Search results for: the long head of the biceps

Authors: Evren Ozgur, Kasim Kocak

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As a result of global warming and climate change, air temperature has increased and will continue to increase in the future. Increases in air temperatures have effects on a large number of variables in meteorology. One of the most important effects is the changes in the types of precipitation, especially in mid-latitudes. Because of increasing air temperatures, less snowfall was observed in the eastern parts of Turkey. Snowfall provides most of the water supply in spring and summer months, especially in mountainous regions of Turkey. When the temperature begins to increase in spring season, this snow starts to melt and plays an important role in agricultural purposes, drinking water supply and energy production. On the other hand, defining the snow season is very crucial especially in mountainous areas which have winter tourism opportunities. A reduction in the length of the snow season (LSS) in these regions will result in serious consequences in the long run. In the study, snow season was examined for 10 meteorological stations that are located above the altitude of 1000m. These stations have decreasing trends in the ratio of number of snowy days to total precipitation days considering earlier studies. Daily precipitation records with the observation period of 1971-2011 were used in the study. Then, the observation period was separated into 4 non-overlapping parts in order to identify decadal variations. Changes in the length of the snow season with increasing temperatures were obtained for these stations. The results of LSS were evaluated with the number of snowy days for each station. All stations have decreasing trend in number of snowy days for 1971-2011 period. In addition, seven of the results are statistically significant. Besides, decrease is observed regarding the length of snow season for studied stations. The decrease varies between 6.6 and 47.6 days according to decadal snow season averages of the stations.

Keywords: climate change, global warming, precipitation, snowfall, Turkey

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Authors: H. Ju, M. Jones, G. D. Mishra

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Introduction: Limited longitudinal studies have examined the relationship between BMI and dysmenorrhea, resulting in mixed results. This study aims to investigate the long-term association between BMI and dysmenorrhea. Methods: 9,688 women from Australian Longitudinal Study on Women’s Health (ALSWH), a prospective population-based cohort study, were followed for 13 years. Data were collected through self-reported questionnaires repeatedly on all variables, including dysmenorrhea, weight and height. The longitudinal association between dysmenorrhea and BMI or BMI transition (change of BMI categories between two successive surveys) was investigated by generalized estimating equations. Results: When the women were aged 22 to 27 years, approximately 11% were obese, 7% underweight, and 25% reported dysmenorrhea. Over the study period, the prevalence of obesity doubled whereas that of underweight declined substantially. The prevalence of dysmenorrhea remained relatively stable. Compared to women with a normal weight, significantly higher odds of reporting dysmenorrhea were detected for both women who were underweight (odds ratio (OR) 1.25, 95% confidence interval (CI) 1.09, 1.43) and obese (OR 1.20, 95% CI 1.10, 1.31). Being overweight was not associated with increased risk of dysmenorrhea. Compared to women who remained at normal weight or overweight over time, significant risk was detected for women who: remained underweight or obese (OR 1.35, 95% CI 1.23, 1.49), were underweight but became normal or overweight (OR 1.29, 95% CI 1.11, 1.50), became underweight (OR 1.24, 95% CI 1.01, 1.52). However, the higher risk among obese women disappeared when they lost weight and became normal weight or overweight (OR 1.07, 95% CI 0.87, 1.30). Conclusions: A U-shaped association was revealed between dysmenorrhea and BMI, revealing higher risk of dysmenorrhea for both underweight and obese women. Further, the risk disappeared when obese women lost weight and acquired a healthier BMI. However obesity certainly poses a greater burden of disease from the public health perspective, thus requires greater effort to tackle the increasing problem at the population level. It is important to maintain a healthy weight over time for women to enjoy a better reproductive health.

Keywords: body mass index, dysmenorrhea, obesity, painful period, underweight

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Authors: Syed Kamran Sami, Saqib Siddiqui

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In recent times, flexible supercapacitors retaining high electrochemical performance and steadiness along with mechanical endurance has developed as a spring of attraction due to the exponential progress and innovations in energy storage devices. To meet the rampant increasing demand of energy storage device with the small form factor, a unique, low cost and high-performance supercapacitor with considerably higher capacitance and mechanical robustness is required to recognize their real-life applications. Here in this report, synthesis route of electrode materials with low rigidity and high charge storage performance is reported using 1D-1D hybrid structure of zinc oxide (ZnO) nanorods, and conductive polymer smeared polyvinylidene fluoride–trifluoroethylene (P(VDF–TrFE)) electrospun nanofibers. The ZnO nanorods were uniformly grown on poly (3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT: PSS) coated P(VDF-TrFE) nanofibers using hydrothermal growth to manufacture light weight, permeable electrodes for supercapacitor. The PEDOT: PSS coated P(VDF-TrFE) porous web of nanofibers act as framework with high surface area. The incorporation of ZnO nanorods further boost the specific capacitance by 59%. The symmetric device using the fabricated 1D-1D hybrid electrodes reveals fairly high areal capacitance of 1.22mF/cm² at a current density of 0.1 mA/cm² with a power density of more than 1600 W/Kg. Moreover, the fabricated electrodes show exceptional flexibility and high endurance with 90% and 76% specific capacitance retention after 1000 and 5000 cycles respectively signifying the astonishing mechanical durability and long-term stability. All the properties exhibited by the fabricated electrode make it convenient for making flexible energy storage devices with the low form factor.

