Search results for: Act of 28 October 2002

Authors: Israel B. Bitton

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“Memory” is associated with various phenomena, from physical to mental, personal to collective and historical to cultural. As part of a broader exploration of memory studies in philosophy and science (slated for academic publication October 2021), this specific study employs analytical methods of cognitive psychology and philosophy of memory to theorize that A) the primary human will (drive) is to significance, in that every human action and expression can be rooted in a most primal desire to be cosmically significant (however that is individually perceived); and B) that the will to significance manifests as the will to memorability, an innate desire to be remembered by others after death. In support of these broad claims, a review of various popular culture “touchpoints”—historic and contemporary records spanning literature, film and television, traditional news media, and social media—is presented to demonstrate how this very theory is repeatedly and commonly expressed (and has been for a long time) by many popular public figures as well as “everyday people.” Though developed before COVID, the crisis only increased the theory’s relevance: so many people were forced to die alone, leaving them and their loved ones to face even greater existential angst than what ordinarily accompanies death since the usual expectations for one’s “final moments” were shattered. To underscore this issue of, and response to, what can be considered a sociocultural “memory gap,” this study concludes with a summary of several projects launched by journalists at the height of the pandemic to document the memorable human stories behind COVID’s tragic warped speed death toll that, when analyzed through the lens of Viktor E. Frankl’s psychoanalytical perspective on “existential meaning,” shows how countless individuals were robbed of the last wills and testaments to their self-significance and memorability typically afforded to the dying and the aggrieved. The resulting insight ought to inform how government and public health officials determine what is truly “non-essential” to human health, physical and mental, at times of crisis.

Keywords: cognitive psychology, covid, neuroscience, philosophy of memory

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Authors: Arif Anwar Surani, Salman Ali, Asif Surani, Sohaib Zahid, Akbar Shoukat Ali, Zeeshan-Ul-Hassan Usmani, Joseph Varon, Salim Surani

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Objective: Terrorism and suicidal bomb blast attacks are commonplace in Karachi, Pakistan. During the years 2000 to 2007, there were over 60 bomb explosions resulting in more than 1500 casualties. These explosions produce a wide variety of external injuries. We undertook this study to evaluate pattern of external injury produced after bomb blast attacks and to compare injury profile resulting from explosions in open versus semi-confined blast environments. Method: A retrospective, cross-sectional, study was conducted to review injuries sustained after bomb blast attacks in Karachi, Pakistan, from January 2000 to October 2007. Emergency medical records and medico legal certificates of patients presented to three major public sector hospitals of Karachi were evaluated using self-design proforma. Results: Data of 481 victims meet inclusion criteria and were incorporated for final analysis. Of these, 63.6% were injured in open spaces and 36.4% were injured in semi-confined blast environments. Lacerations were commonly encountered as external injury (47.7%) followed by penetrating wounds (15.3%). Lower and upper extremities were most commonly affected (38.6% and 19% respectively). Open and semi-confined blast environments produced a specific injury pattern and profile (p=<0.001). Conclusions: Bomb blast attacks in Karachi produce an external injury pattern consistent with other studies, with exception of an increased frequency in penetrating wounds. Semi-confined blast environments were associated with severe injuries. Further studies are required to better classify injuries and their severity based on standardized scoring systems. Effective emergency response systems must be designed to cope with mass causalities following bomb explosions.

Keywords: bomb blast attacks, injury pattern, external injury, open space, semi-confined space, blast environment

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Authors: Tess Howard, Lily Owens, Maneesha De Silva, Russell Hodgson

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Purpose: This study aims to evaluate the cost-effectiveness of laparoscopic common bile duct exploration (CBDE) compared to endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy for the emergency management of common bile duct (CBD) stones. Methodology: A retrospective case note review was conducted on consecutive patients undergoing emergency management of CBD stones using either CBDE, or ERCP and cholecystectomy at a single centre between January 2014-October 2014. Data on admission and procedural costs, length of hospital stay, postoperative complications and further stone related interventions were analysed. Results: A total of 350 patients were analysed. Among them, 299 patients underwent CBDE at the time of cholecystectomy, while the remaining 51 underwent ERCP either pre-, intra- or post cholecystectomy. CBDE was associated with lower overall costs compared to ERCP with an average hospital stay cost of $13,093 vs $22,930 respectively. This was largely attributed to shorter hospital stays (6.5 vs 10.3 days), decreased need for intensive care unit admission and fewer postoperative interventions within the CBDE group. Notably, single procedure laparoscopic cholecystectomy with CBDE demonstrated decreased operative costs compared to laparoscopic cholecystectomy combined with ERCP pre-/intra- or post-operatively ($3,747 vs. $4,641). Conclusion: Emergent CBDE is a cost-effective alternative to ERCP for managing CBD stones when combined with cholecystectomy. The upfront investment in equipment for CBDE and increased cholecystectomy procedural time is counterbalanced by reduced hospital stay, fewer procedures and subsequent cost savings. Economic considerations, in conjunction with clinical outcomes, should inform the selection of the optimal approach for CBD stone management in emergency settings.

Keywords: choledocolithiasis, management, cost-effectiveness, endoscopic retrograde cholangiopancreatography, ERCP, CBDE, common bile duct exploration

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Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.

