Search results for: post pandemic period

Authors: K. Shyamnath, K. Suresh Kutty

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The purpose of the study was to find out the effect of three resistance training methods on performance-related variables of powerlifters. A total of forty male students (N=40) who had participated in Kannur University powerlifting championship were selected as subjects. The age group of the subjects ranged from 18 years old to 25 years old. The selected subjects were equally divided into four groups (n=10) of three experimental groups and a control group. The experimental Group I underwent traditional resistance training (TRTG), Group II underwent combined traditional resistance training and plyometrics (TRTPG), and Group III underwent combined traditional resistance training and resistance training with high rhythm (TRTHRG). Group IV acted as the control group (CG) receiving no training during the experimental period. The duration of the experimental period was sixteen weeks, five days per week. Powerlifting performance was assessed by the 1RM test in the squat, bench press and deadlift. Performance-related variables assessed were chest girth, arm girth, forearm girth, thigh girth, and calf girth. Pre-test and post-test were conducted a day before and two days after the experimental period on all groups. Analysis of covariance (ANCOVA) was applied to analyze the significant difference. The 0.05 level of confidence was fixed as the level of significance to test the F ratio obtained by the analysis of covariance. The result indicates that there is a significant effect of all the selected resistance training methods on the performance and selected performance-related variables of powerlifters. Combined traditional resistance training and plyometrics and combined traditional resistance training and resistance training with high rhythm proved better than the traditional resistance training in improving performance and selected performance-related variables of powerlifters. There was no significant difference between combined traditional resistance training and plyometrics and combined traditional resistance training and resistance training with high rhythm in improving performance and selected performance-related variables of powerlifters.

Keywords: girth, plyometrics, powerlifting, resistance training

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Authors: Nelomi Anandagoda, Leanne J. Eveson

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During the COVID-19 pandemic, the surge in in-patient admissions across the medical directorate of a district general hospital necessitated the implementation of an incident rota. Conscious of the impact on training and professional development, the idea of developing a virtual teaching programme was conceived. The programme initially aimed to provide junior doctors, specialist nurses, pharmacists, and allied healthcare professionals from medical specialties and those re-deployed from other specialties (e.g., ophthalmology, GP, surgery, psychiatry) the knowledge and skills to manage the deteriorating patient with COVID-19. The programme was later developed to incorporate the general internal medicine curriculum. To facilitate continuing medical education whilst maintaining social distancing during this period, a virtual platform was used to deliver teaching to junior doctors across two large district general hospitals and two community hospitals. Teaching sessions were recorded and uploaded to a common platform, providing a resource for participants to catch up on and re-watch teaching sessions, making strides towards reducing discrimination against the professional development of less than full-time trainees. Thus, creating a learning environment, which is inclusive and accessible to adult learners in a self-directed manner. The negative impact of the pandemic on the well-being of healthcare professionals is well documented. To support the multi-disciplinary team, the virtual teaching programme evolved to included sessions on well-being, resilience, and work-life balance. Providing teaching for learners across the multi-disciplinary team (MDT) has been an eye-opening experience. By challenging the concept that learners should only be taught within their own peer groups, the authors have fostered a greater appreciation of the strengths of the MDT and showcased the immense wealth of expertise available within the trust. The inclusive nature of the teaching and the ease of joining a virtual teaching session has facilitated the dissemination of knowledge across the MDT, thus improving patient care on the frontline. The weekly teaching programme has been running for over eight months, with ongoing engagement, interest, and participation. As described above, the teaching programme has evolved to accommodate the needs of its learners. It has received excellent feedback with an appreciation of its inclusive, multi-disciplinary, and holistic nature. The COVID-19 pandemic provided a catalyst to rapidly develop novel methods of working and training and widened access/exposure to the virtual technologies available to large organisations. By merging pedagogical expertise and technology, the authors have created an effective online learning environment. Although the authors do not propose to replace face-to-face teaching altogether, this model of virtual multidisciplinary team, cross-site teaching has proven to be a great leveler. It has made high-quality teaching accessible to learners of different confidence levels, grades, specialties, and working patterns.

Keywords: cross-site, cross-speciality, inter-disciplinary, multidisciplinary, virtual teaching

Procedia PDF Downloads 167

Authors: Isaac Kwaku Adu, Jacob Doku Tetteh, John Joseph Puthenkalam, Kwabena Effah Antwi

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The continuous increase in population implies increase in food demand. There is, therefore, the need to increase agricultural production and other forest products to ensure food security and economic development. This paper employs the three-level intensity analysis to assess the total change of land-use in two-time intervals (1986-2002 and 2002-2017), the net change and swap as well as gross gains and losses in the two intervals. The results revealed that the overall change in the 31-year period was greater in the second period (2002-2017). Agriculture and forest categories lost in the first period while the other land class gained. However, in the second period agriculture and built-up increased greatly while forest, water bodies and thick bushes/shrubland experienced loss. An assessment revealed a reduction of forest in both periods but was greater in the second period and expansion of agricultural land was recorded as population increases. The pixels gaining built-up targeted agricultural land in both intervals, it also targeted thick bushes/shrubland and waterbody in the second period only. Built-up avoided forest in both intervals as well as waterbody and thick bushes/shrubland. To help in developing the best land-use strategies/policies, a further validation of the social factors is necessary.

