Search results for: advance care planning

Authors: Joyce Fernandez

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This study examined the effects of critical incident stress debriefing and other related interventions on the psychological recovery of earthquake survivors. It is a mixed experimental and qualitative study using post-test only control group design and focus group discussion. After the conduct of critical incident stress debriefing activities and other related interventions in the form of counseling and psychiatric treatment to the survivors of a 6.9 magnitude earthquake, a post-test measuring the level of psychological recovery was given to randomized participants categorized as intervention and control groups. Using the traumatic assessment and belief scale as instrument for the quantitative aspect in order to gauge recovery in the psychological need areas of safety, trust, esteem, intimacy and control, the findings are the following: Intervention group participants have relatively better adjustment along the five psychological need areas compared to the control group participants; there is no significant difference in the psychological recovery among female and male participants of the invention and control groups and; there are significant differences between intervention and control groups in the psychological need areas of self-safety, self-trust, other-trust, self-esteem, and self-intimacy. Using a guided interview for the qualitative data, the themes derived are the following. Safety: The world is an unsafe place to live because of the calamities. Trust: Trust and dependence are anchored on the family. Esteem: Participants are having confused self-worth. Intimacy: Participants are thriving on attachment with their family. Control: Participants have unaltered desire to help but feeling restricted because of personal and logistical concerns.As an outcome of the study a Psychosocial Care Program for Individuals, Families and Communities Affected by Disaster and Trauma was proposed.

Keywords: critical incident stress debriefing, earthquake survivors, psychological recovery, related interventions

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Authors: Shahan Waheed, Muhammad Waqas, Asher Feroz

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Objectives: To determine the utility of base deficit in traumatic brain injury in assessing the severity and to correlate with the conventional computed tomography scales in grading the severity of head injury. Methodology: Observational cross-sectional study conducted in a tertiary care facility from 1st January 2010 to 31st December 2012. All patients with isolated traumatic brain injury presenting within 24 hours of the injury to the emergency department were included in the study. Initial Glasgow Coma Scale and base deficit values were taken at presentation, the patients were followed during their hospital stay and CT scan brain findings were recorded and graded as per the Rotterdam scale, the findings were cross-checked by a radiologist, Glasgow Outcome Scale was taken on last follow up. Outcomes were dichotomized into favorable and unfavorable outcomes. Continuous variables with normal and non-normal distributions are reported as mean ± SD. Categorical variables are presented as frequencies and percentages. Relationship of the base deficit with GCS, GOS, CT scan brain and length of stay was calculated using Spearman`s correlation. Results: 154 patients were enrolled in the study. Mean age of the patients were 30 years and 137 were males. The severity of brain injuries as per the GCS was 34 moderate and 109 severe respectively. 34 percent of the total has an unfavorable outcome with a mean of 18±14. The correlation was significant at the 0.01 level with GCS on presentation and the base deficit 0.004. The correlation was not significant between the Rotterdam CT scan brain findings, length of stay and the base deficit. Conclusion: The base deficit was found to be a good predictor of severity of brain injury. There was no association of the severity of injuries on the CT scan brain as per the Rotterdam scale and the base deficit. Further studies with large sample size are needed to further evaluate the associations.

Keywords: base deficit, traumatic brain injury, Rotterdam, GCS

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Authors: Halimatu S. Abdullahi, Ray E. Sheriff, Fatima Mahieddine

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Agriculture is essential to the continuous existence of human life as they directly depend on it for the production of food. The exponential rise in population calls for a rapid increase in food with the application of technology to reduce the laborious work and maximize production. Technology can aid/improve agriculture in several ways through pre-planning and post-harvest by the use of computer vision technology through image processing to determine the soil nutrient composition, right amount, right time, right place application of farm input resources like fertilizers, herbicides, water, weed detection, early detection of pest and diseases etc. This is precision agriculture which is thought to be solution required to achieve our goals. There has been significant improvement in the area of image processing and data processing which has being a major challenge. A database of images is collected through remote sensing, analyzed and a model is developed to determine the right treatment plans for different crop types and different regions. Features of images from vegetations need to be extracted, classified, segmented and finally fed into the model. Different techniques have been applied to the processes from the use of neural network, support vector machine, fuzzy logic approach and recently, the most effective approach generating excellent results using the deep learning approach of convolution neural network for image classifications. Deep Convolution neural network is used to determine soil nutrients required in a plantation for maximum production. The experimental results on the developed model yielded results with an average accuracy of 99.58%.

