Search results for: Greek public hospital sector

Authors: S. Yakubu, E. A. Isah

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One of the objectives of the school discipline policy is to instill discipline among students. However, despite the availability of this policy in various secondary schools in Nigeria, there seem to be numerous cases of indiscipline among students, which has become a source of concern to all stakeholders in the education sector. In an attempt to proffer possible solutions to this unending challenge, the study investigated the influence of knowledge and attitude on compliance of secondary school students towards school discipline policy in Ibadan North Local Government Area of Oyo State, Nigeria. The descriptive survey research design was employed to collect the requisite data. The multi-stage sampling procedure was adopted to select 570 respondents as the sample for the study. The data collected were analyzed using statistical measures of Mean, Standard deviation and Pearson Product Moment Correlation. The findings of the study showed that knowledge and compliance of school discipline policy among secondary school students in Ibadan North Local Government Area of Oyo State were significantly related (r =0.330, p<0.05). The study also revealed a significant relationship between attitude and compliance of school discipline policy among secondary school students in Ibadan North Local Government Area of Oyo State (r = 0.593, p<0.05). Based on the findings, it was recommended that school rules and regulations should be emphasized and given more awareness for easy compliance. Also, students should be encouraged to portray a positive attitude towards their respective rules and regulations.

Keywords: knowledge, attitude, compliance, school discipline policy

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Authors: Elizabeth Adebomi Akinlotan, Olukemi Odukoya

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INTRODUCTION: Physical Activity is defined as activity that involves bodily movement which is done as a part of daily activity in the form of working, playing, active transportation such as walking and also as a form of recreational activity. Physical inactivity has been identified as the fourth leading risk factor for global mortality and morbidity causing an estimated 3.2 million deaths globally and 5.5% of total deaths and it remains a pressing public health issue. There is a shift in the major causes of death from communicable to non-communicable diseases in many developed countries and this is fast becoming the case in developing countries. Physical activity is an important determinant of health and has been associated with lower mortality rates as it reduces the risk of developing chronic diseases such as diabetes mellitus, hypertension, stroke, cancer and osteoporosis. It improves musculoskeletal health, controls weight and reduces symptoms of depression. AIM: The aim is to study the knowledge, attitude and practices of physical activity among adults in Alimosho local government area. METHODOLOGY: This was a descriptive cross sectional survey designed to study the knowledge, attitude and practice of physical activity among adults in Alimosho Local Government Area. The study population were 250 adults aged 18-65 who were residents of the area of more than 6 months duration and had no chronic disease condition or physical disability. A multistage sampling method was used to select the respondents and data was collected using interviewer administered questionnaires. The data was analyzed with the use of EPI-info 2007 statistical software. Chi Square was thereafter used to test the association between selected variables. The level of statistical significance was set at 5% (p<0.05). RESULTS: In general, majority (61.6%) of the respondents had a good knowledge of what physical activity entails, 34.0% had fair knowledge and 4.4% had poor knowledge. There was a favorable attitude towards physical activity among the respondents with 82.4% having an overall positive attitude. Below a third of the respondents (26.4%) reported having a high physical activity (METS > 3001) while 40.0% had moderate (601-3000 METS) levels of activity and 33.6% were inactive (<600METS). There is statistical significance between the gender of the respondent and the levels of physical activity (p=0.0007); 75.2% males reached the minimum recommendations while 24.8% were inactive and 55.0% females reached the minimum recommendations while 45.0% were inactive. Results also showed that of 95 respondents who were satisfied with their levels of physical activity, 33.7% were insufficiently active while 66.3% were either minimally active or highly active and of 110 who were unsatisfied with their levels of physical activity, 72.0% were above the minimum recommendations while 38.0% were insufficiently active. CONCLUSION: In contrast to the high level of knowledge and favorable attitude towards physical activity, there was a lower level of practice of high or moderate physical activities. It is recommended that more awareness should be created on the recommended levels of physical activity especially for the vigorous intensity and moderate intensity physical activity.

Keywords: METS, physical activity, physical inactivity, public health

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Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.

Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn

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Authors: Sina Gharevali

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Staphylococcus aureus is one of the most important factors for nosocomial infections and infections acquired in a hospital setting role as is. Drug-resistant bacteria methicillin, which in 1961 was reported in many parts of the world, Made the role as the last drug, vancomycin, in the treatment of infections caused by the Staphylococcus aureus chain be taken into consideration. The aim of this study was to evaluate the antimicrobial effects of copper nanoparticles and compared it with antibiotics on Staphylococcus aureus resistant to vancomycin in vitro and animal model. In this study, this test was performed, and the most effective antibiotic for vancomycin-resistant Staphylococcus aureus was determined by disk diffusion method. After various concentrations of copper nanoparticles and antibiotics were prepared and vancomycin resistant Staphylococcus aureus bacteria with serial dilution method for determining antibiotic ciprofloxacin. Minimum Inhibitory Concentration and Minimum Bactericidal Concentrationcopper nanoparticles was performed. The agar dilution method for bacterial growth in different concentrations of copper nanoparticles and antibiotics ciprofloxacin was performed. The agar dilution method for bacterial growth in different concentrations of copper nanoparticles and antibiotics ciprofloxacin was performed. Then the broth dilution method for the antibiotic ciprofloxacin, nano-particles, and nano-particles of copper and copper-established antibiotic synergy MIC and MBC were obtained. MBC was obtained from the experimental animal model test method, and the results were compared. The results showed that copper nanoparticles compared with the antibiotic ciprofloxacin in vitro and animal model more effective in inhibiting the growth of Staphylococcus aureus resistant to vancomycin and ciprofloxacin and extent of the impact of the Synthetic effect of lower copper nanoparticles. Which can then be used to treat clinical research as a candidate.

Keywords: nanoparticles, copper, staphylococcus, aureus

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Authors: Isaac Kofi Mensah, Jianing Mi, Cheng Feng

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Electronic government is the application of Information and Communication Technologies (ICTs) by the government to improve public service delivery to citizens and businesses. The purpose of this study is to investigate factors influencing the adoption and use of e-government services from different nationalities perspectives. The Technology Acceptance Model (TAM) will be used as the theoretical framework for the study. A questionnaire would be developed and administered to 500 potential respondents who are students from different nationalities in China. Predictors such as perceived usefulness, perceived ease of use, computer self-efficacy, trust in both the internet and government, social influence and perceived service quality would be examined with regard to their impact on the intention to use e-government services. This research is currently at the design and implementation stage. The completion of this study will provide useful insights into understanding factors impacting the decision to use e-government services from a cross and multi nationalities perspectives.

Keywords: different nationalities, e-government, e-government services, technology acceptance model (TAM)

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Authors: Hadach Mohamed

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Tourism becomes more and more a source of added value for developing countries. In Morocco, the sector contributes at 20% of national GDP, or the effects of this activity become increasingly harmful. The methodology we followed is qualitative, we analyzed the data according to a process-based approach in two longitudinal period from 2001 to 2009 and a period of real time from 2010 to 2014.Through a process-based longitudinal study we analyzed the effects of tourism on the three components of sustainability: economic, environmental and socio-cultural in Essaouira destination in the south west of Morocco. The objective of this paper is to identify among others, harmful effects of mass tourism on fragile destination in terms of load capacity, promotion of youth employment and respect for indigenous traditions. This study also aims to analyze the impact of tourism on the fragile destination, which depends heavily on this activity; it also seeks to test a series of indicators for sustainable development of sensitive areas. Within results, we found that tourism as an activity is very linked to the international situation, tested sustainable development indicators showed us that tourism is environmentally destructive, job creator and changer modes and lives of indigenous. Between the two periods analyzed, the situation becomes more and more vulnerable and the state intervention is becoming more indispensable. We also found that 70% of the population of the destination does not benefit from the income generated by the destination. This raises questions about the fate of the added value of this activity.

Keywords: economic, environmental and socio-cultural, fragile destination, tourism sustainability

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Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

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BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

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Authors: Ruben Molina, Melissa Ochoa

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The rapid expansion and facilities that the Chinese government has granted to its inhabitants to travel abroad has brought benefits to the economies of the countries where these tourists travel. Due to the great economic spill that these tourists make in their travels and the great potential they possess, they become one of the most attractive segments in the world, causing countries to seek to attract them for the profits. The Chinese tourist is a tourist who seeks to know the culture, culinary experiences, traditions and folklore of the place where they travel, more than seeking sun and beach. Mexico is a country that has a great mix of tourist products and services, which favors that the tourism offer focuses on the satisfaction of the needs and preferences of the different segments of international tourists who arrive in Mexico: sun and beach tourism and also cultural tourism. Mexico has 51 sites inscribed on the World Heritage List, of which 12 are natural, 37 are cultural and 2 are mixed. Despite the great tourist attraction of the country and the strategic importance of the sector for the economy, Mexico has not managed to have a large number of tourists or income from international tourism for 15 years. One way to increase the travel industry is to attract the Chinese tourist to Mexico, which is considered a priority by countries like the United States, France and Spain due to the advantages they entail. Therefore, this article will describe the tastes, preferences and habits of Chinese tourists coming to the most popular destinations in Mexico through a Likert scale and it will be described which are the most attractive cultural factors in Mexico for the Chinese tourists and will be proposing strategies of attraction for Mexico and its destinations.

