Search results for: children's literature

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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Obesity is associated with an increased risk of developing insulin resistance. Insulin resistance often progresses to type-2 diabetes mellitus and is linked to a wide variety of other pathophysiological features including hypertension, hyperlipidemia, atherosclerosis (metabolic syndrome) and polycystic ovarian syndrome. Macrosomia is common in infants born to not only women with gestational diabetes mellitus but also non-diabetic obese women. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age (LGA) are more likely to be obese in childhood. It is also established from previous studies that Asian populations have higher percentage body fat at a lower body mass index compared to Caucasians. High leptin levels in cord blood have been reported to correlate with fetal adiposity at birth. Previous studies have also shown that cord blood C-peptide and insulin levels are significantly and positively correlated with birth weight. Therefore, the objective of this preliminary study was to determine the relationship between parameters of fetal insulin resistance such as leptin, C-peptide and insulin and the birth weight of the newborn in a study population in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns and the concentration of insulin, leptin, and C-peptide were measured by ELISA technique. Birth weight, length, occipital frontal, chest, hip and calf circumferences of newborns were measured and characteristics of the mother such as age, height, weight before pregnancy and weight gain were collected. The relationship between insulin, leptin, C-peptide, and anthropometrics were assessed by Pearson’s correlation while the Mann-Whitney U test was used to assess the differences in cord blood leptin, C-peptide, and insulin levels between groups. A significant difference (p < 0.001) was observed between the insulin levels of infants born LGA (18.73 ± 0.64 µlU/ml) and AGA (13.08 ± 0.43 µlU/ml). Consistently, A significant increase in concentration (p < 0.001) was observed in C-peptide levels of infants born LGA (9.32 ± 0.77 ng/ml) compared to AGA (5.44 ± 0.19 ng/ml). Cord blood leptin concentration of LGA infants (12.67 ng/mL ± 1.62) was significantly higher (p < 0.001) compared to the AGA infants (7.10 ng/mL ± 0.97). Significant positive correlations (p < 0.05) were observed among cord leptin levels and the birth weight, pre-pregnancy maternal weight and BMI between the infants of AGA and LGA. Consistently, a significant positive correlation (p < 0.05) was observed between the birth weight and the C peptide concentration. Significantly high concentrations of leptin, C-peptide and insulin levels in the cord blood of LGA infants suggest that they may be involved in regulating fetal growth. Although previous studies suggest comparatively high levels of body fat in the Asian population, values obtained in this study are not significantly different from values previously reported from Caucasian populations. According to this preliminary study, maternal pre-pregnancy BMI and weight may contribute as significant indicators of cord blood parameters of insulin resistance and possibly the birth weight of the newborn.

Keywords: large for gestational age, leptin, C-peptide, insulin

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Authors: Wei-Chieh Yeh, Yung-Tang Shen

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The concept of community building started in 1994 in Taiwan. After years of development, it fostered the notion of active local resident participation in community issues as co-operators, instead of minions. Participatory design gives participants more control in the decision-making process, helps to reduce the friction caused by arguments and assists in bringing different parties to consensus. This results in an increase in the efficiency of projects run in the community. Therefore, the participation of local residents is key to the success of community building. This study applied participatory design to develop plans for the reuse of deserted spaces in the community from the first stage of brainstorming for design ideas, making creative models to be employed later, through to the final stage of construction. After conducting a series of participatory designed activities, it aimed to integrate the different opinions of residents, develop a sense of belonging and reach a consensus. Besides this, it also aimed at building the residents’ awareness of their responsibilities for the environment and related issues of sustainable development. By reviewing relevant literature and understanding the history of related studies, the study formulated a theory. It took the “2012-2014 Changhua County Community Planner Counseling Program” as a case study to investigate the implementation process of participatory design. Research data are collected by document analysis, participants’ observation and in-depth interviews. After examining the three elements of “Design Participation”, “Construction Participation”, and” Follow–up Maintenance Participation” in the case, the study emerged with a promising conclusion: Maintenance works were carried out better compared to common public works. Besides this, maintenance costs were lower. Moreover, the works that residents were involved in were more creative. Most importantly, the community characteristics could be easy be recognized.

Keywords: participatory design, deserted space, community building, reuse

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Authors: Hasan Muslemani, Jeffrey Wilson, Xi Liang, Francisco Ascui, Katharina Kaesehage

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This paper aims to examine consumer behaviour towards, and the willingness to adopt, green steel use in the automotive sector, in order to identify potential barriers and opportunities for its widespread adoption. Semi-structured interviews were held with experts from global, regional and country-specific industry associations and automakers. The analysis shows there is a new shift towards lifecycle thinking in the sector, although these efforts have been voluntary and driven by customer and employee pressures rather than regulation. The paper further appraises possible demand for green steel within different vehicle types (based on size and powertrain), and shows that manufacturers of electric heavy-duty vehicles are most likely to adopt green steel in the first instance, given the amount of incorporated steel in the vehicles and the fact that lifecycle emissions lie predominantly in their manufacturing phase. A case for green advanced higher-strength steels (AHSS) can also be made in light-duty passenger vehicles, which may mitigate competition from light-weight alternative materials in terms of cost and greenness (depending on source and utilisation zones). This work builds on a wide sustainability-related literature in the automotive sector and highlights areas in need of urgent action if the sector as a whole were to meet its Paris Agreement climate targets, in particular a need to revisit current CO2 performance regulations to include Scope 1 and Scope 2 emissions, engage in educational green marketing campaigns, and explore innovative market-based mechanisms to bridge the gap between relatively-low carbon abatement costs of steelmaking and high abatement costs of vehicle manufacturing.

