Search results for: capacity for care

Authors: Anusha Jain, Santosh Vishwanathan, Praveen K. Gupta, Shwetha S., Kavitha S. N.

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Agriculture has a major impact on the Indian economy, with the highest employment ratio than any sector of the country. Currently, most of the traditional agricultural practices and farming methods are manual, which results in farmers not realizing their maximum productivity often due to increasing in labour cost, inefficient use of water sources leading to wastage of water, inadequate soil moisture content, subsequently leading to food insecurity of the country. This research paper aims to solve this problem by developing a full-fledged web application-based platform that has the capacity to associate itself with a Microcontroller-based Automated Irrigation System which schedules the irrigation of crops based on real-time soil moisture content employing soil moisture sensors centric to the crop’s requirements using WSN (Wireless Sensor Networks) and M2M (Machine To Machine Communication) concepts, thus optimizing the use of the available limited water resource, thereby maximizing the crop yield. This robust automated irrigation system provides end-to-end automation of Irrigation of crops at any circumstances such as droughts, irregular rainfall patterns, extreme weather conditions, etc. This platform will also be capable of achieving a nationwide united farming community and ensuring the welfare of farmers. This platform is designed to equip farmers with prerequisite knowledge on tech and the latest farming practices in general. In order to achieve this, the MailChimp mailing service is used through which interested farmers/individuals' email id will be recorded and curated articles on innovations in the world of agriculture will be provided to the farmers via e-mail. In this proposed system, service is enabled on the platform where nearby crop vendors will be able to enter their pickup locations, accepted prices and other relevant information. This will enable farmers to choose their vendors wisely. Along with this, we have created a blogging service that will enable farmers and agricultural enthusiasts to share experiences, helpful knowledge, hardships, etc., with the entire farming community. These are some of the many features that the platform has to offer.

Keywords: WSN (wireless sensor networks), M2M (M/C to M/C communication), automation, irrigation system, sustainability, SAAS (software as a service), soil moisture sensor

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Authors: Leena Inamdar, David Allen, Sushma Acquilla, James Gore

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Health systems globally are facing increasingly complex challenges. Emerging health threats, changing population demographics and increasing health inequalities, globalisation, economic constraints on government spending are some of the most critical ones. These challenges demand not only innovative funding and cross-sectoral approaches, but also require a multidisciplinary public health workforce equipped with skills and expertise to meet the future challenges of the Sustainable Development Goals (SDGs). We aim to outline an approach to assessing the feasibility of establishing a competency-based public health training at a country level. Although the SDGs provide an enabling impetus for change and promote positive developments, public health training and education still lag behind. Large gaps are apparent in both the numbers of trained professionals and the options for high quality training. Public health training in most Low-Middle Income Countries is still largely characterized by a traditional and limited public health focus. There is a pressing need to review and develop core and emerging competences for a well-equipped workforce fit for the future. This includes the important role of national Health and Human Resource Ministries in determining these competences. Public health has long been recognised as a multidisciplinary field, with need for professionals from a wider range of disciplines such as management, health promotion, health economics, law. Leadership and communication skills are also critical to achieve the successes in meeting public health outcomes. Such skills and competences need to be translated into competency-based training and education, to prepare current public health professionals with the skills required in today’s competitive job market. Integration of academic and service based public-health training, flexible accredited programmes to support existing mid-career professionals, continuous professional development need to be explored. In the current global climate of austerity and increasing demands on health systems, the need for stepping up public health training and education is more important than ever. By using a case study, we demonstrate the process of assessing the in-county capacity to establish a competency based public health training programme that will help to develop a stronger, more versatile and much needed public health workforce to meet the SDGs.

Keywords: public health training, competency-based, assessment, SDGs

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Authors: Bei Shan Lin, Tzu Yu Huang, Ya Ping Chen, Chun Mel Lu

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This research is divided into two parts. The first part is to adopt the method of supercritical carbon dioxide fluid extraction to extract sage essential oil (Salvia officinalis) and to find out the differences when the procedure is under different pressure conditions. Meanwhile, this research is going to probe into the composition of the extracted sage essential oil. The second part will talk about the effect of the aromatherapy with extracted sage essential oil to improve the sleeping quality for women in menopause. The extracted sage substance is tested by inhibiting DPPH radical to identify its antioxidant capacity, and the extracted component was analyzed by gas chromatography-mass spectrometer. Under two different pressure conditions, the extracted experiment gets different results. By 3000 psi, the extracted substance is IC50 180.94mg/L, which is higher than IC50 657.43mg/L by 1800 psi. By 3000 psi, the extracted yield is 1.05%, which is higher than 0.68% by 1800 psi. Through the experimental data, the researcher also can conclude that the extracted substance with 3000psi contains more materials than the one with 1800 psi. The main overlapped materials are the compounds of cyclic ether, flavonoid, and terpenes. Cyclic ether and flavonoids have the function of soothing and calming. They can be applied to relieve cramps and to eliminate menopause disorders. The second part of the research is to apply extracted sage essential oil to aromatherapy for women who are in menopause and to discuss the effect of the improvement for the sleeping quality. This research adopts the approaching of Swedish upper back massage, evaluates the sleeping quality with the Pittsburgh Sleep Quality Index, and detects the changes with heart rate variability apparatus. The experimental group intervenes with extracted sage essential oil to the aromatherapy. The average heart beats detected by the apparatus has a better result in SDNN, low frequency, and high frequency. The performance is better than the control group. According to the statistical analysis of the Pittsburgh Sleep Quality Index, this research has reached the effect of sleep quality improvement. It proves that extracted sage essential oil has a significant effect on increasing the activities of parasympathetic nerves. It is able to improve the sleeping quality for women in menopause

Keywords: supercritical carbon dioxide fluid extraction, Salvia officinalis, aromatherapy, Swedish massage, Pittsburgh sleep quality index, heart rate variability, parasympathetic nerves

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Authors: Aarti Agarwal, Ajmal Khan