Keywords: ZnO nanorods, electrospinning, mechanical endurance, flexible supercapacitor

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Authors: Harini Aiyer, Kalyani Premkumar

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Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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Authors: Shiv Jyoti Pandey, Shveta Puri, G. M. Bhat, Neha Raina

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The Jammu and Kashmir (J&K) region of Northwest Himalaya has a long history of earthquake activity which falls within Seismic Zones IV and V. To know the crustal structure beneath this region, we utilized teleseismic receiver function method. This paper presents the results of the analyses of the teleseismic earthquake waves recorded by 10 seismic observatories installed in the vicinity of major thrusts and faults. The teleseismic waves at epicentral distance between 30o and 90o with moment magnitudes greater than or equal to 5.5 that contains large amount of information about the crust and upper mantle structure directly beneath a receiver has been used. The receiver function (RF) technique has been widely applied to investigate crustal structures using P-to-S converted (Ps) phases from velocity discontinuities. The arrival time of the Ps, PpPs and PpSs+ PsPs converted and reverberated phases from the Moho can be combined to constrain the mean crustal thickness and Vp/Vs ratio. Over 500 receiver functions from 10 broadband stations located in the Jammu & Kashmir region of Northwest Himalaya were analyzed. With the help of H-K stacking method, we determined the crustal thickness (H) and average crustal Vp/Vs ratio (K) in this region. We also used Neighbourhood algorithm technique to verify our results. The receiver function results for these stations show that the crustal thickness under Jammu & Kashmir ranges from 45.0 to 53.6 km with an average value of 50.01 km. The Vp/Vs ratio varies from 1.63 to 1.99 with an average value of 1.784 which corresponds to an average Poisson’s ratio of 0.266 with a range from 0.198 to 0.331. High Poisson’s ratios under some stations may be related to partial melting in the crust near the uppermost mantle. The crustal structure model developed from this study can be used to refine the velocity model used in the precise epicenter location in the region, thereby increasing the knowledge to understand current seismicity in the region.

Keywords: H-K stacking, Poisson’s ratios, receiver function, teleseismic

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Authors: Chinumani Choudhury

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Heavy metal contamination is an alarming problem, which poses a serious risk to human health and the surrounding geology. Soils get contaminated with heavy metals due to the un-regularized industrial discharge of the toxic metal-rich effluents. Under such a condition, the remediation of the contaminated sites becomes imperative for a sustainable, safe, and healthy environment. Phytoextraction, which involves the removal of heavy metals from the soil through root absorption and uptake, is a viable remediation technique, which ensures extraction of the toxic inorganic compound available in the soil even at low concentrations. The soil present in the Silghat Region of Assam, India, is mostly contaminated with Zinc (Zn) and Lead (Pb), having concentrations as high as to cause a serious environmental problem if proper measures are not taken. In the present study, an extensive experimental study was carried out to understand the effectiveness of two commonly planted trees in Assam, namely, i) Indian Pennywort and ii) Fenugreek, in the removal of heavy metals from the contaminated soil. The basic characterization of the soil in the contaminated site of the Silghat region was performed and the field concentration of Zn and Pb was recorded. Various long-term laboratory pot tests were carried out by sowing the seeds of Indian Pennywort and Fenugreek in a soil, which was spiked, with a very high dosage of Zn and Pb. The tests were carried out for different concentration of a particular heavy metal and the individual effectiveness in the absorption of the heavy metal by the plants were studied. The concentration of the soil was monitored regularly to assess the rate of depletion and the simultaneous uptake of the heavy metal from the soil to the plant. The amount of heavy metal uptake by the plant was also quantified by analyzing the plant sample at the end of the testing period. Finally, the study throws light on the applicability of the studied plants in the field for effective remediation of the contaminated sites of Assam.

Keywords: phytoextraction, heavy-metals, Indian pennywort, fenugreek

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Authors: Oluwaseun A. Oyetade, Roelof J. Kriek

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The development of effective catalysts for the oxygen evolution reaction (OER) is of great importance to combat energy-related concerns in the environment. Herein, we report a one-step solvothermal method employed for the fabrication of nickel selenide hybrids (NiSe-Ni₃Se₂) and a series of nickel selenide hybrid/multiwalled carbon nanotube composites (NiSe-Ni₃Se₂/MWCNT) as electrocatalysts for OER in alkaline media. The catalytic activities of these catalysts were investigated via several electrochemical characterization techniques, such as linear sweep voltammetry, chronoamperometric studies at constant potential, electrochemical surface area determination, and Tafel slope calculation, under alkaline conditions. Morphological observations demonstrated the agglomeration of non-uniform NiSe-Ni₃Se₂ microspheres around carbon nanotubes (CNTs), demonstrating the successful synthesis of NiSe-Ni₃Se₂/MWCNT nanocomposites. Among the tested electrocatalysts, the 20% NiSe-Ni₃Se₂/MWCNT nanocomposite demonstrated the highest activity, exhibiting an overpotential of 325 mV to achieve a current density of 10 mA.cm⁻² in 0.1 mol.dm⁻³ KOH solution. The NiSe-Ni₃Se₂/MWCNT nanocomposites showed improved activity toward OER compared to bare NiSe-Ni₃Se₂ hybrids and MWCNTs, exhibiting an overpotential of 528, 392 and 434 mV for 10%, 30% and 50% NiSe-Ni₃Se₂/MWCNT nanocomposites, respectively. These results compare favourably to the overpotential of noble catalysts, such as RuO₂ and IrO₂. Our results imply that the addition of MWCNTs increased the activity of NiSe-Ni₃Se₂ hybrids due to an increased number of catalytic sites, dispersion of NiSe-Ni₃Se₂ hybrid nanoparticles, and electronic conductivity of the nanocomposites. These nanocomposites also demonstrated better long-term stability compared to NiSe-Ni₃Se₂ hybrids and MWCNTs. Hence, NiSe-Ni₃Se₂/MWCNT nanocomposites possess the potential as effective electrocatalysts for OER in alkaline media.

