Search results for: fast healthcare interoperability resources (fhir)

Authors: Aakriti Chetan Shah, Elle Sein

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Background/purpose: Group B Streptococcus(GBS) is the leading cause of severe early onset infection in newborns, with the incidence of Early Onset Group B Streptococcus (EOGBS) in the UK and Ireland rising from 0.48 to 0.57 per 1000 births from 2000 to 2015. A WHO study conducted in 2017, has shown that 38.5% of cases can result in stillbirth and infant deaths. This is an important problem to consider as 20% of women worldwide have GBS colonisation and can suffer from these detrimental effects. Current Royal College of Obstetricians and Midwives (RCOG) guidelines do not recommend bacteriological screening for pregnant women due to its low sensitivity in antenatal screening correlating with the neonate having GBS but advise a patient information leaflet be given to pregnant women. However, a Healthcare Safety Investigation Branch (HSIB) 2019 learning report found that only 50% of trusts and health boards reported giving GBS information leaflets to all pregnant mothers. Therefore, this audit aimed to assess current practices of information dissemination about GBS at Chelsea & Westminster (C&W) Hospital. Methodology: A quantitative cross-sectional study was carried out using a questionnaire based on the RCOG GBS guidelines and the HSIB Learning report. The study was conducted in antenatal clinics at Chelsea & Westminster Hospital, from 29th January 2021 to 14th February 2021, with twenty-two practicing obstetricians and midwives participating in the survey. The main outcome measure was the proportion of obstetricians and midwives who disseminate information about GBS to pregnant women, and the reasons behind why they do or do not. Results: 22 obstetricians and midwives responded with 18 complete responses. Of which 12 were obstetricians and 6 were midwives. Only 17% of clinical staff routinely inform all pregnant women about GBS, and do so at varying timeframes of the pregnancy, with an equal split in the first, second and third trimester. The primary reason for not informing women about GBS was influenced by three key factors: Deemed relevant only for patients at high risk of GBS, lack of time in clinic appointments and no routine NHS screening available. Interestingly 58% of staff in the antenatal clinic believe it is necessary to inform all women about GBS and its importance. Conclusion: It is vital for obstetricians and midwives to inform all pregnant women about GBS due to the high prevalence of incidental carriers in the population, and the harmful effects it can cause for neonates. Even though most clinicians believe it is important to inform all pregnant women about GBS, most do not. To ensure that RCOG and HSIB recommendations are followed, we recommend that women should be given this information at 28 weeks gestation in the antenatal clinic. Proposed implementations include an information leaflet to be incorporated into the Mum and Baby app, an informative video and end-to-end digital clinic documentation to include this information sharing prompt.

Keywords: group B Streptococcus, early onset sepsis, Antenatal care, Neonatal morbidity, GBS

Procedia PDF Downloads 175

Authors: Tamer ElSerafi

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In recent approaches to heritage conservation, the whole context of historic areas becomes as important as the single historic building. This makes the provision of infrastructure and network of mobility an effective element in the urban conservation. Sustainable urban conservation projects consider the high density of activities, the need for a good quality access system to the transit system, and the importance of the configuration of the mobility network by identifying the best way to connect the different districts of the urban area through a complex unique system that helps the synergic development to achieve a sustainable mobility system. A sustainable urban mobility is a key factor in maintaining the integrity between socio-cultural aspects and functional aspects. This paper illustrates the mobility aspects, mobility problems in historic districts, and the needs of the mobility systems in the first part. The second part is a practical analysis for different mobility plans. It is challenging to find innovative and creative conservation solutions fitting modern uses and needs without risking the loss of inherited built resources. Urban mobility management is becoming an essential and challenging issue in the urban conservation projects. Depending on literature review and practical analysis, this paper tries to define and clarify the guidelines for mobility management in historic districts as a key element in sustainability of urban conservation and development projects. Such rules and principles could control the conflict between the socio–cultural and economic activities, and the different needs for mobility in these districts in a sustainable way. The practical analysis includes a comparison between mobility plans which have been implemented in four different cities; Freiburg in Germany, Zurich in Switzerland and Bray Town in Ireland. This paper concludes with a matrix of guidelines that considers both principles of sustainability and livability factors in urban historic districts.

Keywords: sustainable mobility, urban mobility, mobility management, historic districts

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Authors: Felix E. Gbenoba, Opeyemi Dahunsi

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Self-instructional materials are at the heart of instructional delivery in Open and Distance Learning (ODL). The success of any ODL institution depends on the availability of instructional materials in quality and quantity. An ODL study material is expected to fully play the teacher plays in the face-to-face learning environment. In Nigeria, efforts to deliver ODL learning materials have been peculiarly challenging. Although researchers are unrelenting in hewing out ways to make ODL delivery in Africa generally and Nigeria in particular, meet the learners’ needs and acceptable global practices, the prospects of integrating instructional media into distance learning courses are largely unexplored. In the present study, we critically examine the prospects of integration of instructional media into ODL courses for pedagogic and other benefits it portends for delivery via the distance learning mode. Although efforts to integrate media in ODL have been recorded before now, the reality has not matched the expectation so far in Nigeria. This does not mean that the existing instructional materials have not produced any significant positive results in improving the overall learning (and teaching) experience in its institutions; it implies that increased integration as suggested here will further improve the experience as well as bring up the new challenges. Obstacles and problems of instructional materials and media development that could have affected the open educational resource initiatives are well established. The first aspect of this paper recalls the revolutionary strides that ODL brought to delivery of education in Nigeria particularly. The other aspect is on what instructional media are, their role, prospects and challenges for ODL in Nigeria; these are examined vis a vis the challenges of development, production and distribution of print instructional materials as the major format of instructional delivery at Nigeria’s only single mode ODL institution, NOUN. In the third aspect, we justify the need and benefits of integrating instructional media into the courses and make recommendations.