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Background and Objective: Breathing difficulty is most distressing symptom for the patient and their caregivers providing palliative care to individuals with advanced malignancy. It needs to be tackled effectively and sometimes preemptively to provide relief from respiratory obstruction. Interventional procedures like tracheal stenting are becoming increasingly popular as a part of palliation for respiratory symptoms. We present a case of esophageal tumor earlier stented by Gastroenterologist to maintain esophageal patency, but the tumor outgrew to produce tracheal infiltration and thereby causing airway obstruction. Method and Result: 62-year-old man presented with unresectable Carcinoma oesophagus with inability to swallow. A metallic stent was placed by the gastroenterologist, to maintain esophageal patency and enable patient to swallow. Two months later, the patient returned to hospital in emergency with respiratory distress. CT neck and thorax revealed tumor infiltration through posterior tracheal wall. Lower extent of the tumor was till 1 cm above the carina. Airway stenting with Tracheo bronchial stent with Y configuration was planned under general anaesthesia with airway blocks. Superior Laryngeal Nerve Block, Glossopharyngeal block and Trans tracheal infiltration of local anaesthetics were performed. The patient was sedated with Fentanyl, Midazolam and propofol infusion but was breathing spontaneously. Once the rigid bronchoscope was placed inside trachea, breathing was supported with oxygen and sevoflurane. Initially, the trachea was cleared of tumor by coring. After creating space, tracheal stent was positioned and deployed. After stent placement patient was awakened, suctioned and nebulized. His respiratory stridor relieved instantaneously and was shifted to recovery. Conclusion: Airway blocks help in decreasing the incidence and severity of coughing during airway instrumentation thereby help in proper stent placement. They also reduce the requirement of general anaesthetics and hasten the post stenting recovery. Airway stent provided immediate relief to patient from symptoms of respiratory difficulty. Decision for early tracheal stenting may be taken for a select group of patients with high propensity for local spread, thereby avoiding respiratory complications and providing better quality of life in patients with inoperable malignancy.

Keywords: tracheal stent, respiratory difficulty, esophageal tumor, anaesthetic management

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Authors: Thea Freese, Michael Gille, Andrew Hursthouse, John Struthers

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Ship operators on the North and Baltic Sea have been experiencing increased political interest in marine environmental protection and cleaner vessel operations. Stricter legislation on SO2 and NOx emissions, ballast water management and other measures of protection are currently being phased in or will come into force in the coming years. These measures benefit the health of the marine environment, while increasing company’s operational costs. In times of excess shipping capacity and linked consolidation in the industry non-compliance with environmental rules is one way companies might hope to stay competitive with both intra- and inter-modal trade. Around 5-15% of industry participants are believed to neglect laws on vessel-source pollution willingly or unwillingly. Exploratory in-depth interviews conducted with 12 experts from various stakeholder groups informed the researchers about variables influencing compliance levels, including awareness and apprehension, willingness to comply, ability to comply and effectiveness of controls. Semi-structured expert interviews were evaluated using qualitative content analysis. A model of determinants of compliance was developed and is presented here. While most vessel operators endeavour to achieve full compliance with environmental rules, a lack of availability of technical solutions, expediency of implementation and operation and economic feasibility might prove a hindrance. Ineffective control systems on the other hand foster willing non-compliance. With respect to motivations, lacking time, lacking financials and the absence of commercial advantages decrease compliance levels. These and other variables were inductively developed from qualitative data and integrated into a model on environmental compliance. The outcomes presented here form part of a wider research project on economic effects of maritime environmental legislation. Research on determinants of compliance might inform policy-makers about actual behavioural effects of shipping companies and might further the development of a comprehensive legal system for environmental protection.

Keywords: compliance, marine environmental protection, exploratory qualitative research study, clean vessel operations, North and Baltic Sea area

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

Procedia PDF Downloads 85

Authors: M. Azharul Islam, M. Russel Sarker, M. Shahadat Hossen

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Air pollution is one of the major environmental problems that have gained importance in all over the world. Air pollution is a problem for all of us. The present study was conducted to explore the people’s perception level and awareness of air pollution in selected areas of Mymensingh in Bangladesh. Health impacts of air pollution also studied through personal interview and structured questionnaire. The relationship of independent variables (age, educational qualification, family size, residence and communication exposure) with the respondent’s perception level and awareness of air pollution (dependent variable) was studied to achieve the objectives of the study. About 600 respondents were selected randomly from six sites for collecting data during the period of July 2016 to June 2017. Pearson’s product-moment correlation coefficients were computed to examine the relationship between the concerned variables. The results revealed that about half (46.67%) of the respondents had a medium level of perception and awareness about air pollution in their areas where 31.67 percent had low, and 21.67 percent had a high level. In rural areas of the study sites, 43.33 percent respondents had low, 50 percent had medium, and only 6.67 percent had high perception and awareness on air pollution. In case of urban areas, 20 percent respondents had low, 43.33 percent had medium, and 36.67 percent had a high level of awareness and perception on air pollution. The majority of the respondents (93.33 percent) were lacking of proper awareness about air pollution in rural areas while 63.33 percent in urban areas. Out of five independent variables, three variables such as- educational qualification, residence status and communication exposure had positive and significant relationship. Age of respondents had negative and significant relationship with their awareness of air pollution where family size of the respondents had no significant relationship with their perception and awareness of air pollution. Thousands of people live in urban areas where urban smog, particle pollution, and toxic pollutants pose serious health concerns. But most of the respondents of the urban sites are not familiarize about the real causes of air pollution. Respondents exposed higher level of experience for air pollutants, such as- irritation of the eyes, coughing, tightness of chest and many health difficulties. But respondents of both rural and urban area hugely suffered such health problems and the tendency of certain difficulties increased day by day. In this study, most of the respondents had lack of knowledge on the causes of such health difficulties due to their lower perception level. Proper attempts should be taken to raise literacy level, communication exposure to increase the perception and awareness of air pollution among the respondents of the study areas. Extra care with above concerned fields should be taken to increase perception and awareness of air pollution in rural areas.

