Search results for: early mobilisation in intensive care (ICU)

Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: Behrooz Nikahval, Mohammad Saeed Ahrari-Khafi, Sakineh Behroozpoor, Saeed Nazifi

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Osteoarthritis (OA) is a progressive and degenerative condition of the articular cartilage and other joints’ structures. It is essential to diagnose this condition as early as possible. The present research was performed to measure the Osteoprotegrin (OPG) and Tumor Necrosis Factor α (TNF-α) in synovial fluid and blood serum of dogs with surgically transected cruciate ligament as a model of OA, to evaluate if measuring of these parameters can be used as a way of early diagnosis of OA. In the present study, four mature, clinically healthy dogs were selected to investigate the effect of experimental OA, on OPG and TNF-α as a way of early detection of OA. OPG and TNF-α were measured in synovial fluid and blood serum on days 0, 14, 28, 90 and 180 after surgical transaction of cranial cruciate ligament in one stifle joint. Statistical analysis of the results showed that there was a significant increase in TNF-α in both synovial fluid and blood serum. OPG showed a decrease two weeks after OA induction. However, it fluctuated afterward. In conclusion, TNF-α could be used in both synovial fluid and blood serum as a way of early detection of OA; however, further research still needs to be conducted on OPG values in OA detection.

Keywords: osteoarthritis, osteoprotegrin, tumor necrosis factor α, synovial fluid, serum, dog

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Authors: Fahimeh Ghorbani, Alam Saleh

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Ideology, politics and art have always been omnipresent patterns of Islam since its early age. The Islamic empire, expanded from China to Andalusia, has instrumentalized art and architecture to enhance political legitimacy of different dynasties or states throughout its history. Quranic verses utilized to convey ideological messages in the major mosques and mausoleums. Iranians had already been employing art and architecture to propagate their political legitimacy prior to Islam. The land of Iran and its art with strong civilizational pre-Islamic history has been profoundly politicized since the rise of Islam in the region. Early Islamic period in Iran has witnessed introduction of a new architectural language, new formulas for spatial configuration in built spaces, as well as new system of architectural decoration. Studying Iran’s Early Islamic architecture helps in better understanding the process of socio-political identity making of Iranian-Islamic culture, and thus art and architecture. This period also set the stage for formation of glorious architectural movements through Persianate world in later periods. During the Early Islamic period in Iran, the innovative combination of Islamic ideology and Iranian Architecture created formidable ideological tools in politicizing art in the region and beyond. As such, this paper aims to investigate the political history and architectural legacy from late Sassanid to Early Islamic period, delves into the ways in which Early Islamic architecture played role in transforming Persian concepts of kingship, administration, and social organization. In so doing, the study focuses on the Perso-Islamic architectural synthesis under the Samanids and Seljuk dynasty as case studies. The paper also explores how the newly introduced Islamic architecture has been employed to address the question of political legitimacy and to propagate states’ political agenda in early Islamic Iran (650-1250). As for the existing literature, despite its uniqueness and significance, Early Islamic architecture of Iran has received little scholarly attention. However, there exists a sizeable body of scholarship on socio-historic condition of the land of Iran during Early Islamic period which provide a solid base for the project. Methodologically speaking, the authors look into the subject through various lenses. They will conduct historic and archival research in libraries, private collections, and archives in Iran and the related neighbouring countries in Persian, Arabic and English. The methods of visual and formal analysis are applied to examine architectural features of the period. There are also a high number of intriguing, yet poorly examined, published and unpublished documents, old plans, drawings and photos of monuments preserved in Cultural Heritage of Iran Organization which will be consulted.

Keywords: Iran, Islamic architecture, early Islamic Iran, early Islamic architecture, politicized art, political legitimacy, propaganda, aesthetics

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Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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Authors: Diriba Dereje

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Background: Cardiac and renal disease are the most prevalent chronic non-communicable diseases (CNCD) affecting the community in a significant manner. The best and recommended method in halting CNCD is by working on prevention as early as possible. This is only possible if early surrogate markers are identified. As part of the stated solution, this study will identify an association between microalbuminuria (an early surrogate marker of renal and cardiac disease) and lung function test among adult in the community. Objective: The main aim of this study was to assess an association between microalbuminuria (an early surrogate marker of renal and cardiac disease) and lung function test among adult in the community. Methodology: Community based cross sectional study was conducted among 384 adult in Jimma town. A systematic sampling technique was used in selecting participants to the study. In searching for the possible association, binary and multivariate logistic regression and t-test was conducted. Finally, the association between microalbuminuria and lung function test was well stated in the form of figures and written description. Result and Conclusion: A significant association was found between microalbuminuria and different lung function test parameters.

