Search results for: public care

Authors: Nour Eddine Nachouane, Aicha Knidiri

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The Hispano-Moorish art was born in 786 when Abd ar-Rahman built the first mosque in Cordoba. It is a still-living art in the trades of the big Moroccan cities. Everyone agrees that the different artistic forms of Arab-Muslim art find their full development in traditional Moroccan architecture, and this heritage allows artists and artisans to create magnificent masterpieces. Marrakech, by way of example, constitutes a symbolic city, which represents the reflection of a rich history of this art carried by a long artisanal tradition that is still living nowadays. Despite its ratification by UNESCO as intangible cultural heritage, and beyond official speeches, several of those craft trades are endangered, and with them the whole history of millennial savoir-faire. From the empirical study of the old historic center, 'the medina' of Marrakech, we explore in this article the opportunity offered by the tourism industry in order to protect these craft trades. We question artisans on the evolution of the sector and the challenges of the transmission of this heritage. We evoke the case of Spanish cities like Granada in a comparative reflection on the strategies and perceptions of the public administrations of a part, and, on the other hand, on the shared experience of artisans and tourists. In an interdisciplinary approach mixing anthropology, history, sociology, and even geography, we question the capacity of heritage processes to mobilize and involve a set of actors and activate a trajectory for the safeguarding of Andalusian arts and techniques. The basic assumption of this research is that the promotion of traditional craft trades through tourism and based on good scientific knowledge can present an original offer to cope with globalization and guarantee the transmission of that savoir-faire to new generations. Research in the field of Islamic arts does not constitute a retreat into the nationalist identity or a fixation on the past but an opening towards cultural diversity, free from any standardization.

Keywords: heritage, art andalusi, handcraft, tourism

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Authors: H. Fuad Usman, M. Rafay Khan Sial, Shahzaib Hamid

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The trend of renewable energy resources has been amplified due to global warming and other environmental related complications in the 21st century. Recent research has very much emphasized on the generation of electrical power through renewable resources like solar, wind, hydro, geothermal, etc. The use of the photovoltaic cell has become very public as it is very useful for the domestic and commercial purpose overall the world. Although a single cell gives the low voltage output but connecting a number of cells in a series formed a complete module of the photovoltaic cells, it is becoming a financial investment as the use of it fetching popular. This also reduced the prices of the photovoltaic cell which gives the customers a confident of using this source for their electrical use. Photovoltaic cell gives the MPPT at single specific point of operation at a given temperature and level of solar intensity received at a given surface whereas the focal point changes over a large range depending upon the manufacturing factor, temperature conditions, intensity for insolation, instantaneous conditions for shading and aging factor for the photovoltaic cells. Two improved algorithms have been proposed in this article for the MPPT. The widely used algorithms are the ‘Incremental Conductance’ and ‘Perturb and Observe’ algorithms. To extract the maximum power from the source to the load, the duty cycle of the convertor will be effectively controlled. After assessing the previous techniques, this paper presents the improved and reformed idea of harvesting maximum power point from the photovoltaic cells. A thoroughly go through of the previous ideas has been observed before constructing the improvement in the traditional technique of MPP. Each technique has its own importance and boundaries at various weather conditions. An improved technique of implementing the use of both ‘Perturb and Observe’ and ‘Incremental Conductance’ is introduced.

Keywords: duty cycle, MPPT (Maximum Power Point Tracking), perturb and observe (P&O), photovoltaic module

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

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Authors: M. Azharul Islam, M. Russel Sarker, M. Shahadat Hossen

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Air pollution is one of the major environmental problems that have gained importance in all over the world. Air pollution is a problem for all of us. The present study was conducted to explore the people’s perception level and awareness of air pollution in selected areas of Mymensingh in Bangladesh. Health impacts of air pollution also studied through personal interview and structured questionnaire. The relationship of independent variables (age, educational qualification, family size, residence and communication exposure) with the respondent’s perception level and awareness of air pollution (dependent variable) was studied to achieve the objectives of the study. About 600 respondents were selected randomly from six sites for collecting data during the period of July 2016 to June 2017. Pearson’s product-moment correlation coefficients were computed to examine the relationship between the concerned variables. The results revealed that about half (46.67%) of the respondents had a medium level of perception and awareness about air pollution in their areas where 31.67 percent had low, and 21.67 percent had a high level. In rural areas of the study sites, 43.33 percent respondents had low, 50 percent had medium, and only 6.67 percent had high perception and awareness on air pollution. In case of urban areas, 20 percent respondents had low, 43.33 percent had medium, and 36.67 percent had a high level of awareness and perception on air pollution. The majority of the respondents (93.33 percent) were lacking of proper awareness about air pollution in rural areas while 63.33 percent in urban areas. Out of five independent variables, three variables such as- educational qualification, residence status and communication exposure had positive and significant relationship. Age of respondents had negative and significant relationship with their awareness of air pollution where family size of the respondents had no significant relationship with their perception and awareness of air pollution. Thousands of people live in urban areas where urban smog, particle pollution, and toxic pollutants pose serious health concerns. But most of the respondents of the urban sites are not familiarize about the real causes of air pollution. Respondents exposed higher level of experience for air pollutants, such as- irritation of the eyes, coughing, tightness of chest and many health difficulties. But respondents of both rural and urban area hugely suffered such health problems and the tendency of certain difficulties increased day by day. In this study, most of the respondents had lack of knowledge on the causes of such health difficulties due to their lower perception level. Proper attempts should be taken to raise literacy level, communication exposure to increase the perception and awareness of air pollution among the respondents of the study areas. Extra care with above concerned fields should be taken to increase perception and awareness of air pollution in rural areas.

