Search results for: one year follow-up

Authors: Thaer Khaleel Swaid, Maryam Al Ahmad, Ishtiaq Ahmad

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47-year-old female, known to have a liver cyst and hemangiomas, presented to the gastroenterology clinic for chronic moderate postprandial epigastric pain, which is aggravated by food, leaning forward and relieved on lying flat. The pain was associated with nausea, vomiting, heartburn and excessive burping. She opened her bowel daily, having well-formed stools without blood or mucus. The patient denied NSAID intake, smoking or alcohol. On physical examination during the episode of pain abdomen revealed a soft, lax abdomen and mild tenderness in the epigastric region without organomegaly. Bowel sounds were audible. Her routine hematological and biochemical parameters were within normal, including CBC, Celiac serology, Lipase, Metabolic profile and H pylori stool antigen. The patient underwent an Ultrasound of the abdomen which showed multiple liver cysts, hemangioma, normal GB and biliary tree. Based on the clinical picture and to narrow our differential diagnosis, an ultrasound Doppler for the abdomen was ordered, and it showed celiac artery peak systolic velocity in expiration is 270cm/s, suggestive of median arcuate ligament syndrome. She Had computerized tomography abdomen done and showed a Narrowing of the celiac artery at the origin, likely secondary to low insertion of the median arcuate ligament. Furthermore, Gastroscopy and, later on colonoscopy were done, which was unremarkable. A laparoscopic decompression of the celiac trunk was indicated, for which the patient was referred to vascular surgery. This case confirms that Median Arcuate Ligament syndrome is an unusual diagnosis and is always challenging. Usually, patients undergo extensive workups before a final diagnosis is achieved. Our case highlights the challenge of diagnosing MALS since this entity is rare. It is a good choice to perform abdominal ultrasound with Doppler imaging on a patient with symptoms such as postprandial angina.

Keywords: Unveiling the Mystery, MALS, rare entity, Rare vascular phenomenon

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Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

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Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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Authors: Moksha Singh

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The proponents of deinstitutionalization, including Goffman and others, in their works, have regarded institutions (orphanages to be specific) as regulated social arrangements that negatively impinge upon a resident’s development. They, therefore, propose alternative forms of care. However, even after five decades of this critique institutionalization remains the only hope for children with social, physical and mental disabilities in larger parts of the developing world such as the conflict affected state of Jammu and Kashmir in India. This paper is based on the experiences of children who lost their parents to insurgency and counter-insurgency operations and the rehabilitation process. This study is qualitative in nature and adopts descriptive-cum-exploratory research design. Using theoretical sampling, six orphanages and thirty one child residents who lost their parent(s) in the course of the armed conflict in the state of Jammu and Kashmir in India were studied in the year 2009-2010. It included interviews, observation, life histories and introspective accounts of the orphans and the management. The results were drawn through the qualitative examination, understanding, and interpretation of the primary and secondary data. The findings suggested that rehabilitation of these conflict-affected children is taking place mainly through residential child care facilities run by non-governmental bodies. Alternative forms of rehabilitation are not functional in the state because of various geopolitical and socio-cultural complexities. Even after five years of arriving at these conclusions and more, the state of Jammu and Kashmir still lacks a comprehensive rehabilitation plan for these children. This has further encouraged a mushroomed growth of legal and illegal institutions. Some of these institutions compromise the standard norms of functioning and yet remain the only hope for thousands rendered orphan. These institutions, therefore, are there to stay as other alternative forms of care are not available in the state. A comprehensive intervention policy is needed based on the cultural specifics of the state and incorporation of views of institutions offering aid, the state and the children. The paper introduces Small Group Residential Care Model through which it is expected that the restoration process can be made smooth and effective.

Keywords: armed conflict, children's rights, institutionalization, orphanages, rehabilitation

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Authors: Madifedile Thasi, Azola Mayeza

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In South Africa, provision of housing to the growing population has been described as one of the greatest challenges facing the government. Between 1994 to 2015, more than 2.5 million housing units were provided by the government for the poorest households and the low-income earners under the Reconstruction and Development Programme (RDP). Yet, the latest census figure revealed that about 2.1 million households still live in shacks and informal dwellings. Human settlements patterns remain dysfunctional across in South Africa because of rapid urbanisation. The housing backlog is growing at a rate of 178 000 units a year. The aforementioned predicament calls the need for innovative approaches to address the issue in a sustainable way and this need not be overemphasized. Aside from the issue of cost, the delivery of more housing units comes with environmental and sustainability issues. The prefabrication building technology has resulted into accelerated housing delivery to a satisfactory level in some countries such as Nigeria and Malaysia that are facing similar issue. It is therefore expected to be a foremost option to address the social housing backlog in South Africa and within the country housing sustainability agenda. This paper appraises the factors responsible for the limited implementation of prefabrication technology in South African housing projects. The objective is to recommend the method and materials that can be best sustained in the country in terms of local availability, cost effectiveness and environmental friendliness. It presents empirical data to support the hypothesis that a wider implementation of prefabrication technology in the social housing projects will be of significant benefit, by providing fast turnaround, cost-effective and sustainable solution that will dent the housing backlog, as well as improving the quality of the social housings. It was found that only 17 000 units of the RDP housings provided were constructed using alternative building technologies. Furthermore, there are variety of prefabricated technologies in the market but mostly have limited production capacity, minimal manufacturing capacity and most materials are imported, which leads to unavailability of the technology for large scale delivery and utilization despite its obvious advantages.

Keywords: prefabrication technology, sustainable social housings, South Africa, housing delivery

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Authors: Renu Pattanshetty

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The aim of this narrative review is to highlight the impact of menopause on osteoporosis and weight gain. The review also aims to summarize physiotherapeutic strategies to combat the same.A thorough literature search was conducted using electronic databases like MEDline, PUBmed, Highwire Press, PUBmed Central for English language studies that included search terms like menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies from the year 2000 till date. Out of 157 studies that included metanalyses, critical reviews and randomized clinical trials, a total of 84 were selected that met the inclusion criteria. Prevalence of obesity is increasing world - wide and is reaching epidemic proportions even in the menopausal women. Prevalence of abdominal obesity is almost double than that general obesity with rates in the US with 65.5% in women ages 40-59 years and 73.8 in women aged 60 years or more. Physical activities and exercises play a vital role in prevention and treatment of osteoporosis and weight gain related to menopause that aim to boost the general well-being and any symptoms brought about by natural body changes. Endurance exercises lasting about 30 minutes /day for 5 days/ week has shown to decrease weight and prevent weight gain. In addition, strength training with at least 8 exercises of 8-12 repetitions working for whole body and for large muscle groups has shown to result positive outcomes. Hot flashes can be combatted through yogic breathing and relaxation exercises. Prevention of fall strategies and resistance training are key to treat diagnosed cases of osteoporosis related to menopause. One to three sets with five to eight repetitions of four to six weight bearing exercises have shown positive results. Menopause marks an important time for women to evaluate their risk of obesity and osteoporosis. It is known fact that bone benefit from exercises are lost when training is stopped, hence, practicing bone smart habits and strict adherence to recommended physical activity programs are recommended which are enjoyable, safe and effective.

