Search results for: post disasters

Authors: Himanshu Lal, Bipasha Ghosh, Arun Srivastava

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A pilot study of indoor air quality in terms of bioaerosol (fungus and bacteria) and few selective microbial volatile organic compounds (MVOCs) was carried out in different indoor sections of a library for two seasons, namely monsoon and post monsoon. Bioaerosol sampling was carried out using Anderson six stage viable sampler at a flow rate of 28.3 L/min while MVOCs were collected on activated charcoal tubes ORBOTM 90 Carboxen 564.Collected MVOCs were desorbed using carbon disulphide (CS2) and analysed by GC-FID. Microscopic identification for fungus was only carried out. Surface dust was collected by sterilised buds and cultured to identify fungal contaminants. Unlike bacterial size distribution, fungal bioaerosol concentration was found to be highest in the fourth stage in different sections of the library. In post monsoon season both fungal bioaerosol (710 to 3292cfu/m3) and bacterial bioaerosol (298 to 1475cfu/m3) were fund at much greater concentration than in monsoon. In monsoon season unlike post monsoon, I/O ratio for both the bioaerosol fractions was more than one. Rain washout could be the reason of lower outdoor concentration in monsoon season. On the contrary most of the MVOCs namely 1-hexene, 1-pentanol and 1-octen-3-ol were found in the monsoon season instead of post monsoon season with the highest being 1-hexene with 7.09µg/m3 concentration. Among the six identified fungal bioaerosol Aspergillus, Cladosporium and Penicillium were found in maximum concentration while Aspergillus niger, Curvuleria lunata, Cladosporium cladosporioides and Penicillium sp., was indentified in surface dust samples. According to regression analysis apart from environmental factors other factors also played an important role. Thus apart from outdoor infiltration and human sources, accumulated surface dust mostly on organic materials like books, wooden furniture and racks can be attributed to being one of the major sources of both fungal bioaerosols as well as MVOCs found in the library.

Keywords: bacteria, Fungi, indoor air, MVOCs

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Authors: Thanura Randula Abeywardena

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This study recognized the effectiveness of cold-water immersion recovery post exhaustive short-term exercise. The purpose of this study was to understand if 16- 20°C of cold-water immersion would be beneficial in a tropical environment to achieve optimal recovery in sprint swim performance in comparison to 10-15°C of water immersion. Two 100m-sprint swim performance times were measured along with blood lactate (BLa), heart rate (HR) and rate of perceived exertion (RPE) in a 25m swimming pool with full body head out horizontal water immersions of 10-15°C, 16-20°C and 29-32°C (pool temperature) for 10 minutes followed by 5 minutes of seated passive rest outside; in between the two swim performances. Twelve well-trained adult swimmers (5 male and 5 female) within the top twenty in the Sri Lankan national swimming championships in 100m Butterfly and Freestyle in the years 2020 & 2021 volunteered for this study. One-way ANOVA analysis (p<0.05) suggested performance time, Bla and HR had no significant differences between the 3 conditions after the second sprint; however, RPE was significantly different with p=0.034 between 10-15°C and 16-20°C immersion conditions. The study suggested that the recovery post the two cold-water immersion conditions were similar in terms of performance and physiological factors; however, the 16-20°C temperature had a better “feel good” factor post sprint 2. Further study is recommended as there was participant bias with the swimmers not reaching optimal levels in sprint 1. Therefore, they might have possibly fully recovered before sprint 2, invalidating the physiological effect of recovery.

Keywords: hydrotherapy, blood lactate, fatigue, recovery, sprint-performance, sprint-swimming

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Authors: Kuan-Han Lin, Kuan-Yin Lin, Ka-Chun Siu

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The purpose of this systematic review was to determine the impact of post-traumatic stress disorders (PTSD) symptom or depressive symptoms on return to work (RTW) after occupational injury. The original articles of clinical trials and observational studies from PubMed, MEDLINE, and PsycINFO between January 1980 and November 2016 were retrieved. Two reviewers evaluated the abstracts identified by the search criteria for full-text review. To be included in the final analysis, studies were required to use either intervention or observational study design to examine the association between psychiatric symptoms and RTW. A modified checklist designed by Downs & Black and Crombie was used to assess the methodological quality of included study. A total of 58 articles were identified from the electronic databases after duplicate removed. Seven studies fulfilled the inclusion criteria and were critically reviewed. The rates of RTW in the included studies were reported to be 6% to 63.6% among workers after occupational injuries. This review found that post-traumatic stress symptom and depressive symptoms were negatively associated with RTW. Although the impact of psychiatric symptoms on RTW after occupational injury remains poorly understood, this review brought up the important information that injured workers with psychiatric symptoms had poor RTW outcome. Future work should address the effective management of psychiatric factors affecting RTW among workers.

