Search results for: women population

Authors: Muhammad Nouman, Fahad Tiwana, Muhammad Irfan, Mohsin Tiwana

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Traffic congestion has been increasing significantly in major metropolitan areas as a result of increased motorization, urbanization, population growth and changes in the urban density. Traffic congestion compromises efficiency of transport infrastructure and causes multiple traffic concerns; including but not limited to increase of travel time, safety hazards, air pollution, and fuel consumption. Traffic management has become a serious challenge for federal and provincial governments, as well as exasperated commuters. Effective, flexible, efficient and user-friendly traffic information/database management systems characterize traffic conditions by making use of traffic counts for storage, processing, and visualization. While, the emerging data collection technologies continue to proliferate, its accuracy can be guaranteed through the comparison of observed data with the manual handheld counters. This paper presents the design of tablet based manual traffic counting application and framework for development of traffic database management system for Pakistan. The database management system comprises of three components including traffic counting android application; establishing online database and its visualization using Google maps. Oracle relational database was chosen to develop the data structure whereas structured query language (SQL) was adopted to program the system architecture. The GIS application links the data from the database and projects it onto a dynamic map for traffic conditions visualization. The traffic counting device and example of a database application in the real-world problem provided a creative outlet to visualize the uses and advantages of a database management system in real time. Also, traffic data counts by means of handheld tablet/ mobile application can be used for transportation planning and forecasting.

Keywords: manual count, emerging data sources, traffic information quality, traffic surveillance, traffic counting device, android; data visualization, traffic management

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Authors: Adel A. Ghobbar

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The airline industry is continuously challenging how to safely increase the service life of the aircraft with limited maintenance budgets. Operators are looking for the most qualified maintenance providers of aircraft components, offering the finest customer service. Component owner and maintenance provider is offering an Abacus agreement (Aircraft Component Leasing) to increase the efficiency and productivity of the customer service. To increase the customer service, the current focus on No Fault Found (NFF) units must change into the focus on Early Failure (EF) units. Since the effect of EF units has a significant impact on customer satisfaction, this needs to increase the reliability of EF units at minimal cost, which leads to the goal of this paper. By identifying the reliability of early failure (EF) units with regards to No Fault Found (NFF) units, in particular, the root cause analysis with an integrated cost analysis of EF units with the use of a failure mode analysis tool and a cost model, there will be a set of EF maintenance improvements. The data used for the investigation of the EF units will be obtained from the Pentagon system, an Enterprise Resource Planning (ERP) system used by Fokker Services. The Pentagon system monitors components, which needs to be repaired from Fokker aircraft owners, Abacus exchange pool, and commercial customers. The data will be selected on several criteria’s: time span, failure rate, and cost driver. When the selected data has been acquired, the failure mode and root cause analysis of EF units are initiated. The failure analysis approach tool was implemented, resulting in the proposed failure solution of EF. This will lead to specific EF maintenance improvements, which can be set-up to decrease the EF units and, as a result of this, increasing the reliability. The investigated EFs, between the time period over ten years, showed to have a significant reliability impact of 32% on the total of 23339 unscheduled failures. Since the EFs encloses almost one-third of the entire population.

Keywords: supportability, no fault found, FMEA, early failure, availability, operational reliability, predictive model

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Authors: Josie West

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This paper focuses on the conflicts and utility of Marxist Feminist frames for sex work research, drawing on findings uncovered through in-depth interviews with online sex workers, alongside critical discourse analysis of media and political commentary. It brings the critical perspective of women into digital workerism and gig economy dialogue who, despite their significant presence within online work, have been overlooked. The autonomist Marxist concept of class composition is adopted to unpack the social, technical and political composition of this often-invisible segment of the service sector. Autonomism makes visible the perspective of workers engaged in processes of mobilization and demobilizaiton. This allows researchers to find everyday forms of resistance which occur within and outside trade unions. On the other hand, Marxist feminist arguments about invisibility politics can generate unhelpful allegories about sex work as domestic labour within the reproductive sphere. Nick Srnicek’s development of Marx’s notion of infrastructure rents helps theorize experiences of unpaid labour within online sex work. Moreover, debates about anti-work politics can cause conflict among sex workers fighting for the labour movement and those rejecting the capitalist work ethic. This illuminates’ tensions caused by white privilege and differing experiences of sex work. The monopolistic and competitive nature of sex work platforms within platform capitalism, and the vulnerable position of marginalised workers within stigmatized/criminalised markets, complicates anti-work politics further. This paper is situated within the feminist sex wars and the intensely divisive question of whether sex workers are victims of the patriarchy or symbols of feminist resistance. Camgirls are shown to engage in radical tactics of resistance against their technical composition on popular sex work platforms. They also engage in creative acts of resistance through performance art, in an attempt to draw attention to stigma and anti-criminalization politics. This sector offers a fascinating window onto grassroots class-action, alongside education about ‘whorephobia.’ A case study of resistance against Only Fans, and a small workers co-operative which emerged during the pandemic, showcases how workers engage in socialist and political acts without the aid of unions. Workers are victims of neoliberalism and simultaneous adopters of neoliberal strategies of survival. The complex dynamics within unions are explored, including tensions with grass-roots resistance, financial pressures and intersecting complications of class, gender and race.