Keywords: convolution, feature extraction, image analysis, validation, precision agriculture

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Authors: Mercy Okezue, Kari Clase, Stephen Byrn, Paddy Shivanand

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Medicines regulatory authorities expect pharmaceutical companies and contract research organizations to seek ways to certify that their laboratory control measurements are reliable. Establishing and maintaining laboratory quality standards are essential in ensuring the accuracy of test results. ‘ISO/IEC 17025:2017’ and ‘WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL)’ are two quality standards commonly employed in developing laboratory quality systems. A review was conducted on the two standards to elaborate on areas on convergence and divergence. The goal was to understand how differences in each standard's requirements may influence laboratories' choices as to which document is easier to adopt for quality systems. A qualitative review method compared similar items in the two standards while mapping out areas where there were specific differences in the requirements of the two documents. The review also provided a detailed description of the clauses and parts covering management and technical requirements in these laboratory standards. The review showed that both documents share requirements for over ten critical areas covering objectives, infrastructure, management systems, and laboratory processes. There were, however, differences in standard expectations where GPPQCL emphasizes system procedures for planning and future budgets that will ensure continuity. Conversely, ISO 17025 was more focused on the risk management approach to establish laboratory quality systems. Elements in the two documents form common standard requirements to assure the validity of laboratory test results that promote mutual recognition. The ISO standard currently has more global patronage than GPPQCL.

Keywords: ISO/IEC 17025:2017, laboratory standards, quality control, WHO GPPQCL

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Authors: Dan Han, Yukun Zhang, Jie Zheng, Rui Zhang

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Making full use of space along transportation infrastructure to develop renewable energy sources, especially solar energy resources, has become a research focus in relevant fields. In recent years, relevant international researches can be classified into three stages of theoretical and technical exploration, exploratory practice as well as planning implementation. Compared with traditional solar energy development mode, the development of solar energy resources in places along the transportation infrastructure has special advantages, which can also bring forth new opportunities for the development of green transportation. 'Road Integrated Photovoltaic', a development model of combining transport and new energy, has been actively studied and applied in developed countries, but it was still in its infancy in China. 'New Silk Road Economic Belt' has great advantage to carry out the 'Road Integrated Photovoltaic' because of the rich solar energy resources in its path, the shortages of renewable energy, the constraints of agricultural land and other reasons. Especially the massive amount of construction of transportation infrastructure brought by Silk Road Economic Belt, large area of developable land along the transportation line will be generated. Abundant solar energy recourses along the Silk Road will provide extremely superb practical opportunities to the land development along transportation infrastructure. We take PVsyst, GIS and Google map software for simulation of its potential by taking Lan-Xin Railway as an example, so potential electrical energy generation can be quantified and further analyzed. Research of 'New Silk Road Economic Belt' combined with 'Road Integrated Photovoltaic' is a creative development for the along transport and energy infrastructure. It not only can make full use of solar radiation and land in its path, but also bring more long-term advantages and benefits.

Keywords: land use, silk road economic belt, solar energy, transportation infrastructure

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Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

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Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

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Authors: Abeer K. Jameel, Harry Evdorides

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Iraq is a middle income country where the road safety issue is considered one of the leading causes of deaths. To control the road risk issue, the Iraqi Ministry of Planning, General Statistical Organization started to organise a collection system of traffic accidents data with details related to their causes and severity. These data are published as an annual report. In this paper, a review of the available crash data in Iraq will be presented. The available data represent the rate of accidents in aggregated level and classified according to their types, road users’ details, and crash severity, type of vehicles, causes and number of causalities. The review is according to the types of models used in road safety studies and research, and according to the required road safety data in the road constructions tasks. The available data are also compared with the road safety dataset published in the United Kingdom as an example of developed country. It is concluded that the data in Iraq are suitable for descriptive and exploratory models, aggregated level comparison analysis, and evaluation and monitoring the progress of the overall traffic safety performance. However, important traffic safety studies require disaggregated level of data and details related to the factors of the likelihood of traffic crashes. Some studies require spatial geographic details such as the location of the accidents which is essential in ranking the roads according to their level of safety, and name the most dangerous roads in Iraq which requires tactic plan to control this issue. Global Road safety agencies interested in solve this problem in low and middle-income countries have designed road safety assessment methodologies which are basing on the road attributes data only. Therefore, in this research it is recommended to use one of these methodologies.

Keywords: road safety, Iraq, crash data, road risk assessment, The International Road Assessment Program (iRAP)

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Authors: Maria C. Proença, Maria T. Rebelo, Marília Antunes, Maria J. Alves, Hugo Osório, Sofia Cunha, João Casaca

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Using a geographic information system (GIS), the relations between a georeferenced data set of Culex pipiens sl. mosquitoes collected in Portugal mainland during seven years (2006-2012) and meteorological and physiographic parameters such as: air relative humidity, air temperature (minima, maxima and mean daily temperatures), daily total rainfall, altitude, land use/land cover and proximity to water bodies are evaluated. Focus is on the mosquito females; the characterization of its habitat is the key for the planning of chirurgical non-aggressive prophylactic countermeasures to avoid ambient degradation. The GIS allow for the spatial determination of the zones were the mosquito mean captures has been above average; using the meteorological values at these coordinates, the limits of each parameter are identified/computed. The meteorological parameters measured at the net of weather stations all over the country are averaged by month and interpolated to produce raster maps that can be segmented according to the thresholds obtained for each parameter. The intersection of the maps obtained for each month show the evolution of the area favorable to the species through the mosquito season, which is from May to October at these latitudes. In parallel, mean and above average captures were related to the physiographic parameters. Three levels of risk could be identified for each parameter, using above average captures as an index. The results were applied to the suitability meteorological maps of each month. The Culex pipiens critical niche is delimited, reflecting the critical areas and the level of risk for transmission of the pathogens to which they are competent vectors (West Nile virus, iridoviruses, rheoviruses and parvoviruses).

