Search results for: daily exposure

Authors: Rajkumar Ghosh, Bhabani Prasad Mukhopadhay

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Groundwater contamination with fluoride has emerged as a global concern affecting millions of people, leading to the widespread occurrence of fluorosis. It affects bones and teeth, leading to dental and skeletal fluorosis. This study presents a comprehensive analysis of the relationship between groundwater contamination and fluorosis. It delves into the causes of fluoride contamination in groundwater, its spatial distribution, and adverse health impacts of fluorosis on affected communities. Fluoride contamination in groundwater can be attributed to both natural and anthropogenic sources. Geogenic sources involve the dissolution of fluoride-rich minerals present in the aquifer materials. On the other hand, anthropogenic activities such as industrial discharges, agricultural practices, and improper disposal of fluoride-containing waste contribute to the contamination of groundwater. The spatial distribution of fluoride contamination varies widely across different regions and geological formations. High fluoride levels are commonly observed in areas with fluorine-rich geological deposits. Additionally, agricultural and industrial centres often exhibit elevated fluoride concentrations due to anthropogenic contributions. Excessive fluoride ingestion during tooth development leads to dental fluorosis, characterized by enamel defects, discoloration, and dental caries. The severity of dental fluorosis varies based on fluoride exposure levels during tooth development. Long-term consumption of fluoride-contaminated water causes skeletal fluorosis, resulting in bone and joint pain, decreased joint mobility, and skeletal deformities. In severe cases, skeletal fluorosis can lead to disability and reduced quality of life. Various defluoridation techniques such as activated alumina, bone char, and reverse osmosis have been employed to reduce fluoride concentrations in drinking water. These methods effectively remove fluoride, but their implementation requires careful consideration of cost, maintenance, and sustainability. Diversifying water sources, such as rainwater harvesting and surface water supply, can reduce the reliance on fluoride-contaminated groundwater, especially in regions with high fluoride concentrations. Groundwater contamination with fluoride remains a significant public health challenge, leading to the widespread occurrence of fluorosis globally. This scientific report emphasizes the importance of understanding the relationship between groundwater contamination and fluorosis. Implementing effective mitigation strategies and preventive measures is crucial to combat fluorosis and ensure sustainable access to safe drinking water for communities worldwide. Collaborative efforts between government agencies, local communities, and scientific researchers are essential to address this issue and safeguard the health of vulnerable populations. Additionally, the report explores various mitigation strategies and preventive measures to address the issue and offers recommendations for sustainable management of groundwater resources to combat fluorosis effectively.

Keywords: fluorosis, fluoride contamination, groundwater contamination, groundwater resources

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Authors: Elaine Crable, Amit Sen

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Short-term study abroad programs have become a mainstay of MBA programs. The benefits of international business experiences, along with its exposure to global cultures, are well documented. However, developing a rewarding study, abroad program at the graduate level can be challenging for Faculty, especially when devising such a program for a group of part-time MBA students who come with a wide range of experiences and demographic characteristics. Each student has individual expectations for the study abroad experience. This study provides suggestions and considerations for Faculty that are planning to design a short-term study abroad program, especially for part-time MBA students. Insights are based on a recent experience leading a group of twenty-one students on a ten-day program to Morocco. The trip was designed and facilitated by two faculty members and a local Moroccan facilitator. This experience led to a number of insights and recommendations. First, the choice of location is critical. The choice of Morocco was very deliberate, owing to its multi-faceted cultural landscape and international business interest. It is an Islamic State with close ties to Europe both culturally and geographically and Morocco is a multi-lingual country with some combination of three languages spoken by most – English, Arabic, and French. Second, collaboration with a local ‘academic’ partner allowed the level of instruction to be both rigorous and significantly more engaging. Third, allowing students to participate in the planning of the trip enabled the trip participants to collaborate, negotiate, and share their own experiences and strengths. The pre-trip engagement was structured by creating four sub-groups, each responsible for an assigned city. Each student sub-group had to provide a historical background of the assigned city, plan the itinerary including sites to visit, cuisine to experience, industries to explore, markets to visit, plus provide a budget for that city’s expenses. The pre-planning segment of the course was critical for the success of the program as students were able to contribute to the design of the program through collaboration and negotiation with their peers. Fourth, each student sub-group was assigned industry to study within Morocco. The student sub-group prepared a presentation and a group paper with their analysis of the chosen industries. The pre-planning activities created strong bonds among the trip participants, which was evident when faced with on-ground challenges, especially when it was necessary to quickly evacuate due to a surprise USA COVID evacuation notice. The entire group supported each other when quickly making their way back to the United States. Unfortunately, the trip was cut short by two days due to this emergency exit, but the feedback regarding the program was very positive all around. While the program design put pressure on the Faculty leads regarding planning and coordination upfront, the outcome in terms of student engagement, student learning, collaboration and negotiation were all favorable and worth the effort. Finally, an added value, the cost of the program for the student was significantly lower compared to running a program with a professional provider.

Keywords: business education, experiential learning, international education, study abroad

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Authors: Sarah A. Harris, Fleur L. McIntyre, Paola T. Chivers, Benjamin G. Piggott, Fiona H. Farringdon

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Australian Rules Football (ARF) is an invasion based, contact field sport with over one million participants. The contact nature of the game increases exposure to all injuries, including head trauma. Evidence suggests that both concussion and sub-concussive traumas such as head knocks may damage the brain, in particular the prefrontal cortex. The prefrontal cortex may not reach full maturity until a person is in their early twenties with males taking longer to mature than females. Repeated trauma to the pre-frontal cortex during maturation may lead to negative social, cognitive and emotional effects. It is also during this period that males exhibit high levels of risk taking behaviours. Risk propensity and the incidence of injury is an unexplored area of research. Little research has considered if the level of player’s (especially younger players) risk propensity in everyday life places them at an increased risk of injury. Hence the current study, investigated if a relationship exists between risk propensity and self-reported injuries including diagnosed concussion and head knocks, among male ARF players aged 18 to 31 years. Method: The study was conducted over 22 weeks with one West Australian Football League (WAFL) club during the 2015 competition. Pre-season risk propensity was measured using the 7-item self-report Risk Propensity Scale. Possible scores ranged from 9 to 63, with higher scores indicating higher risk propensity. Players reported their self-perceived injuries (concussion, head knocks, upper body and lower body injuries) fortnightly using the WAFL Injury Report Survey (WIRS). A unique ID code was used to ensure player anonymity, which also enabled linkage of survey responses and injury data tracking over the season. A General Linear Model (GLM) was used to analyse whether there was a relationship between risk propensity score and total number of injuries for each injury type. Results: Seventy one players (N=71) with an age range of 18.40 to 30.48 years and a mean age of 21.92 years (±2.96 years) participated in the study. Player’s mean risk propensity score was 32.73, SD ±8.38. Four hundred and ninety five (495) injuries were reported. The most frequently reported injury was head knocks representing 39.19% of total reported injuries. The GLM identified a significant relationship between risk propensity and head knocks (F=4.17, p=.046). No other injury types were significantly related to risk propensity. Discussion: A positive relationship between risk propensity and head trauma in contact sports (specifically WAFL) was discovered. Assessing player’s risk propensity therefore, may identify those more at risk of head injuries. Potentially leading to greater monitoring and education of these players throughout the season, regarding self-identification of head knocks and symptoms that may indicate trauma to the brain. This is important because many players involved in WAFL are in their late teens or early 20’s hence, may be at greater risk of negative outcomes if they experience repeated head trauma. Continued education and research into the risks associated with head injuries has the potential to improve player well-being.