Keywords: agricultural land, forest, Ghana, land-use, intensity analysis, remote sensing

Procedia PDF Downloads 143

Authors: Rajnish Gourh, Nitesh Sharma, Nikhil Patil

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Introduction: Adequate nutrition is essential for improving pregnancy and its outcomes. Failure to comply with the required daily intake of nutrition can lead to complications threatening both mother and child survival. Objectives: To provide access to nutritious diet to mothers in antenatal and post-natal stage for supporting a healthy progressive pregnancy, positive delivery outcome, and lactation and to promote regular consumption of the foods by the mothers and help overcome the dietary gap by nutrition education during pregnancy time. Methodology: Total of 95 ANC mothers were identified from Malvada PHC area, in Palghar district of Maharashtra. This short-term cohort intended for the proposed supplementation and education was targeted for follow-up until birth and six-months of post-natal period. In month of May 2016 to June 2017. Results: Average weight of women was observed 40.01kg, (SD- 5.024) at registered for ANC at Centre in the first month. In same month, average Haemoglobin level of women was observed 9.13gm/dl. Average increase in weight of women during pregnancy in month October 2016 was 48.83kg. Birth weight of 14 babies was less than 2 kgs. 13 babies with birth weight in range of 2.1kgs to 2.4kgs. 68 babies with birth weight in range of 2.5kg to 3kg and above. Conclusion: Importance of consumption of food, improving levels of nutrient intake and outcome of delivery was excellent.

Keywords: delivery status, nutrition, pregnancy, education

Procedia PDF Downloads 159

Authors: Sidra Suleman, Maliha Suleman, Stephen Brindley

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Oral rehabilitation of head and neck cancer patients plays a crucial role in the quality of life for such individuals post-treatment. Placement of dental implants or implant-retained prostheses can help restore oral function and aesthetics, which is often compromised following surgery. Conventional prosthodontic techniques can be insufficient in rehabilitating such patients due to their altered anatomy and reduced oral competence. Hence, there is a strong clinical need for the placement of dental implants. With an increasing incidence of head and neck cancer patients, the demand for such treatment is rising. Aim: The aim of the study was to determine the survival rate of dental implants in head and neck cancer patients placed at the Restorative and Maxillofacial Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: All patients who received dental implants between January 1, 2013 to December 31, 2020 were identified. Patients were excluded based on three criteria: 1) non-head and neck cancer patients, 2) no outpatient follow-up post-implant placement 3) provision of non-dental implants. Scanned paper notes and electronic records were extracted and analyzed. Implant survival was defined as fixtures that had remained in-situ / not required removal. Sample: Overall, 61 individuals were recruited from the 143 patients identified. The mean age was 64.9 years, with a range of 35 – 89 years. The sample included 37 (60.7%) males and 24 (39.3%) females. In total, 211 implants were placed, of which 40 (19.0%) were in the maxilla, 152 (72.0%) in the mandible and 19 (9.0%) in autogenous bone graft sites. Histologically 57 (93.4%) patients had squamous cell carcinoma, with 43 (70.5%) patients having either stage IVA or IVB disease. As part of treatment, 42 (68.9%) patients received radiotherapy, which was carried out post-operatively for 29 (69.0%) cases. Whereas 21 (34.4%) patients underwent chemotherapy, 13 (61.9%) of which were post-operative. The Median follow-up period was 21.9 months with a range from 0.9 – 91.4 months. During the study, 23 (37.7%) patients died and their data was censored beyond the date of death. Results: In total, four patients who had received radiotherapy had one implant failure each. Two mandibular implants failed secondary to osteoradionecrosis, and two maxillary implants did not survive as a result of failure to osseointegrate. The overall implant survival rates were 99.1% at three years and 98.1% at both 5 and 7 years. Conclusions: Although this data shows that implant failure rates are low, it highlights the difficulty in predicting which patients will be affected. Future studies involving larger cohorts are warranted to further analyze factors affecting outcomes.

Keywords: oncology, dental implants, survival, restorative

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Authors: Maria Spanoudaki, Pauldy C. J. Otermans, Dev Aditya

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Relationships form an integral part of our everyday wellbeing. In this study, the focus is on Inner Wellbeing which can be described as an individuals' thoughts and feelings about what they can do and be. Relationships can come in many forms and can be divided into Social Connections (thoughts and feelings about the social network people can establish and rely on), and Close Relationships (thoughts and feeling about the emotional support people can receive from significant others or their close, intimate circle). The purpose of this study is to compare the Social Connections and Close Relationship dimensions of Inner Wellbeing during the COVID-19 pandemic between the UK and India. 392 participants in the UK and 205 participants India completed an online questionnaire using the Inner Wellbeing scale. Factor analyses showed that the construct of Inner Wellbeing can be described as one factor for the UK sample whereas it can be described as two factors (one focusing on positive items and one focusing on negative items) for the Indian sample. Results showed that Social Connections were significantly during COVID-19 in the UK compared to India, whereas there is no significant difference for Close Relationships. The implications on relationships and wellbeing are discussed in detail.

Keywords: social networks, relationship maintenance, relationship satisfaction, COVID-19

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Authors: Sonia Achour

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Owing to the outbreak of the Corona pandemic, the shift to online learning took place abruptly. Neither practitioners nor learners were prepared for this sudden move. Higher education providers were compelled to implement online courses on a very short notice. Sultan Qaboos University is one among these. The question of motivation attracted a great number of educators. A case study was carried out so as to shed some lights on students' perceptions towards virtual learning and how it influenced their motivation to learning. The data was collected by means of semi-structured interviews of a focused group of 16 students along with classroom observation over a 12 week period. Both interviews and class observation revealed that there was a general negative feeling about the online teaching platform and its impact on the learners' motivation. Several factors were identified, namely the absence of interaction, social isolation, inconsistency of instructional knowledge, unfamiliarity with the new learning environment, IT illiteracy, and teacher development. The researcher aims at demonstrating the effect of virtual classrooms on students' motivation to acquire L2. The findings may be used to inform future decisions about courses, curriculum design. And teacher development

