Search results for: premature birth

Authors: Sang Ho Lee, Tae Heon Moon, Youn Taik Leem, Kwang Woo Nam

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Knowledge and IT inputs to other industrial production have become more important as a key factor for the competitiveness of national and regional economies, such as knowledge economies in smart cities. Knowledge and IT industries lead the industrial innovation and technical (r)evolution through low cost, high efficiency in production, and by creating a new value chain and new production path chains, which is referred as knowledge and IT dynamics. This study aims to investigate the knowledge and IT dynamics in Korea, which are analyzed through the input-output model and structural path analysis. Twenty-eight industries were reclassified into seven categories; Agriculture and Mining, IT manufacture, Non-IT manufacture, Construction, IT-service, Knowledge service, Non-knowledge service to take close look at the knowledge and IT dynamics. Knowledge and IT dynamics were analyzed through the change of input output coefficient and multiplier indices in terms of technical innovation, as well as the changes of the structural paths of the knowledge and IT to other industries in terms of new production value creation from 1985 and 2010. The structural paths of knowledge and IT explain not only that IT foster the generation, circulation and use of knowledge through IT industries and IT-based service, but also that knowledge encourages IT use through creating, sharing and managing knowledge. As a result, this paper found the empirical investigation on the knowledge and IT dynamics of the Korean economy. Knowledge and IT has played an important role regarding the inter-industrial transactional input for production, as well as new industrial creation. The birth of the input-output production path has mostly originated from the knowledge and IT industries, while the death of the input-output production path took place in the traditional industries from 1985 and 2010. The Korean economy has been in transition to a knowledge economy in the Smart City.

Keywords: knowledge and IT industries, input-output model, structural path analysis, dynamics of knowledge and it, knowledge economy, knowledge city and smart city

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Authors: Sabine Pau, Sophia Volz, Emanuel Bauer, Amelie De Gregorio, Frank Reister, Wolfgang Janni, Florian Ebner

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Purpose: The umbilical cord pH is a well evaluated contributor for prediction of neonatal outcome. This study correlates nenonatal umbilical cord pH with the weekday of delivery, the time of birth as well as the staff hand over times (midwifes and doctors). Material and Methods: This retrospective study included all deliveries of a 20 year period (1994-2014) at our primary obstetric center. All deliveries with a newborn cord pH under 7,20 were included in this analysis (6929 of 48974 deliveries (14,4%)). Further subgroups were formed according to the pH (< 7,05; 7,05 – 7,09; 7,10 – 7,14; 7,15 – 7,19). The data were then separated in day- and night time (8am-8pm/8pm-8am) for a first analysis. Finally, handover times were defined at 6 am – 6.30 am, 2 pm -2.30 pm, 10 pm- 10.30 pm (midwives) and for the doctors 8-8.30 am, 4 – 4.30 pm (Monday- Thursday); 2 pm -2.30 pm (Friday) and 9 am – 9.30 am (weekend). Routinely a shift consists of at least three doctors as well as three midwives. Results: During the last 20 years, 6929 neonates were born with an umbilical cord ph < 7,20 ( < 7,05 : 7,1%; 7,05 – 7,09 : 10,9%; 7,10 – 7,14 : 30,2%; 7,15 – 7,19:51,8%). There was no significant difference between either night/day delivery (p = 0.408), delivery on different weekdays (p = 0.253), delivery between Monday to Thursday, Friday and the weekend (p = 0.496 ) or delivery during the handover times of the doctors as well as the midwives (p = 0.221). Even the standard deviation showed no differences between the groups. Conclusion: Despite an increased workload over the last 20 years, the standard of care remains high even during the handover times and night shifts. This applies for midwives and doctors. As the neonatal outcome depends on various factors, further studies are necessary to take more factors influencing the fetal outcome into consideration. In order to maintain this high standard of care, an adaption of work-load and changing conditions is necessary.

Keywords: delivery, fetal umbilical cord pH, day time, hand over times

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Authors: Muhammad Arif Jalil, Somchat Sonasang, Preecha Yupapin

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This study hypothesizes that the universe is at the center of the universe among the white and black holes, which are the entangled pairs. The coupling between them is in terms of spacetime forming the universe and things. The birth of things is based on exchange energy between the white and black sides. That is, the transition from the white side to the black side is called wave-matter, where it has a speed faster than light with positive gravity. The transition from the black to the white side has a speed faster than light with negative gravity called a wave-particle. In the part where the speed is equal to light, the particle rest mass is formed. Things can appear to take shape here. Thus, the gravity is zero because it is the center. The gravitational force belongs to the Earth itself because it is in a position that is twisted towards the white hole. Therefore, it is negative. The coupling of black-white holes occurs directly on both sides. The mass is formed at the saturation and will create universes and other things. Therefore, it can be hundreds of thousands of universes on both sides of the B and white holes before reaching the saturation point of multi-universes. This work will use the DJV circuit that the research team made as an entangled or two-level system circuit that has been experimentally demonstrated. Therefore, this principle has the possibility for interpretation. This work explains the emergence of multiple universes and can be applied as a practical guideline for searching for universes in the future. Moreover, the results indicate that the DJV circuit can create the elementary particles according to Feynman's diagram with rest mass conditions, which will be discussed for fission and fusion applications.