Keywords: instructional delivery, instructional media, ODL, media integration, Nigeria, self-instructional materials

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Authors: A. K. Srivastava, Sandeep K. Singh, A. K. Kulshetra

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Agriculture is the backbone of developing countries of Asian sub-continent like India. Uttar Pradesh is the most populous and fifth largest State of India. Total population of the state is 19.95 crore, which is 16.49% of the country that is more than that of many other countries of the world. Uttar Pradesh occupies only 7.36% of the total area of India. It is a well-established fact that agriculture has virtually been the lifeline of the State’s economy in the past for long and its predominance is likely to continue for a fairly long time in future. The total geographical area of the state is 242.01 lakh hectares, out of which 120.44 lakh hectares is facing various land degradation problems. This needs to be put under various conservation and reclamation measures at much faster pace in order to enhance agriculture productivity in the State. Keeping in view the above scenario Department of Agriculture, Government of Uttar Pradesh has formulated a multi-purpose project namely Bhoomi Sena for the entire state. The main objective of the project is to improve the land degradation using low cost technology available at village level. The total outlay of the project is Rs. 39643.75 Lakhs for an area of about 226000 ha included in the 12th Five Year Plan (2012-13 to 2016-17). It is expected that the total man days would be 310.60 lakh. An attempt has been made to use the space technology like remote sensing, geographical information system, at cadastral level for the overall management of agriculture engineering work which is required for the treatment of degradation of the land. After integration of thematic maps a proposed action plan map has been prepared for the future work.

Keywords: GPS, GIS, remote sensing, topographic survey, cadestral mapping

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Authors: Iman Shabanzadeh

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The purpose of this research is to understand the lived experience of private sector entrepreneurs in facing the sources of freedom and unfreedom and benefiting from opportunities and basic capabilities in the process of realizing entrepreneurial ability in order to get closer to the macro situation of the narrative of human development in Iranian society. Therefore, the main question of the present research is to figure out what sources of freedom and social opportunities and unfreedom entrepreneurs in Iran's society benefit from the process of transforming their potential entrepreneurial abilities into entrepreneurial and business enterprises. In terms of methodology, the current research method will be thematic analysis in the form of semi-structured interviews with entrepreneurs active in small and medium-sized enterprises in Tehran, whose process of establishing and expanding their entrepreneurial activity has been in the last two decades. By examining the possibilities and refusals of advancing these people in the three stages of 'Idea creation and desire for entrepreneurship’, ‘Starting and creating a business’, and finally, ‘Continuing and expanding the business’, the findings of the research show the impact of five main resources for people to realize their potential talents, from the stage of creating an idea to expanding their business. These sources include' family institution,’ ‘education institution,’ ‘social norms and beliefs,’ ‘government and market,’ and ‘personality components of the entrepreneur.’ Finally, the findings are reported in three levels of basic themes (fifteen items), organizing themes (five items), and comprehensive themes (one item) and in the form of a theme network.

Keywords: entrepreneurship, human development, capability, sources of freedom

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Authors: Syed Asif Hassan, Tabrej Khan

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Tuberculosis (TB) caused by bacillus Mycobacterium tuberculosis (Mtb) continues to take a disturbing toll on human life and healthcare facility worldwide. The global burden of TB remains enormous. The alarming rise of multi-drug resistant strains of Mycobacterium tuberculosis calls for an increase in research efforts towards the development of new target specific therapeutics against diverse strains of M. tuberculosis. Therefore, the discovery of new molecular scaffolds targeting new drug sites should be a priority for a workable plan for fighting resistance in Mycobacterium tuberculosis (Mtb). Mtb non-acylated lipoprotein LprG (Rv1411c) has a Toll-like receptor 2 (TLR2) agonist actions that depend on its association with triacylated glycolipids binding specifically with the hydrophobic pocket of Mtb LprG lipoprotein. The detection of a glycolipid carrier function has important implications for the role of LprG in Mycobacterial physiology and virulence. Therefore, considering the pivotal role of glycolipids in mycobacterial physiology and host-pathogen interactions, designing competitive antagonist (chemotherapeutics) ligands that competitively bind to glycolipid binding domain in LprG lipoprotein, will lead to inhibition of tuberculosis infection in humans. In this study, a unified approach involving ligand-based virtual screening protocol USRCAT (Ultra Shape Recognition) software and molecular docking studies using Auto Dock Vina 1.1.2 using the X-ray crystal structure of Mtb LprG protein was implemented. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the Ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has the higher hypothetical affinity, also has greater negative value. Based on the USRCAT, Lipinski’s values and molecular docking results, [(2R)-2,3-di(hexadecanoyl oxy)propyl][(2S,3S,5S,6R)-3,4,5-trihydroxy-2,6-bis[[(2R,3S,4S,5R,6S)-3,4,5-trihydroxy-6 (hydroxymethyl)tetrahydropyran-2-yl]oxy]cyclohexyl] phosphate (XPX) was confirmed as a promising drug-like lead compound (antagonist) binding specifically to the hydrophobic domain of LprG protein with affinity greater than that of PIM2 (agonist of LprG protein) with a free binding energy of -9.98e+006 Kcal/mol and binding affinity of -132 Kcal/mol, respectively. A further, in vitro assay of this compound is required to establish its potency in inhibiting molecular evasion mechanism of MTB within the infected host macrophages. These results will certainly be helpful in future anti-TB drug discovery efforts against Multidrug-Resistance Tuberculosis (MDR-TB).

Keywords: antagonist, agonist, binding affinity, chemotherapeutics, drug-like, multi drug resistance tuberculosis (MDR-TB), RV1411c protein, toll-like receptor (TLR2)

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Authors: Anisa Gumel

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This study examines the present condition of solid waste management in Nigeria. The author explores the challenges and opportunities affecting municipal solid waste management in "Nigeria" and determines the most profound challenges by analysing the interdependence and interrelationship among identified variables. In this study, multiple stakeholders, including 15 waste management professionals interviewed online, were utilised to identify the difficulties and opportunities affecting municipal solid waste in Nigeria. The interviews were transcribed and coded using NVivo to produce pertinent variables. An online survey of Nigerian internet and social media users was done to validate statements made by experts on the identified variable. In addition, a panel of five experts participated in a focus group discussion to discover the most influential factors that influence municipal solid waste management in Nigeria by analysing the interrelationships as well as the driving and reliant power of variables. The results show significant factors affecting municipal solid waste in Nigeria, including inadequate funding, lack of knowledge, and absence of legislation, as well as behavioural, financial, technological, and legal concerns grouped into five categories. Some claims stated by experts in the interview are supported by the survey data, while others are not. In addition, the focus group reveals patterns, correlations, and driving forces between variables that have been analysed. This study will provide decision-makers with a roadmap for resolving important waste management concerns in Nigeria and managing scarce resources effectively. It will also help non-governmental organisations combat malaria in Nigeria and other underdeveloped nations. In addition, the work contributes to the literature for future scholars to consult.