Keywords: depression, men, postpartum, risk factors, women

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Authors: Nchanji Yvonne Kiki, Mala William Armand, Nchanji Eileen Bogweh, Ramcilovik-Suominen Sabaheta, Kotilainen Juha

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The Campo Ma'an National Park was created as part of an environmental and biodiversity compensation for the Chad-Cameroon Oil Pipeline Project, which was meant to help alleviate poverty and boost the livelihood of rural communities around the area. This paper examines different strategies and coping mechanisms employed by the indigenous people and local communities to deal with the national and internationally driven conservation policies and initiatives in the case of the Campo Ma'an National Park. While most literature on park management/co-management/nature conservation has focused on the negative implications for local peoples’ livelihoods, fewer studies have investigated the strategies of local people to respond to these policies and renegotiate their position in a way that enables them to continue their traditional livelihoods using the existing local knowledge systems. This study contributes to the current literature by zooming into not only the impacts of nature conservation policies but also the local individual and collective strategies and responses to such policies and initiatives. We employ a qualitative research approach using ethnomethodology and a convivial lens to analyze data collected from October to November 2018. We find that conservation policies have worsened some existing livelihoods on the one hand and constrained livelihood improvement of indigenous people and local communities (IPLC) on the other hand. Nonetheless, the IPLC has devised individual and collective coping mechanisms to deal with these conservation interventions and the negative effects they have caused. Upon exploring these mechanisms and their effectiveness, this study proposes a management approach to conservation centered on both people and nature, based on indigenous and local people's knowledge and practices, promoting nature for and by humans and strengthening both livelihood and conservation. We take inspiration from the convivial conservation approach and thinking by Bucher and Fletcher.

Keywords: conservation policies, national park management, indigenous and local people’s experiences, livelihoods, local knowledge, coping strategies, conviviality

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Authors: Chee Young Kim, Tae Hyun Kim, Anbok Lee, Hyun-Ah Kim, Woosung Lim, Ku Sang Kim, Jinsun Lee, Yoo Seok Kim, Beom Seok Ko

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Background: CollatampTM is Gentamicin-containing collagen sponge well known for its hemostatic effect, commonly utilized in surgeries. We inserted CollatempTM wrapped by SurgicelTM (oxidized cellulose polymer) to fill up the defect after breast conserving surgery. The purpose of this study is to verify the furthermore cosmetic value of CollatampTM in breast conserving surgery conducted in breast cancer patients. Methods: 17 patients were enrolled in this study, underwent breast conserving surgery with CollatampTM wrapped by SurgicelTM insertion, in Inje University Busan Paik Hospital from October 2015 to September 2016. Patient satisfaction, cosmetic outcome, results at 6 months from operation was analyzed to verify the effectiveness and usefulness of CollatampTM for cosmetics. Patient satisfaction was investigated through interviews on a scale of good, fair, poor, and the cosmetic outcome was investigated through physical examination by a surgeon who did not participate in the operations. Results: Among 17 patients, nine of them gave ‘good’ for patient satisfaction, eight gave ‘fair’ and none of them ‘poor’. Also, cosmetic outcome came out with 11 ‘good’s, six ‘fair’s, no ‘poor’. In ‘good’ patient satisfaction group, the mean value of resection to breast volume ratio was 16%, compared to 24% of ‘fair’ group. The mean value of actual resection volume was 100.6cm3, 102.7cm3 each. In ‘good’ cosmetic outcome group, the mean value of resection to breast volume ratio was 18%, compared to 23% of ‘fair’ group. The mean value of actual resection volume was 99.2cm3, 105.9cm3 respectively. According to these results, patient satisfaction and cosmetic outcome after surgeries were more reliable on the resection to breast volume ratio, rather than the actual resection volume. There were eight cases of postoperative complications, consisting of a lymphedema, a seroma, and six patients had mild pain. Conclusions: Cosmetic effect of CollatampTM in breast conserving surgery was more reliable on the resection to breast volume ratio, rather than the actual resection volume. In this short term survey, patients were tend to be satisfied with the cosmetics, all giving either good or fair scores. However, long term outcomes should be further assessed.

Keywords: breast cancer, breast conserving surgery, collatamp, cosmetics

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Authors: Ngoc-Hieu Vu

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Although dairy production in Vietnam is a relatively new agricultural activity, milk production increased remarkably in recent years. Smallholders are still the main drivers for this development, especially in the southern part of the country. However, information on the farming practices is very limited. Therefore, this study aimed to characterize husbandry practices, educational experiences, decision-making practices, constraints, income and expenses of smallholder dairy farms in Southern Vietnam. A total of 200 farms, located in the regions Ho Chi Minh (HCM, N=80 farms), Lam Dong (N=40 farms), Binh Duong (N=40 farms) and Long An (N=40 farms) were included. Between October 2013 and December 2014 farmers were interviewed twice. On average, farms owned 3.200m2, 2.000m2, and 193m2 of pasture, cropping and housing area, respectively. The number of total, milking and dry cows, heifers, and calves were 20.4, 11.6, 4.7, 3.3, and 2.9 head. The number of lactating dairy cows was higher (p<0.001) in HCM (15.5) and Lam Dong (14.7) than in Binh Duong (6.7) and Long An (10.7). Animals were mainly crossbred Holstein-Friesian (HF) cows with at least 75% HF origin (84%), whereas a higher (P<0.001) percentage of purebred HF was found in HCM and Lam Dong and crossbreds in Binh Duong and Long An. Animals were mainly raised in tie-stalls (94%) and machine-milked (80%). Farmers used their own replacement animals (76%), and both genetic and phenotypic information (67%) for selecting sires. Farmers were predominantly educated at primary school level (53%). Major constraints for dairy farming were the lack of capital (43%), diseases (17%), marketing (22%), lack of knowledge (8%) and feed (7%). Monthly profit per lactating cow was superior in Lam Dong (2,817 thousand VND) and HCM (2,798 thousand VND) compared to other regions in Long An (2,597 thousand VND), and Binh Duong (1,775 thousand VND). Regional differences may be mainly attributed to environmental factors, urbanization, and particularly governmental support and the availability of extension and financial institutions. Results from this study provide important information on farming practices of smallholders in Southern Vietnam that are useful in determining regions that need to be addressed by authorities in order to improve dairy production.