Keywords: Green steel, Consumer behaviour, Automotive industry, Environmental sustainability

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Authors: I. Székács, Á. Fejes, S. Klátyik, E. Takács, D. Patkó, J. Pomóthy, M. Mörtl, R. Horváth, E. Madarász, B. Darvas, A. Székács

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Environmental and toxicological characteristics of formulated pesticides may substantially differ from those of their active ingredients or other components alone. This phenomenon is demonstrated in the case of the herbicide active ingredient glyphosate. Due to its extensive application, this active ingredient was found in surface and ground water samples collected in Békés County, Hungary, in the concentration range of 0.54–0.98 ng/ml. The occurrence of glyphosate appeared to be somewhat higher at areas under intensive agriculture, industrial activities and public road services, but the compound was detected at areas under organic (ecological) farming or natural grasslands, indicating environmental mobility. Increased toxicity of the formulated herbicide product Roundup, compared to that of glyphosate was observed on the indicator aquatic organism Daphnia magna Straus. Acute LC50 values of Roundup and its formulating adjuvant Polyethoxylated Tallowamine (POEA) exceeded 20 and 3.1 mg/ml, respectively, while that of glyphosate (as isopropyl salt) was found to be substantially lower (690-900 mg/ml) showing good agreement with literature data. Cytotoxicity of Roundup, POEA and glyphosate has been determined on the neuroectodermal cell line, NE-4C measured both by cell viability test and holographic microscopy. Acute toxicity (LC50) of Roundup, POEA and glyphosate on NE-4C cells was found to be 0.013±0.002%, 0.017±0.009% and 6.46±2.25%, respectively (in equivalents of diluted Roundup solution), corresponding to 0.022±0.003 and 53.1±18.5 mg/ml for POEA and glyphosate, respectively, indicating no statistical difference between Roundup and POEA and 2.5 orders of magnitude difference between these and glyphosate. The same order of cellular toxicity seen in average cell area has been indicated under quantitative cell visualization. The results indicate that toxicity of the formulated herbicide is caused by the formulating agent, but in some parameters toxicological synergy occurs between POEA and glyphosate.

Keywords: glyphosate, polyethoxylated tallowamine, Roundup, combined aquatic and cellular toxicity, synergy

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Authors: Omer Livvarcin, Mary Kay Park, Michael Miles

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The current literature includes a few studies that mention the impact of relations between teams, the business environment, and experiences from previous projects. There is, however, limited research that treats the phenomenon of project atmosphere (PA) as a whole. This is especially true of research identifying parameters and sub-parameters, which allow project management (PM) teams to build a project culture that ultimately imbues project success. This study’s findings identify a number of key project atmosphere parameters and sub-parameters that affect project management success. One key parameter identified in the study is a cluster related to cultural concurrence, including artifacts such as policies and mores, values, perceptions, and assumptions. A second cluster centers on motivational concurrence, including such elements as project goals and team-member expectations, moods, morale, motivation, and organizational support. A third parameter cluster relates to experiential concurrence, with a focus on project and organizational memory, previous internal PM experience, and external environmental PM history and experience). A final cluster of parameters is comprised of those falling in the area of relational concurrence, including inter/intragroup relationships, role conflicts, and trust. International and intercultural project management data was collected and analyzed from the following countries: Canada, China, Nigeria, South Korea and Turkey. The cross-cultural nature of the data set suggests increased confidence that the findings will be generalizable across cultures and thus applicable for future international project management success. The intent of the identification of project atmosphere as a critical project management element is that a clear understanding of the dynamics of its sub-parameters upon projects may significantly improve the odds of success of future international and intercultural projects.

Keywords: project management, project atmosphere, cultural concurrence, motivational concurrence, relational concurrence

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Authors: Jacob Hatherell, Jason Matthews, Arnaud Marmier

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Anvil Staking is a cold-forming process that is used in the assembly of plain spherical bearings into a rod-end housing. This process ensures that the bearing outer lip conforms to the chamfer in the matching rod end to produce a lightweight mechanical joint with sufficient strength to meet the pushout load requirement of the assembly. Finite Element (FE) analysis is being used extensively to predict the behaviour of metal flow in cold forming processes to support industrial manufacturing and product development. On-going research aims to validate FE models across a wide range of bearing and rod-end geometries by systematically isolating and understanding the uncertainties caused by variations in, material properties, load-dependent friction coefficients and strain rate sensitivity. The improved confidence in these models aims to eliminate the costly and time-consuming process of experimental trials in the introduction of new bearing designs. Previous literature has shown that friction coefficients do not remain constant during cold forming operations, however, the understanding of this phenomenon varies significantly and is rarely implemented in FE models. In this paper, a new approach to evaluate the normal contact pressure versus friction coefficient relationship is outlined using friction calibration charts generated via iterative FE models and ring compression tests. When compared to previous research, this new approach greatly improves the prediction of forming geometry and the forming load during the staking operation. This paper also aims to standardise the FE approach to modelling ring compression test and determining the friction calibration charts.