Keywords: municipal solid waste, stakeholders, public, experts

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Authors: Damayanti Sen

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The Fair and Equitable Treatment standard has emerged as a core tenet of a formulated legal structure aimed at encouraging investment through the granting of a secure and stable environment for the investor in the Host State. As an absolute, non-contingent standard, it constitutes an independent and reliable system for the protection of the investor and is frequently invoked and applied in investor-state dispute settlement under bilateral and multilateral investment treaties. Thus far, the standard has been examined principally as a measure for determining the responsibility of host countries towards investors and investments. The conduct of investor in applying the Fair and Equitable Treatment Standard is relatively unexplored. Such an assessment may be necessary in light of the development of new defenses to demands of host governments to confine the application of the standard in order to ensure a proper balance between the protection of investors and the inherent right of a State to regulate economic conduct within its borders. This paper explores the implications of including considerations of investor conduct in the determination of whether an act of the host country’s administrative and/or judicial authorities has breached the fair and equitable treatment principle. The need for such defenses are of special concern for governments of developing countries, whose limited resources can affect their ability to provide an effective evaluation of the nature of the proposed investment, and, subsequently, to ensure that the expected benefits are realized. On the basis of conceptual analysis, and emerging international judicial and arbitral case law, this paper suggests that investor duties such as, the avoidance of unconscionable conduct, the reasonable assessment of investment risk in the host country, and a duty to operate an investment reasonably are leading to a new limit upon the fair and equitable treatment standard- one that can be succinctly captured in the phrase “Caveat Investor”.

Keywords: BITs, FET Standard, investor behavior, arbitral case law

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Authors: Christine F. Boos, Fernando M. Azevedo

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Electroencephalogram (EEG) is a record of the electrical activity of the brain that has many applications, such as monitoring alertness, coma and brain death; locating damaged areas of the brain after head injury, stroke and tumor; monitoring anesthesia depth; researching physiology and sleep disorders; researching epilepsy and localizing the seizure focus. Epilepsy is a chronic condition, or a group of diseases of high prevalence, still poorly explained by science and whose diagnosis is still predominantly clinical. The EEG recording is considered an important test for epilepsy investigation and its visual analysis is very often applied for clinical confirmation of epilepsy diagnosis. Moreover, this EEG analysis can also be used to help define the types of epileptic syndrome, determine epileptiform zone, assist in the planning of drug treatment and provide additional information about the feasibility of surgical intervention. In the context of diagnosis confirmation the analysis is made using long term EEG recordings with at least 24 hours long and acquired by a minimum of 24 electrodes in which the neurophysiologists perform a thorough visual evaluation of EEG screens in search of specific electrographic patterns called epileptiform discharges. Considering that the EEG screens usually display 10 seconds of the recording, the neurophysiologist has to evaluate 360 screens per hour of EEG or a minimum of 8,640 screens per long term EEG recording. Analyzing thousands of EEG screens in search patterns that have a maximum duration of 200 ms is a very time consuming, complex and exhaustive task. Because of this, over the years several studies have proposed automated methodologies that could facilitate the neurophysiologists’ task of identifying epileptiform discharges and a large number of methodologies used neural networks for the pattern classification. One of the differences between all of these methodologies is the type of input stimuli presented to the networks, i.e., how the EEG signal is introduced in the network. Five types of input stimuli have been commonly found in literature: raw EEG signal, morphological descriptors (i.e. parameters related to the signal’s morphology), Fast Fourier Transform (FFT) spectrum, Short-Time Fourier Transform (STFT) spectrograms and Wavelet Transform features. This study evaluates the application of these five types of input stimuli and compares the classification results of neural networks that were implemented using each of these inputs. The performance of using raw signal varied between 43 and 84% efficiency. The results of FFT spectrum and STFT spectrograms were quite similar with average efficiency being 73 and 77%, respectively. The efficiency of Wavelet Transform features varied between 57 and 81% while the descriptors presented efficiency values between 62 and 93%. After simulations we could observe that the best results were achieved when either morphological descriptors or Wavelet features were used as input stimuli.

Keywords: Artificial neural network, electroencephalogram signal, pattern recognition, signal processing

Procedia PDF Downloads 525

Authors: Takahiro Nishimura, Kouki Doi, Hiroshi Fujimoto

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Touch-sensitive screens that serve as displays and input devices have been adopted in many portable terminals such as smartphones and personal media players, and the market of touch-sensitive screens has expanded greatly. One of the advantages of touch-sensitive screen is the flexibility in the graphical user interface (GUI) design, and it is imperative to design an appropriate GUI to realize an easy-to-use interface. Moreover, it is important to evaluate the relationship between pointing performance and GUI design. There is much knowledge regarding easy-to-use GUI designs for portable terminals with touch-sensitive screens, and most have focused on GUI design approaches for women or children with small hands. In contrast, GUI design approaches for users with large hands have not received sufficient attention. In this study, to obtain knowledge that contributes to the establishment of individualized easy-to-use GUI design guidelines, we conducted experiments to investigate the relationship between thumb length and pointing performance on portable terminals with touch-sensitive screens. In this study, fourteen college students who participated in the experiment were divided into two groups based on the length of their thumbs. Specifically, we categorized the participants into two groups, thumbs longer than 64.2 mm into L (Long) group, and thumbs longer than 57.4 mm but shorter than 64.2 mm into A (Average) group, based on Japanese anthropometric database. They took part in this study under the authorization of Waseda University’s ‘Ethics Review Committee on Research with Human Subjects’. We created an application for the experimental task and implemented it on the projected capacitive touch-sensitive screen portable terminal (iPod touch (4th generation)). The display size was 3.5 inch and 960 × 640 - pixel resolution at 326 ppi (pixels per inch). This terminal was selected as the experimental device, because of its wide use and market share. The operational procedure of the application is as follows. First, the participants placed their thumb on the start position. Then, one cross-shaped target in a 10 × 7 array of 70 positions appeared at random. The participants pointed the target with their thumb as accurately and as fast as possible. Then, they returned their thumb to the start position and waited. The operation ended when this procedure had been repeated until all 70 targets had each been pointed at once by the participants. We adopted the evaluation indices for absolute error, variable error, and pointing time to investigate pointing performance when using the portable terminal. The results showed that pointing performance varied with thumb length. In particular, on the lower right side of the screen, the performance of L group with long thumb was low. Further, we presented an approach for designing easy-to- use button GUI for users with long thumbs. The contributions of this study include revelation of the relationship between pointing performance and user’s thumb length when using a portable terminal in terms of accuracy, precision, and speed of pointing. We hope that these findings contribute to an easy-to-use GUI design for users with large hands.

