Search results for: urban delicacy management

Authors: Bushra Alghamdi, Alla Alsharif, Hamzah Aljohani, Saba Kassim

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Introduction: Collaborative work has always been acknowledged as a fundamental concept in delivering oral health care. Aim: This study aimed to assess the perception and attitude of pharmacists in oral health promotion and to determine the confident levels of pharmacists in delivering advice on oral health problems. Methods: An observational cross-sectional survey, using self-administered anonymous questionnaires, was conducted between March and April 2017. The study recruited a convenience sample of registered community pharmacists who were working in local private pharmaceutical stores in the urban area of Madinah, Kingdom of Saudi Arabia (KSA). A preliminary descriptive analysis was performed. Results: Thirty-five pharmacists have completed the surveys. All participants were males, with a mean age of 35.5 ( ± 6.92) years. Eighty-six percent of the participants reported that pharmacists should have a role in oral health promotion. Eighty percent have reported adequate level of confident when giving advice on most of the common oral health problems that include; oral health related risk behaviors such as tobacco cessation (46%), bleeding gums (63%) and sensitive teeth (60%). However, higher percentages of pharmacists have reported low confident levels when giving advice in relation to specific domain of dentistry, such as lost dental fillings (57%), loose crowns (60%), trauma to teeth (40%), denture-related problems (51%) and oral cancer (6.9%). Conclusion: Community pharmacists recognized their potential role in promoting oral health in KSA. Community pharmacists had varying levels of ability and confidence to offer support for oral health. The study highlighted that inner professional collaboration between pharmacists and dental care healthcare should be enhanced.

Keywords: community, oral health, promotion, pharmacist

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Authors: Abdulmalik Altuwayjiri, Milad Pirhadi, Mohammed Kalafy, Badr Alharbi, Constantinos Sioutas

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In this study, we investigated the chemical and toxicological characteristics of PM10 in the metropolitan area of Riyadh, Saudi Arabia. PM10 samples were collected on quartz and teflon filters during cold (December 2019–April 2020) and warm (May 2020–August 2020) seasons, including dust and non-dust events. The PM10 constituents were chemically analyzed for their metal, inorganic ions, and elemental and organic carbon (EC/OC) contents. Additionally, the PM10 oxidative potential was measured by means of the dithiothreitol (DTT) assay. Our findings revealed that the oxidative potential of the collected ambient PM10 samples was significantly higher than those measured in many urban areas worldwide. The oxidative potential of the collected ambient PM¹⁰⁻ samples was also higher during dust episodes compared to non-dust events, mainly due to higher concentrations of metals during these events. We performed Pearson correlation analysis, principal component analysis (PCA), and multi-linear regression (MLR) to identify the most significant sources contributing to the toxicity of PM¹⁰⁻ The results of the MLR analyses indicated that the major pollution sources contributing to the oxidative potential of ambient PM10 were soil and resuspended dust emissions (identified by Al, K, Fe, and Li) (31%), followed by secondary organic aerosol (SOA) formation (traced by SO₄-² and NH+₄) (20%), and industrial activities (identified by Se and La) (19%), and traffic emissions (characterized by EC, Zn, and Cu) (17%). Results from this study underscore the impact of transported dust emissions on the oxidative potential of ambient PM10 in Riyadh and can be helpful in adopting appropriate public health policies regarding detrimental outcomes of exposure to PM₁₀-

Keywords: ambient PM10, oxidative potential, source apportionment, Riyadh, dust episodes

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Authors: M. R. Rouhi, S. Shafiei, A. Taghavipour, H. Adibi-Asl, A. Doosthoseini

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This research targets at alleviating the problem of range anxiety associated with the battery electric vehicles (BEVs) by considering mechanical and control aspects of the powertrain. In this way, all the energy consuming components and their effect on reducing the range of the BEV and battery life index are identified. On the other hand, an appropriate control strategy is designed to guarantee the performance of the BEV and the extended electric range which is evaluated by an extensive simulation procedure and a real-world driving schedule.

Keywords: battery, electric vehicles, ultra-capacitor, model predictive control

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Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

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Background: A myriad of physical, psychosocial, and environmental sequelae are associated with limb loss. However, there is a paucity of empirical South African data, which focuses on these sequelae, how they interface with the amputee’s quality of life as well as the challenges they experience following amputation. Objective: This study sought to explore the biopsychosocial effects of amputation and how amputation affected the quality of life of transtibial amputees. Setting: Participants were recruited from a medical facility, under the KwaZulu-Natal Department of Health in South Africa. Methods: A qualitative approach guided this study. Data was collected using one-on-one interviews with 14 unilateral transtibial amputees. Data was analysed thematically. Results: Five broad themes emerged from the inquiry, which captured amputees’ experiences of phantom limb pain, body image disturbances, and their challenges related to adapting to daily activities. Participants also expressed the salience of familial support as well as the importance of psychological interventions to cope. Conclusion: The findings suggested that support networks and professional psychological intervention are imperative in facilitating successful adjustment to the amputation experience. Raising awareness of limb loss in both, rural and urban settings may help reduce the stigma attached to it. Contribution: Quality of life comprises several domains, namely physical, psychological, environmental, and social albeit limited local and international data exists regarding the environmental and social effects. This study brought to the fore the positive and negative effects of amputation in each domain, as well as various strategies that facilitate successful adjustment to amputation.

Keywords: amputation, quality of life, biopsychosocial, phantom limb pain, body image, support

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Authors: Amit Kumar

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Accurate identification of deteriorated air quality regions is very helpful in devising better environmental practices and mitigation efforts. In the present study, an attempt has been made to identify the air pollutant dispersion patterns especially NOX due to vehicular and industrial sources over a rapidly developing urban city, Visakhapatnam (17°42’ N, 83°20’ E), India, during April 2009. Using the emission factors of different vehicles as well as the industry, a high resolution 1 km x 1 km gridded emission inventory has been developed for Visakhapatnam city. A dispersion model AERMOD with explicit representation of planetary boundary layer (PBL) dynamics and offline coupled through a developed coupler mechanism with a high resolution mesoscale model WRF-ARW resolution for simulating the dispersion patterns of NOX is used in the work. The meteorological as well as PBL parameters obtained by employing two PBL schemes viz., non-local Yonsei University (YSU) and local Mellor-Yamada-Janjic (MYJ) of WRF-ARW model, which are reasonably representing the boundary layer parameters are considered for integrating AERMOD. Significantly different dispersion patterns of NOX have been noticed between summer and winter months. The simulated NOX concentration is validated with available six monitoring stations of Central Pollution Control Board, India. Statistical analysis of model evaluated concentrations with the observations reveals that WRF-ARW of YSU scheme with AERMOD has shown better performance. The deteriorated air quality locations are identified over Visakhapatnam based on the validated model simulations of NOX concentrations. The present study advocates the utility of tNumerical Simulation of Air Pollutant Using Coupled AERMOD-WRF Modeling System over Visakhapatnam: A Case Studyhe developed gridded emission inventory of NOX with coupled WRF-AERMOD modeling system for air quality assessment over the study region.