Keywords: attraction, Chinese tourist, cultural tourism, strategic, Mexico

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Authors: Nurul Liyana Abdul Aziz, Nur Aidya Hanum Aizam

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Course timetabling problems occur every semester in a university which includes the allocation of resources (subjects, lecturers and students) to a number of fixed rooms and timeslots. The assignment is carried out in a way such that there are no conflicts within rooms, students and lecturers, as well as fulfilling a range of constraints. The constraints consist of rules and policies set up by the universities as well as lecturers’ and students’ preferences of courses to be allocated in specific timeslots. This paper specifically focuses on the preferences of the course timetabling problem in one of the public universities in Malaysia. The demands will be considered into our existing mathematical model to make it more generalized and can be used widely. We have distributed questionnaires to a number of lecturers and students of the university to investigate their demands and preferences for their desired course timetable. We classify the preferences thus converting them to construct one mathematical model that can produce such timetable.

Keywords: university course timetabling problem, integer programming, preferences, constraints

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Authors: Diana Bardhi

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Road safety is an essential part of the economic and social development of any industrialized country. Decisions to maintain and improve the reliability, functionality of infrastructure structures can only be achieved through integrated road life cycle planning and management. There has always been a tendency to review road maintenance strategies, but there is still no serious and reliable administration due to not only insufficient funds but also problems in the proper reorganization of this system. The safety and performance of the road system depend on the ongoing activity of road maintenance management. For it to be effective, it is necessary to intervene before the degradation has caused irreparable damage or damage with a high economic cost of repairs. Investments in road infrastructure during 2006-2014 show that the life of these projects presents problems related to the maintenance and management of life cycle performance in a wide range of constituent elements. Maintenance planning includes various problems that depend on the degree of degradation of asphalt layers, the degree of damage to road structures (bridges, tunnels, culverts, and the economic planning of resources for their repair). The purpose of this study is first to provide a brief overview of the problems in the field of maintenance and life cycle management of road infrastructure investments, proposing ways to reorganize the sector of administration and maintenance of ongoing roads and secondly testing and evaluating the work and nature of standards of different types of road infrastructure projects, through a methodology consisting of a) development, b) data collection, and c) analysis.

Keywords: infrastructure, maintenance, depreciation, efficiency

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Authors: Antigoni Parmaxi, Anna Nicolaou, Salomi Papadima-Sophocleous, Dimitrios Boglou

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This study provides an overview of the socio linguistic situation of an under-researched city, Limassol, Cyprus, with regard to multilingualism and plurilingualism. More specifically, it explores issues pertaining to multilingualism and plurilingualism in education, the public sphere, economic life, the private sphere, and urban spaces. Through an examination of Limassol’s history of language diversity, as well as through an analysis of the city from a contemporary point of view, the study attempts to portray the multilingual Limassol of yesterday and of today. Findings demonstrate several aspects of multilingualism, such as how communication is achieved among the citizens, how the city encourages multilingualism, as well as what policies and practices are implemented in the various spheres in order to promote intercultural dialogue and mutual understanding. As a result of the findings, suggestions for best practices, introduction or improvement of policies and visions of the city are put forward.

Keywords: language diversity, social inclusion, multilingualism, language visibility, language policy

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Authors: M. Touhidul Islam Sarker, Mohammod Abul Kashem

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The purpose of this paper is to improve the e-learning system and digitize the learning method in the educational sector. The learner will login into e-learning platform and easily access the digital content, the content can be downloaded and take an assessment for evaluation. Learner can get access to these digital resources by using tablet, computer, and smart phone also. E-learning system can be defined as teaching and learning with the help of multimedia technologies and the internet by access to digital content. E-learning replacing the traditional education system through information and communication technology-based learning. This paper has designed and implemented integrated e-learning system architecture with University Management System. Moodle (Modular Object-Oriented Dynamic Learning Environment) is the best e-learning system, but the problem of Moodle has no school or university management system. In this research, we have not considered the school’s student because they are out of internet facilities. That’s why we considered the university students because they have the internet access and used technologies. The University Management System has different types of activities such as student registration, account management, teacher information, semester registration, staff information, etc. If we integrated these types of activity or module with Moodle, then we can overcome the problem of Moodle, and it will enhance the e-learning system architecture which makes effective use of technology. This architecture will give the learner to easily access the resources of e-learning platform anytime or anywhere which digitizes the learning method.

