Search results for: long term services and supports

Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: Goutam Kumar Ghorai, Sandip Sadhukhan, Arpita Sarkar, Debprasad Sinha, G. Sarkar, Ashis K. Dhara

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Diabetes mellitus is one of the most common chronic diseases in all countries and continues to increase in numbers significantly. Diabetic retinopathy (DR) is damage to the retina that occurs with long-term diabetes. DR is a major cause of blindness in the Indian population. Therefore, its early diagnosis is of utmost importance towards preventing progression towards imminent irreversible loss of vision, particularly in the huge population across rural India. The barriers to eye examination of all diabetic patients are socioeconomic factors, lack of referrals, poor access to the healthcare system, lack of knowledge, insufficient number of ophthalmologists, and lack of networking between physicians, diabetologists and ophthalmologists. A few diabetic patients often visit a healthcare facility for their general checkup, but their eye condition remains largely undetected until the patient is symptomatic. This work aims to focus on the design and development of a fully automated intelligent decision system for screening retinal fundus images towards detection of the pathophysiology caused by microaneurysm in the early stage of the diseases. Automated detection of microaneurysm is a challenging problem due to the variation in color and the variation introduced by the field of view, inhomogeneous illumination, and pathological abnormalities. We have developed aconvolutional neural network for efficient detection of microaneurysm. A loss function is also developed to handle severe class imbalance due to very small size of microaneurysms compared to background. The network is able to locate the salient region containing microaneurysms in case of noisy images captured by non-mydriatic cameras. The ground truth of microaneurysms is created by expert ophthalmologists for MESSIDOR database as well as private database, collected from Indian patients. The network is trained from scratch using the fundus images of MESSIDOR database. The proposed method is evaluated on DIARETDB1 and the private database. The method is successful in detection of microaneurysms for dilated and non-dilated types of fundus images acquired from different medical centres. The proposed algorithm could be used for development of AI based affordable and accessible system, to provide service at grass root-level primary healthcare units spread across the country to cater to the need of the rural people unaware of the severe impact of DR.

Keywords: retinal fundus image, deep convolutional neural network, early detection of microaneurysms, screening of diabetic retinopathy

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Authors: Lorho Mary Maheo, Arundhati Maibam Devi

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Background: Maternal and child health (MCH) cares are the health services provided to mothers and children. It includes the health promotion, preventive, curative and rehabilitation health care for mothers and children. Materials and method: The present study sample comprises of 208 women within the age range 15-69 years from two remote villages of Tamenglong District in Manipur. They were randomly chosen for assessing their health as well as the child’s health adopting an interview schedule method. Results: The findings of the study revealed that majority (80%) of the women have their first conception in their first year of married life. A decadal change has been observed with regard to the last pregnancy i.e., antenatal check-up, place of delivery as well as the service provider. However, irrespective of age of the women, home delivery is still preferred though very few are locally trained. Pre- and post-delivery resting period vary depending on the busy schedule of the agricultural works as the population under study is basically agriculturist. Postnatal care remains to be traditional as they are strongly associated with cultural beliefs and practices that continue to prevail in the studied community. Breast feeding practices such as colostrums given, initiation of breastfeeding, weaning was all taken into account.  Immunization of children has not reached the expected target owing to a variety of reasons. Maternal health care also includes use of birth control measures. The health status of women would invariably improve if family planning is meaningfully adopted. Only 10.1% of the women adopted the modern birth control implying its deep-rooted value attached to the children. Based on the self-assessment report on their health treatment a good number of the respondents resorted to self-medication even to the extent of buying allopathic medicine without a doctor’s prescription. One important finding from the study is the importance attributed to the traditional health care system which is easily affordable and accessible to the villagers. Conclusion: The overall condition of maternal and child care is way behind till now as no adequate/proper health services are available.

Keywords: antenatal, breastfeeding, child health, maternal, Tamenglong District

Procedia PDF Downloads 243

Authors: Jin-Hee Ahn, Seok-Hyeon Jeon, Young-Bin Lee, Min-Gyun Ha, Yu-Chan Hong

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Corrosion durability of steel bridges can be generally affected by atmospheric environments of bridge installation, since corrosion problem is related to environmental factors such as humidity, temperature, airborne salt, chemical components as SO₂, chlorides, etc. Thus, atmospheric environment condition should be measured to estimate corrosion condition of steel bridges as well as measurement of actual corrosion damage of structural members of steel bridge. Even in the same atmospheric environment, the corrosion environment may be different depending on the installation direction of structural members. In this study, therefore, atmospheric corrosion monitoring was conducted using atmospheric corrosion monitoring sensor, hygrometer, thermometer and airborne salt collection device to examine the corrosion durability of steel bridges. As a target steel bridge for corrosion durability monitoring, a cable-stayed bridge with truss steel members was selected. This cable-stayed bridge was located on the coast to connect the islands with the islands. Especially, atmospheric corrosion monitoring was carried out depending on structural direction of a cable-stayed bridge with truss type girders since it consists of structural members with various directions. For atmospheric corrosion monitoring, daily average electricity (corrosion current) was measured at each monitoring members to evaluate corrosion environments and corrosion level depending on structural members with various direction which have different corrosion environment in the same installed area. To compare corrosion durability connected with monitoring data depending on corrosion monitoring members, monitoring steel plate was additionally installed in same monitoring members. Monitoring steel plates of carbon steel was fabricated with dimension of 60mm width and 3mm thickness. And its surface was cleaned for removing rust on the surface by blasting, and its weight was measured before its installation on each structural members. After a 3 month exposure period on real atmospheric corrosion environment at bridge, surface condition of atmospheric corrosion monitoring sensors and monitoring steel plates were observed for corrosion damage. When severe deterioration of atmospheric corrosion monitoring sensors or corrosion damage of monitoring steel plates were found, they were replaced or collected. From 3month exposure tests in the actual steel bridge with various structural member with various direction, the rust on the surface of monitoring steel plate was found, and the difference in the corrosion rate was found depending on the direction of structural member from their visual inspection. And daily average electricity (corrosion current) was changed depending on the direction of structural member. However, it is difficult to identify the relative differences in corrosion durability of steel structural members using short-term monitoring results. After long exposure tests in this corrosion environments, it can be clearly evaluated the difference in corrosion durability depending on installed conditions of steel bridges. Acknowledgements: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03028755).