Keywords: pointing performance, portable terminal, thumb length, touch-sensitive screen

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Authors: Lu Song Ma Li Zhi

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With the rapid advancement of artificial intelligence technology, large language models (LLMs) have become a milestone in the field of natural language processing, demonstrating remarkable capabilities in semantic understanding, intelligent question answering, and text generation. These models are gradually penetrating various industries, particularly showcasing significant application potential in the data analysis domain. However, retraining or fine-tuning these models requires substantial computational resources and ample downstream task datasets, which poses a significant challenge for many enterprises and research institutions. Without modifying the internal parameters of the large models, prompt engineering techniques can rapidly adapt these models to new domains. This paper proposes a prompt design strategy aimed at leveraging the capabilities of large language models to automate the generation of data analysis code. By carefully designing prompts, data analysis requirements can be described in natural language, which the large language model can then understand and convert into executable data analysis code, thereby greatly enhancing the efficiency and convenience of data analysis. This strategy not only lowers the threshold for using large models but also significantly improves the accuracy and efficiency of data analysis. Our approach includes requirements for the precision of natural language descriptions, coverage of diverse data analysis needs, and mechanisms for immediate feedback and adjustment. Experimental results show that with this prompt design strategy, large language models perform exceptionally well in multiple data analysis tasks, generating high-quality code and significantly shortening the data analysis cycle. This method provides an efficient and convenient tool for the data analysis field and demonstrates the enormous potential of large language models in practical applications.

Keywords: large language models, prompt design, data analysis, code generation

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Authors: Alain Gholam

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Visual thinking routines are principles based on several theories, approaches, and strategies. Such routines promote thinking skills, call for collaboration and sharing of ideas, and above all, make thinking and learning visible. Visual thinking routines were implemented in the teaching methodology graduate course at the American University in Dubai. The study used mixed methods. It was guided by the following two research questions: 1). To what extent do visual thinking inspire learning in the classroom, and make time for students’ questions, contributions, and thinking? 2). How do visual thinking routines inspire learning in the classroom and make time for students’ questions, contributions, and thinking? Eight student teachers enrolled in the teaching methodology course at the American University in Dubai (Spring 2017) participated in the following study. First, they completed a survey that measured to what degree they believed visual thinking routines inspired learning in the classroom and made time for students’ questions, contributions, and thinking. In order to build on the results from the quantitative phase, the student teachers were next involved in a qualitative data collection phase, where they had to answer the question: How do visual thinking routines inspire learning in the classroom and make time for students’ questions, contributions, and thinking? Results revealed that the implementation of visual thinking routines in the classroom strongly inspire learning in the classroom and make time for students’ questions, contributions, and thinking. In addition, student teachers explained how visual thinking routines allow for organization, variety, thinking, and documentation. As with all original, new, and unique resources, visual thinking routines are not free of challenges. To make the most of this useful and valued resource, educators, need to comprehend, model and spread an awareness of the effective ways of using such routines in the classroom. It is crucial that such routines become part of the curriculum to allow for and document students’ questions, contributions, and thinking.

Keywords: classroom display, student engagement, thinking classroom, visual thinking routines

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Authors: Ranjeet Sable, Mahotsavi Patil, Aadesh Nimbalkar, Prajakta Palaskar, Ritu Sagar

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The exact amount of water used by various crops in different climatic conditions is necessary to step for design, planning, and management of irrigation schemes, water resources, scheduling of irrigation systems. Evaporation and transpiration are combinable called as evapotranspiration. Water loss from trees during photosynthesis is called as transpiration and when water gets converted into gaseous state is called evaporation. For calculation of correct evapotranspiration, we have to choose the method in such way that is should be suitable and require minimum climatic data also it should be applicable for wide range of climatic conditions. In hydrology, there are multiple correlations and regression is generally used to develop relationships between three or more hydrological variables by knowing the dependence between them. This research work includes the study of various methods for calculation of evapotranspiration and selects reasonable and suitable one Pune region (Maharashtra state). As field methods are very costly, time-consuming and not give appropriate results if the suitable climate is not maintained. Observation recorded at Pune metrological stations are used to calculate evapotranspiration with the help of Radiation Method (RAD), Modified Penman Method (MPM), Thornthwaite Method (THW), Blaney-Criddle (BCL), Christiansen Equation (CNM), Hargreaves Method (HGM), from which Hargreaves and Thornthwaite are temperature based methods. Performance of all these methods are compared with Modified Penman method and method which showing less variation with standard Modified Penman method (MPM) is selected as the suitable one. Evapotranspiration values are estimated on a monthly basis. Comparative analysis in this research used for selection for raw data-dependent methods in case of missing data.

Keywords: Blaney-Criddle, Christiansen equation evapotranspiration, Hargreaves method, precipitations, Penman method, water use efficiency

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Authors: J. Magerman, P. Martin

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Nursing students' clinical abilities is highly dependent on the quality of the clinical experience obtained while placed in the clinical environment. The clinical environment has amongst other, key role players which include the clinical supervisor. The primary role of the clinical supervisor is to guide nursing students to become the best practice nursing professionals. However, globally literature alludes to the failure of educating institutions to deliver competent nursing professionals to meet the needs of patients and deliver quality patient care. At the participating university, this may be due to various factors such as large student numbers and social and environmental challenges experienced by clinical supervisors. The aim of this study was to explore and describe the lived experiences of clinical supervisors who supervise nursing students at a higher education institution. The study employed a qualitative research approach utilizing a descriptive phenomenological design. Purposive sampling was used to select participants, who supervised first and second year nursing studnets at the higher education institution under study. TH esample comprised of eight clinical supervisors who supervise first and secon year nursing studnets at teh institution under study. Data was collected by means of in-depht interviews. Data was analysed using Collaizzi's seven steps method of qualitative analysis. Five major themes identified , focussed on the experiences regarding time a sa constraint to job productivity, the impact of teh organisational culture on the fluidity of support, interpersonal relationships a sa dynamic communication process, impact on the self, and limited resources. Trustworthiness of the data was ensured by means of applying Guba's model of truth value, applicability, consistency and neutrality. Reflexivity was also used by the researcher to further enhance trustworthiness.