Keywords: Culex pipiens, ecological niche, risk assessment, risk management

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Authors: Manuel I. Capel, Antonio Tomeu, Alberto Salguero

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Tumor growth from a transformed cancer-cell up to a clinically apparent mass spans through a range of spatial and temporal magnitudes. Through computer simulations, Cellular Automata (CA) can accurately describe the complexity of the development of tumors. Tumor development prognosis can now be made -without making patients undergo through annoying medical examinations or painful invasive procedures- if we develop appropriate CA-based software tools. In silico testing mainly refers to Computational Biology research studies of application to clinical actions in Medicine. To establish sound computer-based models of cellular behavior, certainly reduces costs and saves precious time with respect to carrying out experiments in vitro at labs or in vivo with living cells and organisms. These aim to produce scientifically relevant results compared to traditional in vitro testing, which is slow, expensive, and does not generally have acceptable reproducibility under the same conditions. For speeding up computer simulations of cellular models, specific literature shows recent proposals based on the CA approach that include advanced techniques, such the clever use of supporting efficient data structures when modeling with deterministic stochastic cellular automata. Multiparadigm and multiscale simulation of tumor dynamics is just beginning to be developed by the concerned research community. The use of stochastic cellular automata (SCA), whose parallel programming implementations are open to yield a high computational performance, are of much interest to be explored up to their computational limits. There have been some approaches based on optimizations to advance in multiparadigm models of tumor growth, which mainly pursuit to improve performance of these models through efficient memory accesses guarantee, or considering the dynamic evolution of the memory space (grids, trees,…) that holds crucial data in simulations. In our opinion, the different optimizations mentioned above are not decisive enough to achieve the high performance computing power that cell-behavior simulation programs actually need. The possibility of using multicore and GPU parallelism as a promising multiplatform and framework to develop new programming techniques to speed-up the computation time of simulations is just starting to be explored in the few last years. This paper presents a model that incorporates parallel processing, identifying the synchronization necessary for speeding up tumor growth simulations implemented in Java and C++ programming environments. The speed up improvement that specific parallel syntactic constructs, such as executors (thread pools) in Java, are studied. The new tumor growth parallel model is proved using implementations with Java and C++ languages on two different platforms: chipset Intel core i-X and a HPC cluster of processors at our university. The parallelization of Polesczuk and Enderling model (normally used by researchers in mathematical oncology) proposed here is analyzed with respect to performance gain. We intend to apply the model and overall parallelization technique presented here to solid tumors of specific affiliation such as prostate, breast, or colon. Our final objective is to set up a multiparadigm model capable of modelling angiogenesis, or the growth inhibition induced by chemotaxis, as well as the effect of therapies based on the presence of cytotoxic/cytostatic drugs.

Keywords: cellular automaton, tumor growth model, simulation, multicore and manycore programming, parallel programming, high performance computing, speed up

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Authors: Ramin Mirzada, Takuya Maruyama

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Kabul is the heart of political, commercial, cultural, educational and social life in Afghanistan and the fifth fastest growing city in the world. Minimum income inclined most of Kabul residents to use public transport, especially buses, although there is no proper bus system, beside that there is no proper fare exist in Kabul city Due to wars. From 1992 to 2001 during civil wars, Kabul suffered damage and destruction of its transportation facilities including pavements, sidewalks, traffic circles, drainage systems, traffic signs and signals, trolleybuses and almost all of the public transport system (e.g. Millie bus). This research is mainly focused on Kabul city’s transportation system. In this research, the data used have been gathered by Japan International Cooperation Agency (JICA) in 2008 and this data will be used to find demand and fare structure, additionally a survey was done in 2016 to find satisfaction level of Kabul residents for fare structure. Aim of this research is to observe the demand for Large Buses, compare to the actual supply from the government, analyze the current fare structure and compare it with the proposed fare (distance based fare) structure which has already been analyzed. Outcome of this research shows that the demand of Kabul city residents for the public transport (Large Buses) exceeds from the current supply, so that current public transportation (Large Buses) is not sufficient to serve public transport in Kabul city, worth to be mentioned, that in order to overcome this problem, there is no need to build new roads or exclusive way for buses. This research proposes government to change the fare from fixed fare to distance based fare, invest on public transportation and increase the number of large buses so that the current demand for public transport is met.