Keywords: autonomist marxism, digital labor, feminism, neoliberalism, sex work, platform capitalism

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Authors: Mohamed Abdalla Khalil Mahmoud, Omnia Haidar Suliman

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Information and Communication technologies have revolutionized the way services are developed and offered to customers and have achieved evident success in a variety of vital sectors and widely contributed to the growth and resilience of the economy worldwide. Consequently, governments, especially of developing countries, have turned their attention to examine possible ways to utilize contemporary technology advances to offer essential governmental services to citizens, especially in areas where government agencies are not present. This paper investigates the challenges that impede governments of developing countries to provide basic services to its constituents nationwide. Sudan, as a case study, has taken major steps to provide essential governmental services via electronic channels. However, these services are still not widely used by the citizens, resulting in waste of financial and human resources and efforts that could have been invested more appropriately. This paper examines the challenges that hinder the Sudan’s government in their pursuit of availing its services via electronic channels. Different categories of e-government challenges, such as organizational, technological, social and, demographic, and financial and economic, have been explored in order to pinpoint the major challenges. A structured questionnaire is used to survey the target population of e-government professionals and executives who have direct involvement in the implementation of this nationwide endeavor in Sudan. The survey has successfully identified the main challenges that have high impact on the government’s effort to offer its services via electronic channels, such as Lack of coordination between public and private sectors and Lack of the benefits recognition of the e-government program. The findings of this paper can be used as a solid foundation for improving the way governmental services are offered to citizens in Sudan, resulting in a successful investment of financial and human resources and benefiting the targeted customers of all types.

Keywords: citizen, digital, e-channels, public sector, Sudan, technology

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Authors: Tony Jehi, Sujatha Rajaram, Nader majzoub, Joan Sabate

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Aging significantly increases the incidence of various cardiometabolic diseases, including cardiovascular disease (CVD). To combat CVD and its associated risk factors, it is imperative to adopt a healthy dietary pattern that is rife with beneficial nutrient and non-nutrient compounds. Unsaturated fats, specifically n-3 polyunsaturated fatty acids (n-3 PUFA), have cardio-protective effects; the opposite is true for saturated fatty acids. What role, if any, does the biomarker of fatty acid intake (specific fatty acids in the erythrocyte) play in predicting cardiometabolic risk among the elderly, a population highly susceptible to increased mortality and morbidity from CVD risk factors, remains unclear. This was a secondary analysis of the Walnuts and Healthy Aging Study. Briefly, elderly (n=192, mean age 69 y) participants followed their usual diet and were randomized into two groups to either eat walnuts daily or abstain from eating walnuts for a period of 2 years. The purpose was to identify potential associations between erythrocyte membrane fatty acids and cardiometabolic risk factors (body weight, blood pressure, blood lipids, and fasting glucose). Erythrocyte n-3 PUFA were inversely associated with total cholesterol (ß = -3.83; p= 0.02), triglycerides (ß = -7.66; p= <0.01), and fasting glucose (ß = -0.19; p=0.03). Specifically, erythrocyte ALA (ß= -1.59; P = 0.04) and DPA (ß= -0.62; P=0.04) were inversely associated with diastolic blood pressure and fasting glucose, respectively. N-6 PUFAs were positively associated with systolic blood pressure (ß=1.10; P=0.02). Mono-unsaturated fatty acids were positively associated with TAG (ß = 4.16; P=0.03). Total saturated fatty acids were not associated with any cardiometabolic risk factors. No association was found between any erythrocyte fatty acid and body weight. In conclusion, erythrocyte n-3 PUFA may be used as a biomarker to predict the cardiometabolic risk among healthy elders, providing support for the American Heart Association guidelines for including n-3 PUFA for preventing CVD.

Keywords: cardiometabolic diseases, erythrocyte fatty acids, elderly, n-3 PUFA

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Authors: Maryam Zahmatkesh

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Middle managers form a significant occupational category in organisations. They undertake a vital role, as they sit between the operational and strategic roles. Traditionally they were acting as diplomat administrators, and were only in power to meet the demands of professionals. Following the introduction of internal market, in line with the principles of New Public Management, middle managers have been considered as change agents. More recently, in the debates of middle managers, there is emphasis on entrepreneurialism and enacting strategic role. It was assumed that granting autonomy to the local organisations and the inception of semi-autonomous hospitals (Foundation Trusts in England and Board of Trustees in Iran) would give managers more autonomy to act proactively and innovatively. This thesis explores the hospital middle managers’ perception of and responses to public management reforms (in particular, hospital autonomy) in England and Iran. In order to meet the aims of the thesis, research was undertaken within the interpretative paradigm, in line with social constructivism. Data were collected from interviews with forty-five middle managers, observational fieldwork and documentary analysis across four teaching university hospitals in England and Iran. The findings show the different ways middle managers’ autonomy is constrained in the two countries. In England, middle managers have financial and human recourses, but their autonomy is constrained by government policy and targets. In Iran, middle managers are less constrained by government policy and targets, but they do not have financial and human resources to exercise autonomy. Unbalanced autonomy causes tension and frustration for middle managers. According to neo-institutional theory, organisations are deeply embedded within social, political, economic and normative settings that exert isomorphic and internal population-level pressures to conform to existing and established modes of operation. Health systems which are seeking to devolve autonomy to middle managers must appreciate the multidimensional nature of the autonomy, as well as the wider environment that organisations are embedded, if they are about to improve the performance of managers and their organisations.

Keywords: autonomy, healthcare organisations, middle managers, new public management

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Authors: Shivani Dolas, A. Richa Mishra

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The existence of Courtyards in India can be traced back to ‘Indus valley civilization’ and various layers of history bearing implications like socio-cultural, traditional, religious, climatic, etc., moreover serving as a breathing space in case of historical core areas. Over time, with the overlay of various historic layers within the historic urban cores and the present high density populace, the cores are getting congested day by day. In this case, courtyards may emerge out as an efficient medium to provide quality of life through livable spaces. Presently, with the growing population of the historic town of Gwalior, town in Madhya Pradesh holds remarkable essence of courtyards with its multiple concepts over time. Its scale and function varies from an imposing grand appearance in palatial form, up to functional practices as residential. Its privilege can also be drawn in urban forms, in sharing single space by multiple dwellings and in temples which can be sketched specifically in the region. Moreover, the effectiveness of courtyards has proven balance and control of micro-climate in such composite climate region. The research paper aims to underline the concept of courtyards in case of a mixed use neighborhood, Naya bazar, in Lashkar area of Gwalior, which developed during 19th century, highlighting the need of its preservation. The paper also elaborates its various implications on user-space relationship as in the present context, and growing congestion in the area, user and space relationship is seen lost. The noticeable change in the behavioral context in buildings and users can be noticed with the downfall of courtyards, isolating users with land. Also, a concern has been expressed on negligence of courtyard planning in future development, suggesting recommendations on preserving the courtyard typology as heritage.