Keywords: WRF-ARW, AERMOD, planetary boundary layer, air quality

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Authors: Muhammad Mamoon-Ur-Rashid, Gul Rehman

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Entomopathogenic fungi are considered effective bio-control agents for the management of a range of insect pests including red palm weevil. The research studies were conducted under laboratory and field conditions against 5th and 6th instars larvae and adults of [Rhynchophorus ferrugineus (Olivier)] at the faculty of Agriculture, Gomal University Dera Ismail Khan (KPK) Pakistan. The 5th instar larvae were used under field conditions whereas, the 6th instar larvae and newly emerged adults were used under lab conditions. Conidial suspensions were used at five different concentrations of 1×10⁴, 1×10⁵, 1×10⁶, 1×10⁷ and 1×10⁸, conidia per ml. The data were recorded on the mortality, total larval duration, weight of larvae, pre-pupal and pupal durations, percent pupal formation, pupal weight, percent adult emergence, and adult longevity (♂ and ♀) of red palm weevil. The B. bassiana had varying degrees of pathogenicity against different developmental stages of red palm weevil. The maximum larval duration (113.40 days) was noted when 5th instar larvae were treated with the maximum concentration (1 × 10⁸) of B. bassiana, whereas; the minimum total larval duration of 87.20 days was recorded on the lowest concentration (1 × 10⁴) of B. bassiana. The maximum pre-pual and pupal durations were noted at the maximum concentration. The maximum life span of adult male and females were noted at the lowest concentration, whereas; the minimum values were noted at the maximum concentration. The earliest mortality of red palm weevil was observed 1-day after treatment at higher concentrations of 1 × 10⁷ and 1 × 10⁸, whereas; it was recorded 3 and 4 days after treatment at lower concentrations of 1 × 10⁵ and 1 × 10⁴. At 10 days after treatment, the entomopathogenic fungus caused > 80% cumulative mortality of 5th and 6th instar larvae and adult weevils at the maximum concentrations which were more than double than those recorded at the lowest concentration. Overall, the 5th instar larvae of red palm weevils were most susceptible to the fungus compared to the 6th instar larvae and adult weevils. Based on current findings, it is suggested that entomopathogenic fungi could be used for the safer management of red palm weevil.

Keywords: entomopathogenic nematodes, mortality, red palm weevil, sub-lethal effects

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Authors: Muhammad Safi, Abdul Manan

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In recent years, research in aircraft avionics systems (i.e., radars and antennas) has grown revolutionary. Aircraft technology is experiencing an increasing inclination from all mechanical to all electrical aircraft, with the introduction of inhabitant air vehicles and drone taxis over the last few years. This develops an overriding need to summarize the history, latest trends, and future development in aircraft avionics research for a better understanding and development of new technologies in the domain of avionics systems. This paper focuses on the future trends in antennas and phased arrays for avionics systems. Along with the general overview of the future avionics trend, this work describes the review of around 50 high-quality research papers on aircraft communication systems. Electric-powered aircraft have been a hot topic in the modern aircraft world. Electric aircraft have supremacy over their conventional counterparts. Due to increased drone taxi and urban air mobility, fast and reliable communication is very important, so concepts of Broadband Integrated Digital Avionics Information Exchange Networks (B-IDAIENs) and Modular Avionics are being researched for better communication of future aircraft. A Ku-band phased array antenna based on a modular design can be used in a modular avionics system. Furthermore, integrated avionics is also emerging research in future avionics. The main focus of work in future avionics will be using integrated modular avionics and infra-red phased array antennas, which are discussed in detail in this paper. Other work such as reconfigurable antennas and optical communication, are also discussed in this paper. The future of modern aircraft avionics would be based on integrated modulated avionics and small artificial intelligence-based antennas. Optical and infrared communication will also replace microwave frequencies.

Keywords: AI, avionics systems, communication, electric aircrafts, infra-red, integrated avionics, modular avionics, phased array, reconfigurable antenna, UAVs

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Authors: Francisco Javier Montes Ruiz-Cabello, Guillermo Guerrero-Vacas, Sara Bermudez-Romero, Miguel Cabrerizo Vilchez, Miguel Angel Rodriguez-Valverde

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Galvanized steel is one of the widespread metallic materials used in industry. It consists on a iron-based alloy (steel) coated with a layer of zinc with variable thickness. The zinc is aimed to prevent the inner steel from corrosion and staining. Its production is cheaper than the stainless steel and this is the reason why it is employed in the construction of materials with large dimensions in aeronautics, urban/ industrial edification or ski-resorts. In all these applications, turning the natural hydrophilicity of the metal surface into superhydrophobicity is particularly interesting and would open a wide variety of additional functionalities. However, producing a superhydrophobic surface on galvanized steel may be a very difficult task. Superhydrophobic surfaces are characterized by a specific surface texture which is reached either by coating the surface with a material that incorporates such texture, or by conducting several roughening methods. Since galvanized steel is already a coated material, the incorporation of a second coating may be undesired. On the other hand, the methods that are recurrently used to incorporate the surface texture leading to superhydrophobicity in metals are aggressive and may damage their surface. In this work, we used a novel strategy which goal is to produce superhydrophobic galvanized steel by a two-step non-aggressive process. The first process is aimed to create a hierarchical structure by incorporating zinc nanoparticles sintered on the surface at a temperature slightly lower than the zinc’s melting point. The second one is a hydrophobization by a thick fluoropolymer layer deposition. The wettability of the samples is characterized in terms of tilting plate and bouncing drop experiments, while the roughness is analyzed by confocal microscopy. The durability of the produced surfaces was also explored.

