Search results for: secondary schools
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4564

Search results for: secondary schools

844 The Dual Catastrophe of Behçet’s Disease Visual Loss Followed by Acute Spinal Shock After Lumbar Drain Removal

Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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843 Day-Case Ketamine Infusions in Patients with Chronic Pancreatitis

Authors: S. M. C. Kelly, M. Goulden

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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.

Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis

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842 Understanding Staff Beliefs and Attitudes about Implementation of Restorative Justice Practices for Juvenile Justice Involved Youth

Authors: Lilian Ijomah

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Restorative justice practices continue to gain recognition globally in the criminal and juvenile justice systems and schools. Despite considerable research, little is known about how juvenile detention center staff members’ knowledge, beliefs, and attitudes affect implementation. As with many interventions, effective implementation relies on the staff members who must do the daily work. This phenomenological study aimed to add to the existing literature by examining staff knowledge, beliefs, and attitudes on restorative justice practices, barriers to effective implementation, and potential differences in knowledge, beliefs, and attitudes between education staff and juvenile detention officers at the research site. The present study used semi-structured interviews and focus groups of both types of staff members who work with the youth in a juvenile justice facility to answer three research questions: (1) To what extent are staff members knowledgeable about the principles behind restorative approach to discipline and about how the approach should be carried out?; (2) What are staff member beliefs and attitudes toward the restorative justice program and its implementation in a juvenile justice setting?; and (3) What similarities and differences are there between (a) knowledge and (b) beliefs and attitudes of the educators and juvenile detention officers? A total of 28 staff members participated, nine educators, and 19 detention officers. The findings for the first research question indicated that both groups (educators and juvenile detention officers) were knowledgeable about two of the three principles of restorative justice: repairing the harm done by the offender and reducing risks for future occurrence; but did not show clear knowledge of one principle, active involvement from all stakeholders. For research question 2, staff beliefs and attitudes were categorized into two types, positive beliefs and attitudes (e.g., that restorative justice is more appropriate than the use of punitive measures) and negative beliefs and attitudes (e.g., that restorative justice is ‘just another program that creates extra work for staff’). When the two staff groups were compared to answer research question 3, both groups were found to have similar knowledge (showing knowledge of two of the three principles) and somewhat different beliefs and attitudes – both groups showed a mix of positive and negative, but the educators showed somewhat more on the positive side. Both groups also identified barriers to implementation such as the perception of restorative justice as ‘soft’, lack of knowledge and exposure to restorative justice, shortage of resources and staff, and difficulty sustaining the restorative justice approach. The findings of this study are largely consistent with current literature but also extend the literature by studying staff knowledge, attitudes, and beliefs in a juvenile detention center and comparing the two staff groups. Recommendations include assessing staff knowledge and attitudes toward restorative justice during the hiring process, ensuring adequate staff training, communicating clearly to build positive attitudes and beliefs, providing adequate staffing, and building a sense of community.

Keywords: juvenile justice, restorative justice, restorative practices, staff attitudes and beliefs

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841 The Marriage of a Sui Juris Girl: Permission of Wali (Guardian) or Consent of Ward in the Context of Personal Law in Pakistan

Authors: Muhammad Farooq

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The present article explores the woman's consent as a paramount element in contracting a Muslim marriage. Also, whether permission of the wali (guardian) is a condition per se for a valid nikah (marriage deed) in the eye of law and Sharia. The researcher attempts to treat it through the related issues, inter alia; the marriage guardian, the women's legal capacity to give consent whether she is a virgin or nonvirgin and how that consent is to be given or may be understood. Does her laugh, tears or salience needs a legal interpretation as well as other female manifestations of emotion explained by the Muslim jurists? The silence of Muslim Family Law Ordinance 1961 (hereafter; MFLO 1961) in this regard and the likely reasons behind such silence is also inquired in brief. Germane to the theme, the various cases in which the true notion of woman's consent is interpreted by courts in Pakistan are also examined. In order to address the issue in hand, it is proposed to provide a brief overview of a few contemporary writers' opinions in which the real place of woman's consent in Muslim marriage is highlighted. Key to the idea of young Muslim woman's marriage, the doctrine of kafa'a (equality or suitability) between the man and woman is argued here to be grounded in the patriarchal and social norms. It is, therefore, concluded that such concept was the result of analogical reasoning and has less importance in the present time. As such it is not a valid factor in current scenarios to validate or invalidate marital bonds. A standard qualitative convention is used for this research. Among primary and secondary sources; for examples, Qur'an, Sunnah, Books, Scholarly articles, texts of law and case law is used to point out the researcher's view. In summation, the article is concluded with a bold statement that a young woman being a party to the contract, is absolutely entitled to 'full and free' consent for the Muslim marriage contract. It is the woman, an indispensable partaker and her consent (not the guardian' permission) that does validate or invalidate the said agreement in the eye of contemporary personal law and in Sharia.

Keywords: consent of woman, ejab (declaration), Nikah (marriage agreement), qabol (acceptance), sui juris (of age; independent), wali (guardian), wilayah (guardianship)

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840 Nature of the Prohibition of Discrimination on Grounds of Sexual Orientation in EU Law

Authors: Anna Pudlo

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The EU law encompasses many supranational legal systems (EU law, ECHR, international public law and constitutional traditions common to the Member States) which guarantee the protection of fundamental rights, with partly overlapping scopes of applicability, various principles of interpretation of legal norms and a different hierarchy. In EU law, the prohibition of discrimination on grounds of sexual orientation originates from both the primary and secondary EU legislation. At present, the prohibition is considered to be a fundamental right in pursuance of Article 21 of the Charter, but the Court has not yet determined whether it is a right or a principle within the meaning of the Charter. Similarly, the Court has not deemed this criterion to be a general principle of EU law. The personal and materials scope of the prohibition of discrimination on grounds of sexual orientation based on Article 21 of the Charter requires each time to be specified in another legal act of the EU in accordance with Article 51 of the Charter. The effect of the prohibition of discrimination on grounds of sexual orientation understood as above will be two-fold, for the States and for the Union. On the one hand, one may refer to the legal instruments of review of EU law enforcement by a Member State laid down in the Treaties. On the other hand, EU law does not provide for the right to individual petition. Therefore, it is the duty of the domestic courts to protect the right of a person not to be discriminated on grounds of sexual orientation in line with the national procedural rules, within the limits and in accordance with the principles set out in EU law, in particular in Directive 2000/78. The development of the principle of non-discrimination in the Court’s case-law gives rise to certain doubts as to its applicability, namely whether the principle as the general principle of EU law may be granted an autonomous character, with respect to the applicability to matters not included in the personal or material scope of the Directives, although within the EU’s competence. Moreover, both the doctrine and the opinions of the Advocates-General have called for the general competence of CJEU with regard to fundamental rights which, however, might lead to a violation of the principle of separation of competence. The aim of this paper is to answer the question what is the nature of the prohibition of discrimination on grounds of sexual orientation in EU law (a general principle in EU law, or a principle or right under the Charter’s terminology). Therefore, the paper focuses on the nature of Article 21 of the Charter (a right or a principle) and the scope (personal and material) of the prohibition of discrimination based on sexual orientation in EU law as well as its effect (vertical or horizontal). The study has included the provisions of EU law together with the relevant CJEU case-law.