Keywords: courtyards, Gwalior, historic settlement, heritage

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Authors: Chica Riska Ashari, Yoli Farradika

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Background: Nutritional problems arise due to food security problems in the family, such as the ability of families to obtain food which is common in poor people due to lack of economic access to buy food. For this reason, it is hoped that there will be actions or behaviors that can be taken to fulfill their food or known as the Food Coping Strategy. The purpose of this study is to identify the eating patterns and Food Coping strategies of household students of prof. DR. HAMKA Muhammadiyah University Jakarta during the covid-19 pandemic. Methods: This study is a quantitative observational study with a cross-sectional approach. The dependent variable in this study is food coping strategies and eating patterns. The location of this research is Prof. DR. Hamka Muhammadiyah University. The population in this study were all students of Prof. DR. HAMKA Muhammadiyah University. The sampling technique is purposive sampling. The minimum number of samples in this study is 97 people with a response rate or drop out an estimate of 10%, so the total number of samples was 107 people. Statistical analysis with descriptive analysis. Results: The results showed that most of the food coping strategies were carried out by the students of the household of Prof. DR. HAMKA Muhammadiyah University, were buying the cheaper food (91.6%), then changing the priority of buying food (75.7%) and household members who carry out this food coping strategy are mothers (59.8%) then followed by students themselves (57, 9%). The diet of most students at the Prof. DR. HAMKA Muhammadiyah University in a day was fond of consuming sugar and foods containing sugar (candy, sugar, honey, sweet drinks) (98.1%) then eggs (97.2%). Conclusion: Food coping strategies are mostly used by households students at Prof. DR. HAMKA Muhammadiyah University who were buying the cheaper food and the member who did this behavior the most were the mothers. The diet of most students at Prof. DR. HAMKA Muhammadiyah University in a day was fond of consuming sugar and foods containing sugar (candy, sugar, honey, sweet drinks).

Keywords: behavior, eating patterns, food coping strategies, food security, students

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Authors: Muhammad Sufyan, Muhammad D. Gogi, Muhammad Arshad, Ahmad Nawaz, Muhammad Usman

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Cotton (Gossypium hirsutum) universally known as silver fiber and is one of the most important cash crop of Pakistan. A wide array of pests constraints cotton production among which sucking insect pests cause serious losses. Mostly new chemistry insecticides used to control a wide variety of insect pests including sucking insect pests. In the present study efficacy of different neonicotinoids was evaluated against sucking insect pests of cotton in the field and in laboratory for red and dusky cotton bug. The experiment was conducted at Entomology Research Station, University of Agriculture Faisalabad, in a Randomized Complete Block Design (RCBD). Field trial was conducted to evaluate the efficacy of Confidence Ultra (Imidacloprid) 70% SL, Confidor (Imidacloprid) 20% SL, Kendo (Lambda cyhalothrin) 24.7 SC, Actara (Thiamethoxam) 25% WG, Forcast (Tebufenozide+ Emamectin benzoate) 8.8 EW and Timer (Emamectin benzoate) 1.9 EC at their recommended doses. The data was collected on per leaf basis of thrips, aphid, jassid and whitefly before 24 hours of spray. The post treatment data was recorded after 24, 48 and 72 hours. The fresh, non-infested and untreated cotton leaves was collected from the field and brought to the laboratory to assess the efficacy of neonicotinoids against red and dusky cotton bug. After data analysis all the insecticides were found effective against sucking pests. Confidence Ultra was highly effective against the aphid, jassid, and whitefly and gave maximum mortality, while showed non-significant results against thrips. In case of aphid plot which was treated with Kando 24.7 SC showed significant mortality after 72 hours of pesticide application. Similar trends were found in laboratory conditions with all these treatments by making different concentrations and had significant impact on dusky cotton bug and red cotton bug population after 24, 48 and 72 hours after application.

Keywords: cotton, laboratory and field conditions, neonicotinoids, sucking insect pests

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Authors: V. Karthickeyan

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The demand for energy is anticipated to increase, due to growing urbanization, industrialization, upgraded living standards and cumulatively increasing human population. The general public is becoming gradually aware of the diminishing fossil fuel resources along with the environmental issues, and it has become clear that biofuel is intended to make significant support to the forthcoming energy needs of the native and industrial sectors. Nowadays, the investigation on biofuels obtained from peels of fruits and vegetables have gained the consideration as an environment-friendly alternative to diesel. In the present work, biofuel was produced from non-edible Lemon Oil (LO) using steam distillation process. LO is characterized by its beneficial aspects like low kinematic viscosity and enhanced calorific value which provides better fuel atomization and evaporation. Furthermore, the heating values of the biofuels are approximately equal to diesel. A single cylinder, four-stroke diesel engine was used for this experimentation. An engine modification technique namely Thermal Barrier Coating (TBC) was attempted. Combustion chamber components were thermally coated with ceramic material namely partially stabilized zirconia (PSZ). The benefit of thermal barrier coating is to diminish the heat loss from engine and transform the collected heat into piston work. Performance characteristics like Brake Thermal Efficiency (BTE) and Brake Specific Fuel Consumption (BSFC) were analyzed. Combustion characteristics like in-cylinder pressure and heat release rate were analyzed. In addition, the following engine emissions namely nitrogen oxide (NO), carbon monoxide (CO), hydrocarbon (HC), and smoke were measured. The acquired performance combustion and emission characteristics of uncoated engine were compared with PSZ coated engine. From the results, it was perceived that the LO biofuel may be considered as the prominent alternative in the near prospect with thermal barrier coating technique to enrich the performance, combustion and emission characteristics of diesel engine.

