Search results for: life cycle GHG

Authors: Lei Ping

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The Western discourse of ‘modernity’ along with its objects, ideologies, and culture are brought to Imperial China by force of arms which confronted Chinese traditions. The struggle and conflicts between ‘Zhong’ (Chinese) and ‘Wai' (foreign), ‘Jiu’(Old) and ‘Xin’(New) are continuous during the turbulent times of 19th Century China. Since the foundation of the People’s Republic in 1949, China has gone through radical social, economic and cultural reform under the Communist Party’s highly centralised and autocratic political regime. The regime and Chairman Mao’s eagerness to identify the new China and establish a revolutionary mono-culture have increased political influence on the modernisation process. The ten years of Cultural Revolution (1966-76) have commonly been neglected and separated from China’s modern history due to its political, emotional and various other associations. Its cultural productions which dictated the Chinese stages during this period, namely the yangbanxi (Model Works), are largely viewed as political propaganda material with little or no artistic value in the nation’s cultural development. This paper argues that far from being anti modernisation of culture, the yangbanxi carry continuities that originate from before the cultural revolution and influence later cultural productions up till today. The focus of the paper is on Hongse Niangzijun (The Red Detachment of Women), a ballet yangbanxi (Model Works) which was performed to President Nixon during his visit to China in 1972. It depicts the female soldier Wu Qionghua’s life story: a transformation from a peasant girl to a mature communist soldier. The first part of the paper begins with an introduction to the cultural, social and political contexts under which the ballet was created and made a yangbanxi (Model work). The second part examines the application of musical devices (e.g. instrumentation, leitmotif), ranging from typical Western techniques to Chinese musical and theatrical traditions. By analysing, connecting and comparing these musical devices of various origins, the paper illustrates that the yangbanxi (Model Works) largely contributes to the ever-present, continuing and evolving modernisation of contemporary Chinese culture.

Keywords: cultural revolution, Hongse Niangzijun (Red Detachment of Women), modern China, music, Yangbanxi (model works)

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Authors: Elvis Munyoka

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While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the paper will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugee youth, mental health, employment, resettlement, racism

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Authors: Manuela Amorim, Cláudia S. Marques, Maria Conceição Calhau, Hélder J. Pinheiro, Maria Manuela Pintado

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Recently it has been recognized peptides from different food sources with biological activities. However, no relevant study has proven the potential of brewer yeast peptides in the modulation of gut microbiota. The importance of human intestinal microbiota in maintaining host health is well known. Probiotics, prebiotics and the combination of these two components, can contribute to support an adequate balance of the bacterial population in the human large intestine. The survival of many bacterial species inhabiting the large bowel depends essentially on the substrates made available to them, most of which come directly from the diet. Some of these substrates can be selectively considered as prebiotics, which are food ingredients that can stimulate beneficial bacteria such as Lactobacilli or Bifidobacteria growth in the colon. Moreover, conventional food can be used as vehicle to intake bioactive compounds that provide those health benefits and increase people well-being. In this way, the main objective of this work was to study the potential prebiotic activity of brewer yeast peptide extract (BYP) obtained via hydrolysis of yeast proteins by cardosins present in Cynara cardunculus extract for possible use as a functional ingredient. To evaluate the effect of BYP on the modulation of gut microbiota in diet-induced obesity model, Wistar rats were fed either with a standard or a high-fat diet. Quantified via 16S ribosomal RNA (rRNA) expression by quantitative PCR (qPCR), genera of beneficial bacteria (Lactobacillus spp. and Bifidobacterium spp.) and three main phyla (Firmicutes, Bacteroidetes and Actinobacteria) were assessed. Results showed relative abundance of Lactobacillus spp., Bifidobacterium spp. and Bacteroidetes was significantly increased (P < 0.05) by BYP. Consequently, the potential health-promoting effects of WPE through modulation of gut microbiota were demonstrated in vivo. Altogether, these findings highlight the possible intervention of BYP as gut microbiota enhancer, promoting healthy life style, and the incorporation in new food products, leads them bringing associated benefits endorsing a new trend in the improvement of new value-added food products.

Keywords: functional ingredients, gut microbiota, prebiotics, brewer yeast peptide extract

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Authors: Barbara Klimek

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Wolves are one of the most misrepresented species in literature and the media. They’re often portrayed as vicious, man-eating beasts whose main life goal is to hunt and kill people. Many movie directors use wolves as their main characters in different types of films, especially horror, thriller and science fiction movies to create gore and fear. This, in turn, results in people being afraid of wolves and wanting to destroy them. Such cultural creations caused wolves being stalked, abused and killed by people and in many areas they were completely destroyed. This paper analyzes the representations of wolves in the chosen films in the four main portrayed aspects: 1. the overall picture – true versus false, positive versus negative, based on stereotypes or realistic, displaying wolf behavior typical of the species or fake 2. subjectivity – how humans treat and talk about the animals – as subjects or as objects 3. animal welfare – how humans treat wolves and nature, are the human – animal relations positive and appropriate or negative and abusive 4. empathy – are human characters shown to co-feel the suffering with the wolves, do they display signs of empathy towards the animals, do the animals empathize with humans? The detailed analysis of the text and pictures presented in the chosen films concludes that wolves are especially misrepresented in the movies. Their behavior is shown as fake and negative, based on stereotypes and myths, the human – animal relations are shown mainly as negative where people fear the animals and hunt them and wolves stalk, follow, attack and kill humans. It shows that people do not understand the needs of these animals and are unable to show empathy towards them. The article will discuss the above-mentioned study results in detail and will present many examples. Animal representations in cultural creations, including film have a great impact on how people treat particular species of animals. The media shape people’s attitudes, what in turn results in people either respecting and protecting the animals or fearing, disliking and destroying the particular species.