Keywords: database, e-learning, LMS, Moodle

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Authors: Sunil Kumar Singal, Manoj Sood, Upendra Bajpai

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Instream technology is the upcoming sustainable approach in the hydro sector for energy harnessing. With well-known cross-sections and regulated supply, open channels are the most prominent locations for the installation of hydrokinetic turbines. The fluctuation in generated torque varies with site condition (flow depth and flow velocity), as well as with the type of turbine. The present experimental study aims to investigate the torque/power fluctuations of crossflow hydrokinetic turbines operating at different flow velocities and water depths. The flow velocity is varied from 1.0 m/s to 2.0 m/s. The complete assembly includes an open channel having dimensions of 0.3 m (depth) x 0.71 m (width) x 4.5 m (length), along with a lifting mechanism for varying the channel slope, a digital transducer for monitoring the torque, power, and rpm, a digital handheld water velocity meter for measuring the flow velocity. Further, a time series of torque, power, and rpm is plotted for a duration of 30 minutes showing the continuous operation of the turbine. A comparison of Savonius, Darrieus, and their improved twisted and helical blades is also presented in the study. A correlation has also been developed for assessing the hydropower generation from the installed turbine. The developed correlations will be very useful in the decision-making process for development at a site.

Keywords: darrieus turbine, flow velocity, open channel, savoinus turbine, water depth, hydropower

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Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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Authors: Murtadha Kareem, Oliver Faust

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Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Mahdi Karazmodeh, Pooyan Jafari

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One of the most interesting topics in finance is the relation between stock prices and exchange rates. During the past decades different stock markets in different countries have been the subject of study for researches. The volatilities of exchange rates and its effect on stock prices during the past 10 years have continued to be an attractive research topic. The subject of this study is one of the most important indices, FTSE 100. 20 firms with the highest market capitalization in 5 different industries are chosen. Firms are included in oil and gas, mining, pharmaceuticals, banking and food related industries. 5 different criteria have been introduced to evaluate the relationship between stock markets and exchange rates. Return of market portfolio, returns on broad index of Sterling are also introduced. The results state that not all firms are sensitive to changes in exchange rates. Furthermore, a Granger Causality test has been run to observe the route of changes between stock prices and foreign exchange rates. The results are consistent, to some level, with the previous studies. However, since the number of firms is not large, it is suggested that a larger number of firms being used to achieve the best results. However results showed that not all firms are affected by foreign exchange rates changes. After testing Granger Causality, this study found out that in some industries (oil and gas, pharmaceuticals), changes in foreign exchange rate will not cause any changes in stock prices (or vice versa), however, in banking sector the situation was different. This industry showed more reaction to these changes. The results are similar to the ones with Richards and Noel, where a variety of firms in different industries were evaluated.

Keywords: stock prices, foreign exchange rate, exchange rate exposure, Granger Causality

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Authors: Sutinon Yuchomsuk, Satchachon Changthom, Pruet Areesawangvong, Monsiri Jinapen

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Background: Esophageal squamous cell carcinoma can be presented with many symptoms, such as dysphagia or weight loss. However, in some circumstances, rare presentations can be found, e.g., dyspnea, which is more common in pulmonary malignancy. And dyspnea is also one of the most common presentations of COVID-19 infection. So, in this case, we can learn from many points in patient symptoms and findings leading to the diagnosis of esophageal squamous cell carcinoma. Method: This research is a case-report study including one patient from Mahasarakham Hospital, Thailand. Data were collected during December 2021. Result: A 55-year-old Thai male patient with an unknown past medical history presented with dyspnea and shortness of breath for the duration of three days prior to admission. His symptom also included cough, fever, and sore throat. Laboratory results indicated that the patient had COVID-19 pneumonia. Further investigation showed that he had cardiac tamponade and suspected pulmonary/esophageal cancer. Lung biopsy and pericardiocentesis were done, which were positive for carcinoma from pericardial effusion but negative for malignancy from the lung biopsy. Later esophagogastroduodenoscopy was done with endoscopic tissue biopsy; the result was positive for squamous cell carcinoma of the esophagus. Conclusion: Most commonly, esophageal cancer is presented with dysphagia or weight loss. However, in some rare cases, patients can also be presented with dyspnea due to cardiac tamponade. And in recent years, COVID-19 has become a pandemic all over the world, sometimes masking symptoms of other diseases. Such as in this case, the patient didn’t improve after the pneumonia was resolved, which led to the final diagnosis of metastatic esophageal cancer.