Keywords: ceramic material, thermal barrier coating, biofuel and diesel engine

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Authors: Michael Zaidman, Naum Simanovsky

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Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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Authors: Mst. Nilufa Sultana, Shatirah Akib, Muhammad Aqeel Ashraf, Mohamed Roseli Zainal Abidin

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Most people today are aware that global Climate change, is not just a scientific theory but also a fact with worldwide consequences. Global climate change is due to rapid urbanization, industrialization, high population growth and current vulnerability of the climatic condition. Water is becoming scarce as a result of global climate change. To mitigate the problem arising due to global climate change and its drought effect, harvesting rainwater from green roofs, an environmentally-friendly and versatile technology, is becoming one of the best assessment criteria and gaining attention in Malaysia. This paper addresses the sustainability of green roofs and examines the quality of water harvested from green roofs in comparison to rainwater. The factors that affect the quality of such water, taking into account, for example, roofing materials, climatic conditions, the frequency of rainfall frequency and the first flush. A green roof was installed on the Humid Tropic Centre (HTC) is a place of the study on monitoring program for urban Stormwater Management Manual for Malaysia (MSMA), Eco-Hydrological Project in Kualalumpur, and the rainwater was harvested and evaluated on the basis of four parameters i.e., conductivity, dissolved oxygen (DO), pH and temperature. These parameters were found to fall between Class I and Class III of the Interim National Water Quality Standards (INWQS) and the Water Quality Index (WQI). Some preliminary treatment such as disinfection and filtration could likely to improve the value of these parameters to class I. This review paper clearly indicates that there is a need for more research to address other microbiological and chemical quality parameters to ensure that the harvested water is suitable for use potable water for domestic purposes. The change in all physical, chemical and microbiological parameters with respect to storage time will be a major focus of future studies in this field.

Keywords: Green roofs, INWQS, MSMA-SME, rainwater harvesting, water treatment, water quality parameter, WQI

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Authors: Ergün Şakalar, Şeyma Özçirak Ergün, Emrah Yalazi̇, Emine Altinkaya, Cengiz Ataşoğlu

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In recent years, food allergies which cause serious health problems affect to public health around the world. Foodstuffs which contain allergens are either intentionally used as ingredients or are encased as contaminant in food products. The prevalence of clinical allergy to peanuts and nuts is estimated at about 0.4%-1.1% of the adult population, representing the allergy to pistachio the 7% of the cases of tree nut causing allergic reactions. In order to protect public health and enforce the legislation, methods for sensitive analysis of pistachio and peanut contents in food are required. Pea, pistachio and peanut are used together, to reduce the cost in food production such as baklava, snack foods.DNA technology-based methods in food analysis are well-established and well-roundedtools for species differentiation, allergen detection. Especially, the probe-based TaqMan real-time PCR assay can amplify target DNA with efficiency, specificity, and sensitivity.In this study, pistachio, peanut and pea were finely ground and three separate series of triplet mixtures containing 0.1, 1, 10, 100, 1000, 10,000 and 100,000 mg kg-1 of each sample were prepared for each series, to a final weight of 100 g. DNA from reference samples and industrial products was successfully extracted with the GIDAGEN® Multi-Fast DNA Isolation Kit. TaqMan probes were designed for triplex determination of ITS, Ara h 3 and pea lectin genes which are specific regions for identification pistachio, peanut and pea, respectively.The real-time PCR as quantitative detected pistachio, peanut and pea in these mixtures down to the lowest investigated level of 0.1, 0.1 and 1 mg kg-1, respectively. Also, the methods reported here are capable of detecting of as little as 0.001% level of peanut DNA, 0,000001% level of pistachio DNA and 0.000001% level of pea DNA. We accomplish that the quantitative triplex real-time PCR method developed in this study canbe applied to detect pistachio, peanut and peatraces for three allergens at once in commercial food products.

Keywords: allergens, DNA, real-time PCR, TaqMan probe

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Authors: Sahar Fahmy Mehanna

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Wild fisheries and aquaculture offer excellent opportunities to decrease hunger and improve nutrition, relieve poverty, create economic growth and guarantee healthier use of natural resources. Employment in fisheries and aquaculture has grown continuously quicker than in the agriculture sector, providing up to 55 million jobs worldwide. Fisheries and aquaculture supplied Egypt with 2.1 million tons of fish in 2021, mostly used as food for people. Fish production in Egypt has grown dramatically in the last three decades, where fish production increased from about 346 thousand tons in 1990 to up to 2.1 million tons in 2021. In contrast to natural resources, which increased by only 30% in the period from 1990 to 2021, aquaculture production increased by 2502% during the same period. The majority of wild fisheries production in Egypt arises from coastal areas, where pollution is one of the main challenges severely affected both the productivity and quality of fish stocks. Our marine resources are at the risk of irreversible loss to habitats, ecological functions, and biodiversity because of overfishing, pollution, destructive fishing methods, climatic changes, unsustainable coastal area development and the competing demands from different industrial uses and human activities. Illegal, Unreported and Unregulated (IUU) Fishing continues to be a big challenge to achieve sustainable fisheries. Furthermore, poor governance, management and practices are a further challenge. Reducing overfishing, stimulating responsible and sustainable fisheries management, applying aquaculture new and friendly practices and conserving the marine environment health are among the government’s best opportunities to provide highly nutritious food to the increasing population in Egypt. The present presentation will discuss the fishery regulations in the Egyptian marine fisheries that taken to maintain, protect and promote the different Egyptian marine environments and to what extent these regulations were effective.