Keywords: clinical supervision, clinical supervisors, nursing students, clinical placements

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Authors: Regina A. Tayong, Reza Barati

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A stable, fast and robust three-phase, 2D IMPES simulator has been developed for assessing the influence of; breaker concentration on yield stress of filter cake and broken gel viscosity, varying polymer concentration/yield stress along the fracture face, fracture conductivity, fracture length, capillary pressure changes and formation damage on fracturing fluid cleanup in tight gas reservoirs. This model has been validated as against field data reported in the literature for the same reservoir. A 2-D, two-phase (gas/water) fracture propagation model is used to model our invasion zone and create the initial conditions for our clean-up model by distributing 200 bbls of water around the fracture. A 2-D, three-phase IMPES simulator, incorporating a yield-power-law-rheology has been developed in MATLAB to characterize fluid flow through a hydraulically fractured grid. The variation in polymer concentration along the fracture is computed from a material balance equation relating the initial polymer concentration to total volume of injected fluid and fracture volume. All governing equations and the methods employed have been adequately reported to permit easy replication of results. The effect of increasing capillary pressure in the formation simulated in this study resulted in a 10.4% decrease in cumulative production after 100 days of fluid recovery. Increasing the breaker concentration from 5-15 gal/Mgal on the yield stress and fluid viscosity of a 200 lb/Mgal guar fluid resulted in a 10.83% increase in cumulative gas production. For tight gas formations (k=0.05 md), fluid recovery increases with increasing shut-in time, increasing fracture conductivity and fracture length, irrespective of the yield stress of the fracturing fluid. Mechanical induced formation damage combined with hydraulic damage tends to be the most significant. Several correlations have been developed relating pressure distribution and polymer concentration to distance along the fracture face and average polymer concentration variation with injection time. The gradient in yield stress distribution along the fracture face becomes steeper with increasing polymer concentration. The rate at which the yield stress (τ_o) is increasing is found to be proportional to the square of the volume of fluid lost to the formation. Finally, an improvement on previous results was achieved through simulating yield stress variation along the fracture face rather than assuming constant values because fluid loss to the formation and the polymer concentration distribution along the fracture face decreases as we move away from the injection well. The novelty of this three-phase flow model lies in its ability to (i) Simulate yield stress variation with fluid loss volume along the fracture face for different initial guar concentrations. (ii) Simulate increasing breaker activity on yield stress and broken gel viscosity and the effect of (i) and (ii) on cumulative gas production within reasonable computational time.

Keywords: formation damage, hydraulic fracturing, polymer cleanup, multiphase flow numerical simulation

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Authors: Marco Sewald

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WWSE School Development (Wahrnehmungs- und wertorientierte Schulentwicklung) contains surveys on pupils, teachers and parents and enables schools to align the development to the requirements mentioned by these three stakeholders. WWSE includes a derivative set of questions for Christian schools, meeting their specific needs. The conducted research on WWSE is reflecting contemporary questions on school development, questioning the quality of the implementation of the results of past surveys, delivered by WWSE School Development in Christian schools in Germany. The research focused on questions connected to organizational development, including leadership and change management. This is done contoured to the two other areas of WWSE: human resources development and development of school teaching methods. The chosen research methods are: (1) A quantitative triangulation on three sets of data. Data from a past evaluation taken in 2011, data from a second evaluation covering the same school conducted in 2014 and a structured survey among the teachers, headmasters and members of the school board taken within the research. (2) Interviews with teachers and headmasters have been conducted during the research as a second stage to fortify the result of the quantitative first stage. Results: WWSE is supporting modern school development. While organizational development, leadership, and change management are proofed to be important for modern school development, these areas are widespread underestimated by teachers and headmasters. Especially in comparison to the field of human resource development and to an even bigger extent in comparison to the area of development of school teaching methods. The research concluded, that additional efforts in the area of organizational development are necessary to meet modern demands and the research also shows which areas are the most important ones.

Keywords: school as a social organization, school development, school leadership, WWSE, Wahrnehmungs- und wertorientierte Schulentwicklung

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Authors: Mara Gabrielli, Jordi Pamies Rovira

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From a theoretical and interdisciplinary approach to visual ethnography and visual anthropology, this small scale, in-depth study explores the potential of photography as a participatory ethnographic method for a deep-understanding of the socio-educational integration of young refugees and asylum-seekers in the host society as regards their daily experiences, their needs, desires, expectations, and future goals. Qualitative data is collected by the author by observing 12 young participants in the age group 12-24 years per week for 12 months. The data consists of field notes, participatory observation, in-depth interviews with professionals, and the use of visual participatory ethnographic methods. Therefore, the young participants build their stories through the implementation of two participatory photographic methods - the 'photo-diary' and the 'photo-elicitation' - that permit them to analyse and narrate their social and educational experiences from their perspectives, thus collaborating in the construction of knowledge during the different stages of the research. Preliminary findings show the high resilience and social adaptability of young refugees and asylum-seekers to achieve their goals and overcome structural and socio-cultural barriers. However, the uncertainty of their administrative situation during the asylum submission and the lack of specific resources might impact negatively on their educational pathways and the transition to the labour market. Finally, this study also highlights the benefits of participatory photographic methods in ethnographic research, which impacts positively the well-being of these young people, helps them to develop critical thinking, and it also allows them to access information more respectfully when narrating painful experiences.

Keywords: photo-diary, photo-elicitation, resilience, strategies, visual methodologies, young refugees and asylum seekers

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Authors: Alfiah Hasanah, Silvia Mendolia, Oleg Yerokhin

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This paper explores the impacts of adult child migration on the health of elderly parents left behind. The maternal and children health are a priority of health-related policy in most low and middle-income country, and so there is lack of evidence on the health of older population particularly in Indonesia. With increasing life expectancy and limited access to social security and social services for the elderly in this country, the consequences of increasing number of out-migration of adult children to parent health are important to investigate. This study use Indonesia Family Life Survey (IFLS), the only large-scale continuing longitudinal socioeconomic and health survey that based on a sample of households representing about 83 percent of the Indonesian population in its first wave. Using four waves of IFLS including the recent wave of 2014, several indicators of the self-rated health status, interviewer-rated health status and days of illness are used to estimate the impact of labour out-migration of adult children on parent health status. Incorporate both individual fixed effects to control for unobservable factors in migrant and non-migrant households and the ordered response of self-rated health, this study apply the ordered logit of “Blow-up and Cluster” (BUC ) estimator. The result shows that labour out-migration of adult children significantly improves the self-rated health status of the elderly parent left behind. Findings of this study are consistent with the view that migration increases family resources and contribute to better health care and nutrition of the family left behind.