Keywords: corrosion, atmospheric environments, steel bridge, monitoring

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Authors: Koboro J. Selala

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Whilst the system of collective bargaining is well-researched in South Africa, recent studies reveal that this is an area of law and practice that is poorly understood. Despite the growing attention being paid by most scholars to the role of collective bargaining in the labour relations system, only a handful of the studies have considered collective bargaining as a mechanism of dispute resolution. The purpose of this paper is to provide a critical analysis of the current understanding of the right to engage in collective bargaining in South Africa to assess the extent to which collective bargaining is used to resolve labour disputes. The overall objective is to offer a deeper understanding of the role of collective bargaining in dispute resolution process within the South African constitutional labour law context. To this end, the paper examines the applicable legal framework of collective bargaining to address two fundamental questions that are critical to the proper understanding of the functioning of the South African collective labour dispute resolution system. The first concerns the extent to which the current South African legislative framework supports the fundamental labour rights entrenched in the Constitution of the Republic of South Africa. The second addresses the role of trade unions in collective dispute resolution processes and the extent to which they can best utilize collective bargaining to resolve labour disputes. Finally, the paper discusses the general implications of the findings to stimulate further research and to enhance the constitutional development of collective labour rights in South Africa.

Keywords: collective bargaining, constitution, freedom of association, labour relations act

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Authors: Tomas Linas Šepetys

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In online content-sharing service platforms, the ability of creators to restrict illicit use of audiovisual creative works has effectively been abolished, largely due to specific infrastructure where a huge volume of copyrighted audiovisual content can be made available to the public. The European Union legislator has attempted to strengthen the positions of creators in the realm of online content-sharing services. Article 17 of the new Digital Single Market Directive considers online content-sharing service providers to carry out acts of communication to the public of any creative content uploaded to their platforms by users and posits requirements to obtain licensing agreements. While such regulation intends to assert authors‘ ability to effectively control the dissemination of their creative works, it also creates threats of parody content overblocking through automated content monitoring. Such potentially paradoxical outcome of the efforts of the EU legislator to deliver economic safeguards for the creators in the online content-sharing service platforms leads to presume lack of informity on legislator‘s part regarding creative works‘ economic exploitation opportunities provided to creators in the online content-sharing infrastructure. Analysis conducted in this scientific research discloses that the aforementioned irregularities of parody and other creative content dissemination are caused by EU legislators‘ lack of assessment of value extraction conditions for parody creators in the online content-sharing service platforms. Historical and modeling research method application reveals the existence of two creative content dissemination models and their unique mechanisms of commercial value creation. Obligations to obtain licenses and liability over creative content uploaded to their platforms by users set in Article 17 of the Digital Single Market Directive represent technological replication of the proprietary dissemination model where the creator is able to restrict access to creative content apart from licensed retail channels. The online content-sharing service platforms represent an open dissemination model where the economic potential of creative content is based on the infrastructure of unrestricted access by users and partnership with advertising services offered by the platform. Balanced modeling of proprietary dissemination models in such infrastructure requires not only automated content monitoring measures but also additional regulatory monitoring solutions to separate parody and other types of creative content. An example of the Digital Single Market Directive proves that regulation can dictate not only the technological establishment of a proprietary dissemination model but also a partial reduction of the open dissemination model and cause a disbalance between the economic interests of creators relying on such models. The results of this scientific research conclude an informative role of the creative works dissemination model in the EU copyright law modernization process. A thorough understanding of the commercial prospects of the open dissemination model intrinsic to the online content-sharing service platform structure requires and encourages EU legislators to regulate safeguards for parody content dissemination. Implementing such safeguards would result in a common application of proprietary and open dissemination models in the online content-sharing service platforms and balanced protection of creators‘ economic interests explicitly based on those creative content dissemination models.

Keywords: copyright law, creative works dissemination model, digital single market directive, online content-sharing services

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Authors: Zahra Alimorad

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There is a strong belief that language teachers' actual practices in the classroom context are largely determined by the underlying perceptions they hold about the nature of language and language learning. That being so, it can be envisaged that teaching procedures of ESP (English for Specific Purposes) teachers teaching reading comprehension will mainly be driven by their perceptions about the nature of reading. To examine this issue, four Iranian university professors holding Ph.D. in either TEFL (Teaching English as a Foreign Language) or English Literature who were teaching English to Engineering and Sciences students were recruited to participate in this study. To collect the necessary data, classroom observations and follow-up semi-structured interviews were used. Furthermore, the materials utilized by the teachers such as textbooks, syllabuses, and tests were also examined. Although it can be argued that their perceptions were partially compatible with the established principles, results of the study pointed to a lack of congruence between these teachers' perceptions and their practices, on the one hand, and between the established principles and the practices, on the other. While the literature mostly supports a metacognitive-strategy approach to reading comprehension, the teachers were mainly adopting a skills-based approach to the teaching of reading. That is, they primarily focused on translation as the core activity in the classroom followed by reading aloud, defining words, and explaining grammatical structures. This divergence was partly attributed to the contextual constraints and partly to students' lack of motivation by the teachers.

Keywords: English teachers, perceptions, practice, principles, reading comprehension

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Authors: Meliha Nur Cercinli

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In the last period of the Ottoman Empire, foreign officers played important role in the political area. Behind their political activities, their wives had a considerable influence on Ottoman social life. Despite the difficult conditions, these women involved in educating girls, encouraging Ottoman women to take part in the production area. For this purpose, they opened many schools and workplaces in various regions of the capital-Istanbul. One of these women was Lady Alice Lowther, who was known as the wife of British ambassador Gerard Agustus Lowther. She arranged various organizations in order to create necessary resources to help families of martyrs. Also, she chaired the Committee for Aid to Ottoman Military Families (Asker Ailelerine Yardım Komitesi), made an effort to establish the Society for Protection Animals in Istanbul (Istanbul Himaye-i Hayvanat Cemiyeti) with the supports of The Royal Society For Prevention Cruelty For Animals. Apart from these, she was also a good observer and writer as a traveller. She wrote and published her memories with the name of Down The Old Road (1921), When It Was June (1923) Land Of Gold Mohur (1932), Moments In Portugal Or Land Of The Laurel (1939). This paper aims to analyze Lady Alice Lowther’s activities in Istanbul based on Ottoman Archive documents. In addition, her books will also be examined as they will present a different perspective regarding her experiences.