Keywords: egypt, marine fisheries, fishery regulations, fisheries management, Marine ecosystem conservation

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Authors: Judith Mogouong, Philippe Constant, Robert Lavallee, Claude Guertin

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The emerald ash borer (EAB) is an exotic wood borer insect native from China, which is associated with important environmental and economic damages in North America. Beetles are known to be vectors of microbial communities related to their adaptive capacities. It is now established that environmental stress factors may induce physiological events on the host trees, such as phytochemical changes. Consequently, that may affect the establishment comportment of herbivorous insect. Considering the number of insects collected on ash trees (insects’ density) as an abiotic factor related to stress damage, the aim of our study was to explore the dynamic of EAB gut microbial community genome (microbiome) when facing that factor and to monitor its diversity. Insects were trapped using specific green Lindgren© traps. A gradient of the captured insect population along the St. Lawrence River was used to create three levels of insects’ density (low, intermediate, and high). After dissection, total DNA extracted from insect guts of each level has been sent for amplicon sequencing of bacterial 16S rRNA gene and fungal ITS2 region. The composition of microbial communities among sample appeared largely diversified with the Simpson index significantly different across the three levels of density for bacteria. Add to that; bacteria were represented by seven phyla and twelve classes, whereas fungi were represented by two phyla and seven known classes. Using principal coordinate analysis (PCoA) based on Bray Curtis distances of 16S rRNA sequences, we observed a significant variation between the structure of the bacterial communities depending on insects’ density. Moreover, the analysis showed significant correlations between some bacterial taxa and the three classes of insects’ density. This study is the first to present a complete overview of the bacterial and fungal communities associated with the gut of EAB base on culture-independent methods, and to correlate those communities with a potential stress factor of the host trees.

Keywords: gut microbiome, DNA, 16S rRNA sequences, emerald ash borer

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Authors: Iacopo Testi, Diego Pajarito, Nicoletta Roberto, Carmen Greco

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Today, a consistent segment of the world’s population lives in urban areas, and this proportion will vastly increase in the next decades. Therefore, understanding the key trends in urbanization, likely to unfold over the coming years, is crucial to the implementation of sustainable urban strategies. In parallel, the daily amount of digital data produced will be expanding at an exponential rate during the following years. The analysis of various types of data sets and its derived applications have incredible potential across different crucial sectors such as healthcare, housing, transportation, energy, and education. Nevertheless, in city development, architects and urban planners appear to rely mostly on traditional and analogical techniques of data collection. This paper investigates the prospective of the data science field, appearing to be a formidable resource to assist city managers in identifying strategies to enhance the social, economic, and environmental sustainability of our urban areas. The collection of different new layers of information would definitely enhance planners' capabilities to comprehend more in-depth urban phenomena such as gentrification, land use definition, mobility, or critical infrastructural issues. Specifically, the research results correlate economic, commercial, demographic, and housing data with the purpose of defining the youth economic discomfort index. The statistical composite index provides insights regarding the economic disadvantage of citizens aged between 18 years and 29 years, and results clearly display that central urban zones and more disadvantaged than peripheral ones. The experimental set up selected the city of Rome as the testing ground of the whole investigation. The methodology aims at applying statistical and spatial analysis to construct a composite index supporting informed data-driven decisions for urban planning.

Keywords: data science, spatial analysis, composite index, Rome, urban planning, youth economic discomfort index

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Authors: Andrea Corsale

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The historical and geographical regions of Banat and Crişana in Western Romania have long been characterized by a high degree of ethnic diversity. However, this traditionally complex cultural, linguistic, and religious mosaic has undergone a progressive simplification during the past century due to deportations, emigration, and assimilation, and both regions now have a large Romanian-speaking majority population. This contribution focuses on Jewish heritage in the two largest cities of these two regions, Timişoara (Banat) and Oradea (Crişana). The two cities shared some historical events but also went through different experiences, despite their relative geographic proximity. The Jewish community of Timişoara survived the Holocaust basically intact, an almost unique case in Central-Eastern Europe, but largely left the city after the war. Instead, the Jewish community of Oradea was almost completely deported and killed in Auschwitz, and a renewed post-war community gradually emigrated abroad in the following decades. The two Jewish communities are now very small in size but inherited a vast tangible and intangible heritage (synagogues, cemeteries, community buildings, characteristic architecture, memories, local traditions, and histories), partially restored and recovered in recent years. The author’s fieldwork shows that local Jewish stakeholders are aware of the potential of this heritage in terms of cultural and economic benefits, but significant weaknesses and concerns exist, as the small dimension of these communities, and their financial constraints, challenge their future role in the eventual promotion and management of this heritage, which is now basically in the hands of the non-Jewish public and private stakeholders. Projects, experiences, and views related to Jewish heritage conservation and promotion in these two contexts will be portrayed and analysed in order to contribute to a broader discussion on representations and narratives of minority heritage within cultural tourism development dynamics.

Keywords: Jewish heritage, ethnic minorities, heritage tourism, Romania

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Authors: S. K. Kakraliya, H. S. Jat, Manish Kakraliya, P. C. Sharma, M. L. Jat

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The biggest challenge in agriculture is to produce more food for the continually increasing world population with in the limited land and water resources. Serious water deficits and reducing natural resources are some of the major threats to the agricultural sustainability in many regions of South Asia. Food and water security may be gained by bringing improvement in the crop water productivity and the amount produced per unit of water consumed. Improvement in the crop water productivity may be achieved by pursuing alternative modern agronomics approaches, which are more friendly and efficient in utilizing natural resources. Therefore, a research trial on conservation agriculture (CA) and precision water management (PWM) was conducted in 2018-19 at Karnal, India to evaluate the effect on crop productivity and irrigation in sodic soils under rice-wheat (RW) systems of Indo-Gangetic Plains (IGP). Eight scenarios were compared varied in the tillage, crop establishment, residue and irrigarion management i.e., {First four scenarios irrigated with flood irrigation method;Sc1-Conventional tillage (CT) without residue, Sc2-CT with residue, Sc3- Zero tillage (ZT) without residue, Sc4-ZT with residue}, and {last four scenarios irrigated with sub-surface drip irrigation method; Sc5-ZT without residue, Sc6- ZT with residue, Sc7-ZT inclusion legume without residue and Sc8- ZT inclusion legume with residue}. Results revealed that CA-flood irrigation (S3, Sc4) and CA-PWM system (Sc5, Sc6, Sc7 and Sc8) recorded about ~5% and ~15% higher wheat yield, respectively compared to Sc1. Similar, CA-PWM saved ~40% irrigation water compared to Sc1. Rice yield was not different under different scenarios in the first year (kharif 2019) but almost half irrigation water saved under CA-PWM system. Therefore, results of our study on modern agronomic practices including CA and precision water management (subsurface drip irrigation) for RW rotation would be addressed the existing and future challenges in the RW system.