Keywords: EU law, EU principles, non-discrimination in EU law, Charter of the Fundamental Rights

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839 School Refusal Behaviours: The Roles of Adolescent and Parental Factors

Authors: Junwen Chen, Celina Feleppa, Tingyue Sun, Satoko Sasagawa, Michael Smithson

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School refusal behaviours refer to behaviours to avoid school attendance, chronic lateness in arriving at school, or regular early dismissal. Poor attendance in schools is highly correlated with anxiety, depression, suicide attempts, delinquency, violence, and substance use and abuse. Poor attendance is also a strong indicator of lower achievement in school, as well as problematic social-emotional development. Long-term consequences of school refusal behaviours include fewer opportunities for higher education, employment, and social difficulties, and high risks of later psychiatric illness. Given its negative impacts on youth educational outcomes and well-being, a thorough understanding of factors that are involved in the development of this phenomenon is warranted for developing effective management approaches. This study investigated parental and adolescent factors that may contribute to school refusal behaviours by specifically focusing on the role of parental and adolescents’ anxiety and depression, emotion dysregulation, and parental rearing style. Findings are expected to inform the identification of both parental and adolescents’ factors that may contribute to school refusal behaviours. This knowledge will enable novel and effective approaches that incorporate these factors to managing school refusal behaviours in adolescents, which in turn improve their school and daily functioning. Results are important for an integrative understanding of school refusal behaviours. Furthermore, findings will also provide information for policymakers to weigh the benefits of interventions targeting school refusal behaviours in adolescents. One-hundred-and-six adolescents aged 12-18 years (mean age = 14.79 years old, SD = 1.78, males = 44) and their parents (mean age = 47.49 years old, SD = 5.61, males = 27) completed an online questionnaire measuring both parental and adolescents’ anxiety, depression, emotion dysregulation, parental rearing styles, and adolescents’ school refusal behaviours. Adolescents with school refusal behaviours reported greater anxiety and depression, with their parents showing greater emotion dysregulation. Parental emotion dysregulation and adolescents’ anxiety and depression predicted school refusal behaviours independently. To date, only limited studies have investigated the interplay between parental and youth factors in relation to youth school refusal behaviours. Although parental emotion dysregulation has been investigated in relation to youth emotion dysregulation, little is known about its role in the context of school refusal. This study is one of the very few that investigated both parental and adolescent factors in relation to school refusal behaviours in adolescents. The findings support the theoretical models that emphasise the role of youth and parental psychopathology in school refusal behaviours. Future management of school refusal behaviours should target adolescents’ anxiety and depression while incorporating training for parental emotion regulation skills.

Keywords: adolescents, school refusal behaviors, parental factors, anxiety and depression, emotion dysregulation

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838 Providing Tailored as a Human Rights Obligation: Feminist Lawyering as an Alternative Practice to Address Gender-Based Violence Against Women Refugees

Authors: Maelle Noir

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International Human rights norms prescribe the obligation to protect refugee women against violence which requires, inter alia, state provision of justiciable, accessible, affordable and non-discriminatory access to justice. However, the interpretation and application of the law still lack gender sensitivity, intersectionality and a trauma-informed approach. Consequently, many refugee survivors face important structural obstacles preventing access to justice and often experience secondary traumatisation when navigating the legal system. This paper argues that the unique nature of the experiences of refugees with gender-based violence against women exacerbated throughout the migration journey calls for a tailored practice of the law to ensure adequate access to justice. The argument developed here is that the obligation to provide survivors with justiciable, accessible, affordable and non-discriminatory access to justice implies radically transforming the practice of the law altogether. This paper, therefore, proposes feminist lawyering as an alternative approach to the practice of the law when addressing gender-based violence against women refugees. First, this paper discusses the specific nature of gender-based violence against refugees with a particular focus on two aspects of the power-violence nexus: the analysis of the shift in gender roles and expectations following displacement as one of the causes of gender-based violence against women refugees and the argument that the asylum situation itself constitutes a form of state-sponsored and institutional violence. Second, the re-traumatising and re-victimising nature of the legal system is explored with the objective to demonstrate States’ failure to comply with their legal obligation to provide refugee women with effective access to justice. Third, this paper discusses some key practical strategies that have been proposed and implemented to transform the practice of the law when dealing with gender-based violence outside of the refugee context. Lastly, this analysis is applied to the specificities of the experiences of refugee survivors of gender-based violence.

Keywords: feminist lawyering, feminist legal theory, gender-based violence, human rights law, intersectionality, refugee protection

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837 Importance of Detecting Malingering Patients in Clinical Setting

Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra

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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.

Keywords: disability, India, malingering, neuropsychological assessment

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836 Legal Issues of Collecting and Processing Big Health Data in the Light of European Regulation 679/2016

Authors: Ioannis Iglezakis, Theodoros D. Trokanas, Panagiota Kiortsi

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This paper aims to explore major legal issues arising from the collection and processing of Health Big Data in the light of the new European secondary legislation for the protection of personal data of natural persons, placing emphasis on the General Data Protection Regulation 679/2016. Whether Big Health Data can be characterised as ‘personal data’ or not is really the crux of the matter. The legal ambiguity is compounded by the fact that, even though the processing of Big Health Data is premised on the de-identification of the data subject, the possibility of a combination of Big Health Data with other data circulating freely on the web or from other data files cannot be excluded. Another key point is that the application of some provisions of GPDR to Big Health Data may both absolve the data controller of his legal obligations and deprive the data subject of his rights (e.g., the right to be informed), ultimately undermining the fundamental right to the protection of personal data of natural persons. Moreover, data subject’s rights (e.g., the right not to be subject to a decision based solely on automated processing) are heavily impacted by the use of AI, algorithms, and technologies that reclaim health data for further use, resulting in sometimes ambiguous results that have a substantial impact on individuals. On the other hand, as the COVID-19 pandemic has revealed, Big Data analytics can offer crucial sources of information. In this respect, this paper identifies and systematises the legal provisions concerned, offering interpretative solutions that tackle dangers concerning data subject’s rights while embracing the opportunities that Big Health Data has to offer. In addition, particular attention is attached to the scope of ‘consent’ as a legal basis in the collection and processing of Big Health Data, as the application of data analytics in Big Health Data signals the construction of new data and subject’s profiles. Finally, the paper addresses the knotty problem of role assignment (i.e., distinguishing between controller and processor/joint controllers and joint processors) in an era of extensive Big Health data sharing. The findings are the fruit of a current research project conducted by a three-member research team at the Faculty of Law of the Aristotle University of Thessaloniki and funded by the Greek Ministry of Education and Religious Affairs.