Keywords: air pollution, awareness, health impacts, perception of people

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Authors: Oluwatobi Emmanuel Olaniyi, Babafemi George Ogunjemite

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The high rate of infrastructural development in Ikogosi warm spring towards harnessing her great ecotourism potentials calls for a serious concern, as more forest areas are been opened up for public access and the landscape is modified. On this note, we investigated the implication of ecotourism development on the floristic composition and forest structure in Ikogosi. The study aimed at identifying the past and present status of infrastructural development, assessing and comparing the floristic composition and structure of the built- up/ recreational areas and undisturbed forested areas, to infer on the impact of ecotourism development on the study site. We conducted stakeholder interview and field observation to identify the past and present status of infrastructural development respectively. A total of ten quadrants were employed in the vegetation assessment to characterize the woody tree species composition, diameter at breast height and height, to obtain mean indices characterizing each part of the site. These indices were compared using T – test analysis. A total of 49 different woody tree species distributed in 21 families were identified in the built-in/ recreational areas while 67 different woody tree species belonging to 25 families were recorded in the undeveloped forested areas. Although, the latter has a higher mean diameter at breast height of woody trees, it was not significantly different from the former (T-test = -0.74, p = 0.46). On the contrary, the built-up area had a higher mean trees height than the undeveloped areas, but the difference was not statistically significant (T-test= 1.04, p = 0.30). Despite these, the slight reduction in richness and diversity of the woody tree species in the built- up/ recreational areas implies mitigating the negative effects of infrastructural development on the warm spring's vegetation.

Keywords: ecosystem services, forest structure, vegetation assessment, warm-spring

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Authors: P. Mukhopadhyay, N. C. Dey

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Occupational health hazard is a very common term in every emerging country. Along with the unorganized sector, most organized sectors including government industries are suffering from this affliction. In addition to workload, the seasonal changes also have some impacts on working environment. With this focus in mind, one hundred male industrial workers, who are directly involved to the task of Periodic Overhauling (POH) in a fabricating workshop in the public domain are selected for this research work. They have been studied during work periods throughout different seasons in a year. For each and every season, the participants working heart rate (WHR) is measured and compared with the standards given by different national and internationally recognized agencies i.e., World Health Organization (WHO) and American Conference of Governmental Industrial Hygienists (ACGIH) etc. The different environmental parameters i.e. dry bulb temperature (DBT), wet bulb temperature (WBT), globe temperature (GT), natural wet bulb temperature (NWB), relative humidity (RH), wet bulb globe temperature (WBGT), air velocity (AV), effective temperature (ET) are recorded throughout the seasons to critically observe the effect of seasonal changes on the WHR of the workers. The effect of changes in environment to the WHR of the workers is very much surprising. It is found that the percentages of workers who belong to the ‘very heavy’ workload category are 83.33%, 66.66% and 16.66% in the summer, rainy and winter seasons, respectively. Ongoing undertaking of this type of job profile forces the worker towards occupational disorders causing absenteeism. This occurrence results in lower production rates, and on the other hand, costs due to medical claims also weaken the industry’s economic condition. In this circumstance, the authors are trying to focus on some remedial measures from the ergonomic angle by proposing a new work/ rest regimen and introducing engineering controls along with management controls which may help the worker, and consequently, the management also.

Keywords: workload, working heart rate, occupational health hazard, industrial worker

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Authors: K. C. Wong, K. L. Siu, S. N. Ng, K. N. Yip, Y. Y. Yuen, K. W. Lee, K. W. Wong, C. C. Li, H. P. Lam

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Background: Occupational injuries among nursing profession were found related to repeated bedside nursing care, such as transfer, lifting and manual handling patients from previous studies. Likewise, undergraduate nursing students are also exposed to potential safety hazard due to their similar work nature of registered nurses. Especially, those students who worked as Temporary undergraduate nursing students (TUNS) which is a part-time clinical job in hospitals in Hong Kong who mainly assisted in providing bedside cares appeared to at high risk of work-related injuries. Several studies suggested the level of compliance with safe work behaviors was highly associated with work-related injuries. Yet, it had been limitedly studied among nursing students. This study was conducted to assess and compare the compliance with safe work behaviors and the levels of awareness of different workplace safety issues between undergraduate nursing students with or without TUNS experiences. Methods: This is a quantitative descriptive study using convenience sampling. 362 undergraduate nursing students in Hong Kong were recruited. The Safe Work Behavior relating to Patient Handling (SWB-PH) was used to assess their compliance of safe-work behaviors and the level of awareness of different workplace safety issues. Results: The results showed that most of the participants (n=250, 69.1%) who were working as TUNS. However, students who worked as TUNS had significantly lower safe-work behaviors compliance (mean SWB-PH score = 3.64±0.54) than those did not worked as TUNS (SWB-PH score=4.21±0.54) (p<0.001). Particularly, these students had higher awareness to seek help and use assistive devices but lower awareness of workplace safety issues and awareness of proper work posture than students without TUNS experiences. The students with TUNS experiences had higher engagement in help-seeking behaviors might be possibly explained by their richer clinical experiences which served as a facilitator to seek help from clinical staff whenever necessary. Besides, these experienced students were more likely to bear risks for occupational injuries and worked alone when no available aid which might be related to the busy working environment, heightened work pressures and high expectations of TUNS. Eventually, students who worked as TUNS might target on completing the assigned tasks and gradually neglecting the occupational safety. Conclusion: The findings contributed to an understanding of the level of compliance with safe work behaviors among nursing students with different clinical experiences. The results might guide the modification of current safety protocols and the introduction of multiple clinical training courses to improve nursing student’s engagement in safe work behaviors.