Keywords: aging, migration, panel data, self-rated health

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Authors: Januar Parlaungan Siregar, Davindra Brabu Mathivanan, Dandi Bachtiar, Mohd Ruzaimi Mat Rejab, Tezara Cionita

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Natural fibres play a significant role in mass industries such as automotive, construction and sports. Many researchers have found that the natural fibres are the best replacement for the synthetic fibres in terms of cost, safety, and degradability due to the shortage of landfill and ingestion of non biodegradable plastic by animals. This study mainly revolved around pineapple leaf fibre (PALF) which is available abundantly in tropical countries and with excellent mechanical properties. The composite formed in this study is highly biodegradable as both fibre and matrix are both derived from natural based products. The matrix which is polylactic acid (PLA) is made from corn starch which gives the upper hand as both material are renewable resources are easier to degrade by bacteria or enzyme. The PALF is treated with different alkaline solution to remove excessive moisture in the fibre to provide better interfacial bonding with PLA. Thereafter the PALF is washed with distilled water several times before placing in vacuum oven at 80°C for 48 hours. The dried PALF later were mixed with PLA using extrusion method using fibre in percentage of 30 by weight. The temperature for all zone were maintained at 160°C with the screw speed of 50 rpm for better bonding and afterwards the products of the mixture were pelletized using pelletizer. The pellets were placed in the specimen-sized mould for hot compression under the temperature of 170°C at 5 MPa for 5 min and subsequently were cold pressed under room temperature at 5 MPa for 5 min. The specimen were tested for tensile and flexure strength according to American Society for Testing and Materials (ASTM) D638 and D790 respectively. The effect of surface modification on PALF with different alkali solution will be investigated and compared.

Keywords: natural fibre, PALF, PLA, composite

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Authors: Fairuz A. Ulinnuha, Bimo K. Fuadi

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The world’s population continues to grow resulting in steady migration from rural to urban areas. Increased numbers of people and cities hand in hand with greater exploitation of world’s resource. Every year, more cities are feeling the devastating of this impact of this situation. During the 1970’s, some of eco-concept were applied to urban settings, one of them is Ecological Cities. A non-profit organization, Urban Ecology, was founded in California in 1975 to 'rebuild cities in balance with nature'. Efforts to synthesize ecological and urban planning approaches were slowed somewhat in the 1980s, but useful refinements were made. Consideration of social impact acknowledges that the ecological design is not just about ecology itself. It is also about questioning and redefining our understanding of the ecology. When ecologist did recognize the existence of cities, they were usually concerned with resource flows. One popular approach was to study the flow and transformation of energy through urban ecosystem. This research method is descriptive method, following LEED Certification which is the international standard of the sustainable building, is more widely applied. But there remains problem that the moral imperative of sustainability and by implication of sustainable design, tends to supplant the disciplinary contribution. Sustainable design is not always seen as design excellence or design innovation. This can provoke the skepticism and cause the tension those who promote disciplinary knowledge and those who push for sustainability. The challenges of rapid urbanization and limited of global resources has become more pressing. So, there is a need to find an alternative design approaches. The urban, as the site of complex relation (economy, political, social, cultural), need a complex problem solving that can solve current and future condition. The aim of this study is to discussed about conjoining of ecology such as public park and sustainable design.

Keywords: ecology, cities, urban, sustainability

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Authors: Prima Fithri, Lusi Susanti, Karin Bestarina

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Indonesia's electrification ratio is still around 80.1%, which means that approximately 19.9% of households in Indonesia have not been getting the flow of electrical energy. Household electricity consumptions in Indonesia are generally still dominated by the public urban. In the city of Padang, West Sumatera, Indonesia, about 94.10% are power users of government services (PLN). The most important thing of the issue is human resources efficient energy. Consumer behavior in utilizing electricity becomes significant. Intensive questioner survey, in-depth interview and statistical analysis are carried out to collect scientific evidences of the behavioral based changes instruments to reduce electricity consumption in household sector. The questioner was developed to include five factors assuming affect the electricity consumption pattern in household sector. They are: attitude, energy price, household income, knowledge and other determinants. The survey was carried out in Padang, West Sumatra Province Indonesia. About 210 questioner papers were proportionally distributed to households in 11 districts in Padang. Stratified sampling was used as a method to select respondents. The results show that the household size, income, payment methods and size of house are factors affecting electricity saving behavior in residential sector. Household expenses on electricity are strongly influenced by gender, type of job, level of education, size of house, income, payment method and level of installed power. These results provide a scientific evidence for stakeholders on the potential of controlling electricity consumption and designing energy policy by government in residential sector.

Keywords: electricity, energy saving, household, behavior, policy

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Authors: Samira Eskandari

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The image of Tehran has been impacted in recent years due to poor urban management and fragmented governance. There is no cohesive urban beautification framework in Tehran to enforce builders take aesthetic factors seriously when design and construct new buildings. The existing guidelines merely provide people with recommendations, not regulations. Obviously, Tehran needs a more comprehensive and strict urban beautification framework to restore its image. The damaged image has impacted the city’s social, economic and environmental growth. This research aims to find and examine a solution by which the employment of urban beautification regulation would be guaranteed, and city image would be organized. The methodology is based on a qualitative approach associated with analytical methods, in-depth surveys and interviews with Tehran citizens, authorities and experts, and use of academic resources as well as simulation. As a result, one practical solution is to incorporate aesthetic guidelines into a survival-related framework like a seismic guideline. Tehran is a seismic site, and all the buildings in Tehran have to be retrofitted against earthquake during construction. Hence, by integrating seismic regulations and aesthetic disciplines, urban beautification will be somehow guaranteed. Besides, the seismic image can turn into Tehran’s brand and enhances city identity. This research is trying to increase the social, environmental, and economic interconnectedness between urban planning and seismic planning by the usage of landscape architecture methods. As a case study, the potential outcomes are simulated in Tajrish, a suburb located in the north of Tehran. The result is that, by the redefinition of the morphology of seismic retrofitting systems, used in the significant city image elements, and re-function them in accordance with the Iranian culture and traditions, the city image would become more harmonized and legible.