Keywords: esophageal cancer, cardiac tamponade, metastatic squamous cell carcinoma, COVID-19 infection

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Authors: Tarang Varmora, Krupa Shah, Karan Patel

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Environmental pollution and shortage of conventional fuel are the main concerns in the transportation sector. Most of the vehicles use an internal combustion engine (ICE), powered by gasoline fuels. This results into emission of toxic gases. Hybrid electric vehicle (HEV) powered by electric machine and ICE is capable of reducing emission of toxic gases and fuel consumption. However to build HEV, it is required to accommodate motor and batteries in the vehicle along with engine and fuel tank. Thus, overall weight of the vehicle increases. To improve the fuel economy and acceleration, the weight of the HEV can be minimized. In this paper, the design methodology to reduce the weight of the hybrid racing car is proposed. To this end, the chassis design is optimized. Further, attempt is made to obtain the maximum strength with minimum material weight. The best configuration out of the three main configurations such as series, parallel and the dual-mode (series-parallel) is chosen. Moreover, the most suitable type of motor, battery, braking system, steering system and suspension system are identified. The racing car is designed and analyzed in the simulating software. The safety of the vehicle is assured by performing static and dynamic analysis on the chassis frame. From the results, it is observed that, the weight of the racing car is reduced by 11 % without compromising on safety and cost. It is believed that the proposed design and specifications can be implemented practically for manufacturing hybrid racing car.

Keywords: design optimization, hybrid racing car, simulation, vehicle, weight reduction

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Authors: Jayeola Olabisi, T. Olawale Oladunjoye, Ademola A. Adewumi

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The study empirically examines the relationship that exists between the economic environment and entrepreneurial development in Nigeria. A structured questionnaire is administered on the study and data collected are analysed using Analysis of Variance and Regression. The following variables are indices of determination; Interest Rate (IR); Income Tax (IT). The results of the study show that there is a significant relationship between IR and ED in Nigeria (p < 0.5) with a positive correlation (r=0.526, r2=0.276). Also, there is a significant relationship between IT and ED in Nigeria (p < 0.05), with a positive association (r=0.546; r2=0.299). The study concludes that the emergence of the higher level of the stable economic environment is critical to entrepreneurial development in Nigeria. Therefore, government involvement in public private partnership for infrastructural development, enlargement of productive, judicious and transparent use of funds collected from income tax and affordable interest rate will galvanise the inward sourcing of raw materials that boost entrepreneurial development in Nigeria.

Keywords: interest rate, income tax, business environment and entrepreneurial development

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Authors: Dolly Kumari, H. Lhungdim

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Maternal health is one of the crucial health indicators for any country. 5th goal of Millennium Development Goals is also emphasising on improvement of maternal health. Soon after Independence government of India realizing the importance of maternal and child health care services, and took steps to strengthen in 1st and 2nd five year plans. In past decade the other health indicator which is life expectancy at birth has been observed remarkable improvement. But still maternal mortality is high in India and in some states it is observe much higher than national average. Government of India pour lots of fund and initiate National Rural Health Mission (NRHM) in 2005 to improve maternal health in country by providing affordable and accessible health care services. Accredited Social Heath Activist (ASHA) is one of the key components of the NRHM. Mainly ASHAs are selected female aged 25-45 years from village itself and accountable for the monitoring of maternal health care for the same village. ASHA are trained to works as an interface between the community and public health system. This study tries to assess the role of ASHA in utilizing maternal health care services and to see the level of awareness about benefits given under JSY scheme and utilization of those benefits by eligible women. For the study concurrent evaluation data from National Rural health Mission (NRHM), initiated by government of India in 2005 has been used. This study is based on 78205 currently married women from 70 different districts of India. Descriptive statistics, chi2 test and binary logistic regression have been used for analysis. The probability of institutional delivery increases by 2.03 times (p<0.001) while if ASHA arranged or helped in arranging transport facility the probability of institutional delivery is increased by 1.67 times (p<0.01) than if she is not arranging transport facility. Further if ASHA facilitated to get JSY card to the pregnant women probability of going for full ANC is increases by 1.36 times (p<0.05) than reference. However if ASHA discuses about institutional delivery and approaches to get register than probability of getting TT injection is 1.88 and 1.64 times (p<0.01) higher than that if she did not discus. Further, Probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 years. The probability of benefits from JSY schemes is 1.25 times (p<0.001) higher among women who get married after 18 year of age than before 18 years, it is also 1.28 times (p<0.001) and 1.32 times (p<0.001) higher among women have 1 to 8 year of schooling and with 9 and above years of schooling respectively than the women who never attended school. Those women who are working have 1.13 times (p<0.001) higher probability of getting benefits from JSY scheme than not working women. Surprisingly women belongs to wealthiest quintile are .53times (P<0.001) less aware about JSY scheme. Results conclude that work done by ASHA has great influence on maternal health care utilization in India. But results also show that still substantial numbers of needed population are far from utilization of these services. Place of delivery is significantly influenced by referral and transport facility arranged by ASHA.