Keywords: Occupational safety, Safety compliance, Safe-work behavior, Nursing students

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Authors: Ekeh Greg

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Learning has been part of human existence from time immemorial. The aim of every learning is to know the truth. In education, it is desirable that true knowledge is imparted and imbibed. For this to be achieved, there is need for honesty, in this context, academic honesty among students, especially in e-learning. This is an ethical issue since honesty bothers on human conduct. However, research findings have shown that academic honesty has remained a big challenge to online learners, especially among the university students. This is worrisome since the university education is the final education system and a gateway to life in the wider society after schooling. If they are practicing honesty in their academic life, it is likely that they will practice honesty in the in the society, thereby bringing positive contributions to the society wherever they find themselves. With this in mind, the significance of this study becomes obvious. On grounds of this significance, this paper focuses on strategies that are adjudged certain to enhance the practice of honesty in e-learning so as to enable learners to be well equipped to contribute to the society through honest ways. The aim of the paper is to contribute to the efforts of instilling the consciousness and practice of honesty in the minds and hearts of learners. This will, in turn, promote effective teaching and learning, academic high standard, competence and self-confidence in university education. Philosophical methods of conceptual analysis, clarification, description and prescription are adopted for the study. Philosophical perspective is chosen so as to ground the paper on the basis of rationality rather than emotional sentiments and biases emanating from cultural, religious and ethnic differences and orientations. Such sentiments and biases can becloud objective reasoning and sound judgment. A review of related literature is also carried out. The findings show that academic honesty in e-learning is a cherished value, but it is bedeviled by some challenges, such as care-free attitude on the part of students and absence of monitoring. The findings also show that despite the challenges facing academic honesty, strategies such as self-discipline, determination, hard work, imbibing ethical and philosophical principles, among others, can certainly enhance the practice of honesty in e-learning among university students. The paper, therefore, concludes that these constitute strategies for enhancing academic honesty among students. Consequently, it is suggested that instructors, school counsellors and other stakeholders should endeavour to see that students are helped to imbibe these strategies and put them into practice. Students themselves are enjoined to cherish honesty in their academic pursuit and avoid short-cuts. Short-cuts can only lead to mediocrity and incompetence on the part of the learners, which may have long adverse consequences, both on themselves and others.

Keywords: academic, ethical, philosophical, strategies

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Authors: Daria Pashneva, Julija Pauraite, Agne Minderyte, Vadimas Dudoitis, Lina Davuliene, Kristina Plauskaite, Inga Garbariene, Steigvile Bycenkiene

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Black carbon (BC) has received particular attention around the world, not only for its impact on regional and global climate change but also for its impact on air quality and public health. In order to study the relationship between indoor and outdoor BC concentrations, studies were carried out in Vilnius, Lithuania. The studies are aimed at determining the relationship of concentrations, identifying dependencies during the day and week with a further opportunity to analyze the key factors affecting the indoor concentration of BC. In this context, indoor and outdoor continuous real-time measurements of optical BC-related light absorption by aerosol particles were carried out during the cold season (from October to December 2020). The measurement venue was an office located in an urban background environment. Equivalent black carbon (eBC) mass concentration was measured by an Aethalometer (Magee Scientific, model AE-31). The optical transmission of carbonaceous aerosol particles was measured sequentially at seven wavelengths (λ= 370, 470, 520, 590, 660, 880, and 950 nm), where the eBC mass concentration was derived from the light absorption coefficient (σab) at 880 nm wavelength. The diurnal indoor eBC mass concentration was found to vary in the range from 0.02 to 0.08 µgm⁻³, while the outdoor eBC mass concentration - from 0.34 to 0.99 µgm⁻³. Diurnal variations of eBC mass concentration outdoor vs. indoor showed an increased contribution during 10:00 and 12:00 AM (GMT+2), with the highest indoor eBC mass concentration of 0.14µgm⁻³. An indoor/outdoor eBC ratio (I/O) was below one throughout the entire measurement period. The weekend levels of eBC mass concentration were lower than in weekdays for indoor and outdoor for 33% and 28% respectively. Hourly mean mass concentrations of eBC for weekdays and weekends show diurnal cycles, which could be explained by the periodicity of traffic intensity and heating activities. The results show a moderate influence of outdoor eBC emissions on the indoor eBC level.

Keywords: black carbon, climate change, indoor air quality, I/O ratio

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Authors: Athena Pedro, Zandile Batweni, Laura Bradfield, Michael Dare, Ashley Nyman

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The rapid growth and development of an infant in the first 1000 days of life means that this time period provides the greatest opportunity for a positive developmental impact on a child’s life socially, emotionally, cognitively and physically. Current research is being focused on children in the first 1000 days, but there is a lack of research and understanding of mothers and their experiences during this crucial time period. Thus, it is imperative that more research is done to help better understand the experiences of mothers during the first 1000 days of their child’s life, as well as gain more insight into mothers’ knowledge regarding this time period. The first 1000 days of life, from conception to two years, is a critical period, and the child’s attachment to his or her mother or primary caregiver during this period is crucial for a multitude of future outcomes. The aim of this study was to explore mothers’ understanding and experience of the first 1000 days of their child’s life, specifically looking at attachment in the context of Bowlby and Ainsworths’ attachment theory. Using a qualitative methodological framework, data were collected through semi-structured individual interviews with 12 first-time mothers from low-income communities in Cape Town. Thematic analysis of the data revealed that mothers articulated the importance of attachment within the first 1000 days of life and shared experiences of how they bond and form attachment with their babies. Furthermore, these mothers expressed their belief in the long-term effects of early attachment of responsive positive parenting as well as the lasting effects of poor attachment and non-responsive parenting. This study has implications for new mothers and healthcare staff working with mothers of new-born babies, as well as for future contextual research. By gaining insight into the mothers’ experiences, policies and intervention efforts can be formulated in order to assist mothers during this time, which ultimately promote the healthy development of the nation’s children and future adult generation. If researchers are also able to understand the extent of mothers’ general knowledge regarding the first 1000 days and attachment, then there will be a better understanding of where there may be gaps in knowledge and thus, recommendations for effective and relevant intervention efforts may be provided. These interventions may increase knowledge and awareness of new mothers and health care workers at clinics and other service providers, creating a high impact on positive outcome. Thus, improving the developmental trajectory for many young babies allows them the opportunity to pursue optimal development by reaching their full potential.