Keywords: menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies

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Authors: Loonibha Manandhar, Rajendra Bhandari, Kumud Raj Kafle

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Nepal’s Terai region is a part of the Ganges river basin which is one of the most disaster-prone areas of the world, with recurrent monsoon flooding causing millions in damage and the death and displacement of hundreds of people and households every year. The vulnerability of human settlements to natural disasters such as floods is increasing, and mapping changes in land use practices and hydro-geological parameters is essential in developing resilient communities and strong disaster management policies. The objective of this study was to develop a flood hazard zonation map of Orai Khola watershed and map the decadal land use/land cover dynamics of the watershed. The watershed area was delineated using SRTM DEM, and LANDSAT images were classified into five land use classes (forest, grassland, sediment and bare land, settlement area and cropland, and water body) using pixel-based semi-automated supervised maximum likelihood classification. Decadal changes in each class were then quantified using spatial modelling. Flood hazard mapping was performed by assigning weights to factors slope, rainfall distribution, distance from the river and land use/land cover on the basis of their estimated influence in causing flood hazard and performing weighed overlay analysis to identify areas that are highly vulnerable. The forest and grassland coverage increased by 11.53 km² (3.8%) and 1.43 km² (0.47%) from 1996 to 2016. The sediment and bare land areas decreased by 12.45 km² (4.12%) from 1996 to 2016 whereas settlement and cropland areas showed a consistent increase to 14.22 km² (4.7%). Waterbody coverage also increased to 0.3 km² (0.09%) from 1996-2016. 1.27% (3.65 km²) of total watershed area was categorized into very low hazard zone, 20.94% (60.31 km²) area into low hazard zone, 37.59% (108.3 km²) area into moderate hazard zone, 29.25% (84.27 km²) area into high hazard zone and 31 villages which comprised 10.95% (31.55 km²) were categorized into high hazard zone area.

Keywords: flood hazard, land use/land cover, Orai river, supervised maximum likelihood classification, weighed overlay analysis

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Authors: Jiri Beranovsky, Jaroslav Knapek, Tomas Kralik, Kamila Vavrova

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The paper deals with the results of research focused on the complex aspects of the use of intentionally grown biomass on agricultural land for the production of solid biofuels as an alternative for individual household heating. . The study primarily deals with the analysis of CO2 emissions of the logistics cycle of biomass for the production of energy pellets. Growing, harvesting, transport and storage are evaluated in the pellet production cycle. The aim is also to take into account the consumption profile during the year in terms of heating of common family houses, which are typical end-market segment for these fuels. It is assumed that in family houses, bio-pellets are able to substitute typical fossil fuels, such as brown coal and old wood burning heating devices and also electric boilers. One of the competing technology with the pellets are heat pumps. The results show the CO2 emissions related with considered fuels and technologies for their utilization. Comparative analysis is aimed biopellets from intentionally grown biomass, brown coal, natural gas and electricity used in electric boilers and heat pumps. Analysis combines CO2 emissions related with individual fuels utilization with costs of these fuels utilization. Cost of biopellets from intentionally grown biomass is derived from the economic models of individual energy crop plantations. At the same time, the restrictions imposed by EU legislation on Ecodesign's fuel and combustion equipment requirements and NOx emissions are discussed. Preliminary results of analyzes show that to achieve the competitiveness of pellets produced from specifically grown biomass, it would be necessary to either significantly ecological tax on coal (from about 0.3 to 3-3.5 EUR/GJ), or to multiply the agricultural subsidy per area. In addition to the Czech Republic, the results are also relevant for other countries, such as Bulgaria and Poland, which also have a high proportion of solid fuels for household heating.

Keywords: CO2 emissions, heating costs, energy crop, pellets, brown coal, heat pumps, economical evaluation

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Authors: Olalekan Lawrence Ojo

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Designing microwave terrestrial propagation networks requires a thorough evaluation of the severity of multipath fading, especially at frequencies below 10 GHz. In nations like Nigeria, without a large enough databases to support the existing empirical models, the mistakes in the prediction technique intended for the evaluation may be severe. The need for higher bandwidth for various satellite applications makes the investigation of the effects of radio refractivity, fading due to multipath, and Geoclimatic factors on satellite propagation links more important. One of the key elements to take into account for the best functioning of microwave frequencies is the clear air effects. This work has taken into account the geographical distribution of radio refractivity and fades depth over a number of stations in Nigeria. Data from five locations in Nigeria—Akure, Enugu, Jos, Minna, and Sokoto—based on five-year (2017–2021) measurement methods of atmospheric pressure, relative, and humidity temperature—at two levels (ground surface and 100 m heights)—are studied to deduced their effects on signals propagated through a µwave communication links. The assessments included considerations for µwave communication systems as well as the impacts of the dry and wet components of radio refractivity, the effects of the fade depth at various frequencies, and a 20 km link distance. The results demonstrate that the percentage occurrence of the dry terms dominated the radio refractivity constituent at the surface level, contributing a minimum of about 78% and a maximum of about 92%, while at heights of 100 meters, the percentage occurrence of the dry terms dominated the radio refractivity constituent, contributing a minimum of about 79% and a maximum of about 92%. The spatial distribution reveals that, regardless of height, the country's tropical rainforest (TRF) and freshwater swampy mangrove (FWSM) regions reported the greatest values of radio refractivity. The statistical estimate shows that fading values can differ by as much as 1.5 dB, especially near the TRF and FWSM coastlines, even during clear air conditions. The current findings will be helpful for budgeting Earth-space microwave links, particularly for the rollout of Nigeria's 5G and 6G projected microcellular networks.