Keywords: big health data, data subject rights, GDPR, pandemic

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835 Media, Politics and Power in the Representation of the Refugee and Migration Crisis in Europe

Authors: Evangelia-Matroni Tomara

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This thesis answers the question whether the media representations and reporting in 2015-2016 - especially, after the image of the drowned three-year-old Syrian boy in the Mediterranean Sea which made global headlines in the beginning of September 2015 -, the European Commission regulatory sources material and related reporting, have the power to challenge the conceptualization of humanitarianism or even redefine it. The theoretical foundations of the thesis are based on humanitarianism and its core definitions, the power of media representations and the relative portrayal of migrants, refugees and/or asylum seekers, as well as the dominant migration discourse and EU migration governance. Using content analysis for the media portrayal of migrants (436 newspaper articles) and qualitative content analysis for the European Commission Communication documents from May 2015 until June 2016 that required various depths of interpretation, this thesis allowed us to revise the concept of humanitarianism, realizing that the current crisis may seem to be a turning point for Europe but is not enough to overcome the past hostile media discourses and suppress the historical perspective of security and control-oriented EU migration policies. In particular, the crisis helped to shift the intensity of hostility and the persistence in the state-centric, border-oriented securitization in Europe into a narration of victimization rather than threat where mercy and charity dynamics are dominated and into operational mechanisms, noting the emergency of immediate management of the massive migrations flows, respectively. Although, the understanding of a rights-based response to the ongoing migration crisis, is being followed discursively in both political and media stage, the nexus described, points out that the binary between ‘us’ and ‘them’ still exists, with only difference that the ‘invaders’ are now ‘pathetic’ but still ‘invaders’. In this context, the migration crisis challenges the concept of humanitarianism because rights dignify migrants as individuals only in a discursive or secondary level while the humanitarian work is mostly related with the geopolitical and economic interests of the ‘savior’ states.

Keywords: European Union politics, humanitarianism, immigration, media representation, policy-making, refugees, security studies

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834 Biodiversity Conservation Practices Among Indigenous Peoples in Caraga Region, Mindanao, Philippines

Authors: Milagros S. Salibad, Levita B. Grana

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The presence and role of Indigenous Peoples residing in key biodiversity, protected, and watershed areas within the ancestral domain in the Caraga Region hold immense significance. This study aimed to determine the level of biodiversity conservation practices among the Mamanwas, Manobos, and Higaonons, and identify facilitating or hindering factors. Employing a mixed-method research design, 421 respondents participated through a researcher-made questionnaire. Focus group discussions, key informant interviews, researcher field notes, community immersions, and secondary sources were done. The three groups have demonstrated a high level of biodiversity conservation practices manifesting their commitment to conserving their natural resources and ecosystems. Evidently, selecting and cutting only mature trees for shelter and tribal usage, and preservation of large trees that harbor ancestors’ spirits and worship through rituals (Mambabaja). Each group exhibited unique environmental practices shaped by their distinct cultures, traditions, customary knowledge, and access to information. The Mamanwa practiced traditional hunting and gathering by using traps while Manobo practiced shifting cultivation to maintain soil fertility and biodiversity, and Higaonon managed forest resources through traditional forest management (establishment of sacred forests and conservation areas). Various facilitating and hindering factors influenced their conservation efforts. Their traditional knowledge and practices, partnership and collaboration, legal recognition and support, access to information, and biodiversity monitoring system facilitate practices. Insufficient government assistance, political and social issues, scarce financial support, inadequate policy enforcement, lack of livelihood opportunities, and land use conflicts hinder them. Monitoring the sustainability of IPs' local biodiversity conservation practices is essential as they contribute to conservation endeavors.

Keywords: biodiversity, conservation, indigenous peoples, traditional knowledge

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833 A Study on Awareness and Attitude of First-Year Medical Students on Epilepsy in University of Khartoum 2020-2021

Authors: Mohammed E. Ibrahim, Baraa A. Taha, Kamil M. A. Shabban

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Background: Epilepsy is a common but widely misunderstood illness. Consequently, patients with epilepsy suffer from considerable stigmatization in society. This social stigma and discrimination often cause more suffering for the patients than the disease itself. Since very few studies have explored the misperceptions about epilepsy among university students in Sudan, it is not possible to provide focused intervention aimed at eliminating this discrimination. Methods: A cross-sectional study was applied among the first-year medical students at the University of Khartoum between December (2020) and February (2021). A 29-item standardized questionnaire was self-administered by 198 students (out of 320) who agreed to participate in this study. Google form was the tool used to collect the data. The data were analyzed using the Statistical Package for Social Science software version 26. Result: Overall, the results indicate a negative trend in knowledge and attitude toward epilepsy. The vast majority of the respondents (84.8%) have read or heard about epilepsy, while 43.9% had seen someone with epilepsy. Only 7.5% of the participants reported that epilepsy is contagious, whereas 43.4% of them think that epilepsy is a psychological disorder. About 62.2% of students think head/birth trauma is a cause of epilepsy. On the other side, about 15.7% and 5.1% believed that evil spirits and punishment from god can also be a possible cause of epilepsy; we found these false beliefs are more common in participants from rural areas (p-value < 0.05). In regard to attitude, 19.7% of students thought that it is inappropriate for a patient with epilepsy to have a child. This attitude correlates with the mother’s education as the percentage is higher for those who have lower mother’s education (through secondary school education and below) (p < 0.05). The majority of Our participant knew that some people with epilepsy need life-long drug treatment; this belief was found to be more common in females than their counterparts(p < 0.05). . Finally, most of the respondents (93.9%) thought that a child with epilepsy Can be successful in a normal class. This belief is four-time as common in participants whose mothers have higher education (through university education and above) compared with corresponding respondents (p < 0.05). Conclusion: This study concludes that students' knowledge about epilepsy is limited and requires immediate intervention through educational campaigns to develop a well-informed and tolerant community.

Keywords: epilepsy, awareness, attitude, university students, Sudan

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832 Eco-Design of Construction Industrial Park in China with Selection of Candidate Tenants

Authors: Yang Zhou, Kaijian Li, Guiwen Liu

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Offsite construction is an innovative alternative to conventional site-based construction, with wide-ranging benefits. It requires building components, elements or modules were prefabricated and pre-assembly before installed into their final locations. To improve efficiency and achieve synergies, in recent years, construction companies were clustered into construction industrial parks (CIPs) in China. A CIP is a community of construction manufacturing and service businesses located together on a common property. Companies involved in industrial clusters can obtain environment and economic benefits by sharing resources and information in a given region. Therefore, the concept of industrial symbiosis (IS) can be applied to the traditional CIP to achieve sustainable industrial development or redevelopment through the implementation of eco-industrial parks (EIP). However, before designing a symbiosis network between companies in a CIP, candidate support tenants need to be selected to complement the existing construction companies. In this study, an access indicator system and a linear programming model are established to select candidate tenants in a CIP while satisfying the degree of connectivity among the enterprises in the CIP, minimizing the environmental impact, and maximizing the annualized profit of the CIP. The access indicator system comprises three primary indicators and fifteen secondary indicators, is proposed from the perspective of park-based level. The fifteen indicators are classified as three primary indicators including industrial symbiosis, environment performance and economic benefit, according to the three dimensions of sustainability (environment, economic and social dimensions) and the three R's of the environment (reduce, reuse and recycle). The linear programming model is a method to assess the satisfactoriness of all the indicators and to make an optimal multi-objective selection among candidate tenants. This method provides a practical tool for planners of a CIP in evaluating which among the candidate tenants would best complement existing anchor construction tenants. The reasonability and validity of the indicator system and the method is worth further study in the future.

