Search results for: primary care givers

Authors: Jakia Rajoana

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The aim of this paper is to examine the role of women entrepreneurs in bringing about sustainable rural tourism (SRT) development in Sundarbans area of Bangladesh. Theoretically, it draws upon empowerment and entrepreneurial marketing concepts. Women entrepreneurship development and lack of empowered women as role models is an important issue for developing economies in South Asia. Despite the substantial role women play in rural economy of Sundarbans, their contribution remains overlooked as enterprises led by them are run on an informal basis and their business acumen is not taken seriously both by their families and society at large. Studies on SRT fail to engage in sufficient depth with the term applied in this paper as ‘invisible women on the margins’ who run their enterprises with no formal training or societal/familial support. Moreover, the link between their (non) tourism enterprise and their empowerment remains under-theorized. Thus empirically, this research seeks to fill a significant gap by focusing on a considerably under-researched Sundarbans region. Methodologically, this study follows a qualitative research design using visual ethnographic approach. Participant observation, semi-structured interviews, and documentation are the primary data collection instruments in three coastal communities – Munshigonj, Burigoalini and Gabura – in the Sundarbans area. By focusing on the narratives of these under-investigated women, this work aims to provide in-depth and nuanced insights into salient issues on marginal communities experience from rural women’s perspectives. Initial findings illustrate that the Sundarbans women have low income due to no or little education. In addition, socio-cultural and religious factors also restrict the scope of their extensive contribution to workplace. In addition, physical and social violence which is a common occurrence for these women inhibits their agency and contributes to their disempowerment.

Keywords: gender, empowerment, entrepreneurial marketing, sustainable rural tourism, Sundarbans

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Authors: Vivian W. L. Tsang, Karen Lockhart, Samuel Spiegel, Annalee Yassi

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Background: Workers in the informal economy often incur exposure to well-documented occupational health hazards. Insufficient attention has been afforded to rigorously evaluating intervention programs to reduce the risks, especially in artisanal and small-scale gold mining (ASGM). Objectives: This systematic review, conducted as part of the World Health Organization’s Global Plan of Action for Workers’ Health, sought to assess the state of knowledge on occupational health programs and interventions for the informal artisanal and small-scale gold mining (ASGM) sector, an occupation which directly employs at least 50 million people. Methods: We used a comprehensive search strategy for four well-known databases relevant to health outcomes: PubMed, Engineering Village, OVID Medline, and Web of Science, and employed the PRISMA framework for our analysis. Findings: Ten studies met the inclusion criteria of a primary study focused on assessing the impact of interventions addressing occupational health concerns in ASGM. There were no studies evaluating or even identifying comprehensive occupational health and safety programs for this sector, although target interventions addressing specific hazards exist. Major areas of intervention –education and introduction of mercury-reducing/eliminating technology were identified, and the challenges and limitations of each intervention taken into the assessment. Even for these, however, there was a lack of standardization for measuring outcome or impact, let alone long-term health outcomes for miners and mining communities. Conclusion: There is an urgent need for research on comprehensive occupational health programs addressing the array of hazards faced by artisanal and small-scale miners.

Keywords: informal economy, artisanal and small-scale gold mining, occupational health, health and safety, workplace safety

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Authors: Nicodemus Tiendem, Arrey Mbayong Napoleon

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The heightening of competition and the quest for market share has left business persons and research communities re-examining and reinventing their competitive practices. A case in point is Porter’s generic strategy which has received a lot of criticism lately regarding its inability to maintain a company’s competitive power. This is because it focuses more on the organisation and ignores her external partners, who have a strong bearing on the company’s performance. This paper, therefore, sought to examine Porter’s generic strategies alongside supply chain quality management practices in terms of their effectiveness in building the competitive power of manufacturing companies in Cameroon. This was done with the use of primary data captured from a survey study across the supply chains of 20 manufacturing companies in Cameroon using a five-point Likert scale questionnaire. For each company, four 1st tier suppliers and four 1st tier distributors were carefully chosen to participate in the study alongside the companies themselves. In each case, attention was directed to persons involved in the supply chains of the companies. This gave a total of 180 entities comprising the supply chains of the 20 manufacturing companies involved in the study, making a total of 900 participants. The data was analysed using three multiple regression models to assess the effect of Porter’s generic strategy and supply chain quality management on the marketing performance of the companies. The findings proved that in such a competitive atmosphere, supply chain quality management is a better tool for marketing performance over Porter’s generic strategies and hence building the competitive power of the companies at all levels of the study. Although the study made use of convenience sampling, where sample selectivity biases the results, the findings aligned with many other recent developments in line with building the competitive power of manufacturing companies and thereby made the findings suitable for generalisation.