Keywords: depressive symptom, occupational injury, post-traumatic stress disorder, return to work

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Authors: Alphan Telek

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Political secularism is different from philosophical secularism in terms of its inclusionary, peaceful, liberal and democratic aspects. Secularism as a political principle not only takes the separation of state and religion as a basis but also it aims to exclude any kind of ethnic, religious, racial, gender domination at the state level. Thus, although political secularism does not see any problem with the visibility and implementation of religious views and symbols in the public sphere, it stands against the fusion of political power and religious views or more generally any kind of identity. Iranian context especially the post-reformist period, which starts in 2005, shows religious and/or reformist intellectuals try to put forward the political secularism and make it attractable to the large masses. Three prominent figures of reformist intellectualism Abdolkarim Soroush, Mohsen Kadivar and Akbar Ganji form the basic vocabulary of political secularism in the post-reformist period of Iran. Their intellectual and political struggle against the Islamic regime’s anti-democratic policies and actions do carry significance not only for Iranian democracy but also for all Muslim people around the world that demand a more equal, free, and just society. The political and intellectual discourses of Iranian intellectuals indicate that political secularism is a requirement of democratic state and society. In this paper, it is discussed the relationship between political secularism, state, society, and Islam. Thus, it will be argued that secularism as a political principle is increasingly held by Iranian intellectuals to show the relation between secularism and democracy.

Keywords: political secularism, Iranian intellectuals, democracy, Middle East

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Authors: Faizan Sultan

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Non-government organizations (NGOs) in Pakistan have the potential to deliver services such as health, education, and rural development through targeting the most vulnerable communities of society. Having this significant importance, NGOs are facing numerous challenges in service delivery. So, there is a need to identify the challenges NGOs face in community development, particularly post-conflict development. The current study has analyzed the social and political constraints in development projects in the post-conflict region of the Swat district of Khyber Pakhtunkhwa. The objectives of this study are “What are the social and political constraints faced by the nongovernmental organizations in the implementation of development aid Projects in post-conflict development of Swat and to examine the challenges in coordination mechanism between government departments, NGOs, and community in reconstruction activities”. This research is based upon both the quantitative and qualitative data that is being gathered from the NGO representatives, government officials, and community members who were involved in post-conflict development interventions in the Swat region. A purposive sampling technique was used to select respondents from the community members/activists (25 in number) and government and NGO officials (10 in number). Based on analysis against our objectives, NGOs have faced numerous constraints such as Insecurity, Negative Perceptions about NGOs, restrictions on women's mobility, government policies and regulations, lack of coordination and networking, trust deficit, and political interference while implementing their project interventions. These findings concluded that constraints have affected project implementation to a greater extent, including women's participation, involvement of marginalized populations, and equal distribution of resources. In the Swat region, NGOs cannot openly discuss sensitive projects such as human rights, gender-based projects, or women empowerment as these issues are very sensitive to the local community due to their cultural values. The community may not allow their females to go outside their homes as this region is a male-dominated society. Similarly, lack of communication and poor networking for the arrangements of the project meetings were also the major constraints.

Keywords: national disaster management authority, millennium development goals, provincial disaster management authority, provincial reconstruction, rehabilitation and settlement authority

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Authors: Hasnizan Aksah, Adi Irfan Che Ani

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Refurbished historic government buildings should perform as intended to support the organization’s goals that enhance occupant satisfaction. However, these buildings may have issues associated with functional performance evaluation. The aim of this study is to develop a Post Occupancy Evaluation (POE) sustainability assessment tool for functional performance evaluation of refurbished historic government buildings. Developing an assessment tool requires a strategic methodology for a logical and cohesive tool that incorporating relevant theories and practical experiences. In this study, mixed method approaches use to collect all necessary data to achieve the objectives of this study. The design of sampling involves are interviews and survey questionnaires to relevant professionals in order to evaluate the criteria and problem encircled in functional performance evaluation. Then, the involvement of expert panels is required in establishing the assessment tool. During the process of investigation on the functional performance criteria, it was discovered that is seen to be critical in aspects of comfort, safety, and services. The proposed assessment tool has a significant role in providing opportunities for the improvement of building performance especially on functional performance for the future historic government building refurbishment project. It is hoped that the tool developed from this study will give benefits to related professionals, public agencies, local municipality, and relevant interested parties in historic building management.

Keywords: refurbished historic government buildings, functional performance, Post Occupancy Evaluation, sustainability

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Authors: Farhan Ahmad Atif, Abd Ur Rehman, Muhammad Babir

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Dietary cation anion difference (DCAD) is an important aspect of dairy nutrition, especially in the transition period. Sahiwal cattle is the highest milk producing breed among Zebu cattle. We planned first study on transition Sahiwal cattle to determine the effects of feeding varying levels of negative DCAD. For this purpose, twenty pregnant cows (at the 250th day of gestation) were selected and randomly divided into 5 groups comprising four animals each. Five iso-caloric (2100 Kcal) and iso-nitrogenous (12%) diets were formulated and each diet was allotted to each group. The animals received positive DCAD diet served as control. Diets were supplemented with NutriCAB® to attain 0, -15, -30 and -45 DCAD levels. Experimental diets were fed at ad-libitum upto parturition and data regarding feed intake were recorded on daily. Post-partum incidence of milk fever, dystocia, retention of placenta (RP), mastitis as well as milk production, milk fat percentage and serum Ca levels were recorded. Urine and blood pH were determined weekly during the last month of pregnancy. Results showed that prepartum feed intake and blood pH were not affected (P > 0.05), while urine pH was significantly reduced (P < 0.05) by lowering DCAD levels. Post parturient blood calcium level linearly increased (P < 0.05) with decreasing DCAD. Pre-partum negative DCAD feeding had no effect (P > 0.05) on post-parturient milk production and fat percentage. However, parturient related problems decreased with decreasing DCAD feeding. It was concluded that negative DCAD feeding raised serum calcium level and reduced the incidence of post-parturient problems in Sahiwal cattle.