Keywords: football, head injuries, injury identification, risk

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Authors: Sara E. Baumann, Megan A. Rabin, Mary Hawk, Bhimsen Devkota, Kajol Upadhyaya, Guna Raj Shrestha, Brigit Joseph, Annika Agarwal, Jessica G. Burke

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In Nepal, prevailing sociocultural norms associated with menstruation prompt adherence to stringent rules that limit participation in daily activities. Chhaupadi is a specific menstrual tradition in Nepal in which women and girls segregate themselves and follow a series of restrictions during menstruation. Despite having numerous physical and mental health implications, extant interventions have yet to sustainably address the harms associated with chhaupadi. In this study, the authors describe insights garnered from a collaboration with community members in Dailekh district, who formulated their own approaches to mitigate the adverse facets of chhaupadi. Envisaged as an entry point to improve women’s menstrual health experiences, this investigation employed an approach that uses Human-centered Design and a community-engaged approach. The authors conducted a four-day design workshop which unfolded in two phases: The Discovery Phase, to uncover chhaupadi context and key stakeholders, and the Design Phase, to design contextually relevant interventions. Diverse community-members, including those with lived experience practicing chhaupadi, developed five intervention concepts: 1) harnessing Female Community Health Volunteers as role models, for counseling, and raising awareness; 2) focusing on mothers and mother’s groups to instigate behavioral shifts; 3) engaging the broader community in behavior change efforts; 4) empowering fathers to effect change in their homes through counseling and education; and 5) training and emboldening youth to advocate for positive change through advocacy in their schools and homes. This research underscores the importance of employing multi-level approaches tailored to specific stakeholder groups, given Nepal’s rich cultural diversity. The engagement of Female Community Health Volunteers emerged as a promising yet underexplored intervention concept for chhaupadi, warranting broader implementation. Crucially, it is also imperative for interventions to prioritize tackling deleterious aspects of the chhaupadi tradition, emphasizing safety considerations, all while acknowledging chhaupadi’s entrenched cultural history; for some, there are positive aspects of the tradition that women and girls wish to preserve.

Keywords: human-centered design, menstrual health, Nepal, community-engagement, intervention development, women's health, rural health

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Authors: Ali Hashemifarzad, Jens Zum Hingst

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The structure of the world’s energy systems has changed significantly over the past years. One of the most important challenges in the 21st century in Germany (and also worldwide) is the energy transition. This transition aims to comply with the recent international climate agreements from the United Nations Climate Change Conference (COP21) to ensure sustainable energy supply with minimal use of fossil fuels. Germany aims for complete decarbonization of the energy sector by 2050 according to the federal climate protection plan. One of the stipulations of the Renewable Energy Sources Act 2017 for the expansion of energy production from renewable sources in Germany is that they cover at least 80% of the electricity requirement in 2050; The Gross end energy consumption is targeted for at least 60%. This means that by 2050, the energy supply system would have to be almost completely converted to renewable energy. An essential basis for the development of such a sustainable energy supply from 100% renewable energies is to predict the energy requirement by 2050. This study presents two scenarios for the final energy demand in Germany in 2050. In the first scenario, the targets for energy efficiency increase and demand reduction are set very ambitiously. To build a comparison basis, the second scenario provides results with less ambitious assumptions. For this purpose, first, the relevant framework conditions (following CUTEC 2016) were examined, such as the predicted population development and economic growth, which were in the past a significant driver for the increase in energy demand. Also, the potential for energy demand reduction and efficiency increase (on the demand side) was investigated. In particular, current and future technological developments in energy consumption sectors and possible options for energy substitution (namely the electrification rate in the transport sector and the building renovation rate) were included. Here, in addition to the traditional electricity sector, the areas of heat, and fuel-based consumptions in different sectors such as households, commercial, industrial and transport are taken into account, supporting the idea that for a 100% supply from renewable energies, the areas currently based on (fossil) fuels must be almost completely be electricity-based by 2050. The results show that in the very ambitious scenario a final energy demand of 1,362 TWh/a is required, which is composed of 818 TWh/a electricity, 229 TWh/a ambient heat for electric heat pumps and approx. 315 TWh/a non-electric energy (raw materials for non-electrifiable processes). In the less ambitious scenario, in which the targets are not fully achieved by 2050, the final energy demand will need a higher electricity part of almost 1,138 TWh/a (from the total: 1,682 TWh/a). It has also been estimated that 50% of the electricity revenue must be saved to compensate for fluctuations in the daily and annual flows. Due to conversion and storage losses (about 50%), this would mean that the electricity requirement for the very ambitious scenario would increase to 1,227 TWh / a.

Keywords: energy demand, energy transition, German Energiewende, 100% renewable energy production

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Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

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Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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Authors: Johannes Gantner, Michael Held, Rafael Horn, Matthias Fischer

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At the United Nations Climate Change Conference 2015 a global agreement on the reduction of climate change was achieved stating CO₂ reduction targets for all countries. For instance, the EU targets a reduction of 40 percent in emissions by 2030 compared to 1990. In order to achieve this ambitious goal, the environmental performance of the different European electricity grid mixes is crucial. First, the electricity directly needed for everyone’s daily life (e.g. heating, plug load, mobility) and therefore a reduction of the environmental impacts of the electricity grid mix reduces the overall environmental impacts of a country. Secondly, the manufacturing of every product depends on electricity. Thereby a reduction of the environmental impacts of the electricity mix results in a further decrease of environmental impacts of every product. As a result, the implementation of the two-degree goal highly depends on the decarbonization of the European electricity mixes. Currently the production of electricity in the EU27 is based on fossil fuels and therefore bears a high GWP impact per kWh. Due to the importance of the environmental impacts of the electricity mix, not only today but also in future, within the European research projects, CommONEnergy and Senskin, time-dynamic Life Cycle Assessment models for all EU27 countries were set up. As a methodology, a combination of scenario modeling and life cycle assessment according to ISO14040 and ISO14044 was conducted. Based on EU27 trends regarding energy, transport, and buildings, the different national electricity mixes were investigated taking into account future changes such as amount of electricity generated in the country, change in electricity carriers, COP of the power plants and distribution losses, imports and exports. As results, time-dynamic environmental profiles for the electricity mixes of each country and for Europe overall were set up. Thereby for each European country, the decarbonization strategies of the electricity mix are critically investigated in order to identify decisions, that can lead to negative environmental effects, for instance on the reduction of the global warming of the electricity mix. For example, the withdrawal of the nuclear energy program in Germany and at the same time compensation of the missing energy by non-renewable energy carriers like lignite and natural gas is resulting in an increase in global warming potential of electricity grid mix. Just after two years this increase countervailed by the higher share of renewable energy carriers such as wind power and photovoltaic. Finally, as an outlook a first qualitative picture is provided, illustrating from environmental perspective, which country has the highest potential for low-carbon electricity production and therefore how investments in a connected European electricity grid could decrease the environmental impacts of the electricity mix in Europe.