Keywords: Lady Lowther, Ottoman Empire, women history, social life

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Authors: Nyamsuren Baljinnyam, Narmandakh Khaltar, Otgonbaatar Olzkhuu

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Undergraduate students study English I (elective) and II (compulsory) courses which are included in the General foundation courses in the Teacher Education Curriculum Framework at the Mongolian National University of Education. Teachers at the English Department have designed and developed 2 levels (from pre-intermediate to upper-intermediate) English coursebooks since 2016 and published the second editions of each in 2018 and 2019. Developing coursebooks based on the students’ needs, satisfaction, and dissatisfaction with these instructional materials are essential phenomena in the delivery service of teaching English at the tertiary level. Thus, this study aims at findings from students’ views on English coursebooks which are studied mostly in the first and second semesters of the undergraduate academic program. The purpose of this research project was to determine the overall pedagogical value and suitability of the book to students’ needs and 21st-century teacher education concepts. We have designed a coursebook evaluation checklist with 28 questionnaires, including Morris’s English as a foreign language coursebook evaluation checklist (2017). The study is a 2 phased descriptive survey study that covered 572 and 519 undergraduate students who studied in the spring term of the 2021-2022 academic year and the fall term of the 2022-2023 academic year at 7 branch schools of Mongolian National University of Education (MNUE). Data analysis consists of student responses to each item. Coursebook evaluation data is classified into 3 main categories as “general attributes”, “learning content” and “task evaluation”. Some results of the study indicate the following findings: 97 percent of the total survey participants (in total 1091) have given positive responses to the coursebooks that these are fully aimed at acquiring the students’ language learning skills: reading, writing, listening, and speaking; 78 percent responded that the coursebooks were different from the English Textbooks that they learned in secondary schools; and 91 percent answered that the English coursebooks could give motivation to the students to achieve their self-study.

Keywords: coursebook evaluation, improving English, student satisfaction and dissatisfaction with coursebooks, language learning materials, language tasks, students’ needs

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Authors: Andrea Bertocchi, Alessio Barnaba Di Fonzo, Davide Talarico, Simone Rivaroli, Jeff Konin

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The patient is a 89 years old male (180cm/85kg) retired notary former golfer with no past medical history. He describes a progressive ideomotor slowdown for 14 months. The disorder is characterized by short-term memory deficits and, for some months, also by unstable walking with a broad base with skidding and risk of falling at directional changes and urinary urgency. There were also episodes of aggression towards his wife and staff. At the time, the patient takes no prescribed medications. He has difficulty eating, dressing, and some problems with personal hygiene. In the initial visit, the patient was alert, cooperating, and performed simple tasks; however, he has a hearing impairment, slowed spontaneous speech, and amnestic deficit to the short story. Ideomotor apraxia is not present. He scored 20 points in the MMSE. From a motor function, he has deficits using Medical Research Council (MRC) 3-/5 in bilateral lower limbs and requires maximum assistance from sit to stand with existing premature fatigue. He’s unable to walk for about 1 month. Tremors and hypertonia are absent. BERG was unable to be administered, and BARTHEL was obtained 45/100. An Amyloid Angiopathy is suspected and then confirmed at the neurological examination. Therehabilitation objectives were the recovery of mobility and reinforcement of the UE/LE, especially legs, for recovery of standing and walking. The cognitive aspect was also an essential factor for the patient's recovery. The literature doesn’t demonstrate any particular studies regarding motor and cognitive rehabilitation on this pathology. Failing to manage his attention on exercise and tending to be disinterested and falling asleep constantly, we used golf-specific gestures to stimulate his mind to work and get results because the patient has memory recall of golf related movement. We worked for 4 months with a frequency of 3 sessions per week. Every session lasted for 45 minutes. After 4 months of work, the patient walked independently with the use of a stick for about 120 meters without stopping. MRC 4/5 AI bilaterally andpostural steps performed independently with supervision. BERG 36/56. BARTHEL 65/100. 6 Minutes Walking Test (6MWT), at the beginning, it wasn’t measurable, now, he performs 151,5m with Numeric Rating Scale 4 at the beginning and 7 at the end. Cognitively, he no longer has episodes of aggression, although the short-term memory and concentration deficit remains. Amyloid Angiopathy is a mix of motor and cognitive disorder. It is worth the thought that cerebral amyloid angiopathy manifests with functional deficits due to strokes and bleedings and, as such, has an important rehabilitation indication, as classical stroke is not associated with amyloidosis. Exploring the motor patterns learned at a young age and remained in the implicit and explicit memory of the patient allowed us to set up effective work and to obtain significant results in the short-middle term. Surely many studies will still be done regarding this pathology and its rehabilitation, but the importance of the cognitive sphere applied to the motor sphere could represent an important starting point.

Keywords: amyloid angiopathy, cognitive rehabilitation, golf, motor disorder

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Authors: Jasmeet Kaur, Anup Singh, Shashikant Iyengar, Arun Kumar, Ira Sahay

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Latent autoimmune diabetes in adults (LADA) is an irreversible autoimmune disease that affects insulin production. LADA is characterized by the production of Glutamic acid decarboxylase (GAD) antibodies, which is similar to type 1 diabetes. Individuals with LADA may eventually develop overt diabetes and require insulin. In this condition, the pancreas produces little or no insulin, which is a hormone used by the body to allow glucose to enter cells and produce energy. While type 1 diabetes was traditionally associated with children and teenagers, its prevalence has increased in adults as well. LADA is frequently misdiagnosed as type 2 diabetes, especially in adulthood when type 2 diabetes is more common. LADA develops in adulthood, usually after age 30. Managing LADA involves metabolic control with exogenous insulin and prolonging the life of surviving beta cells, thereby slowing the disease's progression. This case study examines the impact of approximately 3 months of low-carbohydrate dietary intervention in a 42-year-old woman with LADA who was initially misdiagnosed as having type 2 diabetes. Her c-peptide was 0.13 and her HbA1c was 9.3% when this trial began. Low-carbohydrate interventions have been shown to improve blood sugar levels, including fasting, post-meal, and random blood sugar levels, as well as haemoglobin levels, blood pressure, energy levels, sleep quality, and satiety levels. The use of low-carbohydrate dietary intervention significantly reduces both hypo- and hyperglycaemia events. During the 3 months of the study, there were 2 to 3 hyperglycaemic events owing to physical stress and a single hypoglycaemic event. Low-carbohydrate dietary therapies lessen insulin dose inaccuracy, which explains why there were fewer hyperglycaemic and hypoglycaemic events. In three months, the glycated haemoglobin (HbA1c) level was reduced from 9.3% to 6.3%. These improvements occur without the need for caloric restriction or physical activity. Stress management was crucial aspect of the treatment plan as stress-induced neuroendocrine hormones can cause immunological dysregulation. Additionally, supplements that support immune system and reduce inflammation were used as part of the treatment during the trial. Long-term studies are needed to track disease development and corroborate the claim that such dietary treatments can prolong the honeymoon phase in LADA. Various factors can contribute to additional autoimmune attacks, so measuring c-peptide is crucial on a regular basis to determine whether insulin levels need to be adjusted.