Keywords: film, movies, representations, wolves

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Authors: Enes Caliskan, Hatice Camgoz Akdag

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There is no doubt that humanity needs to realize the sustainability problems in the world and take serious action regarding that. All members of the United Nations adopted the 2030 Agenda for Sustainable Development, the most comprehensive study on sustainability internationally, in 2015. The summary of the study is 17 sustainable development goals. It covers everything about sustainability, such as environment, society and governance. The use of Information and Communication Technology (ICT), such as the Internet, mobile phones, and satellites, is essential for tackling the main issues facing sustainable development. Hence, the contributions of 3 major ICT companies to the sustainable development goals are assessed in this study. Quality Function Deployment (QFD) is utilized as a methodology for this study. Since QFD is an excellent instrument for comparing businesses on relevant subjects, a House of Quality must be established to complete the QFD application. In order to develop a House of Quality, the demanded qualities (voice of the customer) and quality characteristics (technical requirements) must first be determined. UN SDGs are used as demanded qualities. Quality characteristics are derived from annual sustainability and corporate social responsibility reports of ICT companies. The companies' efforts, as indicated by the QFD results, are concentrated on the use of recycled raw materials and recycling, reducing GHG emissions through energy saving and improved connectivity, decarbonizing the value chain, protecting the environment and water resources by collaborating with businesses that have completed CDP water assessments and paying attention to reducing water consumption, ethical business practices, and reducing inequality. The evaluations of the three businesses are found to be very similar when they are compared. The small differences between the companies are usually about the region they serve. Efforts made by the companies mostly concentrate on responsible consumption and production, life below water, climate action, and sustainable cities and community goals. These efforts include improving connectivity in needed areas for providing access to information, education and healthcare.

Keywords: multi-criteria decision-making, sustainable supply chain risk, supply chain agility, quality function deployment, Sustainable development goals

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Authors: Rogaleva Liudmila, Malkin Valery

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Physical culture lessons are considered not only to be a means of physical development of students, but a matter of their personal development. Physical culture lessons can enable to develop such qualities of students as activity and initiation, readiness to cooperate, self-confidence, ability to define and reach targets, readiness to overcome difficulties and assess their abilities (and disadvantages) properly in any precise situation as well to be responsible for their own decision. The solution of this problem is possible under the circumstance if the students aware themselves as the subject of the activity that are able to develop their possibilities. The research was aimed to learn the matters that enable female teenagers of senior forms to become strong personalities attending physical culture lessons. There were two stages of the research. At the first stage we define the interests and demands of the girls. According the results of research we changed the programme of physical culture lessons. We took into consideration values of youth subculture: youth music, preferences to sport-dancing physical activities, demand of self-determination, revealing their individualities, needs of cooperative work. At the second stage we worked out motivating technology of course. This technology was aimed to create sush conditions under which students could show themselves as the subjects of activity and self-development. The active participation sport-dance festivals during 2-3 years creates the conditions for their self-realization. 78% students of the experimental groups considered their main motives to were: the interest, developing of their abilities, the satisfaction of the achievements of targets. Control groups 67% of the students claimed the success school good marks. The girls said that due to festivals they became self-confident (94%), responsible (86%), ability to cooperate (73%), aspiration for reaching the target (68%), self-exactingness (57 %). The main factors that provide successful performance were called: efforts to reach the target (87%), mutual support and mutual understanding (77%). The research on values showed that in the experimental groups we can find increase of importance of such values as: social initiative (active life) 83%, friends (75%), self-control (73%), effectiveness in deeds (58%).

Keywords: physical culture, subject, personal development, self-determination

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Authors: Arun Kumar Yadav

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Coal contributes a significant role in India’s developmental mission. But, ironically, on the other side it causes large scale population displacement and significant changes in indigenous people’s livelihood mechanism. Dhanbad which is regarded as one of the oldest and large mining area, as well as a “Coal Capital of India”. Here, mining exploration work started nearly a century ago. But with the passage of time, mining brings a lot of changes in the life of local people. In this context, study tries to do comparative situational analysis of the changes in the living condition of dwellers living in mines affected and non-mines affected villages based on livelihood approach. Since, this place has long history of mining so it is very difficult to conduct before and after comparison between mines and non-mines affected areas. Consequently, the present study is based on relative comparison approach to elucidate the actual scenario. By using primary survey data which was collected by the author during the month of September 2014 to March 2015 at Dhanbad, Jharkhand. The data were collected from eight villages, these were categorised broadly into mines and non-mines affected villages. Further at micro level, mines affected villages has been categorised into open cast and underground mines. This categorization will help us to capture the deeper understanding about the issues of mine affected villages group. Total of 400 household were surveyed. Result depicts that in every sphere mining affected villages are more vulnerable. Regarding financial capital, although mine affected villages are engaged in mining work and get higher mean income. But in contrast, non-mine affected villages are more occupationally diversified. They have an opportunity to earn money from diversified extents like agricultural land, working in mining area, selling coal informally as well as receiving remittances. Non-mines affected villages are in better physical capital which comprises of basic infrastructure to support livelihood. They have an access to secured shelter, adequate water supply & sanitation, and affordable information and transport. Mining affected villages are more prone to health risks. Regarding social capital, it shows that in comparison to last five years, law and order has been improved in mine affected villages.

Keywords: displacement, indigenous, livelihood, mining

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Authors: Matt S. Van Deren, Michael Papenfus

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Seattle is one of the hundreds of cities in the United States that relies on a combined sewer system to collect and convey municipal wastewater. By design, these systems convey all wastewater, including industrial and commercial wastewater, human sewage, and stormwater runoff, through a single network of pipes. Serious problems arise for combined sewer systems during heavy precipitation events when treatment plants and storage facilities are unable to accommodate the influx of wastewater needing treatment, causing the sewer system to overflow into local waterways through sewer outfalls. CSOs (Combined Sewer Overflows) pose a serious threat to human and environmental health. Principal pollutants found in CSO discharge include microbial pathogens, comprising of bacteria, viruses, parasites, oxygen-depleting substances, suspended solids, chemicals or chemical mixtures, and excess nutrients, primarily nitrogen and phosphorus. While concentrations of these pollutants can vary between overflow events, CSOs have the potential to spread disease and waterborne illnesses, contaminate drinking water supplies, disrupt aquatic life, and effect a waterbody’s designated use. This paper estimates the economic impact of CSOs on residential property values. Using residential property sales data from Seattle, Washington, this paper employs a hedonic valuation model that controls for housing and neighborhood characteristics, as well as spatial and temporal effects, to predict a consumer’s willingness to pay for improved water quality near their homes. Initial results indicate that a 100,000-gallon decrease in the average annual overflow discharged from a sewer outfall within 300 meters of a home is associated with a 0.053% increase in the property’s sale price. For the average home in the sample, the price increase is estimated to be $18,860.23. These findings reveal some of the important economic benefits of improving water quality by reducing the frequency and severity of combined sewer overflows.