Keywords: dairy farms, milk yield, Southern Vietnam, socio-economics

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Authors: Recep Kesli, Gulsah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Stenotrophomonas maltophilia (S. maltophilia) has recently emerged as an important nosocomial microorganism. Treatment of invasive infections caused by this organism is problematic because this microorganism is usually resistant to a wide range of commonly used antimicrobials. We aimed to evaluate clinical isolates of S. maltophilia in respect to sampling sites and antimicrobial resistant. Method: During a two years period (October 2013 and September 2015) eighteen samples collected from the intensive care unit (ICU) patients hospitalized in Afyon Kocatepe University, ANS Practice and Research Hospital. Identification of the bacteria was determined by conventional methods and automated identification system-VITEK 2 (bio-Mérieux, Marcy l’toile, France). Antibacterial resistance tests were performed by Kirby Bauer disc (Oxoid, England) diffusion method following the recommendations of CLSI. Results: Eighteen S. maltophilia strains were identified as the causative agents of different infections. The main type of infection was lower respiratory tract infection (83,4 %); three patients (16,6 %) had bloodstream infection. While, none of the 18 S. maltophilia strains were found to be resistant against to trimethoprim sulfametaxasole (TMP-SXT) and levofloxacine, eight strains 66.6 % were found to be resistant against ceftazidim. Conclusion: The isolation of S.maltophilia starains resistant to TMP-SXT is vital. In order to prevent or minimize infections due to S. maltophilia such precuations should be utilized: Avoidance of inappropriate antibiotic use, prolonged implementation of foreign devices, reinforcement of hand hygiene practices and the application of appropriate infection control practices. Microbiology laboratories also may play important roles in controlling S. maltophilia infections by monitoring the prevalence, continuously, the provision of local antibiotic resistance paterns data and the performance of synergistic studies also may help to guide appropirate antimicrobial therapy choices.

Keywords: Stenotrophomonas maltophilia, trimethoprim-sulfamethoxazole, antimicrobial resistance, Stenotrophomonas spp.

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Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Miroslav Dumbrovsky

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The paper deals with impacts of climate change with the main emphasis on land degradation, agriculture and forestry management in the landscape. Land degradation, due to adverse effect of farmers activities, as a result of inappropriate conventional technologies, was a major issue in the Czech Republic during the 20th century and will remain for solving in the 21st century. The importance of land degradation is very high because of its impact on crop productivity and many other adverse effects. Land degradation through soil degradation is causing losses on crop productivity and quality of the environment, through decreasing quality of soil and water (especially water resources). Negative effects of conventional farming practices are increased water erosion, as well as crusting and compaction of the topsoil and subsoil. Soil erosion caused by water destructs the soil’s structure, reduces crop productivity due to deterioration in soil physical and chemical properties such as infiltration rate, water-holding capacity, loss of nutrients needed for crop production, and loss of soil carbon. Water erosion occurs on fields with row crops (maize, sunflower), especially during the rainfall period from April to October. Recently there is a serious problem of greatly expanded production of biofuels and bioenergy from field crops. The result is accelerated soil degradation. The damages (on and off- site) are greater than the benefits. An effective soil conservation requires an appropriate complex system of measures in the landscape. They are also important to continue to develop new sophisticated methods and technologies for decreasing land degradation. The system of soil conservation solving land degradation depend on the ability and the willingness of land users to apply them. When we talk about land degradation, it is not just a technical issue but also an economic and political issue. From a technical point of view, we have already made many positive steps, but for successful solving the problem of land degradation is necessary to develop suitable economic and political tools to increase the willingness and ability of land users to adopt conservation measures.

Keywords: land degradation, soil erosion, soil conservation, climate change

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Authors: Nadeem Munawar, Iftikhar Hussain, Tariq Mahmood

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The lesser bandicoot rat (Bandicota bengalensis) is widely distributed and a serious agricultural pest in Pakistan. It has wide adaptation with rice-wheat-sugarcane cropping systems of Punjab, Sindh and Khyber Pakhtunkhwa and wheat-groundnut cropping system of Pothwar area, thus inflicting heavy losses to these crops. Comparative efficacies of four food baits (onion, guava, potato and peanut butter smeared bread/Chapatti) were tested in multiple feeding tests for kill trapping of this rat species in the Pothwar Plateau between October 2013 to July 2014 at the sowing, tilling, flowering and maturity stages of wheat, groundnut and millet crops. The results revealed that guava was the most preferred bait as compared to the rest of three, presumably due to particular taste and smell of the guava. The relative efficacies of all four tested baits guava also scoring the highest trapping success of 16.94 ± 1.42 percent, followed by peanut butter, potato, and onion with trapping successes of 10.52 ± 1.30, 7.82 ± 1.21 and 4.5 ± 1.10 percent, respectively. In various crop stages and season-wise the highest trapping success was achieved at maturity stages of the crops, presumably due to higher surface activity of the rat because of favorable climatic conditions, good shelter, and food abundance. Moreover, the maturity stage of wheat crop coincided with spring breeding season and maturity stages of millet and groundnut match with monsoon/autumn breeding peak of the lesser bandicoot rat in Pothwar area. The preferred order among four baits tested was guava > peanut butter > potato > onion. The study recommends that the farmers should periodically carry out rodent trapping at the beginning of each crop season and during non-breeding seasons of this rodent pest when the populations are low in numbers and restricted under crop boundary vegetation, particularly during very hot and cold months.