Keywords: earthquake, retrofitting systems, Tehran image, urban beautification

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Authors: Reham Algheshairy, Khaled Tayeb, Christopher Smith, Rebecca Gregg, Haruna Musa

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Background: Diabetes is a medical condition that refers to the pancreas’ inability to secrete sufficient insulin levels, a hormone responsible for controlling glucose levels in the body. Any surplus glucose in the blood stream is excreted through the urinary system. Insulin resistance in blood cells can also cause this condition despite the fact that the pancreas is producing the required amount of insulin A number of researchers claim that the prevalence of diabetes in Saudi Arabia has reached epidemic proportions, although one study did observe one positive in the rise in the awareness of diabetes, possibly indicative of Saudi Arabia’s improving healthcare system. While a number of factors can cause diabetes, the ever-increasing incidence of the disease in Saudi Arabia has been blamed primarily on low levels of physical activity and high levels of obesity. Objectives: The project has two aims. The first aim of the project is to investigate the regulatory effects of consumption of Nigella seeds and Ajwah dates on blood glucose levels in diabetic patients with type 2 diabetes. The second aim of the project is to investigate whether these dietary factors may have potentially beneficial effects in controlling the complications that associated with type 2 diabetes. Methods: This use a random-cross intervention trail of 75 Saudi male and female with type 2 diabetes in Al-Noor hospital in Makkah ( KSA) aged between 18 and 70 years were divided into 3 groups. Group 1 will consume 2g of Nigella Sativa seeds daily along with a modified diet for 12 weeks, group 2 will be given Ajwah dates daily with a modified diet for 12 weeks and group 3 will follow a modified diet for 12 weeks. Anthropometric measurements were taken at baseline, along with bloods for HbA1c, fasting blood sugar and at the end of 12 weeks. Results: This study found significant decrease in blood level (FBG & 2PPBG) and HbA1c in the groups with diet and Nigella seeds) compared to Ajwa date. However, there is no significant change were found in HbA1c, FBG and 2hrpp regarding Ajwa group. Conclusion: This study illustrated a significant improvement in some markers of glycaemia following 2 g of Ns and diet for 12 weeks. The dose of 2g/day of consumed Nigella seeds was found to be more effective in controlling BGL and HbA1c than control and Ajwa groups. This suggests that Nigella seeds and following a diet may have a potential effect (a role in controlling outcomes for type 2 diabetes and controlling the disease). Further research is needed on a large scale to determine the optimum dose and duration of Nigella and Ajwa in order to achieve the desired results.

Keywords: type 2 diabetes, Nigella seeds, Ajwa dates, fasting blood glucose, control

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Authors: Sharon Diaz Ruiz

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This qualitative study addresses college English instructors’ perceptions of classroom diversity and culturally diverse teaching strategies within the adult English language learning classroom environment. Every year, English college instructors face numerous challenges as the adult Latinx population keeps rising. To better understand the Latinx adult learners and the language classroom dynamics, research should focus on the experiences, pedagogical methods, and teaching insights of full-time and adjunct minority professors at degree-granting postsecondary institutions. Culturally responsive teaching is used as the framework to understand and explore the perceptions of English instructors on the realities and needs of Latinx adult emergent bilinguals enrolled in developmental English courses. Snowball sampling allows the researcher to locate members who meet these specific criteria: adjunct and part-time English instructors of adult Latinx language learners. Participants answered a demographic questionnaire and then contributed to 45-minute in-depth interviews to explore their perceptions of culturally responsive practices in the Latinx adult emergent bilinguals’ basic and intermediate developmental English courses. The interviews shed light on topics such as teaching biases, educators’ cultural experiences, and resources and strategies faculty recommend for effective culturally responsive teaching strategies. The result of this investigation will shed light on the gap in the literature documenting the application of culturally responsive pedagogy to Latino adult language learners.

Keywords: Latinx, English language learners, English faculty, adult learners, critical theory, culturally responsive theory

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Authors: Tiffany Yung Hsuan Ma

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The Whole Language Approach, which gained prominence in the 1980s, and the increasing emphasis on multimodal resources in educational research have elevated the utilization of picture books in English as a foreign language (EFL) instruction. This approach underscores real-world language application, providing EFL learners with a range of sensory stimuli, including visual elements. Additionally, the substantial impact of picture books on fostering prosocial behaviors in children has garnered recognition. These narratives offer opportunities to impart essential values such as kindness, fairness, and respect. Examining how picture books enhance vocabulary acquisition can offer valuable insights for educators in devising engaging language activities conducive to a positive learning environment. This research entails a case study involving two kindergarten-aged EFL learners and employs qualitative methods, including worksheets, observations, and interviews with parents. It centers on three pivotal inquiries: (1) The extent of young learners' acquisition of essential vocabulary, (2) The influence of these books on their behavior at home, and (3) Effective teaching strategies for the seamless integration of picture storybooks into EFL instruction for young learners. The findings can provide guidance to parents, educators, curriculum developers, and policymakers regarding the advantages and optimal approaches to incorporating picture books into language instruction. Ultimately, this research has the potential to enhance English language learning outcomes and promote moral education within the Taiwanese EFL context.

Keywords: EFL, vocabulary acquisition, young learners, picture book, moral education

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Authors: Safa Abdussalam

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Adolescence is a period of storm and stress. It is a transitional period. Adolescents undergo a lot of changes physically, emotionally and mentally during adolescence. Physical changes include puberty, sexual maturation, changes in height, weight, hormonal changes, changes in body image, changes in brain and in sexuality. Changes also occur in their cognition. According to Piaget’s theory, adolescent enter formal operational stage and engage in hypothetical-deductive reasoning. Main characteristic of adolescent cognition is adolescent egocentrism: imaginary audience and personal fable. One of the most common struggle majority of adolescents face is the conflict between parent and adolescent. They often complain that parents do not understand them/their situation. Common topics of conflict include identity crisis, issues with personal freedom and issues over personal preferences. Conflict resolution refers to solving conflicts in a healthy way. There is a lack of resources in dealing with such conflicts creatively. To deal with parent-adolescent conflict, a conflict resolution board game is designed. The board game consists of tokens, dice, 10 conflict situation cards and two conflict resolution sheets. Purpose of using a board game is to help adolescents understand the conflict situations and resolutions in a fun, creative and interactive way. It can be used for self-help or even therapists can use it in their clinical practice. The study aims to assess the effectiveness of the board game in dealing with the conflict. Experimental design will be used. Samples include 15 adolescents belonging to age group 10-19. Samples will be divided into two groups: Experimental group and control group. A pre-test and post-test will be conducted. The board game will be demonstrated to the experimental group. Results will be obtained after statistical analysis. Board games are a great way to be used with children and adolescents.