Keywords: benefits, hedonic, Seattle, sewer

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Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Calvin Pak-Wing Cheng, Julie Sittlington, Yu-Tao Xiang, Tim Man Ho Li

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Insomnia is one of the most common health problems in the general population. Insomnia can be acute, intermittent, and become chronic, often due to comorbidity with other physical and mental health conditions. Although there are conventional pharmaceutical and psychotherapeutic treatments to treat symptoms of insomnia, however; there is no robust and novel randomized controlled trial (RCT) using transdermal neurostimulation on individuals with insomnia symptoms. This gives us the impetus to execute the first nationwide RCT. Aim: To evaluate the efficacy of Electrical Vestibular Stimulation (VeNS) on individuals with insomnia in Hong Kong. Design: This study was a two-armed, double blinded, randomized, sham-controlled trial. Sampling: 60 community-dwelling adults aged 18 and 60 years with moderate insomnia symptoms or above (Insomnia Severity Index > 14) were recruited. All subjects were computerized randomized into either the active VeNS group or the sham VeNS group on a 1:1 ratio. Intervention: All participants received a home-use VeNS device and used 30-min VeNS sessions during five consecutive days across a 4-week period (total treatment hours: 10). Baseline measurements and post-VeNS evaluation of the psychological outcomes, including 1) insomnia severity, 2) sleep quality, and 3) quality of life were investigated. The short-and long-term sustainability of the VeNS intervention was assessed immediately after poststim and at a 1-month and 3-month follow-up period. Data analysis: A mixed GEE model was used to analyze the repeated measures data. Missing data were managed by multiple imputations. The level of significance was set to p < 0.05. Significance of the study: This is the first trial to examine the efficacy and safety of VeNS among adults with insomnia symptoms in Hong Kong. Findings that emerged were used to determine whether this VeNS device can be considered a self-help technological device to reduce the severity of insomnia in the community setting and to reduce the global disease burden. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04452981.

Keywords: adults, insomnia, neuromodulation, rct, vestibular stimulation

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Authors: Song Hung Chi, Lee Chun Benn

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Follow by the “A Research on Types of Settlement Housing Alterations of Chinese New Village in Malaysia- A Study in Ampang New Village, Selangor” preliminary informed that the main factors for expansion and enlargement suitably due to the needs of user's life and restoration purpose. The alterations behavior generally derived at the rear position of main house with different types of derivatives, the averages expansion area are not exceeding of 100㎡, while building materials used were wooden, wooden structure, and zinc which are non-permanent building materials. Therefore, a subsequent studies taken in this paper, further to analyze the drawing with summarize method, to explore the derived forms and the constituted rules of housing alterations in Ampang Village, as a more complete presentation of housing alterations in New Village. Firstly, classified the existing housing alterations into three types by using summarize method, which are Type 1, Additional of Prototype House; Type 2, Expansion of Prototype House; and Type 3, Diffusion of Additional. The results shows that the derivative mode of alterations can be divided into the use of "continuous wall" or "non-continuous wall," this will affects the structural systems and roof styles of alterations, and formed the different layers of interior space with "stages" and "continuity". On the aspects of spatial distribution, sacrificial area as a prescriptive function of space, it was mostly remains in the original location which in the center of living area after alterations. It is an important characteristic in a New Village house, reflecting the traditional Ethics of Hakka Chinese communities in the settlement. In addition, wooden as the main building materials of constituted rules for the prototype house, although there were appeared other building materials, such as cement, brick, glass, metal and zinc after alterations, but still mostly as "wooden house" pattern. Result show because of the economy of village does not significantly improve, and also forming the similarity types in alterations and constructions of the additional building with the existing. It did not significantly improve on the quality of living, but only increased the area of usage space.

Keywords: Ampang new village, derived forms, constituted rules, alterations

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Authors: Aiman Zehra, Sajad Mohd Wani

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Packaging has a vital role as it contains and protects the food that moves from the supply chain to the consumer. Chitosan (CH) has been extensively used in food packaging applications among the plentiful natural macromolecules, including all the polysaccharide class, owing to its easy film-forming capacity, biodegradability, better oxygen and water vapour barrier ability and good mechanical strength. Compared to synthetic films, the films produced from chitosan present poor barrier and mechanical properties. To overcome its deficient qualities, a number of modification procedures are required to enhance the mechanical and physical properties. Various additives such as plasticizers (e.g., glycerol and sorbitol), crosslinkers (e.g.,CaCl₂, ZnO), fillers (nanoclay), and antimicrobial agents (e.g. thyme essential oil) have been used to improve the mechanical, thermal, morphological, antimicrobial properties and emulsifying agents for the stability and elasticity of chitosan-based biodegradable films. Different novel biocomposite films based on chitosan incorporated with thyme essential oil and different additives (ZnO, CaCl₂, NC, and PEG) were successfully prepared and used as packaging material for carrot candy. The chitosan film incorporated with crosslinkers was capable of forming a protective barrier on the surface of the candy to maintain moisture content, water activity, TSS, total sugars, and titratable acidity. ZnO +PEG +NC +CaCl₂ remarkably promotes a synergistic effect on the barrier properties of the film. The combined use of ZnO +PEG +NC +CaCl₂ in CH-TO films was more effective in preventing the moisture gain in candies. The lowest a𝓌 (0.624) was also observed for the candies stored in treatment. The color values L*, a*, b* of the candies were also retained in the film containing all the additives during the 6th month of storage. The value for L*, a*, and b* observed for T was 42.72, 9.89, and 10.84, respectively. The candies packaged in film retained TSS and acidity. The packaging film significantly p≤0.05 conserved sensory qualities and inhibited microbial activity during storage. Carrot candy was found microbiologically safe for human consumption even after six months of storage in all the packaging materials.