Keywords: dairy cattle, transition, metabolic diseases, reproductive disorders, incidence

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Authors: Hamid Fallah

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Undoubtedly, flood is known as a natural disaster, and in practice, flood is considered the most terrible natural disaster in the world both in terms of loss of life and financial losses. From 1988 to 1997, about 390,000 people were killed by natural disasters in the world, 58% of which were related to floods, 26% due to earthquakes, and 16% due to storms and other disasters. The total damages in these 10 years were about 700 billion dollars, which were 33, 29, 28% related to floods, storms and earthquakes, respectively. In this regard, the worrisome point has been the increasing trend of flood deaths and damages in the world in recent decades. The increase in population and assets in flood plains, changes in hydro systems and the destructive effects of human activities have been the main reasons for this increase. During rain and snow, some of the water is absorbed by the soil and plants. A percentage evaporates and the rest flows and is called runoff. Floods occur when the soil and plants cannot absorb the rainfall, and as a result, the natural river channel does not have the capacity to pass the generated runoff. On average, almost 30% of precipitation is converted into runoff, which increases with snow melting. Floods that occur differently create an area called flood plain around the river. River floods are often caused by heavy rains, which in some cases are accompanied by snow melt. A flood that flows in a river without warning or with little warning is called a flash flood. The casualties of these rapid floods that occur in small watersheds are generally more than the casualties of large river floods. Coastal areas are also subject to flooding caused by waves caused by strong storms on the surface of the oceans or waves caused by underground earthquakes. Floods not only cause damage to property and endanger the lives of humans and animals, but also leave other effects. Runoff caused by heavy rains causes soil erosion in the upstream and sedimentation problems in the downstream. The habitats of fish and other animals are often destroyed by floods. The high speed of the current increases the damage. Long-term floods stop traffic and prevent drainage and economic use of land. The supports of bridges, river banks, sewage outlets and other structures are damaged, and there is a disruption in shipping and hydropower generation. The economic losses of floods in the world are estimated at tens of billions of dollars annually.

Keywords: flood, hydrological engineering, gis, dam, small hydropower, suitablity

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Authors: Ahmed Amin Mousa, M. Abd El Salam

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The current study presents a proposed program for acquisition the skills and techniques needed to produce concept cartoon. The proposed program has been prepared for non-specialist students who have never used neither graphics nor animating software. It was presented to postgraduates in Faculty of Education for Early Childhood, Cairo University, during the spring term of the 2014-2015 academic year. The program works in three different aspects: Drawing and images editing, sound manipulation, and creating animation. In addition, the researchers have prepared a questionnaire for measuring the quality of the concept cartoons produced by the students. The questionnaire was used as a pre-test and post-test, and at the end of the study, a significant difference was determined in favour of post-test results.

Keywords: cartoon, concept cartoon, kindergarten, animation

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Authors: Leyla Sattarzadeh, Shahin Fathi Molk Kian, Maghsoud Peeri, Mohammadali Azarbaijani, Hasan Matin Homaee

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Inflammation by various mechanisms may cause atherosclerosis. Systemic circulating inflammatory markers such as C-reactive protein (CRP), pro-inflammatory cytokines such as Interleukin-6 (IL-6), vascular inflammatory markers as adhesion molecules like Intracellular Adhesion Molecule-1 (ICAM-1) and Vascular Cell Adhesion Molecule-1 (VCAM-1) are the predictors of cardiovascular diseases. Regarding the conflicting results about the effect of different patterns of resistance exercise training on these inflammatory markers, present study aimed to examine the effect of different patterns of eight week resistance exercise training on CRP, IL-6, ICAM-1 and VCAM-1 levels in healthy untrained women. 56 healthy volunteered untrained female university students (aged: 21 ± 3 yr., Body Mass Index: 21.5 ± 3.5 kg/m²) were selected purposefully and divided into four groups. At the end of training protocol and after subject drop during the protocol, upper body exercise training (n=11), lower body (n=12) and whole body resistance exercise training group (n=11) completed the eight weeks of training period although the control group (n=7) did anything. Blood samples gathered pre and post-experimental period and CRP, IL-6, ICAM-1 and VCAM-1 levels were evaluated using special laboratory kits, then the difference of pre and post values of each indices analyzed using one-way analysis of variance (α < 0.05). The results of one way ANOVA for difference of pre and post values of CRP, ICAM-1 and VCAM-1 showed no significant changes due to the exercise training, but there were significant differences between groups about IL-6. Tukey post- hoc test indicated that there is significant difference between the differences of pre and post values of IL-6 between lower body exercise training group and control group, and eight weeks of lower body exercise training lead to significant changes in IL-6 values. There were no changes in anthropometric indices. The findings show that the different patterns of upper, lower and whole body exercise training by involving the different amounts of muscles altered the IL-6 values in lower body exercise training group probably because of engaging the bigger amount of muscles, but showed any significant changes about CRP, ICAM-1 and VCAM-1 probably due to intensity and duration of exercise or the lower levels of these markers at baseline of healthy people.

Keywords: resistance training, C-reactive protein, interleukin-6, intracellular adhesion molecule-1, vascular cell adhesion molecule-1

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Authors: Moein Izadi, Ali Mohammadzadeh

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Detection of damaged parts of roads after earthquake is essential for coordinating rescuers. In this study, an approach is presented for the semi-automatic detection of damaged roads in a city using pre-event vector maps and both pre- and post-earthquake QuickBird satellite images. Damage is defined in this study as the debris of damaged buildings adjacent to the roads. Some spectral and texture features are considered for SVM classification step to detect damages. Finally, the proposed method is tested on QuickBird pan-sharpened images from the Bam City earthquake and the results show that an overall accuracy of 81% and a kappa coefficient of 0.71 are achieved for the damage detection. The obtained results indicate the efficiency and accuracy of the proposed approach.