Keywords: multi-universes, feynman diagram, fission, fusion

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Authors: Melanie Tang

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According to Nietzsche, the eternal recurrence is his most important idea. However, it is perhaps his most cryptic and difficult to interpret. Early readings considered it as a cosmological hypothesis about the cyclic nature of time. However, following Nehamas’s ‘Life as Literature’ (1985), it has become a widespread interpretation that the eternal recurrence never really had any theoretical dimensions, and is not actually a philosophy of time, but a practical thought experiment intended to measure the extent to which we have mastered and perfected our lives. This paper endeavours to challenge this line of thought becoming scholarly consensus, and to carry out a more complex analysis of the eternal recurrence as it is presented in Thus Spoke Zarathustra. In its wider scope, this research proposes that Thus Spoke Zarathustra — as opposed to The Birth of Tragedy — be taken as the primary source for a study of Nietzsche’s Aesthetics, due to its more intrinsic aesthetic qualities and expressive devices. The eternal recurrence is the central philosophy of a work that communicates its ideas in unprecedentedly experimental and aesthetic terms, and a more in-depth understanding of why Nietzsche chooses to present his conception of time in aesthetic terms is warranted. Through hermeneutical analysis of Thus Spoke Zarathustra and engagement with secondary sources such as those by Nehamas, Karl Löwith, and Jill Marsden, the present analysis challenges the ethics of self-perfection upon which current interpretations of the recurrence are based, as well as their reliance upon a linear conception of time. Instead, it finds the recurrence to be a cyclic interplay between the self and the world, rather than a metric pertaining solely to the self. In this interpretation, time is found to be composed of an intertemporal rather than linear multitude of will to power, which structures itself through tensional cycles into an experience of circular time that can be seen to have aesthetic dimensions. In putting forth this understanding of the eternal recurrence, this research hopes to reopen debate on this key concept in the field of Nietzsche studies.

Keywords: Nietzsche, eternal recurrence, Zarathustra, aesthetics, time

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Authors: Juan Manuel Uriarte Lopez, Hector Raul Guemez Gaxiola, Javier Alonso Romo Rubio, Juan Manuel Romo Valdez

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The objective of this investigation was to determine the influence of the use of recycled vegetable oil from restaurants in the productive performance of sows in lactation. Twenty-four hybrids lactating sows (Landrace x Yorkshire) were divided into three treatments with eight sows per treatment. On day 107 of gestation, the sows were moved to the mesh floor maternity cages in an environment regulated by the environment regulated (2.4 × 0.6 m) contained an area (2.4 × 0.5 m) for newborn pigs on each side, all diets were provided as a dry powder, and the sows received free access to water throughout the experimental period. After farrowing, the sows were fasted for 12 hours, the daily feed ration gradually increased, and the sows had ad libitum access to feed on the fourth day. The diets used were corn-soybean meal-based, containing 0 (CONT), recycled vegetable oil 1.0 % (RVOL), or recycled vegetable oil 1.5 % (RVOH) for 30 days. The diets contained similar calculated levels of crude protein and metabolizable energy and contained vitamins and minerals that exceeded National Research Council (1998) recommendations; sows were fed three times daily. On day 30, piglets were weaned, and performances of lactating sows and nursery piglets were recorded. Results indicated that average daily feed intake (5.58, 5.55, and 5.49 kg for CONT, RVOL, and RVO, respectively) of sows were not affected (P > 0.05) by different dietary. There was no difference in the average body weight of piglets on the day of birth, with 1.33, 1.36, and 1.35 kg, respectively (P > 0.05). There was no difference in average body weight of piglets on day 30, with 6.91, 6.75, and 7.05 kg, respectively 0.05) between treatments numbers of weaned piglets per sow (9.95, 9.80, and 9.80) were not affected by treatments (P > 0.05).In conclusion, the substitution of virgin vegetable oil for recycled vegetable oil in the diet does not affect the productive performance of lactating sows.