Keywords: supply chain quality management, Porter’s generic strategies, competitive power, marketing performance, manufacturing companies, Cameroon

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Authors: Radwa El Shorbagy, Alaa El Din Balbaa, Khaled Ayad, Waleed Reda

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Introduction: Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated. Objective: to determine the contribution of proximal hip strategy to dynamic postural control in patients with recurrent ankle sprain. Methods: Fifteen subjects with recurrent ankle sprain (group A) and fifteen healthy control subjects (group B) participated in this study. Abductor-adductors as well as flexor-extensor hip musculatures control was abolished by fatigue using the Biodex Isokinetic System. Dynamic postural control was measured before and after fatigue by the Biodex Balance System Results: Repeated measures MANOVA was used to compare between and within group differences, In group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) increased overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p= 0.00) whereas; in group B fatiguing of hip flexors-extensors increased significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Moreover, patients with ankle sprain had significantly lower dynamic balance after hip muscles fatigue compared to the control group. Specifically, after hip flexor-extensor fatigue, the OASI, APSI and MLSI were increased significantly than those of the control values (p= 0.002, 0.011, and 0.003, respectively) whereas fatiguing of hip abductors-adductors increased significantly in OASI and APSI only (p=0.012, 0.026, respectively). Conclusion: To maintain dynamic balance, patients with recurrent ankle sprain seem to relay more on the hip strategy. This means that those patients depend on a top to down instead of down to top strategy clinical relevance: patients with recurrent ankle sprain less efficient in maintaining the dynamic postural control due to the change in motor strategies. Indicating that health care providers and rehabilitation specialists should treat CAI as a global/central and not just as a simple local or peripheral injury.

Keywords: ankle sprain, fatigue hip muscles, dynamic balance

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Authors: Meltem Anafarta Şendağ, Funda Kutlu

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Attachment theory has some major postulates that direct attention of psychologists from many different domains. First, the theory suggests that attachment is a lifetime process. This means that every human being from cradle to grave needs someone stronger to depend on in times of stress. Second, the attachment is a dynamic process and as one goes through developmental stages it is being transferred from one figure to another (friends, romantic partners). Third, the quality of attachment relationships later in time directly affected by the earliest attachment relationship established between the mother and the infant. Depending on these postulates, attachment literature focuses mostly on mother – child attachment during childhood and romantic relationship during adulthood. However, although romantic partners are important attachment figures in adults’ life, parents are not dropped out from the attachment hierarchy but they keep being important attachment figures. Despite the fact that parents could still be an important figure in adults’ life, adult – parent attachment is overlooked in the literature. Accordingly, this study focuses on adult daughters’ current attachment to their old mothers in relation with early parental bonding and current attachment to husbands. Participants of the study were 383 adult women (Average age = 40, ranging between 23 and 70) whose mothers were still alive and who were married at the time of the study. Participants were completed Adult Attachment Scale, Parental Bonding Instrument, and Experiences in Close Relationship – II together with demographic questionnaire. Results revealed that daughters’ attachment to their mothers weakens as they get older, have more children, and have longer marriages. Stronger attachment to mothers was found positively correlated with current satisfaction with the relationship, perception of maternal care before the age of 12 and negatively correlated with perception of controlling behavior before the age 12. Considering the relationship between current parental attachment and romantic attachment, it was found that as the current attachment to mother strengthens attachment avoidance towards husband decreases. Results revealed that although attachment between the adult daughters and old mothers weakens, the relationship is still critical in daughters’ lives. The strength of current attachment with the mother is related both with the early relationship with the mother and current attachment with the husband. The current study is thought to contribute to attachment theory emphasizing the attachment as a lifetime construct.

Keywords: adult daughter, attachment, old mothers, parental bonding

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Authors: Behrang Ekrami, Amin Tamadon, Iman Razeghian Jahromi, Darioush Moghadas, Mehdi Ghahremani-Seno, Mostafa Ghaderi-Zefrehei, Ahmad Sodagar Amiri, Taheri Reza

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Persian fallow deer (Dama dama mesopotamica) is belonging to the family Cervidae and is only found in a few protected areas in the northwest, north, and southwest of Iran. The aims of this study were analysis of inbreeding and morphometric parameters of semen in male Persian fallow deer to investigate the cause of reduced fertility of this endangered species in Dasht-e-Naz National Refuge, Sari, Iran. The Persian fallow deer semen was collected from four adult bucks randomly during the breeding and non-breeding season from five dehorned and horned deer's by an artificial vagina. Twelve blood samples was taken from Persian fallow deer and mitochondrial DNA was extracted, amplified, extracted, sequenced and then were considered for genetic analysis. The Persian fallow deer semen, both with normal and abnormal spermatozoa, is similar to that of domestic ruminants but very smaller and difficult to observe at the primary observation. The post-mating season collected ejaculates contained abnormal spermatozoa, debris and secretion of accessory glands in horned bucks and accessory glands secretion free of any spermatozoa in dehorned or early velvet budding bucks. Microscopic evaluation in all four bucks during the mating season showed the mean concentration of 9×106 spermatozoa/ml. The mean ± SD of age, testes length and testes width was 4.60 ± 1.52 years, 3.58 ± 0.32 and 1.86 ± 0.09 cm, respectively. The results identified 1120 loci (assuming each nucleotide as locus) in which 377 were polymorphic. In conclusion, reduced fertility of male Persian fallow deer may be caused by inbreeding of the protected herd in a limited area of Dasht-e-Naz National Refuge.