Keywords: autoimmune, diabetes, LADA, low_carb, nutrition

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Authors: Veronica S. Moertini, Vinsensius Kevin, Gede Karya

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Customer reviews have been collected by many kinds of e-commerce websites selling products, services, hotel rooms, tickets and so on. Each website collects its own customer reviews. The reviews can be crawled, collected from those websites and stored as big data. Text analysis techniques can be used to analyze that data to produce summarized information, such as customer opinions. Then, these opinions can be published by independent service provider websites and used to help customers in choosing the most suitable products or services. As the opinions are analyzed from big data of reviews originated from many websites, it is expected that the results are more trusted and accurate. Indonesian customers write reviews in Indonesian language, which comes with its own structures and uniqueness. We found that most of the reviews are expressed with “daily language”, which is informal, do not follow the correct grammar, have many abbreviations and slangs or non-formal words. Hadoop is an emerging platform aimed for storing and analyzing big data in distributed systems. A Hadoop cluster consists of master and slave nodes/computers operated in a network. Hadoop comes with distributed file system (HDFS) and MapReduce framework for supporting parallel computation. However, MapReduce has weakness (i.e. inefficient) for iterative computations, specifically, the cost of reading/writing data (I/O cost) is high. Given this fact, we conclude that MapReduce function is best adapted for “one-pass” computation. In this research, we develop an efficient technique for extracting or mining opinions from big data of Indonesian reviews, which is based on MapReduce with one-pass computation. In designing the algorithm, we avoid iterative computation and instead adopt a “look up table” technique. The stages of the proposed technique are: (1) Crawling the data reviews from websites; (2) cleaning and finding root words from the raw reviews; (3) computing the frequency of the meaningful opinion words; (4) analyzing customers sentiments towards defined objects. The experiments for evaluating the performance of the technique were conducted on a Hadoop cluster with 14 slave nodes. The results show that the proposed technique (stage 2 to 4) discovers useful opinions, is capable of processing big data efficiently and scalable.

Keywords: big data analysis, Hadoop MapReduce, analyzing text data, mining Indonesian reviews

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Authors: J. Bahrawi, M. Elhag

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Estimation of evapotranspiration is always a major component in water resources management. Traditional techniques of calculating daily evapotranspiration based on field measurements are valid only for local scales. Earth observation satellite sensors are thus used to overcome difficulties in obtaining daily evapotranspiration measurements on regional scale. The Surface Energy Balance System (SEBS) model was adopted to estimate daily evapotranspiration and relative evaporation along with other land surface energy fluxes. The model requires agro-climatic data that improve the model outputs. Advance Along Track Scanning Radiometer (AATSR) and Medium Spectral Resolution Imaging Spectrometer (MERIS) imageries were used to estimate the daily evapotranspiration and relative evaporation over the entire Nile Delta region in Egypt supported by meteorological data collected from six different weather stations located within the study area. Daily evapotranspiration maps derived from SEBS model show a strong agreement with actual ground-truth data taken from 92 points uniformly distributed all over the study area. Moreover, daily evapotranspiration and relative evaporation are strongly correlated. The reliable estimation of daily evapotranspiration supports the decision makers to review the current land use practices in terms of water management, while enabling them to propose proper land use changes.

Keywords: daily evapotranspiration, relative evaporation, SEBS, AATSR, MERIS, Nile Delta

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Authors: Rameesha Javaid

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Balochistan, the largest landmass named after and dominated by the 55% Baloch population, which has had a difficult anti-center history like their brothers the Kurds of Middle East, reluctantly acceded to Pakistan in 1947. The region, which attained the status of a province after two decades of accession, has lagged behind in social development and economic growth as compared to the other three federating units. The province has seen the least financial autonomy and administrative decentralization both in autocratic and democratic dispensations under geostrategic and security considerations. Significant corrections have been recently made in the policy framework through changing the formula for intra-provincial National Finance Award, curtailing the number of subjects under federal control, and reactivating the Council of Common Interests. Yet policymaking remains overwhelmingly bureaucratic under a weak parliamentary oversight. The provincial coalition governments are unwieldy and directionless. The government machinery has much less than the optimal capability, character, integrity, will, and opportunity to perform. Decentralization further loses its semblance in the absence of local governments for long intervals and with the hold of hereditary tribal chiefs. Increased allocations failed to make an impact in the highest per capita cost environment due to long distances and scattered settlements. Decentralization, the basic ingredient of federalism has remained mortgaged to geo-strategic factors, internal security perceptions, autocratic and individualistic styles of governments, bureaucratic policymaking structures, bad governance, non-existent local governments, and feudalistic tribal lords. This suboptimal federalism speaks for the present underdevelopment in Balochistan and will earmark the milestones in the future.

Keywords: Balochistan, economic development, federalism, political economy

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Authors: Umair Shoukat Ali, Rashna Hoshang Sukhia, Mubassar Fida

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Introduction: The objective of the study was to compare outcomes in terms of Bleeding index (BI), Gingival Index (GI), and Orthodontic Plaque Index (OPI) with video graphics and plaque disclosing tablets (PDT) versus verbal instructions in adult orthodontic patients undergoing fixed appliance treatment (FAT). Materials and Methods: Adult orthodontic patients have recruited from outpatient orthodontic clinics who fulfilled the inclusion criteria and were randomly allocated to three groups i.e., video, PDT, and verbal groups. We included patients undergoing FAT for six months of both genders with all teeth bonded mesial to first molars having no co-morbid conditions such as rheumatic fever and diabetes mellitus. Subjects who had gingivitis as assessed by Bleeding Index (BI), Gingival Index (GI), and Orthodontic Plaque Index (OPI) were recruited. We excluded subjects having > 2 mm of clinical attachment loss, pregnant and lactating females, any history of periodontal therapy within the last six months, and any consumption of antibiotics or anti-inflammatory drugs within the last one month. Pre- and post-interventional measurements were taken at two intervals only for BI, GI, and OPI. The primary outcome of this trial was to evaluate the mean change in the BI, GI, and OPI in the three study groups. A computer-generated randomization list was used to allocate subjects to one of the three study groups using a random permuted block sampling of 6 and 9 to randomize the samples. No blinding of the investigator or the participants was performed. Results: A total of 99 subjects were assessed for eligibility, out of which 96 participants were randomized as three of the participants declined to be part of this trial. This resulted in an equal number of participants (32) that were analyzed in all three groups. The mean change in the oral hygiene indices score was assessed, and we found no statistically significant difference among the three interventional groups. Pre- and post-interventional results showed statistically significant improvement in the oral hygiene indices for the video and PDT groups. No statistically significant difference for age, gender, and education level on oral hygiene indices were found. Simple linear regression showed that the video group produced significantly higher mean OPI change as compared to other groups. No harm was observed during the trial. Conclusions: Visual aids performed better as compared to the verbal group. Gender, age, and education level had no statistically significant impact on the oral hygiene indices. Longer follow-ups will be required to see the long-term effects of these interventions. Trial Registration: NCT04386421 Funding: Aga Khan University and Hospital (URC 183022)

