Search results for: public hospital

Authors: S. Fata, M. A. Tokat, N. Bagardi, B. Yilmaz

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Nowadays, various traditional practices are used throughout the world with aim to improve fertility. Various traditional remedies, acupuncture, religious practices such as sacrifice are frequently used. Studies often evaluate the traditional practices used by the women. But the use of this non-medical practice by couples and specific application reasons of this methods has been less investigated. The aim of this study was to evaluate the common used non-medical practices and determine perceived benefits by couples with fertility problems in Turkey. This is a descriptive study. Research data were collected between May-July 2016, in Izmir Ege Birth Education and Research Hospital Assisted Reproduction Clinic, from 151 couples with fertility problem. Personal Information Form and Non-Medical Practices Used for Fertility Evaluation Form was used. Number 'GOA 2649' permission letter from Dokuz Eylul University Non-Invasive Research Ethics Board, permission letter from the institution and the written consent from participants has been received to carry out the study. In the evaluation of the data, frequencies and proportions analysis were used. The average age of women participating in the study was 32.87, the 35.8% were high school graduates, 60.3% were housewife and the 58.9% lived in city. The 30.5% of husbands were high school graduates, the 96.7% were employed and the 60.9% lived in city. The 78.1% of couples lived as a nuclear family, the average marriage year was 7.58, in 33.8% the fertility problem stems from women, 42.4% of them received a diagnosis for 1-2 years, 35.1% were being treated for 1-2 years. The 35.8% of women reported use of non-medical applications. The 24.4% of women used figs, onion cure, hacemat, locust, bee-pollen milk, the 18.2% used herbs, the 13.1% vowed, the 12.1% went to the tomb, the 10.1% did not bath a few days after the embryo transfer, the 9.1% used thermal water baths, the 5.0% manually corrected the womb, the 5.0% printed amulets by Hodja, the 3.0% went to the Hodja/pilgrims. Among the perceived benefits of using non-medical practices; facilitate pregnancy and implantation, improve oocyte quality were the most recently expressed. Women said that they often used herbs to develop follicles, did not bath after embryo transfer with aim to provide implantation, and used thermal waters to get rid of the infection. Compared to women, only the 25.8% of men used the non-medical practice. The 52.1% reported that they used peanuts, hacemat, locust, bee-pollen milk, the 14.9% used herbs, the 12.8% vowed, the 10.1% went to the tomb, the 10.1% used thermal water baths. Improve sperm number, motility and quality were the most expected benefits. Men said that they often used herbs to improve sperm number, used peanuts, hacemat, locust, bee-pollen milk to improve sperm motility and quality. Couples in Turkey often use non-medical practices to deal with fertility problems. Some of the practices considered as useful can adversely affect health. Healthcare providers should evaluate the use of non-medical practices and should inform if the application is known adverse effects on health.

Keywords: fertility, couples, non-medical practice, perceived benefit

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Authors: Guanglin Song

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(Objective) Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. (Methods) A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city.(Conclusion) The findings reveal that:1.there exists overall maldistribution and over-concentration of healthcare resources in Study Area, characterized by structural imbalance; 2.the low rate of primary care utilization in Study Area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem; 3.gradual optimization of the healthcare facility layout in Study Area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance.(Prospects) This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. Provide some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: flow of public services, urban networks, healthcare facilities, spatial planning, urban networks

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Authors: Nachawit Tikul

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This study aimed to determine low-income housing adaptations for flooding, which causes living problems and housing damage, and the results from improvement. Three low-income settlements in Chiang Mai which experienced different flood types, i.e. flash floods in Samukeepattana, drainage floods in Bansanku, and river floods in Kampangam, were chosen for the study. Almost all of the residents improved their houses to protect the property from flood damage by changing building materials to flood damage resistant materials for walls, floors, and other parts of the structure that were below the base of annual flood elevation. They could only build some parts of their own homes, so hiring skilled workers or contractors was still important. Building materials which have no need for any special tools and are easy to access and use for construction, as well as low cost, are selected for construction. The residents in the three slums faced living problems for only a short time and were able to cope with them. This may be due to the location of the three slums near the city where assistance is readily available. But the housing and the existence in the slums can endure only the regular floods and residence still have problems in unusual floods, which have been experienced 1-2 times during the past 10 years. The residents accept the need for evacuations and prepare for them. When faced with extreme floods, residence have evacuated to the nearest safe place such as schools and public building, and come back to repair the houses after the flood. These are the distinguishing characteristics of low-income living which can withstand serious situations due to the simple lifestyle. Therefore, preparation of living areas for use during severe floods and encouraging production of affordable flood resistant materials should be areas of concern when formulating disaster assistance policies for low income people.