Keywords: microalbuminuria, lung function, association, test

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Authors: Meherun Nahar

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Background:The Chittagong Hill Tracts (CHT) is one of the most diverse regions in Bangladesh in terms of geography, ethnicity, culture and traditions of the people and home of thirteen indigenous ethnic people. In Bangladesh indigenous children aged 6-10 years remain out of school, and the majority of those who do enroll drop out before completing primary school. According to different study that the dropout rate of indigenous children is much higher than the estimated national rate, children dropping out especially in the early years of primary school. One of the most critical barriers for these children is that they do not understand the national language in the government pre-primary school. And also their school readiness and development become slower. In this situation, indigenous children excluded from the mainstream quality education. To address this issue Save the children in Bangladesh and other organizations are implementing community-based Mother Tongue-Based Multilingual Education program (MTBMLE) in the Chittagong Hill Tracts (CHT) for improving the enrolment rate in Government Primary Schools (GPS) reducing dropout rate as well as quality education. In connection with that Save the children conducted comparative research in Chittagong hill tracts on children readiness through Mother tongue-based and Non-mother tongue ECCD center. Objectives of the Study To assess Mother Language based ECCD centers and Non-Mother language based ECCD centers children’s school readiness and development. To assess the community perception over Mother Language based and Non-Mother Language based ECCD center. Methodology: The methodology of the study was FGD, KII, In-depth Interview and observation. Both qualitative and quantitative research methods were followed. The quantitative part has three components, School Readiness, Classroom observation and Headteacher interview and qualitative part followed FGD technique. Findings: The interviews with children under school readiness component showed that in general, Mother Language (ML) based ECCD children doing noticeably better in all four areas (Knowledge, numeracy, fine motor skill and communication) than their peers from Non-mother language based children. ML students seem to be far better skilled in concepts about print as most of them could identify cover and title of the book that was shown to them. They could also know from where to begin to read the book or could correctly point the letter that was read. A big difference was found in the area of identifying letters as 89.3% ML students of could identify letters correctly whereas for Non mother language 30% could do the same. The class room observation data shows that ML children are more active and remained engaged in the classroom than NML students. Also, teachers of ML appeared to have more engaged in explaining issues relating to general knowledge or leading children in rhyming/singing other than telling something from text books. The participants of FGDs were very enthusiastic on using mother language as medium of teaching in pre-schools. They opined that this initiative elates children to attend school and enables them to continue primary schooling without facing any language barrier.

Keywords: Chittagong hill tracts, early childhood care and development (ECCD), indigenous, mother language

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Authors: Jessica Raven Gates, Gemma Wilson-Menzfeld, Professor Alison Steven

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In 2019, the Primary Care system in the UK National Health Service (NHS) was subject to reform and restructuring. Primary Care Networks (PCNs) were established, which aligned with a trend towards integrated care both within the NHS and internationally. The introduction of PCNs brought groups of GP practices in a locality together, to operate as a network, build on existing services and collaborate at a larger scale. PCNs were expected to bring a range of benefits to patients and address some of the workforce pressures in the NHS, through an expanded and collaborative workforce. The early establishment of PCNs was disrupted by the emerging COVID-19 pandemic. This study, set in the context of the pandemic, aimed to explore experiences of the PCN workforce, and their perceptions of the establishment of PCNs. Specific objectives focussed on examining factors perceived as enabling or hindering the success of a PCN, the impact on day-to-day work, the approach to implementing change, and the influence of the COVID-19 pandemic upon PCN development. This study is part of a three-phase PhD project that utilized qualitative approaches and was underpinned by social constructionist philosophy. Phase 1: a systematic narrative review explored the provision of preventative healthcare services in UK primary settings and examined facilitators and barriers to delivery as experienced by the workforce. Phase 2: informed by the findings of phase 1, semi-structured interviews were conducted with fifteen participants (PCN workforce). Phase 3: follow-up interviews were conducted with original participants to examine any changes to their experiences and perceptions of PCNs. Three main themes span across phases 2 and 3 and were generated through a Framework Analysis approach: 1) working together at scale, 2) network infrastructure, and 3) PCN leadership. Findings suggest that through efforts to work together at scale and collaborate as a network, participants have broadly accepted the concept of PCNs. However, the workforce has been hampered by system design and system complexity. Operating against such barriers has led to a negative psychological impact on some PCN leaders and others in the PCN workforce. While the pandemic undeniably increased pressure on healthcare systems around the world, it also acted as a disruptor, offering a glimpse into how collaboration in primary care can work well. Through the integration of findings from all phases, a new theoretical model has been developed, which conceptualises the findings from this Ph.D. study and demonstrates how the workforce has experienced change associated with the establishment of PCNs. The model includes a contextual component of the COVID-19 pandemic and has been informed by concepts from Complex Adaptive Systems theory. This model is the original contribution to knowledge of the PhD project, alongside recommendations for practice, policy and future research. This study is significant in the realm of health services research, and while the setting for this study is the UK NHS, the findings will be of interest to an international audience as the research provides insight into how the healthcare workforce may experience imposed policy and service changes.