Keywords: galvanaized steel, superhydrophobic surfaces, sintering nanoparticles, zinc nanopowder

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Authors: Tris Kee

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This research investigates social sustainability factors in transitional housing projects and their impact on fostering healthy living environments that promote physical activity and social interaction for residents. Social sustainability is integral to individual health and well-being, as emphasized by Goal 11 of the 2030 Agenda for Sustainable Development, which highlights the importance of safe, affordable, and accessible transport systems, green spaces, and public spaces catering to vulnerable populations' needs. Communal spaces in urban environments are essential for fostering social sustainability, as they serve as settings for physical activities and social interactions among diverse socio-economic groups. Factors such as neighborhood social atmosphere, historical context, social disparity, and mobility can influence the relationship between existing and transitional communities. Mental health effects can be measured through housing segregation, mobility and accessibility, and housing tenure. A significant research gap exists in understanding the living environment of transitional housing in Hong Kong and the social sustainability factors affecting residents' mental and physical health. To address this gap, our study employs a mixed-methods approach combining survey questionnaires and interviews to gather both quantitative and qualitative data. This methodology will provide comprehensive insights into residents' experiences and perceptions. Our research's main contribution is identifying key social sustainability factors in transitional housing and their impact on residents' well-being, informing policy-making and the creation of inclusive, healthy living environments. By addressing this research gap, we aim to provide valuable insights for future housing projects, ultimately promoting the development of socially sustainable transitional communities.

Keywords: social sustainablity, affordable housing, transitional housing, high density housing

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Authors: Ziara Carmelli G. Tan, Irene Carmelle S. Tan

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Background: Trichotillomania (TTM) and Major Depressive Disorder (MDD) are two psychiatric conditions that frequently co-occur, presenting a significant challenge for treatment due to their complex interplay. TTM involves repetitive hair-pulling, leading to noticeable hair loss and distress, while MDD is characterized by persistent low mood and loss of interest or pleasure, leading to dysfunctionality. This case report examines the intricate relationship between TTM and MDD in a young adult female, emphasizing the need for a comprehensive, multifaceted therapeutic approach to address both disorders effectively. Case Presentation: The patient is a 21-year-old female college student and youth church leader who presented with chronic hair-pulling and depressive symptoms. Her premorbid personality was marked by low self-esteem and a strong need for external validation. Despite her academic and social responsibilities and achievements, she struggled with managing her emotional distress, which was exacerbated by her family dynamics and her role within her church community. Her hair-pulling and mood symptoms were particularly triggered by self-esteem threats and feelings of inadequacy. She was diagnosed with Trichotillomania, Scalp and Major Depressive Disorder. Intervention/Management: The patient’s treatment plan was comprehensive, incorporating both pharmacological and non-pharmacological interventions. Initial pharmacologic management was Fluoxetine 20mg/day up, titrated to 40mg/day with no improvement; hence, shifted to Escitalopram 20mg/day and started with N-acetylcysteine 600mg/day with noted significant improvement in symptoms. Psychotherapeutic strategies played a crucial role in her treatment. These included supportive-expressive psychodynamic psychotherapy, which helped her explore and understand underlying emotional conflicts. Cognitive-behavioral techniques were employed to modify her maladaptive thoughts and behaviors. Grief processing was integrated to help her cope with significant losses. Family therapy was done to address conflicts and collaborate with the treatment process. Psychoeducation was provided to enhance her understanding of her condition and to empower her in her treatment journey. A suicide safety plan was developed to ensure her safety during critical periods. An interprofessional approach, which involved coordination with the Dermatology service for co-management, was also a key component of her treatment. Outcome: Over the course of 15 therapy sessions, the patient demonstrated significant improvement in both her depressive symptoms and hair-pulling behavior. Her active engagement in therapy, combined with pharmacological support, facilitated better emotional regulation and a more cohesive sense of self. Her adherence to the treatment plan, along with the collaborative efforts of the interprofessional team, contributed to her positive outcomes. Discussion: This case underscores the significance of addressing both TTM and its comorbid conditions to achieve effective treatment outcomes. The intricate interplay between TTM and MDD in the patient’s case highlights the importance of a comprehensive treatment plan that includes both pharmacological and psychotherapeutic approaches. Supportive-expressive psychodynamic psychotherapy, Cognitive-behavioral techniques, and Family therapy were particularly beneficial in addressing the complex emotional and behavioral aspects of her condition. The involvement of an interprofessional team, including dermatology co-management, was crucial in providing holistic care. Future practice should consider the benefits of such a multidisciplinary approach to managing complex cases like this, ensuring that both the psychological and physiological aspects of the disorders are adequately addressed.

Keywords: cognitive-behavioral therapy, interprofessional approach, major depressive disorder, psychodynamic psychotherapy, trichotillomania

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Authors: Yu-Yao Wang, Xiao-Meng Hu, Joanne Yeung, Xiao-Yan Li

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The high private cost and unquantified external cost limit the development of reclaimed water. In this study, an integrated framework comprising life cycle assessment (LCA), quantitative microbial risk assessment (QMRA), and life cycle costing (LCC) was developed to evaluate both costs of reclaimed water supply in water systems of various scales. LCA assesses the environmental impacts, and QMRA estimates the associated pathogenic impacts. These impacts are monetized as external costs and analyzed with the private cost by LCC to count the total life cycle cost. The framework evaluated the Hong Kong urban water system in the baseline scenario (BS) and five wastewater reuse scenarios (RS). They are RSI: substituting freshwater for toilet flushing only, RSII: substituting both freshwater and seawater for toilet flushing, RSIII: using reclaimed water for all non-potable uses, RSIV: using reclaimed water for all non-potable uses and indirect potable uses, and RSV: non-potable use and indirect potable use by conveying 100% reclaimed water to recharge the reservoirs. The results show that substituting freshwater and seawater for toilet flushing has the least total life cycle cost, exhibiting that it is the most cost-effective option for Hong Kong. Meanwhile, the evaluation results show that the external cost of each scenario is comparable to the corresponding private cost, indicating the importance of the inclusion of comprehensive external cost evaluation in private cost assessment of water systems with reclaimed water supply.