Keywords: SVM classifier, disaster management, road damage detection, quickBird images

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Authors: Shehzad Khan, Jehangir Khan, Shah Babar, Rashid Mahmood, Rizwan Khan, Sanya Hadi

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Ascaris lumbricoides are familiar with the roundworm that causes biliary infections in humans. Nevertheless, ascariasis is primarily found in the jejunum and transferred in numerous body parts with the intake of Ascaris lumbricoides present in food and water. These study methods were implemented at the Saidu Teaching Hospital Radiology Department from December 2021 to January 2023. This study includes the participants suffering from biliary ascariasis admitted or visited Saidu Teaching Hospital in that time frame. Clinical assessment of the participants was done based on the appearance of signs and symptoms present in them. The participant's laboratory test was done to determine the level of basic body parameters. After that ultrasonography was used to diagnose the presence and appearance of worms. Endoscopic retrograde cholangiopancreatography (ERCP) was used to extract worms from biliary channels, and the incidence of post-ERCP biliary ascariasis was accessed with ultrasonography. This study's results show the presence of numerous types of worms in the biliary channels of patients. Also, the level of body parameters, for instance, neutrophil, hemoglobin, and others, were compared at the time of admission and at the time of discharge from the hospital. Furthermore, the incidence of post-ERCP biliary ascariasis was reported as 4% in females, and 1% in males, respectively.

Keywords: Ascaris, biliary, ERCP, ultrasound

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Authors: Esha Banerji

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This paper attempts an assessment of India's behaviour as a foreign policy actor amidst the COVID 19 pandemic by briefly surveying the various introductions and alterations made to India's foreign policy. First, the paper attempts to establish the key strategic pillars of Indian foreign policy after reviewing the existing works. It then proceeds to assess the prominent part played by Health Diplomacy ("Vaccine Maitri") in India's bilateral and multilateral relations during the pandemic and the role of the Indian diaspora in shaping India's foreign policy. This is followed by examining "India's Neighbourhood First policy" and the way it's been employed by the Indian government to extend India’s strategic influence during the pandemic. An empirical assessment will be done to examine the changing dynamics of India's relation with different regional groupings like SAARC, ASEAN, BIMSTEC, etc. The paper also explores the new alliances formed post-pandemic and India's role in them. This paper analyses the contemporary challenges that the largest nation in South Asia faces with the onset of a global pandemic and how Ancient Indian values like "Vasudhaiva Kutumbakam" have influenced India's foreign policy, especially during the pandemic. It also attempts to grasp the changes within the negotiation style of the Indian government, and the role played by various stakeholders in shaping India's position in the present geopolitical landscape. The study has been conducted using data collected from government records, External Affairs Ministry database, and other available literature. The paper concludes with an attempt to predict the far-reaching strategic implications that the policy, as mentioned above, may have for India.

Keywords: Indian foreign policy, COVID19, diplomacy, post pandemic world

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Authors: K. Vallianou, T. Alexopoulos, V. Plaka, M. K. Seleventi, V. Skanavis, C. Skanavis

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The present research addresses the role of place attachment and emotions in community resiliency and recovery within the context of a disaster. Natural disasters represent a disruption in the normal functioning of a community, leading to a general feeling of disorientation. This study draws on the trauma caused by a natural hazard such as a forest fire. The changes of the sense of togetherness are being assessed. Finally this research determines how the place attachment of the inhabitants was affected during the reorientation process of the community. The case study area is Mati, a small coastal town in eastern Attica, Greece. The fire broke out on July 23^rd, 2018. A quantitative research was conducted through questionnaires via phone interviews, one year after the disaster, to address community resiliency in the long-run. The sample was composed of 159 participants from the rural community of Mati plus 120 coming from Skyros Island that was used as a control group. Inhabitants were prompted to answer items gauging their emotions related to the event, group identification and emotional significance of their community, and place attachment before and a year after the fire took place. Importantly, the community recovery and reorientation were examined within the context of a relative absence of government backing and official support. Emotions related to the event were aggregated into 4 clusters related to: activation/vigilance, distress/disorientation, indignation, and helplessness. The findings revealed a decrease in the level of place attachment in the impacted area of Mati as compared to the control group of Skyros Island. Importantly, initial distress caused by the fire prompted the residents to identify more with their community and to report more positive feelings toward their community. Moreover, a mediation analysis indicated that the positive effect of community cohesion on place attachment one year after the disaster was mediated by the positive feelings toward the community. Finally, place attachment contributes to enhanced optimism and a more positive perspective concerning Mati’s future prospects. Despite an insufficient state support to this affected area, the findings suggest an important role of emotions and place attachment during the process of recovery. Implications concerning the role of emotions and social dynamics in meshing place attachment during the disaster recovery process as well as community resiliency are discussed.