Keywords: fade depth, geoclimatic factor, refractivity, refractivity gradient

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Authors: Joseph Dodson, Robert Roth, Alexander Hodakowski, Leah Greenfield, Melissa Porterhouse, Natalie Maltby, Rachel Sadowsky

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Introduction: Throughout the COVID-19 pandemic, countless research publications were released regarding SARS-CoV-2 and its variants, suggested treatments, and vaccine safety and efficacy. Daily publication of research became overwhelming for health professionals and the general public to stay informed. To address this problem, a group of 70 students across the four colleges at Rush University created the “Rush University COVID-19 Journal Club.” To broaden the available audience, the journal club then expanded to social media. Methods: Easily accessible and understandable summaries of the research were written by students and sent to faculty sponsors for feedback. Following the revision, summaries were published weekly on the Rush University COVID-19 Journal Club website for clinicians and students to use for reference. An Instagram page was then created, and information was further condensed into succinct posts to address COVID-19 “FAQs.” Next, a survey was distributed to followers of the Instagram page with questions meant to assess the effectiveness of the platform and gain feedback. A 5-point Likert scale was used as the primary question format. Results: The Instagram page accrued 749 followers and posted 52 unique posts over a 2 year period. Preliminary results from the surveys demonstrate that over 80% of respondents strongly agree that the Instagram posts 1) are an effective platform for the public presentation of factual COVID-19-related information; 2) provide relevant and valuable information; 3) provide information that is clear, concise, and can be easily understood. Conclusion: These results suggest that the Rush COVID-19 Journal Club was able to successfully create a social media presence and convey information without sacrificing scholarly integrity. Other academic institutions may benefit from the application of this model to help students and clinicians with the interpretation and evaluation of research topics with large bodies of evidence.

Keywords: SARS-CoV-2, COVID-19, public health, social media, SARS-CoV-2 vaccine, SARS-CoV-2 variants

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Authors: E. A. Krasikov

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As a main barrier against radioactivity outlet reactor pressure vessel (RPV) is a key component in terms of NPP safety. Therefore, present-day demands in RPV reliability enhance have to be met by all possible actions for RPV in-service embrittlement mitigation. Annealing treatment is known to be the effective measure to restore the RPV metal properties deteriorated by neutron irradiation. There are two approaches to annealing. The first one is so-called ‘dry’ high temperature (~475°C) annealing. It allows obtaining practically complete recovery, but requires the removal of the reactor core and internals. External heat source (furnace) is required to carry out RPV heat treatment. The alternative approach is to anneal RPV at a maximum coolant temperature which can be obtained using the reactor core or primary circuit pumps while operating within the RPV design limits. This low temperature «wet» annealing, although it cannot be expected to produce complete recovery, is more attractive from the practical point of view especially in cases when the removal of the internals is impossible. The first RPV «wet» annealing was done using nuclear heat (US Army SM-1A reactor). The second one was done by means of primary pumps heat (Belgian BR-3 reactor). As a rule, there is no recovery effect up to annealing and irradiation temperature difference of 70°C. It is known, however, that along with radiation embrittlement neutron irradiation may mitigate the radiation damage in metals. Therefore, we have tried to test the possibility to use the effect of radiation-induced ductilization in ‘wet’ annealing technology by means of nuclear heat utilization as heat and neutron irradiation sources at once. In support of the above-mentioned conception the 3-year duration reactor experiment on 15Cr3NiMoV type steel with preliminary irradiation at operating PWR at 270°C and following extra irradiation (87 h at 330°C) at IR-8 test reactor was fulfilled. In fact, embrittlement was partly suppressed up to value equivalent to 1,5 fold neutron fluence decrease. The degree of recovery in case of radiation enhanced annealing is equal to 27% whereas furnace annealing results in zero effect under existing conditions. Mechanism of the radiation-induced damage mitigation is proposed. It is hoped that «wet » annealing technology will help provide a better management of the RPV degradation as a factor affecting the lifetime of nuclear power plants which, together with associated management methods, will help facilitate safe and economic long-term operation of PWRs.

Keywords: controlling, embrittlement, radiation, steel, wet annealing

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Authors: Shalinawati Ramli, Khairani Omar, Nurul Azmawati Mohamed, Zarini Ismail, Nur Syahrina Rahim, Nurul Hayati Chamhuri

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Medical doctors’ work to prevent, diagnose, treat diseases, disorders, and injuries as well as prescribing medication. Many people are attracted to this profession because it gives them the opportunity to help others. Doctors’ improve quality of life by providing advice, healing physical ailments and performing complex surgeries. Medicine is a profession in which dedication to the wellbeing of others is of paramount importance. Balancing the requirements of work and personal life can be a struggle as the demand of work as a doctors’ is great. Perception and expectation of medical students regarding the lifestyle of doctors’ is important to ensure that they had made the right career choice. Thus, the aim of this study is to assess the perception of pre-clinical students regarding doctors’ lifestyle. This study is a cross-sectional study involving all third-year pre-clinical medical students at University Sains Islam Malaysia. A total of 81 students participated in this study. Participants were given a set of questionnaire consisting of demographic data, open-ended questions on their perception on doctors’ lifestyle of working environment, salary expectation and family life. Thematic analysis were used to analyse the data. The participants comprised 69% female and their age range was between 20-21 years old. Majority of them were from middle-income families. Majority of the students perceived that the doctors’ lifestyle would be busy (72%). Approximately 30% of them expected that the time schedule will be unpredictable, 21% mentioned that sacrifice is required and 16% perceived it as a tiring job. Other themes emerged were ‘requiring high commitment’ (6%), challenging (7%) and risky (4%). With regards to salary expectation, 48% expected reasonable salary, 33% high salary and 12% described it as 'not worth compared to the workload'. Majority of them perceived that their family life will be restricted (62%) and time management is important (33%). Only 15% mentioned that family members have to sacrifice and spousal understanding is important (7%). About 10% of them perceived that their family will not be affected by their profession. Majority of the medical students perceived a busy doctors’ lifestyle, reasonable salary and restricted family life. However, there was a significant proportion of them who required counselling for better preparation of their future lifestyle.