Keywords: air pollution, awareness, health impacts, perception of people

Procedia PDF Downloads 215

Authors: Getalem E. Haylia

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The Ribb dam is one of the irrigation projects in the Upper Blue Nile basin, Ethiopia, to irrigate the Fogera plain. Reservoir sedimentation is a major problem because it reduces the useful reservoir capacity by the accumulation of sediments coming from the watersheds. Estimates of sediment yield are needed for studies of reservoir sedimentation and planning of soil and water conservation measures. The objective of this study was to simulate the Ribb dam catchment sediment yield using SWAT model and to estimate Ribb reservoir effective life according to trap efficiency methods. The Ribb dam catchment is found in North Western part of Ethiopia highlands, and it belongs to the upper Blue Nile and Lake Tana basins. Soil and Water Assessment Tool (SWAT) was selected to simulate flow and sediment yield in the Ribb dam catchment. The model sensitivity, calibration, and validation analysis at Ambo Bahir site were performed with Sequential Uncertainty Fitting (SUFI-2). The flow data at this site was obtained by transforming the Lower Ribb gauge station (2002-2013) flow data using Area Ratio Method. The sediment load was derived based on the sediment concentration yield curve of Ambo site. Stream flow results showed that the Nash-Sutcliffe efficiency coefficient (NSE) was 0.81 and the coefficient of determination (R²) was 0.86 in calibration period (2004-2010) and, 0.74 and 0.77 in validation period (2011-2013), respectively. Using the same periods, the NS and R² for the sediment load calibration were 0.85 and 0.79 and, for the validation, it became 0.83 and 0.78, respectively. The simulated average daily flow rate and sediment yield generated from Ribb dam watershed were 3.38 m³/s and 1772.96 tons/km²/yr, respectively. The effective life of Ribb reservoir was estimated using the developed empirical methods of the Brune (1953), Churchill (1948) and Brown (1958) methods and found to be 30, 38 and 29 years respectively. To conclude, massive sediment comes from the steep slope agricultural areas, and approximately 98-100% of this incoming annual sediment loads have been trapped by the Ribb reservoir. In Ribb catchment, as well as reservoir systematic and thorough consideration of technical, social, environmental, and catchment managements and practices should be made to lengthen the useful life of Ribb reservoir.

Keywords: catchment, reservoir effective life, reservoir sedimentation, Ribb, sediment yield, SWAT model

Procedia PDF Downloads 168

Authors: Adela Mariana Vadastreanu, Adrian Bot, Andreea Maier, Dorin Maier

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This paper approaches the need for innovation management in the context of an existing integrated management system implemented in an organization. The road to success for companies in today’s economic environment is more demanding than ever and the capacity of adapting to the rapid changes is compensatory in order to resist on the market. The managers struggle, daily, with increasingly complex problems, caused by fierce competition in the market but also from the rising demands of customers. Innovation seems to be the solution for these problems. During the last decade almost all companies have been certificated according to various management systems, like quality management system, environmental management system, health and safety management system and others; furthermore many companies have implemented an integrated management system, by integrating two or more management systems. The problem rising today is how to integrate innovation in this integrated management systems. The challenge of the problem is that the development of an innovation management system is in the early phase. In this paper we have studied the possibility of integrating some of the innovation request in an existing management system, we have identify the innovation performance request and we proposed some recommendations regarding innovation management and its implementation as a part of an integrated management system. This paper lies down the bases for developing an model of integration management systems that include innovation as a main part of it. Organizations are becoming more aware of the importance of Integrated Management Systems (IMS). Integrating two or more management systems into an integrated management system can have much advantages.This paper examines various models of management systems integration in accordance with professional references ISO 9001, ISO 18001 and OHSAS 18001, highlighting strengths and weaknesses, creating a basis for future development of integrated management systems, and their involvement in various other processes within the organization, such as innovation management. The more and more demanding economic context emphasizes the awareness of the importance of innovation for organizations. This paper highlights the importance of the innovation for an organization and also gives some practical solution in order to improve the overall success of the business through a better approach of innovation. Various standards have been developed in order to certificate organizations that they respect the requirements. Applying an integrated standards model is shown to be a more effective way then applying the standards independently. The problem that arises is that in order to adopt the integrated version of standards there have to be made some changes at the organizational level. Every change that needs to be done has an effect on its activity, and in this sense the paper tries to deal with the changes needed for adopting an integrated management system and if those changes have an influence over the performance. After the analysis of the results, we can conclude that in order to improve the performance a necessary step is the implementation of innovation in the existing integrated management system.

Keywords: innovation, integrated management systems, innovation management, quality

Procedia PDF Downloads 299

Authors: S. Albert, R. Cossu, A. Grinham, C. Heatherington, C. Wilson

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Shipping trends suggest increasing vessel size and draught visiting Australian ports highlighting potential challenges to port infrastructure and requiring optimization of shipping channels to ensure safe passage for vessels. The Port of Brisbane in Queensland, Australia has an 80 km long access shipping channel which vessels must transit 15 km of relatively shallow coffee rock (generic class of indurated sands where sand grains are bound within an organic clay matrix) outcrops towards the northern passage in Moreton Bay. This represents a risk to shipping channel deepening and maintenance programs as the dredgeability of this material is more challenging due to its high cohesive strength compared with the surrounding marine sands and potential higher acid sulfate risk. In situ assessment of acid sulfate sediment for dredge spoil control is an important tool in mitigating ecological harm. The coffee rock in an anoxic undisturbed state does not pose any acid sulfate risk, however when disturbed via dredging it’s vital to ensure that any present iron sulfides are either insignificant or neutralized. To better understand the potential risk we examined the reduction potential of coffee rock across the entire dredge cycle in order to accurately portray the true outcome of disturbed acid sulfate sediment in dredging operations in Moreton Bay. In December 2014 a dredge trial was undertaken with a trailing suction hopper dredger. In situ samples were collected prior to dredging revealed acid sulfate potential above threshold guidelines which could lead to expensive dredge spoil management. However, potential acid sulfate risk was then monitored in the hopper and subsequent discharge, both showing a significant reduction in acid sulfate potential had occurred. Additionally, the acid neutralizing capacity significantly increased due to the inclusion of shell fragments (calcium carbonate) from the dredge target areas. This clearly demonstrates the importance of assessing potential acid sulfate risk across the entire dredging cycle and highlights the need to carefully evaluate sources of acidity.