Keywords: Sub-surface drip, Crop residue, Crop yield , Zero tillage

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Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

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Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

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Authors: Metkel Gebremedhin, Biruk Kebede, Guash Abay

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Job satisfaction largely determines the productivity and efficiency of human resources for health. There is scanty evidence on factors influencing the job satisfaction of health extension professionals (HEPs) in Addis Ababa. The objective of this study was to determine the level of and factors influencing job satisfaction among extension health workers in Addis Ababa city. This was a cross-sectional study conducted in Addis Ababa, Ethiopia. Among all public health centers found in the Addis Ababa city administration health bureau that would be included in the study, a multistage sampling technique was employed. Then we selected the study health centers randomly and urban health extension professionals from the selected health centers. In-depth interview data collection methods were carried out for a comprehensive understanding of factors affecting job satisfaction among Health extension professionals (HEPs) in Addis Ababa. HEPs working in Addis Ababa areas are the primary study population. Multivariate logistic regression with 95% CI at P ≤ 0.05 was used to assess associated factors to job satisfaction. The overall satisfaction rate was 10.7% only, while 89.3%% were dissatisfied with their jobs. The findings revealed that variables such as marital status, staff relations, community support, supervision, and rewards have a significant influence on the level of job satisfaction. For those who were not satisfied, the working environment, job description, low salary, poor leadership and training opportunities were the major causes. Other factors influencing the level of satisfaction were lack of medical equipment, lack of transport facilities, lack of training opportunities, and poor support from woreda experts. Our study documented a very low level of overall satisfaction among health extension professionals in Addis Ababa city public health centers. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of extension health professionals as they represent a sensitive domain of the health system of Addis Ababa city. Improving the overall work environment, review of job descriptions and better salaries might bring about a positive change.

Keywords: job satisfaction, extension health professionals, Addis Ababa

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Authors: Purnima Anjali Mohanty, Mousumi Padhi

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Background of the study: In the background of the passage of the Transgender Bill 2016, which is the first such step of formal recognition of the rights of transgender, the Hijras have been recognized under the wider definition of Transgender. Fascinatingly, in the Hindu social context, Hijras have a long social standing during marriages and childbirths. Other than this ironically, they live an ostracized life. The Bill rather than recognizing their unique characteristics and needs, reinforces the societal dualism through a parallelism of their legal rights with rights available to women. Purpose of the paper: The research objective was to probe why and to what extent did they identify themselves with the feminine gender roles. Originality of the paper: In the Indian context, the subject of eunuch has received relatively little attention. Among the studies that exist, there has been a preponderance of studies from the perspective of social exclusion, rights, and physical health. There has been an absence of research studying the self-identity of Hijras from the gender perspective. Methodology: The paper adopts the grounded theory method to investigate and discuss the underlying gender identity of transgenders. Participants in the study were 30 hijras from various parts of Odisha. 4 Focus group discussions were held for collecting data. The participants were approached in their natural habitat. Following the methodological recommendations of the grounded theory, care was taken to select respondents with varying experiences. The recorded discourses were transcribed verbatim. The transcripts were analysed sentence by sentence, and coded. Common themes were identified, and responses were categorized under the themes. Data collected in the latter group discussions were added till saturation of themes. Finally, the themes were put together to prove that despite the demand for recognition as third gender, the eunuchs of Odisha identify themselves with the feminine roles. Findings: The Hijra have their own social structure and norms which are unique and are in contrast with the mainstream culture. These eunuchs live and reside in KOTHIS (house), where the family is led by a matriarch addressed as Maa (mother) with her daughters (the daughters are eunuchs/effeminate men castrated and not castrated). They all dress up as woman, do womanly duties, expect to be considered and recognized as woman and wife and have the behavioral traits of a woman. Looking from the stance of Feminism one argues that when the Hijras identify themselves with the gender woman then on what grounds they are given the recognition as third gender. As self-identified woman; their claim for recognition as third gender falls flat. Significance of the study: Academically it extends the study of understanding of gender identity and psychology of the Hijras in the Indian context. Practically its significance is far reaching. The findings can be used to address legal and social issues with regards to the rights available to the Hijras.

Keywords: feminism, gender perspective, Hijras, rights, self-identity

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Authors: Upasana G. Singh, Meera Gungea

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Learning is no more confined to the traditional classroom, teacher, and student interaction. Many universities offer courses through the Open and Distance Learning (ODL) mode, attracting a diversity of learners in terms of age, gender, and profession to name a few. The ODL mode has surfaced as one of the famous sought-after modes of learning, allowing learners to invest in their educational growth without hampering their personal and professional commitments. This mode of learning, however, requires that those who ultimately choose to adopt it must be prepared to undertake studies through such medium. The purpose of this research is to assess whether students who join universities offering courses through the ODL mode are ready to embark and study within such a framework. This study will be helpful to unveil the challenges students face in such an environment and thus contribute to developing a framework to ease adoption and integration into the ODL environment. Prior to the implementation of e-learning, a readiness assessment is essential for any institution that wants to adopt any form of e-learning. Various e-learning readiness assessment models have been developed over the years. However, this study is based on a conceptual model for e-Learning Readiness Assessment which is a ‘hybrid model’. This hybrid model consists of 4 main parameters: 1) Technological readiness, 2) Culture readiness, 3) Content readiness, and 4) Demographics factors, with 4 sub-areas, namely, technology, innovation, people and self-development. The model also includes the attitudes of users towards the adoption of e-learning as an important aspect of assessing e-learning readiness. For this study, some factors and sub-factors of the hybrid model have been considered and adapted, together with the ‘Attitude’ component. A questionnaire was designed based on the models and students where the target population were students enrolled at the Open University of Mauritius, in undergraduate and postgraduate courses. Preliminary findings indicate that most (68%) learners have an average knowledge about ODL form of learning, despite not many (72%) having previous experience with ODL. Despite learning through ODL 74% of learners preferred hard copy learning material and 48% found difficulty in reading learning material on electronic devices.