Keywords: institutional delivery, JSY beneficiaries, referral faculty, public health

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Authors: N. E Okoligwe, Okezie A. Ihugba

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Few scholars disagrees that electricity consumption is an important supporting factor for economy growth. However, the relationship between electricity consumption and economy growth has different manifestation in different countries according to previous studies. This paper examines the causal relationship between electricity consumption and economic growth for Nigeria. In an attempt to do this, the paper tests the validity of the modernization or depending hypothesis by employing various econometric tools such as Augmented Dickey Fuller (ADF) and Johansen Co-integration test, the Error Correction Mechanism (ECM) and Granger Causality test on time series data from 1971-2012. The Granger causality is found not to run from electricity consumption to real GDP and from GDP to electricity consumption during the year of study. The null hypothesis is accepted at the 5 per cent level of significance where the probability value (0.2251 and 0.8251) is greater than five per cent level of significance because both of them are probably determined by some other factors like; increase in urban population, unemployment rate and the number of Nigerians that benefit from the increase in GDP and increase in electricity demand is not determined by the increase in GDP (income) over the period of study because electricity demand has always been greater than consumption. Consequently; the policy makers in Nigeria should place priority in early stages of reconstruction on building capacity additions and infrastructure development of the electric power sector as this would force the sustainable economic growth in Nigeria.

Keywords: economic growth, electricity consumption, error correction mechanism, granger causality test

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Authors: Dhanashree Moghe, Roberta Bullingham, Rizwan Ahmed, Tarun Singhal

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Aim: The NHS Bowel Screening Programme recommends the use of endoscopic tattooing for suspected malignant lesions that later require surgical or endoscopic localisation, using local protocols as guidance. This is in accordance with guidance from the BSG (The British Society of Gastroenterologists). We used a well-recognised local protocol as a standard to audit current tattooing practice in a large district general hospital with no current local guidelines. Method: A retrospective quantitative analysis of 50 patients who underwent segmental colonic resection for cancer over a 6-month period in 2021. We reviewed historic electronic endoscopy reports recording relevant data on tattoo indication and placement. Secondly, we carried out an anonymous survey of 16 independent lower GI endoscopists on self-reported details of their practice. Results: In our study, 28 patients (56%) had a tattoo placed at the time of their colonoscopy. Of these, only 53% (n=15) had the tattoo distal to the lesion, with the measured distance of the tattoo from the lesion only being documented in 8 reports. Only seven patients (25%) had a circumferential (4 quadrant) placement of the tattoo. 13 patients had lesions either in the caecum or rectum, locations deemed unnecessary as per BSG guidelines. Of the survey responses collected, there were four different protocols being used to guide practice. Only 50% of respondents placed tattoos at the correct distance from the lesion, and 83% placed the correct number of tattoos. Conclusion: There is a lack of standardisation of practices in colonic tattooing demonstrated in our study with incomplete compliance to our standard. The inadequate documentation of tattoo location can contribute to confusion and inaccuracy in the intraoperative localisation of lesions. This has the potential to increase operation length and morbidity. There is a need to standardise both technique and documentation in colonoscopic tattooing practice.

Keywords: colorectal cancer, endoscopic tattooing, colonoscopy, NHS BSCP

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Authors: Kim Anema, Matthias Max, Chris Zevenbergen

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For any flood risk manager the 'safety paradox' has to be a familiar concept: low probability leads to a sense of safety, which leads to more investments in the area, which leads to higher potential consequences: keeping the aggregated risk (probability*consequences) at the same level. Therefore, it is important to mitigate potential consequences apart from probability. However, when the (perceived) probability is so low that there is no recognizable trend for society to adapt to, addressing the potential consequences will always be the lagging point on the agenda. Preparedness programs fail because of lack of interest and urgency, policy makers are distracted by their day to day business and there's always a more urgent issue to spend the taxpayer's money on. The leading question in this study was how to address the social consequences of flooding in a context of (perceived) low probability. Disruptions of everyday urban life, large or small, can be caused by a variety of (un)expected things - of which flooding is only one possibility. Variability like this is typically addressed with resilience - and we used the concept of Community Resilience as the framework for this study. Drawing on face to face interviews, an extensive questionnaire and publicly available statistical data we explored the 'whole society response' to two recent urban flood events; the Brisbane Floods (AUS) in 2011 and the Dresden Floods (GE) in 2013. In Brisbane, we studied how the societal impacts of the floods were counteracted by both authorities and the public, and in Dresden we were able to validate our findings. A large part of the reactions, both public as institutional, to these two urban flood events were not fuelled by preparedness or proper planning. Instead, more important success factors in counteracting social impacts like demographic changes in neighborhoods and (non-)economic losses were dynamics like community action, flexibility and creativity from authorities, leadership, informal connections and a shared narrative. These proved to be the determining factors for the quality and speed of recovery in both cities. The resilience of the community in Brisbane was good, due to (i) the approachability of (local) authorities, (ii) a big group of ‘secondary victims’ and (iii) clear leadership. All three of these elements were amplified by the use of social media and/ or web 2.0 by both the communities and the authorities involved. The numerous contacts and social connections made through the web were fast, need driven and, in their own way, orderly. Similarly in Dresden large groups of 'unprepared', ad hoc organized citizens managed to work together with authorities in a way that was effective and speeded up recovery. The concept of community resilience is better fitted than 'social adaptation' to deal with the potential consequences of an (im)probable flood. Community resilience is built on capacities and dynamics that are part of everyday life and which can be invested in pre-event to minimize the social impact of urban flooding. Investing in these might even have beneficial trade-offs in other policy fields.