Keywords: electricity grid mixes, EU27 countries, environmental impacts, future trends, life cycle assessment, scenario analysis

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Authors: S. F. Afzali, W. L. Wong

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The epizootic ulcerative syndrome (EUS) causes by the oomycete fungus, Aphanomyces invadans; known to be one of the infectious fish diseases for farmed and wild fishes in fresh and brackish-water from the Asia-pacific region, America and Africa. Although, EUS had been documented by the Office International des Epizooties (OIE) since 1995, hitherto, there is neither standard chemical agents that can be used for successful treatment of this destructive infection in the time of outbreak; nor available vaccine for prevention. Plant-based remedies in controlling fish diseases are gaining much attention recently as an alternative to chemical treatments, which possess negative effects to the environment and human. In present study, Sonneratia alba, a mangrove plant belongs to the Sonneratiaceae family, was screened in vitro and in vivo for its antifungal activity against A. invadans mycelium growth and its effects on fish innate immune system and disease resistant. The in vitro tests was performed using the disc diffusion methods with measurements of minimum inhibitory concentration (MIC) and inhibition zone. For in vivo study, the S. alba extract supplemented diets were administrated at 0.0, 1.0%, 3.0%, and 5.0% on healthy goldfish, Carassius auratus, which challenged with A. invadans zoospores (100 spores/ml). To compare the significant differences in the hematological and immunological parameters obtained from the experiments, the data were analysed using the SPSS. The methanol extract of S. alba effectively inhibited the mycelial growth of A. invadans at a minimum concentration of 1000 ppm for agar and filter paper diffusion experiments. In the agar diffusion test, 500 ppm of the extract inhibited the fungus mycelial growth up to 96 hours after exposure. The mycelial growth from the edge of the pre-inoculated A. invadans agar discs treated with S. alba extracts at concentrations of 100, 500 and 1000 ppm were 15, 8 and 0 mm respectively. The results of the filter paper disc test showed that the S. alba extract at its minimal inhibitory concentration (1000 ppm) has similar qualitative inhibitory effect as malachite green at 1 ppm and formalin at 250 ppm. According to the in vivo tests findings, in the infected fish fed with 3.0% and 5.0% supplementation diet, the numbers of white blood cell and myeloperoxidase activity significantly increased after the second week of treatment. Whilst the numbers of red blood cell significantly decreased in the infected fish fed with 0.0 and 1.0% supplementation diet. After the third week of feeding, significant increases in the total protein, albumin level, lysozyme activity were recorded in the infected fish fed with 3.0% and 5.0% supplementation diet. Also, the enriched diets increased the survival rate as compared to the untreated group that suffered from 90% mortality. The present study indicated that S. alba extract may inhibit the mycelial growth of A. invadans effectively, suggesting an alternative to other chemotherapeutic agents, which brought much environmental and health concerns to the public, for EUS treatment.

Keywords: fungal pathogen, goldfish, organic extract, treatment

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Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

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Authors: Festa Shabani

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This paper aims at investigating bilingual speech in the International Schools of Prishtina. More particularly, it seeks to analyze bilingual phenomena among adolescent students highly exposed to English with the latter as the language of instruction at school in naturally-occurring conversations within school environment. Adolescence was deliberately chosen since it is regarded as an age when peer influence on language choice is the greatest. Driven by daily unsystematic observation and prior research already undertaken, the hypothesis stated is that Albanian continues to be the dominant language among Prishtina international schools’ students with a lot of code-switched items from the English. Furthermore, they will also use lexical borrowings - words already adapted in the receiving language, from the language they have been in contact with, in their speech often in the lack of existing equivalents in Albanian or for other reasons. This is done owing to the fact that the language of instruction at school is English, and any topic related to the language they have been exposed to will trigger them to use English. Therefore, this needs special attention in an attempt to identify patterns of their speech; in this way, linguistic and socio-pragmatic factors will be considered when analyzing the motivations behind their language choice. Methodology for collecting data include participant systematic observation and tape-recording. While observing them in their natural conversations, the fieldworker also took notes, which helped transcribe details better. The paper starts by raising the question of whether code-switching is occurring among Prishtina International Schools’ students highly exposed to English. The data gathered from students in informal settings suggests that there are well-founded grounds for an affirmative answer. The participants in this study are observed to be code-switching, although showing differences in degree. However, a generalization cannot be made on the basis of the findings except in so far it appears that English has, in turn, became a language to which they turn when identifying with the group when discussing about particular school topics. Particularly, participants seemed to use intra-sentential CS in cases when they seem to find an English expression rather easier than an Albanian one when repeating or emphasizing a point when urged to talk about educational issues with English being their language of instruction, and inter-sentential code-switching, particularly when quoting others. Concerning the grammatical aspect of code-switching, the intrasentential CS is used more than the intersentetial one. Speaking of gender, the results show that there were really no significant differences in regards quantity between male and female participants. However, the slight tendency for men to code switch intrasententially more than women was manifested. Similarly, a slight tendency again for a difference to emerge is on intersentential switching, which contributes 21% to the total number of switches for women, but 11% to the total number of switches for men.

Keywords: Albanian, code-switching contact linguistics, bilingual phenomena, lexical borrowing, English

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Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

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Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

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Authors: Bhavana Gulaty, Arshia Chaudhri

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Great civic projects contribute integrally to a city, and every city undergoes a recurring cycle of urban transformations and regeneration by their insertion. The M.I.C.E. (Meetings, Incentives, Convention and Exhibitions) industry is the forbearer of one category of such catalytic civic projects. Through a specific focus on M.I.C.E. destinations, this paper illustrates the multifarious dimensions that urban catalysts impact the city on S.P.U.R. (Seed. Profile. Urbane. Reflections), the theoretical framework of this paper aims to unearth these dimensions in the realm of the COEX (Convention & Exhibition) biosphere. The ‘COEX Biosphere’ is the filter of such catalysts being ecosystems unto themselves. Like a ripple in water, the impact of these strategic interventions focusing on art, culture, trade, and promotion expands right from the trigger; the immediate context to the region and subsequently impacts the global scale. These ripples are known to bring about significant economic, social, and political and network changes. The COEX inventory in the Asian context has one such prominent addition; the proposed India International Convention and Exhibition Centre (IICC) at New Delhi. It is envisioned to be the largest facility in Asia currently and would position India on the global M.I.C.E map. With the first phase of the project scheduled to open for use in the end of 2019, this flagship project of the Government of India is projected to cater to a peak daily footfall of 3,20,000 visitors and estimated to generate 5,00,000 jobs. While the economic benefits are yet to manifest in real time and ‘Good design is good business’ holds true, for the urban transformation to be meaningful, the benefits have to go beyond just a balance sheet for the city’s exchequer. This aspect has been found relatively unexplored in research on these developments. The methodology for investigation will comprise of two steps. The first will be establishing an inventory of the global success stories and associated benefits of COEX projects over the past decade. The rationale for capping the timeframe is the significant paradigm shift that has been observed in their recent conceptualization; for instance ‘Innovation Districts’ conceptualised in the city of Albuquerque that converges into the global economy. The second step would entail a comparative benchmarking of the projected transformations by IICC through a toolkit of parameters. This is posited to yield a matrix that can form the test bed for mapping the catalytic trajectory for projects in the pipeline globally. As a ready reckoner, it purports to be a catalyst to substantiate decision making in the planning stage itself for future projects in similar contexts.