Keywords: acid sulfate, coffee rock, indurated sand, dredging, maintenance dredging

Procedia PDF Downloads 352

Authors: K. C. Wong, K. L. Siu, S. N. Ng, K. N. Yip, Y. Y. Yuen, K. W. Lee, K. W. Wong, C. C. Li, H. P. Lam

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Background: Occupational injuries among nursing profession were found related to repeated bedside nursing care, such as transfer, lifting and manual handling patients from previous studies. Likewise, undergraduate nursing students are also exposed to potential safety hazard due to their similar work nature of registered nurses. Especially, those students who worked as Temporary undergraduate nursing students (TUNS) which is a part-time clinical job in hospitals in Hong Kong who mainly assisted in providing bedside cares appeared to at high risk of work-related injuries. Several studies suggested the level of compliance with safe work behaviors was highly associated with work-related injuries. Yet, it had been limitedly studied among nursing students. This study was conducted to assess and compare the compliance with safe work behaviors and the levels of awareness of different workplace safety issues between undergraduate nursing students with or without TUNS experiences. Methods: This is a quantitative descriptive study using convenience sampling. 362 undergraduate nursing students in Hong Kong were recruited. The Safe Work Behavior relating to Patient Handling (SWB-PH) was used to assess their compliance of safe-work behaviors and the level of awareness of different workplace safety issues. Results: The results showed that most of the participants (n=250, 69.1%) who were working as TUNS. However, students who worked as TUNS had significantly lower safe-work behaviors compliance (mean SWB-PH score = 3.64±0.54) than those did not worked as TUNS (SWB-PH score=4.21±0.54) (p<0.001). Particularly, these students had higher awareness to seek help and use assistive devices but lower awareness of workplace safety issues and awareness of proper work posture than students without TUNS experiences. The students with TUNS experiences had higher engagement in help-seeking behaviors might be possibly explained by their richer clinical experiences which served as a facilitator to seek help from clinical staff whenever necessary. Besides, these experienced students were more likely to bear risks for occupational injuries and worked alone when no available aid which might be related to the busy working environment, heightened work pressures and high expectations of TUNS. Eventually, students who worked as TUNS might target on completing the assigned tasks and gradually neglecting the occupational safety. Conclusion: The findings contributed to an understanding of the level of compliance with safe work behaviors among nursing students with different clinical experiences. The results might guide the modification of current safety protocols and the introduction of multiple clinical training courses to improve nursing student’s engagement in safe work behaviors.

Keywords: Occupational safety, Safety compliance, Safe-work behavior, Nursing students

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Authors: Castillo-Acevedo J, Mena-Rivero R, Silva-Poot H

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In Mexico, as largely of the developing countries, the rural housing is a study object, since the diversity of constructive idiosyncrasies for locality, involves various factors that make it vulnerable; an important aspect of study is the progressive deterioration that is seen in the rural housing. Various social programs, contribute financial resources in the field of housing to provide support for families living in rural areas, however, they do not provide a coordination with the self-construction that is usually the way in which is built in these areas. The present study, exposes the physical situation and an economic assessment that presents the rural self-constructed housing in three rural communities in the south of the state of Quintana Roo, Mexico, which were built with funding from federal social programs. The information compilation was carried out in a period of seven months in which there was used the intentional sampling of typical cases, where the object study was the housing constructed with supports of the program “Rural Housing” between the year 2009 and 2014. Instruments were used as the interview, ballot papers of observation, ballot papers of technical verification and various measuring equipment laboratory for the classification of pathologies; for the determination of some pathologies constructive Mexican standards were applied how NMX-C-192-ONNCCE, NMX-C-111-ONNCCE, NMX-C-404-ONNCCE and finally used the software of Opus CMS ® with the help of tables of the National Consumer Price Index (CPI) for update of costs and wages according to the line of being applied in Mexico, were used for an economic valuation. The results show 11 different constructive pathologies and exposes greater presence with the 22.50% to the segregation of the concrete; the economic assessment shows that 80% of self-constructed housing, exceed the cost of construction it would have compared to a similar dwelling built by a construction company; It is also exposed to the 46.10% of the universe of study represent economic losses in materials to the social activities by houses not built. The system of self-construction used by the social programs, affect to some extent the program objectives applied in underserved areas, as implicit and additional costs affect the economic capacity of beneficiaries who invest time and effort in an activity that are not specialists, which this research provides foundations for sustainable alternatives or possibly eliminate the practice of self-construction of implemented social programs in marginalized rural communities in the south of state of Quintana Roo, Mexico.

Keywords: economic valuation, pathologies constructive, rural housing, social programs

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Authors: Ekeh Greg

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Learning has been part of human existence from time immemorial. The aim of every learning is to know the truth. In education, it is desirable that true knowledge is imparted and imbibed. For this to be achieved, there is need for honesty, in this context, academic honesty among students, especially in e-learning. This is an ethical issue since honesty bothers on human conduct. However, research findings have shown that academic honesty has remained a big challenge to online learners, especially among the university students. This is worrisome since the university education is the final education system and a gateway to life in the wider society after schooling. If they are practicing honesty in their academic life, it is likely that they will practice honesty in the in the society, thereby bringing positive contributions to the society wherever they find themselves. With this in mind, the significance of this study becomes obvious. On grounds of this significance, this paper focuses on strategies that are adjudged certain to enhance the practice of honesty in e-learning so as to enable learners to be well equipped to contribute to the society through honest ways. The aim of the paper is to contribute to the efforts of instilling the consciousness and practice of honesty in the minds and hearts of learners. This will, in turn, promote effective teaching and learning, academic high standard, competence and self-confidence in university education. Philosophical methods of conceptual analysis, clarification, description and prescription are adopted for the study. Philosophical perspective is chosen so as to ground the paper on the basis of rationality rather than emotional sentiments and biases emanating from cultural, religious and ethnic differences and orientations. Such sentiments and biases can becloud objective reasoning and sound judgment. A review of related literature is also carried out. The findings show that academic honesty in e-learning is a cherished value, but it is bedeviled by some challenges, such as care-free attitude on the part of students and absence of monitoring. The findings also show that despite the challenges facing academic honesty, strategies such as self-discipline, determination, hard work, imbibing ethical and philosophical principles, among others, can certainly enhance the practice of honesty in e-learning among university students. The paper, therefore, concludes that these constitute strategies for enhancing academic honesty among students. Consequently, it is suggested that instructors, school counsellors and other stakeholders should endeavour to see that students are helped to imbibe these strategies and put them into practice. Students themselves are enjoined to cherish honesty in their academic pursuit and avoid short-cuts. Short-cuts can only lead to mediocrity and incompetence on the part of the learners, which may have long adverse consequences, both on themselves and others.