Keywords: flooding, low-income settlement, housing, adaptation

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Authors: Li Maksym, Prabhakar M. N., Jung-Il Song

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In this study, a flame retardant and hydrophobic cotton textile were prepared by utilizing a renewable halogen-free bio-based solution based on chitosan, urea, and phytic acid, named bio-flame retardant liquid (BFL), through facile dip-coating technology. Deposition of BFL on the surface of the cotton was confirmed by Fourier-transform infrared spectroscopy and scanning electron microscope coupled with energy-dispersive X-ray spectrometer. Thermal and flame retardant properties of the cottons were studied with thermogravimetric analysis, differential scanning calorimetry, vertical flame test, cone calorimeter test. Only with 8.8% of dry weight gain treaded cotton showed self-extinguish properties during fire test. Cone calorimeter test revealed a reduction of peak heat release rate from 203.2 to 21 kW/m2 and total heat release from 20.1 to 2.8 MJ/m2. Incidentally, BFL remarkably improved the thermal stability of flame retardant cotton from expressed in an enhanced amount of char at 700 °C (6.7 vs. 33.5%). BFL initiates the formation of phosphorous and silica contain char layer whichrestrains the propagation of heat and oxygen to unburned materialstrengthen by the liberation of non-combustible gases, which reduce the concentration of flammable volatiles and oxygen hence reducing the flammability of cotton. In addition, hydrophobicity and specific ignition test for upholstery application were performed. In conjunction, the proposed flame retardant cotton is potentially translatable to be utilized as upholstery materials in public transport.

Keywords: cotton farbic, flame retardancy, surface coating, intumescent mechanism

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Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

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Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

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Authors: Anand Choudhary

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Following the global economic crisis in 2008, businesses and more especially the big multinational conglomerates were increasingly viewed by the people world over as one of the major causes of the economic problems faced by millions globally, in terms of job loss and lifetime savings being wiped out as banks and pension funds went bankrupt and people stared at an insecure financial future. This caused a lot of resentment in the public against big businesses and fueled several protest movements by the people such as “Occupy Wall Street” in different parts of the world. This forced the big businesses to respond to the challenge by adopting more people-centric policies and initiatives for local communities in societies where they operate as part of their corporate social responsibility (CSR), in order to regain their social acceptance among the people whilst earning their ‘social license to operate’. The current paper studies many of such large MNCs across the United States of America, India and South Africa, which changed the way they did business earlier, following the global economic crisis in 2008, by incorporating capacity building initiatives for local communities as part of their CSR strategy and explores whether it has contributed to improving their financial performance. It is a conceptual research paper using secondary source data. The findings reveal that there is a positive correlation between the companies’ corporate social performance and corporate financial performance. In addition, the findings also bring to light that the MNCs examined as part of the current paper have improved their image in the eyes of their stakeholders following the change in their CSR strategy and initiatives.

Keywords: corporate social responsibility (CSR), Corporate Social Performance (CSP), Corporate Financial Performance (CFP), local communities

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Authors: Tugba Saricaoglu

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This study argues about the potential representation and interpretation of Basilica of Smyrna through gamification. Representation can be defined as a key which plays a role as a converter in order to provide interpretation of something according to the person who perceives. Representation of cultural heritage is a hypothetical and factual approach in terms of its sustainable conservation. Today, both site interpreters and public of cultural heritage have varying perspectives due to their different demographic, social, and even cultural backgrounds. Additionally, gamification application offers diversion of methods suchlike video games to improve user perspective of non-game platforms, contexts, and issues. Hence, cultural heritage and video game decided to be analyzed. Moreover, there are basically different ways of representation of cultural heritage such as digital, physical, and virtual methods in terms of conservation. Virtual reality (VR) and augmented reality (AR) technologies are two of the contemporary digital methods of heritage conservation. In this study, 3D documented ruins of the Basilica will be presented in the virtual and augmented reality based technology as a theoretical gamification sample. Also, this paper will focus on two sub-topics: First, evaluation of the video-game platforms applied to cultural heritage sites, and second, potentials of cultural heritage to be represented in video game platforms. The former will cover the analysis of some case(s) with regard to the concepts and representational aspects of cultural heritage. The latter will include the investigation of cultural heritage sites which carry such a potential and their sustainable conversation. Consequently, after mutual collection of information from cultural heritage and video game platforms, a perspective will be provided in terms of interpretation of representation of cultural heritage by sampling that on Basilica of Smyrna by using VR and AR based technologies.

Keywords: Basilica of Smyrna, cultural heritage, digital heritage, gamification

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Authors: Aisha M. Khairat

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Community education in the Arab Republic of Egypt is a model that provides education to remote, underprivileged villages and hamlets where children have no access to public education. The community education model is based on the philosophy of transforming individuals to reach their full potential and on instilling the seeds of empowerment and citizenship to induce societal transformation. This research aims at investigating the degree to which the leadership style and organizational culture of the Egyptian community schools demonstrates an empowering approach. Nile Valley NGO, an Egyptian Non-Governmental Organization (NGO) leading hundreds of Egyptian community schools was studied to investigate the perceptions of empowerment amongst its leadership. This in turn will have serious implications on the level of empowerment the communities managed by Nile Valley NGO are experiencing, and will serve as an indicator to the degree to which community schools are achieving their goals in transforming individuals and empowering communities and reforming Egyptian education – and not just a tool to reach literacy. This mixed-methods research utilized surveys and semi-structured interviews to capture the perceptions of empowerment in the views of a sample of 380 community schools facilitators (teachers) spanning 8 Egyptian governorates and Nile Valley NGO’s community education project team and leadership. The findings demonstrate interesting leadership approaches with traits from transformational and servant leadership theoretical models. The organizational culture at Nile Valley NGO reflects the universal dichotomy between market-oriented and humanitarian orientations. The perceptions of empowerment were positive, and several success stories were uncovered in spite of the many challenges faced on the national level and despite the scarcity or resources.