Keywords: life cycle assessment, life cycle costing, quantitative microbial risk assessment, water reclamation, reclaimed water, alternative water resources

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Authors: M. D. Antoine

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Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in autism care (e.g., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year following an autism spectrum disorder (ASD) diagnosis to identify challenges and potential barriers to communication within the healthcare system in Ottawa, Canada. From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (e.g., family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (e.g., naturopath, occupational therapist, speech and language pathologist) operating in Ottawa. We interpreted the data using thematic analysis. Findings revealed communication challenges between the parents/caregivers and conventional providers while they experience better communication flow with fewer challenges in alternative care settings. However, parents/caregivers are the only links between the health professionals of both streams. From the five contexts examined: organizational, interpersonal, media, cultural, and political-legal, we found four themes (provider knowledge, care integration, flexible care, and time constraints) underlining specific barriers to communication flow between the parties involved in the care of autistic children. The increasing interest in alternative medicine is forcing changes in the healthcare system. Communications occur outside the norms making openings for better communication and information-sharing increasingly essential. Within the identified themes in the current study, the necessity for better communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers would support effective parent/caregiver-provider communication. The findings of the current study contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.

Keywords: alternative medicine, autism care management, autism spectrum disorder, conventional medicine, parent-provider communication

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Authors: Rahila Yilangai, Sonali Saha, Amartya Saha, Augustine Ezealor

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Gallery forests in sub-Saharan Africa are drastically disappearing due to intensive anthropogenic activities thus reducing ecosystem services, one of which is water provisioning. The role played by forest cover in regulating streamflow and water yield is not well understood, especially in West Africa. This pioneering 2-year study investigated the interrelationships between plant cover and hydrology in protected and unprotected gallery forests. Rainfall, streamflow, and evapotranspiration (ET) measurements/estimates over 2015-2016 were obtained to form a water balance for both catchments. In addition, transpiration in the protected gallery forest with high vegetation cover was calculated from stomatal conductance readings of selected species chosen from plot level data of plant diversity and abundance. Results showed that annual streamflow was significantly higher in the unprotected site than the protected site, even when normalized by catchment area. However, streamflow commenced earlier and lasted longer in the protected site than the degraded unprotected site, suggesting regulation by the greater tree density in the protected site. Streamflow correlated strongly with rainfall with the highest peak in August. As expected, transpiration measurements were less than potential evapotranspiration estimates, while rainfall exceeded ET in the water cycle. The water balance partitioning suggests that the lower vegetation cover in the unprotected catchment leads to a larger runoff in the rainy season and less infiltration, thereby leading to streams drying up earlier, than in the protected catchment. This baseline information is important in understanding the contribution of plants in water cycle regulation, for modeling integrative water management in applied research and natural resource management in sustaining water resources with changing the land cover and climate uncertainties in this data-poor region.

Keywords: evapotranspiration, gallery forest, rainfall, streamflow, transpiration

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Authors: Ashley R. Logsdon, Becky F. Antle, Cynthia M. Kamer

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This study examines the cost and benefits of a family treatment drug court in an urban county in a southeastern state. Additionally, this cost analysis will provide a detailed description of the type and cost of activities to produce the services provided to child welfare families. This study utilized return-on-investment analysis, which uses child welfare practices, disaggregates them into separate activities and estimates costs for these activities including child-level placement data for total cost of care for the child. Direct and indirect costs were considered as well as saving calculations what costs would be associated with child welfare outcomes both short and long term. The costs included were general program costs (salaries, drug screens, transportation, childcare, parent education, program evaluation, visitation, incentives) or personnel costs for other team members (judges, court administrators, child welfare workers, child welfare supervisors, and community mental health provider). The savings that were used in the study were length of time in out of home care, Medicaid costs, substance exposed births, emergency room utilization and jail/probation costs. This study documents an overall savings of between $168,993.30 and $837,993.30. The total savings per family divided by the 40 families who have participated in the program was between $4,224.83 to $20,949.83 per family. The results of this cost benefit analysis are consistent with prior research documenting savings associated with out of home care and jail/probation; however, there are also unique contributions of this study to the literature on cost effectiveness of family treatment drug courts. We will present recommendations for further utilization of family treatment drug courts and how to expand the current model.

Keywords: child welfare, cost analysis, family drug court, family treatment drug court

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Authors: Marc Polo, Núria Arbonés Arán

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Amsterdam is considered one of the great European capitals, which concentrates the headquarters of various multinational companies and which, in addition, enjoys a huge tourist attraction. Its typical residential buildings next to the canals, the museums, or its striking "Red Light District" are a great focus of attraction. In 2019 almost 9 million tourists visited it, but few of them traveled to the farthest neighborhood in the city: Amsterdam-Zuidoost (Amsterdam-Southeast). This neighborhood is geographically separated from the urban core, which makes it an exclave of Amsterdam as it does not border any of the other boroughs. Bijlmermeer neighborhood is the largest of the Amsterdam-Zuidoost, and it was born in the 1960s with the expectations of becoming the city of the future. Its main architect, Siegfried Nassuth, was inspired by the Swiss Le Corbusier to design nearly 18,000 homes, most of which were in high-rise tower blocks and built together, forming a recognizable "honeycombed" pattern. For more than 40 years, a series of infrastructure and social vicissitudes have made the neighborhood outline quite different as it was expected to be. It helped also varied elements such as ethnicity, demolitions, or unoccupied apartments. The called “city of the future” became home to immigrants, drug addicts, and vandals, and the conflicts denigrated the Amsterdam-Zuidoost. This work analyzes the evolution of the Bijlmermeer from its origins and illustrates relevant international referents able to help the area. The purpose of the work is to show how different variations along the recent history didn't help enough, but how there are positive perspectives for the future taking advantage of the food as a creative issue. The research, based on academic literature, existing material in different stadiums, plus the analysis of the city imaginaries, will help to concrete relevant elements in terms of innovation, creativity, and disruption. Despite of radical renewal that is taking place, the research will demonstrate that there are still new opportunities for the old Bijlmermeer.