Keywords: carbon nanotubes, electrocatalysts, nanocomposites, nickel selenide hybrids, oxygen evolution reaction

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Authors: Stanley Fore, Sharon Chipeperekwa

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The start of the 2011 academic year in South Africa saw a number of Institutions of Higher Learning introducing online registration for their students. The efficiency and effectiveness of Information Systems are increasingly becoming a necessity and not an option for many organizations. An information system should be able to allow end users to access information easily and navigate with ease. The selected University of Technology (UoT) in this research is one of the largest public institution of higher learning in the Western Cape Province and boasts of an enrolment of more than 30000 students per academic year. An observation was made that, during registration students’ stand in long queues waiting to register or for assistance to register. The system tends to ‘freeze’ whilst students are registering and students are in most cases unfamiliar with the system interface. They constantly have to enquire what to do next when going through online registration process. A mixed method approach will be adopted which comprises of quantitative and qualitative approaches. The study uses constructs of the updated DeLone and McLean IS success model (2003) to analyse and explain the student’s perceptions of the online registration system. The research was undertaken to establish the student’s perceptions of the online registration system. This research seeks to identify and analyse the challenges and success factors of introducing an online registration system whilst highlighting the extent to which this system has been able to solve the numerous problems associated with the manual era. The study will assist management and those responsible for managing the current system to determine how well the system is working or not working to achieve user satisfaction. It will also assist them going forward on what to consider before, during and after implementation of an information system. Respondents will be informed of the objectives of the research, and their consent to participate will be sought. Ethical considerations that will be applied to this study include; informed consent and protection from harm, right to privacy and involvement of the research.

Keywords: online registration, information systems, University of Technology, end-users

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Authors: Ghalia Shamlan, M. Denise Robertson, Adam Collins

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Appetite control (i.e. control of energy intake) is important for weight maintenance. Exercise contributes to the most variable component of energy expenditure (EE) but its impact is beyond the energy cost of exercise including physiological, behavioural, and appetite effects. Exercise is known to acutely influence effect appetite but evidence as to the independent effect of intensity is lacking. This study investigated the role of exercise intensity on appetite, energy intake (EI), appetite related hormone, fat utilisation and subjective measures of appetite. One hour after a standardised breakfast, 10 sedentary overweight volunteers. Subjects undertook either 8 repeated 60 second bouts of cycling at 95% VO2max (high intensity) or 30 minutes of continuous cycling, at a fixed cadence, equivalent to 50% of the participant’s VO2max (low intensity) in a randomised crossover design. Glucose, NEFA, glucagon-like peptide-1 (GLP-1) were measured fasted, postprandial, and pre and post-exercise. Satiety was assessed subjectively throughout the study using visual analogue scales (VAS). Ad libitum intake of a pasta meal was measured at the end (3-h post-breakfast). Interestingly, there was not significant difference in EE fat oxidation between HI and LI post-exercise. Also, no significant effect of high intensity (HI) was observed on the ad libitum meal, 24h and 48h EI post-exercise. However the mean 24h EI was 3000 KJ lower following HI than low intensity (LI). Despite, no significant differences in hunger score, glucose, NEFA and GLP-1 between both intensities were observed. However, NEFA and GLP-1 plasma level were higher until 30 min post LI. In conclusion, the similarity of EE and oxidation outcomes could give overweight individuals an option to choose between intensities. However, HI could help to reduce EI. There are mechanisms and consequences of exercise in short and long-term appetite control; however, these mechanisms warrant further explanation. These results support the need for future research in to the role of in regulation energy balance, especially for obese people.

Keywords: appetite, exercise, food intake, energy expenditure

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Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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Authors: Dorna Kargar, Mehrasa Masih

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Due to its special geological and geographical conditions, Iran has always been exposed to various natural hazards. Earthquake is one of the natural hazards with random nature that can cause significant financial damages and casualties. This is a serious threat, especially in areas with active faults. Therefore, considering the population density in some parts of the country, locating and zoning high-risk areas are necessary and significant. In the present study, seismic hazard assessment via probabilistic and deterministic method for Tehran, the capital of Iran, which is located in Alborz-Azerbaijan province, has been done. The seismicity study covers a range of 200 km from the north of Tehran (X=35.74° and Y= 51.37° in LAT-LONG coordinate system) to identify the seismic sources and seismicity parameters of the study region. In order to identify the seismic sources, geological maps at the scale of 1: 250,000 are used. In this study, we used Kijko-Sellevoll's method (1992) to estimate seismicity parameters. The maximum likelihood estimation of earthquake hazard parameters (maximum regional magnitude Mmax, activity rate λ, and the Gutenberg-Richter parameter b) from incomplete data files is extended to the case of uncertain magnitude values. By the combination of seismicity and seismotectonic studies of the site, the acceleration with antiseptic probability may happen during the useful life of the structure is calculated with probabilistic and deterministic methods. Applying the results of performed seismicity and seismotectonic studies in the project and applying proper weights in used attenuation relationship, maximum horizontal and vertical acceleration for return periods of 50, 475, 950 and 2475 years are calculated. Horizontal peak ground acceleration on the seismic bedrock for 50, 475, 950 and 2475 return periods are 0.12g, 0.30g, 0.37g and 0.50, and Vertical peak ground acceleration on the seismic bedrock for 50, 475, 950 and 2475 return periods are 0.08g, 0.21g, 0.27g and 0.36g.