Keywords: community resilience, natural disasters, place attachment, wildfire

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Authors: Li Chin Law, Epaminondas Mastorakos, Mohd Roslee Othman, Antonis Trakakis

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The paper introduces an alternative concept of carbon capture for shipping by using pre-combustion carbon capture technology (Pre-CCS), which was proven to be less energy intensive than post-combustion carbon capture from the engine exhaust. Energy assessment on amine-based post-combustion CCS on LNG-fuelled ships showed that the energy efficiency of CCS ships reduced from 48% to 36.6%. Then, an energy assessment was carried out to compare the power and heat requirements of the most used hydrogen production methods and carbon capture technologies. Steam methane reformer (SMR) was found to be 20% more energy efficient and achieved a higher methane conversion than auto thermal reaction and methane decomposition. Next, pressure swing adsorber (PSA) has shown a lower energy requirement than membrane separation, cryogenic separation, and amine absorption in pre-combustion carbon capture. Hence, an integrated system combining SMR and PSA (SMR-PSA) with waste heat integration (WHR) was proposed. This optimized SMR-based integrated system has achieved 65% of CO₂ reduction with less than 7-percentage point of energy penalty (41.7% of energy efficiency). Further integration of post-combustion CCS with the SMR-PSA integrated system improved carbon capture rate to 86.3% with 9-percentage points of energy penalty (39% energy efficiency). The proposed system was shown to be able to meet the carbon reduction targets set by International Maritime Organization (IMO) with certain energy penalties.

Keywords: shipping, decarbonisation, alternative fuels, low carbon, hydrogen, carbon capture

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Authors: Chun-Ying Lee, Kun-Hsien Lee, Bor-Wei Wang

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The process of post-supercritical CO₂ electroplating uses the electrolyte solution after being mixed with supercritical CO₂ and released to atmospheric pressure. It utilizes the microbubbles that form when oversaturated CO₂ in the electrolyte returns to gaseous state, which gives the similar effect of pulsed electroplating. Under atmospheric pressure, the CO₂ bubbles gradually diffuse. Therefore, the introduction of ultrasound and/or other agitation can potentially excite the CO₂ microbubbles to achieve an electroplated surface of even higher quality. In this study, during the electroplating process, three different modes of agitation: magnetic stirrer agitation, ultrasonic agitation and a combined mode (magnetic + ultrasonic) were applied, respectively, in order to obtain an optimal surface morphology and mechanical properties for the electroplated Ni coating. It is found that the combined agitation mode at a current density of 40 A/dm² achieved the smallest grain size, lower surface roughness, and produced an electroplated Ni layer that achieved hardness of 320 HV, much higher when compared with conventional method, which were usually in the range of 160 to 300 HV. However, at the same time, the electroplating with combined agitation developed a higher internal stress of 320 MPa due to the lower current efficiency of the process and finer grain in the coating. Moreover, a new control methodology for tailoring the coating’s mechanical property through its thickness was demonstrated by the timely introduction of ultrasonic agitation during the electroplating process with post supercritical CO₂ mixed electrolyte.

Keywords: nickel electroplating, micro-bubbles, supercritical carbon dioxide, ultrasonic agitation

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Authors: Amr Hamdy

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Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Many methods have been developed to decrease its rate. The aim of this study was to evaluate the applicability of a new non-pharmacologic maneuver in decreasing its rate. Methods: This case series study was conducted in one centre in Cairo, Egypt, from January-2010 to June-2013. 400 pregnant–women aged 18 years or more and candidate for normal labour; were enrolled to this study. High-risk subjects for PPH were excluded. After placental delivery, the new maneuver was done by sustained traction of the anterior and posterior lips of the cervix by two ovum forceps for duration of 90 seconds. The amount of blood loss was estimated by standardized visual estimation after removal of the forceps. All subjects were followed up for 6 hours. Results: The rate of PPH, defined as more than 500 ml, was 8 cases (2%) with 95% CI (0.63-3.37%). The rate of PPH was not affected by parity, gestational age, episiotomy or the presence of tears. PPH is more in cases with anemia (p 0.032). It occurred in all cases with uterine atony (p <0.001). The range of estimated blood loss was 550-600ml in cases with PPH and 150-450ml in cases without PPH. Severe PPH more than 1000 ml, did not occur. Conclusion: This pilot study introduced a novel maneuver that can be helpful in decreasing the rate of PPH and reducing the amount of post partum blood loss.Despite the low rate of PPH showed in this study, the need for conducting a randomized controlled study is at its highest level before further inclusion of such manoeuvre to be a part of the current medical practice and before considering it as an evident tool to decrease the burden of PPH.

Keywords: maternal mortality, new manoeuvre, post-partum haemorrhage, uterine atony

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Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