Keywords: Bandicota bengalensis, efficacy, food baits, Pothwar

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Authors: Phalla Miech, William Leung, Ty Chhay, Sina Vor, Arata Hidano

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Smallholder pig farms (SPFs) are prevalent in Cambodia but are vulnerable to disease impacts, as evidenced by the recent incursion of African swine fever into the region. As part of the ‘PigFluCam+’ project, we sought to provide an updated picture of pig husbandry and biosecurity practices among SPFs in south-central Cambodia. A multi-stage sampling design was adopted to select study districts and villages within four provinces: Phnom Penh, Kandal, Takeo, and Kampong Speu. Structured interviews were conductedbetween October 2020 - May 2021 among all consenting households keeping pigs in 16 target villages. Recruited SPFs (n=176) kept 6.8 pigs on average (s.d.=7.7), with most (88%) keeping cross-bred varieties of sows (77%), growers/finishers (39%), piglets/weaners (22%), and few keeping boars (5%). Chickens (83%) and waterfowl (56%) were commonly raised and could usually contact pigs directly (79%). Pigs were the primary source of household income for 28% of participants. While pigs tended to be housed individually (40%) or in groups (33%), 13% kept pigs free-ranging/tethered. Pigs were commonly fed agricultural by-products (80%), commercial feed (60%), and, notably, household waste (59%). Under half of SPFs vaccinated their pigs (e.g., against classical swine fever, Aujesky’s, and pasteurellosis, although the target disease was often unknown). Among 20 SPFs who experienced pig morbidities/mortalities within the past 6 months, only 3 (15%) reported to animal health workers, and disease etiology was rarely known. Common biosecurity measures included nets covering pig pens (62%) and restricting access to the site/pens (46%). Boot dips (0.6%) and PPE (1.2%) were rarely used. Pig smallholdings remain an important contributor to rural livelihoods. Current practices and biosecurity challenges increase risk pathways for a range of disease threats of both local and global concern. Ethnographic studies are needed to better understand local determinants and develop context-appropriate strategies.

Keywords: smallholder production, swine, biosecurity practices, Cambodia, African swine fever

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Authors: Ammar Amsyar Abdul Haddi, Mohd Hasni Jaafar

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Heavy metals are elements naturally presented in the environment that can cause adverse effect to health. But not much literature was found on effects toward lung function, where impairment of lung function may lead to various lung diseases. The objective of the study is to explore the lung function impairment, urinary heavy metal level, and its associated factors among the community in Klang valley, Malaysia. Sampling was done in Kuala Lumpur suburb public and housing areas during community events throughout March 2019 till October 2019. respondents who gave the consent were given a questionnaire to answer and was proceeded with a lung function test. Urine samples were obtained at the end of the session and sent for Inductively coupled plasma mass spectrometry (ICP-MS) analysis for heavy metal cadmium (Cd) and lead (Pb) concentration. A total of 200 samples were analysed, and of all, 52% of respondents were male, Age ranging from 18 years old to 74 years old with a mean age of 38.44. Urinary samples show that 12% of the respondent (n=22) has Cd level above than average, and 1.5 % of the respondent (n=3) has urinary Pb at an above normal level. Bivariate analysis show that there was a positive correlation between urinary Cd and urinary Pb (r= 0.309; p<0.001). Furthermore, there was a negative correlation between urinary Cd level and full vital capacity (FVC) (r=-0.202, p=0.004), Force expiratory volume at 1 second (FEV1) (r = -0.225, p=0.001), and also with Force expiratory flow between 25-75% FVC (FEF25%-75%) (r= -0.187, p=0.008). however, urinary Pb did not show any association with FVC, FEV1, FEV1/FVC, or FEF25%-75%. Multiple linear regression analysis shows that urinary Cd remained significant and negatively affect FVC% (p=0.025) and FEV1% (p=0.004) achieved from the predicted value. On top of that, other factors such as education level (p=0.013) and duration of smoking(p=0.003) may influencing both urinary Cd and performance in lung function as well, suggesting Cd as a potential mediating factor between smoking and impairment of lung function. however, there was no interaction detected between heavy metal or other influencing factor in this study. In short, there is a negative linear relationship detected between urinary Cd and lung function, and urinary Cd is likely to affects lung function in a restrictive pattern. Since smoking is also an influencing factor for urinary Cd and lung function impairment, it is highly suggested that smokers should be screened for lung function and urinary Cd level in the future for early disease prevention.

Keywords: lung function, heavy metals, community

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Authors: V. Markogianni, D. Kalivas, G. Petropoulos, E. Dimitriou

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Lake water quality monitoring in combination with the use of earth observation products constitutes a major component in many water quality monitoring programs. Landsat 8 images of Trichonis Lake (Greece) acquired on 30/10/2013 and 30/08/2014 were used in order to explore the possibility of Landsat 8 to estimate water quality parameters and particularly CDOM absorption at specific wavelengths, chlorophyll-a and nutrient concentrations in this oligotrophic freshwater body, characterized by inexistent quantitative, temporal and spatial variability. Water samples have been collected at 22 different stations, on late August of 2014 and the satellite image of the same date was used to statistically correlate the in-situ measurements with various combinations of Landsat 8 bands in order to develop algorithms that best describe those relationships and calculate accurately the aforementioned water quality components. Optimal models were applied to the image of late October of 2013 and the validation of the results was conducted through their comparison with the respective available in-situ data of 2013. Initial results indicated the limited ability of the Landsat 8 sensor to accurately estimate water quality components in an oligotrophic waterbody. As resulted by the validation process, ammonium concentrations were proved to be the most accurately estimated component (R = 0.7), followed by chl-a concentration (R = 0.5) and the CDOM absorption at 420 nm (R = 0.3). In-situ nitrate, nitrite, phosphate and total nitrogen concentrations of 2014 were measured as lower than the detection limit of the instrument used, hence no statistical elaboration was conducted. On the other hand, multiple linear regression among reflectance measures and total phosphorus concentrations resulted in low and statistical insignificant correlations. Our results were concurrent with other studies in international literature, indicating that estimations for eutrophic and mesotrophic lakes are more accurate than oligotrophic, owing to the lack of suspended particles that are detectable by satellite sensors. Nevertheless, although those predictive models, developed and applied to Trichonis oligotrophic lake are less accurate, may still be useful indicators of its water quality deterioration.