Keywords: community education, community schools in Egypt, empowerment, organizational culture, leadership

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Authors: Claire Biasco, Thaier Hayajneh

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A smart city is the integration of digital technologies in urban environments to enhance the quality of life. Smart cities capture real-time information from devices, sensors, and network data to analyze and improve city functions such as traffic analysis, public safety, and environmental impacts. Current smart cities face controversy due to their reliance on real-time data tracking and surveillance. Internet of Things (IoT) devices and blockchain technology are converging to reshape smart city infrastructure away from its centralized model. Connecting IoT data to blockchain applications would create a peer-to-peer, decentralized model. Furthermore, blockchain technology powers the ability for IoT device data to shift from the ownership and control of centralized entities to individuals or communities with Decentralized Autonomous Organizations (DAOs). In the context of smart cities, DAOs can govern cyber-physical systems to have a greater influence over how urban services are being provided. This paper will explore how the core components of a smart city now apply to DAOs. We will also analyze different definitions of DAOs to determine their most important aspects in relation to smart cities. Both categorizations will provide a solid foundation to conduct a cybersecurity assessment of DAOs in smart cities. It will identify the benefits and risks of adopting DAOs as they currently operate. The paper will then provide several mitigation methods to combat cybersecurity risks of DAO integrations. Finally, we will give several insights into what challenges will be faced by DAO and blockchain spaces in the coming years before achieving a higher level of maturity.

Keywords: blockchain, IoT, smart city, DAO

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Authors: Shazia Farooq Mirza

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The purpose of this study was to explore the challenges faced by visually impaired children and their parents in doing homework assignments using Braille. This study had a quantitative approach and it was descriptive in nature. It took place in 6 public and special private schools of Lahore.177 visually impaired children of grades 4-10 and 153 parents of the visually impaired children were the volunteer participants of this study which were selected through a convenient sampling method. A survey method was adopted for the data collection. And for this purpose 2 self-developed validated questionnaires were used as instruments. The instruments were constructed by exploring the factors and sub-factors from the literature review. Thirty students with visual impairment and 30 parents of the students with visual impairment filled the questionnaires as a pilot study, and it ensured the reliability of the instruments. Data were analyzed using a statistical package of social sciences and it was completely interpreted. Findings revealed that the common challenges faced by the students with visual impairment were Physical Stress, Readiness, Braille Knowledge, Braille Skill and Communications. And the major challenges faced by the parents of the students with visual impairment were the Availability of the helping material, the Availability of the reading material, Braille Knowledge, Braille skills, School and family interactions, Behavior management and the Environment and equipment. Conclusions were drawn on the basis of the major findings. Future suggestions are given in light of the conclusions. This study will be beneficial for the children with visual impairment, the parents of the children with visual impairment, the special education teachers and for the policymakers of the special schools.

Keywords: challenges, visually impaired children, homework, parents, braille

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Authors: Rafael Martinez

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Our view of cities is dominated by the built environment. Buildings, streets, avenues, bridges, flyovers, and so on virtually exclude anything not fixed, permanently alterable or indefinitely temporal. Yet, city environments can also be shaped by temporally produced structures which, regardless of their transience, act as thresholds separating or segregating people and spaces. Academic works on cities conceptualize them, whether temporary or permanent, as tangible environments. This paper considers the idea of the ephemeral city, a city purposely produced and lived in as an impermanent, fluid and transitional environment resulting from an alignment of different forces. In particular, the paper proposes to observe how certain performative practices inform the emergence of ephemeral spaces in the city’s daily life. With Singapore as its backdrop and focusing foreign workers, the paper aims at documenting how everyday life practices, such as flirting, result in production of transitional space, informed by semiotic blurs, and yet material, perceptible, human and tangible for some. In this paper, it is argued that flirting for Singapore's foreign workers entails skillful understanding of what is proposed as the 'flirting cartography.' Thus, spatially, flirtation becomes not only a matter to be taken for granted but also a form of producing a fleeting space that requires deployment of various techniques drawn upon a particular knowledge. The paper is based upon a performative methodology which seeks to understand the praxis and rationale of the ephemerality of some spaces produced by foreign workers within this cosmopolitan city. By resorting to this methodological approach, the paper aims to establish the connection between the visibility gained by usually marginalized populations through their ephemeral reclamation of public spaces in the city.