Keywords: oral hygiene, orthodontic treatment, adults, randomized clinical trial

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Authors: Piotr Tylec, Julia Wierzbicka, Natalia Gajewska, Krzysztof Przeczek, Grzegorz Torbicz, Alicja Dudek, Magdalena Pisarska-Adamczyk, Mateusz Wierdak, Michal Pedziwiatr

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Introduction: Many patients have described changes in taste perception after weight loss surgery. However, little data is available about short term changes in taste after surgery. Aim: We aimed to evaluate short-term changes in taste preference after bariatric surgeries in comparison to colorectal surgeries. Material and Methods: Between April 2018 and April 2019, a total of 121 bariatric patients and 63 controls participated. Bariatric patients underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric by-pass. Controls underwent oncological colorectal surgeries. Patients who developed clinical complications requiring restriction of oral intake after surgery or withdraw their consent were excluded from the study. In the end, 85 bariatric patients and 44 controls were included. In all of them, the 16-item ERAS Protocol was applied. Using 10-points Numeric Rating Scale (1-10) patients completed questionnaire and rated their appetite and thirst (1 - no appetite/not thirsty, 10 – normal appetite/very thirsty) and flavoured standardized liquids' taste (1- horrible, 10-very tasty) and food images for the 6 group of taste (sweet, umami, sour, spicy, bitter and salty) (1 - not appetizing, 10 - very appetizing) preoperatively and on the first postoperative day. Data were analysed with Statistica 13.0 PL. Results: Analysed group consist of 129 patients (85 bariatric, 44 controls). Mean age and BMI in a research group was 44.91 years old, 46.22 kg/m² and in control group 62.09 years old, 25.87 kg/m², respectively. Our analysis revealed significant differences in changes of appetite between both groups (research: -4.55 ± 3.76 vs. control: -0.85 ± 4.37; p < 0.05), ratings bitter (research: 0.60 ± 2.98 vs. control: -0.88 ± 2.58; p < 0.05) and salty (research: 1.20 ± 3.50 vs. control: -0.52 ± 2.90; p < 0.05) flavoured liquids and ratings for sweet (research: 1.62 ± 3.31 vs. control: 0.01 ± 2.63; p < 0.05) and bitter (research: 1.21 ± 3.15 vs. control: -0.09 ± 2.25; p < 0.05) food images. There were statistically significant results in the ratings of other images, but in comparison to the control group, they were not statistically significant. Conclusion: The study showed that bariatric surgeries quickly decreases appetite and desire to eat certain types of food, such as salty. Moreover, the bitter taste was more desirable in the research group in comparison to control group. Nevertheless, the sweet taste was more appetible in the bariatric group than in control.

Keywords: bariatric surgery, general surgery, obesity, taste preference

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Authors: Mouna Essaadi, Mohamed Khafallah, Abdallah Saad, Hamid Chaikhy

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This paper presents a comparative analysis between conventional direct torque control (C_DTC), Modified direct torque control (M_DTC) and twelve sectors direct torque control (12_DTC).Those different strategies are compared by simulation in term of torque, flux and stator current performances. Finally, a summary of the comparative analysis is presented.

Keywords: C_DTC, M_DTC, 12_DTC, torque dynamic, stator current, flux, performances

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Authors: Salako Emmanuel Adekunle

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With numerous advantages of ICT in teaching such as using images to improve the retentive memory of students, academic staff is yet to deliver instructions adequately and effectively due to no power supply, lack of technical supports and non-availability of functional ICT tools. This study was conducted to investigate the attitudes of academic staff towards the use of information communication technology as a pedagogical tool for effective teaching in FCT College of Education, Zuba-Abuja, Nigeria. A sample of 200 academic staff from five schools/faculties was involved in the study. The respondents were selected by using simple random sampling technique (SRST). A questionnaire was developed and validated by the experts in Measurement and Evaluation, and reliability co-efficient of 0.85 was obtained. It was used to gather relevant data from the respondents. This study revealed that the respondents had positive attitudes towards the use of ICT as a pedagogical tool for effective teaching. Also, the uses of ICT by the academic staff included: to encourage closer relationship for attainment of higher academic, and to deliver instructions effectively. The study also revealed that there is a significant relationship between the attitudes and the uses of ICT by the academic staff. Based on these findings, some recommendations were made which include: power supply should be provided to operate ICT facilities for effective teaching, and technical assistance on ICT usage for effective delivery of instructions should be provided among other recommendations.

Keywords: academic staff, attitudes, information communication technology, pedagogical tool, teaching, use

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Authors: Prince S. Campbell, Janine B. Adams, Melusi Thwala, Opeoluwa Oyedele, Paula E. Melariri

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Schistosomiasis, often known as bilharzia, is a parasitic water-borne disease caused by trematode flatworms of the genus Schistosoma. Schistosomiasis infection and prevention have been found to be influenced by a range of socio-cultural risk factors, including human characteristics (e.g., gender, age, education, knowledge, attitude, and practices), as well as environmental and economic elements. Lack of awareness of the disease may also contribute to an individual's tendency to participate in behaviours or activities that heighten their susceptibility to infection. The current study assessed the community knowledge, attitude and practices (KAP) on schistosomiasis and implemented an educational intervention following pre-test interviews. A cross-sectional quasi-experimental research design was used in this quantitative study. Pre- and post-intervention interview format surveys were conducted using a structured questionnaire, targeting individuals aged 18–65 years residing within 5 km of select water bodies. The questionnaire contained 54 close-ended questions about schistosomiasis causes, transmission, and clinical symptoms and the participants were interviewed face-to-face in their homes. Data was captured on Question Pro and analyzed using Microsoft Office Excel 365 (2019) and R (version 4.3.1) software. Overall, 380 individuals completed the pre and post-intervention assessments; 194 and 185 were males (51.1%) and females (48.7%), respectively. A notable 91.3% of participants did not know about schistosomiasis in the pre-intervention phase; however, the mean post-intervention test score (9.4 ± 1.4) for knowledge among participants was higher than the pre-intervention test score (2.2 ± 2.1) indicating a good and improved knowledge of schistosomiasis among the participants. Furthermore, the paired samples t-test results demonstrated that the increase in knowledge levels was statistically significant (p<0.001). Also, the post-intervention improvement of both practice (p<0.001) and attitude (p<0.001) levels was statistically significant. A positive correlation (r=0.23, p<0.001) was found between knowledge and attitude in the pre-intervention stage. Knowledgeable participants had a more positive attitude towards obtaining medical assistance and disease prevention. Moreover, attitudes and practices correlated negatively (r=-0.13, p=0.013) post-intervention; hence, those with positive attitudes did not engage in risky water-related practices, which was the desired outcome. The educational intervention had a favourable impact on the KAP of the study population as the majority were able to recall the disease aetiology, symptoms, transmission pattern, and preventative measures three months post-intervention. Nevertheless, previous research has suggested that participants were unable to recall information about the disease following the intervention. Consequently, research should prioritize behavioural modification strategies that may result in a more persistent outcome in terms of the participants' knowledge, which could ultimately contribute to the development of long-term positive attitudes and practices.