Keywords: Persian fallow deer, genetic analysis, spermatozoa, reproductive characteristics

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Authors: Pradip Kumar Das

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Phenomenal growth of population and industry exploits the environment in varied ways. Consequently, the greenhouse effect and other allied problems are threatening mankind the world over. Protection and up gradation of environment have, therefore, become the prime necessity all of mankind for the sustainable development of environment. People in humbler walks of life including the corporate citizens have become aware of the impacts of environmental pollution. Governments of various nations have entered the picture with laws and regulations to correct and cure the effects of present and past violations of environmental practices and to obstruct future violations of good environmental disciplines. In this perspective, environmental audit directs verification and validation to ensure that the various environmental laws are complied with and adequate care has been taken towards environmental protection and preservation. The discipline of environmental audit has experienced expressive development throughout the world. It examines the positive and negative effects of the activities of an enterprise on environment and provides an in-depth study of the company processes any growth in realizing long-term strategic goals. Environmental audit helps corporations assess its achievement, correct deficiencies and reduce risk to the health and improving safety. Environmental audit being a strong management tool should be administered by industry for its own self-assessment. Developed countries all over the globe have gone ahead in environment quantification; but unfortunately, there is a lack of awareness about pollution and environmental hazards among the common people in India. In the light of this situation, the conceptual analysis of this study is concerned with the rationale of environmental audit on the industry and the society as a whole and highlights the emerging dimensions in the auditing theory and practices. A modest attempt has been made to throw light on the recent development in environmental audit in developing nations like India and the problems associated with the implementation of environmental audit. The conceptual study also reflects that despite different obstacles, environmental audit is becoming an increasing aspect within the corporate sectors in India and lastly, conclusions along with suggestions have been offered to improve the current scenario.

Keywords: environmental audit, environmental hazards, environmental laws, environmental protection, environmental preservation

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Authors: Ahmed Eid, Amita Gupta

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Abstract: Background: Background Medical gases are estimated to contribute to 5% of the carbon footprints produced by hospitals, Desflurane has the largest impact, but all increase significantly when used with N2O admixture. Climate Change Act 2008, we must reduce our carbon emission by 80% of the 1990 baseline by 2050.NHS carbon emissions have reduced by 18.5% (2007-2017). The NHS Long Term Plan has outlined measures to achieve this objective, including a 2% reduction by transforming anaesthetic practices. FGF is an important variable that determines the utilization of inhalational agents and can be tightly controlled by the anaesthetist. Aims and Objectives Environmental safety, Identification of areas of high N20 and different anaesthetic agents used across the St Helier operating theatres and consider improvising on the current practice. Methods: Data was collected from St Helier operating theatres and retrieved daily from Care Station 650 anaesthetic machines. 60 cases were included in the sample. Collected data (average flow rate, amount and type of agent used, duration of surgery, type of surgery, duration, and the total amount of Air, O2 and N2O used. AAGBI impact anaesthesia calculator was used to identify the amount of CO2 produced and also the cost per hour for every pt. Communication via reminder emails to staff emphasized the significance of low-flow anaesthesia and departmental meeting presentations aimed at heightening awareness of LFA, Distribution of AAGBI calculator QR codes in all theatres enables the calculation of volatile anaesthetic consumption and CO2e post each case, facilitating informed environmental impact assessment. Results: A significant reduction in the flow rate use in the 2nd sample was observed, flow rate usage between 0-1L was 60% which means a great reduction of the consumption of volatile anaesthetics and also Co2e. By using LFA we can save money but most importantly we can make our lives much greener and save the planet.

Keywords: low flow anesthesia, sustainability project, N₂0, Co2e

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Authors: T. Frawley, G. O'Kelly

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The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

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Authors: Lori W. Gordon, Karen A. Jones

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Today’s high-speed data connectivity depends on a vast global network of infrastructure across space, air, land, and sea, with undersea cable infrastructure (UCI) serving as the primary means for intercontinental and ‘long-haul’ communications. The UCI landscape is changing and includes an increasing variety of state actors, such as the growing economies of Brazil, Russia, India, China, and South Africa. Non-state commercial actors, such as hyper-scale content providers including Google, Facebook, Microsoft, and Amazon, are also seeking to control their data and networks through significant investments in submarine cables. Active investments by both state and non-state actors will invariably influence the growth, geopolitics, and security of this sector. Beyond these hyper-scale content providers, there are new commercial satellite communication providers. These new players include traditional geosynchronous (GEO) satellites that offer broad coverage, high throughput GEO satellites offering high capacity with spot beam technology, low earth orbit (LEO) ‘mega constellations’ – global broadband services. And potential new entrants such as High Altitude Platforms (HAPS) offer low latency connectivity, LEO constellations offer high-speed optical mesh networks, i.e., ‘fiber in the sky.’ This paper focuses on understanding the role of submarine cables within the larger context of the global data commons, spanning space, terrestrial, air, and sea networks, including an analysis of national security policy and geopolitical implications. As network operators and commercial and government stakeholders plan for emerging technologies and architectures, hedging risks for future connectivity will ensure that our data backbone will be secure for years to come.