Keywords: chitosan, biodegradable films, antimicrobial activity, thyme essential oil, crosslinkers

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Authors: Ivana Prochazkova

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Cognitive linguistics offers biblical scholarship a specific methodological tool for analysis and interpretation of metaphorical expressions. Its methodology makes it possible to study processes involved in constructing the meaning of individual metaphorical expressions and whole conceptual metaphors; to analyze their function in the text; to follow the semantic development of concepts and conceptual domains, and to trace semantic changes and their motivation. The legal language in the Hebrew canon is extremely specific and formalized. Especially in the preambles to the collections of laws in the Pentateuch, more general considerations of the motif of keeping and breaking the law are encountered. This is also true in the psalms and wisdom literature. Legal theory and the philosophy of law deal with these motifs today. Metaphors play an important role in texts that reflect on more general issues. The purpose of this conference contribution is to write all over the central metaphorical concept, conceptual metaphor ךרד תורה (TORAH/LAW IS A JOURNEY), its function in the Torah and principal trends of the further development in the Prophets and the Writings. The conceptual metaphor תורה ךרד (TORAH/LAW IS A JOURNEY) constitutes a coherent system in conjunction with other metaphors that include e.g., conceptual metaphors נחה תורה (TORAH/LAW LEADS); its variant רעה תורה (TORAH IS A SHEPHERD/GUIDE); מקור תורה (TORAH/LAW IS A FOUNTAIN/A SOURCE OF LIFE). Some conceptual metaphors are well known, and their using are conventional (עשׁר תורה TORAH/LAW IS RICHES, שׂשׂון תורה TORAH/LAW IS DELIGHT, דבשׁ תורה TORAH/LAW IS HONEY, שׁמשׁ תורה TORAH/LAW IS SUN ). But some conceptual metaphors are by its occurrence innovative and unique (e.g., שׁריון תורה TORAH /LAW IS BODY ARMOR, כובע תורה TORAH /LAW IS A HELMET, בגד תורה TORAH/LAW IS A GARMENT, etc.). There will be given examples. Conceptual metaphors will be described by means of some 'metaphorical vehicles,' which are Hebrew expressions in the source domain that are repeatedly used in metaphorical conceptualizations of the target domain(s). Conceptual metaphors will be further described by means of 'generic narrative structures,' which are the particular aspects of a conceptual metaphor that emerge during the metaphorical structuring of concepts. They are the units of the metaphorical vehicles – the Hebrew expressions in the source domain – that structure concepts in much the same way that the conceptual metaphor in the target domain does. And finally, they will be described by means of the network of correspondences that exist between metaphorical vehicles – or generic metaphorical structures – and the Hebrew expressions in the target domain.

Keywords: cognitive theology, conceptual metaphor in the Old Testament, conceptual metaphors of the Torah, conceptual domain of law, righteousness, and justice

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Authors: Luke Sniewski, Pante Farvid, Phil Carter, Rita Csako

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Background and Aims: Self-Perceived Problematic Porn Use (SPPPU) refers to individuals who identify as or perceive themselves to be addicted to porn. These individuals feel they are unable to regulate their porn consumption and experience adverse consequences as a result of their use in everyday life. To the author’s best knowledge, this research represents the first study to intervene with pornography use with mindfulness meditation, and aims to investigate the experiences and challenges of men with SPPPU as they engage in a mindfulness meditation intervention. As meditation is commonly characterized by sitting and observing one’s internal experience with non-reaction and acceptance, the study’s principal hypothesis was that consistent practice of meditation would develop the participant’s capacity to respond to cravings, urges, and unwanted thoughts in less reactive, more productive ways. Method: This 12-mixed method research utilised Single Case Experimental Design (SCED) methodology, with a standard AB design. Each participant was randomly assigned to an initial baseline time period between 2 to 5 weeks before learning the meditation technique and practicing it for the remainder of the 12-week study. The pilot study included 3 participants, while the intervention study included 12. The meditation technique used for the study involved a 15-minute guided breathing exercise in the morning, along with a 15-minute guided concentration meditation in the evening. Results: At the time of submission, only pilot study results were available. Results from the pilot study indicate an improved capacity for self-awareness of the uncomfortable mental and emotional states that drove their participants’ pornography use. Statistically significant reductions were also observed in daily porn use, total weekly time spent viewing porn, as well as lowered Pornography Craving Questionnaire (PCQ) and Problematic Pornography Use Scale (PPUS) scores. Conclusion: Pilot study results suggest that meditation could serve as a complementary tool for health professionals to provide clients in conjunction with therapeutic interventions. Study limitations, directions for future research, and clinical implications to be discussed as well.

Keywords: meditation, behavioural change, pornography, mindfulness

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Authors: Fatemeh Jannesarvatan, Ghazaal Parastooei, Jimmy frerejan, Saedeh Mokhtari, Peter Van Rosmalen

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Medical and dental education increasingly emphasizes the acquisition, integration, and coordination of complex knowledge, skills, and attitudes that can be applied in practical situations. Instructional design approaches have focused on using real-life tasks in order to facilitate complex learning in both real and simulated environments. The Four component instructional design (4C/ID) model has become a useful guideline for designing instructional materials that improve learning transfer, especially in health profession education. The objective of this study was to apply the 4C/ID model in the creation of virtual patients (VPs) that dental students can use to practice their clinical management and clinical reasoning skills. The study first explored the context and concept of complication factors and common errors for novices and how they can affect the design of a virtual patient program. The study then selected key dental information and considered the content needs of dental students. The design of virtual patients was based on the 4C/ID model's fundamental principles, which included: Designing learning tasks that reflect real patient scenarios and applying different levels of task complexity to challenge students to apply their knowledge and skills in different contexts. Creating varied learning materials that support students during the VP program and are closely integrated with the learning tasks and students' curricula. Cognitive feedback was provided at different levels of the program. Providing procedural information where students followed a step-by-step process from history taking to writing a comprehensive treatment plan. Four virtual patients were designed using the 4C/ID model's principles, and an experimental design was used to test the effectiveness of the principles in achieving the intended educational outcomes. The 4C/ID model provides an effective framework for designing engaging and successful virtual patients that support the transfer of knowledge and skills for dental students. However, there are some challenges and pitfalls that instructional designers should take into account when developing these educational tools.