Keywords: landsat 8, oligotrophic lake, remote sensing, water quality

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Authors: Behcet Al, Mustafa Bogan, Mehmet Murat Oktay, Suat Zengin, Hasan Bayram

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Objective: In the last two decades there is a strong scientific interest regarding the role of aerosols for the Earth’s climate and associated changes. Aerosol particles are very important to the Earth-atmosphere climate system playing a crucial role in cloud and precipitation processes, air quality and climate. Here, we evaluated the association between saharran dust and emergency department admission, hospitalization, and mortality. Method: The records of admission to emergency department of Gaziantep University and the dust stroms of 31 months were studied. Patients admitted to ED at dust strom with chronic obstructive lung disease (COLD), asthma bronchiale (AB), serebrovascular events (SVE), acute myocardial infarction (AMI), stabile and unstabile angina pectoris (SAAP andUSAP); and the days with and without dust stroms were included. The study was realized from March 2010 to October 2012. The admission of three days before strom (group 1), during strom days (group 2) and three days after strom (group 3) were determined. The mean level of dust PM10 particulate was calculated, and the results were compared. Results: 5864 patients with chronic obstructive lung disease, asthma bronchiale, serebrovascular events, acute myocardial infarction, stabile and unstabile angyina pectoris admitted during the days with and without dust stroms. 28 dust stroms ocurred during 31 months. The totaliy of stroms continiued 78 days. Of admissions, 35.5% (n=2075) were in group1, 29.8% (n=1746) in group 2, and 34.8% (n=2043) were in group 3. The mean of PM10 for groups (group 1, 2 and 3) were 78.53 mg/m3 (range 19–276) particulate, 108.7 mg/m3 (range 34–631) particulate, and 60.9 mg/m3 (range 17–160) particulate respectively. The mean admission per a day for groups were 24.86, 22.55, and 24.50 respectively. The mortality was 12 in group 1, 12 in group 2, and 17 in grou 3. The hospitalization ratio for groups were 0.24, 0.27, and 0.27 respectively. Conclusion: However, the mean level of PM10 particulate for groups 2 (in dust strom days) is significantly higher (p=0.001) than the days before (group 1) and after (group 3) dust stroms, the mean admissions/day, hostilalization and mortality related to deseases (COLD, AB, SVE, AMI, SAAP andUSA) for group 2 is lower than the group 1 and group 3.

Keywords: Saharran dust, PM10 particulate, emergency department admission, mortality

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Authors: Zhiqiang Yan, Chen Fan, Yafei Wang, Beicheng Xia

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Urban lakes play an invaluable role in urban water systems such as flood control, water supply, and public recreation. However, over 38% of the urban lakes have suffered from severe eutrophication in China. Chlorine that could remarkably inhibit the growth of phytoplankton in eutrophic, has been widely used in the agricultural, aquaculture and industry in the recent past. However, little information has been reported regarding the effects of chlorine on the lake ecosystem, especially on the main aquatic species.To investigate the ecological response of main aquatic species and system stability to chlorine interference in shallow urban lakes, a mini system dynamic model was developed based on the competition and predation of main aquatic species and total phosphorus circulation. The main species of submerged macrophyte, phytoplankton, zooplankton, benthos, spiroggra and total phosphorus in water and sediment were used as variables in the model,while the interference of chlorine on phytoplankton was represented by an exponential attenuation equation. Furthermore, the eco-exergy expressing the development degree of ecosystem was used to quantify the complexity of the shallow urban lake. The model was validated using the data collected in the Lotus Lake in Guangzhoufrom1 October 2015 to 31 January 2016.The correlation coefficient (R), root mean square error-observations standard deviation ratio (RSR) and index of agreement (IOA) were calculated to evaluate accuracy and reliability of the model.The simulated values showed good qualitative agreement with the measured values of all components. The model results showed that chlorine had a notable inhibitory effect on Microcystis aeruginos，Rachionus plicatilis, Diaphanosoma brachyurum Liévin and Mesocyclops leuckarti (Claus).The outbreak of Spiroggra.spp. inhibited the growth of Vallisneria natans (Lour.) Hara, leading to a gradual decrease of eco-exergy and the breakdown of ecosystem internal equilibria. This study gives important insight into using chlorine to achieve eutrophication control and understand mechanism process.

Keywords: system dynamic model, urban lake, chlorine, eco-exergy

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Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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Authors: Alonge Isaac Olusola

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This paper focuses on the evolution and development of Yoruba theatre during the pre-colonial, colonial and post-colonial years and how Yoruba crime films have been influenced by foreign culture. It emphasizes on the transition of theatre from the ground to the stage and from the stage to the screen with emphasis on the contribution of late Chief Hubert Ogunde who is regarded as the doyen of Yoruba and the entire Nigerian theatre. Using the Theory of Post-colonialism, two modern Yoruba crime films are carefully selected from the numerous available ones to highlight and explain the various aspects of Yoruba films that have been greatly influenced by the foreign cultural practices. The questions to be answered here include 'Which attitudes or cultural practices are widely believed to be that of Yoruba?', 'To what extent are they projected in the selected Yoruba crime films?', 'Which attitudes or cultural practices are widely believed to be foreign among the Yoruba people?', 'To what extent are they projected in the selected Yoruba crime films?'. Although, the British colonial masters granted political independence to Nigeria on October 1, 1960, but a seed of multi-culture and counterculture had been sown into the lives of the Yoruba people. Under the literature review, there is an intensive illumination on some scholars’ ideas and views on what constitutes Yoruba culture, the evolution and development of drama, theatre and films in the Yoruba society and the nature of criminals and criminalities in the Yoruba society and the western world in the pre-colonial and post-colonial times. Furthermore, the processes of interaction between man, his values and his thoughts are also highlighted – a situation that procreates criminal or benevolent acts. Consequently, the paper dwells on how colonialism, despite its so-called merits put the gradual process of urbanization and civilization among the originally rustic, cohesive and moralistic Yoruba society on a supersonic speed that culminated in acquisition of attitudes that are alien to the Yoruba culture. Since a drama is nothing but the theatrical replication of what occurs in the real life, the paper then focuses on the submission that Yoruba crime films have experienced a serious foreign influence in form and content as a result of this encounter. In conclusion, the findings of the impact of foreign cultural practices on Yoruba crime films are highlighted and expatiated with a view to recommending a few steps that could be taken to retain the projection of the original Yoruba cultural practices in Yoruba films, especially the ones that have crime as a theme.