Keywords: attachment, experience, first 1000 days, knowledge, mothers

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Authors: Esraa Elaraby, Dania Abu Zahra, Ghidaa Maswadah, Osama Amira, Mohamed Alshoura, Nihar Dash

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Background: Human being uses salon for a variety of purposes, from trimming of hair and shaving to a range of beauty treatments such as manicure and pedicure. Salon activities involve use of several instruments including scissors, scalpels and razors, materials such as soaps, solutions, creams and gels on human skin and body. Besides, salon customers also use chair, bed and many other common shared utensils and appliances. These salons related activities create a suitable environment for the transmission of several diseases and pathogens including hepatitis B and C, scabies, tuberculosis, staphylococcus and MRSA etc. The transmission of these pathogens can be prevented by maintenance of adequate hygiene and standard preventive measures. Aim: To assess the customer’s level of knowledge about salon-acquired infections and practices taken to prevent their transmission. Methods: A cross-sectional study was conducted among 500 participants across the Emirates. Moreover, self-administered questionnaires (in English and Arabic) were distributed through convenience sampling methods between February and April 2017. Results: The study included 500 participants of which 250 were females. The mean age of the study population was 33 years (SD=4.77). The participants were from several nationalities including 325 Arabs (Non-GCC) (66.2%), 108 Non-Arabs (22%), and 59 Arabs (GCC) (11.8%). The majority of the participants 421 (84.4%) had required knowledge about salon-associated infections with a mean knowledge score of 6/10 (60%). However, when it comes down to preventive practices, only 73 of the 500 participants (14.6%) did carry their own equipment. Thus, there was insufficient correlation between the level of knowledge and preventive practices (p=0.139) of salon-associated infections. Conclusion: People’s knowledge about the salon-associated infections among UAE residents was good, but only a small number practically took the required preventative measures towards this issue. Therefore, a public awareness program is recommended to enhance the deficiencies in knowledge and practices to prevent salon-acquired infections among the users. Up to our knowledge, this is the first study of this kind in the UAE targeting the salon customers about this important issue.

Keywords: awareness, knowledge, practices, salon-associated infections

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Dlir Abdullah Ahmed

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Overall aims of this study are to investigate the effects of differences of opinions among Shari’ah supervisory bodies on standardization and internationalization of Islamic banking products and services. The study has used semi-structured in-depth interview where five respondents from both the Middle East and Malaysia Shari’ah advisors participated in the interview sessions. The data were analyzed by both manual and software techniques. The findings reveal that indeed there are differences of opinions among Shari’ah advisors in different jurisdictions. These differences are due to differences in educational background, schools of thoughts, environment in which they operate, and legal requirements. Moreover, the findings also reveal that these differences in opinions among Shari’ah bodies create confusions among public and bankers, and negatively affect standardization of Islamic banking transactions. In addition, the study has explored the possibility to develop Islamic-based products. However, the finding shows that it is difficult for the industry to have Islamic-based products due to high competition from conventional counterpart, legal constraints and moral hazard. Furthermore, the findings indicate that lack of political will and unity, lack of technology are the main constraints to internationalization of Islamic banking products. Last but not least, the study found that there are possibility of convergence of opinions, standardization of Islamic banking products and services if there are unified international Shari’ah h advisory council, international basic requirements for Islamic Shari’ah h advisors, and increase training and educations of Islamic bankers. This study has several implications to the bankers, policymakers and researchers. The policymakers should be able to resolve their political differences and set up unified international advisory council and international research and development center. The bankers should increase training and educations of the workforce as well improve on their banking infrastructure to facility cross-border transactions.

Keywords: Shari’ah h views, Islamic banking, products & services, standardization.

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Authors: Taiebe Shokri, Shahram Yazdani, Leila Afshar, Soleiman Ahmadi

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Introduction: The importance of professionalism in higher education not only determines the appropriate and inappropriate behaviors and guides faculty members in the implementation of professional responsibilities, but also guarantees faculty members' adherence to professional principles and values, ensures the quality of teaching and facilitator will be the teaching-learning process in universities and will increase the commitment to meet the needs of students as well as the development of an ethical culture based on ethics. Therefore, considering the important role of medical education teachers to prepare teachers and students in the future, the need to determine the concept of professional teacher and teacher, and the characteristics of teacher professionalism, we have explained the concept of professionalism in teachers in this study. Methods: The concept analysis method used in this study was Walker and Avant method which has eight steps. Walker and Avant state the purpose of concept analysis as follows: The process of distinguishing between the defining features of a concept and its unrelated features. The process of concept analysis includes selecting a concept, determining the purpose of the analysis, identifying the uses of the concept, determining the defining features of the concept, identifying a model, identifying boundary and adversarial items, identifying the precedents and consequences of the concept, and defining empirical references. is. Results: Professionalism in its general sense, requires deep knowledge, insight, creating a healthy and safe environment, honesty and trust, impartiality, commitment to the profession and continuous improvement, punctuality, criticism, professional competence, responsibility, and Individual accountability, especially in social interactions, is an effort for continuous improvement, the acquisition of these characteristics is not easily possible and requires education, especially continuous learning. Professionalism is a set of values, behaviors, and relationships that underpin public trust in teachers.