Keywords: communications, global, infrastructure, technology

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Authors: Jeffrey A. Lavarias, Jessie C. Elauria, Arnold R. Elepano, Engelbert K. Peralta, Delfin C. Suministrado

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Shelling process is one of the primary processes and critical steps in the processing of chocolate or any product that is derived from cocoa beans. It affects the quality of the cocoa nibs in terms of flavor and purity. In the Philippines, small-scale food processor cannot really compete with large scale confectionery manufacturers because of lack of available postharvest facilities that are appropriate to their level of operation. The impact of this study is to provide the needed intervention that will pave the way for cacao farmers of engaging on the advantage of value-adding as way to maximize the economic potential of cacao. Thus, provision and availability of needed postharvest machines like mechanical cacao sheller will revolutionize the current state of cacao industry in the Philippines. A mechanical cacao sheller was developed, fabricated, and evaluated to establish optimum shelling conditions such as moisture content of cocoa beans, clearance where of cocoa beans passes through the breaker section and speed of the breaking mechanism on shelling recovery, shelling efficiency, shelling rate, energy utilization and large nib recovery; To establish the optimum level of shelling parameters of the mechanical sheller. These factors were statistically analyzed using design of experiment by Box and Behnken and Response Surface Methodology (RSM). By maximizing shelling recovery, shelling efficiency, shelling rate, large nib recovery and minimizing energy utilization, the optimum shelling conditions were established at moisture content, clearance and breaker speed of 6.5%, 3 millimeters and 1300 rpm, respectively. The optimum values for shelling recovery, shelling efficiency, shelling rate, large nib recovery and minimizing energy utilization were recorded at 86.51%, 99.19%, 21.85kg/hr, 89.75%, and 542.84W, respectively. Experimental values obtained using the optimum conditions were compared with predicted values using predictive models and were found in good agreement.

Keywords: cocoa beans, optimization, RSM, shelling parameters

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Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Olga Shuvaeva, Tamara Romanova, Sergey Volynkin, Valentina Podolinnaya

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Green chemistry concept is focused on the prevention of environmental pollution caused by human activity. However, there are a lot of contaminated areas in the world which pose a serious threat to ecosystems in terms of their conservation. Therefore in accordance with the principles of green chemistry, it should not be forgotten about the need to clean these areas. Furthermore, the waste material often contains the valuable components, the extraction of which by traditional wet chemical technologies is inefficient both from the economic and environmental protection standpoint. Wherein, the plants may be successfully used to ‘scavenge’ a range of metals from polluted land sites in an approach allowing to carry out both of these processes – phytoremediation and phytomining in conjunction. The goal of the present work was to study bioaccumulation ability of floating macrophytes such as water hyacinth and pondweed toward Hg, Ba, Cd, Mo and Pb as pollutants in aquatic medium and terrestrial plants (birch, reed, and cane) towards gold and silver as valuable components. The peculiarity of ongoing research was that the plants grew under extreme conditions (pH of drainage and pore waters was about 2.5). The study was conducted at the territory of Ursk tailings (Southwestern Siberia, Russia) formed as a result of primary polymetallic ores cyanidation. The waste material is mainly presented (~80%) by pyrite (FeS₂) and barite (BaSO₄), the raw minerals included FeAsS, HgS, PbS, Ag₂S as minor ones. It has been shown that water hyacinth demonstrates high ability to accumulate different metals, and what is especially important – to remove mercury from polluted waters with BCF value more than 1000. As for the gold, its concentrations in reed and cane growing near the waste material were estimated as 500 and 900 μg∙kg⁻¹ respectively. It was also found that the plants can survive under extreme conditions of acidic environment and hence we can assume that there is a principal opportunity to use them for the valuable substances extraction from an area of the mining waste dumps burial.

Keywords: bioaccumulation, gold, heavy metals, mine tailing

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Authors: Md. Mizanoor Rahman, Md. Zakir Hossain Talukder, M. Mahruf C. Shohel, Prithvi Shrestha

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In Bangladesh, classroom practice and English Learning (EL) competencies acquired both by the teacher and learner in primary and secondary schools are still very weak. Therefore, English is the most commonly failed examination subject at the school level; in addition, there are severe problems in communicative English by the Bangladeshi nationals– this has been characterized as a constraint to economic development. Job applicants and employees often lack English language skills necessary to work effectively. As a result; both government and its international development partners such as DFID, UNESCO, and CIDA have been very active to uplift the quality of the English language learning and implementing projects with innovative approaches. Recently; the economy has been increasing and in line with this, the technology has been deployed in English learning to improve reading, writing, speaking and listening skills. Young Bangladeshi creative, from a variety of backgrounds including film, animation, photography, and digital media are being trained to develop ideas for English Language Teaching (ELT) media. They are being motivated to develop a wide range of ideas for low cost English learning media products. English Language education policy in Bangladesh supports communicative language teaching practices and accordingly, actors have been influencing curriculum, textbook, deployment of technology and assessment changes supporting communicative ELT. The various projects are also being implemented to reform the curriculum, revise the textbook and adjust the assessment mechanism so that the country can increase in proficiency in communicative English among the population. At present; the numbers of teachers, students and adult learners classified at higher levels of proficiency because of deployment of technology and motivation for learning and using English among school population of Bangladesh. The current paper discusses the various interventions in Bangladesh with appropriate media to improve the competencies of the ELT among population.