Keywords: culture, films, theatre, Yoruba

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Authors: Claudia L. Bianchi, Giuseppina Cerrato, Federico Galli, Federica Minozzi, Valentino Capucci

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At the beginning of the industrial productions, porcelain gres tiles were considered as just a technical material, aesthetically not very beautiful. Today thanks to new industrial production methods, both properties, and beauty of these materials completely fit the market requests. In particular, the possibility to prepare slabs of large sizes is the new frontier of building materials. Beside these noteworthy architectural features, new surface properties have been introduced in the last generation of these materials. In particular, deposition of TiO₂ transforms the traditional ceramic into a photocatalytic eco-active material able to reduce polluting molecules present in air and water, to eliminate bacteria and to reduce the surface dirt thanks to the self-cleaning property. The problem of photocatalytic materials resides in the fact that it is necessary a UV light source to activate the oxidation processes on the surface of the material, processes that are turned off inexorably when the material is illuminated by LED lights and, even more so, when we are in darkness. First, it was necessary a thorough study change the existing plants to deposit the photocatalyst very evenly and this has been done thanks to the advent of digital printing and the development of an ink custom-made that stabilizes the powdered TiO₂ in its formulation. In addition, the commercial TiO₂, which is used for the traditional photocatalytic coating, has been doped with metals in order to activate it even in the visible region and thus in the presence of sunlight or LED. Thanks to this active coating, ceramic slabs are able to purify air eliminating odors and VOCs, and also can be cleaned with very soft detergents due to the self-cleaning properties given by the TiO₂ present at the ceramic surface. Moreover, the presence of dopant metals (patent WO2016157155) also allows the material to work as well as antibacterial in the dark, by eliminating one of the negative features of photocatalytic building materials that have so far limited its use on a large scale. Considering that we are constantly in contact with bacteria, some of which are dangerous for health. Active tiles are 99,99% efficient on all bacteria, from the most common such as Escherichia coli to the most dangerous such as Staphilococcus aureus Methicillin-resistant (MRSA). DIGITALIFE project LIFE13 ENV/IT/000140 – award for best project of October 2017.

Keywords: Ag-doped microsized TiO₂, eco-active ceramic, photocatalysis, digital coating

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Authors: V. S. Manivasagam, R. Nagarajan

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Modeling the soil, water and crop growth interactions are attaining major importance, considering the future climate change and water availability for agriculture to meet the growing food demand. Progress in understanding the crop growth response during water stress period through crop modeling approach provides an opportunity for improving and sustaining the future agriculture water use efficiency. An attempt has been made to evaluate the potential use of crop modeling approach for assessing the minimal supplementary irrigation requirement for crop growth during water limited condition and its practical significance in sustainable improvement of crop yield and water productivity. Among the numerous crop models, water driven-AquaCrop model has been chosen for the present study considering the modeling approach and water stress impact on yield simulation. The study has been evaluated in rainfed maize grown area of semi-arid Shanmuganadi watershed (a tributary of the Cauvery river system) located in southern India during the rabi cropping season (October-February). In addition to actual rainfed maize growth simulation, irrigated maize scenarios were simulated for assessing the supplementary irrigation requirement during water shortage condition for the period 2012-2015. The simulation results for rainfed maize have shown that the average maize yield of 0.5-2 t ha-1 was observed during deficit monsoon season (<350 mm) whereas 5.3 t ha-1 was noticed during sufficient monsoonal period (>350 mm). Scenario results for irrigated maize simulation during deficit monsoonal period has revealed that 150-200 mm of supplementary irrigation has ensured the 5.8 t ha-1 of irrigated maize yield. Thus, study results clearly portrayed that minimal application of supplementary irrigation during the critical growth period along with the deficit rainfall has increased the crop water productivity from 1.07 to 2.59 kg m-3 for major soil types. Overall, AquaCrop is found to be very effective for the sustainable irrigation assessment considering the model simplicity and minimal inputs requirement.

Keywords: AquaCrop, crop modeling, rainfed maize, water stress

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Authors: Dawd Ahmed, Venkatesh Uddameri

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Agriculture in Ethiopia is the main economic sector influenced by agricultural drought. A simultaneous assessment of drought trends using multiple drought indicators is useful for drought planning and management. Intra-season and seasonal drought trends in Ethiopia were studied using a suite of drought indicators. Standardized Precipitation Index (SPI), Standardized Precipitation Evapotranspiration Index (SPEI), Palmer Drought Severity Index (PDSI), and Z-index for long-rainy, dry, and short-rainy seasons are used to identify drought-causing mechanisms. The Statistical software package R version 3.5.2 was used for data extraction and data analyses. Trend analysis indicated shifts in late-season long-rainy season precipitation into dry in the southwest and south-central portions of Ethiopia. Droughts during the dry season (October–January) were largely temperature controlled. Short-term temperature-controlled hydrologic processes exacerbated rainfall deficits during the short rainy season (February–May) and highlight the importance of temperature- and hydrology-induced soil dryness on the production of short-season crops such as tef. Droughts during the long-rainy season (June–September) were largely driven by precipitation declines arising from the narrowing of the intertropical convergence zone (ITCZ). Increased dryness during long-rainy season had severe consequences on the production of corn and sorghum. PDSI was an aggressive indicator of seasonal droughts suggesting the low natural resilience to combat the effects of slow-acting, moisture-depleting hydrologic processes. The lack of irrigation systems in the nation limits the ability to combat droughts and improve agricultural resilience. There is an urgent need to monitor soil moisture (a key agro-hydrologic variable) to better quantify the impacts of meteorological droughts on agricultural systems in Ethiopia.