Keywords: lactating, sow, vegetable, oil

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Authors: Vaishakh Medikeri

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Energy in this Universe is the most basic characteristic of every particle. Since the birth of life on this planet, there has been a quest undertaken by the living beings to analyze, understand and harness the precious natural facts of the nature. In this quest, one of the greatest undertaken is the process of harnessing the naturally available energy. Scientists around the globe have discovered many ways to harness the freely available energy. But even today we speak of “Power Crisis”. Nikola Tesla once said “Nature has stored up in this universe infinite energy”. Energy is everywhere around us in unlimited quantities; all of it waiting to be harnessed by us. Here in this paper a method has been proposed to harness earth's electric field and transmit the stored electric energy using strong magnetic fields and electric fields. In this paper a new technique has been proposed to harness earth's electric field which is everywhere around the world in infinite quantities. Near the surface of the earth there is an electric field of about 120V/m. This electric field is used to charge a capacitor with high capacitance. Later the energy stored is allowed to pass through a device which converts the DC stored into AC. The AC so produced is then passed through a step down transformer to magnify the incoming current. Later the current passes through the RLC circuit. Later the current can be transmitted wirelessly using the principle of resonant inductive coupling. The proposed apparatus can be placed in most of the required places and any circuit tuned to the frequency of the transmitted current can receive the energy. The new source of renewable energy is of great importance if implemented since the apparatus is not costly and can be situated in most of the required places. And also the receiver which receives the transmitted energy is just an RLC circuit tuned to the resonant frequency of the transmitted energy. By using the proposed apparatus the energy losses can be reduced to a very large extent.

Keywords: capacitor, inductive resonant coupling, RLC circuit, transmission of electricity

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Authors: Edit Xhajanka, Gresa Baboci, Irene Malagnino, Mimoza Canga, Vito Antonio Malagnino

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Purpose: This study aimed at identifying dental caries increment or reduction, based on factors such as smoking, the scaling of teeth, BMI before and during pregnancy, carbohydrates consumption in relation to childbirth. Material and method: In this observational study, the sample included a total of 98 pregnant women and their age class was 18-45 years old, with a median age of 31.5 years. The setting of the participants resides in Vlora –Albania. Moreover, 64.4% were from the city and 35.6% were from the nearby villages. The study was conducted in the time period January 2018 –June 2021. Body mass index (BMI) was calculated using the standard formula (kg/m²). Maternal pre, during and post-pregnancy BMI was collected by using a validated questionnaire. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: Based on the data analysis, 44.4% of the sample declared that they did smoke before pregnancy and 55.6% not smoked during their pregnancy. As a result, no association was found between smoking and length of pregnancy P=0.95. There is also a strong relation (P=0.000) between the number of teeth with caries before pregnancy and the number of teeth with caries during pregnancy. There is a significant relationship between the scaling of teeth and childbirth, P=0.05. BMI before and during pregnancy in relation to carbohydrates consumption have a significant correlation P=0.004 and P=0.002. The values of BMI before and during pregnancy in relation to childbirth have a strong correlation: P=0.043 and P=0.040, respectively. As a result, obesity was associated with preterm birth. The percentage of children born during 34-36 weeks of pregnancy was 69%, and children born during 32-34 weeks of pregnancy were 31%. CONCLUSION: There was a positive association between dental caries experience, BMI and carbohydrates consumption. Obesity in pregnancy is increasing worldwide; that is why this study suggests the importance of an appropriate weight before and during pregnancy.

Keywords: BMI, dental caries, pregnancy, scaling, smoking

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Authors: Thananyada Buapian

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Overnutrition is emerging as a morbid disease in developing and Westernized countries. Because of its comorbidity diseases, it is cost-effective to prevent and manage this disease earlier. In Thailand, this alarming disease has long been studied, but the prevalence is still higher than that in the past. Physicians should recognize it well and have a definite direction to face and combat this dangerous disease. Rapid changes in the tremendous figure of overnutrition students indicate that genetic factors are not the primary determinants since human genes have remained unchanged for a century. This study aims to assess the prevalence of overnutrition students and to investigate the non-genetic factors affecting over nutrition students. A cross-sectional school-based survey was conducted. A two-stage sampling was adopted. Respondents included 1,850 students in grades 4 to 6 in Ayutthaya Province. An anthropometric measurement and questionnaire were developed. Childhood over nutrition was defined as a weight-for-height Z-score above +2SD of NCHS/WHO references. About thirty three percent of the children were over nutrition in Ayutthaya province. Stepwise multiple logistic regression analysis showed that 8 statistically significant non genetic factors explain the variation of childhood over nutrition by 18 percent. Sex is the prime factor to explain the variation of childhood over nutrition, followed by duration of light physical activities, duration of moderate physical activities, having been breastfed, the presence of a healthy role model of the caregiver, number of siblings, birth order, and occupation of the caregiver, respectively. Non genetic factors, especially the subjects’ demographic and physical activities, as well as the caregivers’ background and family environment, should be considered in viable approach to remedy this health imbalance in children.

Keywords: non genetic factors, non-genetic, over nutrition, over nutrition students

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Authors: Maryam Borjali

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Introduction. Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. e objective of present study was to identify nonmedical determinants related to this abnormality from the mother’s perspectives. Methods. is research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results. Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions. Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers’ prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Keywords: congenital_cou, cultural, social, platform

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Authors: Mihai-Ionut Firescu, Mark A. P. Carson

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We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.

Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism

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Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain

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Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.

Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore

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Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

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Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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Authors: Dato Surmanidze, Dato Antadze, Tornike Partenadze

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Public online services in Georgia are concentrated on main target segments: public administration, business, population, non-governmental and other interested organizations. Therefore, the strategy of digital Georgia is focused on providing G2C, G2B/B2G, G2NGO and G2G services. In G2C framework sophisticated and high-technological online services have been developed in order to provide passports, identity cards, documentations concerning residence and civil acts (birth, marriage, divorce, child adoption, change of name and surname, death, etc) as well as other services. Websites like my.gov.ge and sda.gov.ge have distance services like electronic application, processing and decision making. In line with international standards automatic services like electronic tenders, product catalogues, invoices and payment have been developed. This creates better investment climate for foreign companies in Georgia in the framework of G2B politics. The website mybusiness.gov.ge creates better conditions for local business. Among electronic services is e-NRMS (electronic system for national resource management) which was introduced by the Ministry of Finance of Georgia. The system was created in order to ensure management of national resources by state and business organizations. It is integrated with bank services and provides G2C, G2B and B2G representatives with electronic services. Also a portal meteo.gov.ge was created which gives electronic services concerning air, geological, environmental and pollution issues. Also worknet.gov.ge should be mentioned which is an electronic hub of information management for employers and employees. The information portal of labor market will facilitate receipt of information, its analysis and delivery to interested people like employers and employees. However, nowadays it’s been two years that only employees portal is activated. Therefore, awareness about the portal, its competitiveness and success is undermined.

Keywords: electronic services, public administration, information technology, information society

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Authors: Rauza Sukma Rita, Katsuya Dezaki, Yuko Maejima, Toshihiko Yada

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Oxytocin is a nine-amino acid peptide synthesized in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) of the hypothalamus. Oxytocin promotes contraction of the uterus during birth and milk ejection during breast feeding. Although oxytocin receptors are found predominantly in the breasts and uterus of females, many tissues and organs express oxytocin receptors, including the pituitary, heart, kidney, thymus, vascular endothelium, adipocytes, osteoblasts, adrenal gland, pancreatic islets, and many cell lines. On the other hand, in pancreatic islets, oxytocin receptors are expressed in both α-cells and β-cells with stronger expression in α- cells. However, to our knowledge there are no reports yet about the effect of oxytocin on cytosolic calcium reaction on α and β-cell. This study aims to investigate the effect of oxytocin on α-cells and β-cells and its oscillation pattern. Islet of Langerhans from wild type mice were isolated by collagenase digestion. Isolated and dissociated single cells either α-cells or β-cells on coverslips were mounted in an open chamber and superfused in HKRB. Cytosolic concentration ([Ca2+]i) in single cells were measured by fura-2 microfluorimetry. After measurement of [Ca2+]i, α-cells were identified by subsequent immunocytochemical staining using an anti-glucagon antiserum. In β-cells, the [Ca2+]i increase in response to oxytocin was observed only under 8.3 mM glucose condition, whereas in α-cells, [Ca2+]i an increase induced by oxytocin was observed in both 2.8 mM and 8.3 mM glucose. The oscillation incidence was induced more frequently in β-cells compared to α-cells. In conclusion, the present study demonstrated that oxytocin directly interacts with both α-cells and β-cells and induces increase of [Ca2+]i and its specific patterns.

Keywords: α-cells, β-cells, cytosolic calcium concentration, oscillation, oxytocin

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Authors: Samarpreet Singh, Gerald Giesbrecht

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Both c-section and antibiotic exposure are linked to gut microbiota imbalance in infants. Such disturbance is associated with the Hypothalamic-Pituitary-Adrenal (HPA) axis function. However, the literature only has contradicting evidence for the association between c-sections and the HPA axis. Therefore, this study aims to test if the mode of delivery and antibiotics exposure is associated with the HPA axis. Also, whether exposure to both interacts with the HPA-axis. It was hypothesized that associations and interactions would be observed. Secondary data analysis was used for this co-relational study. Data for the mode of delivery and antibiotics exposure variables were documented from hospital records or self-questionnaires. In addition, cortisol levels (Area under the curve with respect to increasing (AUCi) and Area under the curve with respect to ground (AUCg)) were based on saliva collected from three months old during the infant’s visit to the lab and after drawing blood. One-way and between-subject ANOVA analyses were run on data. No significant association between delivery mode and infant cortisol level was found, AUCi and AUCg, p > .05. Only the infant’s AUCg was found to be significantly higher if there were antibiotics exposure at delivery (p = .001) or their mothers were exposed during pregnancy (p < .05). Infants born by c-section and exposed to antibiotics at three months had higher AUCi than those born vaginally, p < .02. These results imply that antibiotic exposure before three months is associated with an infant’s stress response. The association might increase if antibiotic exposure occurs three months after a c-section birth. However, more robust and causal evidence in future studies is needed, given a variable group’s statistically weak sample size. Nevertheless, the results of this study still highlight the unintended consequences of antibiotic exposure during delivery and pregnancy.