Keywords: English learning, technology, education, psychological sciences

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Authors: Iori Hamada

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Australia's skilled migrant selection system is constantly changing its target skills and criteria according to the labour market demands. The government's intention to employ this highly selective market-driven selection system is to better target the skills needed in the economy, enable skilled migrants to be employed in industries that have the highest need, and consequently boost the economy and population. However, migration scholars have called this intention into question, arguing that the system is not making the best use of skilled migrants. This paper investigates the impact of recent reforms in Australian skilled migration system on skilled migrants' employment and related life conditions. Drawing on semi-structured qualitative interviews with Japanese skilled migrants in Australia, it argues that Australia’s skilled migrant selection system guarantees neither skilled migrants' employment nor successful transfer of their skills to the labour market. The findings show that Japanese skilled migrants are often unemployed or under-employed, although they intend to achieve upward occupational mobility. The interview data also reveal that male unemployment or under-employment status prompts some Japanese men to leave Australia and find a job that better matches their skills and qualifications in a new destination. Further, it finds that Japanese male skilled migrants who experience downward occupational mobility tend to continue to take a primary breadwinner role, which affects the distribution of paid and unpaid work within their families. There is a growing body of research investigating skilled migrants’ downward career mobility. However, little has been written on skilled Japanese migrants. Further, the work-family intersection is a 'hot public policy topic' in Australia and elsewhere. Yet, the existing studies focus almost exclusively on non-migrant families. This calls attention to the urgency of assessing the work-family lives of skilled migrants. This study fills these gaps, presenting additional insight into Japanese skilled migrants’ work and family in and beyond Australia.

Keywords: Australia, employment, family, Japanese skilled migrants

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Authors: Debasis Sarkar, Jatan Talati

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This paper is an attempt to develop an Integrated Mass Rapid Transit System (MRTS) for a smart city project in Western India. Integrated transportation is one of the enablers of smart transportation for providing a seamless intercity as well as regional level transportation experience. The success of a smart city project at the city level for transportation is providing proper integration to different mass rapid transit modes by way of integrating information, physical, network of routes fares, etc. The methodology adopted for this study was primary data research through questionnaire survey. The respondents of the questionnaire survey have responded on the issues about their perceptions on the ways and means to improve public transport services in urban cities. The respondents were also required to identify the factors and attributes which might motivate more people to shift towards the public mode. Also, the respondents were questioned about the factors which they feel might restrain the integration of various modes of MRTS. Furthermore, this study also focuses on developing a utility equation for respondents with the help of multiple linear regression analysis and its probability to shift to public transport for certain factors listed in the questionnaire. It has been observed that for shifting to public transport, the most important factors that need to be considered were travel time saving and comfort rating. Also, an Integrated MRTS can be obtained by combining metro rail with BRTS, metro rail with monorail, monorail with BRTS and metro rail with Indian railways. Providing a common smart card to transport users for accessing all the different available modes would be a pragmatic solution towards integration of the available modes of MRTS.

Keywords: mass rapid transit systems, smart city, metro rail, bus rapid transit system, multiple linear regression, smart card, automated fare collection system

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Authors: Kristel Faye Tandog

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The State Owned Enterprise (SOE) or also called Public Enterprise (PE) has been playing a vital role in a country’s social and economic development. Following this idea, this study focused on the Factor Structures of Financial Performance of the Local Economic Enterprises (LEEs) namely: Food Court, Market, Slaughterhouse, and Terminal in Matalam, Cotabato. It aimed to determine the profile of the LEEs in terms of organizational structure, manner of creation, years in operation, source of initial operating requirements, annual operating budget, geographical location, and size or description of the facility. This study also included the different financial ratios of LEE that covered a five year period from Calendar Year 2009 to 2013. Primary data using survey questionnaire was administered to 468 respondents and secondary data were sourced out from the government archives and financial documents of the said LGU. There were 12 dominant factors identified namely: “management”, “enforcement of laws”, “strategic location”, “existence of non-formal competitors”, “proper maintenance”, “pricing”, “customer service”, “collection process”, “rentals and services”, “efficient use of resources”, “staffing”, and “timeliness and accuracy”. On the other hand, the financial performance of the LEE of Matalam, Cotabato using financial ratios needs reformatting. This denotes that refinement as to the following ratios: Cash Flow Indicator, Activity, Profitability and Growth is necessary. The cash flow indicator ratio showed difficulty in covering its debts in successive years. Likewise, the activity ratios showed that the LEE had not been effective in putting its investment at work. Moreover, profitability ratios revealed that it had operated in minimum capacity and had incurred net losses and thus, it had a weak profit performance. Furthermore, growth ratios showed that LEE had a declining growth trend particularly in net income.

Keywords: factor structures, financial performance, financial ratios, state owned enterprises

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Authors: Hamideh Nouri, Sattar Chavoshi Borujeni

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Grey infrastructure is an unavoidable part of urbanisation that is threatening the local microclimates. Sustainable urbanisation requires more green infrastructure in cities such as green roofs to minimise urbanisation impacts. The environmental, social and economic benefits of green roofs are widely deliberated. However, there is still a lack of assessment of the water management for green roofs. This paper aimed to assess the irrigation management of green roofs in a semi-arid region where blue water scarcity is one of the primary challenges in urban water management. To determine the appropriate water source and growing media for green roofs, an experiment was established at the University of South Australia, Australia. This study compared the performance of two growing media and three water sources on the drainage quality, medium weight and survival rate of potted Tussock grass (Poa labillardieral), an endemic plant to Australia and recommended for green roofs. Three irrigation sources were tap water, mixed of wastewater-stormwater, and rainwater. The growing media were natural sandy loam soil and Scoria - one of the most used commercial growing media for green roofs. The drainage quality of these media was tested by analysing leachate samples. Medium weight was measured before and after watering, and all pots were monitored for their survival rates. Results showed that although plant growing development was significantly higher in Scoria, the survival rate was lower. For all three water sources, EC and pH of the leachate were significantly lower from Scoria than the sandy loam soil. However, the mixed of wastewater-stormwater had the highest EC, and rainwater had the lowest EC. Results did not present a significant difference between pH of different water resources in the same media. Our experimental results found the scoria and rainwater as the best sources of medium and water for green roofs.