Keywords: online learning, motivation, EFL context, virtual setting

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Authors: Catharina O. Vianna Dias da Silva, Amanda F. Batista, Ana Clara C. Burgos Lessa, Carolina S. Lucchesi Ramacciotti, Maria Clara B. de Andrade, Roberto de B. Silva

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This article aims to analyze the bioethical aspects related to the historical practices of experiments on humans that occurred in Nazi Germany during the period of World War II (1939-1945). The method was based on the bibliographic review of articles published in databases such as SciELO and Pubmed. In the discussion, historical and humanistic aspects that contributed to the construction of a genocidal culture practiced during this period were analyzed. Additionally, an ethical question arises: should the information acquired during this dark period be used by science? After analysis, it was found that these Nazi experiments went over medical and ethical principles, being a deplorable milestone in history. It was also concluded that, although they generated potentially 'useful' results in the scientific field, they should be discarded as an ethical question of principle, of never daring to validate such a deplorable way of obtaining knowledge.

Keywords: Nazism, bioethics, human experimentation, human rights, genocide, torture, medicine

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Authors: Corina E. Niculaescu, Ivan Sangiorgi, Adrian R. Bell

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The COVID-19 pandemic has been life-changing in many aspects of people’s daily and social lives, but has it also changed attitudes towards investments? This paper explores the effect of the COVID-19 pandemic on retail investors’ levels of investments in the U.S. during the first COVID-19 wave in summer 2020. This is an unprecedented health crisis, which could lead to changes in investment behavior, including irrational behavior in retail investors. As such, this study aims to inform policymakers of what happened to investment decisions during the COVID-19 pandemic so that they can protect retail investors during extreme events like a global health crisis. The study aims to answer two research questions. First, was the level of investments affected by the COVID-19 pandemic, and if so, why? Second, how were investments affected by retail investors’ personal experience with COVID-19? The research analysis is based on primary survey data collected on the Amazon Mechanical Turk platform from a representative sample of U.S. respondents. Responses were collected between the 15th of July and 28th of August 2020 from 1,148 U.S. retail investors who hold mutual fund investments and a savings account. The research explores whether being affected by COVID-19, change in the level of savings, and risk capacity can explain the change in the level of investments by using regression analysis. The dependent variable is changed in investments measured as decrease, no change, and increase. For this reason, the methodology used is ordered probit regression models. The results show that retail investors in the U.S. increased their investments during the first wave of COVID-19, which is unexpected as investors are usually more cautious in crisis times. Moreover, the study finds that those who were affected personally by COVID-19 (e.g., tested positive) were more likely to increase their investments, which is irrational behavior and contradicts expectations. An increase in the level of savings and risk capacity was also associated with increased investments. Overall, the findings show that having personal experience with a health crisis can have an impact on one’s investment decisions as well. Those findings are important for both retail investors and policymakers, especially now that online trading platforms have made trading easily accessible to everyone. There are risks and potential irrational behaviors associated with investment decisions during times of crisis, and it is important that retail investors are aware of them before making financial decisions.

Keywords: COVID-19, financial decision-making, health crisis retail investors, survey

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Authors: Chizzoniti Domenico, Beggiora Klizia, Cattani Letizia, Moscatelli Monica

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This paper concerns the study of sustainable construction materials applied on the "Health Post", a prototype for the primary health care situated in alienated areas of the world. It's suitable for social and climatic Sub-Saharan context; however, it could be moved in other countries of the world with similar urgent needs. The idea is to create a Health Post with local construction materials that have a low environmental impact and promote the local workforce allowing reuse of traditional building techniques lowering production costs and transport. The aim of Primary Health Care Centre is to be a flexible and expandable structure identifying a modular form that can be repeated several times to expand its existing functions. In this way it could be not only a health care centre but also a socio-cultural facility.

Keywords: low costs building, sustainable construction materials, green construction system, prototype, health care, emergency

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Authors: Xu Feifei

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The prevalence of COVID-19 currently is the biggest challenge to improving people's quality of life. Its impact on the health-related quality of life (HRQoL) is highly uncertain and has not been summarized so far. The aim of the present systematic review was to assess and provide an up-to-date analysis of the impact of the COVID-19 pandemic on the HRQoL of participants who have been infected, have not been infected but isolated, frontline, with different diseases, and the general population. Therefore, an electronic search of the literature in PubMed databases was performed from 2019 to July 2022 (without date restriction). PRISMA guideline methodology was employed, and data regarding the HRQoL were extracted from eligible studies. Articles were included if they met the following inclusion criteria: (a) reports on the data collection of the health state utility values (HSUVs) related to COVID-19 from 2019 to 2021; (b) English language and peer-reviewed journals; and (c) original HSUV data; (d) using EQ-5D tool to quantify the HRQoL. To identify studies that reported the effects on COVID-19, data on the proportion of overall HSUVs of participants who had the outcome were collected and analyzed using a one-group meta-analysis. As a result, thirty-two studies fulfilled the inclusion criteria and, therefore, were included in the systematic review. A total of 45295 participants and provided 219 means of HSUVs during COVID-19 were included in this systematic review. The range of utility is from 0.224 to 1. The study included participants from Europe (n=16), North America (n=4), Asia (n=10), South America (n=1), and Africa (n=1). Twelve articles showed that the HRQoL of the participants who have been infected with COVID-19 (range of overall HSUVs from 0.6125 to 0.863). Two studies reported the population of frontline workers (the range of overall HSUVs from 0.82 to 0.93). Seven of the articles researched the participants who had not been infected with COVID-19 but suffered from morbidities during the pandemic (range of overall HSUVs from 0.5 to 0.96). Thirteen studies showed that the HRQoL of the respondents who have not been infected with COVID-19 and without any morbidities (range of overall HSUVs from 0.64 to 0.964). Moreover, eighteen articles reported the outcomes of overall HSUVs during the COVID-19 pandemic in different population groups. The estimate of overall HSUVs of direct COVID-19 experience population (n=1333) was 0.751 (95% CI 0.670 - 0.832, I2 = 98.64%); the estimate of frontline population (n=610) was 0.906 ((95% CI 0.854 – 0.957, I2 = 98.61%); participants with different disease (n=132) were 0.768 (95% CI 0.515 - 1.021, I2= 99.26%); general population without infection history (n=29,892) was 0.825 (95% CI 0.766 - 0.885, I2 =99.69%). Conclusively, taking into account these results, this systematic review might confirm that COVID-19 has a negative impact on the HRQoL of the infected population and illness population. It provides practical value for cost-effectiveness model analysis of health states related to COVID-19.