Keywords: educational intervention, knowledge, attitudes and practices, schistosomiasis

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Authors: Zhizhong Yuan, Lili Wang, Chenya Zheng, Wuqi Yang

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How to encourage and support peer-to-peer (P2P) network lending, and effectively monitor the risk of P2P network lending, has become the focus of the Chinese government departments, industrialists, experts and scholars in recent years. The reason is that this convenient online micro-credit service brings a series of credit risks and other issues. Avoiding the risks brought by the P2P network lending model, it can better play a benign role and help China's small and medium-sized private enterprises with vigorous development to solve the capital needs; otherwise, it will bring confusion to the normal financial order. As a form of financial services, P2P network lending has injected new blood into China's non-government finance in the past ten years, and has found a way out for idle funds and made up for the shortage of traditional financial services in China. However, it lacks feasible measures in credit evaluation and government supervision. This paper collects a large amount of data about P2P network lending of China. The data collection comes from the official media of the Chinese government, the public achievements of existing researchers and the analysis and collation of correlation data by the authors. The research content of this paper includes literature review; the current situation of China's P2P network lending development; the risk analysis of P2P network lending in China; the risk prevention strategy of P2P network lending in China. The focus of this paper is to try to find a specific program to strengthen supervision and avoid risks from the perspective of government regulators, operators of P2P network lending platform, investors and users of funds. These main measures include: China needs to develop self-discipline organization of P2P network lending industry and formulate self-discipline norms as soon as possible; establish a regular information disclosure system of P2P network lending platform; establish censorship of credit rating of borrowers; rectify the P2P network lending platform in compliance through the implementation of bank deposition. The results and solutions will benefit all the P2P network lending platforms, creditors, debtors, bankers, independent auditors and government agencies of China and other countries.

Keywords: peer-to-peer(P2P), regulation, risk prevention, supervision

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Authors: Jeansou Moun

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This study argues that constructivism and structuralism, which have been the two important schools of mathematical philosophy since the mid-19th century, can and should be synthesized into structure-constructivism. In fact, the philosophy of mathematics is divided into more than ten schools depending on the point of view. However, the biggest trend is Platonism which claims that mathematical objects are "abstract entities" that exists independently of the human mind and material objects. Its opposite is constructivism. According to the latter, mathematical objects are products of the construction of the human mind. However, whether the basis of the construction is a logical device, a symbolic system, or an empirical perception, it is subdivided into logicism, formalism, and intuitionism. However, these three schools themselves are further subdivided into various variants, and among them, structuralism, which emerged in the mid-20th century, is receiving the most attention. On the other hand, structuralism which emphasizes structure instead of individual objects, is divided into non-eliminative structuralism, which supports the a priori of structure, and non-eliminative structuralism, which rejects any abstract entity. In this context, it is believed that the structure itself is not an a priori entity but a result of the construction of the cognitive subject and that no object has ever been given to us in its full meaning from the outset. In other words, concepts are progressively structured through a dialectical cycle between sensory perception, imagination (abstraction), concepts, judgments, and reasoning. Symbols are needed for formal operation. However, without concrete manipulation, the formal operation cannot have any meaning. However, when formal structurization is achieved, the reality (object) itself is also newly structured. This is the "structure-constructivism".

Keywords: philosophy of mathematics, platonism, logicism, formalism, constructivism, structuralism, structure-constructivism

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Authors: Sevelina Ndlovu

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Financial Technology (fintech) advancement is recognised as one of the most transformational innovations in the financial industry. Fintech has given rise to internet-only digital banking, a novel financial technology advancement, and innovation that allows banking services through internet applications with no need for physical branches. This technology is becoming a new banking normal among consumers for its ubiquitous and real-time access advantages. There is evident switching and migration from traditional banking towards these fintech facilities, which could possibly pose a systemic risk if not properly understood and monitored. Fintech advancement has also brought about the emergence and escalation of financial technology consumption themes such as trust, security, perceived risk, and sustainability within the banking industry, themes scarcely covered in existing theoretic literature. To that end, the objective of this research is to investigate factors that determine fintech adoption and propose an integrated adoption model. This study aims to establish what the significant drivers of adoption are and develop a conceptual model that integrates technological, behavioral, and environmental constructs by extending the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). It proposes integrating constructs that influence financial consumption themes such as trust, perceived risk, security, financial incentives, micro-investing opportunities, and environmental consciousness to determine the impact of these factors on the adoption and intention to use digital banking apps. The main advantage of this conceptual model is the consolidation of a greater number of predictor variables that can provide a fuller explanation of the consumer's adoption of digital banking Apps. Moderating variables of age, gender, and income are incorporated. To the best of author’s knowledge, this study is the first that extends the UTAUT2 model with this combination of constructs to investigate user’s intention to adopt internet-only digital banking apps in the UK context. By investigating factors that are not included in the existing theories but are highly pertinent to the adoption of internet-only banking services, this research adds to existing knowledge and extends the generalisability of the UTAUT2 in a financial services adoption context. This is something that fills a gap in knowledge, as highlighted to needing further research on UTAUT2 after reviewing the theory in 2016 from its original version of 2003. To achieve the objectives of this study, this research assumes a quantitative research approach to empirically test the hypotheses derived from existing literature and pilot studies to give statistical support to generalise the research findings for further possible applications in theory and practice. This research is explanatory or casual in nature and uses cross-section primary data collected through a survey method. Convenient and purposive sampling using structured self-administered online questionnaires is used for data collection. The proposed model is tested using Structural Equation Modelling (SEM), and the analysis of primary data collected through an online survey is processed using Smart PLS software with a sample size of 386 digital bank users. The results are expected to establish if there are significant relationships between the dependent and independent variables and establish what the most influencing factors are.