Keywords: peak ground acceleration, probabilistic and deterministic, seismic hazard assessment, seismicity parameters

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Authors: Al-Nouri Doha Mostfa, Al-Khalifa Abdulrahman Salih

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The effects of long-term supplementation with different dietary omega-6/omega-3 (ω-6/ω-3) polyunsaturated fatty acid (PUFAs) ratios on the bone marrow fatty acids level, plasma biomarkers of bone metabolism, and minerals content in bone were evaluated in rabbits. Weanling male and female New Zealand white rabbits were randomly assigned to five groups and fed ad libitum for 100 days on diets containing 70 g/kg different dietary oils which providing the following ω-6/ω-3 ratios: soy bean oil (SBO control, 8.68), sesame oil (SO, 21.75), fish oil (FO, 0.39), DHA algae oil (DHA, 0.63), and DHA and ARA algae oils (DHA/ARA, 0.68). The bone marrow arachidonic (ARA), eicosapentaenoic (EPA), and docosahexaenoic (DHA) fatty acid levels were significantly influenced by and reflected the dietary ω-6/ω-3 ratios fed to rabbits. Rabbits fed on the FO diet maintained a lower ω-6/ω-3 ratio and a higher EPA and DHA levels, those fed on the DHA/ARA diet maintained a lower ω-6/ω-3 ratio and a higher ARA level, while those fed on the SO diet maintained a higher ω-6/ω-3 ratio and a lower ARA level. Plasma alkaline phosphatase (ALP) activity was significantly higher in male and female rabbits fed the DHA/ARA diet compared with those fed the control, SO, FO, or DHA diets. There was a significant main effect of dietary treatment on femur calcium (Ca), phosphorous (P), magnesium (Mg), and zinc (Zn) contents in both genders. This study confirmed that different dietary oil sources with varying ω-6/ω-3 ratios significantly altered the fatty acids level of bone marrow. In addition, the significant elevation in minerals content and the maintenance of optimal Ca/P ratio in bone of DHA/ARA and DHA fed groups beside the significant elevation in ALP activity in the DHA/ARA fed group proved that marine algae oils may be promising dietary sources for promoting bone mineralization and formation, thus improving bone mass during the growth stage.

Keywords: arachidonic (ARA), docosahexaenoic (DHA), eicosapentaenoic (EPA), growing rabbits

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Authors: Mohit Chauhan, Atul Narayan

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Moisture damage is the continuous deterioration of asphalt concrete mixtures by the loss of adhesive bond between the asphalt binder and aggregates, or loss of cohesive bonds within the asphalt binder in the presence of moisture. Moisture has been known to either cause or exacerbates distresses in asphalt concrete pavements. Since moisture would often retain for a relatively long duration at the bottom of asphalt concrete layer, the movement of traffic loading in this saturated condition would cause excess stresses or strains within the mixture. This would accelerate the degradation of the adhesion and cohesion within the mixture and likely to contribute the development of fatigue cracking in asphalt concrete pavements. In view of this, it is important to investigate the effect of moisture on the fatigue behavior of asphalt concrete mixtures. In this study, changes in fatigue characteristics after moisture conditioning were evaluated by conducting four-point beam fatigue tests on dry and moisture conditioned specimens. For this purpose, mixtures with two different types of binders were prepared and saturated with moisture using 700 mm Hg vacuum. Beam specimens, in this way, were taken to a saturation level of 65-75 percent. After preconditioning specimens in this degree of saturation and 60°C for a period of 24 hours, they were subjected to four point beam fatigue tests in strain-controlled mode with a strain amplitude of 400 microstrain. The results were then compared with the fatigue test results obtained with beam specimens that were not subjected to moisture conditioning. Test results show that the conditioning reduces both fatigue life and initial flexural stiffness of specimen significantly. The moisture conditioning was also found to increase the rate of reduction of flexural stiffness. Moreover, it was observed that the fatigue life ratio (FLR), the ratio of the fatigue life of the moisture conditioned sample to that of the dry sample, is significantly lower than the flexural stiffness ratio (FSR). The study indicates that four-point bending test is an appropriate tool with FLR and FSR as the potential parameters for moisture-sensitivity evaluation.

Keywords: asphalt concrete, fatigue cracking, moisture damage, preconditioning

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Authors: Wafa Al Jabri

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Sickle cell disease (SCD) is a genetic blood disorder that is characterized by a severe painful crisis. SCD among children requires long term dependencies and high caregiving demands that increase the overall family burdens. It is, therefore, essential to examine, support, and promote the well-being of families of children with SCD. Although there has been considerable progress in the international research on family quality of life (FQOL) in recent years; however, research in this field is relatively recent and diverse. Oman is a country in which family quality of life has definitely been under-researched. Therefore, the purpose of the study is to describe the FQOL in families of children with SCD in Oman. The study will also examine the relationships between child, mother, and family-related factors that may influence the overall FQOL. Theoretical Framework: The study is guided by the unified theory of family quality of life to help in understanding the concept of FQOL and the factors that shape it. Method:A convenience sample of 98 mothers of children with SCD will be recruited from the pediatric hematology clinic at Sultan Qaboos University Hospital in Oman to participate in this descriptive, cross sectional, correlational study. Data will be obtained using a self-administered questionnaire that includes child and mother socio-demographic data, questions about the number of visits and admissions to health care facilities for vaso- occlusive crises (VOCs), the Perceived Stress Scale-10, and the Beachcenter-FQOL scale. Anticipated Results: It is expected to find an association among frequency of VOCs, mother’s perceived stress level, and FQOL in families of children with SCD in Oman. Family type, socio-economic status, and number of SCD children in the family are also expected to influence the overall FQOL. Conclusion: The findings of the study might be pivotal in designing and implementing tailored family-based interventions to improve families’ wellbeing.