Keywords: concept analysis, medical education, professionalism, faculty members

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Authors: Gabrielle Brand, Christopher Etherton-Beer

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The learning landscape of higher education environment is changing, with an increased focus over the past decade on how educators might begin to cultivate reflective skills in health professions students. In addition, changing professional requirements demand that health professionals are adequately prepared to practice in today’s complex Australian health care systems, including responding to changing demographics of population ageing. To counteract a widespread perception of health professions students’ disinterest in caring for older persons, the authors will report on an exploratory, mixed method research study that used photographs, narrative and small group work to enhance medical and nursing students’ reflective learning experience. An innovative photo-elicitation technique and reflective questioning prompts were used to increase engagement, and challenge students to consider new perspectives (around ageing) by constructing shared storylines in small groups. The qualitative themes revealed how photographs, narratives and small group work created learning spaces for reflection whereby students could safely explore their own personal and professional values, beliefs and perspectives around ageing. By providing the space for reflection, the students reported how they found connection and meaning in their own learning through a process of self-exploration that often challenged their assumptions of both older people and themselves as future health professionals. By integrating cognitive and affective elements into the learning process, this research demonstrates the importance of embedding visual methodologies that enhance reflection and transformative learning. The findings highlight the importance of integrating the arts into predominantly empirically driven health professional curricula and can be used as a catalyst for individual and/or collective reflection which can potentially enhance empathy, insight and understanding of the lived experiences of older patients. Based on these findings, the authors have developed ‘Depth of Field: Exploring Ageing’ an innovative, interprofessional, digital reflective learning resource that uses Prezi Inc. software (storytelling tool that presents ideas on a virtual canvas) to enhance students’ reflective capacity in the higher education environment.

Keywords: narrative, photo-elicitation, reflective learning, qualitative research

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Authors: Comsun Thongchai, Vorapoj Promasatayaprot

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Background: Child development center is a day care center that gathers large numbers of children in the same areas. As a result, it provides high opportunity for infection, especially gastrointestinal and respiratory infections. Ubon Ratchathani has been a province with an increasing number of cases of Hand foot and mouth disease each year reported between 2014 and 2016. Accorded to a recent investigation reported, HFMD occurred in the Child Development Center and kindergartens, this was a place where HFMD spreads. This research was aimed to investigate the knowledge, attitude and behavior about hand foot and mouth disease preventing of child caregivers in child development centers, Ubon Ratchathani Province. Method: Descriptive study was conducted between April and July, 2017. The study instruments used questionnaires and in-depth interviews on their practices of prevention and environment management of HFMD. The samples of survey questionnaires were caregivers who are working in 160 child development centers of the 160 parishes in Ubon Ratchathani province. The data was analyzed by percentages, means and standard deviations and Pearson Product Moment Correlation Coefficient. Result: The results showed that the majority were female (96.3%), average age 41 years (68.3%), marital status were couples (85.7%) and studied in undergraduate (75.2%). with a period of performance as teachers in child development centers range from 10 to 14 years were percentage 58.7 and 71.8 percent of them had been trained by health worker about the control HFMD. The knowledge for preventive in hand foot mouth disease on child caregivers was at high level. The mean score was 2.76 (S.D. = 0.114). The attitude of child caregivers was at a moderate level. Its mean score was 2.28 (S.D. = 0.247). On the other hand, the level of environmental management to prevent HFMD was low. The mean score was 1.34 (S.D. = 0.215). The factor of personal characteristics as gender, age, educational level, duration at work, knowledge and attitude of preventive HFMD was associated with Preventive of Behaviors to a statistically significant level (p<0.05 respectively). Conclusion: These results should be concerned to develop knowledge and improving practice for preventive hand foot mouth disease of child caregivers in child development centers by training. Preparation of media education, Surveillance of hand foot mouth disease and health behaviors promotion with community participation need to be supported continuously.

Keywords: preventive behavior, child development center, hand foot mouth disease, Thailand

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Authors: Namekong Fokeng Armand

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Background: Zoonoses are nowadays a serious public health problem in both developing and developed countries. They contribute to increase the economic burden. In case of emergence, rural populations are the most affected, hence the need to investigate risk practices in rural households of Penka-Michel (West Cameroon). Methods: This cross-sectional study was conducted from October to November 2021 among 200 heads of households living in the Penka-Michel health district (West Cameroon). It was done using a pre-tested and validated questionnaire, allowing to obtain socio-demographic, economic data, and data on zoonotic risk practices. Results: The participants [women (56%), men (44%)] worked mainly in the informal private sector (53%) and practiced agriculture secondarily (90%). Their highest level of education, for the most part, was a secondary school (50%); the average household size was 06 persons with a monthly income > 36270 FCFA (72%). 74% of household heads thought that animals can transmit diseases, and 17% had heard about zoonotic diseases through the media (65%). Rats caught in households (60%) were consumed there (74%), as was bush meat (61%) or dog meat (18%). For family food (90%), animals were slaughtered within the household (97%), rarely preceded by a veterinary inspection (6%). 87% of households practiced traditional rites with animal blood, 65% shared the same habitat as their animals, 41% did not systematically wash their hands after handling animals. More than 50% of households owned one or more dogs, usually strays (41%) and 48% of which were vaccinated (rabies). Many households had at least one: poultry (98%); pig (50%); dog (57%), cat (52%). 25% of households slaughtered sick animals for consumption, and 27% ate dead animals. Conclusion: This study identified numerous zoonotic risk practices in households in the Penka-Michel health district (West Cameroon). Concerted, multisectoral communication / awareness-raising actions are needed to break with these practices.