Keywords: health services research, qualitative research, NHS workforce, primary care

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: E. Vazquez-Santacruz, M. Gamboa-Zuniga

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In this paper, we show a methodology for bodies classification in lying state using HOG descriptors and pressures sensors positioned in a matrix form (14 x 32 sensors) on the surface where bodies lie down. it will be done in real time. Our system is embedded in a care robot that can assist the elderly patient and medical staff around to get a better quality of life in and out of hospitals. Due to current technology a limited number of sensors is used, wich results in low-resolution data array, that will be used as image of 14 x 32 pixels. Our work considers the problem of human posture classification with few information (sensors), applying digital process to expand the original data of the sensors and so get more significant data for the classification, however, this is done with low-cost algorithms to ensure the real-time execution.

Keywords: real-time classification, sensors, robots, health care, elderly patients, artificial intelligence

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Authors: Yasemin Yücesan, Gabriela Portugal, Maria Figueiredo

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This paper presents a part of an ongoing study on preschool teachers' perspectives and pedagogical practices regarding cultural heritage education. Accordingly, this study is based on a quantitative survey. The study area is Türkiye, and the research participants are preschool teachers actively teaching in preschool education institutions. It is necessary to encourage children to understand the past and cultural heritage values at an early age. Moreover, raising awareness of cultural heritage in preschool children is crucial for recognising and preserving this heritage. Therefore, it is very important to provide people with cultural heritage knowledge at an early age, as the preschool period is a key factor in raising awareness of this issue. In the preschool education programme implemented in Türkiye, it is stated that cultural heritage education is important in early childhood and should be included in the programme. However, although it is stated that cultural heritage education should be included in the preschool education programme, it is not clearly stated which subjects will be included in the programme and what kind of practices will be carried out. Therefore, this study examines the perspectives and pedagogical practices of preschool teachers working in preschool education institutions toward cultural heritage education.

Keywords: cultural heritage, early childhood education, pedagogical practices, preschool teacher

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Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: disposal, healthcare waste, management, Montserrado County, Monrovia

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Authors: Takanori Tanaka, Daisuke Kitao, Daisuke Ikeda

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The aurora is an attractive phenomenon but it is difficult to understand the whole mechanism of it. An approach of data-intensive science might be an effective approach to elucidate such a difficult phenomenon. To do that we need labeled data, which shows when and what types of auroras, have appeared. In this paper, we propose an image retrieval system for auroral all-sky images, some of which include discrete and diffuse aurora, and the other do not any aurora. The proposed system retrieves images which are similar to the query image by using a popular image recognition method. Using 300 all-sky images obtained at Tromso Norway, we evaluate two methods of image recognition methods with or without our original color filtering method. The best performance is achieved when SIFT with the color filtering is used and its accuracy is 81.7% for discrete auroras and 86.7% for diffuse auroras.

Keywords: data-intensive science, image classification, content-based image retrieval, aurora

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Authors: Abdulrahman Algaeed

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The Ophthalmic Ultrasound is the easiest method of early diagnosing Retinoblastoma after clinical examination. It can be done with ease without sedation. King Khaled Eye Specialist Hospital is a tertiary care center where Retinoblastoma patients are often seen and treated there. The first modality to rule out the disease is Ophthalmic Ultrasound. Classic Retinoblastoma is easily diagnosed by using the conventional 10MHz Ophthalmic Ultrasound probe in the regular clinic setup. Retinal lesion with multiple, very highly reflective surfaces within lesion typical of Calcium deposits. The use of Standardized A-scan is very useful where internal reflectivity is classified as very highly reflective. Color Doppler is extremely useful as well to show the blood flow within lesion/s. In conclusion: Ophthalmic Ultrasound should be the first tool to be used to diagnose Retinoblastoma after clinical examination. The accuracy of the Exam is very high.