Keywords: family quality of life, sickle cell disaes, children, family well-being

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Authors: S. K. Dewangan, K. R. Sahu, S. Soni

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Unemployment is today’s basic socio-economic problem eroding national income and living standards, aggravating national development and poverty alleviation. The farmers are encouraged to take up non-agriculture practices which are integrated with Sericulture. Sericulture is one of the primary occupations for livelihood of poor people in tribal area. Most of tribal are involved in Sericulture. Tasar, Eri are the main forest-based cultivation. Among these sericultures is the major crop adopted by the Tribal’s and practiced in respective areas. Out of the 6, 38,588 villages in India, sericultures are practiced in about 69000 villages providing employment to about 7.85 million people. Sericulture is providing livelihood for 9, 47,631 families. India continues to be the second largest producer of silk in the World. Among the four varieties of silk produced, as in 2012-13, Mulberry accounts for 18,715 MT, Eri 3116 MT, Tasar 1729 MT and Muga 119MT of the total raw silk production in the country. Sericulture with its unique features plays an important role in upgrading the socio-economic conditions of the rural folk and with employment opportunities to the educated rural youth and women. In view of the importance of sericulture enterprise for the biodiversity conservation as well as its cultural bondage, the paper tries to enlighten and discuss the significance of sericulture and strategies to be taken for the employment generation in Indian sericulture industry. The present paper explores the possible employment opportunities derived from problem analysis and strategies to be adopted aiming at revolutionary biodiversity conservation in the study area. The paper highlights the sericulture is a way for biodiversity conservation, employment generation in Raigarh district, their utilization and needs as they act as a tool for socio-economic change for tribal. The study concludes with some suggestions to improve the feasibility of sericulture in long term.

Keywords: bio-diversity, employment, sericulture, tribal, income, socio-economic

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Authors: Muhammad Saqib Manzoor, Camille Dickson-Deane, Prashan Karunaratne

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Cobb-Douglas production (utility) function is a fundamental function widely used in economics teaching and research. The key reason is the function's characteristics to describe the actual production using inputs like labour and capital. The characteristics of the function like returns to scale, marginal, and diminishing marginal productivities are covered in the introductory units in both microeconomics and macroeconomics with a 2-dimensional static visualisation of the function. However, less insight is provided regarding three-dimensional surface, changes in the curvature properties due to returns to scale, the linkage of the short-run production function with its long-run counterpart and marginal productivities, the level curves, and the constraint optimisation. Since (freshman) learners have diverse prior knowledge and cognitive skills, the existing “one size fits all” approach is not very helpful. The aim of this study is to bridge this gap by introducing technological intervention with interactive animations of the three-dimensional surface and sequential unveiling of the characteristics mentioned above using Python software. A small classroom intervention has helped students enhance their analytical and visualisation skills towards active and authentic learning of this topic. However, to authenticate the strength of our approach, a quasi-Delphi study will be conducted to ask domain-specific experts, “What value to the learning process in economics is there using a 2-dimensional static visualisation compared to using a 3-dimensional dynamic visualisation?’ Here three perspectives of the intervention were reviewed by a panel comprising of novice students, experienced students, novice instructors, and experienced instructors in an effort to determine the learnings from each type of visualisations within a specific domain of knowledge. The value of this approach is key to suggesting different pedagogical methods which can enhance learning outcomes.

Keywords: cobb-douglas production function, quasi-Delphi method, effective teaching and learning, 3D-visualisations

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Authors: Waleed Ahmed, Huang Xiaohua, Wilayat Ali

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The wheelchair users are generally exposed to physical and psychological health problems, e.g., pressure sores and pain in the hip joint, associated with seating posture or being inactive in a wheelchair for a long time. Reclining Wheelchair with back, thigh, and leg adjustment helps in daily life activities and health preservation. The seat elevating function of an electric wheelchair allows the user (lower limb amputation) to reach different heights. An electric wheelchair is expected to ease the lives of the elderly and disable people by giving them mobility support and decreasing the percentage of accidents caused by users’ narrow sight or joystick operation errors. Thus, this paper proposed the design, analysis and obstacle avoidance control of an electric wheelchair with sit-sleep-seat elevation functions. A 3D model of a wheelchair is designed in SolidWorks that was later used for multi-body dynamic (MBD) analysis and to verify driving control system. The control system uses the fuzzy algorithm to avoid the obstacle by getting information in the form of distance from the ultrasonic sensor and user-specified direction from the joystick’s operation. The proposed fuzzy driving control system focuses on the direction and velocity of the wheelchair. The wheelchair model has been examined and proven in MSC Adams (Automated Dynamic Analysis of Mechanical Systems). The designed fuzzy control algorithm is implemented on Gazebo robotic 3D simulator using Robotic Operating System (ROS) middleware. The proposed wheelchair design enhanced mobility and quality of life by improving the user’s functional capabilities. Simulation results verify the non-accidental behavior of the electric wheelchair.

Keywords: fuzzy logic control, joystick, multi body dynamics, obstacle avoidance, scissor mechanism, sensor

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Authors: Dua K. S. Y. Klaas, Monzur A. Imteaz, Ika Sudiayem, Elkan M. E. Klaas, Eldav C. M. Klaas

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Developing tailored management strategies to ensure the sustainability of groundwater resource under climate and demographic changes is critical for tropical karst island, where relatively small watershed and highly porous soil nature make this natural resource highly susceptible and thus very sensitive to those changes. In this study, long-term impacts of climate variability on groundwater recharge and discharge at the Oemau spring, Rote Island, Indonesia were investigated. Following calibration and validation of groundwater model using MODFLOW code, groundwater flow was simulated for period of 2020-2090 under HadCM3 global model climate (GCM) scenarios, using input data of weather variables downscaled by Statistical Downscaling Model (SDSM). The reported analysis suggests that the sustainability of groundwater resources will be adversely affected by climate change during dry years. The area is projected to variably experience 2.53-22.80% decrease of spring discharge. A subsequent comprehensive set of management strategies as palliative and adaptive efforts was proposed to be implemented by relevant stakeholders to assist the community dealing with water deficit during the dry years. Three main adaptive strategies, namely socio-cultural, technical, and ecological measures, were proposed by incorporating physical and socio-economic characteristics of the area. This study presents a blueprint for assessing groundwater sustainability under climate change scenarios and developing tailored management strategies to cope with adverse impacts of climate change, which may become fundamental necessities across other tropical karst islands in the future.

