubes (CNTs) and carbon nano-fibers (CNFs), place ever-increasing demands on lowering their production costs. Current technologies for CNM generation require intensive premium feedstock consumption and employ costly catalysts; they also require input of external energy. Industrial-scale CNM production is conventionally achieved through chemical vapor deposition (CVD) methods which consume a variety of expensive premium chemical feedstocks such as ethylene, carbon monoxide (CO) and hydrogen (H2); or by flame synthesis techniques, which also consume premium feedstock fuels. Additionally, CVD methods are energy-intensive. Renewable and replenishable feedstocks, such as those found in municipal, industrial, agricultural recycling streams have a more judicious reason for usage, in the light of current emerging needs for sustainability. Agricultural sugarcane bagasse and corn residues, scrap tire chips as well as post-consumer polyethylene (PE) and polyethylene terephthalate (PET) bottle shreddings when either thermally treated by sole pyrolysis or by sequential pyrolysis and partial oxidation result in the formation of gaseous carbon-bearing effluents which when channeled into a heated reactor, produce CNMs, including carbon nano-tubes, catalytically synthesized therein on stainless steel meshes. The structure of the nano-material synthesized depends on the type of feedstock available for pyrolysis, and can be determined by analysing the feedstock. These feedstocks could supersede the use of costly and often toxic or highly-flammable chemicals such as hydrocarbon gases, carbon monoxide and hydrogen, which are commonly used as feedstocks in current nano-manufacturing process for CNMs.

Keywords: nanomaterials, waste plastics, sugarcane bagasse, pyrolysis

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Authors: Kebede Mengistu, Kassahun Alemu, Bikes Destaw

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Introduction: Malnutrition continues to be a major public health problem in developing countries. It is the most important risk factor for the burden of diseases. It causes about 300, 000 deaths per year and responsible for more than half of all deaths in children. In Ethiopia, child malnutrition rate is one of the most serious public health problem and the highest in the world. High malnutrition rates in the country pose a significant obstacle to achieving better child health outcomes. Objective: To assess prevalence of malnutrition and associated factors among children aged 6-59 months at Hidabu Abote district, North shewa, Oromia. Methods: A community based cross sectional study was conducted on 820 children aged 6-59 months from September 8-23, 2012 at Hidabu Abote district. Multistage sampling method was used to select households. Children were selected from each kebeles by simple random sampling. Anthropometric measurements and structured questioners were used. Data was processed using EPi-info soft ware and exported to SPSS for analysis. Then after, sex, age, months, height, and weight transferred with HHs number to ENA for SMART 2007software to convert nutritional data into Z-scores of the indices; H/A, W/H and W/A. Bivariate and multivariate logistic regressions were used to identify associated factors of malnutrition. Results: The analysis this study revealed that, 47.6%, 30.9% and 16.7% of children were stunted, underweight and wasted, respectively. The main associated factors of stunting were found to be child age, family monthly income, children were received butter as pre-lacteal feeding and family planning. Underweight was associated with number of children HHs and children were received butter as per-lacteal feeding but un treatment of water in HHs only associated with wasting. Conclusion and recommendation: From the findings of this study, it is concluded that malnutrition is still an important problem among children aged 6-59 months. Therefore, especial attention should be given on intervention of malnutrition.

Keywords: children, Hidabu Abote district, malnutrition, public health

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Authors: Nneka Evelyn Udeh

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Women’s economic participation and empowerment are fundamental to strengthening women’s rights and enabling women to have control over their lives and exert influence in the society. The economic empowerment of women is a prerequisite for sustainable development, pro-poor growth and the achievement of all the millennium development Goals (MDGs). For women to be in development they need to be empowered morally, socially, economically, and financially and this is why women in Udi Local Government Area of Nigeria meet every August, the eighth month of the year to discuss matters relating to the pursuit of women empowerment, community welfare, and national development. This exploratory study depicts how annual august meetings serve as a stimulator for female empowerment with a case study Udi Local Government area of Enugu state, Nigeria. The paper finds that ‘August Meeting’ is a regular annual occurrence in Udi Local Government Area, Enugu State, Nigeria particularly for married women and is designed to better the lot of women, the child, family, the church, and the Community. Through this forum, with its seminars and workshops, women have the opportunity to learn everything about womanhood and how to chart new courses of action and sources of empowerment. The gathering gives women the opportunity to be integrated into their community development projects, and having women as stakeholders and not mere observers helps guarantee a speedy and steady community and overall national development progress. Funds are raised for community development projects through annual dues, levies, donations, fines, sales, income from money-yielding ventures, endowment and investiture. Annual August meeting also known as ‘Mothers Summit’ is indeed a powerful stimulator for female empowerment. Support and invigoration of this women initiative is essential for sustainable emancipation of female gender, not just in Udi Local Government Area of Nigeria but globally.