Keywords: catalysts, COEX, M.I.C.E., urban transformations

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Authors: Sharmistha Chanda, Anindita Chaudhuri

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This exploratory study highlights the psychological aspects of women's empowerment to find the importance of the psychological dimension of empowerment, such as; meaning, competence, self-determination, impact, and assumption, especially in the weaker marginalized section of women. A large proportion of rural, suburban, and urban poor survive by working in unorganized sectors of metropolitan cities. Relative Poverty and lack of employment in rural areas and small towns drive many people to the metropolitan city for work and livelihood. Women working in that field remain unrecognized as people of low socio-economic status. They are usually willing to do domestic work as daily wage workers, single wage earners, street vendors, family businesses like agricultural activities, domestic workers, and self-employed. Usually, these women accept such jobs because they do not have such an opportunity as they lack the basic level of education that is required for better-paid jobs. The unorganized sector, on the other hand, has no such clear-cut employer-employee relationships and lacks most forms of social protection. Having no fixed employer, these workers are casual, contractual, migrant, home-based, own-account workers who attempt to earn a living from whatever meager assets and skills they possess. Women have become more empowered both financially and individually through small-scale business ownership or entrepreneurship development and in household-based work. In-depth interviews have been done with 10 participants in order to understand their living styles, habits, self-identity, and empowerment in their society in order to evaluate the key challenges that they may face following by qualitative research approach. Transcription has been done from the collected data. The three-layer coding technique guides the data analysis process, encompassing – open coding, axial coding, and selective coding. Women’s Entrepreneurship is one of the foremost concerns as the Government, and non-government institutions are readily serving this domain with the primary objectives of promoting self-employment opportunities in general and empowering women in specific. Thus, despite hardship and unrecognition unorganized sector provides a huge array of opportunities for rural and sub-urban poor to earn. Also, the upper section of society tends to depend on this working force. This study gave an idea about the well-being, and meaning in life, life satisfaction on the basis of their lived experience.

Keywords: marginalized women, psychological empowerment, relative poverty, and unorganized sector.

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Authors: Muritala Babatunde Hassan

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In the contemporary global political economy, foreign direct investment (FDI) is gaining currency on daily basis. Notably, the end of the Cold War has brought about the dominance of neoliberal ideology with its mantra of private-sector-led economy. As such, nation-states now see FDI attraction as an important element in their approach to national development. Governments and policy makers are preoccupying themselves with unraveling the best strategies to not only attract more FDI but also to attain the desired socio-economic development status. In Nigeria, the perceived development potentials of FDI have brought about aggressive hunt for foreign investors, most especially since transition to civilian rule in May 1999. Series of liberal and market oriented strategies are being adopted not only to attract foreign investors but largely to stimulate private sector participation in the economy. It is on this premise that this study interrogates the politics of FDI attraction for domestic development in Nigeria between 1999 and 2014, with the ultimate aim of examining the nexus between regime type and the ability of a state to attract and benefit from FDI. Building its analysis within the framework of institutional utilitarianism, the study posits that the essential FDI strategies for achieving the greatest happiness for the greatest number of Nigerians are political not economic. Both content analysis and descriptive survey methodology were employed in carrying out the study. Content analysis involves desk review of literatures that culminated in the development of the study’s conceptual and theoretical framework of analysis. The study finds no significant relationship between transition to democracy and FDI inflows in Nigeria, as most of the attracted investments during the period of the study were market and resource seeking as was the case during the military regime, thereby contributing minimally to the socio-economic development of the country. It is also found that the country placed much emphasis on liberalization and incentives for FDI attraction at the neglect of improving the domestic investment environment. Consequently, poor state of infrastructure, weak institutional capability and insecurity were identified as the major factors seriously hindering the success of Nigeria in exploiting FDI for domestic development. Given the reality of the currency of FDI as a vector of economic globalization and that Nigeria is trailing the line of private-sector-led approach to development, it is recommended that emphasis should be placed on those measures aimed at improving the infrastructural facilities, building solid institutional framework, enhancing skill and technological transfer and coordinating FDI promotion activities by different agencies and at different levels of government.

Keywords: foreign capital, politics, socio-economic development, FDI attraction strategies

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Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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Authors: Dorothy Ebere Adimora

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The study investigated the predictive power of home environment and peer pressure on disruptive behaviour and risky sexual behaviour of Secondary School Class Two Adolescents in Enugu State, Nigeria. The design of the study is a cross sectional survey of correlational study. The study was carried out in the six Education zones in Enugu state, Nigeria. Enugu State is divided into six education zones, namely Agbani, Awgu, Enugu, Nsukka, Obollo-Afor and Udi. The population for the study was all the 31,680 senior secondary class two adolescents in 285 secondary schools in Enugu State, Nigeria in 2014/2015 academic session. The target population was students in SSS.2 senior secondary class two. They constitute one-sixth of the entire student population in the state. The sample of the study was 528, a multi stage sampling technique was employed to draw the sample. Four research questions and four null hypotheses guided the study. The instruments for data collection were an interview session and a structured questionnaire of four clusters, they are; home environment, peer pressure, risky sexual behaviour and disruptive behaviour disorder questionnaires. The instruments were validated by 3 experts, two in psychology and one in measurement and Evaluation in Faculty of Education, University of Nigeria, Nsukka. The reliability coefficient of the instruments was ascertained by subjection to field trial. The adolescents were asked to complete the questionnaire on their home environment, peer pressure, disruptive behaviour disorder and risky sexual behaviours. The risky sexual behaviours were ascertained based on interview conducted on their actual sexual practice within the past 12 months. The research questions were analyzed using Pearson r and R-square, while the hypotheses were tested using ANOVA and multiple regression analysis at 0.05 level of significance. The results of this survey revealed that the adolescents are sexually active in very young ages. The mean age at sexual debut for the adolescents covered in this survey is a pointer to the fact that some of them started engaging in sexual activities long ago. It was also found that the adolescents engage in disruptive behaviour as a result of their poor home environment factors and association with negative peers. Based on the findings, it was recommended that the adolescents should be exposed to enhanced home environment such as parents’ responsiveness, organization of the environment, availability of appropriate learning materials, opportunities for daily stimulation and to offer a proper guidance to these adolescents to avoid negative peer influence which could result in risky sexual behaviour and disruptive behaviour disorder.