Keywords: transportation, planning, public transport, large buses, Kabul, Afghanistan

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Authors: Pilly Joseph Kagosi

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The study aims at assessing challenges observed during implementation of participatory irrigation management (PIM) approach for food security in semi-arid areas of Tanzania. Data were collected through questionnaire, PRA tools, key informants discussion, Focus Group Discussion (FGD), participant observation and literature review. Data collected from questionnaire was analyzed using SPSS while PRA data was analyzed with the help of local communities during PRA exercise. Data from other methods were analyzed using content analysis. The study revealed that PIM approach has contribution in improved food security at household level due to involvement of communities in water management activities and decision making which enhanced availability of water for irrigation and increased crop production. However there were challenges observed during implementation of the approach including; minimum participation of beneficiaries in decision making during planning and designing stages, meaning inadequate devolution of power among scheme owners; Inadequate and lack of transparency on income expenditure in Water Utilization Associations’ (WUAs), water conflict among WUAs members, conflict between farmers and livestock keepers and conflict between WUAs leaders and village government regarding training opportunities and status; WUAs rules and regulation are not legally recognized by the National court and few farmers involved in planting trees around water sources. However it was realized that some of the mentioned challenges were rectified by farmers themselves facilitated by government officials. The study recommends that, the identified challenges need to be rectified for farmers to realize impotence of PIM approach as it was realized by other Asian countries.

Keywords: potentials of implementing participatory approach, challenges of participatory approach, irrigation management, Tanzania

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Authors: Himanshu Rohela

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BACKGROUND: Ewing sarcoma can arise in either bone or soft tissue. Extraskeletal Ewing sarcoma (EES) is an uncommon primary tumor of the soft tissues, accounting for 20 30% of all reported cases of ES. AIM: Was to investigate demographic distribution, survival analysis and factors affecting the survival and recurrence in patients of EES. METHODS: Retrospective study of 19 biopsy-proven EES was performed. Overall survival (OS) using log-rank test and factors affecting OS and local recurrence (LR) were evaluated for the entire cohort. RESULTS: Patients with EES had a mean age of 19.5 and it was more commonly seen in males (63%). Axial location (58%) and solitary presentation (84%) were more common. The average size was 11 cm, 3 of 19 were metastatic at presentation, with the lung beings the most common site for metastasis. 17 received NACT, 16 with VAC-IE regimen and 1 underwent a second line with GEM/DOCE regimen. Unplanned surgery was done in 2 of 19. 3 patients received definitive RT and 13 underwent surgical-wide local excision. 2 of 13 showed good response to NACT. 10 patients required readmission out of which 6 patients had chemotherapy-related complications, 2 had surgical site complications and one patient developed secondary AML post-completion of treatment. A total of 4 patients had a recurrence. One had local recurrence alone, one had distant recurrence alone and 2 patients had a distant and local recurrence both. Tumor size >10 cm, axial location, and previous unplanned surgery was associated with higher LR rate. The mean overall survival was 32 months (2.66 years), with higher rates seen in non-metastatic and non-recurrent settings. CONCLUSIONS: Early and accurate diagnosis is the key to the management of EES, with promising results seen via NACT and RO resection regimens. But further studies with larger study groups are needed to standardize the treatment protocol and evaluate its efficacy.

Keywords: Ewings, sarcoma, extraskeletal, chemotherapy

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Authors: Fhulufhelo Ramukhithi, Kgothatso Masethe, Tlou Chokoe, Ayanda Maqhashu, Julius Sebei, Tshililo Raphulu, Joseph Mugwabana

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Phenotypic characterisation ensures that the physical appearance of an animal is well documented. The information provided by this phenotypic characterisation study is important for planning management and the use of animal genetic resources. The aim of this study was to characterise the phenotypic characteristics of Bapedi sheep. Bapedi sheep are at risk of extinction like most of the indigenous breeds. As a result, a total of 196 Bapedi ewes and 35 rams were used. Phenotypic-qualitative characteristics were evaluated through visual appraisal. Phenotypic-quantitative characteristics such as body parts measurements were obtained using a flexible tape (cm), while body weight were obtained by using a weighing scale (kg). Bapedi rams (97 %) had higher satisfactory body condition when compared to ewes (75 %). A higher proportion of Bapedi sheep that did not have ticks observed (ewes = 87 % and rams = 91 %). Brown and white colour combination (head x body) was dominating in Bapedi sheep (80 % ewes and 91 % rams). Bapedi ewes did not have any horns; however, 3 % of rams had them. Bapedi sheep had a higher proportion of brown eyes, moderate neck, stiff sideways ears and normal front legs. Bapedi rams had a higher proportion of well-balanced and good attached testicles. Bapedi ewes had average (45 %), small (40 %) and big udders (15 %). Bapedi rams had a significantly higher body weight, height, depth, hearth girth circumference, rump width, hind leg width and length compared to ewes. However, both Bapedi rams and ewes had similar age, body condition score, tail length, length below hock and knee. In conclusion, Bapedi sheep had a higher satisfactory body condition and brown and white colour combination. Some of Bapedi rams’ quantitative characteristics were higher compared to ewes.