Keywords: women empowerment, annual august meeting, Udi Lga, mothers' summit, stimulator, emancipation, sustainability, community welfare, national development, millennium development goal

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Authors: Nayab Kanwal, Noor Us Saher

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The management and utilization of food resources is becoming a big issue due to rapid urbanization, wastage and non-sustainable use of food, especially in developing countries. Therefore, the use of seafood as alternative sources is strongly promoted worldwide. Marine pollution strongly affects marine organisms, which ultimately decreases their export quality. The monitoring of contamination in marine organisms is a good indicator of the environmental quality as well as seafood quality. Monitoring the accumulation of chemical elements within various tissues of organisms has become a useful tool to survey current or chronic levels of heavy metal exposure within an environment. In this perspective, this study was carried out to compare the previous and current levels (Year 2012 and 2014) of heavy metals (Cd, Pb, Cr, Cu and Zn) in crabs marketed in Karachi and to estimate the toxicological risk associated with their intake. The accumulation of metals in marine organisms, both essential (Cu and Zn) and toxic (Pb, Cd and Cr), natural and anthropogenic, is an actual food safety issue. Significant (p>0.05) variations in metal concentrations were found in all crab species between the two years, with most of the metals showing high accumulation in 2012. For toxicological risk assessment, EWI (Estimated weekly intake), Target Hazard quotient (THQ) and cancer risk (CR) were also assessed and high EWI, Non- cancer risk (THQ < 1) showed that there is no serious threat associated with the consumption of shellfish species on Karachi coast. The Cancer risk showed the highest risk from Cd and Pb pollution if consumed in excess. We summarize key environmental health research on health effects associated with exposure to contaminated seafood. It could be concluded that considering the Pakistan coast, these edible species may be sensitive and vulnerable to the adverse effects of environmental contaminants; more attention should be paid to the Pb and Cd metal bioaccumulation and to toxicological risks to seafood and consumers.

Keywords: cancer risk, edible crabs, heavy metals pollution, risk assessment

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Authors: I. A. Landa-Fernandez, I. Monje-Ramirez, M. T. Orta-Ledesma

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Every year plant-parasitic nematodes diminish the yield of high-value crops worldwide causing important economic losses. Currently, Meloidogyne enterolobii has increased its importance due to its high aggressiveness, increasing geographical distribution and host range. Root-knot nematodes inhabit the rhizosphere soil around plant roots. However, they can come into contact with irrigation water. Thus, plant-parasitic nematodes can be transported by water, as eggs or juveniles. Due to their high resistance, common water disinfection methods are not effective for inactivating these parasites. Ozone is the most effective disinfectant for microbial inactivation. The objective of this study is to demonstrate that ozone treatment is an alternative method control in irrigation water of the root-knot nematode M. enterolobii. It has been shown that ozonation is an effective treatment for the inactivation of protozoan cysts and oocysts (Giardia and Cryptosporidium) and for other species of the genus Meloidogyne (M. incognita), but not for the enterolobii specie. In this study, the strain of M. enterolobii was isolated from tomatoes roots. For the tests, eggs were used and were inoculated in water with similar characteristics of irrigation water. Subsequently, the disinfection process was carried out in an ozonation unit. The performance of the treatments was evaluated through the egg's viability by assessing its structure by optical microscopy. As a result of exposure to ozone, the viability of the nematode eggs was reduced practically in its entirety; with dissolved ozone levels in water close to the standard concentration (equal to 0.4 mgO₃/L), but with high contact times (greater than 4 min): 0.2 mgO₃/L for 15 minutes or 0.55 mgO₃/L for 10 minutes. Additionally, the effect of temperature, alkalinity and organic matter of the water was evaluated. Ozonation is effective and a promising alternative for the inactivation of nematodes in irrigation water, which could contribute to diminish the agricultural losses caused by these organisms.

Keywords: inactivation process, irrigation water treatment, ozonation, plant-parasite nematodes

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

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

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

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Authors: Alexander Hedlund, Anna-Karin Stengard, Olof Björkqvist

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A step towards reducing greenhouse gases and energy consumption is to collaborate with the energy system between several industries. This work is based on a case study on integration of pulp and paper mills with a district heating system in Sundsvall, Sweden. Present research shows that it is possible to make a significant reduction in the electricity demand in the mechanical pulping process. However, the profitability of the efficiency measures could be an issue, as the excess steam recovered from the refiners decreases with the electricity consumption. A consequence will be that the fuel demand for steam production will increase. If the fuel price is similar to the electricity price it would reduce the profit of such a project. If the paper mill can be integrated with a district heating system, it is possible to upgrade excess heat from a nearby kraft pulp mill to process steam via the district heating system in order to avoid the additional fuel need. The concept is investigated by using a simulation model describing both the mass and energy balance as well as the operating margin. Three scenarios were analyzed: reference, electricity reduction and energy substitution. The simulation show that the total input to the system is lowest in the Energy substitution scenario. Additionally, in the Energy substitution scenario the steam from the incineration boiler covers not only the steam shortage but also a part of the steam produced using the biofuel boiler, the cooling tower connected to the incineration boiler is no longer needed and the excess heat can cover the whole district heating load during the whole year. The study shows a substantial economic advantage if all stakeholders act together as one system. However, costs and benefits are unequally shared between the actors. This means that there is a need for new business models in order to share the system costs and benefits.

Keywords: energy system, cooperation, simulation method, excess heat, district heating

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