Keywords: 4C/ID model, virtual patients, education, dental, instructional design

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Authors: Johannes Barlang

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Adhesive bonding plays a pivotal role in various industrial applications, ranging from automotive manufacturing to aerospace engineering. The peel strength of adhesives, a critical parameter reflecting the ability of an adhesive to withstand external forces, is crucial for ensuring the integrity and durability of bonded joints. This study provides a synopsis of the methodologies, influencing factors, and significance of peel testing in the evaluation of adhesive performance. Peel testing involves the measurement of the force required to separate two bonded substrates under controlled conditions. This study systematically reviews the different testing techniques commonly applied in peel testing, including the widely used 180-degree peel test and the T-peel test. Emphasis is placed on the importance of selecting an appropriate testing method based on the specific characteristics of the adhesive and the application requirements. The influencing factors on peel strength are multifaceted, encompassing adhesive properties, substrate characteristics, environmental conditions, and test parameters. Through an in-depth analysis, this study explores how factors such as adhesive formulation, surface preparation, temperature, and peel rate can significantly impact the peel strength of adhesively bonded joints. Understanding these factors is essential for optimizing adhesive selection and application processes in real-world scenarios. Furthermore, the study highlights the role of peel testing in quality control and assurance, aiding manufacturers in maintaining consistent adhesive performance and ensuring the reliability of bonded structures. The correlation between peel strength and long-term durability is discussed, shedding light on the predictive capabilities of peel testing in assessing the service life of adhesive bonds. In conclusion, this study underscores the significance of peel testing as a fundamental tool for characterizing adhesive performance. By delving into testing methodologies, influencing factors, and practical implications, this study contributes to the broader understanding of adhesive behavior and fosters advancements in adhesive technology across diverse industrial sectors.

Keywords: adhesively bonded joints, cleavage resistance, elastic adhesives, peel strength

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Authors: Vilma Zydziunaite, Ausra Rutkiene

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In modern society, problems related to the teacher's personality, mental and physical health, teacher's emotions and competencies are becoming more and more relevant. In Lithuania, compared to other European countries, teachers experience specific difficulties at work: they have to work in conditions of constant reforms and changes and face growing competition due to the decrease in students and schools. Professional burnout, teacher’s self-efficacy and perceived stress are interrelated personally and/or organisationally. So, the relationship between teachers' professional burnout, self-efficacy, and perceived stress in the school environment seems to be a relatively underresearched area in Lithuania. The research aim was to reveal and characterize teacher burnout, self-efficacy, and perceived stress in the Lithuanian school context. The quantitative research design with a questioning survey was chosen for the study. The sample size consisted of 427 Lithuanian teachers. Research results revealed the highest scores for exhaustion and the lowest for cynicism; at a time when the teacher experiences professional burnout, cynicism is observed as the weakest characteristic; no significant differences were found according to educational level work experience; significant differences were identified according to age for exhaustion and overall burnout level among teachers; the most of teachers in Lithuanian sample perceive the moderate stress level in school environment; overall burnout has a significant correlation with self-efficacy and stress among Lithuanian teachers. This study has empirical and practical implications: it is relevant to study the problems of teacher's professional burnout, stress, and self-efficacy in connection with contextual qualitative variables and specify the interrelationships between variables in order to be able to identify specific problems and provide empirical evidence to practically solve them. From a practical point of view, the results show that the socio-emotional state of teachers should not be dismissed as an insignificant aspect. Therefore, the school administration must make efforts to develop a positive school climate that supports the socio-emotional state of the teacher. At the same time, school administration must pay great attention to the development of teachers' socio-emotional competencies without ignoring their importance in the teacher's professional life.

Keywords: Lithuania, perceived stress, professional burnout, self-efficacy, teacher

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Authors: Hiripurage Mallika Sandamali Dissanayaka

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Butterflies are found everywhere on Earth, helping flowering plants reproduce through pollination. Wetlands perform many valuable functions such as providing wildlife habitat. Diyasaru Wetland Park was chosen as the study site. It is located in a highly urbanized area of Sri Jayawardenepura Kotte, Sri Lanka. A distribution map was prepared to increase butterfly habitat in the urbanized area, and research was conducted to determine the most suitable sections for using it. As this wetland has footpaths for walking, line transect surveys were used to mark species within the sampling area, and directly observed species were recorded. All data collection was done from 0900 to 1200 hours and 1300 to 1600 hours and fieldwork was done from 11 February 2020 to 20 January 2021. ED binoculars (10.5x45), DSLR cameras (Canon EOS/EFS5 mm 3.5-5.6), and Garmin GPS (Etrex 10) were used to observe butterfly species, identify locations, and take photographs as evidence. Analyzing their habitats using GIS (ArcGIS Pro) to identify their distribution within the park premises, the distribution density of the known size of the population was calculated for each point by kernel density, and local similarity values were calculated for each pair of corresponding features through hotspot analysis, and cell values were determined by inverse distance weighting (IDW) using a linearly weighted combination of a set of sample points. According to the maps prepared to predict the distribution of butterflies in this park, the high level of distribution or favorable areas were near flower gardens and meadows, but some individual species prefer habitats that are more suitable for their life activities, so they live in other areas. Sixty-six (66) species belonging to six (6) families have been recorded in the premises. Sixty (60) species of least concern (LC), two (2) near threatened (NT), and four (4) vulnerable (VU) species have been recorded, and several new species, such as Plum Judy (Abisara echerius), were reported. The outcome of the study will form the basis for decision-making by the Sri Lanka Land Development (SLLD) Corporation for the future development and maintenance of the park.

Keywords: wetland, Lepidoptera, habitat, urban, west

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Authors: Ziwei Song, Junjun Fan, Jeremy Teo, Yang Yu, Yukun Ma, Jie Yan, Shupei Mo, Lisa Tucker-Kellogg, Peter So, Hanry Yu