Keywords: autocorrelation, climate change, droughts, Ethiopia, food security, palmer z-index, PDSI, SPEI, SPI, trend analysis

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Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.

Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit

Procedia PDF Downloads 282

Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

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INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.

Keywords: neuropathic pain, chronic pain, treatment, gabapentin

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Authors: Azziz Assoumani, Francois Lestremau, Celine Ferret, Benedicte Lepot, Morgane Salomon, Helene Budzinski, Marie-Helene Devier, Pierre Labadie, Karyn Le Menach, Patrick Pardon, Laure Wiest, Emmanuelle Vulliet, Pierre-Francois Staub

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Seven French wastewater treatment plants (WWTP) were monitored for 53 contaminants of emerging concern within a nation-wide monitoring campaign in surface waters, which took place in 2018. The overall objective of the 2018 campaign was to provide the exercise of prioritization of emerging substances, which is being carried out in 2021, with monitoring data. This exercise should make it possible to update the list of relevant substances to be monitored (SPAS) as part of future water framework directive monitoring programmes, which will be implemented in the next water body management cycle (2022). One sampling campaign was performed in October 2018 in the seven WWTP, where affluent and sludge samples were collected. Surface water samples were collected in September 2018 at three to five sites upstream and downstream the point of effluent discharge of each WWTP. The contaminants (36 biocides and 17 surfactants, selected by the Prioritization Experts Committee) were determined in the seven WWTP effluent and sludge samples and in surface water samples by liquid or gas chromatography coupled with tandem mass spectrometry, depending on the contaminant. Nine surfactants and three biocides were quantified at least in one WWTP effluent sample. Linear alkylbenzene sulfonic acids (LAS) and fipronil were quantified in all samples; the LAS were quantified at the highest median concentrations. Twelve surfactants and 13 biocides were quantified in at least one sludge sample. The LAS and didecyldimethylammonium were quantified in all samples and at the highest median concentrations. Higher concentration levels of the substances quantified in WWTP effluent samples were observed in the surface water samples collected downstream the effluents discharge points, compared with the samples collected upstream, suggesting a contribution of the WWTP effluents in the contamination of surface waters.

Keywords: contaminants of emerging concern, effluent, monitoring, river water, sludge

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Authors: Hilal Keskin, Gülzade Uysal

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This study was conducted to determine the effect of bedside music mobile use on physiological parameters and pain level during intestinal stomaterapy in infants. The study was carried out with 66 babies (music mobile group: 33, Control group: 33) who were followed in the pediatric surgery and urology unit of Kanuni Sultan Süleyman Training and Research Hospital between December 2018- October 2019. Data were collected using the “Data Collection Form” and “FLACC Pain Scale.” They were evaluated using the appropriate statistical methods in the SPSS 22.0 program. The difference between the descriptive features of music mobile and control group was not significant (p> 0.05) groups are distributed homogeneously. When the in-group results were examined; There was no significant change in the mean values of Hearth Peak Beat (HPB), SpO2 and blood pressure of the infants in the music mobile group during stomaterapy (p>0.05). Body temperature and Face, Leg, Activity, Cry, Consolability (FLACC) Pain Scale scores were found to increase immediately after stomaterapy (p<0.05). It was found that the mean scores of KTA, body temperature and FLACC pain of the babies in the control group increased significantly after the stomaterapy and SpO2 value decreased (p <0,05). After 15 minutes from stomatherapy, KTA, blood pressure, body temperature and FLACC pain scores averaged; although SpO2 value increased, it was determined that it could not reach pre-stomaterapy value. Results between groups; KTA, SpO2, systolic/diastolic blood pressure, body temperature, and FLACC pain score mean values between groups were homogeneous before stomaterapy (p> 0.05). In the control group, a significant increase was found in the mean scores of KTA, body temperature and FLACC pain after stomaterapy compared to the bedside music mobile group, and a significant decrease in SpO2 values (p <0.05). In the control group, the mean body temperature and FLACC pain scores of the infants 15 minutes after stomaterapy were significantly increased and the SpO2 values were significantly lower than the bedside music group (p <0.05). According to the results of the research; The use of bedside music mobile during intestinal stomaterapy was found to be effective in decreasing the physiological parameters and pain level. It can be recommended for use in infants during painful interventions.

Keywords: intestinal stomatherapy, infant, musical mobile, pain, physiological parameters

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Authors: Mehmet Budak, Mehmet Fatih Ustundag