Keywords: construction industrial park, China, industrial symbiosis, offsite construction, selection of support tenants

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831 The Hierarchical Model of Fitness Services Quality Perception in Serbia

Authors: Mirjana Ilic, Dragan Zivotic, Aleksandra Perovic, Predrag Gavrilovic

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The service quality perception depends on many factors, such as the area in which the services are provided, socioeconomic status, educational status, experience, age and gender of consumers, as well as many others. For this reason, it is not possible to apply instrument for establishing the service quality perception that is developed in other areas and in other populations. The aim of the research was to form an instrument for assessing the quality perception in the field of fitness in Serbia. After analyzing the available literature and conducting a pilot research, there were 15 isolated areas in which it was possible to observe the service quality perception. The areas included: material and technical basis, secondary facilities, coaches, programs, reliability, credibility, security, rapid response, compassion, communication, prices, satisfaction, loyalty, quality outcomes and motives. These areas were covered by a questionnaire consisted of 100 items where the number of items varied from area to area from 3 up to 11. The questionnaire was administered to 350 subjects of both genders (174 men and 176 women) aged from 18 to 68 years, being beneficiaries of fitness services for at least 1 year. In each of the areas was conducted a factor analysis in its exploratory form by principal components method. The number of significant factors has been determined in accordance with the Kaiser Guttman criterion. The initial factor solutions were simplified using the Varimax rotation. Analyses per areas have produced from 1 to 4 factors. Afterward, the factor analysis of factor scores on the first principal component of each of the respondents in each of the analyzed area was performed, and the factor structure was obtained with four latent dimensions interpreted as offer, the relationship with the coaches, the experience of quality and the initial impression. This factor structure was analysed by hierarchical analysis of Oblique factors, which in the second order space produced single factor interpreted as a general factor of the service quality perception. The resulting questionnaire represents an instrument which can serve managers in the field of fitness to optimize the centers development, raising the quality of services in line with consumers needs and expectations.

Keywords: fitness, hierarchical model, quality perception, factor analysis

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830 Teaching the Temperature Dependence of Electrical Resistance of Materials through Arduino Investigation

Authors: Vinit Srivastava, Abhay Singh Thakur, Shivam Dubey, Rahul Vaish, Bharat Singh Rajpurohit

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This study examines the problem of students' poor comprehension of the thermal dependence of resistance by investigating this idea using an evidence-based inquiry approach. It suggests a practical exercise to improve secondary school students' comprehension of how materials' resistance to temperature changes. The suggested exercise uses an Arduino and Peltier device to test the resistance of aluminum and graphite at various temperatures. The study attempts to close the knowledge gap between the theoretical and practical facets of the subject, which students frequently find difficult to grasp. With the help of a variety of resistors made of various materials and pencils of varying grades, the Arduino experiment investigates the resistance of a metallic conductor (aluminum) and a semiconductor (graphite) at various temperatures. The purpose of the research is to clarify for students the relationship between temperature and resistance and to emphasize the importance of resistor material choice and measurement methods in obtaining precise and stable resistance values over dynamic temperature variations. The findings show that while the resistance of graphite decreases with temperature, the resistance of metallic conductors rises with temperature. The results also show that as softer lead pencils or pencils of a lower quality are used, the resistance values of the resistors drop. In addition, resistors showed greater stability at lower temperatures when their temperature coefficients of resistance (TCR) were smaller. Overall, the results of this article show that the suggested experiment is a useful and practical method for teaching students about resistance's relationship to temperature. It emphasizes how crucial it is to take into account the resistor material selection and the resistance measurement technique when designing and picking out resistors for various uses. The results of the study are anticipated to guide the creation of more efficient teaching methods to close the gap between science education's theoretical and practical components.

Keywords: electrical resistance, temperature dependence, science education, inquiry-based activity, resistor stability

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829 Influence of Maternal Factors on Growth Patterns of Schoolchildren in a Rural Health and Demographic Surveillance Site in South Africa: A Mixed Method Study

Authors: Perpetua Modjadji, Sphiwe Madiba

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Background: The growth patterns of children are good nutritional indicators of their nutritional status, health, and socioeconomic level. However, the maternal factors and the belief system of the society affect the growth of children promoting undernutrition. This study determined the influence of maternal factors on growth patterns of schoolchildren in a rural site. Methods: A convergent mixed method study was conducted among 508 schoolchildren and their mothers in Dikgale Health and Demographic Surveillance System Site, South Africa. Multistage sampling was used to select schools (purposive) and learners (random), who were paired with their mothers. Anthropometry was measured and socio-demographic, obstetrical, household information, maternal influence on children’s nutrition, and growth were assessed using an interviewer administered questionnaire (quantitative). The influence of the cultural beliefs and practices of mothers on the nutrition and growth of their children was explored using focus group discussions (qualitative). Narratives of mothers were used to best understand growth patterns of schoolchildren (mixed method). Data were analyzed using STATA 14 (quantitative) and Nvivo 11 (qualitative). Quantitative and qualitative data were merged for integrated mixed method analysis using a joint display analysis. Results: Mean age of children was 10 ± 2 years, ranging from 6 to 15 years. Substantial percentages of thinness (25%), underweight (24%), and stunting (22%) were observed among the children. Mothers had a mean age of 37 ± 7 years, and 75% were overweight or obese. A depressed socio-economic status indicated by a higher rate of unemployment with no income (82.3%), and dependency on social grants (86.8%) was observed. Determinants of poor growth patterns were child’s age and gender, maternal age, height and BMI, access to water supply, and refrigerator use. The narratives of mothers suggested that the children in most of their households were exposed to poverty and the inadequate intake of quality food. Conclusion: Poor growth patterns were observed among schoolchildren while their mothers were overweight or obese. Child’s gender, school grade, maternal body mass index, and access to water were the main determinants. Congruence was observed between most qualitative themes and quantitative constructs. A need for a multi sectoral approach considering an evidence based and feasible nutrition programs for schoolchildren, especially those in rural settings and educating mothers, cannot be over-emphasized.