Keywords: green smart cities, urban water, green roofs, green walls, wastewater, stormwater

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Authors: Akram Sadat Jafari Roodbandi, Alireza Choobineh, Nazanin Hosseini, Vafa Feyzi

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Introduction: Physical fitness and optimum functional movement are essential for efficiently performing job tasks without fatigue and injury. Functional Movement Screening (FMS) tests are used in screening of athletes and military forces. Nurses and emergency medical staff are obliged to perform many physical activities such as transporting patients, CPR operations, etc. due to the nature of their jobs. This study aimed to assess relationship between FMS test score and the prevalence of musculoskeletal disorders (MSDs) in emergency nurses and emergency medical services (EMS) staff. Methods: 134 male and female emergency nurses and EMS technicians participated in this cross-sectional, descriptive-analytical study. After video tutorial and practical training of how to do FMS test, the participants carried out the test while they were wearing comfortable clothes. The final score of the FMS test ranges from 0 to 21. The score of 14 is considered weak in the functional movement base on FMS test protocol. In addition to the demographic data questionnaire, the Nordic musculoskeletal questionnaire was also completed for each participant. SPSS software was used for statistical analysis with a significance level of 0.05. Results: Totally, 49.3% (n=66) of the subjects were female. The mean age and work experience of the subjects were 35.3 ± 8.7 and 11.4 ± 7.7, respectively. The highest prevalence of MSDs was observed at the knee and lower back with 32.8% (n=44) and 23.1% (n=31), respectively. 26 (19.4%) health worker had FMS test score of 14 and less. The results of the Spearman correlation test showed that the FMS test score was significantly associated with MSDs (r=-0.419, p < 0.0001). It meant that MSDs increased with the decrease of the FMS test score. Age, sex, and MSDs were the remaining significant factors in linear regression logistic model with dependent variable of FMS test score. Conclusion: FMS test seems to be a usable screening tool in pre-employment and periodic medical tests for occupations that require physical fitness and optimum functional movements.

Keywords: functional movement, musculoskeletal disorders, health care worker, screening test

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Authors: Yuzhen Hu, Sirui Wang

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As a training base for intellectual talents, universities have a large number of students. Teaching is a primary activity in universities, and during the teaching process, a large number of people gather both inside and outside the teaching buildings, posing a strong risk of close contact. The class schedule is the fundamental basis for teaching activities in universities and plays a crucial role in the management of teaching order. Different class schedules can lead to varying degrees of indoor gatherings and trajectories of class attendees. In recent years, highly contagious diseases have frequently occurred worldwide, and how to reduce the risk of infection has always been a hot issue related to public safety. "Reducing gatherings" is one of the core measures in epidemic prevention and control, and it can be controlled through scientific scheduling in specific environments. Therefore, the scientific prevention and control goal can be achieved by considering the reduction of the risk of excessive gathering of people during the course schedule arrangement. Firstly, we address the issue of personnel gathering in various pathways on campus, with the goal of minimizing congestion and maximizing teaching effectiveness, establishing a nonlinear mathematical model. Next, we design an improved genetic algorithm, incorporating real-time evacuation operations based on tracking search and multidimensional positive gradient cross-mutation operations, considering the characteristics of outdoor crowd evacuation. Finally, we apply undergraduate course data from a university in Harbin to conduct a case study. It compares and analyzes the effects of algorithm improvement and optimization of gathering situations and explores the impact of path blocking on the degree of gathering of individuals on other pathways.

Keywords: the university timetabling problem, risk prevention, genetic algorithm, risk control

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Authors: Md. Asif Ullah, M. A. R. Sarkar