Keywords: COVID-19, health-related quality of life, meta-analysis, systematic review, utility value

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Authors: Chia-Ching Tsai

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In the literature, the positive effect of service co-recovery has been evidenced, and which customers’ attribution is the key successful factor has also been indicated. There is also literature investigating on initiation of co-recovery for finding out the superior way to co-recovery, and indicating co-recovery initiated by employees causes better effect of co-recovery. This research postulates the consequences of co-recovery by different initiators affect customers’ attribution and the resultant results. Thus, this research uses a 3x2 factorial design to investigate the impact of initiator of co-recovery and consequence of co-recovery on customers’ attribution and post-recovery satisfaction. The results show initiation of co-recovery has a significant influence on internal attribution, and the employee initiator causes the highest internal attribution. The consequences of co-recovery interact with initiators of co-recovery on internal attribution significantly. Moreover, internal attribution significantly affects post-recovery satisfaction.

Keywords: service co-recovery, initiation of co-recovery, attribution, post-recovery satisfaction

Procedia PDF Downloads 259

Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Renata Karina Reis, Soraia Assad Nasbine Rabeh, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira e Silva, Sheila Araújo Teles

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Context and significance: Nursing team professionals faced challenges in combating the COVID-19 pandemic around the world. They were subjected to exhausting workloads and prolonged use of Personal Protective Equipment. Using N95 masks for long periods of time can cause skin changes. In this context, health professionals who worked on the front lines of fighting the pandemic were more exposed to possible physical and psychological changes. Objective: The aim of the study was to analyze the factors associated with skin lesions resulting from the use of N95 masks among nursing team professionals. Method: The study was carried out in all regions of Brazil from October to December 2020, with professionals from the nursing team who worked in health care during the COVID-19 pandemic. Participants were recruited via social media, and information was collected electronically and stored on the Survey Monkey platform. Descriptive statistics were used to characterize the sample, association tests (Chi-square), with a statistical significance level of p < 0.05. Factors associated with skin lesions resulting from the use of an N95 mask were determined by Binary Logistic Regression, with a significance level of 5% (α = 0.05). Results: 8,405 nursing professionals participated in the study, 5,492 nurses (65.3%), 2,747 nursing technicians (32.7%), and 7,084 females (84.3%). Female nursing team professionals were 1.4 times more likely to develop skin lesions due to the use of N95 masks when compared to males (OR 1.4 [CI95% 1.22 – 1.59] p < 0.001). The following protective factors were identified: nursing technician (ORA 0.608 [CI95% 0.43 – 0.86] p = 0.005) and not having provided assistance in field hospitals for COVID-19 (0.73 [CI95% 0.65-0.81] p<0.000). Conclusion: It was concluded that female nursing team professionals were more likely to have skin changes related to the use of N95 masks. The need for intervention studies is emphasized in order to explore measures to prevent these types of injuries. Descritores: Nursing professionals; COVID-19; SARS-CoV-2; Brazil.

Keywords: nursing professionals, COVID-19, SARS-CoV-2, Brazil

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Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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Authors: Salwa M. Almomen, Mona A. Almaghrabi, Saja M. Alhabardi, Adel A. Alrwisan

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Background: Hepatotoxicity is a major reason for medication withdrawal from the markets. Unfortunately, serious adverse hepatic effects can occur after marketing with limited indicators during clinical development. Therefore, finding possible predictors for hepatotoxicity might guide the monitoring program of various stakeholders. Methods: We examined the clinical review documents for drugs approved in the US from 2011 to 2016 to evaluate their hepatic safety profile. Predictors: we assessed whether these medications meet Hy’s Law with hepatotoxicity grade ≥ 3, labeled hepatic adverse effects at approval, or accelerated approval status. Outcome: post-marketing regulatory action related to hepatotoxicity, including product withdrawal or updates to warning, precaution, or adverse effects sections. Statistical analysis: drugs were included in the analysis from the time of approval until the end of 2019 or the first post-marketing regulatory action related to hepatotoxicity, whichever occurred first. The hazard ratio (HR) was estimated using Cox-regression analysis. Results: We included 192 medications in the study. We classified 48 drugs as having grade ≥ 3 hepatotoxicities, 43 had accelerated approval status, and 74 had labeled information about hepatotoxicity prior to marketing. The adjusted HRs for post-marketing regulatory action for products with grade ≥ 3 hepatotoxicity was 0.61 (95% confidence interval [CI], 0.17-2.23), 0.92 (95%CI, 0.29-2.93) for a drug approved via accelerated approval program, and was 0.91 (95%CI, 0.33-2.56) for drugs with labeled hepatotoxicity information at approval time. Conclusion: This study does not provide conclusive evidence on the association between post-marketing regulatory action and grade ≥ 3 hepatotoxicity, accelerated approval status, or availability of labeled information at approval due to sampling size and channeling bias.