Keywords: amsterdam, bijlmermeer, creativity, food

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Authors: Maryam Pirdehghan

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During the Ba'ath Party's rule in Iraq, propaganda was utilized to justify and to promote Saddam Hussein's image in the collective memory as the greatest Arab leader. Consequently, urban walls were routinely covered with images of Saddam. Relying on these images, the regime aimed to provide a basis for evoking meanings in the public opinion, which would supposedly strengthen Saddam’s power and reconstruct facts to legitimize his political ideology. Nonetheless, Saddam was not always portrayed with common and explicit elements but in certain periods of his rule, the paintings depicted him in an unusual context, where various historical and contemporary elements were combined in a narrative background. Therefore, an understanding of the implied socio-political references of these elements is required to fully elucidate the impact of these images on forming the memory and collective unconscious of the Iraqi people. To obtain such understanding, one needs to address the following questions: a) How Saddam Hussein is portrayed in mural during his rule? b) What of elements and mythical-historical narratives are found in the paintings? c) Which Saddam's political views were subject to the collective memory through mural? Employing visual semiotics, this study reveals that during Saddam Hussein's regime, the paintings were initially simple portraits but gradually transformed into narrative images, characterized by a complex network of historical, mythical and religious elements. These elements demonstrate the transformation of a secular-nationalist politician into a Muslim ruler who tried to instill three major policies in domestic and international relations i.e. the arabization of Iraq, as well as the propagation of pan-arabism ideology (first period), the implementation of anti-Israel policy (second period) and the implementation of anti-American-British policy (last period).

Keywords: Ba'ath Party, Saddam Hussein, mural, Iraq, propaganda, collective memory

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Authors: Afrah Saad Mohsen Al-Mahfadi

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The construction of dams can provide various ecosystem services, but it can also lead to ecological changes such as habitat loss and coastal degradation. Yemen faces multiple risks, including water crises and inadequate environmental policies, which are particularly detrimental to coastal zones like the Ahwar Delta in Abyan. This study aims to examine the impacts of dam construction on downstream wetlands and propose sustainable management approaches. Research Aim: The main objective of this study is to assess the different impacts of dam construction on downstream wetlands, specifically focusing on the Ahwar Delta in Yemen. Methodology: The study utilizes a literature review approach to gather relevant information on dam impacts and adaptation measures. Interviews with decision-making stakeholders and local community members are conducted to gain insights into the specific challenges faced in the Ahwar Delta. Additionally, sensing data, such as Arc-GIS and precipitation data from 1981 to 2020, are analyzed to examine changes in hydrological dynamics. Questions Addressed: This study addresses the following questions: What are the impacts of dam construction on downstream wetlands in the Ahwar delta? How can environmental management planning activities be implemented to minimize these impacts? Findings: The results indicate several future issues arising from dam construction in the coastal areas, including land loss due to rising sea levels and increased salinity in drinking water wells. Climate change has led to a decrease in rainfall rates, impacting vegetation and increasing sedimentation and erosion. Downstream areas with dams exhibit lower sediment levels and slower flowing habitats compared to those without dams. Theoretical Importance: The findings of this study provide valuable insights into the ecological impacts of dam construction on downstream wetlands. Understanding these dynamics can inform decision-makers about the need for adaptation measures and their potential benefits in improving coastal biodiversity under dam impacts. Data Collection and Analysis Procedures: The study collects data through a literature review, interviews, and sensing technology. The literature review helps identify relevant studies on dam impacts and adaptation measures. Interviews with stakeholders and local community members provide firsthand information on the specific challenges faced in the Ahwar Delta. Sensing data, such as Arc-GIS and precipitation data, are analyzed to understand changes in hydrological dynamics over time. Conclusion: The study concludes that while the situation can worsen due to dam construction, practical adaptation measures can help mitigate the impacts. Recommendations include improving water management, developing integrated coastal zone planning, raising awareness among stakeholders, improving health and education, and implementing emergency projects to combat climate change.

Keywords: dam impact, delta wetland, hydrology, Yemen

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Authors: Benedict O. Muyale, Emmanuel S. Murunga

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Cities have always been the loci for nationals as well as growth of cultural fusion and innovation. Over 50%of global population dwells in cities and urban centers. This means that cities are prolific users of natural resources and generators of waste; hence they produce most of the greenhouse gases which are causing global climate change. The root cause of increase in the transport sector carbon curve is mainly the greater numbers of individually owned cars. Development in these cities is geared towards economic progress while environmental sustainability is ignored. Infrastructure projects focus on road expansion, electrification, and more parking spaces. These lead to more carbon emissions, traffic congestion, and air pollution. Recent development plans for Nairobi city are now on road expansion with little priority for electric train solutions. The Vision 2030, Kenya’s development guide, has shed some light on the city with numerous road expansion projects. This chapter seeks to realize the following objectives; (1) to assess the current transport situation of Nairobi; (2) to review green transport solutions being undertaken in the city; (3) to give an overview of alternative green transportation solutions, and (4) to provide a green transportation framework matrix. This preliminary study will utilize primary and secondary data through mainly desktop research and analysis, literature, books, magazines and on-line information. This forms the basis for formulation of approaches for incorporation into the green transportation framework matrix of the main study report.The main goal is the achievement of a practical green transportation system for implementation by the City County of Nairobi to reduce carbon emissions and congestion and promote environmental sustainability.

Keywords: cities, transport, Nairobi, green technologies

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Authors: Nayan Kishore Giri, Ramakar Jha

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Water is a major element for the life of all the mankind in the earth. India’s surface water flows through fourteen major streams. Indian rivers are the main source of potable water in India. In the eastern part of India many toxic hazardous metals discharged into the river from mining industries, which leads many deadly diseases to human being. So the potable water quality is very significant and vital concern at present as it is related with the present and future health perspective of the human race. Consciousness of health risks linked with unsafe water is still very low among the many rural and urban areas in India. Only about 7% of total Indian people using water purifier. This unhealthy situation of water is not only present in India but also present in many underdeveloped countries. The major reason behind this is the high cost of water purifier. This current study geared towards development of economical and efficient technology for the removal of maximum possible toxic metals and pathogen bacteria. The work involves the design of portable purification system and purifying material. In this design Coconut shell granular activated carbon(GAC) and polypropylene filter cloths were used in this system. The activated carbon is impregnated with Iron(Fe). Iron is used because it enhances the adsorption capacity of activated carbon. The thorough analysis of iron impregnated activated carbon(Fe-AC) is done by Scanning Electron Microscope (SEM), X-ray diffraction (XRD) , BET surface area test were done. Then 10 ppm of each toxic metal were infiltrated through the designed purification system and they were analysed in Atomic absorption spectrum (AAS). The results are very promising and it is low cost. This work will help many people who are in need of potable water. They can be benefited for its affordability. It could be helpful in industries and other domestic usage.