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Objectives: In this research, we studied the extent of exposure to physical violence and committing violence in patients diagnosed with schizophrenia in comparison to a control group consisting of patients with psychiatric diseases other than psychotic and mood disorders. Method: Between August 2019 and October 2019, a total of 100 hospitalized patients diagnosed with schizophrenia (clinically in remission, Brief Psychiatric Rate Scale < 30) were sequentially studied while undergoing inpatient treatment at Erenkoy Mental Health Training and Research Hospital. From the outpatient clinic, 50 patients with psychiatric disorders other than psychotic disorders or mood disorders were consecutively included as a control group. All participants were evaluated by the sociodemographic data that also questions the history of violence, physical examination, bilateral comparative hand, and forearm anterior-posterior and lateral radiography. Results: While 59% of patients with schizophrenia and 28% of the control group stated that they were exposed to physical violence at least once in a lifetime (p < 0,001); a defensive wound or fracture was detected in 29% of patients with schizophrenia and 2% of the control group (p < 0.001). On the other hand, 61% of patients diagnosed with schizophrenia, and 32% of the control group expressed that they committed physical violence at least once in a lifetime (p: 0.001). A self-destructive wound or fracture was detected in 53% of the patients with schizophrenia and 24% of the control group (p: 0,001). In the schizophrenia group, the rate of committing physical violence is higher in those with substance use compared to those without substance use (p:0.049). Also, wounds and bone fractures (boxer’s fracture) resulting from self-injury are more common in schizophrenia patients with substance use (p:0,002). In the schizophrenia group, defensive wounds and parry fractures (which are located in the hand, forearm, and arm usually occur as a result of a trial to shield the face against an aggressive attack and are known to be the indicators of interpersonal violence) are higher in those with substance use compared to those who do not (p:0,007). Conclusion: This study shows that exposure to physical violence and the rate of violence is higher in patients with schizophrenia compared to the control group. It is observed that schizophrenia patients who are stigmatized as being aggressive are more exposed to violence. Substance use in schizophrenia patients increases both exposure to physical violence and the use of physical violence. Physical examination and anamnesis that question violence are important tools to reveal the exposure to violence in patients. Furthermore, some specific bone fractures and wounds could be used to detect victimization even after plenty of time passes.

Keywords: fracture, physical violence, schizophrenia, substance use

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Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, Antibiotic misuse, Iraq, Prescribing

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Authors: D. Eranda N. Mandawala, P. A. D. Mokshi V. Perera

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The RajagalaArchaeological site (RAS) is located 26 km from Ampara town (7º29'25.22" N, 81º36'59.05" E) accessible through the Ampara-Uhana-MahaOya highway of the Eastern province of Sri Lanka. This site has recently been added to the tentative list of UNESCO world heritage site and is also a forest reserve. This dry zone forest consists of tropical mixed evergreen vegetation and scrublands on a rocky outcrop of elevation of about 350 meters above mean sea level. It is also scattered with several ponds of differing sizes on rocky outcrops, rocky cliffs, and about 50 cave dwellings. No comprehensive biodiversity survey of any sorts has been conducted at the RAS so far. Therefore, a preliminary survey was conducted to determine its butterfly fauna diversity. An opportunistic Visual Encounter Survey method was used to observe various butterfly species during the morning between 8:00am-12:00noon and in the evening between 2:00-6:00pm on 3 site visits in October 2017, February 2018, and November 2019. All encountered species were photographed using a Nikon D750 camera with Sigma 105mm f/2.8 EX DG OS HSM macro lens, and field guide books were used to identify them. Sri Lanka is home to 248 species of butterflies, of which are 26 are endemic. At RAS, we observed a total of 39 species (15%) of butterflies belonging to 5 Lepidoptera families. Out of these, one endemic species(4%) and 9 endemic subspecieswere also identified. The former was Troidesdarsius, also known as the Sri Lanka birdwing which is the national butterfly and the largest butterfly in Sri Lanka, and the latter were Plains cupid (Chiladespandavalanka), Yamfly (Loxuraatymnus arcuate), Common Cerulean (Jamidescelenotissama), Tawny Rajah(Charaxespsaphonpsaphon), Tamil Yeoman(Cirrochroathaislanka), Angled Castor(Ariadne ariadneminorata), GladeyeBushbrown(Mycalesispatnia patina), Common Crow (Euploea core asela)and Blue Mormon (Papiliopolymnestorparinda). The endemic subspecies belonged to 3 Lepidoptera families (3from Lycaenidae, 5 from Nymphalidae, and 1 from Papilionidae family). Anthropogenic activities such as unauthorized cattle farming, forest clearance, and man-made forest fires currently threaten this site. If such trends continue, it may lead to the reduction of butterfly fauna diversity within this area in the future.

Keywords: lepidoptera, rajagala, Sri Lanka birdwing, endemic

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Authors: Sintayehu W. Dejene

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An ecological and biodiversity conservation study on species composition, population status and habitat association of large mammals and the impact of human interference on their distribution was carried out in Awash National Park, Ethiopia during October, 2012 to July, 2013. A total of 25 species of large mammals were recorded from the study area. Representative sample sites were taken from each habitat type and surveyed using random line transect method. For medium and large mammal survey, indirect methods (foot print and dung) and direct observations were used. Twenty three species of medium to large-sized mammals were identified and recorded from ANP. A total of 25 species of median and large size mammals were recorded from the study area. Out of this, 20 species were rodents of three families and five species were insectivores of two families. Beisa Oryx (Oryx beisa beisa),Soemmerings gazelle (Gazella soemmeringi),Defassa waterbuck (Kobus defassa), Lesser Kudu (Strepsiceros imberbis), Greater Kudu (Strepsiceros strepsiceros), Warthog (Phacochoerus aethiopicus), Baboon (Papio anubis baboon) and Salt's dikdik (Madoqua saltiana) were the most common seen median and large mammals in the study area. Beisa Oryx (Oryx beisa beisa) and Sommering Gazelles (Gazella soemmeringi) are commonly found in the open areas, where as Greater Kudus (Strepsiceros strepsiceros) and Lesser Kudus (Strepsiceros imberbis) was seen in the bushed areas. Defarsa waterbuck (Kobus defassa) was observed in the bushy river area in Northern part of the Park. Anubis baboon (Papio anubis baboon) was seen near to the river side. Hamadryas baboon founded in semi-desert areas of Awash National Park, particularly in Filwoha area. The area is one of a key biodiversity conservation and provide pure water, air, food, grazing land and storage of carbon.

Keywords: awash national park, biodiversity, ecosystem value, habitat association, large mammals, population status, species composition

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