Keywords: banking applications, digital banking, financial technology, technology adoption, UTAUT2

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Authors: Mohammad Moridzadeh, Gholamreza Mesri

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The effectiveness of lime treatment of soils has been commonly evaluated in terms of improved workability and increased undrained unconfined compressive strength in connection to road and airfield construction. The most common method of strength measurement has been the unconfined compression test. However, if the objective of lime treatment is to improve long-term stability of first-time or reactivated landslides in stiff clays and shales, permanent changes in the size and shape of clay particles must be realized to increase drained frictional resistance. Lime-soil interactions that may produce less platy and larger soil particles begin and continue with time under the highly alkaline pH environment. In this research, pH measurements are used to monitor chemical environment and progress of reactions. Atterberg limits are measured to identify changes in particle size and shape indirectly. Also, fully softened and residual strength measurements are used to examine an improvement in frictional resistance due to lime-soil interactions. The main variables are soil plasticity and mineralogy, lime content, water content, and curing period. Lime effect on frictional resistance is examined using samples of clays with different mineralogy and characteristics which may react with lime to various extents. Drained direct shear tests on reconstituted lime-treated clay specimens with various properties have been performed to measure fully softened shear strength. To measure residual shear strength, drained multiple reversal direct shear tests on precut specimens were conducted. This way, soil particles are oriented along the direction of shearing to the maximum possible extent and provide minimum frictional resistance. This is applicable to reactivated and part of first-time landslides. The Brenna clay, which is the highly plastic lacustrine clay of Lake Agassiz causing slope instability along the banks of the Red River, is one of the soil samples used in this study. The Brenna Formation characterized as a uniform, soft to firm, dark grey, glaciolacustrine clay with little or no visible stratification, is full of slickensided surfaces. The major source of sediment for the Brenna Formation was the highly plastic montmorillonitic Pierre Shale bedrock. The other soil used in this study is one of the main sources of slope instability in Harris County Flood Control District (HCFCD), i.e. the Beaumont clay. The shear strengths of untreated and treated clays were obtained under various normal pressures to evaluate the shear envelope nonlinearity.

Keywords: Brenna clay, friction resistance, lime treatment, residual

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Authors: Jyoti Singh, Ranju Bansal

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Fighting pain and inflammation is a common problem faced by physicians while dealing with a wide variety of diseases. Since ancient time nonsteroidal anti-inflammatory agents (NSAIDs) and opioids have been the cornerstone of treatment therapy, however, the usefulness of both these classes is limited due to severe side effects. NSAIDs, which are mainly used to treat mild to moderate inflammatory pain, induce gastric irritation and nephrotoxicity whereas opioids show an array of adverse reactions such as respiratory depression, sedation, and constipation. Moreover, repeated administration of these drugs induces tolerance to the analgesic effects and physical dependence. Further discovery of selective COX-2 inhibitors (coxibs) suggested safety without any ulcerogenic side effects; however, long-term use of these drugs resulted in kidney and hepatic toxicity along with an increased risk of secondary cardiovascular effects. The basic approaches towards inflammation and pain treatment are constantly changing, and researchers are continuously trying to develop safer and effective anti-inflammatory drug candidates for the treatment of different inflammatory conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriasis and multiple sclerosis. Synthetic 3(2H)-pyridazinones constitute an important scaffold for drug discovery. Structure-activity relationship studies on pyridazinones have shown that attachment of a lactam at N-2 of the pyridazinone ring through a methylene spacer results in significantly increased anti-inflammatory and analgesic properties of the derivatives. Further introduction of the heterocyclic ring at lactam nitrogen results in improvement of biological activities. Keeping in mind these SAR studies, a new series of compounds were synthesized as shown in scheme 1 and investigated for anti-inflammatory, analgesic, anti-platelet activities and docking studies. The structures of newly synthesized compounds have been established by various spectroscopic techniques. All the synthesized pyridazinone derivatives exhibited potent anti-inflammatory and analgesic activity. Homoveratryl substituted derivative was found to possess highest anti-inflammatory and analgesic activity displaying 73.60 % inhibition of edema at 40 mg/kg with no ulcerogenic activity when compared to standard drugs indomethacin. Moreover, 2-substituted-4-benzo[d][1,3]dioxole-6-phenylpyridazin-3(2H)-ones derivatives did not produce significant changes in bleeding time and emerged as safe agents. Molecular docking studies also illustrated good binding interactions at the active site of the cyclooxygenase-2 (hCox-2) enzyme.

Keywords: anti-inflammatory, analgesic, pyridazin-3(2H)-one, selective COX-2 inhibitors

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Authors: Gyo Woo Lee, Man Young Kim

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The blocked-off formulations for the analysis of radiative heat transfer are formulated and examined in order to find the solutions in a two-dimensional complex enclosure. The final discretization equations using the step scheme for spatial differencing practice are proposed with the additional source term to incorporate the blocked-off procedure. After introducing the implementation for inactive region into the general discretization equation, three different problems are examined to find the performance of the solution methods.

Keywords: radiative heat transfer, Finite Volume Method (FVM), blocked-off solution procedure, body-fitted coordinate

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Authors: Raju Chhetri

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Agroforestry is one of the main sources of livelihood among the people of Nepal. In particular, this is the only one mode of livelihood among the Chepangs. The monster earthquake (7.3 MW) that hit the country on the 25th of April in 2015 and many of its aftershocks had devastating effects. As a result, not only the big structures collapsed, it incurred great losses on fabrication, collection centers, schools, markets and other necessary service centers. Although there were a large number of aftershocks after the monster earthquake, the most devastating aftershock took place on 12th May, 2015, which measured 6.3 richter scale. Consequently, it caused more destruction of houses, further calamity to the lives of people, and public life got further perdition. This study was mainly carried out to find out the food security and market situation of Agroforestry product of the Chepang community in Raksirang VDC (one of the severely affected VDCs of Makwanpur district) due to the earthquake. A total of 40 households (12 percent) were randomly selected as a sample in ward number 7 only. Questionnaires and focus groups were used to gather primary data. Additional, two Focus Group Discussions (FGD) were convened in the study area to get some descriptive information on this study. Estimated 370 hectares of land, which was full of Agroforestry plantation, ruptured by the earthquake. It caused severe damages to the households, and a serious loss of food-stock, up to 60-80 percent (maize, millet, and rice). Instead of regular cereal intake, banana (Muas Paradisca) consumption was found ‘high scale’ in the emergency period. The market price of rice (37-44 NRS/Kg) increased by 18.9 percent. Some difference in the income range before and after the earthquake was observed. Before earthquake, sale of Agroforestry, and livestock products were continuing, but after the earthquake, Agroforestry product sale is the only one means of livelihood among Chepangs. Nearly 50-60 percent Agroforestry production of banana (Mass Paradisca), citrus (Citrus Lemon), pineapple (Ananus comosus) and broom grass (Thysanolaena maxima) declined, excepting for cash income from the residual. Heavy demands of Agroforestry product mentioned above lay high farm gate prices (50-100 percent) helps surveyed the community to continue livelihood from its sale. Out of the survey samples, 30 households (75 percent) respondents migrated to safe location due to land rupture, ongoing aftershocks, and landslides. Overall food security situation in this community is acute and challenging for the days to come. Immediate and long term both response from a relief agency concerning food, shelter and safe stocking of Agroforestry product is required to keep secured livelihood in Chepang community.