Keywords: HPA-axis, antibiotics, c-section, gut-microbiota, development, stress

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Authors: M. A. Askari, M. A. Nazari, P. Perrier, Y. Payan

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Growth and remodeling of biological structures have gained lots of attention over the past decades. Determining the response of the living tissues to the mechanical loads is necessary for a wide range of developing fields such as, designing of prosthetics and optimized surgery operations. It is a well-known fact that biological structures are never stress-free, even when externally unloaded. The exact origin of these residual stresses is not clear, but theoretically growth and remodeling is one of the main sources. Extracting body organs from medical imaging, does not produce any information regarding the existing residual stresses in that organ. The simplest cause of such stresses is the gravity since an organ grows under its influence from its birth. Ignoring such residual stresses might cause erroneous results in numerical simulations. Accounting for residual stresses due to tissue growth can improve the accuracy of mechanical analysis results. In this paper, we have implemented a computational framework based on fixed-point iteration to determine the residual stresses due to growth. Using nonlinear continuum mechanics and the concept of fictitious configuration we find the unknown stress-free reference configuration which is necessary for mechanical analysis. To illustrate the method, we apply it to a finite element model of healthy human face whose geometry has been extracted from medical images. We have computed the distribution of residual stress in facial tissues, which can overcome the effect of gravity and cause that tissues remain firm. Tissue wrinkles caused by aging could be a consequence of decreasing residual stress and not counteracting the gravity. Considering these stresses has important application in maxillofacial surgery. It helps the surgeons to predict the changes after surgical operations and their consequences.

Keywords: growth, soft tissue, residual stress, finite element method

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Authors: Omolola A. Tajelawi, Hari L. Garbharran

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Revenue leakages are one of the major challenges manufacturers face in production processes, as most of the input materials that should emanate as products from the lines are lost as waste. Rather than generating income from material input which is meant to end-up as products, losses are further incurred as costs in order to manage waste generated. In addition, due to the lack of a clear view of the flow of resources on the lines from input to output stage, acquiring information on the true cost of waste generated have become a challenge. This has therefore given birth to the conceptualization and implementation of waste minimization strategies by several manufacturing industries. This paper reviews the principles and applications of three environmental management accounting tools namely Activity-based Costing (ABC), Life-Cycle Assessment (LCA) and Material Flow Cost Accounting (MFCA) in the manufacturing industry and their effectiveness in curbing revenue leakages. The paper unveils the strengths and limitations of each of the tools; beaming a searchlight on the tool that could allow for optimal resource utilization, transparency in production process as well as improved cost efficiency. Findings from this review reveal that MFCA may offer superior advantages with regards to the provision of more detailed information (both in physical and monetary terms) on the flow of material inputs throughout the production process compared to the other environmental accounting tools. This paper therefore makes a case for the adoption of MFCA as a viable technique for the identification and reduction of waste in production processes, and also for effective decision making by production managers, financial advisors and other relevant stakeholders.

Keywords: MFCA, environmental management accounting, resource efficiency, waste reduction, revenue losses

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Authors: Nimasha Malalasekera

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Working with the indigenous Adivasi (Vedda) community of Dambana in the district of Badulla in Sri Lanka, this research documents linguistic data to address language and cultural endangerment. The ancestral language of Adivasi has undergone sustained restructuration over a long historical period due to its contact with Sinhala, an Indo-Aryan language spoken by the majority Sinhalese. The Vedda language is highly endangered today. At present, all speakers of the Vedda language spoken in Dambana are Adivasi men in the parent generation, who are Sinhala-Vedda bilinguals. Adivasi women and children do not speak the Vedda language but Sinhala in everyday life. Women can understand the Vedda language and would respond to a Vedda language utterance in Sinhala. The use of the Vedda language is largely restricted to self-ascribing Adivasi men who employ it in the context of cultural tourism in Dambana to index ethnolinguistic otherness. Adivasi of Dambana often refers to this distinct linguistic code that they speak as baasapojja or language. This research employs a cooperative model of ethnographic documentation to explore the interrelations between discursive practices, linguistic structures, and linguistic (and broader sociocultural) ideologies in this community. The Vedda language has been previously identified as a dialect of Sinhala or a creole emerging in the contact between Sinhala and the ancestral Vedda language. This paper analyzes the current language endangerment context of bilingual Adivasi members that allows the birth of a mixed language. The aim of this research is to preserve ongoing linguistic innovation among this endangered language speech community. It contributes to the appreciation of creative cultural and linguistic production of a stigmatized minuscule indigenous community of South Asia that strives to assert a distinct linguistic and cultural identity from the dominant populations.