Keywords: extinction, indigenous, phenotypic, smallstock

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Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

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Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

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Authors: Wichai Srisud, Shunnawat Pungbangkradee, Sukanya Chaemchoy

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This research study aims to analyze and assess school management guidelines designed to enhance the level of Student School Engagement of students at Bangkok Christian College, according to three following primary objectives: 1) to evaluate the level of Student School Engagement among Bangkok Christian College students, 2) to examine the Priority Needs Index of school management for promoting an optimum level of Student School Engagement among Bangkok Christian College students, and 3) to develop additional guidelines for school management to further enhance the level of Student School Engagement of Bangkok Christian College students. The research was conducted using Explanatory Design research methodology, with data obtained from a sample comprised of 291 students and 6 administrative personnel. The research findings indicated that: 1) The overall level of Student School Engagement was high. Emotional engagement averaged at the highest level, followed by Behavioral Engagement and Cognitive Engagement, respectively. 2) The Priority Needs Index of school management for promoting Student School Engagement of Bangkok Christian College students was examined, revealing that Evaluation averaged at the highest PNI level, followed by Planning and Implementation, respectively. 3) Guidelines for school management to enhance Student School Engagement of Bangkok Christian College students should consist of four approaches: 3.1) A Cognitive Engagement Enhancing Approach, which must include (1) fostering students’ problem-solving flexibility, and their ability to devise solutions for overcoming potential challenges, and (2) encouraging students to deal effectively with academic setbacks, rather than becoming overwhelmed by what they may perceive as failures, 3.2) An Emotional Engagement Enhancing Approach, cultivating students’ interests, aspirations and goals in learning to maximize emotional investment in their academic pursuits, and 3.3) A Behavioral Engagement Enhancing Approach, for elevating students’ focus and attentiveness during learning, and improving their ability to avoid distractions during study time.

Keywords: school engagement, guidelines for school management

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Authors: Omer Altaf, Liam Wotherspoon, Rolando Orense

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The Wairau Plains are located in the northeast of the South Island of New Zealand, with alluvial deposits of fine-grained silts and sands combined with low-lying topography suggesting the presence of liquefiable deposits over significant portions of the region. Liquefaction manifestations were observed in past earthquakes, including the 1848 Marlborough and 1855 Wairarapa earthquakes, and more recently during the 2013 Lake Grassmere and 2016 Kaikōura earthquakes. Therefore, a good understanding of the deposits that may be susceptible to liquefaction is important for land use planning in the region and to allow developers and asset owners to appropriately address their risk. For this purpose, multiple approaches have been employed to develop regional-scale maps showing the liquefaction vulnerability categories for the region. After applying semi-qualitative criteria linked to geologic age and deposit type, the higher resolution surface mapping of geomorphologic characteristics encompassing the Wairau River and the Opaoa River was used for screening. A detailed basin geologic model developed for groundwater modelling was analysed to provide a higher level of resolution than the surface-geology based classification. This is used to identify the thickness of near-surface gravel deposits, providing an improved understanding of the presence or lack of potentially non-liquefiable crust deposits. This paper describes the methodology adopted for this project and focuses on the influence of geomorphic characteristics and analysis of the detailed geologic basin model on the liquefaction classification of the Lower Wairau Plains.

Keywords: liquefaction, earthquake, cone penetration test, mapping, liquefaction-induced damage

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Authors: Alex Knighton, Roba Khundkar, Michael Dunn

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Neo-colonialism is defined as the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies, and concerns have been raised about its presence in surgical missions. Surgical missions aim to rectify the huge disparity in surgical access worldwide, but their ethics must be carefully considered. This is especially in light of colonial history which affects international relations and global health today, to ensure that colonial attitudes are not influencing efforts to promote equity. This review examines the history of colonial global health, demonstrating that global health initiatives have consistently been used to benefit those providing them, and then asks whether elements of colonialism are still pervasive in surgical missions today. Data was collected from the literature using specified search terms and snowball searching, as well as from international expert web-based conferences on global surgery ethics. A thematic analysis was then conducted on this data, resulting in the identification of six themes which are identifiable in both past and present global health initiatives. These six themes are power, lack of understanding or respect, feelings of superiority, exploitation, enabling of dependency, and acceptance of poorer standards of care. An ethical analysis follows, concluding that the concerns of power and neo-colonialism in global surgery would be addressed by adopting a framework of procedural justice that promotes a refined governance process in which stakeholders are able to propose and reject decisions that affect them. The paper argues that adopting this model would address concerns of the power disparity in the field directly, as well as promoting an ethical framework to enable the other concerns of power disparity and neo-colonialism identified in the present analysis to be addressed.

Keywords: medical ethics, global surgery, global health, neocolonialism, surgical missions

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Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

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Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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Authors: Bahago I. N., Oyewole O. E.