Keywords: potable water, coconut shell GAC, polypropylene filter cloths, SEM, XRD, BET, AAS

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Authors: Maureen Royce, Joshi Jariwala, Sally Kah

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Change is inevitable, but the change process is progressive. Organisational change is the process in which an organisation changes strategies, operational methods, systems, culture, and structure to affect something different in the organisation. This process can be continuous or developed over a period and driven by internal and external factors. Organisational change is essential if organisations are to survive in dynamic and uncertain environments. However, evidence from research shows that many change initiatives fail, leading to severe consequences for organisations and their resources. The complex models of third sector organisations, i.e., social enterprise, compounds the levels of change in these organisations. Interestingly, innovation is associated with a change in social enterprises due to the hybridity of product and service development. Furthermore, the creation of social intervention has offered a new process and outcomes to the lifecycle of change. Therefore, different forms of organisational innovation are developed, i.e., total, evolutionary, expansionary, and developmental, which affect the interventions of social enterprises. This raises both theoretical and business concerns on how the competing hybrid nature of social enterprises change, how change is managed, and the impact on these organisations. These perspectives present critical questions for further investigation. In this study, we investigate the impact of organisational change on employees and organisational development at DaDaFest –a disability arts organisation with a social focus based in Liverpool. The three main objectives are to explore the drivers of change and the implementation process; to examine the impact of organisational change on employees and; to identify barriers to organisation change and development. To address the preceding research objectives, qualitative research design is adopted using semi-structured interviews. Data is analysed using a six-step thematic analysis framework, which enables the study to develop themes depicting the impact of change on employees and organisational development. This study presents theoretical and practical contributions for academics and practitioners. The knowledge contributions encapsulate the evolution of change and the change cycle in a social enterprise. However, practical implications provide critical insights into the change management process and the impact of change on employees and organisational development.

Keywords: organisational change, change management, organisational change system, social enterprise

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Authors: Brianna M. Soule, Jesslyn A. Bryk-Lucy, Linda M. Ritchie

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Colic, defined as abdominal pain in the horse, has several known predisposing factors. Decreased water intake has been shown to predispose equines to impaction colic. The objective of this study was to determine if offering flavored water (sweet feed or banana extract) would increase voluntary water intake in horses to serve as an assessable, noninvasive method for farm managers, veterinarians, or owners to decrease the risk of impaction colic. An a priori power analysis, which was conducted using G*Power version 3.1.9.7, indicated that the minimum sample size required to achieve 80% power for detecting a large effect at a significance level of α = .05 was 19 horses for a one-way repeated measures ANOVA with three treatment levels and assuming a non-sphericity correction of ε=0.5. After a three-day control period, 21 horses were randomly divided into two sequences and offered either banana or sweet feed flavored water. Horses always had a bucket of unflavored water available. A repeated measure study design was used to measure water consumption of each horse over a 62-hour period. A one-way repeated measures ANOVA was conducted to determine whether there were statistically significant differences among the means for the three-day average water intake (ml/kg). Although not statistically significant (F(2, 38) = 1.28, p = .290, partial η2 = .063), the three-day average water intake was largest for banana flavored water (M = 53.51, SD = 9.25 ml/kg), followed by sweet feed (M = 52.93, SD = 11.99 ml/kg), and, finally, unflavored water (M = 50.40, SD = 10.82 ml/kg). Paired-samples t-tests were used to determine whether there was a statistically significant difference between the three-day average water intake (ml/kg) for flavored versus unflavored water. The average unflavored water intake (M = 29.3 ml/kg, SD = 8.9) over the measurement period was greater than the banana flavored water (M = 27.7 ml/kg, SD = 9.8), but the average consumption of the sweet feed flavored water (M = 30.4 ml/kg, SD = 14.6) was greater than unflavored water (M = 24.3 ml/kg, SD = 11.4). None of these differences in average intake were statistically significant (p > .244). Future research is warranted to determine if other flavors significantly increase voluntary water intake in horses.

Keywords: colic, equine, equine science, water intake, flavored water, horses, equine management, equine health, horse health, horse health care management, colic prevention

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Authors: El Hadji Mamadou Sonko, Ndiogou Sankhare, Maïmouna Lo, Jean Birane Gning, Cheikh Diop

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In Senegal, access to water, hygiene, and sanitation in small island towns is a particular problem, which is still poorly understood by the public authorities and development aid actors. The main objective of this study carried out in the Municipality of Foundiougne is to contribute to the knowledge of the problems related to the supply of drinking water, access to sanitation, and hygiene in small island towns in Senegal. The methodology adopted consisted of a literature review and quantitative surveys of a sample of 100 households in the Municipality. Semi-structured interviews using interview guides and informal interviews were also conducted with mechanical and manual emptiers, municipal authorities, public toilet managers, and neighbourhood leaders. Direct observation with photography was also used. The results show that, with regard to access to drinking water, 35% of households have unimproved water services, 46% have a limited level of service, and 19% have a basic level of service. Regarding sanitation, 77% of households are considered to have access to basic sanitation services, compared to 23% with limited sanitation services. However, these figures hide the dysfunctions of the sanitation system. Indeed, manual emptying is practiced exclusively by 4% of households, while 17% of households combine it with mechanical emptying. In addition, domestic wastewater is mainly evacuated outside the sanitation facilities, and all the sludge extracted from the pits is discharged directly into the environment without treatment. As a matter of fact, the surveys showed that 52% of households do not have access to a basic level of hygiene-related to handwashing when leaving the toilet. These results show that there is real work to be done at the level of small urban centres if we want to achieve MDG 6.