Keywords: accelerated approvals, hepatic adverse effects, drug-induced liver injury, hepatotoxicity predictors, post-marketing withdrawal

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Authors: Sajjad Hassanpour, Vicente A. González, Yang Zou, Jiamou Liu

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Earthquakes pose a significant threat to both structural and non-structural elements in buildings, putting human lives at risk. Effective post-earthquake evacuation is critical for ensuring the safety of building occupants. However, current design practices often neglect the integration of post-earthquake evacuation considerations into the early-stage architectural design process. To address this gap, this paper presents a novel automated internal architectural layout generation tool that optimizes post-earthquake evacuation performance. The tool takes an initial plain floor plan as input, along with specific requirements from the user/architect, such as minimum room dimensions, corridor width, and exit lengths. Based on these inputs, firstly, the tool randomly generates different architectural layouts. Secondly, the human post-earthquake evacuation behaviour will be thoroughly assessed for each generated layout using the advanced Agent-Based Building Earthquake Evacuation Simulation (AB2E2S) model. The AB2E2S prototype is a post-earthquake evacuation simulation tool that incorporates variables related to earthquake intensity, architectural layout, and human factors. It leverages a hierarchical agent-based simulation approach, incorporating reinforcement learning to mimic human behaviour during evacuation. The model evaluates different layout options and provides feedback on evacuation flow, time, and possible casualties due to earthquake non-structural damage. By integrating the AB2E2S model into the automated layout generation tool, architects and designers can obtain optimized architectural layouts that prioritize post-earthquake evacuation performance. Through the use of the tool, architects and designers can explore various design alternatives, considering different minimum room requirements, corridor widths, and exit lengths. This approach ensures that evacuation considerations are embedded in the early stages of the design process. In conclusion, this research presents an innovative automated internal architectural layout generation tool that integrates post-earthquake evacuation simulation. By incorporating evacuation considerations into the early-stage design process, architects and designers can optimize building layouts for improved post-earthquake evacuation performance. This tool empowers professionals to create resilient designs that prioritize the safety of building occupants in the face of seismic events.

Keywords: agent-based simulation, automation in design, architectural layout, post-earthquake evacuation behavior

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Authors: Zahidul Islam

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This study investigates the effectiveness of resourcing in post-disaster housing reconstruction with reference to Cyclones Sidr and Aila in Bangladesh. Through evaluating three key theories- Build Back Better approach, Balance Scorecard approach and Dynamic Competency theories, the synthesis of literature, and empirical fieldwork, this research develops a dynamic theoretical framework that moves the trajectory of post-disaster housing reconstruction towards the reconstruction of more resilient houses. The ultimate goal of any post-disaster housing reconstruction project is to provide quality houses and to achieve high levels of satisfaction for beneficiaries. However, post-disaster reconstruction projects often fail in their stated objectives; only 10-20% housing needs are met, with most houses constructed on a temporary rather than permanent basis. A number of scholars have argued that access to resources can significantly increase the capacity and capability of disaster victims to rebuild their lives, including the construction of new homes. This study draws on structured interviews of 285 villagers affected by cyclones to investigate the effectiveness of resourcing in rebuilding houses after Cyclone Sidr in 2007 and Cyclone Aila in 2009. Furthermore, semi-structured interviews were conducted with 20 key stakeholders in UNDP, Oxfam, government officials, and national and international NGOs. The results of this study show that recovery rate of cyclone resilient houses that can withstand cyclone is very low and majority of the population are still vulnerable. Furthermore, hierarchical regression of survey data and thematic analyses of qualitative data indicate that access to resources, level of education, quality of building materials and income generating activities of the respondents are critical for effective post-disaster recovery. Conversely, resource availability, lack of coordination among participant organisations, corruption and lack of access to appropriate land constituted significant obstacles to livelihood recovery. Finally, this study makes significant theoretical contributions to theories of post-disaster recovery by introducing new variables and measures for evaluating the quality and effectiveness of post-disaster housing.

Keywords: disaster, resourcing, housing, resilience

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Authors: Natalia Alvarado, Myldred Hernandez-Gonzalez, Mary Laird, Madeline Phillips, Elizabeth Miller, Luis Mendez, Teresa Satterfield Linares

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Objectives: Focusing on the reported levels of depressive symptoms from Hispanic individuals in the U.S. during the ongoing COVID-19 pandemic, we analyze the psychological effects of being labeled an ‘essential worker/trabajador(a) esencial.’ We situate this attribute within the complex context of how an individual’s mental health is linked to work status and his/her community’s attitude toward such a status. Method: 336 Spanish-speaking adults (Mage = 34.90; SD = 11.00; 46% female) living in the U.S. participated in a mixed-method study. Participants completed a self-report Spanish-language survey consisting of COVID-19 prompts (e.g., Soy un trabajador esencial durante la pandemia. I am an ‘essential worker’ during the pandemic), civic engagement scale (CES) attitudes (e.g., Me siento responsable de mi comunidad. I feel responsible for my community) and behaviors (e.g., Ayudo a los miembros de mi comunidad. I help members of my community), and the Center for Epidemiological Studies Depression Scale (e.g., Me sentía deprimido/a. I felt depressed). The survey was conducted several months into the pandemic and before the vaccine distribution. Results: Regression analyses show that being labeled an essential worker was correlated to CES attitudes (b= .28, p < .001) and higher CES behaviors (b= .32, p < .001). Essential worker status also reported higher levels of depressive symptoms (b= .17, p < .05). In addition, we found that CES attitudes and CES behaviors were related to higher levels of depressive symptoms (b= .11, p <.05, b = .22, p < .001, respectively). These findings suggest that those who are on the frontlines during the COVID-19 pandemic suffer higher levels of depressive symptoms, despite their affirming community attitudes and behaviors. Discussion: Hispanics/Latinxs make up 53% of the high-proximity employees who must work in person and in close contact with others; this is the highest rate of any racial or ethnic category. Moreover, 31% of Hispanics are classified as essential workers. Our outcomes show that those labeled as trabajadores esenciales convey attitudes of remaining strong and resilient for COVID-19 victims. They also express community attitudes and behaviors reflecting a sense of responsibility to continue working to help others during these unprecedented times. However, we also find that the pressure of maintaining basic needs for others exacerbates mental health challenges and stressors, as many essential workers are anxious and stressed about their physical and economic security. As a result, community attitudes do not protect from depressive symptoms as Hispanic essential workers are failing to balance everyone’s needs, including their own (e.g., physical exhaustion and psychological distress). We conclude with a discussion on alternatives to the phrase ‘essential worker’ and of incremental steps that can be taken to address pandemic-related mental health issues targeting US Hispanic workers.