Keywords: earthquake, rupture, agroforestry, livelihood, indigenous, food security

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Authors: Mohamed Elhadi M. Sharif, Mona Masood

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The usage of e-health facilities is seen to be the first priority by the Libyan government. As such, this paper focuses on how the key factors or elements of working size in terms of technological availability, structural environment, and other competence-related matters may affect nurses’ sharing of knowledge in e-health. Hence, this paper investigates learning readiness assessment to raise e-health for Libyan regional hospitals by using e-health services in nursing education.

Keywords: Libyan nurses, e-learning readiness, e-health, nursing education

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Authors: Zurong Liang

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Chinese social work has experienced a sharp rise in staff turnover. Work-family conflict is a key risk factor for employees’ turnover intention. While the relationship between work-family conflict and turnover intention has been widely documented, little is known about its mediating and moderating mechanisms, especially among social workers in China. This study explored the mediating role of job-based and collective psychological ownership and the moderating role of person-organization value congruence. The study drew on data from the China Social Work Longitudinal Study 2019, a nationally representative sample of 1,421 Chinese social workers (79.73% female; mean age = 28.9 years old). We performed a moderated mediation analysis combining a simple slope test and the Johnson-Neyman technique. Both job-based psychological ownership and collective psychological ownership were found to mediate the association between work-family conflict and turnover intention. Person-organization value congruence moderated the indirect relationship between work-family conflict and turnover intention via collective psychological ownership. This study enhances understanding of the impact of the psychological mechanisms of work-family conflict on Chinese social workers’ turnover intention. Specific strategies should be adopted to establish a work environment that supports psychological ownership, enhances social workers’ identification with and attachment to their organizations, and thus reduces their turnover intention.

Keywords: turnover, work-family conflict, ownership, social worker, China

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Authors: Inbal Zuriely, Yonit Weiss, Hilla Zaharoni, Hadas Lewkowicz, Tatiana Vander, Tarif Bader

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early active movement, along with adjusting optimal nutrition, prevents aggravation of muscle degeneracy and functional decline. Eating is a basic activity of daily life, which reflects the patient's independence. When eating and feeding are experienced successfully, they lead to a sense of pleasure and satisfaction. However, when they are experienced as a difficulty, they might evoke feelings of helplessness and frustration. This stresses the essential process of gradual weaning off the enteral feeding tube. the work describes the collaboration of a dietitian, determining the nutritional needs of patients undergoing enteral tube weaning as part of the rehabilitation process, with the suited treatment of an occupational therapist. Occupational therapy intervention regarding eating capabilities focuses on improving the required motor and cognitive components, along with environmental adjustments and aids, imparting eating strategies and training to patients and their families. The project was conducted in the long-term, ventilated patients’ department at the Herzfeld Rehabilitation Geriatric Medical Center on patients undergoing enteral tube weaning with the staff’s assistance. Establishing continuous collaboration between the dietician and the occupational therapist, starting from the beginning of the feeding-tube weaning process: 1.The dietician updates the occupational therapist about the start of the process and the approved diet. 2.The occupational therapist performs cognitive, motor, and functional assessments and treatments regarding the patient’s eating capabilities and recommends the required adjustments for independent eating according to the FIM (Functional Independence Measure) scale. 3.The occupational therapist closely follows up on the patient’s degree of independence in eating and provides a repeated update to the dietician. 4.The dietician accordingly guides the ward staff on whether and how to feed the patient or allow independent eating. The project aimed to promote patients toward independent feeding, which leads to a sense of empowerment, enjoyment of the eating experience, and progress of functional ability, along with performing active movements that will motivate mobilization. From the beginning of 2022, 26 patients participated in the project. 79% of all patients who started the weaning process from tube feeding achieved different levels of independence in feeding (independence levels ranged from supervision (FIM-5) to complete independence (FIM-7). The integration of occupational therapy and dietary treatment is based on a patient-centered approach while considering the patient’s personal needs, preferences, and goals. This interdisciplinary partnership is essential for meeting the complex needs of prolonged mechanically ventilated patients and promotes independent functioning and quality of life.

Keywords: dietary, mechanical ventilation, occupational therapy, tube feeding weaning

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Authors: Jonathan Matyenyika

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In recent years, automobile manufacturers have increasingly produced vehicles equipped with cutting-edge automotive electronic technology to match the fast-paced digital world of today; this has brought about various benefits in different business sectors that make use of these vehicles as a means of turning over a profit. In the logistics industry, vehicles equipped with this technology have proved to be very utilitarian; this paper focuses on the benefits automobile electronic equipped vehicles have in the logistics industry. Automotive vehicle manufacturers have introduced new technological electronic features to their vehicles to enhance and improve the overall performance, efficiency, safety and driver comfort. Some of these features have proved to be beneficial to logistics operators. To start with the introduction of adaptive cruise control in long-distance haulage vehicles, to see how this system benefits the drivers, we carried out research in the form of interviews with long-distance truck drivers with the main question being, what major difference have they experienced since they started to operate vehicles equipped with this technology to which most stated they had noticed that they are less tired and are able to drive longer distances as compared to when they used vehicles not equipped with this system. As a result, they can deliver faster and take on the next assignment, thus improving efficiency and bringing in more monetary return for the logistics company. Secondly, the introduction of electric hybrid technology, this system allows the vehicle to be propelled by electric power stored in batteries located in the vehicle instead of fossil fuel. Consequently, this benefits the logistic company as vehicles become cheaper to run as electricity is more affordable as compared to fossil fuel. The merging of electronic systems in vehicles has proved to be of great benefit, as my research proves that this can benefit the logistics industry in plenty of ways.

Keywords: logistics, manufacturing, hybrid technology, haulage vehicles

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