Keywords: doctors lifestyle, pre-clinical students, perception, understanding

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Authors: Sharein El-Tourky, Sharon Smith, Gary Hitchcock

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Effective fisheries management is necessarily dependent on the accuracy of fisheries models, which can be limited if they omit critical elements. One critical element in the formulation of these models is the trophic interactions at the larval stage of fish development. At this stage, fish mortality rates are at their peak and survival is often determined by resource limitation. Thus it is crucial to identify and quantify essential prey resources and determine how they vary in abundance and availability. The main resources larval fish consume are mesozooplankton. In the Straits of Florida, little is known about temporal and spatial variability of the mesozooplankton community despite its importance as a spawning ground for fish such as the Blue Marlin. To investigate mesozooplankton distribution patterns in the Straits of Florida, a transect of 16 stations from Miami to the Bahamas was sampled once a month in 2003 and 2004 at four depths. We found marked temporal and spatial variability in mesozooplankton biomass, diversity, and depth distribution. Mesozooplankton biomass peaked on the western boundary of the SOF and decreased gradually across the straits to a minimum at eastern stations. Midcurrent stations appeared to be a region of enhanced year-round variability, but limited seasonality. Examination of dominant zooplankton groups revealed groups could be parsed into 6 clusters based on abundance. Of these zooplankton groups, copepods were the most abundant zooplankton group, with the 20 most abundant species making up 86% of the copepod community. Copepod diversity was lowest at midcurrent stations and highest in the Eastern SOF. Interestingly, one copepods species, previously identified to compose up to 90% of larval blue marlin and sailfish diets in the SOF, had a mean abundance of less than 7%. However, the unique spatial and vertical distribution patterns of this copepod coincide with peak larval fish spawning periods and larval distribution, suggesting an important relationship requiring further investigation.

Keywords: mesozooplankton biodiversity, larval fish diet, food web, Straits of Florida, vertical distribution, spatiotemporal variability, cross-current comparisons, Gulf Stream

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Authors: Joshua Adan Valdez, Shawn Gallaher

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Global climate change has impacted atmospheric temperatures contributing to rising sea levels, decreasing sea ice, and increased freshening of high latitude oceans. This freshening has contributed to increased stratification inhibiting local mixing and nutrient transport, modifying regional circulations in polar oceans. In recent years, the Western Arctic has seen an increase in freshwater volume at an average rate of 397+-116km3/year across the Beaufort Gyre. The majority of the freshwater volume resides in the Beaufort Gyre surface lens driven by anticyclonic wind forcing, sea ice melt, and Arctic river runoff, and is typically defined as water fresher than 34.8. The near-isothermal nature of Arctic seawater and non-linearities in the equation of state for near-freezing waters result in a salinity-driven pycnocline as opposed to the temperature-driven density structure seen in the lower latitudes. In this study, we investigate the relationship between freshwater content and dynamic ocean topography (DOT). In situ measurements of freshwater content are useful in providing information on the freshening rate of the Beaufort Gyre; however, their collection is costly and time-consuming. Utilizing NASA’s ICESat-2’s DOT remote sensing capabilities and Air Expendable CTD (AXCTD) data from the Seasonal Ice Zone Reconnaissance Surveys (SIZRS), a linear regression model between DOT and freshwater content is determined along the 150° west meridian. Freshwater content is calculated by integrating the volume of water between the surface and a depth with a reference salinity of ~34.8. Using this model, we compare interannual variability in freshwater content within the gyre, which could provide a future predictive capability of freshwater volume changes in the Beaufort-Chukchi Sea using non-in situ methods. Successful employment of the ICESat-2’s DOT approximation of freshwater content could potentially demonstrate the value of remote sensing tools to reduce reliance on field deployment platforms to characterize physical ocean properties.

Keywords: Cryosphere, remote sensing, Arctic oceanography, climate modeling, Ekman transport

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Authors: Mohan Bilikallahalli Sannathimmappa, Vinod Nambiar, Rajeev Aravindakshan

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Background: Image-based teaching-learning module is innovative student-centered andragogy. The objective of our study was to explore medical students’ perception of effectiveness of image-based learning strategy in promoting their lifelong learning skills and evaluate its impact on improving students’ exam grades. Methods: A prospective single-cohort study was conducted on undergraduate medical students of the academic year 2021-22. The image-based teaching-learning module was assessed through pretest, posttest, and exam grades. Students’ feedback was collected through a predesigned questionnaire on a 3-point Likert Scale. The reliability of the questionnaire was assessed using Cronbach’s alpha coefficient test. In-Course Exam-4 results were compared with In-Course Exams 1, 2, and 3. Correlation coefficients were worked out wherever relevant to find the impact of the exercise on grades. Data were collected, entered into Microsoft Excel, and statistically analyzed using SPSS version 22. Results: In total, 127 students were included in the study. The posttest scores of the students were significantly high (24.75±) as compared to pretest scores (8.25±). Students’ opinion towards the effectiveness of image-based learning in promoting their lifelong learning skills was overwhelmingly positive (Cronbach’s alpha for all items was 0.756). More than 80% of the students indicated image-based learning was interesting, encouraged peer discussion, and helped them to identify, explore, and revise key information and knowledge improvement. Nearly 70% expressed image-based learning enhanced their critical thinking and problem-solving skills. Nine out of ten students recommended image-based learning module for future topics. Conclusion: Overall, Image-based learning was found to be effective in achieving undergraduate medical students learning outcomes. The results of the study are in favor of the implementation of Image-based learning in Microbiology courses. However, multicentric studies are required to authenticate our study findings.

Keywords: active learning, knowledge, medical education, microbes, problem solving

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Authors: Rajinder Singh, Ram Valluru

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Chain Ladder (CL) method, Expected Loss Ratio (ELR) method and Bornhuetter-Ferguson (BF) method, in addition to more complex transition-rate modeling, are commonly used actuarial reserving methods in general insurance. There is limited published research about their relative performance in the context of Mortgage Insurance (MI). In our experience, these traditional techniques pose unique challenges and do not provide stable claim estimates for medium to longer term liabilities. The relative strengths and weaknesses among various alternative approaches revolve around: stability in the recent loss development pattern, sufficiency and reliability of loss development data, and agreement/disagreement between reported losses to date and ultimate loss estimate. CL method results in volatile reserve estimates, especially for accident periods with little development experience. The ELR method breaks down especially when ultimate loss ratios are not stable and predictable. While the BF method provides a good tradeoff between the loss development approach (CL) and ELR, the approach generates claim development and ultimate reserves that are disconnected from the ever-to-date (ETD) development experience for some accident years that have more development experience. Further, BF is based on subjective a priori assumption. The fundamental shortcoming of these methods is their inability to model exogenous factors, like the economy, which impact various cohorts at the same chronological time but at staggered points along their life-time development. This paper proposes an alternative approach of parametrizing the loss development curve and using logistic regression to generate the ultimate loss estimate for each homogeneous group (accident year or delinquency period). The methodology was tested on an actual MI claim development dataset where various cohorts followed a sigmoidal trend, but levels varied substantially depending upon the economic and operational conditions during the development period spanning over many years. The proposed approach provides the ability to indirectly incorporate such exogenous factors and produce more stable loss forecasts for reserving purposes as compared to the traditional CL and BF methods.