Keywords: climate change, groundwater, management strategies, tropical karst island, Rote Island, Indonesia

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Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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Authors: Manish Khanra, Shashank Prabhu

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The decarbonization of hard-to-abate sectors is currently high on the agenda in the EU and its member states, as these sectors have substantial shares in overall GHG emissions while it is facing serious challenges to decarbonize. In particular, the aviation sector accounts for 2.8% of global anthropogenic CO₂ emissions. These emissions are anticipated to grow dramatically unless immediate mitigating efforts are implemented. Hydrogen and its derivatives based on renewable electricity can have a key role in the transition towards CO₂-neutral flights. The substantial shares of energy carriers in the form of drop-in fuel, direct combustion and Hydrogen-to-Electric are promising in most scenarios towards 2050. For creating appropriate policies to ramp up the production and utilisation of hydrogen commodities in the German aviation sector, a detailed analysis of the spatial distribution of supply-demand sites is essential. The objective of this research work is to assess the demand for hydrogen-based alternative fuels in the German aviation sector to achieve the perceived goal of the ‘Net Zero’ scenario by 2050. Here, the analysis of the technological pathways for the production and utilisation of these fuels in various aircraft options is conducted for reaching mitigation targets. Our method is based on data-driven bottom-up assessment, considering production and demand sites and their spatial distribution. The resulting energy demand and its spatial distribution with consideration of technology diffusion lead to a possible transition pathway of the aviation sector to meet short-term and long-term mitigation targets. Additionally, to achieve mitigation targets in this sector, costs and policy aspects are discussed, which would support decision-makers from airline industries, policymakers and the producers of energy commodities.

Keywords: the aviation sector, hard-to-abate sectors, hydrogen demand, alternative fuels, technological pathways, data-driven approach

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Authors: Loyce Nahwera, Joy Wachira, Edwin Kiptolo, Constance Nsibambi, Mshilla Maghanga, Timothy Makubuya

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Introduction: Hypertension is one of the most prominent risk factors for cardiovascular diseases globally, and it can be modified through lifestyle interventions such as exercise. The objective of this study was to investigate the effects of a 12-week aerobic dance programme on systolic blood pressure (SBP) in stage 1 hypertensive individuals. Methods: This study employed an experimental research design. A total of 36 stage 1 hypertensive individuals who were randomly assigned into experimental and control groups completed the study. Systolic BP was measured using a mercury sphygmomanometer at baseline, mid-point and after the program. The experimental group participants trained 3 days a week, 45 minutes per session, at a moderate intensity of 40-60% of maximum oxygen consumption (VO2max) monitored by Garmin heart rate monitors. Data were analyzed using SPSS version 20. The significance level was set at p<0.05. A paired sample t-test was used to compare mean differences within the groups. Results: Data from the 36 participants (22 males and 14 females) (experimental; n=18, control; n=18) show that the experimental group had a mean SBP of 143.83±6.382 mmHg at baseline while the control had a mean of 137.61±6.400 mmHg. Following the end of a 6-week aerobic dance, the mean SBP of the experimental group reduced to 138.06±9.539 mmHg while that of the control marginally decreased to 137.00±8.073 mmHg. At the completion of a 12-week program, the mean SBP of the experimental group reduced to 136.33±9.191 mmHg, while that of the control marginally increased to 139.56±9.954 mmHg. This implies that both the 6-week and 12-week aerobic dance program reduced the SBP of the experimental group by 5.77±7.133 mmHg and 7.50±8.487 mmHg, respectively, while the control group fast reduced marginally by 0.61 before ultimately increasing by 1.95±7.974 mmHg at 12-weeks. The changes were statistically significant (p<0.05) at both 6 and 12 weeks of an aerobic dance program. Conclusion: The study concluded that aerobic dance is an effective non-pharmacological method for managing SBP of stage 1 hypertensive individuals both in the short-term (6 weeks) and long-term (12 weeks).

Keywords: aerobic dance, blood pressure, stage 1 hypertension, systolic blood pressure.

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Authors: Adam J. Carinci

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Background: The opioid epidemic is the most pressing healthcare crisis of our time. There is increasing recognition that opioids have limited long-term efficacy and are associated with hyperalgesia, addiction, and increased morbidity and mortality. Therefore, alternative strategies to combat chronic pain are paramount. We initiated a multicenter retrospective case series to review the efficacy of DRG stimulation in facilitating opioid tapering, opioid discontinuation and as a viable alternative to chronic opioid therapy. Purpose: The dorsal root ganglion (DRG) plays a key role in the development and maintenance of pain. Recent innovations in neuromodulation, specifically, dorsal root ganglion stimulation, offers an effective alternative to opioids in the treatment of chronic pain. This retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy. Procedure: This small multicenter retrospective case series provides preliminary evidence that DRG stimulation facilitates opioid weaning, opioid tapering and is a viable option to opioid therapy in the treatment of chronic pain. A retrospective analysis was completed. Visual analog scale pain scores and pain medication usage were collected at the baseline visit and after four weeks, 3 months and 6 months of treatment. Ten consecutive patients across two study centers were included. The pain was rated 7.38 at baseline and decreased to 1.50 at the 4-week follow-up, a reduction of 79.5%. All patients significantly decreased their opioid pain medication use with an average > 30% reduction in morphine equivalents and four were able to discontinue their medications entirely. Conclusion: This Retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy.