Keywords: academic, ethical, philosophical, strategies

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Authors: Alvin Chun Man Kwok, Wai Sun Chan, Wei Yuan, Joseph Tin Yum Wong

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Cellulose, the most abundant biopolymer, is the major constituent of plant and dinoflagellate cell walls. Thecate dinoflagellates, in particular, are renowned for their remarkable capacity to synthesize intricate cellulosic thecal plates (CTPs). Unlike the extracellular two-dimensional structure of plant cell walls, these CTPs are three-dimensional and reside within the cellular structure itself. The deposition of CTPs occurs with remarkable precision, and their arrangement serves as crucial taxonomic markers. It is noteworthy that these plates possess the hardness of wood, despite the absence of lignin. Partial and prolonged hydrolysis of CTPs results in the formation of uniform long bundles and lowdimensional, modular crystalline whiskers. This observation aligns with the consistent nanomechanical properties, suggesting a CTPboard structure. The unique composition and structural characteristics of CTPs distinguish them from other cellulose-based materials in the natural world. Spectroscopic studies using Raman and FTIR methods indicate a clear low crystallinity index, with the OH shift becoming more distinct following SDS treatment. Birefringence imaging confirms the highly organized structure of CTPs, demonstrating varying degrees of anisotropy in different regions, including both seaward and cytosolic passages. The knockdown of a cellulose synthase enzyme in dinoflagellates resulted in severe malformation of CTPs and hindered the life-cycle transition. Unlike certain other microalgal groups, these unique circum-spherical depositions of CTPs were not pre-fabricated and transported "to site," but synthesized within alveolar sacs at the specific site. Our research is particularly focused on unraveling the mechanisms underlying the biodeposition of CTPs and exploring their potential biotechnological applications. Understanding the processes involved in CTP formation can pave the way for harnessing their unique properties for various practical applications. Dinoflagellates play a crucial role as major agents of algal blooms and are also known for producing anti-greenhouse sulfur compounds such as DMS/DMSP, highlighting the significance of CTPs as a carbon-neutral source of cellulose. Grant acknowledgement: Research in the laboratory are supported by GRF16104523 from Research Grant Council to JTYW.

Keywords: cellulosic thecal plates, dinoflagellates, cellulose, cell wall

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Authors: Athena Pedro, Zandile Batweni, Laura Bradfield, Michael Dare, Ashley Nyman

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The rapid growth and development of an infant in the first 1000 days of life means that this time period provides the greatest opportunity for a positive developmental impact on a child’s life socially, emotionally, cognitively and physically. Current research is being focused on children in the first 1000 days, but there is a lack of research and understanding of mothers and their experiences during this crucial time period. Thus, it is imperative that more research is done to help better understand the experiences of mothers during the first 1000 days of their child’s life, as well as gain more insight into mothers’ knowledge regarding this time period. The first 1000 days of life, from conception to two years, is a critical period, and the child’s attachment to his or her mother or primary caregiver during this period is crucial for a multitude of future outcomes. The aim of this study was to explore mothers’ understanding and experience of the first 1000 days of their child’s life, specifically looking at attachment in the context of Bowlby and Ainsworths’ attachment theory. Using a qualitative methodological framework, data were collected through semi-structured individual interviews with 12 first-time mothers from low-income communities in Cape Town. Thematic analysis of the data revealed that mothers articulated the importance of attachment within the first 1000 days of life and shared experiences of how they bond and form attachment with their babies. Furthermore, these mothers expressed their belief in the long-term effects of early attachment of responsive positive parenting as well as the lasting effects of poor attachment and non-responsive parenting. This study has implications for new mothers and healthcare staff working with mothers of new-born babies, as well as for future contextual research. By gaining insight into the mothers’ experiences, policies and intervention efforts can be formulated in order to assist mothers during this time, which ultimately promote the healthy development of the nation’s children and future adult generation. If researchers are also able to understand the extent of mothers’ general knowledge regarding the first 1000 days and attachment, then there will be a better understanding of where there may be gaps in knowledge and thus, recommendations for effective and relevant intervention efforts may be provided. These interventions may increase knowledge and awareness of new mothers and health care workers at clinics and other service providers, creating a high impact on positive outcome. Thus, improving the developmental trajectory for many young babies allows them the opportunity to pursue optimal development by reaching their full potential.

Keywords: attachment, experience, first 1000 days, knowledge, mothers

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Nafees Ahmed, Nur Izyani Kamaruzman, Saralla Nathan, Mohd Ezharul Hoque Chowdhury, Anuar Zaini Md Zain, Iekhsan Othman, Sharifah Binti Syed Hassan

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Meat quality is always subject to consumer scrutiny when purchasing from retail markets on mislabeling as fresh meat. Various physiological and biochemical changes influence the quality of meat. As a major component of muscle tissue, proteins play a major role in muscle foods. In meat industry, freezing is the most common form of storage of meat products. Repeated cycles of freezing and thawing are common in restaurants, kitchen, and retail outlets and can also occur during transportation or storage. Temperature fluctuation is responsible for physical, chemical, and biochemical changes. Repeated cycles of ‘freeze-thaw’ degrade the quality of meat by stimulating the lipid oxidation and surface discoloration. The shelf life of meat is usually determined by its appearance, texture, color, flavor, microbial activity, and nutritive value and is influenced by frozen storage and subsequent thawing. The main deterioration of frozen meat during storage is due to protein. Due to the large price differences between fresh and frozen–thawed meat, it is of great interest to consumer to know whether a meat product is truly fresh or not. Researchers have mainly focused on the reduction of moisture loss due to freezing and thawing cycles of meat. The water holding capacity (WHC) of muscle proteins and reduced water content are key quality parameters of meat that ultimately changes color and texture. However, there has been limited progress towards understanding the actual mechanisms behind the meat quality changes under the freeze–thaw cycles. Furthermore, effect of freeze-thaw process on integrity of proteins is ignored. In this paper, we have studied the effect of ‘freeze-thawing’ on physicochemical changes of chicken meat protein. We have assessed the quality of meat by pH, spectroscopic measurements, Western Blot. Our results showed that increase in freeze-thaw cycles causes changes in pH. Measurements of absorbance (UV-visible and IR) indicated the degradation of proteins. The expression of various proteins (CREB, AKT, MAPK, GAPDH, and phosphorylated forms) were performed using Western Blot. These results indicated the repeated cycles of freeze-thaw is responsible for deterioration of protein, thus causing decrease in nutritious value of meat. It damges the use of these products in Islamic Sharia.