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Liver is the center of detoxification and exposed to toxic metabolites all the time. It is highly regenerative after injury, with the ability to restore even after 70% partial hepatectomy. Most of the previous studies were using hepatectomy as injury models for liver regeneration study. There is limited understanding of small-scale liver injury, which can be caused by either low dose drug consumption or hepatocyte routine metabolism. Although these small in situ injuries do not cause immediate symptoms, repeated injuries will lead to aberrant wound healing in liver. Therefore, the cellular dynamics during liver regeneration is critical for our understanding of liver regeneration mechanism. We aim to study the liver regeneration of small-scale in situ liver injury in transgenic mice labeling actin (Lifeact-GFP). Previous studies have been using sample sections and biopsies of liver, which lack real-time information. In order to trace every individual hepatocyte during the regeneration process, we have developed and optimized an intravital imaging system that allows in vivo imaging of mouse liver for consecutive 5 days, allowing real-time cellular tracking and quantification of hepatocytes. We used femtosecond-laser ablation to make controlled and repeatable liver injury model, which mimics the real-life small in situ liver injury. This injury model is the first case of its kind for in vivo study on liver. We found that small-scale in situ liver injury is repaired by the coordination of hypertrophy and migration of hepatocytes. Hypertrophy is only transient at initial phase, while migration is the main driving force to complete the regeneration process. From cellular aspect, Akt/mTOR pathway is activated immediately after injury, which leads to transient hepatocyte hypertrophy. From mechano-sensing aspect, the actin cable, formed at apical surface of wound proximal hepatocytes, provides mechanical tension for hepatocyte migration. This study provides important information on both chemical and mechanical signals that promote liver regeneration of small in situ injury. We conclude that hypertrophy and migration play a dominant role at different stages of liver regeneration.

Keywords: hepatocyte, hypertrophy, intravital imaging, liver regeneration, migration

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Authors: Leila H. Khiabani, Mohammadreza Vafaee, Farshad Hashemzadeh

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Industrial waste management regulates different stages of production, storage, transfer, recycling and waste disposal. There are several common practices for industrial waste management. However, due to various local health, economic, social, environmental and aesthetic considerations, the most optimal principles and measures often vary at each specific industrial zone. In addition, waste management strategies are heavily impacted by local administrative, legal, and financial regulations. In this study, a hybrid qualitative and quantitative research methodology has been designed for waste management planning in an industrial city. Firstly, following a qualitative research methodology, the most relevant waste management strategies for the specific industrial city were identified through interviews with environmental planning and waste management experts. Forty experts participated in this study. Alborz industrial city in Iran, which hosts more than one thousand industrial units in nine hundred acres, was chosen as the sample industrial city in this study. The findings from the expert interviews at the first phase were then used to design a quantitative questionnaire for the second phase of the study. The aim of the questionnaire was to quantify the relative impact of different waste management strategies in the sample industrial city. Eight waste management strategies and three implementation policies were included in the questionnaire. The experts were asked to rank the relative effectiveness of each strategy for environmental planning of the sample industrial city. They were also asked to rank the relative effectiveness of each planning policy on each of the waste management strategies. In the end, the weighted average of all the responses was calculated to identify the most effective waste management strategy and planning policies for the sample industrial city. The results suggested that among the eight suggested waste management strategies, industrial composting is the most effective (31%) strategy based on the collective evaluation of the local expert. Additionally, the results suggested that the most effective policy (58%) in the city’s environmental planning is to reduce waste generation by prolonging the effective life of industrial products using higher quality and recyclable materials. These findings can provide useful expert guidelines for prioritization between different waste management strategies in the city’s overall environmental planning roadmap. The findings may also be applicable to similar industrial cities. In addition, a similar methodology can be utilized in the environmental planning of other industrial cities.

Keywords: environmental planning, industrial city, quantitative research, waste management

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Authors: Katalin Szöllősi, László Szabó

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Introduction and purpose: Even though female sexual dysfunctions are common among women in the postpartum period, the profile of these disturbances has not been well investigated in Hungary yet. The aim of the study was to evaluate the postpartum female sexual functions in Hungary. This research sought to investigate the possible predictor factors which can influence postpartum female sexual functions. Method and sample: This was a cross-sectional study, including patients from two maternity clinics in Budapest. 113 women were recruited into our study 3 months after their childbirth. 53 had vaginal birth, 60 had a caesarian section. Data were collected from medical reports in addition by using self-developed questions and validated questionnaires in order to measure important predictors which may be responsible for postpartum sexual dysfunctions such as mode of delivery, parity, urinary incontinence and body image. Sexual functions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). The Hungarian version of Body Image Questionnaire-Short Form14 (BSQ-SF14) was applied for assessing body image. Results: 82,3% of the participants began to have sexual intercourse within three months postpartum. 53,98% of the participants reported sexual dysfunctions (cut-off FSFI score 26,55). According to our results mode of delivery, parity, hemorrhoids, time of intercourse, resumption was not associated with female sexual dysfunctions. We found correlation at a tendential level between urinary incontinence and sexual dysfunctions (p=0,003, R=0,26). We found a negative correlation at a tendential level between the total score of BSQ-SF14 and FSFI (p=0,03, R=-0,269). Only 32,74% of women reported discussing sexual life with health care professionals. However, 67,25% of them would have had the need to be asked about their postpartum health issues. Conclusions and recommendations: The prevalence of female sexual dysfunctions were relatively high after childbirth. We found that incontinence and body image was associated with sexual dysfunctions; other risk factors remained unknown. Despite regular contact with health care professionals, women rarely get any information about postpartum sexual health issues. The high prevalence of dysfunctions indicates the need for further investigation to address other risk factors and proper counselling of women after childbirth.

Keywords: body image, postpartum, sexual dysfunction, urinary incontinence

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Authors: Mostafa Sarabzadeh, Masoumeh Helalizadeh, Seyyed Mahmoud Hejazi

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Multiple Sclerosis is considered as diseases related to central nerve system, the chronic and progressive disease impress on sensory and motor function of people. Due to equilibrium problems in this patients that related to disorder of nerve conduction transmission from central nerve system to organs and the nature of elastic bands that can make changes in neuromuscular junctions and momentary actions, the aim of this research is evaluate elastic training effect by reactionary ropes on nerve conduction velocity (in lower and upper limb) and functional balance in female patients with Multiple Sclerosis. The study was a semi-experimental study that was performed based on pre and post-test method, The statistical community consisted of 16 women with MS in the age mean 25-40yrs, at low and intermediate levels of disease EDSS 1-4 (Expanded Disability Status Scale) that were divided randomly into elastic and control groups, so the training program of experimental group lasted six weeks, 3 sessions per week of elastic exercises with reactionary ropes. Electroneurography parameters (nerve conduction velocity- latency) of Upper and lower nerves (Median, Tibial, Sural, Peroneal) along with balance were investigated respectively by the Electroneurography system (ENG) and Timed up and go (TUG) functional test two times in before and after the training period. After that, To analyze the data were used of Dependent and Independent T-test (with sig level p<0.05). The results showed significant increase in nerve conduction velocity of Sural (p=0.001), Peroneal (p=0.01), Median (p=0.03) except Tibial and also development Latency Time of Tibial (p= 0), Peroneal (p=0), Median (p=0) except Sural. The TUG test showed significant decreases in execution time too (p=0.001). Generally, based on what the obtained data can indicate, modern training with elastic bands can contribute to enhanced nerve conduction velocity and balance in neurosis patients (MS) so lead to reduce problems, promotion of mobility and finally more life expectancy in these patients.