Keywords: growth patterns, maternal factors, rural context, schoolchildren, South Africa

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828 The Political Economy of Conservation at Bhitarkanika Wild Life Sanctuary, India: Conflicts, Sustainability, and Development

Authors: Diptimayee Nayak, V. Upadhyay

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This paper posits the attempt of conservation and the idea of protected areas from the Marxian primitive accumulation to the politics of sustainability. Using field survey data and secondary literature, this paper analyses an Indian wildlife sanctuary, the Bhitarkanika, Odisha and finds how the hegemony of power among different management regimes attempted for conservation and the present protected area management regime attempted to imbibe the policy of ecotourism for achieving sustainability. The paper contends that the current policy of ecotourism in protected areas acts as a veil for the local deprived people, to avoid many legal conflicts like property rights, livelihood, and man-wildlife issues. Moreover, opening the scope to accumulate on the part of tour operators, the policy of ecotourism establishes a nexus between the profit holders/tour operators (the capitalists) and the power hegemony on the part of management authorities. The sustainability attempt of ecotourism may lead to private benefits maximising the profit accumulation and can expand and continue, showing the bulk of employment generation of local people at petty odd jobs, grabbing a lion share! Positing ecotourism as a capitalist project as against the general assumption of one of the drivers of sustainable development, the paper shows that ecotourism in practice may end up ruining the very social-environmental set up, leading to unsustainability related to waste management, equality, culture, relationship and above all polarised private accumulators in absence of sound mechanism. The paper ends with the caveat that while shopping for neoliberal conservation, the conservators found ecotourism as a product without finalising the hallmark of mechanism/ institutions with appropriate modus operandii to check/guard the quality assurance/standard of ecotourism for sustainability. The paper proposes sound structural and institutional mechanism of ecotourism to be developed to harness sustainability in the local economy as well as in conservation.

Keywords: conservation, ecotourism, Marxian capitalism, protected areas, sustainability

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827 Kidney Stones in Individuals Living with Diabetes Mellitus at King Abdul-Aziz Medical City - Tertiary Care Center, Jeddah, Saudi Arabia: A Retrospective Cohort Study

Authors: Suhaib Radi, Ibrahim Basem Nafadi, Abdullah Ahmed Alsulami, Nawaf Faisal Halabi, Abdulrhman Abdullah Alsubhi, Sami Wesam Maghrabi, Waleed Saad Alshehri

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Background: Kidney stones greatly affect individuals. The range of these effects regarding multiple kidney stone factors (size, presence of obstruction, and modality of treatment) in stone formers with and without diabetes has not been well explored in the literature to the best of the author's knowledge. Our goal is to investigate this unexplored correlation between diabetes and kidney stones by conducting a Cohort retrospective study to precisely evaluate the effects of this condition and the existence of complications in adult individuals with diabetes in Saudi Arabia in comparison to a non-diabetic control group. Methodology: This is a retrospective cohort study aiming to evaluate the range of effects of kidney stones in stone formers in a group of adults diagnosed with type 2 diabetes mellitus and adults without diabetes between 2017 and 2019 in Jeddah, Saudi Arabia. An IRB approval has been granted for this study. The data was analyzed using SPSS. The data was collected from the 1st of December 2022 until the 1st of March 2023. Results: A total of 254 individuals diagnosed with kidney stones were included, 127 of whom were adult individuals with type 2 diabetes, and 127 were non-diabetics. Our study shows that the individuals affected with diabetes were more likely to have larger kidney stones in comparison to individuals without diabetes (13.12 mm vs. 10.53 mm, p-value = 0.03). Moreover, individuals with hypertension and dyslipidemia also had significantly larger stones. On the other hand, no significant difference was found in the presence of obstruction and modality of treatment between the two groups. Conclusion: This study done in Saudi Arabia found that individuals with kidney stones who concurrently had diabetes formed larger kidney stones, and they were also found to have other comorbidities such as HTN, dyslipidemia, obesity, and renal disease. The significance of these findings could assist in the future of primary and secondary prevention of renal stones.

Keywords: kidney stone, type 2 DM, metabolic syndrome, lithotripsy

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826 Slöjd International: Translating and Tracking Nordic Curricula for Holistic Health, 1890s-1920s

Authors: Sasha Mullally

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This paper investigates the transnational circulation of European Nordic ideas about and programs for manual education and training over the decades spanning the late 19th and early 20th centuries. Based on the unexamined but voluminous correspondence (English-language) of Otto Salomon, an internationally famous education reformer who popularized a form of manual training called "slöjd" (anglicized as "sloyd"), this paper examines it's circulation and translation across global cultures. Salomon, a multilingual promoter of new standardized program for manual training, based his curricula on traditional handcrqafts, particularly Swedish woodworking. He and his followers claimed that the integration of manual training and craft work provided primary and secondary educators with an opportunity to cultivate the mental, but also the physical, and tangentially, the spiritual, health of children. While historians have examined the networks who came together in person to train at his slöjd school for educators in western Sweden, no one has mapped the international community he cultivated over decades of letter writing. Additionally, while the circulation of his ideas in Britain and Germany, as well as the northeastern United States has been placed in a broader narrative of "western" education reform in the Progressive or late Victorian era, no one has examined the correspondence for evidence of the program's wider international appeal beyond Europe and North America. This paper fills this gap by examining the breadth of his reach through active correspondence with educators in Asia (Japan), South America (Brazil), and Africa (South Africa and Zimbabwe). As such, this research presents an opportunity to map the international communities of education reformers active at the turn of the last century, compare and contrast their understandings of and interpretations of "holistic" education, and reveal the ways manual formation was understood to be foundational to the healthy development of children.

Keywords: history of education, history of medicine and psychiatry, child health, child formation, internationalism

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825 Study of the Influence of Refractory Nitride Additives on Hydrogen Storage Properties of Ti6Al4V-Based Materials Produced by Spark Plasma Sintering

Authors: John Olorunfemi Abe, Olawale Muhammed Popoola, Abimbola Patricia Idowu Popoola

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Hydrogen is an appealing alternative to fossil fuels because of its abundance, low weight, high energy density, and relative lack of contaminants. However, its low density presents a number of storage challenges. Therefore, this work studies the influence of refractory nitride additives consisting of 5 wt. % each of hexagonal boron nitride (h-BN), titanium nitride (TiN), and aluminum nitride (AlN) on hydrogen storage and electrochemical characteristics of Ti6Al4V-based materials produced by spark plasma sintering. The microstructure and phase constituents of the sintered materials were characterized using scanning electron microscopy (in conjunction with energy-dispersive spectroscopy) and X-ray diffraction, respectively. Pressure-composition-temperature (PCT) measurements were used to assess the hydrogen absorption/desorption behavior, kinetics, and storage capacities of the sintered materials, respectively. The pure Ti6Al4V alloy displayed a two-phase (α+β) microstructure, while the modified composites exhibited apparent microstructural modifications with the appearance of nitride-rich secondary phases. It is found that the diffusion process controls the kinetics of the hydrogen absorption. Thus, a faster rate of hydrogen absorption at elevated temperatures ensued. The additives acted as catalysts, lowered the activation energy and accelerated the rate of hydrogen sorption in the composites relative to the monolithic alloy. Ti6Al4V-5 wt. % h-BN appears to be the most promising candidate for hydrogen storage (2.28 wt. %), followed by Ti6Al4V-5 wt. % TiN (2.09 wt. %), whereas Ti6Al4V-5 wt. % AlN shows the least hydrogen storage performance (1.35 wt. %). Accordingly, the developed hydride system (Ti6Al4V-5h-BN) may be competitive for use in applications involving short-range continuous vehicles (~50-100km) as well as stationary applications such as electrochemical devices, large-scale storage cylinders in hydrogen production locations, and hydrogen filling stations.