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This paper illustrates 2-D and 3-D simulations of sub-channels of a Pressurized Water Reactor (PWR) having hexagonal array of fuel rods. At a steady state, the temperature of outer surface of the cladding of fuel rod is kept about 1200°C. The temperature of this isothermal surface is taken as boundary condition for simulation. Water with temperature of 290°C is given as a coolant inlet to the primary water circuit which is pressurized upto 157 bar. Turbulent flow of pressurized water is used for heat removal. In 2-D model, temperature, velocity, pressure and Nusselt number distributions are simulated in a vertical sectional plane through the sub-channels of a hexagonal fuel rod assembly. Temperature, Nusselt number and Y-component of convective heat flux along a line in this plane near the end of fuel rods are plotted for different Reynold’s number. A comparison between X-component and Y-component of convective heat flux in this vertical plane is analyzed. Hexagonal fuel rod assembly has three types of sub-channels according to geometrical shape whose boundary conditions are different too. In 3-D model, temperature, velocity, pressure, Nusselt number, total heat flux magnitude distributions for all the three sub-channels are studied for a suitable Reynold’s number. A horizontal sectional plane is taken from each of the three sub-channels to study temperature, velocity, pressure, Nusselt number and convective heat flux distribution in it. Greater values of temperature, Nusselt number and Y-component of convective heat flux are found for greater Reynold’s number. X-component of convective heat flux is found to be non-zero near the bottom of fuel rod and zero near the end of fuel rod. This indicates that the convective heat transfer occurs totally along the direction of flow near the outlet. As, length to radius ratio of sub-channels is very high, simulation for a short length of the sub-channels are done for graphical interface advantage. For the simulations, Turbulent Flow (K-Є ) module and Heat Transfer in Fluids (ht) module of COMSOL MULTIPHYSICS 5.0 are used.

Keywords: sub-channels, Reynold’s number, Nusselt number, convective heat transfer

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Authors: Angelis P. Barlampas

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Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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Authors: Rumaisa Shahid, Saad Aziz Durrani, Shameel Pervez, Ibatsam Khokhar

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Food waste is a prevalent issue in Pakistan, with over 40 percent of food discarded annually. Despite their decay, rotting fruits retain residual nutritional value consumed by microorganisms, notably fungi and bacteria. Fungi, preferred for their extracellular enzyme release, are gaining prominence, particularly for pectinase production. This enzyme offers several advantages, including clarifying juices by breaking down pectic compounds. In this study, three Aspergillus flavus isolates derived from decomposed fruits and manure were selected for pectinase production. The primary aim was to isolate fungi from diverse waste sources, identify the isolates and assess their capacity for pectinase production. The identification was done through morphological characteristics with the help of Light microscopy and Scanning Electron Microscopy (SEM). Pectinolytic potential was screened using pectin minimal salt agar (PMSA) medium, comparing clear zone diameters among isolates. Identification relied on morphological characteristics. Optimizing substrate (lemon and orange peel powder) concentrations, pH, temperature, and incubation period aimed to enhance pectinase yield. Spectrophotometry enabled quantitative analysis. The temperature was set at room temperature (28 ºC). The optimal conditions for Aspergillus flavus strain AF1(isolated from mango) included a pH of 5, an incubation period of 120 hours, and substrate concentrations of 3.3% for orange peels and 6.6% for lemon peels. For AF2 and AF3 (both isolated from soil), the ideal pH and incubation period were the same as AF1 i.e. pH 5 and 120 hours. However, their optimized substrate concentrations varied, with AF2 showing maximum activity at 3.3% for orange peels and 6.6% for lemon peels, while AF3 exhibited its peak activity at 6.6% for orange peels and 8.3% for lemon peels. Among the isolates, AF1 demonstrated superior performance under these conditions, comparatively.

Keywords: pectinase, lemon peel, orange peel, aspergillus flavus

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Authors: Carmen Silvia Gabriel, Dsniele Bernardi da Costa, Andrea Bernardes, Sabrina Elias Mikael, Daniele da Silva Ramos

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The goal of this quantitative study is to investigate patient safety culture from the perspective of professional from the hospital nursing team.It was conducted in two Brazilian hospitals,.The sample included 282 nurses Data collection occurred in 2013, through the questionnaire Hospital Survey on Patient Safety Culture.Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor overlooks patient safety problems.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.On hospital management support for patient safety, 52.8% refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.On frequency of event reporting, 64.7% said often and always notify events with no damages to patients..About teamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8 % disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6 % classified it as very good. it is concluded that there are positive points in the safety culture, and some weaknesses as a punitive culture and impaired patient safety due to work overload .

Keywords: quality of health care, health services evaluation, safety culture, patient safety, nursing team

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Authors: Sonia Barbouchi, Meriem Samcha

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Scale deposition during water injection into aquifer of oil reservoirs is a serious problem experienced in the oil production industry. One of the primary causes of scale formation and injection well plugging is mixing two waters which are incompatible. Considered individually, the waters may be quite stable at system conditions and present no scale problems. However, once they are mixed, reactions between ions dissolved in the individual waters may form insoluble products. The purpose of this study is to identify the causes of well plugging in a southern Tunisian oilfield, where fresh water has been injected into the producing wells to counteract the salinity of the formation waters and inhibit the deposition of halite. X-ray diffraction (XRD) mineralogical analysis has been carried out on scale samples collected from the blocked well. Two samples collected from both formation water and injected water were analysed using inductively coupled plasma atomic emission spectroscopy, ion chromatography and other standard laboratory techniques. The results of complete waters analysis were the typical input parameters, to determine scaling tendency. Saturation indices values related to CaCO3, CaSO4, BaSO4 and SrSO4 scales were calculated for the water mixtures at different share, under various conditions of temperature, using a computerized scale prediction model. The compatibility study results showed that mixing the two waters tends to increase the probability of barite deposition. XRD analysis confirmed the compatibility study results, since it proved that the analysed deposits consisted predominantly of barite with minor galena. At the studied temperatures conditions, the tendency for barite scale is significantly increasing with the increase of fresh water share in the mixture. The future scale inhibition and removal strategies to be implemented in the concerned oilfield are being derived in a large part from the results of the present study.