Keywords: zoonoses, risky practices, rural households, penka-michel, cameroon

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Authors: Zhaoxu Lu, Yufeng Ma, Linying Gao, Li Wang, Mei Qiang

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Mercury (Hg) is a well-recognized environmental pollutant known by its toxicity of development and neurotoxicity, which may result in adverse health outcomes. However, the mechanisms underlying the teratogenic effects of Hg are not well understood. Imprinting genes are emerging regulators for fetal development subject to environmental pollutants impacts. In this study, we examined the association between paternal preconception Hg exposures and the alteration of DNA methylation of imprinting genes in human sperm DNA. A total of 618 men aged from 22 to 59 was recruited from the Reproductive Medicine Clinic of Maternal and Child Care Service Center and the Urologic Surgery Clinic of Shanxi Academy of Medical Sciences during April 2015 and March 2016. Demographic information was collected using questionnaires. Urinary Hg concentrations were measured using a fully-automatic double-channel hydride generation atomic fluorescence spectrometer. And methylation status in the DMRs of imprinting genes H19, Meg3 and Peg3 of sperm DNA were examined by bisulfite pyrosequencing in 243 participants. Spearman’s rank and multivariate regression analysis were used for correlation analysis between sperm DNA methylation status of imprinting genes and urinary Hg levels. The median concentration of Hg for participants overall was 9.09μg/l (IQR: 5.54 - 12.52μg/l; range = 0 - 71.35μg/l); no significant difference was found in median concentrations of Hg among various demographic groups (p > 0.05). The proportion of samples that a beyond intoxication criterion (10μg/l) for urinary Hg was 42.6%. Spearman’s rank correlation analysis indicates a negative correlation between urinary Hg concentrations and average DNA methylation levels in the DMRs of imprinted genes H19 (rs=﹣0.330, p = 0.000). However, there was no such a correlation found in genes of Peg3 and Meg3. Further, we analyzed of correlation between methylation level at each CpG site of H19 and Hg level, the results showed that three out of 7 CpG sites on H19 DMR, namely CpG2 (rs =﹣0.138, p = 0.031), CpG4 (rs =﹣0.369, p = 0.000) and CpG6 (rs=﹣0.228, p = 0.000), demonstrated a significant negative correlation between methylation levels and the levels of urinary Hg. After adjusting age, smoking, drinking, intake of aquatic products and education by multivariate regression analysis, the results have shown a similar correlation. In summary, mercury nonoccupational environmental exposure in reproductive-aged men associated with altered DNA methylation outcomes at DMR of imprinting gene H19 in sperm, implicating the susceptibility of the developing sperm for environmental insults.

Keywords: epigenetics, genomic imprinting gene, DNA methylation, mercury, transgenerational effects, sperm

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Authors: Nora Kuiper, Candace Rowell, Hugues Preud'Homme, Basem Shomar

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As the global dependence on seawater desalination as a primary drinking water resource increases, a unique class of secondary pollutants is emerging. The presence of bromide salts in seawater may result in increased levels of bromine and brominated byproducts in drinking water. The State of Qatar offers a unique setting to study these pollutants and their impacts on consumers as the country is 100% dependent on seawater desalination to supply municipal tap water and locally produced bottled water. Tap water (n=115) and bottled water (n=62) samples were collected throughout the State of Qatar and analyzed for a suite of inorganic and organic compounds, including 54 volatile organic compounds (VOCs), with an emphasis on brominated byproducts. All VOC identification and quantification was completed using a Bruker Scion GCMSMS with static headspace technologies. A risk survey tool was used to collect information regarding local consumption habits, health outcomes and perception of water sources for adults and children. This study is the first of its kind in the country. Dibromomethane, bromoform, and bromobenzene were detected in 61%, 88% and 2%, of the drinking water samples analyzed. The levels of dibromomethane ranged from approximately 100-500 ng/L and the concentrations of bromoform ranged from approximately 5-50 µg/L. Additionally, bromobenzene concentrations were 60 ng/L. The presence of brominated compounds in drinking water is a public health concern specific to populations using seawater as a feed water source and may pose unique risks that have not been previously studied. Risk assessments are ongoing to quantify the risks associated with prolonged consumption of disinfection byproducts; specifically the risks of brominated trihalomethanes as the levels of bromoform found in Qatar’s drinking water reach more than 60% of the US EPA’s Maximum Contaminant Level of all THMs.