Keywords: actuarial loss reserving techniques, logistic regression, parametric function, volatility

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Authors: Kremena Ivanona, Bistra Kunovska, Jana Djunova, Desislava Djunakova, Zdenka Stojanovska

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In recent decades, the general public has become increasingly interested in the impact of air pollutions on their health. Currently, numerous studies are aimed at identifying pollutants in the indoor environment where they carry out daily activities. Internal pollutants can be of both natural and artificial origin. With regard to natural pollutants, special attention is paid to natural radioactivity. In recent years, radon has been one of the most studied indoor pollutants because it has the greatest contribution to human exposure to natural radionuclides. It is a known fact that lung cancer can be caused by radon radiation and it is the second risk factor after smoking for the onset of the disease. The main objective of the study under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018 is to evaluate the indoor radon as an important air pollutant in school buildings in order to reduce the exposure to children. The measurements were performed in 48 schools located in 55 buildings in one Bulgarian administrative district (Kardjaly). The nuclear track detectors (CR-39) were used for measurements. The arithmetic and geometric means of radon concentrations are AM = 140 Bq/m3, and GM = 117 Bq/m3 respectively. In 51 school rooms, the radon levels were greater than 200 Bq/m3, and in 28 rooms, located in 17 school buildings, it exceeded the national reference level of 300 Bq/m3, defined in the Bulgarian ordinance on radiation protection (or 30% of the investigated buildings). The statistically significant difference in the values of radon concentration by municipalities (KW, р < 0.001) obtained showed that the most likely reason for the differences between the groups is the geographical location of the buildings and the possible influence of the geological composition. The combined effect of the year of construction (technical condition of the buildings) and the energy efficiency measures was considered. The values of the radon concentration in the buildings where energy efficiency measures have been implemented are higher than those in buildings where they have not been performed. This result confirms the need for investigation of radon levels before conducting the energy efficiency measures in buildings. Corrective measures for reducing the radon levels have been recommended in school buildings with high radon levels in order to decrease the children's exposure.

Keywords: air pollution, indoor radon, children exposure, schools

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Authors: Dau Lal Bohra, Sradha Vyas

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Bird species are already showing climate-related changes in the dates they migrate and breed, and in the timing of other key life-history events. Treats of feeding managements raptors have performed important ecological, traditional and aesthetic functions throughout the Indian subcontinent. The declines in India result from elevated adult and juvenile mortality, and low breeding success. The widespread and rapid pattern of declines, i.e. in all areas irrespective of habitat or protection status suggest that persecution through shooting or poisoning, whilst important at a local scale, are unlikely to have caused the declines. A mass killing of several species of vultures in the Indian subcontinent over the last two decades is largely blamed on the presence of a drug. Veterinary diclofenac caused an unprecedented decline in South Asia’s Gyps vulture populations, with some species declining by more than 97% between 1992 and 2007. Veterinary diclofenac causes renal failure in vultures, and killed tens of millions of such birds in the Indian sub-continent. The drug was finally banned there for veterinary purposes in 2006. This drug is now ‘a global problem’ threatening many vulnerable birds of prey. Recently, stappe eagles are also susceptible to veterinary diclofenac, effectively increasing the potential threat level, and the risks for European biodiversity. Steppe eagles are closely related with golden eagles (Aquila chrysaetus), imperial eagles (Aquila heliaca) and Spanish imperial eagles (Aquila adalberti), and all these species scavenge opportunistically on carcasses throughout their range. The Spanish imperial eagle, considered Vulnerable at global level, is now particularly at risk, due to the availability of diclofenac in Spain. These findings strengthen the case for banning veterinary diclofenac across. From year 2011 to 2014 more than 300 hundred birds dead in jorbeer, Bikaner. Now, with unequivocal evidence that this veterinary drug can cause a much wider impact on Europe´s biodiversity, it is time for action – please ban diclofenac human brand also in multi-dose vial from market.

Keywords: mortility, prey of birds, diclofenac, Rajasthan

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Authors: Andrea Gion Saluz, Tal Hertig, Axel Heinrich, Stefan Stevanovic

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Higher temperatures, seasonal changes in precipitation, and extreme weather events are increasingly affecting trees. To counteract the increasing challenges of urban trees, strategies are increasingly being sought to preserve existing tree populations on the one hand and to prepare for the coming years on the other. One such strategy lies in strategic climate tree species selection. The search is on for species or varieties that can cope with the new climatic conditions. Many efforts in German-speaking countries deal with this in detail, such as the tree lists of the German Conference of Garden Authorities (GALK), the project Stadtgrün 2021, or the instruments of the Climate Species Matrix by Prof. Dr. Roloff. In this context, different methods for a correct species selection are offered. One possibility is to select certain physiological attributes that indicate the climate resilience of a species. To calculate the dissimilarity of the present climate of different geographic regions in relation to the future climate of any city, a weighted (standardized) Euclidean distance (SED) for seasonal climate values is calculated for each region of the Earth. The calculation was performed in the QGIS geographic information system, using global raster datasets on monthly climate values in the 1981-2010 standard period. Data from a European forest inventory were used to identify tree species growing in the calculated analogue climate regions. The inventory used is the compilation of georeferenced point data at a 1 km grid resolution on the occurrence of tree species in 21 European countries. In this project, the results of the methodological application are shown for the city of Zurich for the year 2060. In the first step, analog climate regions based on projected climate values for the measuring station Kirche Fluntern (ZH) were searched for. In a further step, the methods mentioned above were applied to generate tree species lists for the city of Zurich. These lists were then qualitatively evaluated with respect to the suitability of the different tree species for the Zurich area to generate a cleaned and thus usable list of possible future tree species.