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Introduction: Chemical peeling is a popular, relatively inexpensive day procedure and generally safe method for treatment of pigmentary skin disorders and for skin rejuvenation. Chemical peels are classified by the depth of action into superficial, medium, and deep peels.Various facial pigmentary conditions have significant impact on quality of life causing psychological stress, necessitating its safe and effective treatment.Aim & Objectives:To compare the efficacy of Salicylic acid, Trichloroaceticacid & Glycolic Acid in facial melanosis(melasma,photomelanosis& post acne pigmentation).To study the side effects of above mentioned peeling agents. Method and Materials:It was a randomized parallel control single blind study consisting of total of 36 cases, 12 cases each of melasma, photo melanosis and post acne pigmentation within age group 20-50 years having fitzpatrick’s skin type4. Woods lamp examination was done to confirm the type of melasma.Patients with keloidal tendency, active herpes infection or past history of hypersensitivity to salicylic acid, trichloroaceticand glycolic acid as well aspatients on systemic isotretinoin were excluded.Clinical photographs at the beginning of therapy and then serially, were taken to assess the clinical response. Prior to application a written informed consent was obtained. A post auricular test peel was performed. Patients were divided into 3 groups, containing 12 patients each of melasma, photomelanosis and post acnepigmentation.All the three peels SA peel 20% (done once in 2 weeks), GA peel 50% (done once in 3 weeks) and TCA 15% (done once in 3 weeks) were used with total six settings for each patient. Before application of peel patients were counseled to wash the face with soap and water. Then face was dried and cleaned with spirit and acetone to remove all cutaneous oils. GA, TCA, SA were applied with cotton buds/gauze withmild strokes. After a contact period off 5-10mins neutralization was done with cold water. Post peel topical sunscreen application was mandatory. MASI was used pre and post treatment to assess melasma. Investigator’s global improvement scale- overall hyperpigmentation (4-significant, 3-moderate, 2-mild, 1-minimal, 0-no change ) and Patient’s satisfaction grading scale (>70%- excellent response, 50-70%- good response, <50%- average response) was used to assess improvement in all the three facial melanosis.Results:In our study of 12 patients of melasma, 4 (33.33%)patients showed excellent results;3 (25%) with GAand 1(8.33%) of TCA.Good response was seen in 4 (33.33%) patients;1(8.33%) each for GA & SA and 2(16.66%) for TCA.Poor response was seen in 4(33.33%) patients;1(8.33%) for TCA and 3 (25%) for SA.Of 12 patients of photomelanosis, excellent resultswas seen in 3(25%)patients of TCA. Good response was seen in 4 (33.33%) patients, 1(8.33%) each of TCA &SA and 2(16.66%) of GA.Poor responsewas seen in 5(41.66%) patients;3 (25%) for SA and 2(16.66%) of GA.Of 12 patients of post acne pigmentation, excellent responsein 3 (25%) patients;2(16.66%) of SA and 1(8.33%) of TCA.Good responsewas seen in 5(41.66%) patients;2(16.66%) of SA and GA and1(8.33%) of TCA.Poor response was seen in 4 (33.33%) patients; 2 (16.66%) for SA and TCA both. No major side effects in the form of scarring or persistant pigmentation was seen. Transient blackening of skin with burning sensation was seen in cases treated with TCA and SA. Post procedural itching and redness was noted with GA peel. Conclusion- In our study GA(50%),TCA(15%) & SA(20%) peels showed excellent response in melasma, photomelanosis and post-acne pigmentation respectively.All the 3 peeling agents were well tolerated without any significant side-effects in the above specified concentrations.

Keywords: facial melanosis, gycolic acid, salicylic acid, trichloroacetic acid

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Authors: M. Taleb, G. Tail, F. Z. Kara, B. Djedouani T. Moussa

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Necrophagous insects usually colonize cadavers within a short time after death. However, they are influenced by weather conditions, and their distribution and activity vary according to different time scales, which can affect the post-mortem interval (PMI) estimation. As no data have been published in Algeria on necrophagous insects visiting corpses, two field surveys were conducted in July 2012 and March 2013 at the National Institute for Criminalistics and Criminology (INCC) using rabbit carcasses (Oryctolagus cuniculus L.). The trials were designed to identify the necrophagous Diptera fauna of Algiers, Algeria and examine their variations according to environmental variables. Four hundred and eighteen Diptera adults belonging to five families were captured during this study. The species which were identified on human corpses in different regions of Algeria were also observed on the rabbit carcasses. Although seasonal variations of the species were observed, their abundance did not significantly vary between the two seasons. In addition to seasonal effects, the ambient temperature, the wind speed, and precipitation affect the number of trapped flies. These conclusions highlight the necessity of considering the environmental factors at a scene to estimate the post-mortem interval accurately. It is hoped that these findings provide basic information regarding the necrophagous Diptera fauna of Algeria.

Keywords: forensic entomology, necrophagous diptera, post-mortem interval, abiotic factors, Algeria

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Authors: Nada A. El-Shahaw, Anas A.Salem, M. Kobeisy, Hoda M. Shabaan

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Reactive oxygen species (ROS) is collective term both oxygen radical, such superoxide (O₂•), hydroxyl(OH•), peroxyl (RO₂), and hydroperoxyl (HO₂•), and certain non-radical oxidizing agents, such as hydrogen peroxide (H₂O₂), hypochlorous acid (HOCL), and ozone (O₃), that can be convert easily to radical. The importance of antioxidants is shown here punicalagin. Punicalagin is preventing the harmful effect of (ROS) in all cells, specially gonadal cells. So, the aim of study was to investigate effects of punicalagin (PL) on maternal live body weight (MLBW), number of services/conception (NS), conception rate (CR), gestation length (GL), kindling rate (KR), total litter size (TLS), live litter size (LLS), kit weight (KW), progesterone (P4) and estradiol-17 (E2) concentrations at 1st and 2nd pregnancy of young does. A total of 28 healthy virgin does (6 months old) were divided into 2 equal groups. Group I, each doe, was injected IM with 100 ug PL twice/week pre-mating and one time 3 days post-mating. Group II, each doe was injected IM with sterilized water (control). Blood samples were taken at pre-mating, mating, post-mating, throughout pregnancy, and immediately post-kindling for assaying P4 and E2. All does were naturally mated with fertile bucks. Results revealed that PL displayed their significant impacts on MLBW, NS/conception, CR, GL, KR, TLS, LLS, KWs (birth and weaning), P4 and E2 concentrations either at 1ˢᵗ/2ⁿᵈ pregnancy or both of them. Conclusively, PL improved pregnancy outcomes of young do particularly at 2ⁿᵈ pregnancy and could be recommended in rabbit's farms.