Keywords: Vedda language, language endangerment, mixed languages, indigenous identity

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Authors: Wafeek Mohamed Ibrahim Mohamed

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In the era of globalization and openness informational. Anyone who thinks about innovation in the earth population in Islam in our contemporary reality, he will find that it is not destined to its civilized extension to last. The purpose of the research is a trial to reach a realistic vision for creative, innovative and intellectual thought for the earth population in Islam as an instrument to Confrontation and observe the changes that have affected in the architecture of the land during different eras. Through knowing the controls of the ruling legitimacy(that served as definitions and laws which formulate its features) and using customs, traditions, and conventions as a telescope for the earth population in Islam, It explained the impact of them on features of creative formation for the architecture of the land in our contemporary reality. The study shows a modern vision to identify innovation in the earth population in Islam. As well as reformulating its mental image and monitoring its changes in Islamic heritage cities. This will be done through a two main branches: firstly, set forth a theory represented in studying creative concepts which formulate the population of the earth in Islam. Such as initiative and responsibility for reviving the dead land, the lane [alley] as formation unit and social solidarity,… Etc.. The second branch is preparing a practical, critical vision for innovative conceptual thought for the architecture of the land of Islam, through studying the development of a traditional Islamic city., The conceptual thought of making the birth festival ["Al-Refaee"] and its emulation for governing roles in the traditional city building. The research concludes The necessity of forming the suggested a creative vision for identifying how to re-form the conceptual for our contemporary population of the earth. It poses an important question which is how to return to creativity in the architecture of the land of Islam in our built environments.

Keywords: innovation and creation, architecture, the land in Islam, criticism of design

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: K. S. Suganya, R. Nedunchezhian

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In recent years, blockchain technology has been found to be the most significant discovery in this digital era, after the discovery of the Internet and Cloud Computing. Blockchain is a simple, distributed public ledger that contains all the user’s transaction details in a block. The global copy of the block is then shared among all its peer-peer network users after validation by the Blockchain miners. Once a block is validated and accepted, it cannot be altered by any users making it a trust-free transaction. It also resolves the problem of double-spending by using traditional cryptographic methods. Since the advent of bitcoin, blockchain has been the backbone for all its transactions. But in recent years, it has found its roots and uses in many fields like Smart Contracts, Smart City management, healthcare, etc. Identity management against digital identity theft has become a major concern among financial and other organizations. To solve this digital identity theft, blockchain technology can be employed with existing identity management systems, which maintain a distributed public ledger containing details of an individual’s identity containing information such as Digital birth certificates, Citizenship number, Bank details, voter details, driving license in the form of blocks verified on the blockchain becomes time-stamped, unforgeable and publicly visible for any legitimate users. The main challenge in using blockchain technology to prevent digital identity theft is ensuring the pseudo-anonymity and privacy of the users. This survey paper will exert to study the blockchain concepts, consensus protocols, and various blockchain-based Digital Identity Management systems with their research scope. This paper also discusses the role of Blockchain in COVID-19 pandemic management by self-sovereign identity and supply chain management.

Keywords: blockchain, consensus protocols, bitcoin, identity theft, digital identity management, pandemic, COVID-19, self-sovereign identity

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Authors: Rachel Dolan

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Background: Over two thirds of women in prison in England are mothers, and estimates suggest between 100 and 200 women per year give birth during imprisonment. There are currently six mother and baby units (MBUs) in prisons in England which admit women and babies up to the age of 18 months. Although there are only 65 places available, and despite positive impacts, they are rarely full. Mental illness may influence the number of admissions, as may interpretation of admission criteria. They are the only current alternative to separation for imprisoned mothers and their babies. Aims: To identify the factors that affect the decision to apply for/be offered a place in a prison MBU; to measure the impact of a placement upon maternal mental health and wellbeing; To measure the Initial outcomes for mother and child. Methods: A mixed methods approach - 100 pregnant women in English prisons are currently being recruited from prisons in England. Quantitative measures will establish the prevalence of mental disorder, personality disorder, substance misuse and quality of life. Qualitative interviews will document the experiences of pregnancy and motherhood in prison. Results: Preliminary quantitative findings suggest the most prevalent mental disorders are anxiety and depression and approximately half the participants meet the criteria for one or more personality disorders. The majority of participants to date have been offered a place in a prison MBU, and those in a prison with an MBU prior to applying are more likely to be admitted. Those with a previous history of childcare issues, who are known to social services are less likely to be offered a place. Qualitative findings suggest that many women are often hungry and uncomfortable during pregnancy, many have feelings of guilt about having a child in prison and that feelings of anxiety and worry are exacerbated by lack of information.