Keywords: ephemeral, flirting, Singapore, space

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Authors: Alexander B. Barker, Megan Parkin, Shreesh Sinha, Emma Wilson, Rachael L. Murray

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Objectives: Exposure to HFSS imagery is associated with consumption of foods high in fat, sugar, or salt (HFSS), and subsequently obesity, among young people. We report and compare the results of two content analyses, one of two popular terrestrial children’s television channels in the UK and the other of a selection of children’s programs available on video-on-demand (VOD) streaming sites. Design: Content analysis of three days’ worth of programs (including advertisements) on two popular children’s television channels broadcast on UK television (CBeebies and Milkshake) as well as a sample of 40 highest-rated children’s programs available on the VOD platforms, Netflix and Amazon Prime, using 1-minute interval coding. Setting: United Kingdom, Participants: None. Results: HFSS content was seen in 181 broadcasts (36%) and in 417 intervals (13%) on terrestrial television, ‘Milkshake’ had a significantly higher proportion of programs/adverts which contained HFSS content than ‘CBeebies’. In VOD platforms, HFSS content was seen in 82 episodes (72% of the total number of episodes), across 459 intervals (19% of the total number of intervals), with no significant difference in the proportion of programs containing HFSS content between Netflix and Amazon Prime. Conclusions: This study demonstrates that HFSS content is common in both popular UK children’s television channels and children's programs on VOD services. Since previous research has shown that HFSS content in the media has an effect on HFSS consumption, children’s television programs broadcast either on TV or VOD services are likely having an effect on HFSS consumption in children and legislative opportunities to prevent this exposure are being missed.

Keywords: public health, epidemiology, obesity, content analysis

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Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

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Authors: Pinqiao Wang

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Mindfulness, derived from Buddhism, has been developed to improve individuals' well-being, first in the West and then gaining growing popularity in Asia. Numerous research studies have proven the effectiveness of mindfulness among clinical groups and the public all over the world. However, as enthusiasm surges, reflections on mindfulness and its commodification and instrumentalization arise. Hong Kong was seen as the model of a free market by neoliberal economists. The relationships between its socioeconomic neoliberalism, Western-inspired democracy aspiration, and political harmonization with China Mainland have been fraught with tensions, which have been further exacerbated by socio-political changes since the 2010s. Under such circumstances, mental health problems have come into the spotlight in Hong Kong recently. Mindfulness has gained growing popularity in Hong Kong, with its influence reaching from primary schools to corporate settings. A more comprehensive socio-political analysis of mindfulness within the Hong Kong context warrants further exploration. Drawing on interview responses from mindfulness practitioners, we examine the connections between the ideologies underlying mindfulness and contemporary capitalist society. On the one hand, mindfulness focuses on the present moment and self-improvement, representing neoliberal capitalist spirituality and reinforcing existing power relations. On the other hand, mindfulness fosters the acceptance of difference, which is argued to demonstrate the potential for advancing democracy at both the individual and community levels. Academically, this research provides empirical evidence to advance the current discussions and debates surrounding the socio-political potential of mindfulness. Practically, it serves as a reflection on mindfulness practices to optimize their impact on individuals and society.

Keywords: neoliberal subjectivity, qualitative analysis, social construction, technologies of the self, therapeutic culture

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Authors: Anyi Katherine Garzon Robles, Luis Carlos Gomez Florez

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Since the advent of the Internet, the use of Information Technologies (IT) has increased exponentially. The field of informatics and telecommunications has put on the table countless possibilities for the development of different socio-economic activities, promoting a change of social paradigm and the emergence of the so-called information and knowledge society. For more than a decade, the Colombian government has been working on the incorporation of IT into the public sector through an e-government strategy. However, to date, many technological gaps has not yet been identified in the country to our knowledge, especially in rural areas and far from large cities, where factors such as low investment and the expansion of the armed conflict have led to economic and technological stagnation. This paper presents the research results obtained from the execution of a research project, which was approach from a qualitative approach and a methodological design of a participatory action research type. This design consists of nine fundamental stages divided into four work cycles. For which different strategies for data collection and analysis were established. From which, a methodology was obtained for the identification of technological gaps and the measurement of the level of technological acceptance in the rural sector, based on the TAM (Technology Acceptance Model) model, as a previous activity to the development of IT solutions framed in the e-government strategy in Colombia. The result of this research work represents a contribution from academia for the improvement of the country's technological development and a guide for the proper planning of IT solutions aimed at promoting a close relationship between government and citizens.

Keywords: E-government, knowledge society, level of technological acceptance, technological gaps, technology acceptance model

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Authors: Mohd Ruzlin Mohd Mokhtar

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At present, most operators who are working on projects for utilities such as power, water, oil, gas, telecommunication and sewerage are using technologies e.g. Total station, Global Positioning System (GPS), Electromagnetic Locator (EML) and Ground Penetrating Radar (GPR) to perform underground utility mapping. With the increase in popularity of Horizontal Directional Drilling (HDD) method among the local authorities and asset owners, most of newly installed underground utilities need to use the HDD method. HDD method is seen as simple and create not much disturbance to the public and traffic. Thus, it was the preferred utilities installation method in most of areas especially in urban areas. HDDs were installed much deeper than exiting utilities (some reports saying that HDD is averaging 5 meter in depth). However, this impacts the accuracy or ability of existing underground utility mapping technologies. In most of Malaysia underground soil condition, those technologies were limited to maximum of 3 meter depth. Thus, those utilities which were installed much deeper than 3 meter depth could not be detected by using existing detection tools. The accuracy and reliability of existing underground utility mapping technologies or work procedure were in doubt. Thus, a mitigation action plan is required. While installing new utility using Horizontal Directional Drilling (HDD) method, a more accurate underground utility mapping can be achieved by using Gyro OMU compared to existing practice using e.g. EML and GPR. Gyro OMU is a method to accurately identify the location of HDD thus this mapping can be used or referred to avoid those cost of breakdown due to future HDD works which can be caused by inaccurate underground utility mapping.