Keywords: climate change, climate region, climate tree, urban tree

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Authors: Phoenix W. Y. Lam

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As one of the most important service-oriented industries in contemporary society, tourism has increasingly seen the influence of the Internet on all aspects of travelling. Travellers nowadays habitually research online before making travel-related decisions. One platform on which such research is conducted is destination forums. The emergence of such online destination forums in the last decade has allowed tourists to share their travel experiences quickly and easily with a large number of online users around the world. As such, these destination forums also provide invaluable data for tourism bodies to better understand travellers’ views on their destinations. Collecting posts from the Hong Kong travel forum on the world’s largest travel website TripAdvisor®, the present study identifies the top questions asked by TripAdvisor users about Hong Kong through a corpus-based discourse analytic approach. Based on questions posted on the forum and their associated meta-data gathered in a one-year period, the study examines the top questions asked by travellers around the world to identify the key geographical locations in which users have shown the greatest interest in the city. Questions raised by travellers from different geographical locations are also compared to see if traveller communities by location vary in terms of their areas of interest. This analysis involves the study of key words and concordance of frequently-occurring items and a close reading of representative examples in context. Findings from the present study show that travellers who asked the most questions about Hong Kong are from North America and Asia, and that travellers from different locations have different concerns and interests, which are clearly reflected in the language of the questions asked on the travel forum. These findings can therefore provide tourism organisations with useful information about the key markets that should be targeted for promotional purposes, and can also allow such organisations to design advertising campaigns which better address the specific needs of such markets. The present study thus demonstrates the value of applying linguistic knowledge and methodologies to the domain of tourism to address practical issues.

Keywords: corpus, hong kong, online travel forum, tourism, TripAdvisor

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Authors: Natalia Sáez, Dina Shulfman

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There is an important research gap regarding accessible pedagogical techniques for teaching foreign languages to adults with visual impairments. English as a foreign language (EFL), in particular, is needed in many countries to expand occupational opportunities and improve living standards. Within EFL research, teaching and learning prepositions have only recently gained momentum, considering that they constitute one of the most difficult structures to learn in a foreign language and are fundamental for communicating about spatial relations in the world, both on the physical and imaginary levels. Learning to use prepositions would not only facilitate communication when referring to the surrounding tangible environment but also when conveying ideas about abstract topics (e.g., justice, love, society), for which students’ sociocultural knowledge about space could play an important role. By potentiating visually impaired students’ ability to construe mental spatial imagery, this study made efforts to explore pedagogical techniques that cater to their strengths, helping them create new worlds by welcoming and expanding their sociocultural funds of knowledge as they learn to use English prepositions. Fifteen visually impaired adults living in Chile participated in the study. Their first language was Spanish, and they were learning English at the intermediate level of proficiency in an EFL workshop at La Biblioteca Central para Ciegos (The Central Library for the Blind). Within this workshop, a series of activities and interviews were designed and implemented with the intention of uncovering students’ spatial funds of knowledge when learning literal/physical uses of three English prepositions, namely “in,” “at,” and “on”. The activities and interviews also explored whether students used their original spatial funds of knowledge when learning metaphorical uses of these prepositions and if their use of spatial imagery changed throughout the learning activities. Over the course of approximately half a year, it soon became clear that the students construed mental images of space when learning both literal/physical and metaphorical uses of these prepositions. This research could inform a new approach to inclusive language education using pedagogical methods that are relevant and accessible to students with visual impairments.

Keywords: EFL, funds of knowledge, prepositions, spatial cognition, visually impaired students

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Authors: Yasmeen Coaxum

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The year 2020 became synonymous with the words “Emergency Remote Teaching,” which was imposed upon educators during the COVID-19 pandemic. Consequently, teachers were compelled to find new and engaging ways to educate their students outside of the face-to-face classroom setting. Now online instruction has become more of the norm rather than a way to manage educational expectations during a crisis. Therefore, implementing a strategic way to create online environments for students to thrive, create, and fully engage in their learning process is essential. The Synchronous Online Flipped Learning Approach or SOFLA® is a distance learning model that most closely replicates actual classroom teaching. SOFLA® includes structured, interactive, multimodal activities in an eight-step learning cycle with both asynchronous and synchronous components that foster autonomous and interactive learning among today’s online learners. The results of a pilot study in an Intensive English Program at a university, using SOFLA® methodology to facilitate podcasting in an online learning environment will be shared. Previous findings on student-produced podcasting projects have shown that students felt they improved their pronunciation, vocabulary, and speaking skills. However, few if any studies have been conducted on using a structured online flipped learning approach to facilitate such projects. Therefore, the purpose of this study is to assess the effect of using the SOFLA® framework to enhance optimum engagement in the online environment while using podcasts as the primary tool of instruction. Through data from interviews, questionnaires, and the results of formative and summative assessments, this study also investigates the affective and academic impact this flipped learning method combined with podcasting has on the students in terms of speaking confidence and vocabulary retention, and production. The steps of SOFLA will be illustrated, a video demonstration of the Anchor podcasting app will be shown, and final student projects and questionnaire responses will be shared. The specific context is a 14-week advanced level conversation and listening class. Participants vary in age but are all adult language learners representing a diverse array of countries.

Keywords: mall online flipped learning, podcasting, productive vocabulary

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Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis

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Authors: Jiexuan Lin, Huiyi Chen