Keywords: mothers, prison, mother and baby units, mental health

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Authors: Izzudeen Adetunji

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The intrinsic nexus between man and society is apparently unknown to many people despite understanding the real responsibility and immense roles in society. Amongst the in-depth roles of a man as an agent of the societal reformer is to be a driven force towards installing normalcy and socio-cultural change in society. The paradoxical attitudes of man in engaging in social vices, illicit characters, and unwanted attitudes have given birth to decay and ill-society. However, the need for social change or socio-cultural evolution might be necessary to install normalcy and social order. Nigerian Arabic poets since the 19th century have tremendously engaged in utilizing their poetry for social change through socio-cultural, religious, economic, scientific, or technological forces. This engagement has hitherto yielded a positive outcome for societal reform. The anthology of Ibn Yusuf is one of the compendiums of poetries revealing societal depravity, man’s social vices, and atrocities; which later called to flawlessness. The theoretical framework would be examined through the Heraclitan model, focusing on a parallel to that of a living organism, which, in order to remain alive, must constantly change. Therefore, the thrust of this paper is to examine the societal maladies as elucidated in Ibn Yusuf’s anthology and proffer a contrapuntal criticism of it. Before delving into the main discussion, the paper will examine the concepts of existentialism and realism as a philosophical interface. Likewise, the issues of man and social change, an overview of Nigerian Arabic poetry, will be discussed. Ibn Yusuf’s biography and scholarship and the review of his anthology will be studied. The paper will conclude by critically examining the contrapuntal criticism of societal maladies through Ibn Yusuf’s anthology.

Keywords: societal depravity, existentialism, realism, Nigeria Arabic poetry, Ibn Yusuf’s anthology, contrapuntal criticism

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Authors: Irem Ozten, Neri̇man Caglayan Keles

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Aim: Breastfeeding is a special process for a mother and her baby, and it is the first feeding option for a baby. However, not every society approves of breastfeeding in public to the same degree. The purpose of this study is to determine the attitudes and behaviors of women living in Türkiye toward breastfeeding in public. Materials and methods: This descriptive study was carried out in December 2023 with 515 women (N=515) who had babies aged 0-5 years and breastfed their babies. Based on the review of the literature, an online (Google Forms) data collection form consisting of 40 questions was created. While 13 of these questions were about sociodemographic and obstetric characteristics, 27 were about breastfeeding in public. It took each participant 5-7 minutes to respond to the data collection form by marking their choices on the form. The responses of the participants were analyzed using the R Core Team statistics program. Results: The mean age of the participants (N=515) was 30.6±4.07 (range: 20-44). According to their statements, 76.1% of the participants had undergraduate university degrees, and 77.1% of them had given vaginal birth in their last delivery. While 68.3% of the participants stated that they had heard about the concept of breastfeeding in public, 47.4% said they comfortably breastfed their babies in public, but 33.6% said they breastfed their babies for a shorter period than usual. It was determined that 40% of the participants were embarrassed about being seen by someone while breastfeeding their babies in public, 38.6% were afraid of men while breastfeeding, and 89.7% looked for a suitable place to breastfeed their babies. Among the participants, 93.6% stated that they covered their breasts with a cloth while breastfeeding, 49.5% thought a mother should breastfeed her baby in a place where she can be alone with her baby, and 29.1% thought a mother should breastfeed her baby in private. Conclusion: According to the results of the study, although most women had heard of the concept of breastfeeding in public, and some were comfortable breastfeeding in public, some breastfed their baby in public for a shorter period than usual, they covered their breasts with a cloth while breastfeeding their babies, they were embarrassed about being seen by someone while breastfeeding, and they were afraid of men while breastfeeding. Therefore, awareness should be raised about breastfeeding in public, and environments where mothers can conveniently breastfeed their babies should be created.

Keywords: breastfeeding in public, breastfeeding, breastfeeding attitudes, breastfeeding bahaviors

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Authors: P. Nafisi Poor, P. Javid

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Religion and divinity have always held important meaning to humans, and therefore it affects different aspects of life including art and architecture. Numerous works of art are related to religion whether supporting or denying it. Religion and religious scholars have influenced and changed art throughout history. This paper focuses on Islam and Christianity because these two religions have been the most discussed and most popular of all time, starting from the birth of Jesus to the arrival of Mohammad. Based on this popularity, these religions have influenced the arts and especially architecture. Islam on one hand changed Iranian and Arabian architecture and they applied it in different places around the world. From the appearance of Islam at 622 AD to this day, Islamic architecture has been evolving; however, one of the most important periods for this style was between 1501 AD and 1736 AD in Iran. Christianity, on the other hand, changed European architecture especially between 1150 AD and 1450 AD or the so-called "Gothic" era, which begins at medieval time and reaches its peak at International Gothic ages. At both of these periods, designing buildings based on spiritual concepts and divine statements reached its peak, and architects were considering God and religion as their center of attention. This article studies the focus on the religions of Islam and Christianity in terms of architecture and presents a general philosophy of both styles to comprehend the idea behind each one, followed by an analysis of their geometry and architectural aspects derived from the best examples, all to understand the purpose of each style and to realize, which one was more successful in reaching their purpose. Subsequently, a comprehensive review of each building is provided including 3D visualizations to help achieve the goal of the article. These studies can support diverse inquiries about both Islamic and Gothic architecture and can be used as a resource to support studies and research towards designing based on religion or for divine purposes.