Keywords: open learning, distance learning, student readiness, a hybrid model

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Authors: Umar Rehman, Holly Roy, K. T. Tsang, D. S. Jeyaretna, W Singleton, B. Fisher, P. A. Glew, J. Greig, Peter C. Whitfield

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Introduction: A brain abscess is a life-threatening condition, carrying significant mortality. It requires rapid identification and treatment. Management involves a combination of antibiotics and surgery. The aim of the current study was to identify common bacteria responsible for cerebral abscesses as well as the long term functional and neurological outcomes of patients following treatment in a retrospective series at a single UK neurosurgical centre. Methodology: We analysed patients that had received a diagnosis of 'cerebral abscess' or 'subdural empyema' between June 2002 and June 2018. This was done in the form of a retrospective review. The search resulted in a total of 180 patients; with 37 patients being excluded (spinal abscess, below 18 or non-abscess related admissions). Data were collected from medical case notes including information about demographics, comorbidities, immunosuppression, presentation, size/location of lesions, pathogens, treatment, and outcomes. Results: In total, we analysed 143 patients between the ages of 18-90. Focal neurological deficit and headaches were seen in 84% and 68% of patients respectively. 108 positive brain cultures were seen; with the largest proportion, 59.2% being gram-positive cocci, with strep intermedius being the most common pathogen identified in 13.9% of patients. Of the patients with positive blood cultures (n=11), 72.7% showed the same organism both in the blood and on the brain cultures. Long term outcomes (n=72) revealed that 48% of patients seizure-free without requiring anti-epileptics, 51.3% of patients had full recovery of their neurological symptoms. There was a mortality rate of 13.9% in the series. Conclusion: In conclusion, the largest bacterial cause of abscess within our population was due to gram-positive cocci. The majority of the patient demonstrated full neurological recovery with close to half of patients not requiring anti-epileptics following discharge.

Keywords: bacteria, cerebral abscess, long term outcome, neurological deficit

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Authors: Laid Fekih

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Background: The purpose of this paper is to examine the psychological stressors caused by urbanization, a field study conducted on a sample range of youth who live in urban areas. Some of them reside in areas with green surroundings while others reside in lack of green areas, which saw the terrible expansion of urban. The study included the impact of urbanization on the mental health of youths; select the psychological problems most commonly caused by urbanization, and the impact of green spaces in alleviating stress. Method: The method used in this research is descriptive, as the data collected from a sample of 160 young men were analyzed. The tool used is the psychological distress test. We proceeded with some statistical techniques, which provided percentages, analysis of variance, and t-tests. Results: The findings of this research were: (i) The psychological stressors caused by urban expansion are mainly in the intensity of stress, incompetence, emotional, and psychosomatic problems. (ii) There was a statistically significant difference at the level of significance 0.02 among young people who live in places in green spaces and without green space in terms of psychological stressors, in favor of young people who live in places free of greenery. (iii) The quality of this primary variable effect of housing (rental or ownership) is statistically significant in favor of young people living in rented accommodation. Conclusion: The green spaces provided by Tlemcen city are inadequate and insufficient to fulfill the population's requirements for contact with nature, leading to such effects that may negatively affect mental health, which makes it a prominent process that should not be neglected. Incorporating green spaces into the design of buildings, homes, and communities to create shared spaces, which facilitate interaction and foster well-being, becomes the main purpose. We think this approach can support the reconstruction of the built environment with green spaces by facilitating the link between psychological stress perception studies and technologies.

Keywords: psychological stressors, urbanization, psychological problems, green spaces

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Authors: Jemely M. Punzalan, Christine B. Bernal, Beatrice B. Canonigo, Maria Rosario F. Cabansag, Dennis S. Flores, Paul Joseph T. Galutira, Remedios D. Chan

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Background: Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders predominates in women of childbearing age. Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) is the only health specific quality of life tool for pediatric SLE, which has been translated to different languages except in Filipino. Objective: The primary objective of this study was to develop a Filipino translation of the SMILEY and to examine the validity and reliability of this translation. Methodology: The SMILEY was translated into Filipino by a bilingual individual and back-translated by another bilingual individual blinded from the original English version. The translation was evaluated for content validity by a panel of experts and subjected to pilot testing. The pilot-tested translation was used in the validity and reliability testing proper. The SMILEY, together with the previously validated PEDSQL 4.0 Generic Core Scale was administered to lupus pediatric patients and their parent at two separate occasions: a baseline and a re-test seven to fourteen days apart. Tests for convergent validity, internal consistency, and test-retest reliability were performed. Results: A total of fifty children and their parent were recruited. The mean age was 15.38±2.62 years (range 8-18 years), mean education at high school level. The mean duration of SLE was 28 months (range 1-81 months). Subjects found the questionnaires to be relevant, easy to understand and answer. The validity of the SMILEY was demonstrated in terms of content validity, convergent validity, internal consistency, and test-retest reliability. Age, socioeconomic status and educational attainment did not show a significant effect on the scores. The difference between scores of child and parent report was showed to be significant with SMILEY total (p=0.0214), effect on social life (p=0.0000), and PEDSQL physical function (p=0.0460). Child reports showed higher scores for the following domains compared to their parent. Conclusion: SMILEY is a brief, easy to understand, valid and reliable tool for assessing pediatric SLE specific HRQOL. It will be useful in providing better care, understanding and may offer critical information regarding the effect of SLE in the quality of life of our pediatric lupus patients. It will help physician understands the needs of their patient not only on treatment of the specific disease but as well as the impact of the treatment on their daily lives.