Keywords: Gyro Orientation Measurement Unit (Gyro OMU), Horizontal Directional Drilling (HDD), Ground Penetrating Radar (GPR), Electromagnetic Locator (EML)

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Authors: Temesgen Kassa Getahun, Gezahegn Mamo, Beksisa Urge

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A cross-sectional study was conducted from December 2019 to May 2020 with the aim of determining the seroprevalence of brucellosis in dairy cows and their owners in the central highland of Oromia, Ethiopia. A total of 352 blood samples from dairy cattle, 149 from animal owners, and 17 from farm workers were collected and initially screened using the Rose Bengal Plate test and confirmed by the Complement Fixation test. Overall seroprevalence was 0.6% (95% CI: 0.0016–0.0209) in bovines and 1.2% (95% CI: 0.0032–0.0427) in humans. Market-based stock replacement (OR=16.55, p=0.002), breeding by artificial insemination (OR=7.58, p=0.05), and parturition pen (OR = 11.511, p=0.027) were found to be significantly associated with the seropositivity for Brucella infection in dairy cattle. Human housing (OR=1.8, p=0.002), contact with an aborted fetus (OR=21.19, p=0.017), drinking raw milk from non-aborted (OR=24.99, p=0.012), aborted (OR=5.72, p=0.019) and retained fetal membrane (OR=4.22, p=0.029) cows had a significant influence on human brucellosis. A structured interview question was administered to 284 respondents. Accordingly, most respondents had no knowledge of brucellosis (93.3%), and in contrast, 90% of them consumed raw milk. In conclusion, the present seroprevalence study revealed that brucellosis was low among dairy cattle and exposed individuals in the study areas. However, since there were no control strategies implemented in the study areas, there is a potential risk of transmission of brucellosis in dairy cattle and the exposed human population in the study areas. Implementation of a test and slaughter strategy with compensation to farmers is recommended, while in the case of human brucellosis, continuous social training and implementing one health approach framework must be applied.

Keywords: abortion, bovine brucellosis, human brucellosis, risk factors, seroprevalence

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Authors: Hang Meng, Wen-Bin Liu, Bi Xiao, Kai-Jun Ma, Jian-Hui Xie, Geng Fei, Tian-Ye Zhang, Lu-Yi Xu, Dong-Chuan Zhang

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The victims in water are often found in the coastal region, along river region or the region with lakes. In China, the examination for the bodies of victims in the water is conducted by forensic doctors working in the public security bureau. Because the enter water time for most of the victims are not clear, and often lack of monitor images and other information, so to find out the corpse enter water time for victims is very difficult. After the corpse of the victim enters the water, it sinks first, then corruption gas produces, which can make the density of the corpse to be less than water, and thus rise again. So the factor that determines the corpse floating time is temperature. On the basis of the temperature data obtained in Shanghai region of China (Shanghai is a north subtropical marine monsoon climate, with an average annual temperature of about 17.1℃. The hottest month is July, the average monthly temperature is 28.6℃, and the coldest month is January, the average monthly temperature is 4.8℃). This study selected about 100 cases with definite corpse enter water time and corpse floating time, analyzed the cases and obtained the empirical law of the corpse floating time. For example, in the Shanghai region, on June 15th and October 15th, the corpse floating time is about 1.5 days. In early December, the bodies who entered the water will go up around January 1st of the following year, and the bodies who enter water in late December will float in March of next year. The results of this study can be used to roughly estimate the water enter time of the victims in Shanghai. Forensic doctors around the world can also draw on the results of this study to infer the time when the corpses of the victims in the water go up.

Keywords: corpse enter water time, corpse floating time, drowning, forensic pathology, victims in the water

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Authors: Amita Jain, Shantanu Prakash, Suruchi Shukla

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Introduction: Acute encephalitis syndrome (AES) is a complex multi etiology syndrome posing a great public health problem in the northern part of India. Japanese encephalitis (JE) virus is an established etiology of AES in this region. Recently, Scrub typhus (ST) is being recognized as an emerging aetiology of AES in JE endemic belt. This study was conducted to establish the direct evidence of Central nervous system invasion by Orientia tsutsugamushi leading to AES. Methodology: A total of 849 cases with clinical diagnosis of AES were enrolled from six districts (Deoria and its adjoining area) of the traditional north Indian Japanese encephalitis (JE) belt. Serum and Cerebrospinal fluid samples were collected and tested for major agent causing acute encephalitis. AES cases either positive for anti-ST IgM antibodies or negative for all tested etiologies were investigated for ST-DNA by real-time PCR. Results: Of these 505 cases, 250 patients were laboratory confirmed for O. tsutsugamushi infection either by anti-ST IgM antibodies positivity (n=206) on serum sample or by ST-DNA detection by real-time PCR assay on CSF sample (n=2) or by both (n=42).Total 29 isolate could be sequenced for 56KDa gene. Conclusion: All the strains were found to cluster with Gilliam strains. The majority of the isolates showed a 97–99% sequence similarity with Thailand and Cambodian strains. Gilliam strain of O.tsusugamushi is an emerging as one of the major aetiologies leading to AES in northern part of India.