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Nigeria has the second highest prevalence of intestinal worms globally, which has not declined since the 1970s, especially in rural communities. Identifying the gaps in self-care practice will pave a way for a suitable intervention. This study investigated the knowledge, perception, and practice of deworming among mothers of under-five children in rural communities of Lafia Local Government Area, Nasarawa State. This study was descriptive cross-sectional and involved 419 mothers selected by systematic sampling technique. Information was obtained using a valid interviewer-questionnaire. Knowledge, perception, and practice was measured using a 10-point scale for each variable, respectively. Scores of 0-4, >4-6, and >6 were categorised as poor, average/fair, and good, respectively, at p<0.05 level of significance. Respondents’ age was 30.3±9.2 years; 46.5% were into trading, 26.7% were unemployed, 9.3% were skilled labour, and 7.4% were farmers. On literacy, secondary school (25.5%) while 9.1% above secondary school. Many (51.1%) had 2-3 children, while 42.2% had 5 or more children. Most of the respondents (96.2%) had good knowledge of deworming, and 3.8% had fair knowledge. Using multivariate model, Mothers between the ages of 25-34 years were 20 times likely to be more knowledgeable, given they have access to health information (O.R 2.39 -164.31). Most (62.3%) had good perception scores, 33.2% had fair scores, while 4.5% had poor perception scores. Majority (66.4%) had a good deworming practice of deworming, 66.4% had good, 28.4% had fair, and 5.3% had poor practice. The test of association between Parent's literacy level, religion, and age were significantly associated with the level of knowledge of deworming. Knowledge of deworming was above average; perception and practice was good. Women of ages 25-34 years could be trained as community volunteers to propagate the right information about deworming in rural communities, especially among young women of ages 13-19 years. Preferred channels to obtaining health information identified in the study should be explored.

Keywords: deworming, mothers of under-five, intestinal worms, rural communities

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Authors: Olga Plaza, Katarzyna Kosinska-Kaczynska, Stepan Feduniw, Dominika Pazdzior, Kinga Zebrowska, Katarzyna Kwiatkowska

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Introduction: The main causes of depression among pregnant women remain unclear. However, it is clear that pregnancy carries a higher risk of depression occurrence. Left untreated, prenatal depression can be a cause of serious both maternal and neonatal complications. Aim of the study: The aim of the study was to define potential risk factors of prenatal depression and to assess the frequency of its occurrence among pregnant women. Material and Methods: A prospective cross-sectional study was performed among 346 women. The self- composed questionnaire consisting of 46 questions, was distributed via the Internet between November 2017 and March 2018. The questionnaire contained the Edinburgh Postnatal Depression Scale (EPDS), in which the results of 13 and more points (out of 30) suggested possible prenatal depression. Statistical analysis was performed with Chi2 Pearson. P value < 0.05 was considered significant. Results: 37.57% (n=130) of women had a score of 13 or more points. Women with depressive symptoms (DS) reported lack of support from the partner (46.9% vs. 16.2%; p < 0.001) as well as other family members (40.8% vs. 14.4%; p < 0.001), current pregnancy being unplanned (21.5% vs. 12.5%; p=0.014) and low socio-economic status (10% vs. 0.9%; p < 0.001). Both early and advanced maternal age seemed to play a role in occurrence of DS: in women aged 17-24 40.8% declared symptoms (vs 28.7%; p < 0.01), in mothers aged ≥37 6.2% did (vs 0.5%; p < 0.001). Smoking during pregnancy was also more frequent among patients with DS (31.5% vs. 18.1%; p=0.004). Previous diagnosis of depression or other mood disorders significantly increased a chance of DS occurrence (respectively- 17.7% vs. 4.6%; p < 0.001 and 49.2% vs. 25%; p<0.001). Parental diagnosis of mood disorders and other mental disorders was also more frequent in this group of patients (respectively- 24.6% vs. 15.7%; p= 0.026 and 26.4% vs. 9.7%; p < 0.001). Only 23.8% of women with DS sought help from healthcare professionals, with 21.5% receiving pharmacological treatment. Conclusions: Pregnant women often report having DS. Evaluation of risk factors of DS and possible prenatal depression is essential in proper screening for depression among pregnant women.

Keywords: obstetrics, polish women, prenatal care, prenatal depression, risk factors

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Authors: Zahra Soltani Shal

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Introduction: The COVID-19 pandemic marks an extraordinary global public health crisis unseen in the last century, with its rapid spread worldwide and associated mortality burden. Healthcare resilience during a pandemic is crucial not only for continuous and safe patients care but also for control of any outbreak. Aim: The present study was conducted to discover the organizational variables effective in increasing resilience and continuing the work of nurses in critical and stressful pandemic conditions. Method: The study population is nurses working in hospitals for patients with coronavirus. Sampling was done purposefully and information was collected from 15 nurses through In-depth semi-structured interviews. The interview was conducted to analyze the data using the framework analysis method consisting of five steps and is classified in the table. Results: According to the findings through semi-structural interviews, among organizational variables, organizational commitment (Affective commitment, continuous commitment, normative commitment) has played a prominent role in nurses' resilience. Discussion: despite the non-withdrawal of nurses and their resilience, due to the negative quality of their working life, the mentioned variable has affected their level of performance and ability and leads to fatigue and physical and mental exhaustion. Implications for practice: By equipping hospitals and improving the facilities of nurses, their organizational commitment can be increased and lead to their resilience in critical situations. Supervisors and senior officials at the hospitals should be responsible for nurses' health and safety. A clear and codified program in critical situations and comprehensive management is effective in improving the quality of the work-life of nurses. Creating an empathetic and interactive environment can help promote nurses' mental health.