Keywords: parenting, peer group, adolescents, sexuality, conduct disorder

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Authors: Peri Ozlem Yuksel-Sokmen, Irfan Cagtay

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Oral languages are destined to disappear rapidly in the absence of interventions aimed at encouraging their usage by young children. The seminal language preservation model proposed by Fishman (1991) stresses the importance of multiple generations using the endangered L1 while engaged in daily routines with younger children. Over the last two decades Fishman (2001) has used his intergenerational transmission model in documenting the revitalization of Basque languages, providing evidence that families are transmitting Euskara as a first language to their children with success. In our study, to motivate usage of Lazuri, we asked caregivers to speak the language while engaged with their toddlers (12 to 48 months) in semi-structured play, and included both parents (N=32) and grandparents (N=30) as play partners. This unnatural prompting to speak only in Lazuri was greeted with reluctance, as 90% of our families indicated that they had stopped using Lazuri with their children. Nevertheless, caregivers followed instructions and produced 67% of their utterances in Lazuri, with another 14% of utterances using a combination of Lazuri and Turkish (Codeswitch). Although children spoke mostly in Turkish (83% of utterances), frequencies of caregiver utterances in Lazuri or Codeswitch predicted the extent to which their children used the minority language in return. This trend suggests that home interventions aimed at encouraging dyads to communicate in a non-preferred, endangered language can effectively increase children’s usage of the language. Alternatively, this result suggests than any use of the minority language on the part of the children will promote its further usage by caregivers. For researchers examining links between play, culture, and child development, structured play has emerged as a critical methodology (e.g., Frost, Wortham, Reifel, 2007, Lilliard et al., 2012; Sutton-Smith, 1986; Gaskins & Miller, 2009), allowing investigation of cultural and individual variation in parenting styles, as well as the role of culture in constraining the affordances of toys. Toy props, as well as picture-books in native languages, can be used as tools in the transmission and preservation of endangered languages by allowing children to explore adult roles through enactment of social routines and conversational patterns modeled by caregivers. Through adult-guided play children not only acquire scripts for culturally significant activities, but also develop skills in expressing themselves in culturally relevant ways that may continue to develop over their lives through community engagement. Further pedagogical tools, such as language games and e-learning, will be discussed in this proposed oral talk.

Keywords: language intervention, pedagogical tools, endangered languages, Lazuri

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Authors: Candy Chieh Lee

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Objective: The purpose of this study is to investigate the relationship between visual perception and social function in patients with schizophrenia. The specific aims are: 1) To explore performances in visual perception and social function in patients with schizophrenia 2) to examine the correlation between visual perceptual skills and social function in patients with schizophrenia The long-term goal is to be able to provide the most adequate intervention program for promoting patients’ visual perceptual skills and social function, as well as compensatory techniques. Background: Perceptual deficits in schizophrenia have been well documented in the visual system. Clinically, a considerable portion (up to 60%) of schizophrenia patients report distorted visual experiences such as visual perception of motion, color, size, and facial expression. Visual perception is required for the successful performance of most activities of daily living, such as dressing, making a cup of tea, driving a car and reading. On the other hand, patients with schizophrenia usually exhibit psychotic symptoms such as auditory hallucination and delusions which tend to alter their perception of reality and affect their quality of interpersonal relationship and limit their participation in various social situations. Social function plays an important role in the prognosis of patients with schizophrenia; lower social functioning skills can lead to poorer prognosis. Investigations on the relationship between social functioning and perceptual ability in patients with schizophrenia are relatively new but important as the results could provide information for effective intervention on visual perception and social functioning in patients with schizophrenia. Methods: We recruited 50 participants with schizophrenia in the mental health hospital (Taipei City Hospital, Songde branch, Taipei, Taiwan) acute ward. Participants who have signed consent forms, diagnosis of schizophrenia and having no organic vision deficits were included. Participants were administered the test of visual-perceptual skills (non-motor), third edition (TVPS-3) and the personal and social performance scale (PSP) for assessing visual perceptual skill and social function. The assessments will take about 70-90 minutes to complete. Data Analysis: The IBM SPSS 21.0 will be used to perform the statistical analysis. First, descriptive statistics will be performed to describe the characteristics and performance of the participants. Lastly, Pearson correlation will be computed to examine the correlation between PSP and TVPS-3 scores. Results: Significant differences were found between the means of participants’ TVPS-3 raw scores of each subtest with the age equivalent raw score provided by the TVPS-3 manual. Significant correlations were found between all 7 subtests of TVPS-3 and PSP total score. Conclusions: The results showed that patients with schizophrenia do exhibit visual perceptual deficits and is correlated social functions. Understanding these facts of patients with schizophrenia can assist health care professionals in designing and implementing adequate rehabilitative treatment according to patients’ needs.

Keywords: occupational therapy, social function, schizophrenia, visual perception

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Authors: Jiro Takagi

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Approximately 90 percent of the casualties in the near-fault-type Kobe earthquake in 1995 resulted from the collapse of wooden houses, although a limited number of collapses of this type of building were reported in the more recent off-shore-type Tohoku Earthquake in 2011 (excluding direct damage by the Tsunami). Kumamoto earthquake in 2016 also revealed the vulnerability of old wooden houses in Japan. There are approximately 24.5 million wooden houses in Japan and roughly 40 percent of them are considered to have the inadequate seismic-resisting capacity. Therefore, seismic strengthening of these wooden houses is an urgent task. However, it has not been quickly done for various reasons, including cost and inconvenience during the reinforcing work. Residents typically spend their money on improvements that more directly affect their daily housing environment (such as interior renovation, equipment renewal, and placement of thermal insulation) rather than on strengthening against extremely rare events such as large earthquakes. Considering this tendency of residents, a new approach to developing a seismic strengthening method for wooden houses is needed. The seismic reinforcement method developed in this research uses folded galvanized thin steel plates as both shear walls and the new exterior architectural finish. The existing finish is not removed. Because galvanized steel plates are aesthetic and durable, they are commonly used in modern Japanese buildings on roofs and walls. Residents could feel a physical change through the reinforcement, covering existing exterior walls with steel plates. Also, this exterior reinforcement can be installed with only outdoor work, thereby reducing inconvenience for residents since they would not be required to move out temporarily during construction. The Durability of the exterior is enhanced, and the reinforcing work can be done efficiently since perfect water protection is not required for the new finish. In this method, the entire exterior surface would function as shear walls and thus the pull-out force induced by seismic lateral load would be significantly reduced as compared with a typical reinforcement scheme of adding braces in selected frames. Consequently, reinforcing details of anchors to the foundations would be less difficult. In order to attach the exterior galvanized thin steel plates to the houses, new wooden beams are placed next to the existing beams. In this research, steel connections between the existing and new beams are developed, which contain a gap for the existing finish between the two beams. The thin steel plates are screwed to the new beams and the connecting vertical members. The seismic-resisting performance of the shear walls with thin steel plates is experimentally verified both for the frames and connections. It is confirmed that the performance is high enough for bracing general wooden houses.