Keywords: balance, elastic bands, multiple sclerosis, nerve conduction, velocity

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Authors: India Sanders, Jeffrey Sherman

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Colorism has been a persistent and ingrained issue in the history of the United States, with far-reaching consequences that continue to affect various aspects of daily life, institutional policies, public spaces, economic structures, and social norms. This complex problem has had a particularly profound impact on the African-American community, shaping how they are perceived and treated within society at large. The prevalence of negative stereotypes surrounding African Americans can lead to severe repercussions such as discrimination and mental health disparities. The effects of such biases can also materialize in diverse forms, impacting the well-being and livelihoods of individuals within this community. Current research has examined how people from different racial groups perceive different skin tones of Black people, looking at the cognitive processes that manifest through categorization and stereotypes. Additionally, studies observed consequences related to colorism and how it directly affects those with darker versus lighter skin tones. However, not much research has been conducted on the influence of stereotypes associated with various skin tones. In the present study, it is hypothesized that participants in Group A will rate positive stereotypes associated with lighter skin tones significantly higher than positive stereotypes associated with darker skin tones. It is also hypothesized that participants in Group B will rate negative stereotypes associated with darker skin tones significantly higher than negative stereotypes associated with lighter skin tones. For this study, a quantitative study on stereotypes of skin tone representation within the African-American community will be conducted. Participants will rate the accuracy of various visual representations within mass media of African Americans with light skin tones and dark skin tones using a Likert scale. Participants will also be provided a questionnaire further examining the perception of stereotypes and how this affects their interactions with African Americans with lighter versus darker skin tones. The purpose of this study is to investigate the impact of skin tone portrayals on African Americans, including associated stereotypes and societal perceptions. It is expected that participants will more likely associate negative stereotypes with African Americans who have darker skin tones, as this is a common and reinforced viewpoint in the cultural and social system.

Keywords: colorism, discrimination, racism, stereotype

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Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

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Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

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Authors: Haoyu Zhao, Qianshu Ma, Min Xie, Yunqi Huang, Yunjia Liu, Huan Song, Hongsheng Gui, Mingli Li, Qiang Wang

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Rationale: Bipolar disorder (BD) and major depressive disorder (MDD), as severe chronic illnesses that restrict patients’ psychosocial functioning and reduce their quality of life, are both categorized into mood disorders. Emerging evidence has suggested that the reliability of self-rated health (SRH) was wellvalidated and that the risk of various health outcomes, including mortality and health care costs, could be predicted by SRH. Compared with other lengthy multi-item patient-reported outcomes (PRO) measures, SRH was proven to have a comparable predictive ability to predict mortality and healthcare utilization. However, to our knowledge, no study has been conducted to assess the association between SRH and hospitalization among people with mental disorders. Therefore, our study aims to determine the association between SRH and subsequent all-cause hospitalizations in patients with BD and MDD. Methods: We conducted a prospective cohort study on people with BD or MDD in the UK from 2006 to 2010 using UK Biobank touchscreen questionnaire data and linked administrative health databases. The association between SRH and 2-year all-cause hospitalizations was assessed using proportional hazard regression after adjustment for sociodemographics, lifestyle behaviors, previous hospitalization use, the Elixhauser comorbidity index, and environmental factors. Results: A total of 29,966 participants were identified, experiencing 10,279 hospitalization events. Among the cohort, the average age was 55.88 (SD 8.01) years, 64.02% were female, and 3,029 (10.11%), 15,972 (53.30%), 8,313 (27.74%), and 2,652 (8.85%) reported excellent, good, fair, and poor SRH, respectively. Among patients reporting poor SRH, 54.19% had a hospitalization event within 2 years compared with 22.65% for those having excellent SRH. In the adjusted analysis, patients with good, fair, and poor SRH had 1.31 (95% CI 1.21-1.42), 1.82 (95% CI 1.68-1.98), and 2.45 (95% CI 2.22, 2.70) higher hazards of hospitalization, respectively, than those with excellent SRH. Conclusion: SRH was independently associated with subsequent all-cause hospitalizations in patients with BD or MDD. This large study facilitates rapid interpretation of SRH values and underscores the need for proactive SRH screening in this population, which might inform resource allocation and enhance high-risk population detection.

Keywords: severe mental illnesses, hospitalization, risk prediction, patient-reported outcomes

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Authors: Tigist mamo, Beryl Oranga, Precious Mubanga

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High rates of child undernutrition in Ethiopia place children at significant risk, highlighting the need for low-cost, nutritious diets starting at six months of age. These diets should be diverse and rich in essential nutrients like proteins, vitamins, and minerals. However, many rural households participating in the Productive Safety Net Program (PSNP) struggle to afford fortified foods and often rely on low-protein, cereal-based diets, leading to micronutrient deficiencies. In addition, fasting practices further restrict the consumption of animal-source foods for 190 to 250 days each year, limiting dietary diversity even more. Addressing these challenges requires solutions beyond nutrition counseling, focusing on factors such as seasonality, food perishability, and safety to promote better health outcomes for children. The program's main objective is to empower caregivers with practical recipes for complementary feeding for children aged 6 to 23 months by enhancing meals with affordable ingredients like cereal, legumes, dried vegetables, and meat. The ongoing implementation research within the SPIR-II program is centered on developing a cost-effective mixed flour and exploring drying techniques to extend shelf life, ultimately addressing the delayed introduction of complementary foods and increasing nutrient-rich options in households. Saleswomen participating in the SPIR-II program have been empowered to produce easy-to-use local complementary flour and conduct door-to-door sales in their neighborhoods. Caregivers who have purchased and fed this flour to their children have reported significant improvements in their nutritional status. Additionally, SPIR-II is testing low-tech drying methods suitable for rural Ethiopian contexts to reduce food loss and promote the inclusion of nutrient-dense foods in children's diets. The paper will highlight the primary outcomes of these initiatives as they are being implemented.