Keywords: organizational commitment, quality of work life, nurses resilience, pandemic, coronavirus

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Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Pedro Henrique Tertuliano Leoni, Carla Aparecida Arena Ventura, Ana Cristina de Oliveira e Silva, Renata Karina Reis

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Context and significance: Resilience is a protective agent for the physical and mental well-being of nursing professionals. Team members are constantly subjected to high levels of work stress that can negatively impact care performance and users of health services. Stress levels have been exacerbated with the COVID-19 pandemic. Objective: The aim of this study was to analyze the resilience of nursing professionals in Brazil during the COVID-19 pandemic. Method: Cross-sectional study with a quantitative approach carried out with professionals from nursing teams from all regions of Brazil. Data collection took place in the first year of the pandemic between October and December 2020. Data were obtained through an online questionnaire posted on social networks. The information collected included the sociodemographic characterization of the nursing professionals and the Brief Resilient Coping Scale was applied. Student's t-test for independent samples and analysis of variance (ANOVA) were used to compare resilience scores with sociodemographic variables. Results: 8,792 nursing professionals participated in the study, 5,767 (65.6%) were nurses, 7,437 (84.6%) were female and 2,643 (30.1%) were from the Northeast region of Brazil, 5,124 (58.8% ) had low levels of resilience. The results showed a statistically significant difference between the resilience score and the variables: professional category (p<0.001); sex (p = 0.003); age range (p<0.001); region of Brazil (p<0.001); marital status (p=0.029) and providing assistance in a field hospital (p<0.001). Conclusion: Participants in this study had, in general, low levels of resilience. There is an urgent need for actions aimed at promoting the psychological health of nursing professionals inserted in pandemic contexts. Descriptors: Psychological Resilience; Nursing professionals; COVID-19; SARSCoV-2.

Keywords: psychological resilience, nursing professionals, COVID-19, SARS-CoV-2

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Authors: Charlotte Lülf

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Migration flows, resulting from war, climate change or economic crisis cannot be tackled by single states but need to be addressed as a transnational and international responsibility. The traditional architecture surrounding the work of the UNHCR and the 1951 Convention, however, is not equipped to deal with these challenges. Widely excluded from legal protection are people not individually persecuted for the statutory criteria, people that flee from the indiscriminate effects of an armed conflict as well as people fleeing natural disasters. With the lack of explicit legal protection and the political reluctance of nation states worldwide to extend their commitment in new asylum laws, the judiciary must be put in focus: it plays a unique role in interpreting and potentially expanding the application of existing regulations. This paper as part of an ongoing Ph.D. Project deals with the current and partly contradicting approaches to the protection of war- and climate refugees. Changing jurisprudential practice of national and regional courts will be assessed, as will be their dialogue to interpret the international obligations of human rights law, migration laws, and asylum laws in an interacting world. In recent judgments refoulment to an armed conflict as well as countries without adequate disaster relief or health care was argued as violating fundamental human and asylum law rights and therefore prohibited – even for applicants without refugee status: The first step towards access to subsidiary protection could herewith be established. Can one observe similar developments in other parts of the world? This paper will evaluate the role of the judiciary to define, redefine and potentially expand protection for people seeking refuge from armed conflicts and natural disasters.

Keywords: human rights law, asylum-seekers, displacement, migration

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Authors: Kalpeshkumar L. Gupta, Shivali Rathore

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India is home to over 30 crore rural poor, aware of the criticality of the situation that has made to come with an innovative business idea. Entrepreneurship in India is on the verge of explosive growth and which is actually need of an hour for employment generation, poverty elevation at grass root through developmental intervention. India economic progress has started from the development of its small and medium scale enterprises to ensure that the sectors continues to stay competitive and achieve sustained growth in the era of global economy many incubators centers has been established with the mission to give the encouragement to many innovative ideas. If we define an Incubator, it is simply an enclosed apparatus in which premature small babies are placed and which provides a controlled and protective environment for their care this gives them a chance to adjust to outside environment, and grow stronger before they face the outside world. In a similar way the startup entrepreneur’s business idea is incubated in the incubation centers. Entrepreneurship has been conventionally rated as risky career, to break the myth and to augment the supply of new entrepreneurs through education; research training the incubation centers has been established, their goal is to help create and grow young businesses by providing them with necessary support and financial and technical services. The startup companies spend on an average two years in a business incubator during which numerous benefits like funding, office space, equipment’s etc. is provided by the incubators to the startup business. Present paper will study the background, role, objectives of different incubators set up in Indian Institute of Management (IIMs) and Indian Institute of Technology (IITs) for our study.