Keywords: experiment, seismic reinforcement, thin steel plates, wooden houses

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Authors: Alessandra Panico, Francesco Bagordo, Tiziana Grassi, Adele Idolo, Marcello Guido, Francesca Serio, Mattia De Giorgi, Antonella De Donno

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In the Province of Lecce (Southeastern Italy) an area with unusual high incidence of chronic respiratory diseases, including lung cancer, was recently identified. The causes of this health emergency are still not entirely clear. In order to determine the risk profile of children living in five municipalities included in this area an epidemiological-molecular study was performed in the years 2014-2016: the IMP.AIR. (Impact of air quality on health of residents in the Municipalities of Sternatia, Galatina, Cutrofiano, Sogliano Cavour and Soleto) study. 122 children aged 6-8 years attending primary school in the study area were enrolled to evaluate the frequency of micronuclei (MNs) in their buccal exfoliated cells. The samples were collected in May 2015 by rubbing the oral mucosa with a soft bristle disposable toothbrush. At the same time, a validated questionnaire was administered to parents to obtain information about health, lifestyle and eating habits of the children. In addition, information on airborne pollutants, routinely detected by the Regional Environmental Agency (ARPA Puglia) in the study area, was acquired. A multivariate analysis was performed to detect any significant association between frequency of MNs (dependent variable) and behavioral factors (independent variables). The presence of MNs was highlighted in the buccal exfoliated cells of about 42% of recruited children with a mean frequency of 0.49 MN/1000 cells, greater than in other areas of Salento. The survey on individual characteristics and lifestyles showed that one in three children was overweight and that most of them had unhealthy eating habits with frequent consumption of foods considered ‘risky’. Moreover many parents (40% of fathers and 12% of mothers) were smokers and about 20% of them admitted to smoking in the house where the children lived. Information regarding atmospheric contaminants was poor. Of the few substances routinely detected by the only one monitoring station located in the study area (PM2.5, SO2, NO2, CO, O3) only ozone showed high concentrations exceeding the limits set by the legislation for 67 times in the year 2015. The study showed that the level of early biological effect markers in children was not negligible. This critical condition could be related to some individual factors and lifestyles such as overweight, unhealthy eating habits and exposure to passive smoking. At present, no relationship with airborne pollutants can be established due to the lack of information on many substances. Therefore, it would be advisable to modify incorrect behaviors and to intensify the monitoring of airborne pollutants (e.g. including detection of PM10, heavy metals, aromatic polycyclic hydrocarbons, benzene) given the epidemiology of chronic respiratory diseases registered in this area.

Keywords: chronic respiratory diseases, environmental pollution, lifestyle, micronuclei

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Authors: Ramzi Bekri Umer

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Aim: This study attempts to investigate the causes and difficulties with women’s incarceration as well as threat for their reintegration after release from prison with emphasis on the correctional facility of Haramaya city. Method and Methodology: Both quantitative and qualitative research methods were employed in this study; key informant interviews and participant observation were utilized to gather qualitative data, while crosssectional and descriptive research designs were used to gather quantitative data. Findings: This study shows that the women's incarceration was caused by their family histories, genderbased violence, illiteracy, and socioeconomic issues. The principal charges made against the female culprits were theft, vandalism, murder, and moral perversion. A poor quality of life in prison, concerns about family dissolution, emotional instability, financial difficulties, and a lack of spirituality were the main causes of unhappiness for the women behind bars, while social stigma, mistrust, and retaliation fears were the main obstacles to the women's ability to reintegrate into their families and communities. Theoretical Importance: This study involves incarcerated women at correctional center of Haramaya who committed various types of crimes. The local government sectors and non-governmental organization will gain from the study in order to create workable plans to reduce women's criminality and the growing number of female lawbreakers. Local communities and other governmental and nongovernmental partners will be able to support gender equality initiatives that seek to eradicate gender-based violence and discrimination, which worsen the criminality of women. Data Collection and Analysis Procedures: The quantitative and qualitative data were collected prospectively from a sample of 100 women prisoners. Quantitative data were analyzed using descriptive statistics, whereas, thematic analysis, were used for qualitative data. Question Answered: 1. What are the main causes women’s imprisonment in Haramaya city correctional facility. 2. What are the main obstacles of the women's ability to reintegrate into their families and communities after released from incarceration. Conclusion: The study concludes that incarcerated women experience a tremendous impact on their daily life. It highlights the importance of addressing factors such as family backgrounds, gender-based violence, illiteracy and socio-economic problem to decrease the number of women imprisonment. Detention environment, fear for family breakup, financial hardship and deprivation of spiritual life are the major sources of distress among the incarcerated women.

Keywords: Ethiopia, women prisoner, incarceration, reintegration

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Authors: T. Lydon, A. McNabola, P. Coughlan

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Energy consumption in the water distribution network (WDN) is a well established problem equating to the industry contributing heavily to carbon emissions, with 0.9 kg CO2 emitted per m3 of water supplied. It is indicated that 85% of energy wasted in the WDN can be recovered by installing turbines. Existing potential in networks is present at small capacity sites (5-10 kW), numerous and dispersed across networks. However, traditional turbine technology cannot be scaled down to this size in an economically viable fashion, thus alternative approaches are needed. This research aims to enable energy recovery potential within the WDN by exploring the potential of pumps-as-turbines (PATs), to realise this potential. PATs are estimated to be ten times cheaper than traditional micro-hydro turbines, presenting potential to contribute to an economically viable solution. However, a number of technical constraints currently prohibit their widespread use, including the inability of a PAT to control pressure, difficulty in the selection of PATs due to lack of performance data and a lack of understanding on how PATs can cater for fluctuations as extreme as +/- 50% of the average daily flow, characteristic of the WDN. A PAT prototype is undergoing testing in order to identify the capabilities of the technology. Results of preliminary testing, which involved testing the efficiency and power potential of the PAT for varying flow and pressure conditions, in order to develop characteristic and efficiency curves for the PAT and a baseline understanding of the technologies capabilities, are presented here: •The limitations of existing selection methods which convert BEP from pump operation to BEP in turbine operation was highlighted by the failure of such methods to reflect the conditions of maximum efficiency of the PAT. A generalised selection method for the WDN may need to be informed by an understanding of impact of flow variations and pressure control on system power potential capital cost, maintenance costs, payback period. •A clear relationship between flow and efficiency rate of the PAT has been established. The rate of efficiency reductions for flows +/- 50% BEP is significant and more extreme for deviations in flow above the BEP than below, but not dissimilar to the reaction of efficiency of other turbines. •PAT alone is not sufficient to regulate pressure, yet the relationship of pressure across the PAT is foundational in exploring ways which PAT energy recovery systems can maintain required pressure level within the WDN. Efficiencies of systems of PAT energy recovery systems operating conditions of pressure regulation, which have been conceptualise in current literature, need to be established. Initial results guide the focus of forthcoming testing and exploration of PAT technology towards how PATs can form part of an efficiency energy recovery system.

Keywords: energy recovery, pump-as-turbine, water distribution network, water distribution network

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Authors: Sandy Elsayed, Aya Mohamed, Noha Nassar