Keywords: acute encephalitis syndrome, O. tsutsugamushi, Gilliam strain, North India, cerebrospinal fluid

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Authors: Ronelle Prinsloo

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Teenage pregnancy in South African schools is a growing concern. In South Africa, many young female learners end their schooling permanently, not because they have completed their studies, but due to pregnancy. The admission policy of public schools is determined by the governing body of such a school, and this policy can determine that a pregnant leaner may not attend school during pregnancy and for a certain period after the birth of the child. This can be seen as an infringement of the rights of the teenage mother to be allowed to attend school. It can also be argued that this conflicts with the best interest of the child as well as the rights of the governing body to determine policy in accordance with the mandate as given to them by the parents and community served by the school. A pregnant learner can argue that the admission policy of a school is discriminatory if it does not allow the pregnant learner to continue her schooling. She may also argue that she is being unfairly discriminated against based on gender because in many instances, the baby’s father is still allowed to go to school. The Constitution (Constitution of the Republic of South Africa, Act 108 of 1996), provides in section 9, that everyone is equal before the law; it goes on to provide that equality includes the full and equal enjoyment of all rights and freedoms and provides those grounds on which one may not be discriminated against including, gender, sex, and pregnancy. Schools should be encouraged to re-enroll students if they have a support system available to assist with the necessary childcare when they attend school. To dramatically increase the number of young people enrolled in alternative pathways such as Further Education and Training or Adult Basic Education and Training must be provided. In addition, alternative systems must offer viable exit opportunities for participants by cohering with further education and economic opportunities.

Keywords: admission policy, Constitution of South Africa, human rights, teenage pregnancy

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Authors: Mohd Noah A. Rahman, Afzaal H. Seyal, Sharul T. Tajuddin, Hartiny Md Azmi

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Taking into consideration the real time situation specifically the higher academic institutions, small, medium to large companies, public to private sectors and the remaining sectors, do experience the inventory or asset shrinkages due to theft, loss or even inventory tracking errors. This happening is due to a zero or poor security systems and measures being taken and implemented in their organizations. Henceforth, implementing the Radio Frequency Identification (RFID) technology into any manual or existing web-based system or web application can simply deter and will eventually solve certain major issues to serve better data retrieval and data access. Having said, this manual or existing system can be enhanced into a mobile-based system or application. In addition to that, the availability of internet connections can aid better services of the system. Such involvement of various technologies resulting various privileges to individuals or organizations in terms of accessibility, availability, mobility, efficiency, effectiveness, real-time information and also security. This paper will look deeper into the integration of mobile devices with RFID technologies with the purpose of asset tracking and control. Next, it is to be followed by the development and utilization of MongoDB as the main database to store data and its association with RFID technology. Finally, the development of a web based system which can be viewed in a mobile based formation with the aid of Hypertext Preprocessor (PHP), MongoDB, Hyper-Text Markup Language 5 (HTML5), Android, JavaScript and AJAX programming language.

Keywords: RFID, asset tracking system, MongoDB, NoSQL

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Authors: Lydie Audrey Amboua Schouame, Sylvie Kwedi Nolna, Antoine Socpa, Alexandre Benjamin Nkoum

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Background: Despite the struggle of the Cameroonian Ministry of Public Health against informal health centers (IHCs) because of their illegality, IHCs are booming in Cameroon and a large part of the population uses them. In 2017, more than 3.000 IHCs were counted across the country. Most of these IHCs have antenatal clinics and they screen pregnant women for HIV. However, there is no data on the Prevention of Mother-To-Child Transmission of HIV (PMTCT) in this informal health sector in Cameroon. This study aimed to investigate the initiation of Antiretroviral treatment (ART) in pregnant women screened HIV positive in IHCs and associated factors. Methods: From January 01, 2018, to June 30, 2020, we carried out a cohort study of pregnant women attending their first antenatal visit and screened HIV positive in informal health centers in the cities of Douala and Ebolowa in Cameroon. Consenting participants were interviewed at two points: at least one week after delivery of the HIV result and three months later. The collected data were entered into Kobo collected and analyzed in SPSS V23.0 software. Results: A total of 182 HIV-infected pregnant women were enrolled in the study. The median age at enrollment was 30 years (IQR, 24-34) and the median gestational age at first ANC was 25 weeks (IQR, 19-31). Overall 61% (111/182) had a secondary level of education, 65% (118/182) were married/in a common-law relationship and 69% (126/182) had no income activity. At their first ANC, 91% (166/182) were naïve to ARV treatment. Among them, only 45% (74/166) initiated ART. The median delay in initiating ARV treatment was 5 days (IQR, 0-25). Of those who have started ART, only 64% (48/74) remained on treatment 3 months later. Conclusion: In order to eliminate mother-to-child transmission of HIV, attention should be paid to IHCs.