Keywords: systemic lupus erythematosus, pediatrics, quality of life, Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY)

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Authors: Nermeen Elbeltagy, Helmy abd Elsatar, Sara Hassan, Mohamed Darwish

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Introduction: with the inial appearance in Wuhan, China, in December 2019, the coronavirus disease-related respiratory infection (COVID-19) has rapidly spread among people all over the world. The WHO considered it a pandemic in March 2020. The severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreaks have proved that pregnant females as well as their fetuses are exposed to adverse outcomes, including high rates of intensive care unit (ICU) admission and case fatality. Physiological changes occurring during pregnancy such as the increased transverse diameter of the thoracic cage as well as the elevation of the diaphragm can expose the mother to severe infections because of her decreased tolerance for hypoxia. Furthermore, vasodilation and changes in lung capacity can cause mucosal edema and an increase in upper respiratory tract secretions. In addition, the increased susceptibility to infection is enhanced by changes in cellmediated immunity. Aim of the work: to study the effect of COVID-19 on pregnant females admitted to El-Shatby Maternity University Hospital regarding maternal antepartum, intrapartum and postpartum adverse effects on the mothers and their neonates. Method: A retrospective cohort study was done between October 2020 and October 2022. Maternal characteristics and associated health conditions of COVID-19 positive parents were investigated. Also, the severity of their conditions and me of infection (first or second or third trimester)were explored. Cases were diagnosed based on presence of symptoms suggestive of COVID-19, laboratory tests (other than PCR) and radiological findings.all cases were confirmed by positive PCR test results. Results: The most common adverse maternal outcomes were pre-term labor (11.6%) followed by premature rupture of membranes (5.7%), post-partum hemorrhage (5.4%), preeclampsia (5.0%) and placental abrupon (4.3%). One sixth of the neonates of the studied paents were admied to NICUs and 6.5% of them had respiratory distress with no neonatal deaths. The majority of neonates (85.4%) had a birth weight of 2500- 4000g (normal range). Most of the neonates (77.9%) had an APGAR score of equal or more than 7 in 5 minutes. Conclusion: the most common comorbidity that might increase the incidence of COVID-19 before pregnancy were diabetes, cardiac disorders/ chronic hypertension and chronic obstructive lung diseases (non-asthma). During pregnancy, anemia followed by gestational diabetes and pre-eclampsia/gestational hypertension were the most prevalent comorbidity. So, severity of infection can be reduced by good antenatal care.

Keywords: COVID-19, pregnancy outcome, complicated pregnancy., COVID in Egypt

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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Authors: Mahera Abdulrahman, Satish Chandrasekhar Nair

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Growing demand for human health research in the United Arab Emirates (UAE) has prompted the need to develop a robust research ethics oversight, particularly given the large unskilled-worker immigrant population and the elderly citizens utilizing health services. Examination of the structure, function, practices and outcomes of the human research ethics committees (HREC) was conducted using two survey instruments, reliable and validated. Results indicate that in the absence of a national ethics regulatory body, the individual emirate’s governed 21 HRECs covering health facilities and academic institutions in the UAE. Among the HRECs, 86% followed International Council for Harmonization-Good Clinical Practice guidelines, 57% have been in operation for more than five years, 81% reviewed proposals within eight weeks, 48% reviewed for clinical and scientific merit apart from ethics, and 43% handled more than 50 research proposals per year. However, researcher recognition, funding transparency, adverse event reporting systems were widespread in less than one-third of all HRECs. Surprisingly, intellectual property right was not included as a research output. Research was incorporated into the vision and mission statements of many (62%) organizations and, mechanisms such as research publications, collaborations, and recognitions were employed as key performance indicators to measure research output. In spite, resources to generate research output such as dedicated budget (19%), support staff (19%) and continuous training and mentoring program for medical residents and HREC members were somehow lacking. HREC structure and operations in the UAE are similar to other regions of the world, resources allocation for efficient, quality monitoring, continuous training, and the creation of a clinical research network are needed to strengthen the clinical research enterprise to scale up for the future. It is anticipated that the results of this study will benefit investigators, regulators, pharmaceutical sponsors and the policy makers in the region.

Keywords: institutional review board, ethics committee, human research ethics, United Arab Emirates (UAE)

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Authors: Peter David Reiss

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The concept of the psychosis prodrome has allowed for the identification of adolescent and young adult patients who have a significantly elevated risk of developing schizophrenia spectrum disorders. A number of different interventions have been tested in order to prevent or delay progression of symptoms. To date, there has been no consistent meta-analytical evidence to support efficacy of antipsychotic treatment for patients in the prodromal state, and their use remains therefore inconclusive. Although antipsychotics may manage symptoms transiently, they have not been found to prevent or delay onset of psychotic disorders. Furthermore, pharmacological intervention in high-risk individuals remains controversial, because of the antipsychotic side effect profile in a population in which only about 20 to 35 percent will eventually convert to psychosis over a two-year period, with even after two years conversion rates not exceeding 30 to 40 percent. This general estimate is additionally problematic, in that it ignores the fact that there is significant variation in individual risk among clinical high-risk cases. The current lack of reliable tests for at-risk patients makes it difficult to justify individual treatment decisions. Preventive treatment should ideally be dictated by an individual’s risk while minimizing potentially harmful medication exposure. This requires more accurate predictive assessments by using valid and accessible prognostic markers. The following will compare prediction and risk modification potential of behavioral biomarkers such as disturbances of basic sense of self and emotion awareness, neurocognitive biomarkers such as attention, working and declarative memory, and neurophysiological biomarkers such as glutamatergic abnormalities and NMDA receptor dysfunction. Identification of robust biomarkers could therefore not only provide more reliable means of psychosis prediction, but also help test and develop new clinical interventions targeted at the prodromal state.

Keywords: at-risk mental state, biomarkers, glutamatergic system, NMDA receptor, psychosis prodrome, schizophrenia

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