Keywords: COVID-19, essential worker, mental health, race and ethnicity

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Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila

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Introduction: The risk factors for the chronicization of postoperative pain are numerous and often intricately intertwined. Among these, the severity of acute postoperative pain is currently recognized as one of the most determining factors. Mastectomy and thoracotomy are described as among the most painful surgeries and the most likely to lead to chronic post-surgical pain (CPSP). Objective: To examine the aspects of acute postoperative pain potentially involved in the development of chronic pain following breast and thoracic surgery. Patients and Methods: A prospective study involving 164 patients was conducted over a six-month period. Postoperative pain (during mobilization) was assessed using a Visual Analog Scale (VAS) at various time points after surgery: Day 0, 1st, 2nd, 5th days, 1st and 6th months. Moderate to severe pain was defined as a VAS score ≥ 4. A comparative analysis (univariate analysis) of postoperative pain intensities at different evaluation phases was performed on patients with and without CPSP to identify potential associations with the risk of chronicization six months after surgery. Results: At the 6th month post-surgery, the incidence of CPSP was 43.0%. Moderate to severe acute postoperative pain (in the first five days) was observed in 64% of patients. The highest pain scores were reported among thoracic surgery patients. Comparative measures revealed a highly significant association between the presence of moderate to severe acute pain, especially lasting for ≥ 48 hours, and the occurrence of CPSP (p-value <0.0001). Likewise, the persistence of subacute pain (up to 4 to 6 weeks after surgery), especially of moderate to severe intensity, was significantly associated with the risk of chronicization at six months (p-value <0.0001). Conclusion: CPSP after breast and thoracic surgery remains a fairly common morbidity that profoundly affects the quality of life. Severe acute postoperative pain, especially if it is prolonged and/or with a slow decline in intensity, can be an important predictive factor for the risk of chronicization. Therefore, more effective and intensive management of acute postoperative pain, as well as longitudinal monitoring of its trajectory over time, should be an essential component of strategies for preventing chronic pain after surgery.

Keywords: chronic post-surgical pain, acute postoperative pain, breast and thoracic surgery, subacute postoperative pain, pain trajectory, predictive factor

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

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

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

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Authors: Manana Lobzhanidze, Marine Kobalava, Lali Chikviladze

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The global pandemic crisis has had a significant impact on educational migration, substantially limiting young people’s access to education abroad. Therefore, it became necessary to study the economic, demographic, social, cultural and other factors associated with educational migration, to identify the economic and political challenges of educational migration and to develop recommendations. The aim of the research is to study the effects of the atypical crisis on educational migration and to make recommendations on effective migration opportunities based on the identification of economic and policy challenges in this area. Bibliographic research is used to assess the effects of the impact of the atypical crisis on educational migration presented in the papers of various scholars. Against the background of the restrictions imposed during the COVID19 pandemic, migration rates have been analyzed, endogenous and exogenous factors affecting educational migration have been identified. Quantitative and qualitative research of students and graduates of TSU Economics and Business Faculty is conducted, the results have been processed by SPSS program, the factors hindering educational migration and the challenges have been identified. The Internet and digital technologies have been shown to play a vital role in alleviating the challenges posed by the COVID-19 pandemic, however, lack of Internet access and limited financial resources have played a disruptive role in the educational migration process. The analysis of quantitative research materials revealed the problems of educational migration caused by the atypical crisis, while some issues were clarified during the focus group meetings. The following theoretical-methodological approaches were used during the research: a bibliographic research, analysis, synthesis, comparison, selection-grouping are used; Quantitative and qualitative research has been carried out, the results have been processed by SPSS program. The article presents the consequences of the atypical crisis for educational migration, identifies the main economic and policy challenges in the field of educational migration, and develops appropriate recommendations to overcome them.