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Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social deficits and repetitive behavior. Multiple studies suggest that oxidative stress and neuroinflammation are key factors in the etiology of ASD and often associated with worsening of ASD-related behaviors. Nuclear factor erythroid 2-related factor 2 (NRF-2) is a transcription factor that promotes expression of antioxidant response element genes in oxidative stress. In ASD subjects, decreased expression of NRF-2 in frontal cortex shifted the redox homeostasis towards oxidative stress, and resulted in inflammation evidenced by elevation of nuclear factor kappa B (NF-κB) transcriptional activity. Dimethyl fumarate (DMF) is a NRF-2 activator that is used in the treatment of psoriasis and multiple sclerosis. It participates in the transcriptional control of inflammatory factors via inhibition of NF-κB and its downstream targets. This study aimed to investigate the role of DMF in alleviating the cognitive impairments and behavior deficits associated with ASD through mitigation of oxidative stress and inflammation in prenatal valproic acid (VPA) rat model of autism. Methods: Pregnant female Wistar rats received a single intraperitoneal injection of VPA (600 mg/kg) to induce autistic-like-behavioral and neurobiological alterations in their offspring. Chronic oral gavage of DMF (150mg/kg/day) started from postnatal day (PND) 24 till PND62 (39 days). Prenatal VPA exposure elicited autistic behaviors including decreased social interaction and stereotyped behavior. Social interaction was evaluated using three-chamber sociability test and calculation of sociability index (SI), while stereotyped repetitive behavior and anxiety associated with ASD were assessed using marble burying test (MBT). Biochemical analyses were done on prefrontal cortex homogenates including NRF-2, and NF-κB expression. Moreover, inducible nitric oxide synthase (iNOS) gene expression and tumor necrosis factor (TNF-) protein expression were evaluated as markers of inflammation. Results: Prenatal VPA elicited decreased social interaction shown by decreased SI compared to control group (p < 0.001) and DMF enhanced SI (p < 0.05). In MBT, prenatal injection of VPA manifested stereotyped behavior and enhanced number of buried marbles compared to control (p < 0.05) and DMF reduced the anxiety-related behavior in rats exhibiting ASD-like behaviors (p < 0.05). In prefrontal cortex, NRF-2 expression was downregulated in prenatal VPA model (p < 0.0001) and DMF reversed this effect (p < 0.0001). The inflammatory transcription factor NF-κB was elevated in prenatal VPA model (p < 0.0001) and reduced (p < 0.0001) upon NRF-2 activation by DMF. Prenatal VPA expressed higher levels of proinflammatory cytokine TNF- compared to control group (p < 0.0001) and DMF reduced it (p < 0.0001). Finally, the gene expression of iNOS was downregulated upon NRF-2 activation by DMF (p < 0.01). Conclusion: This study proposes that DMF is a potential agent that can be used to ameliorate autistic-like-changes through NRF-2 activation along with NF-κB downregulation and therefore, it is a promising novel therapy for ASD.

Keywords: autism spectrum disorders, dimethyl fumarate, neuroinflammation, NRF-2

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Authors: Marcus Goh Tian Xi, Alicia Chua Si Wen, Eunice Gan Ghee Wu, Helen Bound, Lee Liang Ying, Albert Lee

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The Map of Dialogical Inquiry provides a conceptual look at the underlying nature of future-oriented skills. According to the Map, learning is learner-oriented, with conversational time shifted from teachers to learners, who play a strong role in deciding what and how they learn. For example, in courses operating on the principles of Dialogical Inquiry, learners were able to leave the classroom with a deeper understanding of the topic, broader exposure to differing perspectives, and stronger critical thinking capabilities, compared to traditional approaches to teaching. Despite its contributions to learning, the Map is grounded in a qualitative approach both in its development and its application for providing feedback to learners and educators. Studies hinge on openended responses by Map users, which can be time consuming and resource intensive. The present research is motivated by this gap in practicality by aiming to develop and validate a quantitative measure of the Map. In addition, a quantifiable measure may also strengthen applicability by making learning experiences trackable and comparable. The Map outlines eight learning aspects that learners should holistically engage. This research focuses on the Analysing aspect of learning. According to the Map, Analysing has four key components: liking or engaging in logic, using interpretative lenses, seeking patterns, and critiquing and deconstructing. Existing scales of constructs (e.g., critical thinking, rationality) related to these components were identified so that the current scale could adapt items from. Specifically, items were phrased beginning with an “I”, followed by an action phrase, to fulfil the purpose of assessing learners' engagement with Analysing either in general or in classroom contexts. Paralleling standard scale development procedure, the 26-item Analysing scale was administered to 330 participants alongside existing scales with varying levels of association to Analysing, to establish construct validity. Subsequently, the scale was refined and its dimensionality, reliability, and validity were determined. Confirmatory factor analysis (CFA) revealed if scale items loaded onto the four factors corresponding to the components of Analysing. To refine the scale, items were systematically removed via an iterative procedure, according to their factor loadings and results of likelihood ratio tests at each step. Eight items were removed this way. The Analysing scale is better conceptualised as unidimensional, rather than comprising the four components identified by the Map, for three reasons: 1) the covariance matrix of the model specified for the CFA was not positive definite, 2) correlations among the four factors were high, and 3) exploratory factor analyses did not yield an easily interpretable factor structure of Analysing. Regarding validity, since the Analysing scale had higher correlations with conceptually similar scales than conceptually distinct scales, with minor exceptions, construct validity was largely established. Overall, satisfactory reliability and validity of the scale suggest that the current procedure can result in a valid and easy-touse measure for each aspect of the Map.

Keywords: analytical thinking, dialogical inquiry, education, lifelong learning, pedagogy, scale development

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Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward

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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.

Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production

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Authors: Tomás Sobrino, Lara García-Varela, Marta Aramburu-Núñez, Mónica Castro, Noemí Gómez-Lado, Mariña Rodríguez-Arrizabalaga, Antía Custodia, Juan Manuel Pías-Peleteiro, José Manuel Aldrey, Daniel Romaus-Sanjurjo, Ángeles Almeida, Pablo Aguiar, Alberto Ouro

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Introduction: Alzheimer’s disease (AD) and other tauopathies are primary causes of dementia, causing progressive cognitive deterioration that entails serious repercussions for the patients' performance of daily tasks. Currently, there is no effective approach for the early diagnosis and treatment of AD and tauopathies. This study suggests a theragnostic approach based on the importance of phosphorylated tau protein (p-Tau) in the early pathophysiological processes of AD. We have developed a novel theragnostic monoclonal antibody (mAb) to provide both diagnostic and therapeutic effects. Methods/Results: We have developed a p-Tau mAb, which was doped with deferoxamine for radiolabeling with Zirconium-89 (89Zr) for PET imaging, as well as fluorescence dies for immunofluorescence assays. The p-Tau mAb was evaluated in vitro for toxicity by MTT assay, LDH activity, propidium iodide/Annexin V assay, caspase-3, and mitochondrial membrane potential (MMP) assay in both mouse endothelial cell line (bEnd.3) and cortical primary neurons cell cultures. Importantly, non-toxic effects (up to concentrations of p-Tau mAb greater than 100 ug/mL) were detected. In vivo experiments in the tauopathy model mice (PS19) show that the 89Zr-pTau-mAb and 89Zr-Fragments-pTau-mAb are stable in circulation for up to 10 days without toxic effects. However, only less than 0.2% reached the brain, so further strategies have to be designed for crossing the Brain-Blood-Barrier (BBB). Moreover, an intraparenchymal treatment strategy was carried out. The PS19 mice were operated to implement osmotic pumps (Alzet 1004) at two different times, at 4 and 7 months, to stimulate the controlled release for one month each of the B6 antibody or the IgG1 control antibody. We demonstrated that B6-treated mice maintained their motor and memory abilities significantly compared with IgG1 treatment. In addition, we observed a significant reduction in p-Tau deposits in the brain. Conclusions /Discussion: A theragnostic pTau-mAb was developed. Moreover, we demonstrated that our p-Tau mAb recognizes very-early pathology forms of p-Tau by non-invasive techniques, such as PET. In addition, p-Tau mAb has non-toxic effects, both in vitro and in vivo. Although the p-Tau mAb is stable in circulation, only 0.2% achieve the brain. However, direct intraventricular treatment significantly reduces cognitive impairment in Alzheimer's animal models, as well as the accumulation of toxic p-Tau species.