Keywords: doppler, retinoblastoma, reflectivity, ultrasound

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Authors: Amanda Aliende da Matta

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This communication presents an aspect of phenomenon selection in an applied hermeneutic phenomenology study on care and vulnerability: the need to consider it as a situated universal. For that, we will first present the study and its methodology. Secondly, we will expose the need to understand phenomena as situation-defined, incorporating feminist thought. In an informatics class for 14 year olds, we explained the exercise: students have to make a 5 slide presentation about a topic of their choice. A does it on streetwear, B on Cristiano Ronaldo, C on Marvel, but J did it on Down Syndrome. Introducing it to the class, J explains the physical and cognitive differences caused by trisomy; when asked to explain it further, he says: "they are angels, teacher," and shows us a poster on his cellphone that says: if you laugh at a different child he will laugh with you because his innocence outweighs your ignorance. The anecdote shows, better than any theoretical explanation, something that some vulnerable people have; something beautiful and special but difficult to define. Let's call this something caring. The research has the main objective of accounting for the experience of caregiving in vulnerability, and it will be carried out with Applied Hermeneutic Phenomenology (AHP). The method's objective is to investigate the lived human experience in its pre-reflexive dimension to know its meaning structures. Contrary to other research methods, AHP does not produce theory about a specific context but seeks the meaning of the lived experience, in its characteristic of human experience. However, it is necessary that we understand care as defined in a concrete situation. We cannot start the research with an a priori definitive concept of care, or we would fall into the mistake of closing ourselves to only what we already know, as explained by Levinas. We incorporate, then, the notion of situated universals. Loyal to phenomenology, the definition of the phenomenon should start with an investigation of the word's etymology: the word cura, in its etymological root, means care. And care comes from the Latin word cogitātus/cōgĭto, which means "to pursue something in mind" and "to consider thoroughly." The verb cōgĭto, meanwhile, is composed of co- (altogether) and agitare (to deal with or think committedly about something, to concern oneself with) / ăgĭto (to set in motion, to move). Care, therefore, has in its origin a meditation on something, a concern about something, a verb that has a sense of action and movement. To care is to act out of concern for something/someone. This etymology, though, is not the final definition of the phenomenon, but only its skeleton. It needs to be embodied in the concrete situation to become a possible lived experience. And that means that the lived experience descriptions (LEDs) should be selected by taking into consideration how and if care was engendered in that concrete experience. Defining the phenomenon has to take into consideration situated knowledge.

Keywords: applied hermeneutic phenomenology, care ethics, hermeneutics, phenomenology, situated universalism

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Authors: Sehreen Moorat, Mussarat Lakho

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A method of artificial intelligence using digital mammograms data has been proposed in this paper for detection of breast cancer. Many researchers have developed techniques for the early detection of breast cancer; the early diagnosis helps to save many lives. The detection of breast cancer through mammography is effective method which detects the cancer before it is felt and increases the survival rate. In this paper, we have purposed image processing technique for enhancing the image to detect the graphical table data and markings. Texture features based on Gray-Level Co-Occurrence Matrix and intensity based features are extracted from the selected region. For classification purpose, neural network based supervised classifier system has been used which can discriminate between benign and malignant. Hence, 68 digital mammograms have been used to train the classifier. The obtained result proved that automated detection of breast cancer is beneficial for early diagnosis and increases the survival rates of breast cancer patients. The proposed system will help radiologist in the better interpretation of breast cancer.

Keywords: medical imaging, cancer, processing, neural network

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Authors: Rodrique Watong Tchounkeu

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This paper investigated the implementation and impact of inclusive education practices in early childhood settings (ages 3-6) with the overarching aim of fostering a diverse learning environment. The primary objectives were to assess the then-current state of inclusive practices, identify effective methodologies for accommodating diverse learning needs, and evaluate the outcomes of implementing inclusive education in early childhood settings. To achieve these objectives, a mixed-methods approach was employed, combining qualitative interviews with early childhood educators and parents, along with quantitative surveys distributed to a diverse sample of participants. The qualitative phase involved semi-structured interviews with 30 educators and 50 parents, selected through purposive sampling. The interviews aimed to gather insights into the challenges faced in implementing inclusive education, the strategies employed, and the perceived benefits and drawbacks. The quantitative phase included surveys administered to 300 early childhood educators across various settings, measuring their familiarity with inclusive practices, their perceived efficacy, and their willingness to adapt teaching methods. The results revealed a significant gap between the theoretical understanding and practical implementation of inclusive education in early childhood settings. While educators demonstrated a high level of theoretical knowledge, they faced challenges in effectively translating these concepts into practice. Parental perspectives highlighted the importance of collaboration between educators and parents in supporting inclusive education. The surveys indicated a positive correlation between educators' familiarity with inclusive practices and their willingness to adapt teaching methods, emphasizing the need for targeted professional development. The implications of this study suggested the necessity for comprehensive training programs for early childhood educators focused on the practical implementation of inclusive education strategies. Additionally, fostering stronger partnerships between educators and parents was crucial for creating a supportive learning environment for all children. By addressing these findings, this research contributed to the advancement of inclusive education practices in early childhood settings, ultimately leading to more inclusive and effective learning environments for diverse groups of young learners.