Keywords: Foundiougne, Senegal, small island, small town, water-sanitation, hygiene

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Authors: Biruk Wolde, Atalay Ayele, Yonatan Garkabo, Trufat Hailmariam, Zemenu Germewu

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A comprehensive three-dimensional (3D) geological modeling and engineering geological characterization of shallow subsurface soils and rocks are essential for a wide range of geotechnical and seismological engineering applications, particularly in urban environments. The spatial distribution and geological variation of the shallow subsurface of Addis Ababa city have not been studied so far in terms of geological and geotechnical modeling. This study aims at the construction of a 3D geological model, as well as provides awareness into the engineering geological characteristics of shallow subsurface soil and rock of Addis Ababa city. The 3D geological model was constructed by using more than 1500 geotechnical boreholes, well-drilling data, and geological maps. A well-known geostatistical kriging 3D interpolation algorithm was applied to visualize the spatial distribution and geological variation of the shallow subsurface. Due to the complex nature of geological formations, vertical and lateral variation of the geological profiles horizons-solid command has been selected via the Groundwater Modelling System (GMS) graphical user interface software. For the engineering geological characterization of typical soils and rocks, both index and engineering laboratory tests have been used. The geotechnical properties of soil and rocks vary from place to place due to the uneven nature of subsurface formations observed in the study areas. The constructed model ascertains the thickness, extent, and 3D distribution of the important geological units of the city. This study is the first comprehensive research work on 3D geological modeling and subsurface characterization of soils and rocks in Addis Ababa city, and the outcomes will be important for further future research on subsurface conditions in the city. Furthermore, these findings provide a reference for developing a geo-database for the city.

Keywords: 3d geological modeling, addis ababa, engineering geology, geostatistics, horizons-solid

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Authors: Kara Rosenblatt, Kevin Badgett, James Eldridge

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There is a preponderance of information regarding the overall effectiveness of charter schools and their ability to increase academic achievement compared to traditional district schools. Most research on the topic is focused on comparing long and short-term outcomes, academic achievement in mathematics and reading, and locale (i.e., urban, v. Rural). While the lingering unanswered questions regarding effectiveness continue to loom for school leaders, data on charter schools suggests that enrollment increases by 10% annually and that charter schools educate more than 2 million U.S. students across 40 states each year. Given the increasing share of U.S. students educated in charter schools, it is important to better understand possible differences in student achievement defined in multiple ways for students in charter schools and for those in Independent School District (ISD) settings in the state of Texas. Data were retrieved from the Texas Education Agency’s (TEA) repository that includes data organized annually and available on the TEA website. Specific data points and definitions of achievement were based on characterizations of achievement found in the relevant literature. Specific data points include but were not limited to graduation rate, student performance on standardized testing, and teacher-related factors such as experience and longevity in the district. Initial findings indicate some similarities with the current literature on long-term student achievement in English/Language Arts; however, the findings differ substantially from other recent research related to long-term student achievement in social studies. There are a number of interesting findings also related to differences between achievement for students in charters and ISDs and within different types of charter schools in Texas. In addition to findings, implications for leadership in different settings will be explored.

Keywords: charter schools, ISDs, student achievement, implications for PK-12 school leadership

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Authors: Yangyang Zhang

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In The Valley of the Moon, Jack London implicitly presents the connection between the city and the male, the country and the female, constructing a gender space where the city and the countryside are opposed. But meanwhile, London is constantly dismantling the gender space through the reversed travel map so as to highlight the fluidity and productivity of female space. Under such circumstance, the original gender space has to be reorganized. Through the construction of gendered urban and rural spaces, Jack London presents the national crisis in the process of urbanization of the American West in the late 19th century, while the female-led reversed travel map reproduces the original contribution of the American West to the construction of nationality. In the end, the reorganized neutral space “valley of the moon” reflects the “garden” motif in American national imagination and plays an important role in rebuilding national identity. This research studies the feminist geography and cartography in Jack London's novel The Valley of the Moon and analyzes the gender-politics attribution in the literary geography writing in London's novel on this basis. The research returns to the American historical context at the end of the 19th century, focusing on how London’s feminist geography embodies his sense of nationality and investigating how female-dominated literary cartography reconstructs American identity. This paper takes Literary Cartography, and feminist geography as the ideological guide combines with the discourse of gender politics. comprehensively uses various literary criticism methods such as deconstructionist literary criticism, and new historicism literary criticism, etc., Through the study of Jack London's work, the paper aims to analyse how London constructs a national image by literary geography.

Keywords: American identity, American west, feminist geography, garden motif, the valley of the moon

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Authors: Usama Bin Zubair, Syed Azhar Ali

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Introduction: Depression is emerging as a major public health problem in all parts of the world. Developing countries have a unique socioeconomic structure that affects the lives of its inhabitants in several ways. Going abroad for employment is one of the common social problems which have been faced by young males in developing countries. This included both highly qualified individuals as well as the labor class. Objective: To determine the difference in the presence of depressive symptoms among pregnant women with husbands living abroad and those with husbands living with them in Azad Jammu and Kashmir. Methods: The sample population comprised of pregnant women reporting for an antenatal checkup at Amna hospital Rawalakot. Cases constituted the pregnant women with husbands living abroad while controls were the pregnant women with husbands living with them. Patient health questionnaire-9 (PHQ-9) was used to record the presence and severity of depressive symptoms. Age, gestation, parity, rural or urban origin, education, level of family income, daily contact hours on the telephone or what’s app, previous pregnancy loss or complications, number of years abroad and visits to home per year were associated with the presence of depressive symptoms. Findings: The mean age of the study participants was 29.73 ±5.395 years. Sixty-six had significant depression in the case group, while 14 had in the control group (p-value<0.001). Education and rural background had a significant difference between the case and the control group. Less number of visits per year of the husband was strongly linked with the presence of depressive symptoms among the cases. Conclusion: Pregnant women with husbands abroad were found more prone to develop depressive symptoms as compared to those with husbands living with them. Special attention should be paid to the women whose husband had a lesser number of visits to the country.