Keywords: educational migration, atypical crisis, economic-political challenges, educational migration factors

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Authors: Mayantoinette F. Watson

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During such an unprecedented time of the largest public health crisis, the COVID-19 pandemic, nursing students are of the utmost concern regarding their psychological and physical well-being. Questions are emerging and circulating about what will happen to the nursing students and the long-term effects of the pandemic, especially now that hospitals are being overwhelmed with a significant need for nursing staff. Expectations, demands, change, and the fear of the unknown during this unprecedented time can only contribute to the many stressors that accompany nursing students through laborious clinical and didactic courses in nursing programs. The risk of psychological distress is at a maximum, and its effects can negatively impact not only nursing students but also nursing education and academia. The high exposures to interpersonal, economic, and academic demands contribute to the major health concerns, which include a potential risk for psychological distress. Achievement of educational success among nursing students is directly affected by the high exposure to anxiety and depression from experiences within the program. Working relationships and achieving academic success is imperative to positive student outcomes within the nursing program. The purpose of this study is to identify and establish influences and associations within multilevel factors, including the effects of the COVID-19 pandemic on psychological distress in nursing students. Neuman’s Systems Model Theory was used to determine nursing students’ responses to internal and external stressors. The research in this study utilized a mixed-methods, convergent study design. The study population included undergraduate nursing students from Southeastern U.S. The research surveyed a convenience sample of undergraduate nursing students. The quantitative survey was completed by 202 participants, and 11 participants participated in the qualitative follow-up interview surveys. Participants completed the Kessler Psychological Distress Scale (K6), the Perceived Stress Scale (PSS4), and the Dundee Readiness Educational Environment Scale (DREEM12) to measure psychological distress, perceived stress, and perceived educational environment. Participants also answered open-ended questions regarding their experience during the COVID-19 pandemic. Statistical tests, including bivariate analyses, multiple linear regression analyses, and binary logistics regression analyses were performed in effort to identify and highlight the effects of independent variables on the dependent variable, psychological distress. Coding and qualitative content analysis were performed to identify overarching themes within participants’ interviews. Quantitative data were sufficient in identifying correlations between psychological distress and multilevel factors of coping, marital status, COVID-19 stress, perceived stress, educational environment, and social support in nursing students. Qualitative data were sufficient in identifying common themes of students’ perceptions during COVID-19 and included online learning, workload, finances, experience, breaks, time, unknown, support, encouragement, unchanged, communication, and transmission. The findings are significant, specifically regarding contributing factors to nursing students’ psychological distress, which will help to improve learning in the academic environment.

Keywords: nursing education, nursing students, pandemic, psychological distress

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Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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Authors: Wafa Nouari

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The paper investigates the advantages and drawbacks of online creative writing courses for Algerian university students, particularly in light of the COVID-19 pandemic. The paper employs a mixed-methods approach, using both quantitative and qualitative data from surveys, interviews, and online course evaluations. The paper examines three online creative writing courses offered by Oxford University, Stanford University, and Coursera. The paper shows that online creative writing courses can improve the student's writing abilities, enthusiasm, and self-confidence, as well as introduce them to various literary forms and cultures. However, the paper also highlights some challenges and obstacles that the students encounter, such as technical problems, language difficulties, cultural gaps, and lack of feedback and interaction. The paper argues that online creative writing courses can be a useful alternative or addition to conventional classroom instruction, especially during the pandemic. The paper also offers some suggestions for enhancing the quality and effectiveness of online creative writing courses, such as giving more direction, support, and feedback to the students, as well as creating a sense of community and cooperation among them.

Keywords: online creative writing courses, Algerian university students, mixed methods approach, benefits and chanllenges

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Authors: Ana Claudia de Souza Costa, Beatriz de Cássia Pinheiro Goulart, Karine de Cássia Cavalari, Henrique Ceretta Oliveira, Edineis de Brito Guirardello

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Background: During the COVID-19 pandemic, nursing represents the largest category of health professionals who were on the front line. Thus, investigating the practice environment and the job satisfaction of nursing professionals during the pandemic becomes fundamental since it reflects on the quality of care and the safety climate. The aim of this study was to evaluate and compare the nursing professionals' perception of the work environment, job satisfaction, and safety climate of the different hospitals and work shifts during the COVID-19 pandemic. Method: This is a cross-sectional survey with 130 nursing professionals from public, private and mixed hospitals in Brazil. For data collection, was used an electronic form containing the personal and occupational variables, work environment, job satisfaction, and safety climate. The data were analyzed using descriptive statistics and ANOVA or Kruskal-Wallis tests according to the data distribution. The distribution was evaluated by means of the Shapiro-Wilk test. The analysis was done in the SPSS 23 software, and it was considered a significance level of 5%. Results: The mean age of the participants was 35 years (±9.8), with a mean time of 6.4 years (±6.7) of working experience in the institution. Overall, the nursing professionals evaluated the work environment as favorable; they were dissatisfied with their job in terms of pay, promotion, benefits, contingent rewards, operating procedures and satisfied with coworkers, nature of work, supervision, and communication, and had a negative perception of the safety climate. When comparing the hospitals, it was found that they did not differ in their perception of the work environment and safety climate. However, they differed with regard to job satisfaction, demonstrating that nursing professionals from public hospitals were more dissatisfied with their work with regard to promotion when compared to professionals from private (p=0.02) and mixed hospitals (p< 0.01) and nursing professionals from mixed hospitals were more satisfied than those from private hospitals (p= 0.04) with regard to supervision. Participants working in night shifts had the worst perception of the work environment related to nurse participation in hospital affairs (p= 0.02), nursing foundations for quality care (p= 0.01), nurse manager ability, leadership and support (p= 0.02), safety climate (p< 0.01), job satisfaction related to contingent rewards (p= 0.04), nature of work (p= 0.03) and supervision (p< 0.01). Conclusion: The nursing professionals had a favorable perception of the environment and safety climate but differed among hospitals regarding job satisfaction for the promotion and supervision domains. There was also a difference between the participants regarding the work shifts, being the night shifts, those with the lowest scores, except for satisfaction with operational conditions.