Keywords: hydrogen storage, Ti6Al4V hydride system, pressure-composition-temperature measurements, refractory nitride additives, spark plasma sintering, Ti6Al4V-based materials

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824 Challenges for Competency-Based Learning Design in Primary School Mathematics in Mozambique

Authors: Satoshi Kusaka

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The term ‘competency’ is attracting considerable scholarly attention worldwide with the advance of globalization in the 21st century and with the arrival of a knowledge-based society. In the current world environment, familiarity with varied disciplines is regarded to be vital for personal success. The idea of a competency-based educational system was mooted by the ‘Definition and Selection of Competencies (DeSeCo)’ project that was conducted by the Organization for Economic Cooperation and Development (OECD). Further, attention to this topic is not limited to developed countries; it can also be observed in developing countries. For instance, the importance of a competency-based curriculum was mentioned in the ‘2013 Harmonized Curriculum Framework for the East African Community’, which recommends key competencies that should be developed in primary schools. The introduction of such curricula and the reviews of programs are actively being executed, primarily in the East African Community but also in neighboring nations. Taking Mozambique as a case in point, the present paper examines the conception of ‘competency’ as a target of frontline education in developing countries. It also aims to discover the manner in which the syllabus, textbooks and lessons, among other things, in primary-level math education are developed and to determine the challenges faced in the process. This study employs the perspective of competency-based education design to analyze how the term ‘competency’ is defined in the primary-level math syllabus, how it is reflected in the textbooks, and how the lessons are actually developed. ‘Practical competency’ is mentioned in the syllabus, and the description of the term lays emphasis on learners' ability to interactively apply socio-cultural and technical tools, which is one of the key competencies that are advocated in OECD's ‘Definition and Selection of Competencies’ project. However, most of the content of the textbooks pertains to ‘basic academic ability’, and in actual classroom practice, teachers often impart lessons straight from the textbooks. It is clear that the aptitude of teachers and their classroom routines are greatly dependent on the cultivation of their own ‘practical competency’ as it is defined in the syllabus. In other words, there is great divergence between the ‘syllabus’, which is the intended curriculum, and the content of the ‘textbooks’. In fact, the material in the textbooks should serve as the bridge between the syllabus, which forms the guideline, and the lessons, which represent the ‘implemented curriculum’. Moreover, the results obtained from this investigation reveal that the problem can only be resolved through the cultivation of ‘practical competency’ in teachers, which is currently not sufficient.

Keywords: competency, curriculum, mathematics education, Mozambique

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823 Identifying Necessary Words for Understanding Academic Articles in English as a Second or a Foreign Language

Authors: Stephen Wagman

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This paper identifies three common structures in English sentences that are important for understanding academic texts, regardless of the characteristics or background of the readers or whether they are reading English as a second or a foreign language. Adapting a model from the Humanities, the explication of texts used in literary studies, the paper analyses sample sentences to reveal structures that enable the reader not only to decide which words are necessary for understanding the main ideas but to make the decision without knowing the meaning of the words. By their very syntax noun structures point to the key word for understanding them. As a rule, the key noun is followed by easily identifiable prepositions, relative pronouns, or verbs and preceded by single adjectives. With few exceptions, the modifiers are unnecessary for understanding the idea of the sentence. In addition, sentences are often structured by lists in which the items frequently consist of parallel groups of words. The principle of a list is that all the items are similar in meaning and it is not necessary to understand all of the items to understand the point of the list. This principle is especially important when the items are long or there is more than one list in the same sentence. The similarity in meaning of these items enables readers to reduce sentences that are hard to grasp to an understandable core without excessive use of a dictionary. Finally, the idea of subordination and the identification of the subordinate parts of sentences through connecting words makes it possible for readers to focus on main ideas without having to sift through the less important and more numerous secondary structures. Sometimes a main idea requires a subordinate one to complete its meaning, but usually, subordinate ideas are unnecessary for understanding the main point of the sentence and its part in the development of the argument from sentence to sentence. Moreover, the connecting words themselves indicate the functions of the subordinate structures. These most frequently show similarity and difference or reasons and results. Recognition of all of these structures can not only enable students to read more efficiently but to focus their attention on the development of the argument and this rather than a multitude of unknown vocabulary items, the repetition in lists, or the subordination in sentences are the one necessary element for comprehension of academic articles.

Keywords: development of the argument, lists, noun structures, subordination

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822 Economic Efficiency of Cassava Production in Nimba County, Liberia: An Output-Oriented Approach

Authors: Kollie B. Dogba, Willis Oluoch-Kosura, Chepchumba Chumo

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In Liberia, many of the agricultural households cultivate cassava for either sustenance purposes, or to generate farm income. Many of the concentrated cassava farmers reside in Nimba, a north-eastern County that borders two other economies: the Republics of Cote D’Ivoire and Guinea. With a high demand for cassava output and products in emerging Asian markets coupled with an objective of the Liberia agriculture policies to increase the competitiveness of valued agriculture crops; there is a need to examine the level of resource-use efficiency for many agriculture crops. However, there is a scarcity of information on the efficiency of many agriculture crops, including cassava. Hence the study applying an output-oriented method seeks to assess the economic efficiency of cassava farmers in Nimba County, Liberia. A multi-stage sampling technique was employed to generate a sample for the study. From 216 cassava farmers, data related to on-farm attributes, socio-economic and institutional factors were collected. The stochastic frontier models, using the Translog functional forms, of production and revenue, were used to determine the level of revenue efficiency and its determinants. The result showed that most of the cassava farmers are male (60%). Many of the farmers are either married, engaged or living together with a spouse (83%), with a mean household size of nine persons. Farmland is prevalently obtained by inheritance (95%), average farm size is 1.34 hectares, and most cassava farmers did not access agriculture credits (76%) and extension services (91%). The mean cassava output per hectare is 1,506.02 kg, which estimates average revenue of L$23,551.16 (Liberian dollars). Empirical results showed that the revenue efficiency of cassava farmers varies from 0.1% to 73.5%; with the mean revenue efficiency of 12.9%. This indicates that on average, there is a vast potential of 87.1% to increase the economic efficiency of cassava farmers in Nimba by improving technical and allocative efficiencies. For the significant determinants of revenue efficiency, age and group membership had negative effects on revenue efficiency of cassava production; while farming experience, access to extension, formal education, and average wage rate have positive effects. The study recommends the setting-up and incentivizing of farmer field schools for cassava farmers to primarily share their farming experiences with others and to learn robust cultivation techniques of sustainable agriculture. Also, farm managers and farmers should consider a fix wage rate in labor contracts for all stages of cassava farming.