Keywords: brominated byproducts, desalination, trihalomethanes, risk assessment

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Authors: Aman Ullah Khan, Muhammad Younus, Aqil Ijaz, Muti-Ur-Rehman Khan, Sayyed Aun Muhammad, Asif Idrees, Sanan Raza, Amar Nasir

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Dengue fever and malaria are important vector-borne diseases of public health significance affecting millions of people around the globe. Dengue fever is caused by Dengue virus while malaria is caused by plasmodium protozoan. Generally, the consequences of Malaria are less severe compared to dengue fever. This study was designed to differentiate dengue fever and malaria on the basis of clinical and laboratory findings and to compare the changes in both diseases having different causative agents transmitted by the common vector. A total of 200 patients of dengue viral infection (120 males, 80 females) were included in this prospective descriptive study. The blood samples of the individuals were first screened for malaria by blood smear examination and then the negative samples were tested by anti-dengue IgM strip. The strip positive cases were further screened by IgM capture ELISA and their complete blood count including hemoglobin estimation (Hb), total and differential leukocyte counts (TLC and DLC), erythrocyte sedimentation rate (ESR) and platelet counts were performed. On the basis of the severity of signs and symptoms, dengue virus infected patients were subdivided into dengue fever (DF) and dengue hemorrhagic fever (DHF) comprising 70 and 100 confirmed patients, respectively. On the other hand, 30 patients were found infected with Malaria while overall 120 patients showed thrombocytopenia. The patients of DHF were found to have more leucopenia, raised hemoglobin level and thrombocytopenia < 50,000/µl compared to the patients belonging to DF and malaria. On the basis of the outcomes of the study, it was concluded that patients affected by DF were at a lower risk of undergoing haematological disturbance than suffering from DHF. While, the patients infected by Malaria were found to have no significant change in their blood components.

Keywords: dengue fever, blood, serum, malaria, ELISA

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Authors: Madeline Tagg, Choihoong Mui, Elizabeth Lek, Jide Menakaya

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Introduction: Simulation technology is used by neonatal teams to learn and refresh skills and gain the knowledge and confidence to care for sick neonates. In-situ simulation is considered superior to laboratory-based programmes as it closely mirrors real life situations. This study reports our experience of running regular laboratory-based simulation sessions for senior clinicians and nurses and its impact on their knowledge, skills and confidence. Methods: A before and after questionnaire survey was carried out on senior clinicians and nurses that attended a scheduled laboratory-based simulation session. Participants were asked to document their expectations before a 3-hour monthly laboratory programme started and invited to feedback their reflections at the end of the session. The session included discussion of relevant clinical guidelines, immersion in a scenario and video led debrief. The results of the survey were analysed in three skills based categories - improved, no change or a worsened experience. Results: 45 questionnaires were completed and analysed. Of these 25 (55%) were completed by consultants seven and six by nurses and trainee doctors respectively, and seven respondents were unknown. 40 (88%) rated the session overall and guideline review as good/excellent, 39 respondents (86%) rated the scenario session good/excellent and 40/45 fed back a good/excellent debrief session. 33 (73%) respondents completed the before and after questionnaire. 21/33 (63%) reflected an improved knowledge, skill or confidence in caring for sick new-bon babies, eight respondents reported no change and four fed back a worse experience after the session. Discussion: Most respondents found the laboratory based structured simulation session beneficial for their professional development. They valued equally the whole content of the programme such as guideline review and equipment training as well as the simulation and debrief sessions. Two out three participants stated their knowledge of caring for sick new-born babies had been transformed positively by the session. Sessions where simulation equipment failed or relevant staff were absent contributed to a poor educational experience. Summary: A regular structured laboratory-based simulation programme with a rich content is a credible educational resource for improving the knowledge, skills and confidence of senior clinicians caring for sick new born babies.

Keywords: knowledge, laboratory based, neonates, simulation

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Authors: Laxmi R. Kasaraneni

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The Internet connects all the networks, including the nation’s critical infrastructure that are used extensively by not only a nation’s government and military to protect sensitive information and execute missions, but also the primary infrastructure that provides services that enable modern conveniences such as education, potable water, electricity, natural gas, and financial transactions. It has become the central nervous system for the government, the citizens, and the industries. When it is attacked, the effects can ripple far and wide impacts not only to citizens’ well-being but nation’s economy, civil infrastructure, and national security. As such, these critical services may be targeted by malicious hackers during cyber warfare, it is imperative to not only protect them and mitigate any immediate or potential threats, but to also understand the current or potential impacts beyond the IT networks or the organization. The Nation’s IT infrastructure which is now vital for communication, commerce, and control of our physical infrastructure, is highly vulnerable to attack. While existing technologies can address some vulnerabilities, fundamentally new architectures and technologies are needed to address the larger structural insecurities of an infrastructure developed in a more trusting time when mass cyber attacks were not foreseen. This research is intended to improve the core functions of the Internet and critical-sector information systems by providing a clear path to create a safe, secure, and resilient cyber environment that help stakeholders at all levels of government, and the private sector work together to develop the cybersecurity capabilities that are key to our economy, national security, and public health and safety. This research paper also emphasizes the present and future cyber security threats, the capabilities and goals of cyber attackers, a strategic concept and steps to implement cybersecurity for maximum effectiveness, enabling technologies, some strategic assumptions and critical challenges, and the future of cyberspace.

Keywords: critical challenges, critical infrastructure, cyber security, enabling technologies, national security

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

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Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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Authors: Dukali Abujnah

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This study was undertaken to knowledge the chemical composition of some farm animals (cows ) by using ultrasonic milk analyzer. This method was used first time in our country in the field of milk hygiene to determine and comparison the composition percent of raw milk for farm animals as attempt to protect the health of consumers 240 raw milk samples for each species of animals included in this study for two different season of year first (Novembe 2014 - January 2015) , second from (May – Novembe2015) .The chemical analysis. In this way, a range of building suitable to put in the Libyan market product structures, and milk, for use as a new product or exposure to treatment such as pasteurized milk and long-life may be wider study project..Controls have been implemented in operating in Libya, companies which are part of the business created by the Libyan state. It was created only after the companies that made many of the studies and research carried out on areas of Libya which it was possible to intervene. Although troops spent in recent years, companies have not yet found their balance and milk production has not yet come to those set forth in the action plans, due to problems of various types that will be discussed in this study. We believe that these data have been taken in four years if analyzed properly, can provide more accurate information to farmers in their companies want to take dairy cattle breeding. The total bacterial count was 76 and 38 cfu/ml for locally produced and imported UHT milk respectively. Coliforms were negative for all examined locally produce and imported samples. E. coli were not isolated from any of the examined UHT samples. Aerobic spore-formers count mean count was 49 and 27 cfu/ml for both examined samples respectively. Obtained results show that most of the locally produced UHT milk does not satisfy the suggested Libyan Standards for UHT milk for fat% as well as total bacterial count/ml. Economical and public health importance of the obtained results were discussed, and control measures for improving the quality of UHT locally made milk were also discussed.