Keywords: dorsal root ganglion, neuromodulation, opioid sparing, stimulation

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Authors: Marko Kolakovic, Mihaela Mikic, Martina Taborin

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Women entrepreneurship is often regarded as the unused economical potential in many countries, including Republic of Croatia. Although women represent a majority in the population, they are still a minority in the field of entrepreneurship and face many challenges in fulfilling their entrepreneurship potential. The reasons are often hided in historical distorted perceptions about value, credibility, competitiveness, responsibility and knowledge which women have, or can have. This is significant for at least two reasons. First, in terms of global economic crisis, the economy needs more quality, more skilled and educated people willing to face entrepreneurial challenges and create new jobs, new opportunities and higher living standards. Second, in the entrepreneurial activity, women finally have a chance to highlight their own abilities, such as knowledge, relentless work, organizational skills, communication and negotiation skills, responsibility, flexibility, etc., in order to insure their economic independence, for a better social position, and to increase confidence and faith in their own abilities. This paper empirically analyses characteristics of women entrepreneurship in Croatia and conducted policies for it improvement. An empirical research was conducted with the goal of discovering real life experiences and attitudes of Croatian women entrepreneurs. Results show that Croatian women entrepreneurs are usually highly educated, have previous work experience and operate in service sector, due to lower need for start-up capital. The biggest obstacle on their entrepreneurial path represents government bureaucracy. Although the number of women entrepreneurs is rising today and the gap between male and women entrepreneurs in Croatia, as well as women entrepreneurship levels lower than the European average, we believe that there is still a long way to reach potential and successful women entrepreneurship development. Research showed that by breaking down the barriers as access to finance, education investments, knowledge, skills and confidence development, women will be able to accomplish more significant and more efficient entrepreneurial outcome.

Keywords: Croatia, policy, SMEs, women entrepreneurial strategy, women entrepreneurship

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Authors: Juan Alfredo Guevara Carrio, Swamy Toolahalli Thipperudra, Riddhi Naik Dharmeshbhai, Sergio Graniero Echeverrigaray, Jose Vitorio Emiliano, Antonio Helio Castro

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In order to advance the hydrogen economy, several industrial sectors can potentially benefit from the trillions of stimulus spending for post-coronavirus. Blending hydrogen into natural gas pipeline networks has been proposed as a means of delivering it during the early market development phase, using separation and purification technologies downstream to extract the pure H₂ close to the point of end-use. This first step has been mentioned around the world as an opportunity to use existing infrastructures for immediate decarbonisation pathways. Among current technologies used to extract hydrogen from mixtures in pipelines or liquid carriers, membrane separation can achieve the highest selectivity. The most efficient approach for the separation of H₂ from other substances by membranes is offered from the research of 2D layered materials due to their exceptional physical and chemical properties. Graphene-based membranes, with their distribution of pore sizes in nanometers and angstrom range, have shown fundamental and economic advantages over other materials. Their combination with the structure of ceramic and geopolymeric materials enabled the synthesis of nanocomposites and the fabrication of membranes with long-term stability and robustness in a relevant range of physical and chemical conditions. Versatile separation modules have been developed for hydrogen separation, which adaptability allows their integration in industrial prototypes for applications in heavy transport, steel, and cement production, as well as small installations at end-user stations of pipeline networks. The developed membranes and prototypes are a practical contribution to the technological challenge of supply pure H₂ for the mentioned industries as well as hydrogen energy-based fuel cells.

Keywords: graphene nano-composite membranes, hydrogen separation and purification, separation modules, indsutrial prototype

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Authors: Yasuyuki Takahashi, Hirotaka Shimada, Kyoko Saito

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Bone scintigraphy is widely used as a screening tool for bone metastases. However, the 180 to 240 minutes (min) waiting time after the intravenous (i.v.) injection of the tracer is both long and tiresome. To solve this shortcoming, a bone scan with a shorter waiting time is needed. In this study, we applied the Maximum Intensity Projection (MIP) and triple energy window (TEW) scatter correction to a whole body bone SPECT (Merged SPECT) and investigated shortening the waiting time. Methods: In a preliminary phantom study, hot gels of 99mTc-HMDP were inserted into sets of rods with diameters ranging from 4 to 19 mm. Each rod set covered a sector of a cylindrical phantom. The activity concentration of all rods was 2.5 times that of the background in the cylindrical body of the phantom. In the human study, SPECT images were obtained from chest to abdomen at 30 to 180 min after 99mTc- hydroxymethylene diphosphonate (HMDP) injection of healthy volunteers. For both studies, MIP images were reconstructed. Planar whole body images of the patients were also obtained. These were acquired at 200 min. The image quality of the SPECT and the planar images was compared. Additionally, 36 patients with breast cancer were scanned in the same way. The delectability of uptake regions (metastases) was compared visually. Results: In the phantom study, a 4 mm size hot gel was difficult to depict on the conventional SPECT, but MIP images could recognize it clearly. For both the healthy volunteers and the clinical patients, the accumulation of 99mTc-HMDP in the SPECT was good as early as 90 min. All findings of both image sets were in agreement. Conclusion: In phantoms, images from MIP with TEW scatter correction could detect all rods down to those with a diameter of 4 mm. In patients, MIP reconstruction with TEW scatter correction could improve the detectability of hot lesions. In addition, the time between injection and imaging could be shortened from that conventionally used for whole body scans.

Keywords: merged SPECT, MIP, TEW scatter correction, 99mTc-HMDP

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Authors: Aylin Hasbay Büyükkaragöz, Zehra Büyüktuncer, Tuğçe Nur Balcı, Nevin Ergun