Keywords: chicken meat, freeze-thaw, halal, protein, western blot

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Authors: Comsun Thongchai, Vorapoj Promasatayaprot

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Background: Child development center is a day care center that gathers large numbers of children in the same areas. As a result, it provides high opportunity for infection, especially gastrointestinal and respiratory infections. Ubon Ratchathani has been a province with an increasing number of cases of Hand foot and mouth disease each year reported between 2014 and 2016. Accorded to a recent investigation reported, HFMD occurred in the Child Development Center and kindergartens, this was a place where HFMD spreads. This research was aimed to investigate the knowledge, attitude and behavior about hand foot and mouth disease preventing of child caregivers in child development centers, Ubon Ratchathani Province. Method: Descriptive study was conducted between April and July, 2017. The study instruments used questionnaires and in-depth interviews on their practices of prevention and environment management of HFMD. The samples of survey questionnaires were caregivers who are working in 160 child development centers of the 160 parishes in Ubon Ratchathani province. The data was analyzed by percentages, means and standard deviations and Pearson Product Moment Correlation Coefficient. Result: The results showed that the majority were female (96.3%), average age 41 years (68.3%), marital status were couples (85.7%) and studied in undergraduate (75.2%). with a period of performance as teachers in child development centers range from 10 to 14 years were percentage 58.7 and 71.8 percent of them had been trained by health worker about the control HFMD. The knowledge for preventive in hand foot mouth disease on child caregivers was at high level. The mean score was 2.76 (S.D. = 0.114). The attitude of child caregivers was at a moderate level. Its mean score was 2.28 (S.D. = 0.247). On the other hand, the level of environmental management to prevent HFMD was low. The mean score was 1.34 (S.D. = 0.215). The factor of personal characteristics as gender, age, educational level, duration at work, knowledge and attitude of preventive HFMD was associated with Preventive of Behaviors to a statistically significant level (p<0.05 respectively). Conclusion: These results should be concerned to develop knowledge and improving practice for preventive hand foot mouth disease of child caregivers in child development centers by training. Preparation of media education, Surveillance of hand foot mouth disease and health behaviors promotion with community participation need to be supported continuously.

Keywords: preventive behavior, child development center, hand foot mouth disease, Thailand

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Authors: D. M. Rey, V. Delgado, J. Zambrano Nájera

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Increases in urbanization during XX century, has produced changes in natural dynamics of the basins, which has resulted in increases in runoff volumes, peak flows and flow velocities, that in turn increases flood risk. Higher runoff volumes decrease sewerage networks hydraulic capacity and can cause its failure. This in turn generates increasingly recurrent floods causing mobility problems and general economic detriment in the cities. In Latin America, especially Colombia, this is a major problem because urban population at late XX century was more than 70% is in urban areas increasing approximately in 790% in 1940-1990 period. Besides, high slopes product of Andean topography and high precipitation typical of tropical climates increases velocities and volumes even more, causing stopping of cities during storms. Thus, it becomes very important to know hydrological behavior of Andean Urban Watersheds. This research aims to determine the impact of urbanization in high sloped urban watersheds in its hydrology. To this end, it will be used as study area experimental urban watershed named Palogrande-San Luis watershed, located in the city of Manizales, Colombia. Manizales is a city in central western Colombia, located in Colombian Central Mountain Range (part of Los Andes Mountains) with an abrupt topography (average altitude is 2.153 m). The climate in Manizales is quite uniform, but due to its high altitude it presents high precipitations (1.545 mm/year average) with high humidity (83% average). It was applied HEC-HMS Hydrologic model on the watershed. The inputs to the model were derived from Geographic Information Systems (GIS) theme layers of the Instituto de Estudios Ambientales –IDEA of Universidad Nacional de Colombia, Manizales (Institute of Environmental Studies) and aerial photography taken for the research in conjunction with available literature and look up tables. Rainfall data from a network of 4 rain gages and historical stream flow data were used to calibrate and validate runoff depth using the hydrologic model. Manual calibration was made, and the simulation results show that the model selected is able to characterize the runoff response of the watershed due to land use for urbanization in high mountain watersheds.

Keywords: Andean watersheds modelling, high mountain urban hydrology, urban planning, hydrologic modelling

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Authors: Wenqian Bai

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Background: In response to the post-pandemic directives of Xi Jinping concerning the new era of ecological civilization, China has embarked on ecological restoration projects across its territorial spaces. This initiative faces challenges such as complex evaluation metrics and subpar informatization standards. Methodology: This research focuses on Mianzhu City, Sichuan Province, to assess its resource and environmental carrying capacities and the appropriateness of land use for development from ecological, agricultural, and urban perspectives. The study incorporates a range of spatial data to evaluate factors like ecosystem services (including water conservation, soil retention, and biodiversity), ecological vulnerability (addressing issues like soil erosion and desertification), and resilience. Utilizing the Minimum Cumulative Resistance model along with the ‘Three Zones and Three Lines’ strategy, the research maps out ecological corridors and significant ecological networks. These frameworks support the ecological restoration and environmental enhancement of the area. Results: The study identifies critical ecological zones in Mianzhu City's northwestern region, highlighting areas essential for protection and particularly crucial for water conservation. The southeastern region is categorized as a generally protected ecological zone with respective ratings for water conservation functionality and ecosystem resilience. The research also explores the spatial challenges of three ecological functions and underscores the substantial impact of human activities, such as mining and agricultural expansion, on the ecological baseline. The proposed spatial arrangement for ecological restoration, termed ‘One Mountain, One Belt, Four Rivers, Five Zones, and Multiple Corridors’, strategically divides the city into eight major restoration zones, each with specific tasks and projects. Conclusion: With its significant ‘mountain-plain’ geography, Mianzhu City acts as a crucial ecological buffer for the Yangtze River's upper reaches. Future development should focus on enhancing ecological corridors in agriculture and urban areas, controlling soil erosion, and converting farmlands back to forests and grasslands to foster ecosystem rehabilitation.