Keywords: inclusive education, early childhood settings, diverse learning, young learners, practical implementation, parental collaboration

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Authors: Maari Sugawara

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This study investigates the constructed notion of “motherhood” and queered forms of care in contemporary Japan, focusing on rental family services. In Japan, the concept of motherhood is often equated with womanhood, reflecting a pervasive ideology that views motherhood as an essential aspect of a woman's societal role, particularly amidst economic recovery and an aging population. This study interrogates these gendered expectations by linking rental family services, particularly the role of rental mothers, to traditional caregiving roles. It critiques the gendered construction of domestic labor and aims to expand conceptions of alternative family structures and caregiving roles beyond normative frameworks. Emerging in the 1980s to provide companionship for the elderly, rental family services have evolved to meet diverse social needs, with paid actors fulfilling familial roles at various social events. Despite their growing prevalence, academic exploration of this phenomenon remains limited. This research aims to fill that gap by investigating the cultural, social, and economic factors fueling the popularity of rental family services and analyzing their implications for contemporary understandings of family dynamics and care labor in Japan. Furthermore, this study underscores the disproportionate domestic labor burden women in Japan bear, often managing time-intensive household tasks, which creates a "double burden" for those in full-time employment. Care work, including elderly and disability support, is undervalued and typically compensated at near-minimum wage levels, with women predominantly filling these low-wage roles. This gender disparity in Japan's care industry contributes to labor shortages in caregiving and childcare, highlighting broader structural inequities in the labor market. Through semi-structured qualitative interviews with fifteen rental mothers, this study investigates their experiences, motivations, role dynamics, and emotional labor. It critically examines whether the labor performed by rental family actors constitutes a subversive practice deserving of appropriate compensation. Utilizing a role-playing method, the author engages with rental mothers as if they were her own, reflecting the dynamics of compensated labor. This interaction delves into the economic and emotional aspects of constructed motherhood, facilitating a broader inquiry into the value of both productive and reproductive labor in Japan. The study also investigates the relationship between sex work and rental family services within the socio-economic landscape, recognizing the links between the welfare sector and female employment in legal sex work. Although distinct, these sectors merit joint consideration due to the commonality of male clients in both industries. This research engages with theoretical perspectives framing mobile sex work as inherently queer, directly challenging the dominance of heteronormativity. The agency exercised by sex workers complicates narratives of conformity and deviance, underscoring the need to reevaluate caregiving labor in both paid and unpaid contexts. Ultimately, this research critiques the intersection of gender, care, and labor in contemporary Japan by examining the undervaluation of traditional caregiving roles alongside the labor involved in rental family services. It challenges Japanese policies that equate womanhood with motherhood and explores the potential of viewing outsourced care as queered maternal and non-reproductive labor, advocating for the recognition of alternative family structures and non-reproductive forms of motherhood.

Keywords: motherhood, alternative family structures, carework, Japan, queer studies

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Authors: Liana Khandolishvili, Giorgi Dvalashvili

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Karst waters in the world play an important role in the water supply. Among them, the Vaucluse in Chiatura municipality (Georgia) is used as drinking water and is irreplaceable for the local population. Accordingly, it is important to assess their geo-ecological conditions and take care to maintain sustainability. The aim of the paper is to identify the hazards of pollution of underground waters in the karst environment and to develop a scheme for their protection, which will take into consideration both the hydrogeological characteristics and the role of humans. To achieve this goal, the EPIK method was selected using which an epikarst zone of the study area was studied in detail, as well as the protective cover, infiltration conditions and frequency of karst network development, after which the conditions of karst waters in Chiatura municipality was assessed, their main pollutants were identified and the recommendations were prepared for their protection. The results of the study showed that the karst water pollution rate in Chiatura municipality is highest, where karst-fissured layers are represented and intensive extraction works are underway. The EPIK method is innovative in Georgia and was first introduced on the example of karst waters of Chiatura municipality.