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The development of L2 pronunciation competence remains understudied in the literature and it is not clear what may influence learners’ development of L2 pronunciation. The present study was an attempt to find out which of the two common factors in L2 acquisition, i.e., foreign language anxiety or self-perceived L2 proficiency, can better predict Chinese EFL learners’ pronunciation performance. 78 first-year English majors, who had received a three-month pronunciation training course, were asked to 1) fill out a questionnaire on foreign language classroom anxiety, 2) self-report their L2 proficiency in general, in speaking and in pronunciation, and 3) complete an oral and a written test on their L2 pronunciation (the score of the oral part indicates participants’ pronunciation proficiency in oral production, and the score of the written part indexes participants’ ability in applying pronunciation knowledge in comprehension.) Results showed that the pronunciation scores were negatively correlated with the anxiety scores, and were positively correlated with the self-perceived pronunciation proficiency. But only the written scores in the L2 pronunciation test, not the oral scores, were positively correlated with the L2 self-perceived general proficiency. Neither the oral nor the written scores in the L2 pronunciation test had a significant correlation with the self-perceived speaking proficiency. Given the fairly strong correlations, the anxiety scores and the self-perceived pronunciation proficiency were put in regression models to predict L2 pronunciation performance. The anxiety factor alone accounted for 13.9% of the variance and the self-perceived pronunciation proficiency alone explained 12.1% of the variance. But when both anxiety scores and self-perceived pronunciation proficiency were put in a stepwise regression model, only the anxiety scores had a significant and unique contribution to the L2 pronunciation performance (4.8%). Taken together, the results suggested that the learners’ anxiety level could better predict their L2 pronunciation performance, compared with the self-perceived proficiency levels. The obtained data have the following pedagogical implications. 1) Given the fairly strong correlation between anxiety and L2 pronunciation performance, the instructors who are interested in predicting learners’ L2 pronunciation proficiency may measure their anxiety level, instead of their proficiency, as the predicting variable. 2) The correlation of oral scores (in the pronunciation test) with pronunciation proficiency, rather than with speaking proficiency, indicates that a) learners after receiving some amounts of training are to some extent able to evaluate their own pronunciation ability, implying the feasibility of incorporating self-evaluation and peer comments in course instruction; b) the ‘proficiency’ measure used to predict pronunciation performance should be used with caution. The proficiency of specific skills seemingly highly related to pronunciation (i.e., speaking in this case) may not be taken for granted as an effective predictor for pronunciation performance. 3) The correlation between the written scores with general L2 proficiency is interesting.

Keywords: anxiety, Chinese EFL learners, L2 pronunciation, self-perceived L2 proficiency

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Authors: Banu Hatice Gürcüm, Pınar Arslan, Mahmut Yalçın

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Fashion designers create lots of dresses, suits, shoes, and other clothing and accessories, which are purchased every year by consumers. Fashion trends, sketches of designs, accessories affect the apparel goods, but colors make the finishing touches to an outfit. In all fields of apparel men's, women's, and children's wear, including casual wear, suits, sportswear, formal wear, outerwear, maternity, and intimate apparel, color sells. Thus, specialization in color in apparel is a basic concern each season. The perception of color is the key to sales for every sector in textile business. Mechanism of color perception, cognition in brain and color emotion are unique subjects, which scientists have been investigating for many years. The parameters of color may not be corresponding to visual scales since human emotions induced by color are completely subjective. However, with a very few exception each manufacturer concern their top selling colors for each season through seasonal sales reports of apparel companies. This paper examines sensory and instrumental methods for quantifying color of fabrics and investigates the relationship between fabric color and sale numbers. 5 top selling colors for each season from 10 leading apparel companies in the same segment are taken. The compilation is based according to the sales of the companies for 5 to 10 years. The research’s main concern is the corelation with the magnitude of seasonal color selling figures and the CIE chromaticity coordinates. The colors are chosen from the globally accepted Pantone Textile Color System and the three-dimentional measurement system CIE L*a*b* (CIELAB) is used, L* representing the degree of lightness of color, a* the degree of color ranging from magenta to green, and b* the degree of color ranging from blue to yellow. The objective of this paper is to demonstrate the feasibility of relating color perceptance to a laboratory instrument yielding measurements in the CIELAB system. Our approach is to obtain a total of a hundred reference fabrics to be measured on a laboratory spectrophotometer calibrated to the CIELAB color system. Relationships between the CIE tristimulus (X, Y, Z) and CIELAB (L*, a*, b*) are examined and are reported herein.

Keywords: CIELAB, CIE tristimulus, color preference, fashion

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Authors: Kathleen Cravero, Amanda Nace, Samantha Ski

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The Violence Against Children Surveys (VACS) is nationally representative surveys of male and female youth ages 13-24, designed to measure the burden of sexual, physical, and emotional violence experienced in childhood and adolescence. As of 2019, 24 countries implemented or are in the process of implementing a VACS, covering over ten percent of the world’s child population. Since the first article using VACS data from Swaziland was published in 2009, several peer-reviewed articles have been published on the VACS. However, no publications to date have analyzed the breadth of the work and analyzed how the data are represented in the peer-reviewed literature. In this study, we conducted a literature review of all peer-reviewed research that used VACS data or discussed the implementation and methodology of the VACS. The literature review revealed several important findings. Between 2009 and July 2019, thirty-five peer-reviewed articles using VACS data from 12 countries have been published. Twenty of the studies focus on one country, while 15 of the studies focus on two or more countries. Some countries are featured in the literature more than others, for example Kenya (N=14), Malawi (N=12), and Tanzania (N=12). A review of the research by gender demonstrates that research on violence against boys is under-represented. Only two studies specifically focused on boys/young men, while 11 studies focused only on violence against girls. This is despite research which suggests boys and girls experience similar rates of violence. A review of the publications by type of violence revealed significant differences in the types of violence being featured in the literature. Thirteen publications specifically focused on sexual violence, while three studies focused on physical violence, and only one study focused on emotional violence. Almost 70% of the peer-reviewed articles (24 of the 35) were first-authored by someone at the U.S. Centers for Disease Control and Prevention. There were very few first authors from VACS countries, which raises questions about who is leveraging the data and the extent to which capacities for data liberation are being developed within VACS countries. The VACS provide an unprecedented amount of information on the prevalence and past-year incidence of violence against children. Through a review of the peer-reviewed literature on the VACS we can begin to identify trends and gaps in how the data is being used as well as identify areas for further research.

Keywords: data to action, global health, implementation science, violence against children surveys

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Authors: Gayathri Pramod, Sheeja K. P.