Keywords: incubation centres, entrepreneurship, Indian Institute of Management, Indian Institute of Technology

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Authors: Jisong Ryu, Woosik Lee, Yonggu Jang

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The paper discusses the process of establishing a reliable test bed for verifying the usability of Ground Penetrating Radar (GPR) exploration equipment based on an integrated underground spatial map in Korea. The aim of this study is to construct a test bed consisting of metal and non-metal pipelines to verify the performance of GPR equipment and improve the accuracy of the underground spatial integrated map. The study involved the design and construction of a test bed for metal and non-metal pipe detecting tests. The test bed was built in the SOC Demonstration Research Center (Yeoncheon) of the Korea Institute of Civil Engineering and Building Technology, burying metal and non-metal pipelines up to a depth of 5m. The test bed was designed in both vehicle-type and cart-type GPR-mounted equipment. The study collected data through the construction of the test bed and conducting metal and non-metal pipe detecting tests. The study analyzed the reliability of GPR detecting results by comparing them with the basic drawings, such as the underground space integrated map. The study contributes to the improvement of GPR equipment performance evaluation and the accuracy of the underground spatial integrated map, which is essential for urban planning and construction. The study addressed the question of how to verify the usability of GPR exploration equipment based on an integrated underground spatial map and improve its performance. The study found that the test bed is reliable for verifying the performance of GPR exploration equipment and accurately detecting metal and non-metal pipelines using an integrated underground spatial map. The study concludes that the establishment of a test bed for verifying the usability of GPR exploration equipment based on an integrated underground spatial map is essential. The proposed Korean-style test bed can be used for the evaluation of GPR equipment performance and support the construction of a national non-metal pipeline exploration equipment performance evaluation center in Korea.

Keywords: Korea-style GPR testbed, GPR, metal pipe detecting, non-metal pipe detecting

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Authors: Anwaar Anwar Tayel

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Background: Rheumatic arthritis (RA) affect all aspects of patients' life, lead to various degrees of disability, and ultimately has a profound impact on the social, economic, psychological, and sexual aspects of the patient's life. Aim of the study: Identify physical, psychological, and sexual implications of rheumatoid arthritis among women in reproductive age. In addition to investigating the correlations between physical functional disability, psychological problems, and sexual dysfunction.Settings: The study was conducted at Rheumatology Clinic at the Main University Hospital of Alexandria. Subjects: Purposive sample was chosen from women patients with rheumatoid arthritis to be subjects of this study (n=250). Tools: Four tools were used to collect data. Tool I: Socio-demographic questionnaire. Tool II: Stanford Health Assessment Questionnaire Disability Index (HAQ- DI). Tool III: Depression Anxiety Stress Scale (DASS). Tool IV: The Sexual Dysfunction Questionnaire (SDQ) Results: The majority of the studied women suffer from severe physical disability, extreme level of depression, anxiety, and about half of them had an extreme level of stress. Also, the majority of the studied women had a severe level of sexual dysfunction. Also, statistically significant correlations between women's physical disability index, psychological problems, and sexual dysfunction were detected. Conclusion: The findings from this study confirm that women patients with RA suffer from multiple negative implications on the physical, psychological and sexual functions. Recommendations: Provide ongoing support to the patients from the time of diagnosis throughout their care and management. To help them to manage their pain and disabilities, improve their sexual function, promote their mental health, and optimize psychosocial functioning

Keywords: pysical, spycholgical, sexual, implication, rheumatic arthritis

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Authors: M. Mohan, J. P. Roise, G. P. Catts

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Despite living in an era where conservation zones are de-facto the central element in any sustainable wildlife management strategy, we still find ourselves grappling with several pareto-optimal situations regarding resource allocation and area distribution for the same. In this paper, a multi-objective decision making (MODM) model is presented to answer the question of whether or not we can establish mutual relationships between these contradicting objectives. For our study, we considered a Red-cockaded woodpecker (Picoides borealis) habitat conservation scenario in the coastal plain of North Carolina, USA. Red-cockaded woodpecker (RCW) is a non-migratory territorial bird that excavates cavities in living pine trees for roosting and nesting. The RCW groups nest in an aggregation of cavity trees called ‘cluster’ and for our model we use the number of clusters to be established as a measure of evaluating the size of conservation zone required. The case study is formulated as a linear programming problem and the objective function optimises the Red-cockaded woodpecker clusters, carbon retention rate, biofuel, public safety and Net Present Value (NPV) of the forest. We studied the variation of individual objectives with respect to the amount of area available and plotted a two dimensional dynamic graph after establishing interrelations between the objectives. We further explore the concept of interdependency by integrating the MODM model with GIS, and derive a raster file representing carbon distribution from the existing forest dataset. Model results demonstrate the applicability of interdependency from both linear and spatial perspectives, and suggest that this approach holds immense potential for enhancing environmental investment decision making in future.

Keywords: conservation, interdependency, multi-objective decision making, red-cockaded woodpecker

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Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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