Keywords: community resilience, disaster response, social consequences, preparedness

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

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

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

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Authors: Elkington Sibusiso Mnguni

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In South Africa, mining has been a key economic sector since the discovery of gold in 1886 in the Witwatersrand region, where the city of Johannesburg is located. However, some mines have since been decommissioned, and the continuous pumping of acid mine drainage (AMD) also stopped causing the AMD to rise towards the ground surface. This posed a serious environmental risk to the groundwater resources and river systems in the region. This paper documents the development and extent of the environmental damage as well as the measures implemented by the government to alleviate such damage. The study will add to the body of knowledge on the subject of AMD treatment to prevent environmental degradation. The method used to gather and collate relevant data and information was the desktop study. The key findings include the social and environmental impact of the AMD, which include the pollution of water sources for domestic use leading to skin and other health problems and the loss of biodiversity in some areas. It was also found that the technical intervention of constructing a plant to pump and treat the AMD using the high-density sludge technology was the most effective short-term solution available while a long-term solution was being explored. Some successes and challenges experienced during the implementation of the project are also highlighted. The study will be a useful record of the current status of the AMD treatment interventions in the region.

Keywords: acid mine drainage, groundwater resources, pollution, river systems, technical intervention, high density sludge

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Authors: Gamalath M. B. P. Abeysekara

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Primary objective of any organization is to enhance the bottom line profit. Strategic procurement is one of the prominent aspects in view of receiving this ultimate objective. Strategic procurement is an activity used in each and every organization in their operations. Pharmaceutical procurement is an especially significant task for any organizations, particularly state sector concerned. The whole pharmaceutical procurement requirement of the country is procured through the State Pharmaceutical Corporation (SPC) of Sri Lanka. They follow Pharmaceutical Procurement Guideline of 2006 as the procurement principle. The main objective of this project is to identify the importance of State Pharmaceutical Corporation supplier selection criteria and critical analysis of pharmaceutical procurement procedure. State Pharmaceutical Corporations applied net price, product quality, past performance, and delivery of suppliers’ as main criteria for the selection suppliers. Data collection for this study was taken place through a questionnaire, given to fifty doctors within the Colombo district attached to five main state hospitals. Data analysis is carried out with mean and standard deviation functions. The ultimate outcomes indicated product quality, net price, and delivery of suppliers’ are the most important criteria behind the selection of suppliers. Critical analysis proved State Pharmaceutical Corporation should focus on net price reduction, improving laboratory testing facilities and effective communication between up and down stream of supply chain.

Keywords: government procurement procedure, pharmaceutical procurement supplier selection criteria, importance of SPC supplier selection criteria

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Authors: Sahar Iqrar, Malik Adeel Anwar, Zain Akram, Maria Noor

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Introduction: Oral lichen planus is a chronic inflammatory condition of unknown etiology. Oral lichen planus may be related with several other diseases. Grinspan's Syndrome is characterized by a triad of oral lichen planus, hypertension, and diabetes mellitus. Other associations reported in the literature are with chronic liver disease and, with dyslipidemia. The nature of these associations is still not fully understood. Material and methods: Study was conducted in Department of Oral Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A total of n=89 clinically diagnosed patients of oral lichen planus of both gender and all age groups were recruited and detailed history were recorded in the designed performs. Results: A total of n=89 patients were taken with male to female ratio of 3:8 in which 24 were male and 65 females. Mean age was 48.8 ± 13.8 years. Age range of 10-74 years was seen. Among these patients suffering from oral lichen planus, 41.6% (n=37) had a positive history for hypertension with 59.5% (n=22) of these patients were taking different medication for their condition. Whereas Diabetes Mellitus was found in 24.7% (n=22) patients with 72.7% (n=16) of these patients using the hypoglycemic drug (oral or injectable) to control their blood glucose levels. Out of these n=89 lichen planus patients 21.3% had both hypertension and diabetes mellitus (fulfilling the criteria for Grinspan's Syndrome). Out of this Grinspan's Syndrome pool 94.7% (n=19) were taking drug atleast for one of the two conditions. Conclusion: As noticed form the medical history of the patients, most of them were using hypoglycemic drugs for diabetes mellitus and beta blockers, diuretics and calcium channel blockers for hypertension. These drugs are known for lichenoid reaction. Therefore, it should be ruled out at histopathological/ immunological and molecular level whether these patients are suffering from lichen planus or lichenoid drug reaction to truly declare them as patients with Grinspan’s Syndrome.