Keywords: food preservation, easy-to-use mixed flour, complementary feeding, drying techniques

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Authors: S. Vaibhav Kant Sahu, Surabhi Bipin Seth

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Human well-being has multiple constituents including the basic material for a good life, freedom and choice, health, good social relations, and security. Poverty is also multidimensional and has been defined as the pronounced deprivation of well-being. Dhurwa tribe of Bastar (India) have symbiotic relation with nature, it provisions ecosystem service such as food, fuel and fiber; regulating services such as climate regulation and non-material benefits such as spiritual or aesthetic benefits and they are managing their forest from ages. The demand for ecosystem services is now so great that trade-off among services become rule. Aim of study to explore evidences for linkages between ecosystem services and well-being of indigenous community, how much it helps them in poverty reduction and interaction between them. Objective of study was to find drivers of change and evidence concerning link between ecosystem, human development and sustainability, evidence in decision making does it opt for multi sectoral objectives. Which means human well-being as the central focus for assessment, while recognizing that biodiversity and ecosystems also have intrinsic value. Ecosystem changes that may have little impact on human well-being over days or weeks may have pronounced impacts over years or decades; so assessments needed to be conducted at spatial and temporal scales under social, political, economic scales to have high-resolution data. Researcher used framework developed by Millennium ecosystem assessment; since human action now directly or unknowingly virtually alter ecosystem. Researcher used ethnography study to get primary qualitative data, secondary data collected from panchayat office. The responses were transcribed and translated into English, as interview held in Hindi and local indigenous language. Focus group discussion were held with group of 10 women at Tiriya village. Researcher concluded with well-being is not just gap between ecosystem service supply but also increases vulnerability. Decision can have consequences external to the decision framework these consequences are called externalities because they are not part of the decision-making calculus.

Keywords: Bastar, Dhurwa tribe, ecosystem services, millennium ecosystem assessment, sustainability

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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Authors: Carmen Nechita

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This research explores the world of Syrian refugee women living in Dresden and their efforts to reconstruct their lives in the state of Saxony in Germany. The focus is on the initial period of adjustment and understanding how refugee women use culture, family ties, and tradition to contest and rebuild new relationships with the host country. Faced with a new status as “the refugee”, women have to re-imagine their ethno-cultural identity in order to cope with life in Diaspora. In order to understand the coping mechanism and the displacement effects on Syrian women, interviews with twelve refugee women were conducted. Traumatic experiences of loss and oppression are at the core of their confessions. While gender violence, abuse and patriarchal framework shape their narratives, this research argues that there is a need to look at this from a cultural perspective and try to distance ourselves from the western paradigm. The way Syrian women refute and rebuild their national and ethno-cultural identity in order to negotiate for themselves new space within German borders is explored. Two discourses are bridged: one of multiculturalism and one of tradition in order to explain how Syrian women experience western notions of family, womanhood and spousal dynamics. The process is painful, traumatic and marked by feelings of low self-worth, but in the end, new codes emerge and these women come out more empowered. The paper includes the migration experience and explores the ways in which Syrian refugee women tend to tell their complex stories, and how they reconstruct their identity in a new territory while faced with a different culture that discriminates against them. During the research, four distinct phases in the acculturation period were identified: “the survival”, “the honeymoon period”, “the isolation period” and “the anger period”. Each phase is analyzed in order to understand what triggers them, how women migrate from one phase to another and what can be done to make the process easier. This paper contributes to the field of refugee studies by offering a thorough understanding of the initial phases of the acculturation process in the case of Syrian refugee women. The study examines the fleeing and settlement experience in order to understand the complex ways that refugee women cope with the traumatic experience of settlement in another country and in a different culture. *Almanya: The Arabic word for Germany.

Keywords: displacement, migration, refugee women, Syria

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Authors: Maznieda Mahjom, Rohaida Ismail, Masita Arip, Mohd Shaiful Azlan, Nor’Ashikin Othman, Hafizah Abdullah, nor Zahrin Hasran, Joshita Jothimanickam, Syaqilah Shawaluddin, Nadia Mohamad, Raheel Nazakat, Tuan Mohd Amin, Mizanurfakhri Ghazali, Rosmanajihah Mat Lazim

Abstract:

COVID-19 outbreak is particularly detrimental to the mental health of everyone as well as leaving a long devastating crisis in the healthcare sector. Daily increment of COVID-19 cases and close contact, necessitating the testing of a large number of samples, thus increasing the workload and burden to laboratory personnel. This study aims to determine the prevalence of personal-, work- and client-related burnout as well as to measure the concentration of salivary cortisol among laboratory personnel in the main laboratories in Klang Valley, Malaysia. This cross-sectional study was conducted in late 2021 and recruited a total of 404 respondents from three laboratories in Klang Valley, Malaysia. The level of burnout was assessed using Copenhagen Burnout Inventory (CBI) comprising three sub-dimensions of personal-, work- and client-related burnout. The cut-off score of 50% and above indicated possible burnout. Meanwhile, salivary cortisol was measured using a competitive enzyme immunoassay kit (Salimetrics, State College, PA, USA). Normal levels of salivary cortisol concentration in adults are within 0.094 to 1.551 μg/dl (morning) and can be none detected to 0.359 μg/dl (evening). The prevalence of personal-, work- and client-related burnout among laboratory personnel were 36.1%, 17.8% and 7.2% respectively. Meanwhile, the abnormal morning and evening cortisol concentration recorded were 29.5% and 21.8% excluding 6.9%-7.4% missing data. While the IgA level is normal for most of the respondents, which recorded at 95.53%. Laboratory personnel were at risk of suffering burnout during the COVID-19 pandemic. Thus, mental health programs need to be addressed at the department and hospital level by regularly screening healthcare workers and designing an intervention program. It is also vital to improve the coping skills of laboratory personnel by increasing the awareness of good coping skill techniques. The training must be in an innovative way to ensure that the lab personnel can internalise the technique and practise it in real life.

Keywords: burnout, COVID-19, laborotary personnel, salivary cortisol

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Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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