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Urban flooding has been seen rising in cities for the past few years. This rise in urban flooding is the result of increasing urbanization and increasing climate change. A resilient city design focuses on 'living with water'. This means that the city is capable of accommodating the floodwaters without having to risk any loss of lives or properties. The resilient city design incorporates green infrastructure, river edge treatment, open space design, etc. to form a city that functions as a whole for resilience. Sponge urbanism is a recent method for building resilient cities and is founded by China in 2014. Sponge urbanism is the apt method for resilience building for a tropical town like Aluva of Kerala. Aluva is a tropical town that experiences rainfall of about 783 mm per month during the rainy season. Aluva is an urbanized town which faces the risk of urban flooding and riverine every year due to the presence of Periyar River in the town. Impervious surfaces and hard construction and developments contribute towards flood risk by posing as interference for a natural flow and natural filtration of water into the ground. This type of development is seen in Aluva also. Aluva is designed in this research as a town that have resilient strategies of sponge city and which focusses on natural methods of construction. The flood susceptibility of Aluva is taken into account to design the spaces for sponge urbanism and in turn, reduce the flood susceptibility for the town. Aluva is analyzed, and high-risk zones for development are identified through studies. These zones are designed to withstand the risk of flooding. Various catchment areas are identified according to the natural flow of water, and then these catchment areas are designed to act as a public open space and as detention ponds in case of heavy rainfall. Various development guidelines, according to land use, is also prescribed, which help in increasing the green cover of the town. Aluva is then designed to be a completely flood-adapted city or sponge city according to the guidelines and interventions.

Keywords: climate change, flooding, resilient city, sponge city, sponge urbanism, urbanization

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Authors: Kumar Y., Suman D., Sumathi

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Introduction: Burns to the face account for between one-fourth and one-third of all burns. The loss of an eyebrow due to a burn or infection can have negative physical and psychological consequences for patients because eyebrows have a critical functional and aesthetic role on the face. Plastic surgeons face unique challenges in reconstructing eyebrows due to their complex anatomy and variations within genders. As a general rule, there are three techniques for reconstructing the eyebrow: superficial temporal artery island flap, a composite graft from the scalp, and mini or micro follicular grafts from the scalp. In situations where a sufficient amount of subcutaneous tissue is not available and the defect is big such as the case of burns, flaps like the superficial temporal artery scalp flap remain reliable options. In 2018, a 17-year-old female patient presented to the department of Burns Plastic and reconstructive Surgery of Guru Teg Bahadur Hospital, Delhi, India. A scald-burn injury to the face occurred two years before admission, resulting in bilateral eyebrow loss. We reconstructed the bilateral eyebrows using bilateral scalp island flaps based on the posterior branch of the superficial temporal artery. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance, which was consistent with preoperative expectations and the patient stated that she was more comfortable with her social relationships. Among the current treatment procedures, the superficial temporal artery island flap continues to be a versatile option for reconstructing the eyebrows after alopecia, especially in cases of burns. Results: During the 30 days follow-up period, the scalp island flap remained vascularised with normal hair growth, without complications. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance; the patient stated that she was more comfortable with her social relationships. Conclusion: In this case report, we demonstrated how scalp island flaps pedicled by the superficial temporal artery could be performed very safely and reliably to create new eyebrows.

Keywords: alopecia, burns, eyebrow, flap, superficial temporal artery

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Authors: Agim Kukelii, Gevorg Sargsyan

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This study, focusing on the base regional area (county level), estimates the effect of natural disaster damages on aggregate personal income, aggregate wages, wages per worker, aggregate employment, and aggregate income transfer. The study further estimates the dynamics of personal income, employment, and wages under natural disaster shocks. Southeast Texas, located at the center of Golf Coast, is hit by meteorological and hydrological caused natural disasters yearly. On average, there are more than four natural disasters per year that cane an estimated damage average of 2.2% of real personal income. The study uses the panel data method to estimate the average effect of natural disasters on the area’s economy (personal income, wages, employment, and income transfer). It also uses Panel Vector Autoregressive (PVAR) model to study the dynamics of macroeconomic variables under natural disaster shocks. The study finds that the average effect of natural disasters is positive for personal income and income transfer and is negative for wages and employment. The PVAR and the impulse response function estimates reveal that natural disaster shocks cause a decrease in personal income, employment, and wages. However, the economy’s variables bounce back after three years. The novelty of this study rests on several aspects. First, this is the first study to investigate the effects of natural disasters on macroeconomic variables at a regional level. Second, the study uses direct measures of natural disaster damages. Third, the study estimates that the time that the local economy takes to absorb the natural disaster damages shocks is three years. This is a relatively good reaction to the local economy, therefore, adding to the “resiliency” hypothesis. The study has several implications for policymakers, businesses, and households. First, this study serves to increase the awareness of local stakeholders that natural disaster damages do worsen, macroeconomic variables, such as personal income, employment, and wages beyond the immediate damages to residential and commercial properties, physical infrastructure, and discomfort in daily lives. Second, the study estimates that these effects linger on the economy on average for three years, which would require policymakers to factor in the time area need to be on focus.

Keywords: natural disaster damages, macroeconomics effects, PVAR, panel data

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Authors: Elvis Munyoka

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While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the presentation will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugees, employment, mental health, Australia, underemployment

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Authors: Catherine Mary Abou-Zaid, Sandra Goodwin

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This study was conducted in a cardiac center in Bahrain. The rise in the amount of obese patients’ both men and women, being admitted for surgical procedures has become an issue to the nurses and doctors as these patients pose a high risk of major complications arising from their problem. The cessation of obesity in the country is very high and obesity-related diseases has been the cause of concern among men and women, also related individual diseases such as cardiovascular, diabetes and chronic respiratory diseases are rising dramatically within Bahrain in the last 10 years. Rationale for the Study: The ontological approach will help to understand and assess the true nature of the social world and how the world looks at obesity. Obesity has to be looked at as being a realistic ongoing issue. The epistemological approach will look at the theory of the origins of the nature of knowledge, set the rule of validating and learning in the social world of what can be done to curb this concept and how this can help prevent otherwise preventable diseases. Design Methodology: The qualitative design methodology took the form of an ontological/epistemological approach using phenomenology as a framework. The study was based on a social research issue, therefore, ontological ‘realism and idealism’ will feature as the nature of the world from a social and natural context. Epistemological positions of the study will be how we as researchers will find the actual social world and the limiting of that knowledge. The one-to-one interviews will be transcribed and the taped verbatim will be coded and charted giving the thematic analytic results. Recommendations: The significance of the research brought many recommendations. These recommendations were taken from the themes and sub-themes and were presented to the centers management and the necessary arrangements for updating knowledge and attitudes towards obesity in cardiac patients was then presented to the in-service education department. Workshops and training sessions on promoting health education were organized and put into the educational calendar for the next academic year. These sessions would look at patient autonomy, the patients’ rights, healthy eating for patients and families and the risks associated with obesity in cardiac disease processes.

Keywords: cardiac patients, diabetes, education & training, obesity cessation, qualitative

Procedia PDF Downloads 328