Keywords: informal health centers, human immunodeficiency, antiretroviral treatment, pregnant women

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Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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Authors: Mona T. Kashef, Omneya M. Helmy

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Multidrug resistant (MDR) bacteria have become a significant public health threat. The prevalence rates, of Gram negative MDR bacteria, are in continuous increase. However, few data are available about these resistant strains. Since, third generation cephalosporins are one of the most commonly used antimicrobials, we set out to investigate the prevalence, different mechanisms and clonal relatedness of multidrug resistance among third generation resistant Gram negative clinical isolates. A total of 114 Gram negative clinical isolates, previously characterized as being resistant to at least one of 3rd generation cephalosporins, were included in this study. Each isolate was tested, using Kirby Bauer disk diffusion method, against its assigned categories of antimicrobials. The role of efflux pump in resistance development was tested by the efflux pump inhibitor-based microplate assay using chloropromazine as an inhibitor. Detecting different aminoglycosides, β-lactams and quinolones resistance genes was done using polymerase chain reaction. The genetic diversity of MDR isolates was investigated using Random Amplification of Polymorphic DNA technique. MDR phenotype was detected in 101 isolates (89%). Efflux pump mediated resistance was detected in 49/101 isolates. Aminoglycosides resistance genes; armA and aac(6)-Ib were detected in one and 53 isolates, respectively. The aac(6)-Ib-cr allele, that also confers resistance to floroquinolones, was detected in 28/53 isolates. β-lactam resistance genes; blaTEM, blaSHV, blaCTX-M group 1 and group 9 were detected in 52, 29, 61 and 35 isolates, respectively. Quinolone resistance genes; qnrA, qnrB and qnrS were detectable in 2, 14, 8 isolates respectively, while qepA was not detectable at all. High diversity was observed among tested MDR isolates. MDR is common among 3rd generation cephalosporins resistant Gram negative bacteria, in Egypt. In most cases, resistance was caused by different mechanisms. Therefore, new treatment strategies should be implemented.

Keywords: gram negative, multidrug resistance, RAPD typing, resistance genes

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Authors: Dorothy I. Riddle

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Limited mobility (or an inability to walk more than 15 meters without sitting down to rest) restricts full community participation for 13 percent of Canadian adults or 4.2 million persons), yet Canadian accessibility standards are silent on distance to be walked as an accessibility barrier to be addressed. Instead, they focus on ensuring access for the wheeled mobility devices used regularly by le The Accessible Canada Act mandates that Canada be barrier free by 2040, which will necessitate eliminating distance to be walked as a barrier in federal programs and services. This paper details the results of a multi-year research project funded by Accessibility Standards Canada to document the lived experience of those struggling with limited mobility and make recommendations regarding how to ensure accessibility for those with limited mobility. Over 2,600 Canadians from across Canada participated in an online survey and follow-up focus groups. The results underscored the importance of providing not only mobility supports in public facilities but also the information necessary for planning access to federal programs and services. As numerous participants indicated, if they weren’t sure how far they would have to walk, they simply stayed home and depended on friends and relatives for help with errands or appointments. This included failing to participate in civic activities, such as voting, for fear of having to walk too far and stand unsupported for too long. Types of information that were deemed critical included whether or not mobility aids were available, where seating to rest was located throughout the facility, what alternatives to standing while waiting for service and having to walk to the service provider (rather than the provider coming to the customer) were available, and diagrams of accessible parking and its relationship to elevators and services.

Keywords: accessibility standards, distance to be walked, limited mobility, mobility aids, service to customer

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Authors: Krupali Mukeshkumar, Jinesh Shah

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Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.

Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction

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Authors: Montserrat Crespi Vallbona, Marta Domínguez Pérez

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Globalization impacts on cities and especially on their centers, especially on those spaces more visible and coveted. Changes are involved in processes such as touristification, gentrification or studentification, in addition of shop trendiness. The city becomes a good of interchange rather than a communal good for its inhabitants and consequently, its value is monetized. So, these different tendencies are analyzed: on one hand, the presence of tourists, the home rental increase, the explosion of businesses related to tourism; on the other hand; the return of middle classes or gentries to the center in a socio-spatial model that has changed highlighting the centers by their culture and their opportunities as well as by the value of public space and centrality; then, the interest of students (national and international) to be part of these city centers as dynamic groups and emerging classes with a higher purchasing power and better cultural capital than in the past; and finally, the conversion of old stores into modern ones, where vintage trend and the renewal of antiquity is the essence. All these transforming processes impact the European cities and redefine their image. All these trends reinforce the impression and brand of the urban center as an attractive space for investment, keeping such nonsense meaningful. These four tendencies have been spreading correlatively impacting the centers and transforming them involving the displacement of former residents of these spaces and revitalizing the center that is financed and commercialized in parallel. The cases of Madrid and Barcelona as spaces of greater evidence in Spain of these tendencies serve to illustrate these processes and represent the spearhead. Useful recommendations are presented to urban planners to find the conciliation of communal and commercialized spaces.