Keywords: economic efficiency, frontier production and revenue functions, Nimba County, Liberia, output-oriented approach, revenue efficiency, sustainable agriculture

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821 COVID-19 in Nigeria: An external Analysis from the perspective of social media

Authors: Huseyin Arasli, Maryam Abdullahi, Tugrul Gunay

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One of the prominence elements used by the destination marketing organization (DMO) as a marketing strategy is the application of Social media tools. During the current spread of coronavirus disease (COVID-19), travel restriction was placed in most countries of the world, leading to the closure of borders movement. It should be noted that most tourism travelers depend on social media to obtain and exchange different kinds of information about COVID-19 in an unprecedented scale. The situational information people received is valued, which calls for the response of the tourism industry on the epidemic. Therefore, it is highly important to recognize such situational information and to understand how people spread this propaganda on social media platforms so that suitable information that relates the COVID-19 epidemic is available in a manner that will not tarnish the marketing strategies, festival planners. Data for this research study was collected from the desk review, which is a secondary source data, online blogs, and interview through social media chat. The results of this research show that the widespread of COVID-19 pandemics led to rapid lockdown in states and cities all over Nigeria, causing declining demands in hotels, airlines, recreation, and tourism centers. Additionally, billions of dollars lost has been recorded in the high increase of hotels and travel bookings cancellations which caused hundreds and thousands of job loss in the country. The result of this research also revealed that COVID-19 is causing more havoc on the unemployment rate indices of the country. Similarly, the over-dependence of government on petroleum has further caused considerable revenue loss, thereby raising a high poverty rate among less privileged Nigerians. Based on this result, the study suggested that there is an urgent need for the government to diversify its economy by looking at other different sectors such as tourism and agricultural farm produce to harmonize other commercial trades sectors in the country.

Keywords: social media, destination marketing organizations, DMOs, cultural COVID-19, coronavirus, hospitality, travel tour, tourism

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820 Improving Enhanced Oil Recovery by Using Alkaline-Surfactant-Polymer Injection and Nanotechnology

Authors: Amir Gerayeli, Babak Moradi

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The continuously declining oil reservoirs and reservoirs aging have created a huge demand for utilization of Enhanced Oil Recovery (EOR) methods recently. Primary and secondary oil recovery methods have various limitations and are not practical for all reservoirs. Therefore, it is necessary to use chemical methods to improve oil recovery efficiency by reducing oil and water surface tension, increasing sweeping efficiency, and reducing displacer phase viscosity. One of the well-known methods of oil recovery is Alkaline-Surfactant-Polymer (ASP) flooding that shown to have significant impact on enhancing oil recovery. As some of the biggest oil reservoirs including those of Iran’s are fractional reservoirs with substantial amount of trapped oil in their fractures, the use of Alkaline-Surfactant-Polymer (ASP) flooding method is increasingly growing, the method in which the impact of several parameters including type and concentration of the Alkaline, Surfactant, and polymer are particularly important. This study investigated the use of Nano particles to improve Enhanced Oil Recovery (EOR). The study methodology included performing several laboratory tests on drill cores extracted from Karanj Oil field Asmary Formation in Khuzestan, Iran. In the experiments performed, Sodium dodecyl benzenesulfonate (SDBS) and 1-dodecyl-3-methylimidazolium chloride ([C12mim] [Cl])) were used as surfactant, hydrolyzed polyacrylamide (HPAM) and guar gum were used as polymer, Sodium hydroxide (NaOH) as alkaline, and Silicon dioxide (SiO2) and Magnesium oxide (MgO) were used as Nano particles. The experiment findings suggest that water viscosity increased from 1 centipoise to 5 centipoise when hydrolyzed polyacrylamide (HPAM) and guar gum were used as polymer. The surface tension between oil and water was initially measured as 25.808 (mN/m). The optimum surfactant concentration was found to be 500 p, at which the oil and water tension surface was measured to be 2.90 (mN/m) when [C12mim] [Cl] was used, and 3.28 (mN/m) when SDBS was used. The Nano particles concentration ranged from 100 ppm to 1500 ppm in this study. The optimum Nano particle concentration was found to be 1000 ppm for MgO and 500 ppm for SiO2.

Keywords: alkaline-surfactant-polymer, ionic liquids, relative permeability, reduced surface tension, tertiary enhanced oil recovery, wettability change

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819 Effect of Retained Posterior Horn of Medial Meniscus on Functional Outcome of ACL Reconstructed Knees

Authors: Kevin Syam, Devendra K. Chauhan, Mandeep Singh Dhillon

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Background: The posterior horn of medial meniscus (PHMM) is a secondary stabilizer against anterior translation of tibia. Cadaveric studies have revealed increased strain on the ACL graft and greater instrumented laxity in Posterior horn deficient knees. Clinical studies have shown higher prevalence of radiological OA after ACL reconstruction combined with menisectomy. However, functional outcomes in ACL reconstructed knee in the absence of Posterior horn is less discussed, and specific role of posterior horn is ill-documented. This study evaluated functional and radiological outcomes in posterior horn preserved and posterior horn sacrificed ACL reconstructed knees. Materials: Of the 457 patients who had ACL reconstruction done over a 6 year period, 77 cases with minimum follow up of 18 months were included in the study after strict exclusion criteria (associated lateral meniscus injury, other ligamentous injuries, significant cartilage degeneration, repeat injury and contralateral knee injuries were excluded). 41 patients with intact menisci were compared with 36 patients with absent posterior horn of medial meniscus. Radiological and clinical tests for instability were conducted, and knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and the Orthopadische Arbeitsgruppe Knie score (OAK). Results: We found a trend towards significantly better overall outcome (OAK) in cases with intact PHMM at average follow-up of 43.03 months (p value 0.082). Cases with intact PHMM had significantly better objective stability (p value 0.004). No significant differences were noted in the subjective IKDC score (p value 0.526) and the functional OAK outcome (category D) (p value 0.363). More cases with absent posterior horn had evidence of radiological OA (p value 0.022) even at mid-term follow-up. Conclusion: Even though the overall OAK and subjective IKDC scores did not show significant difference between the two subsets, the poorer outcomes in terms of objective stability and radiological OA noted in the absence of PHMM, indicates the importance of preserving this important part of the meniscus.