Keywords: cave, EPIK method, pollution, Karst waters, geology, geography, ecology

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Authors: Karla Sanchez-Ortiz, Yunuen Tapia-Torres, John Larsen, Felipe Garcia-Oliva

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Due to food demand production, the use of synthetic nitrogenous fertilizer has increased in agricultural soils to replace the N losses. Nevertheless, the intensive use of synthetic nitrogenous fertilizer in conventional agriculture negatively affects the soil and therefore the environment, so alternatives such as organic agriculture have been proposed for being more environmentally friendly. However, further research in soil is needed to see how agricultural management affects the dynamics of C and N. The objective of this research was to evaluate the C and N dynamics in the soil with three different agricultural management: an agricultural plot with intensive inorganic fertilization, a plot with semi-organic management and an agricultural plot with recent abandonment (2 years). For each plot, the soil C and N dynamics and the enzymatic activity of NAG and β-Glucosidase were characterized. Total C and N concentration of the plant biomass of each site was measured as well. Dissolved organic carbon (DOC) and dissolved organic nitrogen (DON) was higher in abandoned plot, as well as this plot had higher total carbon (TC) and total nitrogen (TN), besides microbial N and microbial C. While the enzymatic activity of NAG and β-Glucosidase was greater in the agricultural plot with inorganic fertilization, as well as nitrate (NO₃) was higher in fertilized plot, in comparison with the other two plots. The aboveground biomass (AB) of maize in the plot with inorganic fertilization presented higher TC and TN concentrations than the maize AB growing in the semiorganic plot, but the C:N ratio was highest in the grass AB in the abandoned plot. The C:N ration in the maize grain was greater in the semi-organic agricultural plot. These results show that the plot under intensive agricultural management favors the loss of soil organic matter and N, degrading the dynamics of soil organic compounds, promoting its fertility depletion.

Keywords: mineralization, nitrogen cycle, soil degradation, soil nutrients

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Authors: Asier Romero Andonegi, Irati De Pablo Delgado

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The objective of this study is to explore the different methodological procedures that are used to obtain information on the early linguistic development of children. To this end, two different methodological procedures were carried out on the same sample: on the one hand, the MacArthur-Bates Communicative Development Inventories, in its adaptations in Spanish and Basque; and on the other hand, longitudinal observation through professional software: ELAN and CHAT. The sample consists of 8 Basque children/ages 16 to 30 months with different mother tongue (L1). The results show the usefulness of inventories in obtaining information on the development of early communication and language skills, but also their limitations mostly focused on the interpretive overvaluation of their children’s lexical development.

Keywords: early language development, language evaluation, lexicon, MacArthur-Bates communicative development inventories

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Authors: Abdul Rahim Razalli, Nordin Mamat, Lee Kean Low

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The objective of the study is to examine the acquisition of Bahasa Melayu hand coded and Malaysian Sign Language of hearing impaired children and the factors that influencing the acquisition of Malay language at early intervention. A qualitative research design was chosen to answer two research questions. Two sets of instruments have been used to obtain information of proficiency and factors that influence it. Five children with hearing problems, four teachers and three parents were selected as the respondents through purposive sampling technique. The findings show that pupils with hearing problems who mastered Bahasa Melayu hand coded have better acquisition of Bahasa Melayu as compared to those who acquired Malaysian Sign Language. The study also found that the parents, pupils, teachers and environmental factors have an impact on the acquisition of Bahasa Melayu hand coded. The implications of this study show that early intervention of Bahasa Melayu hand coded and the parents, pupils, teachers and environmental factors do help in the language proficiency of children with hearing problems. A more comprehensive study should be undertaken at a higher level to see the impact on an early intervention program for Malay language acquisition of hearing impaired children.

Keywords: Bahasa Melayu hand coded, Malaysian sign Language, hearing impaired children, early intervention

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Authors: Sanjoy Barua Chowdhury

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The aim of this paper is an attempt to analyze the concept of emptiness from the early Buddhist teachings to subsequent Buddhist developmental schools, namely, Madhyamaka and Yogācāra Schools, along with attempting to examine an insightful bridge between the Buddha’s major teaching on dependent origination and the notion of emptiness. The initial part of this qualitative research focuses on the etymological term of emptiness (śūnyatā) and the Buddha’s teaching of emptiness from the Early Buddhist standpoint. Next, this research will seek to explain the concept of emptiness in the Madhyamaka School and Yogācāra School. This study further demonstrates the eradication of suffering is meant of understanding the concept emptiness from an ultimate standpoint with special concerning to focus the connection to the Buddha’s central teaching Dependent Origination.