Keywords: gentrification, shop trendiness, studentification, touristification

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Authors: S. Tebibel, C. Mechati, S. Messaoudi

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Algeria is currently experiencing the same rate of cancer progression as that registered these last years in the western countries. Colorectal cancer, constituting increasingly a major public health problem, is the most common form of cancer after breast and Neck-womb cancer at the woman and prostate cancer at the man. Our work is based on a retrospective study to determine the cases of colorectal cancer through eastern Algeria. Our goal is to carry out an epidemiological, histological and immune- histochemical study to investigate different techniques for the diagnosis of colorectal cancer and their interests and specific in detecting the disease. The study includes 110 patients (aged between 20 to 87 years) with colorectal cancer where the inclusions and exclusions criteria were established. In our study, colorectal cancer, expresses a male predominance, with a sex ratio of 1, 99 and the most affected age group is between 50 and 59 years. We noted that the colon cancer rate is higher than rectal cancer rate, whose frequencies are respectively 60,91 % and 39,09 %. In the series of colon cancer, the ADK lieberkunien is histological the most represented type, or 85,07 % of all cases. In contrast, the proportion of ADK mucinous (colloid mucous) is only 1,49% only. Well-differentiated ADKS, are very significant in our series, they represent 83,58 % of cases. Adenocarcinoma moderately and poorly differentiated, whose proportions are respectively 2,99 % and 0.05 %. For histological varieties of rectal ADK, we see in our workforce that ADK lieberkunien represent the most common histological form, or 76,74%, while the mucosal colloid is 13,95 %. Research of the mutation on the gene encoding K-ras, a major step in the targeted therapy of colorectal cancers, is underway in our study. Colorectal cancer is the subject of much promising research concern: the evaluation of new therapies (antiangiogenic monoclonal antibodies), the search for predictors of sensitivity to chemotherapy and new prognostic markers using techniques of molecular biology and proteomics.

Keywords: adenocarcinoma, age, colorectal cancer, epidemiology, histological section, sex

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Authors: Mahboubeh Varmaziar

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Depression is a significant public health concern affecting people of all ages and genders. Physical activity has been shown to have a positive effect on mental health, particularly in alleviating symptoms of depression. This study aims to explore the impact of continuous exercise on depression levels among young female athletes in Hamadan Province, Iran. In this randomized controlled trial, 72 women aged 20 to 35 years attending sports centers in Hamadan Province were selected through convenient sampling and randomly assigned to either the control or experimental group. The experimental group participated in a continuous exercise program consisting of 20 sessions over six weeks, with each session lasting 30 minutes. In contrast, the control group maintained their usual daily activities at the sports center. Both groups completed demographic and Beck Depression Inventory questionnaires. Data were analyzed using descriptive and inferential statistics, including two-way ANOVA. The results of the two-way ANOVA, after controlling for the pre-test effect, revealed a significant difference in the mean depression scores between the control and experimental groups (p < 0.001). This suggests that the continuous exercise program significantly reduced depression levels in the young female athletes. The findings suggest that continuous exercise is an effective non-pharmacological intervention for reducing depression in young female athletes. Incorporating regular physical activity into treatment plans may serve as a complementary therapy alongside conventional treatments, offering a low-risk and beneficial approach to managing depression.

Keywords: depression, exercise, female athletes, yong women

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Authors: Anagha Pavithran Vattamparambil, Niranjana Regimon

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Dalit and tribal communities in India have the largest suicide rate; however, the current literature does not reflect this reality. While existing research acknowledges socio-cultural risk factors, it fails to discuss structural issues pertaining to marginalized communities in India. Furthermore, the language is framed in an individualistic manner which denies room for recognizing systemic violence and injustice among causative agents of suicide. We aim to examine the representation of Dalit and tribal identities and their experiences of marginalisation as a contributive factor of suicide, as well as discuss the epistemic injustice involved in its exclusion. Electronic searches of PubMed, PsychInfo, and Web of Science databases will be carried out from inception till January 2023 to conduct a systematic scoping review of peer-reviewed articles; it will include all studies involving psychological autopsy in India. A narrative synthesis will be performed to gain insight into the inclusion of the experiences of Dalits and Tribals, the absence of which indicates a lacking understanding of suicide in India. It is also expected to highlight the alienation of lived experiences and narratives of marginalisation from mainstream discourse on suicide that constitutes epistemic injustice. There is a complex interplay of psychological, socio-cultural, economic, and political factors for suicide in the Indian setting. But, political and systemic issues are often downplayed in suicide etiology, including casteist assault, rape, violence, public humiliation, and discrimination which deserves more research attention.

Keywords: dalits, marginalisation, psychological autopsy, suicide, tribals

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