Keywords: locally, UHT milks, farms animals, raw milk analysis milk

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Authors: Jamie Sundvall, Lisa Jennings

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Site based field internship learning (SBL) is an educational approach within a Master’s of Social Work (MSW) university field placement department that promotes a more streamlined approach to the integration of theory and evidence based practices for social work students. The SBL model is founded on research in the field, consideration of current work force needs, United States national trends of MSW graduate skill and knowledge deficits, educational trends in students pursing a master’s degree in social work, and current social problems that require unique problem solving skills. This study explores the use of site-based learning in a hybrid social work program. In this setting, site based learning pairs online education courses and social work field education to create training opportunities for social work students within their own community and cultural context. Students engage in coursework in an online setting with both synchronous and asynchronous features that facilitate development of core competencies for MSW students. Through the SBL model, students are then partnered with faculty in a virtual course room and a university vetted site within their community. The study explores how this model of learning creates community partnerships, through which students engage in a learning loop to develop social work skills, while preparing students to address current community, social, and global issues with the engagement of technology. The goal of SBL is to more effectively equip social work students for practice according to current workforce demands, provide access to education and care to populations who have limited access, and create self-sustainable partnerships. Further, the model helps students learn integration of evidence based practices and helps instructors more effectively teach integration of ethics into practice. The study found that the SBL model increases the influence and professional relevance of the social work profession, and ultimately facilitates stronger approaches to integrating theory into practice. Current implementation of the practice in the United States will be presented in the study. dditionally, future research conceptualization of SBL models will be presented, in order to collaborate on advancing best approaches of translating theory into practice, according to the current needs of the profession and needs of social work students.

Keywords: collaboration, fieldwork, research, site-based learning, technology

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Authors: T. Aragaw, P. Gari

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In spite of social, political, and economic marginalization, women are still considered as the backbone of Ethiopia, one of the least developed countries in the world. The general purpose of this study was to assess factors that affect participation of women in politics, social and economic decisions at Kelem-Wollega Administrative Zone of Oromia Regional State, Ethiopia. Data used in this paper is mainly primary, and a few secondary data were incorporated. Respondents were selected using a systematic random sampling method and were placed questionnaires containing open-ended and closed-ended. Focus group discussion was also used for the study subjects in two offices. According to the information collected from the KWAZ Development and Social Service Office, a total of 18,473 tax-paying employees are present in the Zone, which is 14% of the total population of the Zone. Among the total number of employees in the Zone, 2,617 have been recruited for this study based on the criteria stated. This showed 1.8% of them were comprised of several churches and religious owned integrated development projects in the KWAZ. The 2,103 (80.34%) study participants responded personally, and they completed and returned the questionnaire to the researchers. The study revealed that in public institutions existed in KWAZ, the majority of women were having an educational status of diploma and lower, practicing lower non-decision making and leadership positions. Conclusion: Major barriers hindering women include: Socio-cultural attitudes, lack of necessary experience, education, the burden of domestic responsibilities, and lack of role models of women leaders in the Zone. Empowerment of women via social organizations, critical involvement of the government, and Affirmative action for women is critical. Further research is needed on the scope and challenges in implementing the strategies.

Keywords: women, affirmative action, leadership, empowerment, Ethiopia

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

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Authors: Ma'in Abushaikha

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Memorials are usually a landmark could be either an object, sculpture or a statue. They are built for a specific group or person who has died with historical contribution, or it could refer to an important hub, event or a specific culture, therefore to keep past events alive in the common memory through this kind of physical representation in public areas, or even to satisfy the desire to honour something either it is a person who suffered or died during a conflict or just to honour a group of people or even a whole society in a specific character they used to possess during a specific period of time. The aim behind the research is to look more deeply about the importance of memorials placement and environment for more successful outcomes towards people's psychology, therefore, behavior, manners and characteristics, knowing that in the main, they are usually set for function able purposes so people could be involved meaningfully therefore psychologically more than aesthetically. What contribution either positive or negative does memorialization through its physical/urban elements has towards people? Is it towards locals social reconstruction over time including either their understanding to the current conflicts or is it toward their general behavior, manners and characteristics in terms of psychology? And how important Memorial's placement is for the observer? Moreover, how does that either reduces or increases its value, attractiveness, and its effectiveness? This paper considers taking north Cyprus memorials as the main case study, is good enough as a choice to support the research hypothesis where a comparison between deferent memorials is going to be done as the main approach in trying to address the mentioned questions, by that, the research requires field survey in terms of interviewing both dwellers and general observers as well as library survey by viewing similar studies. As a significant result, this research is about to come up assesses how important memorials placements are, in order to apply its impact to the observers, whereas the most successful placed ones have its more effectiveness on observers psychology by time by introducing several mental reflects by this kind of physical representation.

Keywords: memorials, placement, environment, impact, psychology, characteristics, manners, behavior

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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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