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Purpose: Nutritional supplement usage is widespread among athletes all over the world. However, the usage among disabled athletes is not well-known. This study aimed to evaluate dietary supplement use in disabled athletes, their motivation for consuming supplements, sources of information, and their side effect. Methods: A total of 75 Turkish National Team's disabled athletes (38 female, 37 male) from 5 sport branches (soccer, weight lifting, shooting, table tennis and basketball), aged 13- 55 years, were participated in the study. Nutritional supplement usage was inquired using a questionnaire by a dietitian at their preparation camps. Results: A total of 22.7% of the athletes (18.4% and 27% of, respectively females and males) used some type of dietary supplements. Protein (35.3%), amino acid (29.4%), carnitine (29.4%), creatine (23.5%) and glucosamine (23.5%) were mostly preferred nutritional supplements by all athletes. The most common supplements use was obtained among weightlifters (71.4%), followed by the athletes of soccer (23.5%), table tennis (15.4%), and basketball (6.7%). No nutritional supplement usage was observed among shooters. Total of 41.2% consumers declared more than one reason for taking nutritional supplements. The main motivation for supplement usage was improving athletic performance (63.5%). Other reasons were weight loss, weight gain, muscle development, health protection and nutritional support. Athletes were more likely to get recommendation about nutritional supplement usage from team coaches (48.9%). Of 35.6% athletes reported that they made their own decision about using supplements. Other information sources were health professional, family member, friend and sale manager of sport retail store. Only 3 of 17 athletes reported side effects which were increased urine output, weight gain, loss of appetite and intestinal gas. Conclusions: Nutritional supplement usage was not common among disabled athletes. However, getting information from incompetent sources is disquieting. Considering their health problems, accurate information from competent sources should be provided to disabled athletes. Moreover, long term effects of nutritional supplements among disabled athletes should be examined in further studies.

Keywords: disabled athletes, ergogenic aid, nutritional supplement, vitamin supplementation

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Authors: Komal Rathore, Aydin Sunol, Gita Iranipour, Luke Mulford

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Advanced wastewater treatment plants have complex biological kinetics, time variant influent flow rates and long processing times. Due to these factors, the modeling and operational control of advanced wastewater treatment plants become complicated. However, development of a robust model for advanced wastewater treatment plants has become necessary in order to increase the efficiency of the plants, reduce energy costs and meet the discharge limits set by the government. A dynamic model was designed using the Envirosim (Canada) platform software called BioWin for several wastewater treatment plants in Hillsborough County, Florida. Proper control strategies for various parameters such as mixed liquor suspended solids, recycle activated sludge and waste activated sludge were developed for models to match the plant performance. The models were tuned using both the influent and effluent data from the plant and their laboratories. The plant SCADA was used to predict the influent wastewater rates and concentration profiles as a function of time. The kinetic parameters were tuned based on sensitivity analysis and trial and error methods. The dynamic models were validated by using experimental data for influent and effluent parameters. The dissolved oxygen measurements were taken to validate the model by coupling them with Computational Fluid Dynamics (CFD) models. The Biowin models were able to exactly mimic the plant performance and predict effluent behavior for extended periods. The models are useful for plant engineers and operators as they can take decisions beforehand by predicting the plant performance with the use of BioWin models. One of the important findings from the model was the effects of recycle and wastage ratios on the mixed liquor suspended solids. The model was also useful in determining the significant kinetic parameters for biological wastewater treatment systems.

Keywords: BioWin, kinetic modeling, flowsheet simulation, dynamic modeling

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Authors: Naomi Huang Wenya, Xin Xiaohui, Vijaya Rao, Wong Ting Hway, Chow Kah Hoe Pierce, Tan Hiang Khoon

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Background: The majority of the cancelled elective surgeries caused by the COVID-19 pandemic globally were estimated to occur in low- and middle-income countries (LMICs), where surgical services had long been in short supply even before the pandemic. Therefore, minimising disruption to existing surgical care in LMICs is of crucial importance during a pandemic. This study aimed to explore contributory factors to the continuity of surgical care in LMICs, in the face of a pandemic. Methods: Semi-structured interviews were conducted over zoom, with surgical leaders of 25 tertiary hospitals from 11 LMICs in South and Southeast Asia, from September to October 2020. Key themes were subsequently identified from the interview transcripts, using Braun and Clarke's method of thematic analysis. Results: The COVID-19 pandemic affected all surgical services of participating institutions but to varying degrees. Overall, elective surgeries suffered the gravest disruption, followed by outpatient surgical care, and finally, emergency surgeries. Keeping healthcare workers safe and striving for continuity of essential surgical care emerged as notable response strategies observed across all participating institutions. Conclusion: This study suggested that four factors are important for the resilience of surgical care against COVID-19: adequate COVID-19 testing capacity and effective institutional infection control measures, designated COVID-19 treatment facilities, a whole-system approach to balancing pandemic response and meeting essential surgical needs, and active community engagement. These findings can inform healthcare institutions in other countries, especially LMICs, in their effort to tread a fine line between preserving healthcare capacity for pandemic response and protecting surgical services against pandemic disruption.

Keywords: COVID-19, pandemic, LMICs, continuity of surgical service

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Authors: Kalimah Ibrahiim, Israa Elmousa

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This study employed the world café method alongside semi-structured interviews within a 'conversation café' setting to engage stakeholders from the public health and primary care sectors. The objective was to collaboratively explore strategies to improve outcomes for young people not in education, employment, or training (NEET). The discussions were aimed at identifying the underlying causes of disparities faced by NEET individuals, exchanging experiences, and formulating community-driven solutions to bolster preventive efforts and shape policy initiatives. A thematic analysis of the qualitative data gathered emphasized the importance of community problem-solving through the exchange of ideas and reflective discussions. Healthcare professionals reflected on their potential roles, pinpointing a significant gap in understanding the specific needs of the NEET population and the unclear distribution of responsibilities among stakeholders. The results underscore the necessity for a unified approach in primary care and the fostering of multi-agency collaborations that focus on addressing social determinants of health. Such strategies are critical not only for the immediate improvement of health outcomes for NEET individuals but also for informing broader policy decisions that can have long-term benefits. Further research is ongoing, delving deeper into the unique challenges faced by this demographic and striving to develop more effective interventions. The study advocates for continued efforts to integrate insights from various sectors to create a more holistic and effective response to the needs of the NEET population, ensuring that future strategies are informed by a comprehensive understanding of their circumstances and challenges.

Keywords: multi-agency working, primary care, public health, social inequalities

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