Keywords: ecological restoration, resource and environmental carrying capacity, land development suitability, ecosystem services, ecological vulnerability, ecological networks

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Authors: Zhaoxu Lu, Yufeng Ma, Linying Gao, Li Wang, Mei Qiang

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Mercury (Hg) is a well-recognized environmental pollutant known by its toxicity of development and neurotoxicity, which may result in adverse health outcomes. However, the mechanisms underlying the teratogenic effects of Hg are not well understood. Imprinting genes are emerging regulators for fetal development subject to environmental pollutants impacts. In this study, we examined the association between paternal preconception Hg exposures and the alteration of DNA methylation of imprinting genes in human sperm DNA. A total of 618 men aged from 22 to 59 was recruited from the Reproductive Medicine Clinic of Maternal and Child Care Service Center and the Urologic Surgery Clinic of Shanxi Academy of Medical Sciences during April 2015 and March 2016. Demographic information was collected using questionnaires. Urinary Hg concentrations were measured using a fully-automatic double-channel hydride generation atomic fluorescence spectrometer. And methylation status in the DMRs of imprinting genes H19, Meg3 and Peg3 of sperm DNA were examined by bisulfite pyrosequencing in 243 participants. Spearman’s rank and multivariate regression analysis were used for correlation analysis between sperm DNA methylation status of imprinting genes and urinary Hg levels. The median concentration of Hg for participants overall was 9.09μg/l (IQR: 5.54 - 12.52μg/l; range = 0 - 71.35μg/l); no significant difference was found in median concentrations of Hg among various demographic groups (p > 0.05). The proportion of samples that a beyond intoxication criterion (10μg/l) for urinary Hg was 42.6%. Spearman’s rank correlation analysis indicates a negative correlation between urinary Hg concentrations and average DNA methylation levels in the DMRs of imprinted genes H19 (rs=﹣0.330, p = 0.000). However, there was no such a correlation found in genes of Peg3 and Meg3. Further, we analyzed of correlation between methylation level at each CpG site of H19 and Hg level, the results showed that three out of 7 CpG sites on H19 DMR, namely CpG2 (rs =﹣0.138, p = 0.031), CpG4 (rs =﹣0.369, p = 0.000) and CpG6 (rs=﹣0.228, p = 0.000), demonstrated a significant negative correlation between methylation levels and the levels of urinary Hg. After adjusting age, smoking, drinking, intake of aquatic products and education by multivariate regression analysis, the results have shown a similar correlation. In summary, mercury nonoccupational environmental exposure in reproductive-aged men associated with altered DNA methylation outcomes at DMR of imprinting gene H19 in sperm, implicating the susceptibility of the developing sperm for environmental insults.

Keywords: epigenetics, genomic imprinting gene, DNA methylation, mercury, transgenerational effects, sperm

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Authors: Madeline Tagg, Choihoong Mui, Elizabeth Lek, Jide Menakaya

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Introduction: Simulation technology is used by neonatal teams to learn and refresh skills and gain the knowledge and confidence to care for sick neonates. In-situ simulation is considered superior to laboratory-based programmes as it closely mirrors real life situations. This study reports our experience of running regular laboratory-based simulation sessions for senior clinicians and nurses and its impact on their knowledge, skills and confidence. Methods: A before and after questionnaire survey was carried out on senior clinicians and nurses that attended a scheduled laboratory-based simulation session. Participants were asked to document their expectations before a 3-hour monthly laboratory programme started and invited to feedback their reflections at the end of the session. The session included discussion of relevant clinical guidelines, immersion in a scenario and video led debrief. The results of the survey were analysed in three skills based categories - improved, no change or a worsened experience. Results: 45 questionnaires were completed and analysed. Of these 25 (55%) were completed by consultants seven and six by nurses and trainee doctors respectively, and seven respondents were unknown. 40 (88%) rated the session overall and guideline review as good/excellent, 39 respondents (86%) rated the scenario session good/excellent and 40/45 fed back a good/excellent debrief session. 33 (73%) respondents completed the before and after questionnaire. 21/33 (63%) reflected an improved knowledge, skill or confidence in caring for sick new-bon babies, eight respondents reported no change and four fed back a worse experience after the session. Discussion: Most respondents found the laboratory based structured simulation session beneficial for their professional development. They valued equally the whole content of the programme such as guideline review and equipment training as well as the simulation and debrief sessions. Two out three participants stated their knowledge of caring for sick new-born babies had been transformed positively by the session. Sessions where simulation equipment failed or relevant staff were absent contributed to a poor educational experience. Summary: A regular structured laboratory-based simulation programme with a rich content is a credible educational resource for improving the knowledge, skills and confidence of senior clinicians caring for sick new born babies.

Keywords: knowledge, laboratory based, neonates, simulation

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Authors: Robin Devillers, Chantal van Dijk

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Children face ambiguities in everyday language use. Particularly ambiguity in pronoun resolution can be challenging, whereas adults can rapidly identify the antecedent of the mentioned pronoun. Two main factors underlie this process, namely the accessibility of the referent and the syntactic cues of the pronoun. After 200ms, adults have converged the accessibility and the syntactic constraints, while relieving cognitive effort by considering contextual cues. As children are still developing their cognitive capacity, they are not able yet to simultaneously assess and integrate accessibility, contextual cues and syntactic information. As such, they fail to identify the correct referent and possibly fixate more on the competitor in comparison to adults. In this study, Dutch while-clauses were used to investigate the interpretation of pronouns by children. The aim is to a) examine the extent to which 7-10 year old children are able to utilise discourse and syntactic information during online and offline sentence processing and b) analyse the contribution of individual factors, including age, working memory, condition and vocabulary. Adult and child participants are presented with filler-items and while-clauses, and the latter follows a particular structure: ‘Anna and Sophie are sitting in the library. While Anna is reading a book, she is taking a sip of water.’ This sentence illustrates the ambiguous situation, as it is unclear whether ‘she’ refers to Anna or Sophie. In the unambiguous situation, either Anna or Sophie would be substituted by a boy, such as ‘Peter’. The pronoun in the second sentence will unambiguously refer to one of the characters due to the syntactic constraints of the pronoun. Children’s and adults’ responses were measured by means of a visual world paradigm. This paradigm consisted of two characters, of which one was the referent (the target) and the other was the competitor. A sentence was presented and followed by a question, which required the participant to choose which character was the referent. Subsequently, this paradigm yields an online (fixations) and offline (accuracy) score. These findings will be analysed using Generalised Additive Mixed Models, which allow for a thorough estimation of the individual variables. These findings will contribute to the scientific literature in several ways; firstly, the use of while-clauses has not been studied much and it’s processing has not yet been identified. Moreover, online pronoun resolution has not been investigated much in both children and adults, and therefore, this study will contribute to adults and child’s pronoun resolution literature. Lastly, pronoun resolution has not been studied yet in Dutch and as such, this study adds to the languages