Keywords: emptiness, Madhyamaka, dependent origination, early Buddhism, Yogacara

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Authors: Jamel Slaughter

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Father involvement across the development of a child has been linked to children’s psychological adjustment, fewer behavioral problems, and higher educational attainment. Conversely, there is much less research that highlights father involvement in relation to childhood development during early childhood period prior to preschool age (ages 1-3 years). Most research on fathers and child outcomes have been limited by its focus on the stages of adolescence, middle childhood, and infancy. This study examined the influence of father involvement, during the toddler stage, on 5th grade cognitive development, rule-breaking, and behavior outcomes measured by Child Behavior Checklist (CBCL) scores. Using data from the Early Head Start Research and Evaluation (EHSRE) Study, 1996-2010: United States, a total of 3,001 children and families were identified in 17 sites (cities), representing a diverse demographic sample. An independent samples t-test was run to compare cognitive development, aggressive, and rule-breaking behavior mean scores among children who had early continuous father involvement for the first 14 – 36 months to children who did not have early continuous father involvement for the first 14 – 36 months. Multiple linear regression was conducted to determine if continuous, or non-continuous father involvement (14 month-36 months), can be used to predict outcome scores on the Child Behavior Checklist in aggressive behavior, rule-breaking behavior, and cognitive development, at 5th grade. A statistically significant mean difference in cognitive development scores were found for children who had continuous father involvement (M=1.92, SD=2.41, t (1009) =2.81, p =.005, 95% CI=.146 to .828) compared to those who did not (M=2.60, SD=3.06, t (1009) =-2.38, p=.017, 95% CI= -1.08 to -.105). There was also a statistically significant mean difference in rule-breaking behavior scores between children who had early continuous father involvement (M=1.95, SD=2.33, t (1009) = 3.69, p <.001, 95% CI= .287 to .940), compared to those that did not (M=2.87, SD=2.93, t (1009) = -3.49, p =.001, 95% CI= -1.30 to -.364). No statistically significant difference was found in aggressive behavior scores. Multiple linear regression was performed using continuous father involvement to determine which has the largest relationship to rule-breaking behavior and cognitive development based on CBCL scores. Rule-breaking behavior was found to be significant (F (2, 1008) = 8.353, p<.001), with an R2 of .016. Cognitive development was also significant (F (2, 1008) = 4.44, p=.012), with an R2 of .009. Early continuous father involvement was a significant predictor of rule-breaking behavior and cognitive development at middle childhood. Findings suggest early continuous father involvement during the first 14 – 36 months of their children’s life, may lead to lower levels of rule-breaking behaviors and thought problems at 5th grade.

Keywords: cognitive development, early continuous father involvement, middle childhood, rule-breaking behavior

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Authors: Nelson Igaba, C. Onaga, S. Hlongwane

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Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.

Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement

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Authors: Gülay Dalgıç, Gildis Tachir

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Architectural design studios are ambiencein where architecture design is realized as a palpable product in architectural education. In the design studios that the architect candidate will use in the design processthe information, the methods of approaching the design problem, the solution proposals, etc., are set uptogetherwith the studio coordinators. The architectural design process, on the other hand, is complex and uncertain.Candidate architects work in a process that starts with abstre and ill-defined problems. This process starts with the generation of alternative solutions with the help of representation tools, continues with the selection of the appropriate/satisfactory solution from these alternatives, and then ends with the creation of an acceptable design/result product. In the studio ambience, many designs and thought relationships are evaluated, the most important step is the early design phase. In the early design phase, the first steps of converting the information are taken, and converted information is used in the constitution of the first design decisions. This phase, which positively affects the progress of the design process and constitution of the final product, is complex and fuzzy than the other phases of the design process. In this context, the aim of the study is to investigate the effects of face-to-face learning model and e-learning model on the early design phase. In the study, the early design phase was defined by literature research. The data of the defined early design phase criteria were obtained with the feedback graphics created for the architect candidates who performed e-learning in the first year of architectural education and continued their education with the face-to-face learning model. The findings of the data were analyzed with the common graphics program. It is thought that this research will contribute to the establishment of a contemporary architectural design education model by reflecting the evaluation of the data and results on architectural education.