Keywords: ACL, functional outcome, knee, posterior of medial meniscus

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818 Influence Zone of Strip Footing on Untreated and Cement Treated Sand Mat Underlain by Soft Clay (2nd reviewed)

Authors: Sharifullah Ahmed

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Shallow foundation on soft soils without ground improvement can represent a high level of settlement. In such a case, an alternative to pile foundations may be shallow strip footings placed on a soil system in which the upper layer is untreated or cement-treated compacted sand to limit the settlement within a permissible level. This research work deals with a rigid plane-strain strip footing of 2.5m width placed on a soil consisting of untreated or cement treated sand layer underlain by homogeneous soft clay. Both the thin and thick compared the footing width was considered. The soft inorganic cohesive NC clay layer is considered undrained for plastic loading stages and drained in consolidation stages, and the sand layer is drained in all loading stages. FEM analysis was done using PLAXIS 2D Version 8.0 with a model consisting of clay deposits of 15m thickness and 18m width. The soft clay layer was modeled using the Hardening Soil Model, Soft Soil Model, Soft Soil Creep model, and the upper improvement layer was modeled using only the Hardening Soil Model. The system is considered fully saturated. The value of natural void ratio 1.2 is used. Total displacement fields of strip footing and subsoil layers in the case of Untreated and Cement treated Sand as Upper layer are presented. For Hi/B =0.6 or above, the distribution of major deformation within an upper layer and the influence zone of footing is limited in an upper layer which indicates the complete effectiveness of the upper layer in bearing the foundation effectively in case of the untreated upper layer. For Hi/B =0.3 or above, the distribution of major deformation occurred within an upper layer, and the function of footing is limited in the upper layer. This indicates the complete effectiveness of the cement-treated upper layer. Brittle behavior of cemented sand and fracture or cracks is not considered in this analysis.

Keywords: displacement, ground improvement, influence depth, PLAXIS 2D, primary and secondary settlement, sand mat, soft clay

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817 Challenges to Quality Primary Health Care in Saudi Arabia and Potential Improvements Implemented by Other Systems

Authors: Hilal Al Shamsi, Abdullah Almutairi

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Introduction: As primary healthcare centres play an important role in implementing Saudi Arabia’s health strategy, this paper offers a review of publications on the quality of the country’s primary health care. With the aim of deciding on solutions for improvement, it provides an overview of healthcare quality in this context and indicates barriers to quality. Method: Using two databases, ProQuest and Scopus, data extracted from published articles were systematically analysed for determining the care quality in Saudi primary health centres and obstacles to achieving higher quality. Results: Twenty-six articles met the criteria for inclusion in this review. The components of healthcare quality were examined in terms of the access to and effectiveness of interpersonal and clinical care. Good access and effective care were identified in such areas as maternal health care and the control of epidemic diseases, whereas poor access and effectiveness of care were shown for chronic disease management programmes, referral patterns (in terms of referral letters and feedback reports), health education and interpersonal care (in terms of language barriers). Several factors were identified as barriers to high-quality care. These included problems with evidence-based practice implementation, professional development, the use of referrals to secondary care and organisational culture. Successful improvements have been implemented by other systems, such as mobile medical units, electronic referrals, online translation tools and mobile devices and their applications; these can be implemented in Saudi Arabia for improving the quality of the primary healthcare system in this country. Conclusion: The quality of primary health care in Saudi Arabia varies among the different services. To improve quality, management programmes and organisational culture must be promoted in primary health care. Professional development strategies are also needed for improving the skills and knowledge of healthcare professionals. Potential improvements can be implemented to improve the quality of the primary health system.

Keywords: quality, primary health care, Saudi Arabia, health centres, general medical

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816 Assessment on the Improvement of the Quality of Life after One Year of Regular Physical Activity and Treatment in Patients with Postmenopausal Osteoporosis

Authors: Stoyanka Georgieva Vladeva, Elena Kirilova Kirilova, Nikola Kirilov Kirilov

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Summary: WHO (World Health Organization) recommends the elder people a certain amount of regular physical activity in order to prevent some of the health issues. Postmenopausal osteoporosis is one of the chronic diseases which requires the maintaining of regular physical activity. The regular activity combined with an adequate medical treatment greatly improves the quality of life of the patient. Objectives: Assessment of the effect of the regular physical activity recommended by WHO on the quality of life in patients with postmenopausal osteoporosis. Material and methods: For the period of one year 68 female patients treated with Denosumab have been monitored. The bone density has been measured with the DEXA method in accordance to the T-score. No patients having any oncologic diseases and secondary osteoporosis have been included in the study. The subjects have been divided into groups by their age. The first group – women aged under 65 years (27 subjects) and the second group – women aged over 65 years (41 subjects). All patients have been advised to maintain regular physical activity included in the recommendations of the WHO in accordance with the age and the disease. The quality of life has been assessed in the beginning and at the end of the one-year period using the SF 36V2 questionnaire. Results: Only 31% of the subjects have engaged into regular increased physical activities for the whole period. Among them are mostly patients of the second group (aged over 65 years, 71%). The women from the both groups who were engaging into regular activities for this one-year period all experience an improvement of the quality of life. These results show that older patients understand the necessity of the physical activity for their health. The comparison of the output data to the scales of physical activity, durability, body pain, vitality, social activity and emotional stability has found an improvement at the end of the period in all patients. The osteodensitometry showed general improvement of the T-score. Patients with additional visits to their rheumatologist have better results. Conclusion: Combination of regular physical activity in accordance to the recommendations of WHO and medical treatment including anti-osteoporotic drugs improves the quality of life of women with postmenopausal osteoporosis.

Keywords: elderly patients, osteoporosis, physical activity, quality of life

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815 An Assessment of Impact of Financial Statement Fraud on Profit Performance of Manufacturing Firms in Nigeria: A Study of Food and Beverage Firms in Nigeria

Authors: Wale Agbaje

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The aim of this research study is to assess the impact of financial statement fraud on profitability of some selected Nigerian manufacturing firms covering (2002-2016). The specific objectives focused on to ascertain the effect of incorrect asset valuation on return on assets (ROA) and to ascertain the relationship between improper expense recognition and return on assets (ROA). To achieve these objectives, descriptive research design was used for the study while secondary data were collected from the financial reports of the selected firms and website of security and exchange commission. The analysis of covariance (ANCOVA) was used and STATA II econometric method was used in the analysis of the data. Altman model and operating expenses ratio was adopted in the analysis of the financial reports to create a dummy variable for the selected firms from 2002-2016 and validation of the parameters were ascertained using various statistical techniques such as t-test, co-efficient of determination (R2), F-statistics and Wald chi-square. Two hypotheses were formulated and tested using the t-statistics at 5% level of significance. The findings of the analysis revealed that there is a significant relationship between financial statement fraud and profitability in Nigerian manufacturing industry. It was revealed that incorrect assets valuation has a significant positive relationship and so also is the improper expense recognition on return on assets (ROA) which serves as a proxy for profitability. The implication of this is that distortion of asset valuation and expense recognition leads to decreasing profit in the long run in the manufacturing industry. The study therefore recommended that pragmatic policy options need to be taken in the manufacturing industry to effectively manage incorrect asset valuation and improper expense recognition in order to enhance manufacturing industry performance in the country and also stemming of financial statement fraud should be adequately inculcated into the internal control system of manufacturing firms for the effective running of the manufacturing industry in Nigeria.

Keywords: Althman's Model, improper expense recognition, incorrect asset valuation, return on assets

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