Keywords: pronouns, online language processing, Dutch, eye-tracking, first language acquisition, language development

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

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Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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Authors: Giovanni Duran Polo

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Demonstrate the importance of the stages such as Information, Diagnosis, Management, and Intervention is fundamental to have a historical, live, and quality inhabited center. One of the major actions to take is to promote the concept of the management of a historic center with harmonious development. For that, concerned actors should strengthen the concept that said historic center may be the neighborhood of all and for all. The centers of historical cities, presented as any other urban area, social, environmental issues etc; yet they get added value that have no other city neighborhoods. The equity component, either by the urban plan, or environmental quality offered properties of architectural, landscape or some land uses are the differentiating element, while the tool that makes them attractive face pressure exerted by new housing developments or shopping centers. That's why through the experience of working in historical centers, they are declared the actions in heritage areas. This paper will show how the encounter with each of these places are trying to take the phases of information, to gather all the data needed to be closer to the territory with specific data, diagnosis; which allowed the actors to see what state they were, felt how the heart is related to the rest of the city, show what problems affected the situation and what potential it had to compete in a global market. Also, to discuss the importance of the organization, as it is legal and normative basis for it have an order and a concept, when you know what can and what cannot, in an area where the citizen has many myth or history, when he wanted to intervene in protected buildings. It is also appropriate to show how it could develop the intervention phase, where the shares on the tangible elements and intervention for the protection of the heritage property are executed. The management is the final phase which will carry out all that was raised on paper, it's time to orient, explain, persuade, promote, and encourage citizens to take care of the heritage. It is profitable and also an obligation and it is not an insurmountable burden. It has to be said this is the time to pull all the cards to make the historical center and heritage becoming more alive today. It is the moment to make it more inhabited and to transformer it into a quality place, so citizens will cherish and understand the importance of such a place. Inhabited historical centers, endowments and equipment required, with trade quality, with constant cultural offer, with well-preserved buildings and tidy, modern and safe public spaces are always attractive for tourism, but first of all, the place should be conceived for citizens, otherwise everything will be doomed to failure.

Keywords: development, diagnosis, heritage historic center, intervention, management, patrimony

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Authors: Jamie Sundvall, Lisa Jennings

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Site based field internship learning (SBL) is an educational approach within a Master’s of Social Work (MSW) university field placement department that promotes a more streamlined approach to the integration of theory and evidence based practices for social work students. The SBL model is founded on research in the field, consideration of current work force needs, United States national trends of MSW graduate skill and knowledge deficits, educational trends in students pursing a master’s degree in social work, and current social problems that require unique problem solving skills. This study explores the use of site-based learning in a hybrid social work program. In this setting, site based learning pairs online education courses and social work field education to create training opportunities for social work students within their own community and cultural context. Students engage in coursework in an online setting with both synchronous and asynchronous features that facilitate development of core competencies for MSW students. Through the SBL model, students are then partnered with faculty in a virtual course room and a university vetted site within their community. The study explores how this model of learning creates community partnerships, through which students engage in a learning loop to develop social work skills, while preparing students to address current community, social, and global issues with the engagement of technology. The goal of SBL is to more effectively equip social work students for practice according to current workforce demands, provide access to education and care to populations who have limited access, and create self-sustainable partnerships. Further, the model helps students learn integration of evidence based practices and helps instructors more effectively teach integration of ethics into practice. The study found that the SBL model increases the influence and professional relevance of the social work profession, and ultimately facilitates stronger approaches to integrating theory into practice. Current implementation of the practice in the United States will be presented in the study. dditionally, future research conceptualization of SBL models will be presented, in order to collaborate on advancing best approaches of translating theory into practice, according to the current needs of the profession and needs of social work students.

Keywords: collaboration, fieldwork, research, site-based learning, technology

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

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Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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Authors: Said Cheto, Khawla Oukaltouma, Imane Chamkhi, Ammar Ibn Yasser, Bouchra Benmrid, Ahmed Qaddoury, Lamfeddal Kouisni, Joerg Geistlinger, Youssef Zeroual, Adnane Bargaz, Cherki Ghoulam

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Our study aimed to assess, the role of inoculation of faba bean/wheat intercrops with selected rhizobacteria consortia gathering one rhizobia and two phosphate solubilizing bacteria “PSB” to alleviate the effects of combined water deficit and P limitation on Faba bean/ wheat intercrops versus monocrops under greenhouse conditions. One Vicia faba L variety (Aguadulce “Ag”), and one Triticum durum L. variety (Karim “K”) were grown as sole crops or intercrop in pots containing sterilized substrate (sand: peat 4:1v/v) added either with rock phosphate (RP) as the alone P source (P limitation) or with KH₂PO₄ in nutrient solution (P sufficient control). Plant inoculation was done using rhizobacterial consortia composed; C1(Rhizobium laguerreae, Kocuria sp, and Pseudomonas sp) and C2 (R. laguerreae, Rahnella sp, and Kocuria sp). Two weeks after inoculation, the plants were submitted to water deficit consisting of 40% of substrate water holding Capacity (WHC) versus 80% WHC for well-watered plants. At the flowering stage, the trial was assessed, and the results showed that inoculation with both consortia (C1 and C2) improved faba bean biomass in terms of shoots, roots, and nodules compared to inoculation with rhizobia alone, particularly C2 improved these parametres by 19.03, 78.99, and 72.73%, respectively. Leaf relative water content decreased under combined stress, particularly in response to C1 with a significant improvement of this parameter in wheat intercrops. For faba bean under P limitation, inoculation with C2 increased stomatal conductance (gs) by 35.73% compared to plants inoculated with rhizobia alone. Furthermore, the same inoculum C2 improved membrane stability by 44,33% versus 16,16% for C1 compared to inoculation with rhizobia alone under P deficit. For sole cropped faba bean plants, inoculation with both consortia improved N accumulation compared to inoculation with rhizobia alone with an increase of 70.75% under P limitation. Moreover, under the combined stress, intercropping inoculation with C2 improved plant biomass and N content (112.98%) in wheat plants, compared to the sole crop. Our finding revealed that consortium C2 might offer an agronomic advantage under water and P deficit and could be used as inoculum for enhancing faba bean and wheat production under both monocropping and intercropping systems.

Keywords: drought, phosphorus, intercropping, PSB, rhizobia, vicia faba, Triticum durum

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