Keywords: punicalagin, pregnancy, estradiol-17β, progesterone, does

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students. 

Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant

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Authors: Beloulou Mohamed Lamine, Bouhouf Attef, Meliani Walid, Sellami Dalila, Lamara Abdelhak

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Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with post-surgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariate analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature or component, particularly in surgeries that are more prone to chronicization.

Keywords: chronic postsurgical pain, postsurgical chronic neuropathic pain, regional anesthesia and analgesia techniques (RAAT), neuropathic pain score dn2, preventive impact

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Authors: Emilie Fort

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Two major pitfalls emerge at the intersection of gender and peacebuilding literature: the comprehension of women as a homogeneous category and a focus on women's participation in formal peace processes and state structures. However, women belong (and identify) to distinct ethnic, religious, or social groups, and the variety of their social location impacts their ability to mobilize, to participate in peace processes as well as the way they envision peace. This study is based on interviews conducted (remotely) with women activists from the post-Yugoslav area. It shows that women's economic empowerment and education are central issues that must be addressed for women political participation being effective. This has implications for peace projects –their priorities, scales of implementation, etc.– and the allocation of civil society’s funds.

Keywords: ex-Yugoslavia, gender-based issues, peacebuilding, women activism

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Authors: Jianan Li, Lusen Shi, Haiqiao Du, Wei Chen, Qian Wang, Shuoshuo Kang, Shiming Yang

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Background: Follow-up of cochlear implant effectiveness is mainly focused on 3 years postoperatively, and studies with more than 5 years of observation are rare, especially for local Chinese brands. Objectives: Nurotron (Chinese domestic cochlear implant brand) CI recipients who participated in the clinical trial in 2009 were followed-up for 10 years prospectively, providing data to guide doctors and patients. Material and Methods: From December 2009 to April 2010, 57 subjects underwent Nurotron Venus CI surgery at multiple centers and were continued to be followed up and assessed at 1, 2, 3, 4, 5, and 10 years after switching on. Results: All recipients were successfully implanted with CIs with no difficulty in subsequent use, with one reported case of re-implantation 9 years after implantation. The aided hearing thresholds were significantly improved one month after switching on (p<0.0001) and remained stable afterward for 10 years. Speech recognition scores were significantly higher than pre-operative results (p<0.05) and continued to improve till 3 years after switching on. At 10 years of post-operation, most subjects had improved QOL scores in most sub-items. Conclusions and Significance: Nurotron Venus CI System provides long-term, stable results in hearing speech assistance capabilities and can improve the quality of life of CI recipients.

Keywords: cochlear implantation, hearing loss, post lingual, follow up

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Authors: Shawna Staud, Mary Kaye Scaramucci

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Objective: Rubber cup polishing has been a traditional method of preventative therapy in dental hygiene treatment. Newer methods such as air polishing have changed the way dental hygiene care is provided, yet this technique has not been embraced by students in the program nor by practitioners in the workforce. Students entering the workforce tend to follow office protocol and are limited in confidence to introduce technologies learned in the curriculum. This project was designed to help students gain confidence in newer skills and encourage private practice settings to adopt newer technologies for patient care. Our program recently introduced air polishing earlier in the program before the rubber cup technique to determine if students would embrace the technology to become leading-edge professionals when they enter the marketplace. Methods: The class of 2022 was taught the traditional method of polishing in the first-year curriculum and air polishing in the second-year curriculum. The class of 2023 will be taught the air polishing method in the first-year curriculum and the traditional method of polishing in the second-year curriculum. Pre- and post-graduation survey data will be collected from both cohorts. Descriptive statistics and pre and post-paired t-tests with alpha set at .05 to compare pre and post-survey results will be used to assess data. Results: This study is currently in progress, with a completion date of October 2023. The class of 2022 completed the pre-graduation survey in the spring of 2022. The post-gradation survey will be sent out in October 2022. The class of 2023 cohort will be surveyed in the spring of 2023 and October 2023. Conclusion: Our hypothesis is students who are taught air polishing first will be more inclined to adopt that skill in private practice, thereby embracing newer technology and improving oral health care.

Keywords: luggage handling system at world’s largest pilgrimage center

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Authors: Wasantha Pushpakumara Hitihami Mudiyanselage