Keywords: diabetes mellitus, grinspan's syndrome, lichenoid drug reaction, oral lichen planus

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Authors: Elham Sharif, Nasser Rizk, Sirin Abu Aqel, Ofelia Masoud

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Background: Previous studies have investigated the association of rs1544410, rs7975232 and rs731236 polymorphisms in vitamin D receptor gene and its impact on diseases such as cancer, diabetes and hypertension in different ethnic backgrounds. Aim: The aim of this study is to investigate the association between VDR polymorphisms using three SNP’s (rs1544410, rs7975232 and rs731236) and the severity of the significant lesion in coronary arteries among angiographically diagnosed CAD. Methods: A prospective-retrospective study was conducted on 192 CAD patients enrolled from the cardiology department-Heart Hospital HMC, grouped in 96 subjects with significant stenosis and 96 with non-significant stenosis with a mean age between 30 and 75 years old. Genotyping was performed for the following SNPs rs1544410, rs7975232 and rs731236 using TaqMan assay by the Real Time PCR, ABI 7500 in Health Sciences Labs at Qatar University Biomedical Research Center. Results: The results showed that both groups have matched age and gender distribution but patients with the significant stenosis have significantly higher; BMI (p=0.047); smoking status (p=0.039); FBS (p= 0.031); CK-MB (p=0.025) and Troponin (p=0.002) than the patients with non–significant lesion. Among the traditional risk factors, smoking increases the odds of the severe stenotic lesion in CAD patients by 1.984, with 95% CI between 1.024 – 7.063, with p= 0.042.HWE showed deviations of the rs1544410 and rs731236 among the study subjects. The most frequent genotype in distribution of rs7975232 is the AA among the significant stenosis patients, while the heterozygous AC was the frequent genotype in distribution among the non-significant stenosis group. The carriers of CC genotype in rs7975232 increased the risk of having significant coronary arteries stenotic lesion by 1.83 with 95% CI (1.020 – 3.280), p=0.043. No association was found between the rs7975232 with vitamin D and VDBP. Conclusion: There is a significant association between rs7975232 and the severity of CAD lesion. The carrier of CC genotype in rs7975232 increased the risk of having significant coronary arteries atherosclerotic lesion especially in patients with smoking history independent of vitamin D.

Keywords: vitamin D, vitamin D receptor, polymorphism, coronary harat disease

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Authors: Vered Shenaar-Golan, Nava Wald, Uri Yatzkar

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Background: Parenting children with mental health problems poses multiple challenges, including coping with difficult behavior and negative child emotions. The impact on parents includes financial strain, negative social stigma, and negative feelings of guilt or blame, resulting in significant stress and lower levels of well-being. Given findings that self-compassion plays a significant role in reducing stress and improving well-being, the current study examined the role of self-compassion in the experience of parents raising a child with mental health problems. The study tested (1) whether child behavioral/emotional problem severity is associated with higher parental stress and lower parental well-being; (2) whether self-compassion is associated with lower parental stress and higher parental well-being; and (3) whether self-compassion is a stronger predictor of parental stress and well-being than child behavioral/emotional problem severity. Methods: Three hundred and six mothers and two hundred and fifty-six fathers of children attending a hospital child and adolescent psychiatric center were assessed at admission. Consenting parents completed four questionnaires: Child Strength and Difficulty – parent version, Self-compassion, Parent Feeling Inventory, and Well-Being. Results: Child behavioral/emotional problem severity was associated with higher parental stress and lower parental well-being, and self-compassion was a stronger predictor of parental stress and well-being levels than child behavioral/emotional problem severity. For children with internalizing but not externalizing behavioral/emotional problems, parental self-compassion was the only predictor of parental well-being beyond the severity of child behavioral/emotional problems. Conclusions: Cultivating self-compassion is important in reducing parental stress and increasing parental well-being, particularly with internalizing presentations, and should be considered when designing therapeutic interventions for parents.

Keywords: parenting children with mental health problems, self-compassion, parental stress, feelings, well-being

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