Keywords: adolescent, adolescence, parent-child conflict, conflict resolution

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Authors: Silvia Grassi, Stefano Schiavon, Ernestina Casiraghi, Cristina Alamprese

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Dry-cured ham is an uncooked meat product particularly appreciated for its peculiar sensory traits among which lipid component plays a key role in defining quality and, consequently, consumers’ acceptability. Usually, fat content and distribution are chemically determined by expensive, time-consuming, and destructive analyses. Moreover, different sensory techniques are applied to assess product conformity to desired standards. In this context, visual systems are getting a foothold in the meat market envisioning more reliable and time-saving assessment of food quality traits. The present work aims at developing a simple but systematic and objective visual methodology to assess the fat amount of dry-cured ham slices, in terms of total, intermuscular and intramuscular fractions. To the aim, 160 slices from 80 PDO dry-cured hams were evaluated by digital image analysis and Soxhlet extraction. RGB images were captured by a flatbed scanner, converted in grey-scale images, and segmented based on intensity histograms as well as on a multi-stage algorithm aimed at edge enhancement. The latter was performed applying the Canny algorithm, which consists of image noise reduction, calculation of the intensity gradient for each image, spurious response removal, actual thresholding on corrected images, and confirmation of strong edge boundaries. The approach allowed for the automatic calculation of total, intermuscular and intramuscular fat fractions as percentages of the total slice area. Linear regression models were run to estimate the relationships between the image analysis results and the chemical data, thus allowing for the prediction of the total, intermuscular and intramuscular fat content by the dry-cured ham images. The goodness of fit of the obtained models was confirmed in terms of coefficient of determination (R²), hypothesis testing and pattern of residuals. Good regression models have been found being 0.73, 0.82, and 0.73 the R2 values for the total fat, the sum of intermuscular and intramuscular fat and the intermuscular fraction, respectively. In conclusion, the edge enhancement visual procedure brought to a good fat segmentation making the simple visual approach for the quantification of the different fat fractions in dry-cured ham slices sufficiently simple, accurate and precise. The presented image analysis approach steers towards the development of instruments that can overcome destructive, tedious and time-consuming chemical determinations. As future perspectives, the results of the proposed image analysis methodology will be compared with those of sensory tests in order to develop a fast grading method of dry-cured hams based on fat distribution. Therefore, the system will be able not only to predict the actual fat content but it will also reflect the visual appearance of samples as perceived by consumers.

Keywords: dry-cured ham, edge detection algorithm, fat content, image analysis

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Authors: Nasir Ullah

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Marketing strategies are important factors in the success of a company. Local pharmaceutical companies in Pakistan face several issues, such as low-level budgets, lack of skilled human resources, and challenges to competing with multinational competitors that have negative impacts on their success. However, still there exist local companies with great levels of success in the pharmaceutical sector. This study aims to evaluate the marketing strategies of successful local companies in the pharmaceutical sector of Khyber Pakhtunkhwa, Pakistan. The study employed a constructivist approach to know about successful strategies of the marketing managers that worked well. For this purpose, in-depth interviews were conducted with marketing managers of four pharmaceutical companies which were deemed as successful on the basis of their annual target achievements. Thematic analysis was conducted using Nvivo to devise major themes from the collected data. Four major themes or successful strategies were identified. These are i) share in the profit to marketing and sales staff, ii) invitation to the doctors for participation in free medical camps and health awareness seminars, iv) incentives for the Doctors and retailers, v) utilization of traditional capital (local social relationships) by the marketing officers. The study concludes that profit share to the employees, valuing doctors through their involvement and utilization of traditional capital are the successful marketing strategies of the successful pharmaceutical companies in the Pakhtun society of Pakistan. The study suggests hiring local staff that can utilize their traditional capital to influence doctors' decisions regarding the prescription of their medicine to the patients. The study also suggests profit share or increased bonuses to the marketing and sales staff as a measure of success.

Keywords: successful marketing strategies, pharmaceutical industry, traditional social capital, local companies

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

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Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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Authors: L. K. Nivedha, V. Maruthapandian, R. Kothandaraman

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Rechargeable zinc-air batteries (ZAB) are gaining significant research attention owing to their high energy density and copious zinc resources worldwide. However, the unsolved obstacles such as dendrites, passivation, depth of discharge and the lack of an efficient cathode catalyst restrict their practical application1. By and large, non-noble transition metal-based catalysts are well-reputed materials for catalysing oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) with greater stability in alkaline medium2. Herein, we report the synthesis and application of Mn₃O4-NiFeLDH/Carbon composite as a cathode catalyst for rechargeable ZAB. The synergetic effects of the mixed transition metals (Mn/Ni/Fe) have aided in catalysing ORR and OER in alkaline electrolyte with a shallow potential gap of 0.7 V. The composite, by its distinctive physicochemical characteristics, shows an excellent OER activity with a current density of 1.5 mA cm⁻² at a potential of 1.6 V and a superior ORR activity with an onset potential of 0.8 V when compared with their counterparts. Nevertheless, the catalyst prefers a two-electron pathway for the electrochemical reduction of oxygen which results in a limiting current density of 2.5 mA cm⁻². The bifunctional activity of the Mn₃O₄-NiFeLDH/Carbon composite was utilized in developing rechargeable ZAB. The fully fabricated ZAB delivers an open circuit voltage of 1.4 V, a peak power density of 70 mW cm⁻², and a specific capacity of 800 mAh g⁻¹ at a current density of 20 mA cm⁻² with an average discharge voltage of 1 V and the cell is operable upto 50 mA cm-2. Rechargeable ZAB demonstrated over 110 h at 10 mA cm⁻². Further, the cause for the diminished charge-discharge performance experienced beyond the 100th cycle was investigated, and carbon corrosion was testified using Infrared spectroscopy.

Keywords: rechargeable zinc-air battery, oxygen evolution reaction, bifunctional catalyst, alkaline medium

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