Keywords: depression, pregnancy, lack of support, war zone

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Authors: Girmaye Abebe, Brook Lemma

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Adsorption of phosphorus (P as PO43-) in filter cake was studied to assess the media's capability in removing phosphorous from wastewaters. The composition of the filter cake that was generated from alum manufacturing process as waste residue has high amount of silicate from the complete silicate analysis of the experiment. Series of batches adsorption experiments were carried out to evaluate parameters that influence the adsorption capacity of PO43-. The factors studied include the effect of contact time, adsorbent dose, thermal pretreatment of the adsorbent, neutralization of the adsorbent, initial PO43- concentration, pH of the solution and effect of co-existing anions. Results showed that adsorption of PO43- is fairly rapid in first 5 min and after that it increases slowly to reach the equilibrium in about 1 h. The treatment efficiency of PO43- was increased with adsorbent extent. About 90% removal efficiency was increased within 1 h at an optimum adsorbent dose of 10 g/L for initial PO43- concentration of 10 mg/L. The amount of PO43- adsorbed increased with increasing initial PO43- concentration. Heat treatment and surface neutralization of the adsorbent did not improve the PO43- removal capacity and efficiency. The percentage of PO43- removal remains nearly constant within the pH range of 3-8. The adsorption data at ambient pH were well fitted to the Langmuir Isotherm and Dubinin–Radushkevick (D–R) isotherm model with a capacity of 25.84 and 157.55 mg/g of the adsorbent respectively. The adsorption kinetic was found to follow a pseudo-second-order rate equation with an average rate constant of 3.76 g.min−1.mg−1. The presence of bicarbonate or carbonate at higher concentrations (10–1000 mg/L) decreased the PO43- removal efficiency slightly while other anions (Cl-, SO42-, and NO3-) have no significant effect within the concentration range tested. The overall result shows that the filter cake is an efficient PO43- removing adsorbent against many parameters.

Keywords: wastewater, filter cake, adsorption capacity, phosphate (PO43-)

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Authors: Yih-Wenn Laih

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In recent times, the dependence and co-movement among international financial markets have become stronger than in the past, as evidenced by commentaries in the news media and the financial sections of newspapers. Studying the co-movement between returns in financial markets is an important issue for portfolio management and risk management. The realization of co-movement helps investors to identify the opportunities for international portfolio management in terms of asset allocation and pricing. Since the election of the new Prime Minister, Shinzo Abe, in November 2012, the yen has weakened against the US dollar from the 80 to the 120 level. The policies, known as “Abenomics,” are to encourage private investment through a more aggressive mix of monetary and fiscal policy. Given the close economic relations and competitions among Asia markets, it is interesting to discover the co-movement relations, affected by the depreciation of yen, between stock market of Japan and 5 major Asia stock markets, including China, Hong Kong, Korea, Singapore, and Taiwan. Specifically, we devote ourselves to measure the co-movement of stock markets between Japan and each one of the 5 Asia stock markets in terms of rank correlation coefficients. To compute the coefficients, return series of each stock market is first fitted by a skewed-t GARCH (generalized autoregressive conditional heteroscedasticity) model. Secondly, to measure the dependence structure between matched stock markets, we employ the symmetrized Joe-Clayton (SJC) copula to calculate the probability density function of paired skewed-t distributions. The joint probability density function is then utilized as the scoring scheme to optimize the sequence alignment by dynamic programming method. Finally, we compute the rank correlation coefficients (Kendall's  and Spearman's ) between matched stock markets based on their aligned sequences. We collect empirical data of 6 stock indexes from Taiwan Economic Journal. The data is sampled at a daily frequency covering the period from January 1, 2013 to July 31, 2015. The empirical distributions of returns indicate fatter tails than the normal distribution. Therefore, the skewed-t distribution and SJC copula are appropriate for characterizing the data. According to the computed Kendall’s τ, Korea has the strongest co-movement relation with Japan, followed by Taiwan, China, and Singapore; the weakest is Hong Kong. On the other hand, the Spearman’s ρ reveals that the strength of co-movement between markets with Japan in decreasing order are Korea, China, Taiwan, Singapore, and Hong Kong. We explore the effects of “Abenomics” on Asia stock markets by measuring the co-movement relation between Japan and five major Asia stock markets in terms of rank correlation coefficients. The matched markets are aligned by a hybrid method consisting of GARCH, copula and sequence alignment. Empirical experiments indicate that Korea has the strongest co-movement relation with Japan. The strength of China and Taiwan are better than Singapore. The Hong Kong market has the weakest co-movement relation with Japan.

Keywords: co-movement, depreciation of Yen, rank correlation, stock market

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Authors: Aisha Iddrsiu

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Public Relations (PR) has rapidly evolved around the world, just as companies have expanded to reach other parts of the world. With most multinational corporations conducting businesses in more than one country, only a few of these Multinational Corporations (MNC’s) are actual public relations firms, many have public relations departments or divisions that conduct public relations practices internationally. Hence international public relations is seen as a fast-growing specialty in the field of Public Relations. Multinational companies have devised strategies to effectively communicate and execute their roles within and between foreign publics and other cultures in which they operate through various means including the internet which is among the major inventions that have enabled corporations to establish their presents while targeting anonymous and diverse publics from varied cultures. International public relations practitioners rely on strategies coupled with internet use to communicate among and with foreign publics. Corporate websites and various social media handles have served as an important channel for public relations activities targeting both internal and international publics. In an incessant expansion of corporations and interactions with the publics from different cultures, it has become eminent to understand the public relation strategies used by MNCs in their international communication. This study therefore seeks to establish the international public relation strategies or models employed by Multinational Corporations specifically Arcelik Global in the management of its subsidiaries and communicating with international public. This study analyses both Arçelik global’s (one of the largest multinational companies in Turkey) website and social media accounts to understand the management strategy used with it subsidiary as well as strategies used to communicate with its global and local publics. Other underlying objective of this study are, 1. To examine the dominant international public relations models used by Multinational Corporations (Arcelik global). 2. To understand how Multinational Corporations manage (Arcelik global) its subsidiaries. 3. To understand how Multinational Corporations (Arcelik global) communicate with international or global publics. Research Questions 1. The main global PR strategies employed by multinational corporations (Arcelik global) 2. How subsidiaries of multinational corporations like Arcelik Global are managed. 3. How multinational corporations, like Arcelik worldwide, interact with international publics.

Keywords: multinational corporation, ethnocentric model, polycentric model, international public relations

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Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the ｍedical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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