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Since recent past, Sri Lanka is highly vulnerable to reoccurring climate shocks that severely impact the food security, loss of human & animal lives, destructions of human settlements, displacement of people and damaging properties. Hence, the Government of Sri Lanka has taken important steps towards strengthening legal and institutional arrangements for Disaster Risks management in the country in May 2005. Puttalam administrative district is one of the disaster prone districts in Sri Lanka which constantly face the devastating consequences of the increasing natural disasters annually. Therefore disaster risk management will be a timely intervention in the area to minimize the adverse impacts of the disasters. The few functioning Disaster Risk management networks do not take children’s specific needs and vulnerabilities during emergencies into account. The most affected children and their families were evacuated to the government schools and temples and it was observed that children were left to roaming around as their parents were busy queuing up for relief goods and other priorities. In this sense, VOICE understands that the community has vital role that has to be played in facing challenges of disaster management in the area. During and after the disaster, it was viewed that some children were having psychological disorders which could be impacted negatively to children well–being. Need of child friendly space at emergency is a must action in the area to turn away negative impact coming from the hazards. VOICE with the support of national & international communities have established safer places for the children (Child Centered Spaces – CCS) and their families at emergencies. Village religious venues and schools were selected and equipped with necessary materials to be used for the children at emergency. Materials such as tools, stationeries, play materials, which couldn’t be easily found in surrounding environment, were provided for CCS centers. Village animators, youth and elders were given comprehensive training on Disaster management and their role at CCS. They did the facilitation in keeping children without fear and stress at flooding occurred in 2015 as well as they were able to improve their skills when working with children. Flooding in 2016, the government agencies have taken service of these village animators at early stage of flooding to make all disaster-related recovery actions productively & efficiently. This mechanism is sustained at village level that can be used for disaster events.

Keywords: child centered space, impacts, psychological disorders, village animators

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Authors: Surjeet Bakshi, Surabhi Sharma

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Objective: To assess the impact of educational sessions by reputed regional faculties on knowledge of primary care physicians on evidence based diabetes management methods and practice. Study Design: Retrospective pre-post intervention study. Methodology: Nine cities in Kerala from August to October, 2012 were selected for the study. 125 MBBS doctors participated in the study. 11 regional faculties provided six educational sessions throughout the period. Validated questionnaires were used to evaluate the knowledge of the participants on evidence based diabetes management methods before and after the intervention. Results: The mean score on pre-test was 8 and the mean score on post-test was 9. A paired t-test was conducted on participant’s pre- and post test score and the results were statistically significant (p<0.001). Conclusion: Even though the general attitude to and level of knowledge of diabetes management is good among the primary care physicians in India, there do exist some knowledge gaps which might influence their future practices when it comes to counselling and information on diabetes management methods. In the present study, the performance and awareness level of the participants have expressively improved among primary care physicians. There is a significant improvement in the test score and the training conducted. It seems that if such study programmes are included in the students study programme, it will give higher score in the knowledge and attitude towards diabetes management.

Keywords: diabetes, management, primary care physicians, evidence base, improvement score, knowledge

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Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

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Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

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Authors: Layaly Ayoub, Mariana Ribeiro

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Introduction: Breast cancer is currently considered the leading cause of cancer-related deaths among women in Brazil. Mastectomy, essential in this treatment, often necessitates subsequent breast reconstruction to restore physical appearance and aid in the emotional and psychological recovery of patients. The choice between immediate or delayed reconstruction is influenced by factors such as the type and stage of cancer, as well as the patient's overall health. The decision between autologous breast reconstruction or implant-based reconstruction requires a detailed analysis of individual conditions and needs. Objectives: This study analyzes the techniques and indications used in post-mastectomy breast reconstruction. Methodology: Literature review conducted in the PubMed and SciELO databases, focusing on articles that met the inclusion and exclusion criteria and descriptors. Results: After mastectomy, breast reconstruction is commonly performed. It is necessary to determine the type of technique to be used in each case depending on the specific characteristics of each patient. The tissue expander technique is indicated for patients with sufficient skin and tissue post-mastectomy, who do not require additional radiotherapy, and who opt for a less complex surgery with a shorter recovery time. This procedure promotes the gradual expansion of soft tissues where the definitive implant will be placed. Both temporary and permanent expanders offer flexibility, allowing for adjustment in the expander size until the desired volume is reached, enabling the skin and tissues to adapt to the breast implant area. Conversely, autologous reconstruction is indicated for patients who will undergo radiotherapy, have insufficient tissue, and prefer a more natural solution. This technique uses the transverse rectus abdominis muscle (TRAM) flap, the latissimus dorsi muscle flap, the gluteal flap, and local muscle flaps to shape a new breast, potentially combined with a breast implant. Conclusion: In this context, it is essential to conduct a thorough evaluation regarding the technique to be applied, as both have their benefits and challenges.

Keywords: indications, post-mastectomy, breast reconstruction, techniques

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Authors: Bashar Tarawneh, Yasser Hakam

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Rapid Impact Compaction (RIC) is a modern dynamic compaction device mainly used to compact sandy soils, where silt and clay contents are low. The device uses the piling hammer technology to increase the bearing capacity of soils through controlled impacts. The RIC device uses "controlled impact compaction" of the ground using a 9-ton hammer dropped from the height between 0.3 m to 1.2 m onto a 1.5 m diameter steel patent foot. The delivered energy is about 26,487 to 105,948 Joules per drop. To evaluate the performance of this technique, three project sites in the United Arab Emirates were improved using RIC. In those sites, a loose to very loose fine to medium sand was encountered at a depth ranging from 1.0m to 4.0m below the ground level. To evaluate the performance of the RIC, Cone Penetration Tests (CPT) were carried out before and after improvement. Also, load tests were carried out post-RIC work to assess the settlements and bearing capacity. The soil was improved to a depth of about 5.0m below the ground level depending on the CPT friction ratio (the ratio between sleeve friction and tip resistance). CPT tip resistance was significantly increased post ground improvement work. Load tests showed enhancement in the soil bearing capacity and reduction in the potential settlements. This study demonstrates the successful application of the RIC for middle-deep improvement and compaction of the ground. Foundation design criteria were achieved in all site post-RIC work.

Keywords: compaction, RIC, ground improvement, CPT

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