Keywords: architecture, Gothic, Islamic, religion

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Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

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Authors: Edna Roseline Dede Tetteh

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Reproductive health research and discussions have, over the years, placed a special focus on Africa. This is partly due to the significant relationship between African cultures and reproductive health. Several studies have also acknowledged the economic impact of reproductive health in Africa, because of which reproductive health, particularly family planning, has featured prominently in many economic discussions about Africa. Gender, which is a major element of most African cultures, inspired this study. Given that gender has a significant cultural influence in Africa, the study examined the effect of gender inequality on reproductive health in Africa, with a special focus on Ghana. Specifically, the study examined whether there exists any relationship between gender inequality and reproductive health and, if there is, what the nature and the effect of the relationship are. The study's findings were based on data gathered from 2304 respondents, randomly selected from Ghana's different tribes and ethnic groups. Given that the study was focused on the influence of gender in sexual relationships, the study’s population was people 16 years and above since 16 is the legal age of sexual consent in Ghana. Data was collected through questionnaires and interviews. It was found that the beliefs and practices of the traditional Ghanaian society, like most African societies, have direct and significant impacts on reproductive health. Males in these cultures have more control over reproductive health decisions and choices than females. The study found that it was culturally condemnable for a wife to refuse her husband’s request for sex, even when she is not in the mood for sex, or she is unwell. It was further found that, when it comes to the decision of birth control, males have more power. Consequently, females with reproductive health conditions have no control over choices that support their reproductive health conditions; they must always satisfy their husbands’ sexual needs. Most of the female respondents indicated they had less or no control over protecting themselves from reproductive health risks unless they had the understanding and support of their sexual partners.

Keywords: culture, gender, Ghana, inequality, reproductive health

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Authors: Siobhan Laird

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Under article 12 of the Convention on the Rights of the Child, which extends human rights in their application to those under the age of 18 years, children must be consulted ‘in all matters affecting the child’. The Office of the Children’s Commissioner for England is responsible for improving the welfare of children and young people by ensuring that their Convention rights are respected and realised and their views taken seriously. In 2014 the Children’s Commissioner engaged a team of researchers at the Centre for Social Work, University of Nottingham to develop and roll out an online survey to gather information from children and young people about their exercise of choice within the public care system. Approximately 3,000 children responded to this survey, which comprised both closed and open-ended questions. SPSS was used to analyse the numerical data and a thematic analysis of textual data was conducted on answers to open-ended questions. Findings revealed that children exercised considerable choice over personal space and their spare time, but had much less choice in relation to contact with their birth families, where they lived, or the timings of moves from one placement into another. The majority of children described how they were supported to express their opinions and believed that these were taken seriously. However, a significant number reported problems and explained how specific behaviours by professionals and carers made it difficult for them to express their opinion or to feel that they had influenced decisions which affected them. In open-ended questions eliciting information about their experiences, children and young people were asked to describe how they could be better supported to make choices and what changes would assist for these to be better acknowledged and acted upon by professionals and carers. This paper concludes by presenting the ideas and suggestions of children and young people for improving the public care system in Britain in relation to their exercise of choice.

Keywords: children, choice, participation, public care

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Authors: Sayed Ahmed

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Religious activities that have evolved the sacred into a dynamic cultural phenomenon in the public realm of Sylhet, Bangladesh, and the spatiality of sacred sites and everyday practices in certain built forms have framed these phenomena. Religious rituals in Sylhet gave birth to unique practices of their own and have a vast impact even on contemporary spatial practices, while most Western researchers are not hopeful about the future of religion. However, despite extensive research on urban morphology and religion separately, there is limited literature on the relationship between these two topics to capture religious perceptions and experiences in urban spaces. This research will try to fill the existing gap and explain sacred within the range of Western sociological and philosophical tools implemented in third-world contexts, which was never highlighted before. This perspective of research puts forth the argument that urban morphology influences sacred experiences and how consecrated entities and religious activities shape the city's structure in return. The methodology of the research will map key morphological and religious variables. This mapping might include festival trajectories, street life observations, pedestrian densities, religious activities, public and private interface types with religious commodification, and the identification of blurred boundaries between sacred and profane on smaller to broader urban scales. To relate the derived cartography, illustrative (not representative) interviews about religious signs and symbols will be conducted and compared accordingly. The possible findings might reintroduce the diversity of religious practices in urban places and develop a decent concept of how sacred and urban morphology are mutually reinforcing the city, which has remained a vital nutrient for the survival of its inhabitants. Such infrequent conceptualizations of urban morphology and its relationship to symbolic sacralization are truly ‘outside’ to those that exist in the West.

Keywords: sylhet, religion, urban morphology, symbolic exchange, Baudrillard

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