Keywords: compatibility study, produced water, scaling, water injection

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Authors: Bibiana Hlebova

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The Slovak Republic is a democratic and plural society consisting of people differing in language and culture, and its citizens should already be well prepared for the coexistence of multiple nations, nationalities or ethnic groups. Reflection on culture, art and literature of the Roma minority has taken on a new dimension in Slovakia in the past two decades when it comes to social, cultural and arts integration of this ethnic group with the plural society. Non-Roma view Roma as a specific ethnic group with their own culture, language, customs and traditions, social norms and coexistence that has retained archetypal qualities of Roma identity (romipen) in their real lives as well as in the literary world. Roma characters in works of art are specific and distinguishable from other literary characters simply by being Roma, that is, of a different origin and social status, they represent a different way of life, a distinctive hierarchy of values. The portrayal of Roma and the life of Roma ethnic group in the most dominant genre of Roma literature for children and youth, a Roma fairy tale (paramisi), can work as a suitable means to learn about, accept and tolerate the otherness of Roma in the conditions of school inclusion of students coming from the Roma ethnic group, and to support their identification with their own ethnic group and its cultural traditions. The paper aims to point out not only the specific nature of Roma identity (romipen) through the selected Roma fairy tale (paramisa) – Children of the Sun, but also the diversity of its uses in the educational process within primary education of pupils at elementary schools, advocating the philosophy of inclusive education. Through the suggestions of multi-cultural, emotional, and language and communication education of pupils through the work with the selected Roma fairy tale (paramisa), the author is exploring ways to overcome the issues stemming from the coexistence of Roma and Non-Roma pupils, which are burdened with prejudice, intolerance, aggression and racism on both sides, in the education process.

Keywords: inclusive education, otherness, Roma, Roma fairy tale, Roma identity

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Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi

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Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.

Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis

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Authors: Ranojoy Dutta

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HVAC equipment capacity has a direct impact on occupant comfort and energy consumption of a building. Glazing gains, especially in buildings with high window area, can be a significant contributor to the total peak load on the HVAC system, leading to over-sized systems that mostly operate at poor part load efficiency. In addition, radiant temperature, which largely drives occupant comfort in glazed perimeter zones, is often not effectively controlled despite the HVAC being designed to meet the air temperature set-point. This is due to short wave solar radiation transmitted through windows, that is not sensed by the thermostat until much later when the thermal mass in the room releases the absorbed solar heat to the indoor air. The implication of this phenomenon is increased cooling energy despite poor occupant comfort. EC glazing can significantly eliminate direct solar transmission through windows, reducing both the space cooling loads for the building and improving comfort for occupants near glazing. This paper will review the exact mechanism of how EC glazing would reduce the peak load under design day conditions, leading to reduced cooling capacity vs regular high-performance glazing. Since glazing heat transfer only affects the sensible load, system sizing will be evaluated both with and without the availability of a DOAS to isolate the downsizing potential of the primary cooling equipment when outdoor air is conditioned separately. Given the dynamic nature of glazing gains due to the sun’s movement, effective peak load mitigation with EC requires an automated control system that can predict solar movement and radiation levels so that the right tint state with the appropriate SHGC is utilized at any given time for a given façade orientation. Such an automated EC product will be evaluated for a prototype commercial office model situated in four distinct climate zones.

Keywords: electrochromic glazing, peak sizing, thermal comfort, glazing load

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Authors: Sellidj Abdelaziz, Lebaili Soltane

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A cobalt-based alloy type Co-Cr-Ni-WC was deposited by plasma transferred arc projection (PTA) on a stainless steel valve. The alloy is characterized at the equilibrium by a solid solution Co (γ) mainly dendritic, and eutectic carbides M₇C₃ and ηM₆C. At the deposit/substrate interface, this microstructure is modified by the fast cooling mode of the alloy when applied in the liquid state on the relatively cold steel substrate. The structure formed in this case is heterogeneous and metastable phases can occur and evolve over temperature service. Coating properties and reliability are directly related to microstructures formed during deposition. We were interested more particularly in this microstructure formed during the solidification of the deposit in the region of the interface joining the soldered couple and its evolution during cyclic heat treatments at temperatures similar to those of the thermal environment of the valve. The characterization was carried out by SEM-EDS microprobe CAMECA, XRD, and micro hardness profiles. The deposit obtained has a linear and regular appearance that is free of cracks and with little porosity. The morphology of the microstructure represents solidification stages that are relatively fast with a temperature gradient high at the beginning of the interface by forming a plane front solid solution Co (γ). It gradually changes with the decreasing temperature gradient by getting farther from the junction towards the outer limit of the deposit. The matrix takes the forms: cellular, mixed (cells and dendrites) and dendritic. Dendritic growth is done according to primary ramifications in the direction of the heat removal which takes place in the direction perpendicular to the interface, towards the external surface of the deposit, following secondary and tertiary undeveloped arms. The eutectic carbides M₇C₃ and ηM₆C formed are very thin and are located in the intercellular and interdendritic spaces of the solid solution Co (γ).

Keywords: Co-Ni-Cr-W-C alloy, solid deposit, microstructure, carbides, cyclic heat treatment

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Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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