Keywords: education modeling, architecture education, design education, design process

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Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

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The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

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Authors: Kangkang Tang

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A large amount of blast furnace slag is generated in China. Most ground granulated blast furnace slag (GGBS) however ends up in low-grade applications. Blast furnace slag, ground to an appropriate fineness, can be used as a partial replacement of cementitious material in concrete. The potential for using GGBS in structural concrete, e.g. concrete beams and columns, is investigated at Xi’an Jiaotong-Liverpool University (XJTLU). With 50% of CEM I replaced with GGBS, peak hydration temperatures determined in a suspended concrete slab reduced by 20%. This beneficiary effect has not been further improved with 70% of CEM I replaced with GGBS. Partial replacement of CEM I with GGBS also has a retardation effect on the early-age strength of concrete. More GGBS concrete mixes will be conducted to identify an ‘optimum’ replacement level which will lead to a reduced thermal loading, without significantly compromising the early-age strength of concrete.

Keywords: thermal effect, GGBS, concrete strength and testing, sustainability

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Authors: Paria Soleimani, Arezoo Neshati

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Myocardial infarction is one of the leading causes of ‎death in the world. Some of these deaths occur even before the patient ‎reaches the hospital. Myocardial infarction occurs as a result of ‎impaired blood supply. Because the most of these deaths are due to ‎coronary artery disease, hence the awareness of the warning signs of a ‎heart attack is essential. Some heart attacks are sudden and intense, but ‎most of them start slowly, with mild pain or discomfort, then early ‎detection and successful treatment of these symptoms is vital to save ‎them. Therefore, importance and usefulness of a system designing to ‎assist physicians in the early diagnosis of the acute heart attacks is ‎obvious.‎ The purpose of this study is to determine how well a predictive ‎model would perform based on the only patient-reportable clinical ‎history factors, without using diagnostic tests or physical exams. This ‎type of the prediction model might have application outside of the ‎hospital setting to give accurate advice to patients to influence them to ‎seek care in appropriate situations. For this purpose, the data were ‎collected on 711 heart patients in Iran hospitals. 28 attributes of clinical ‎factors can be reported by patients; were studied. Three logistic ‎regression models were made on the basis of the 28 features to predict ‎the risk of heart attacks. The best logistic regression model in terms of ‎performance had a C-index of 0.955 and with an accuracy of 94.9%. ‎The variables, severe chest pain, back pain, cold sweats, shortness of ‎breath, nausea, and vomiting were selected as the main features.‎

Keywords: Coronary heart disease, Acute heart attacks, Prediction, Logistic ‎regression‎

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Authors: Robert John Godby

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To be responsive now and in the future, workplaces must address the demands of multicultural teams as they become more common elements of the global labor force. This is especially the case for aged care due to the aging population, industry growth and migrant recruitment. This research identifies influences on and improvements for learning in these environments. Its unique contribution is to illuminate how culturally diverse workplaces can work and learn together more effectively. A mixed-methods approach was used to gather data about this topic in two phases. Firstly, the research methods included a survey of 102 aged care workers around Australia from two multi-site aged care organisations. The questionnaire elicited both quantitative and qualitative data about worker characteristics and perspectives on working and learning in aged care. Secondly, a case study of one aged care worksite was formulated drawing on worksite information and interviews with workers. A review of the literature suggests that learning in multicultural work environments is influenced by three main factors: 1) the individual workers themselves, 2) their interaction with each other and 3) the environment in which they work. There are various accounts of these three factors, how they are manifested and how they lead to a change in workers’ disposition, knowledge, or expertise when confronted with new circumstances. The study has found that a key individual factor influencing learning is cultural background. Their unique view of the world was shown to affect their approach to both their work and co-working. Interactional factors suggest that the high requirement for collaboration in aged care positively supports learning in this context; however, it can be hindered by cultural bias and spoken accent. The study also found that environmental factors, such as disruptions caused by the pandemic, were another key influence. For example, the need to wear face masks hindered the communication needed for workplace learning. This was especially challenging due to the diverse language backgrounds and abilities within the teams. Potential improvements for learning in multicultural aged care work environments were identified. These include more frequent and structured inter-peer learning (e.g. buddying), communication training (e.g. English language usage for both native and non-native speaking workers) and support for cross-cultural habitude (e.g. recognizing and adapting to cultural differences). Workplace learning in cross-cultural aged care environments is an area that is not extensively dealt with in the literature. This study addresses this gap and holds the potential to contribute practical insights to aged care and other diverse industries.

Keywords: cross-cultural learning, learning in aged care, migrant learning, workplace learning

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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