Keywords: alzheimer's disease, theragnosis, tau, PET, immunotherapy, tauopathies

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Authors: Marcio Emilio Dos Santos, Kelly C. F. Dos Santos

Abstract:

Caregivers of patients diagnosed with ASD are subjected to high stress situations due to the complexity and multiple levels of daily activities that require the organization of events, behaviors and socioemotional situations, such as immediate decision making and in public spaces. The cognitive and emotional requirement needed to fulfill this caregiving role exceeds the regular cultural process that adults receive in their process of preparation for conjugal and parental life. Therefore, in many cases, caregivers present a high level of overload, poor capacity to organize and mediate the development process of the child or patient about their care. Aims: Improvement in the cognitive and emotional capacities related to the caregiver function, allowing the reduction of the overload, the feeling of incompetence and the characteristic level of stress, developing a more organized conduct and decision making more oriented towards the objectives and procedural gains necessary for the integral development of the patient with diagnosis of ASD. Method: The study was performed with 20 relatives, randomly selected from a total of 140 patients attended. The family members were submitted to the Wechsler Adult Intelligence Scale III intelligence test and the Family assessment Management Measure (FaMM) questionnaire as a previous evaluation. Therapeutic activity in a small group of family members or caregivers, with weekly frequency, with a minimum workload of two hours, using the Feuerstein Instrumental Enrichment Cognitive Development Program - Feuerstein Instrumental Enrichment for ten months. Reapplication of the previous tests to verify the gains obtained. Results and Discussion: There is a change in the level of caregiver overload, improvement in the results of the Family assessment Management Measure and highlight to the increase of performance in the cognitive aspects related to problem solving, planned behavior and management of behavioral crises. These results lead to the discussion of the need to invest in the integrated care of patients and their caregivers, mainly by enabling cognitively to deal with the complexity of Autism. This goes beyond the simple therapeutic orientation about adjustments in family and school routines. The study showed that when the caregiver improves his/her capacity of management, the results of the treatment are potentiated and there is a reduction of the level of the caregiver's overload. Importantly, the study was performed for only ten months and the number of family members attended in the study (n = 20) needs to be expanded to have statistical strength.

Keywords: caregiver overload, cognitive development program ASD caregivers, feuerstein instrumental enrichment, family assessment management measure

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Authors: Rajasekar Elangopandian, Anand Shanmugam

Abstract:

Now-a-days for surveillances unmanned aerial vehicle plays a vital role. Not only for surveillances, aerial photography disaster management and the notice of earth behavior UAV1s envisages meticulously. To reduce the maintenance and fuel nuclear powered Vehicles are greater support. The design consideration is much important for the UAV manufacturing industry and Research and development agency. Eventually design is looking like a pentagon shaped fuselage and black rubber coated paint in order to escape from the enemy radar and other targets. The pentagon shape fuselage has large space to keep the mini nuclear reactor inside and the material is carbon – carbon fiber specially designed by the software called cosmol and hyper mesh 14.2. So the weight consideration will produce the positive result for productivity. The walls of the fuselage are coated with lead and protective shield. A double layer of W/Bi sheet is proposed for radiation protection at the energy range of 70 Kev to 90 Kev. The designed W/bi sheet, only 0.14 mm thick and is 36% light. The properties of the fillers were determined from zeta potential and particle size measurements. The Exposes of the radiation can be attenuated by 3 ways such as minimizing exposure time, Maximizing distance from the radiation source and shielding the whole vehicle. The inside reactor will be switched ON when the UAV starts its cruise. The moderators and the control rods can be inserted by automation technique by newly developed software. The heat generated by the reactor will be used to run the turbine which is fixed inside the UAV called mini turbine with natural rubber composite Shaft radiation shield. Cooling system will be in two mode such as liquid and air cooled. Liquid coolant for the heat regeneration is ordinary water, liquid sodium, helium and the walls are made up of regenerative and radiation protective material. The other components like camera and arms bay will be located at the bottom of the UAV high are specially made products in order to escape from the radiation. They are coated with lead Pb and natural rubber composite material. This technique provides the long rang and endurance for eternal flight mission until we need any changeability of parts or product. This UAV has the special advantage of ` land on String` means it`ll land at electric line to charge the automated electronics. Then the fuel is enriched uranium (< 5% U - 235) contains hundreds of fuel pins. This technique provides eternal duty for surveillances and aerial photography. The landing of the vehicle is ease of operation likewise the takeoff is also easier than any other mechanism which present in nowadays. This UAV gives great immense and immaculate technology for surveillance and target detecting and smashing the target.

Keywords: mini turbine, liquid coolant for the heat regeneration, in order to escape from the radiation, eternal flight mission, it`ll land at electric line

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Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

Abstract:

Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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Authors: Hafsa Kamran, Asma Afreen, Zaheer Ahmed

Abstract:

Internet addiction, an emerging mental health disorder from last two decades, is manifested by the inability in the controlled use of internet leading to academics, social, physiological and/or psychological difficulties. The present study aimed to assess the levels of internet addiction among university students in Lahore and to explore the effects of internet addiction on their dietary behavior and lifestyle. It was an analytical cross-sectional study. Data was collected from October to December 2016 from students of four universities selected through two-stage sampling method. The numbers of participants were 500 and 13 questionnaires were rejected due to incomplete information. Levels of Internet Addiction (IA) were calculated using Young Internet Addiction Test (YIAT). Data was also collected on students’ demographics, lifestyle factors and dietary behavior using self-reported questionnaire. Data was analyzed using SPSS (version 21). Chi-square test was applied to evaluate the relationship between variables. Results of the study revealed that 10% of the population had severe internet addiction while moderate Internet Addiction was present in 42%. High prevalence was found among males (11% vs. 8%), private sector university students (p = 0.008) and engineering students (p = 0.000). The lifestyle habits of internet addicts were significantly of poorer quality than normal users (p = 0.05). Internet addiction was found associated with lesser physically activity (p = 0.025), had shorter duration of physical activity (p = 0.016), had more disorganized sleep pattern (p = 0.023), had less duration of sleep (p = 0.019), reported being more tired and sleepy in class (p = 0.033) and spending more time on internet as compared to normal users. Severe and moderate internet addicts also found to be more overweight and obese than normal users (p = 0.000). The dietary behavior of internet addicts was significantly poorer than normal users. Internet addicts were found to skip breakfast more than a normal user (p = 0.039). Common reasons for meal skipping were lack of time and snacking between meals (p = 0.000). They also had increased meal size (p = 0.05) and habit of snacking while using the internet (p = 0.027). Fast food (p = 0.016) and fried items (p = 0.05) were most consumed snacks, while carbonated beverages (p = 0.019) were most consumed beverages among internet addicts. Internet Addicts were found to consume less than recommended daily servings of dairy (p = 0.008) and fruits (p = 0.000) and more servings of meat group (p = 0.025) than their no internet addict counterparts. In conclusion, in this study, it was demonstrated that internet addicts have unhealthy dietary behavior and inappropriate lifestyle habits. University students should be educated regarding the importance of balanced diet and healthy lifestyle, which are critical for effectual primary prevention of numerous chronic degenerative diseases. Furthermore, it is necessary to raise awareness concerning adverse effects of internet addiction among youth and their parents.

Keywords: dietary behavior, internet addiction, lifestyle, university students

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