Keywords: health facility environment, job satisfaction, patient safety, nursing

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Authors: Obose Angela Oriazowanlan

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The role of entrepreneurship in preventing poverty and mitigating other post-retirement challenges has been acknowledged to be crucial for effective post-retirement life management, but financial constraints could constitute a bane to pre-retirees’ entrepreneurial intentions. Therefore, the study determined the financial knowledge that could spur their intentions and readiness for a business start that could enable them to surmount post-retirement life challenges. Two research questions guided the study. The descriptive survey research design was adopted and the population comprised all the pre-retirees in universities in Edo State. 250 respondents were randomly selected using the simple random sampling technique from three purposive selected universities. Primary data were gathered through the use of a structured questionnaire, which was validated and tested to have a reliability coefficient value of 0.84. The descriptive statistics of mean and standard deviation were used to answer the research questions and test the respondents’ homogeneity. The findings revealed, among others, that the respondents perceived the benefits of entrepreneurship-business startups to ensure their effective post-retirement life management but intended to rely totally on their retirement savings benefits with the Contributory Pension Scheme (CPS) for business startups. Based on the findings, it was recommended, among others, that pre-retirees should make contingency savings plans and that the employers and government should provide them with financial education in order to acquaint them with relevant financial knowledge to access other forms of business financing such as loans, bank overdraft, angel investors, venture capital and government grants among others prior to final disengagement.

Keywords: financial knowledge, entrepreneurial intentions, availability of business funds, business investment and fulfilled post-retirement living.

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Authors: Saima Akbar

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The global financial crisis severely and adversely impacted the Pakistanis’ financial setups with far-reaching consequences for its victims. This study aimed to analyze the various determinants of the banks’ financial performance in Pakistan. The stepwise multiple regression analysis and pre-post analysis were carried out in this regard by using SPSS ver 22. The study found that the assets quality is the most influential determinant of return over assets followed by bank size and solvency. Advances, liquidity, investments, and size have positive while poor assets quality and deposits have a negative impact on the return over assets. The comparison of the pre-crisis and post-crisis coefficient values of the independent variables revealed that the global financial crisis had exerted a significant impact on the relative ability of the financial performance determinants to explain variations in return over assets.

Keywords: pre-crisis, post-crisis, coefficient values, determinants

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Authors: Emmanuel Iyamuremye, Irenee Ndayambaje

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This study investigated the influence of Concrete Pictorial Abstract (CPA) teaching approach on mathematics achievement based on a sample of eighth-grade students (N = 10,345) from the Rwandan Lower Secondary School quasi-experimental study with pre-test and post-test control group of 2019 (RLSQES19). Key aspects studied included mathematics concept understanding and mathematics concept retention and how these are influenced by teacher's teaching approach. Specifically, the study aimed to a.) investigate students' concept understanding and concept retention in mathematics when exposed to CPA approach and to those exposed to non-CPA approach before and after the intervention, and b.) ascertain the significant difference between the performance of the students exposed to CPA approach and those exposed to non-CPA approach in terms of post-test scores and retention test scores. Two groups (control and experimental) undergone pre-test, post-test, and retention test. The assignment of control and experimental group among senior two classes from 10 schools was done randomly. The materials used to determine the performance of the students is a teacher-made test. Descriptive statistics and ANCOVA were used for the analysis of the study. For determining the improvement in concept understanding of mathematics, Hakes methods of calculating gain were used to analyze the pre-test and post test score. The level of performance of the two groups in the pre-test is below average level. During the post-test and retention test, the performance of students in non-CPA group is on average level, and students in CPA group are on above average level. Hakes methods of calculating gain revealed higher significant performance in the post-test and retention test of CPA group of students than non-CPA group of students.

Keywords: concept understanding, concept retention, performance, teaching approach

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Authors: Abdul Hafeez, Shahid Adeel, Ayesha Hussain

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There are number of plants species in the universe which give the protections from different diseases and give colour for the foods and textiles. The environmental condition of the universe suggested toward the ecofriendly textiles. The aim of the paper is to analyze the influence of pre & post mordanting of alum on radiated cotton fabric with Gamma Radiation of different doses by using Ipomoea indica leaves extract. Alum used as mordant with the concentration of 2, 4, 6, 8 and 10% as pre and post mordanting to observe the effect of light and colour fastness of radiated cotton. 6% of alum concentration in pre mordanting gave good colour strength 117.82 with darker in shade toward the greenish tone and in post mordanting 6% concentration gave good colour strength 102.19. The lab values show that the colour is darker in tone and gave bluish effect. Further results showed that alum gave good light and rubbing fastness on gamma radiated cotton fabric.

Keywords: Ipomoea indica, gamma radiation, alum, light fastness

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Authors: Lara A. Alshawawreh, R. Sean Smith, John B. Wood

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This study focuses on the sheltering response in the Middle East, specifically through reviewing two Syrian refugee camps in Jordan, involving Zaatari and Azraq. Zaatari camp involved the rapid deployment of tents and shelters over a very short period of time and Azraq was purpose built and pre-planned over a longer period. At present, both camps collectively host more than 133,000 occupants. Field visits were taken to both camps and the main issues and problems in the sheltering response were highlighted through focus group discussions with camp occupants and inspection of shelter habitats. This provided both subjective and objective research data sources. While every case has its own significance and deployment to meet humanitarian needs, there are some common requirements irrespective of geographical region. The results suggest that there is a gap in the suitability of the required habitat needs and what has been provided. It is recommended that the global international response and support could be improved in relation to the habitat form, construction type, layout, function and critically the cultural aspects. Services, health and hygiene are key elements to the shelter habitat provision. The study also identified the amendments to shelters undertaken by the beneficiaries providing insight into their key main requirements. The outcomes from this study could provide an important learning opportunity to develop improved habitat response for future shelters.

Keywords: culture, post-disaster, refugees, shelters

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