Keywords: anvil staking, finite element analysis, friction coefficient, spherical plain bearing, ring compression tests

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Authors: Abdelmessih Malak Sadek Labib

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The Stability in harsh environments thanks to excellent electrical, mechanical and thermal properties is what ceramics are all about selected materials for many applications despite advent of new materials such as plastics and composites. However, ceramic materials have disadvantages, including brittleness. Fragility is often attributed to pottery strong covalent and ionic bonds in the ceramic body. There is still much to learn about brittle cracks in a attention to detail, hence the fragility of the ceramic and its catastrophic failure of a frequently studied topic, particularly in charging applications. One of the most commonly used ceramics for load-bearing applications such as veneers is porcelain. Porcelain is a type of traditional pottery. Traditional pottery consists mainly of three basic ingredients: clay, which gives plasticity; silica which maintains the shape and stability of the ceramic body over temperature high temperature; and feldspar affecting glazing. In traditional pottery, the inversion of quartz during cooling the process can create microcracks that act as a stress concentration centers. Consequently, subcritical crack growth is caused due to quartz inversion origins unpredictable catastrophic failure of the work of ceramic bodies when reloading. In the case of porcelain, however, this is what the mullite hypothesis says the strength of porcelain can be significantly increased with felt Interlocking of mullite needles in the ceramic body.in this way realistic assessment of the role of quartz and mullite Porcelain with a strength of is needed to grow stronger and smaller fragile porcelain. Currently,the lack of reports on Young's moduli in the literature leads to erroneous conclusions in this regard mechanical behavior of porcelain. Therefore, the current project uses the Young's modulus approach for the investigation the role of quartz and mullite on the mechanical strength of various porcelains, in addition to reducing particle size, flexural strength fractographic forces and techniques.

Keywords: materials, technical, ceramics, properties, thermal, stability, advantages

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Authors: Jessy Rugeyo, William Donner

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This research delves into the resilience of Rwanda's public health infrastructure amidst natural disasters, a critical issue given that the Northern Province alone has witnessed no fewer than 1500 cases of disaster ranging from floods and landslides in the last five years, with more than 200 people killed and thousands of homes destroyed, according to MINEMA. In an era where climate change escalates the frequency and intensity of such disasters, fortifying the resilience of public health systems is paramount. This study offers a comprehensive analysis of the existing state of Rwanda's public health infrastructure and its ability to manage such crises. Employing a mix of literature review, case studies, and policy analysis, the study discerns key vulnerabilities and brings to light the intricacies of disaster management in Rwanda. Case studies centered around past natural disasters in Rwanda provide critical insights into the strengths and weaknesses of the existing disaster response mechanisms. A thorough critique of related disaster management and public health infrastructure policies reveals areas of commendable practice, along with gaps calling for policy enhancements. Findings guide the proposition of targeted strategies to bolster the resilience of Rwanda's public health infrastructure. This research serves as a significant contribution to the domains of disaster studies and public health, offering valuable insights for policymakers, public health and disaster management professionals in Rwanda and similar contexts. It presents actionable recommendations for improvement, underscoring the potential for enhancing Rwanda's disaster management capacity. By advocating for the strengthening of public health infrastructure resilience, the research highlights the potential for improved public health outcomes following natural disasters, thereby showcasing significant implications for public health and disaster management in the country, particularly in the face of a changing climate.

Keywords: public health infrastructure, disaster resilience, natural disaster, disaster management, emergency preparedness, health policy

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Authors: Vaishali Joshi, Pallav Joshi

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The main objective of this study is to examine the fashion consumption behavior of females with respect to their age group. Differences were studied in the pre-purchase, purchase and post-purchase behavior of females belonging to three age cohorts such as Generation X, Generation Y, and Generation Z. Quantitative approach was used to conduct this research. Data was collected through structured questionnaire. The questionnaire consisted of three sections. Section one included a question of the source of information of purchasing fashion apparels which measure the pre-purchase behavior. Section two measures purchase behavior which included two questions: i. motivations for purchasing fashion apparel and ii. important attributes considered for purchasing fashion apparel. The last section included a question regarding disposal of fashion apparel which measures the post-purchase behavior. Hundred females were selected as the respondents for this study through convenience sampling in the fashion streets. They were categorized into three age groups and then the results were analyzed. Four hypotheses were developed after reviewing the existing literature. Regression analysis was conducted for testing the hypothesis. Hypothesis one was accepted which stated that ‘social influence’ as a source of information for purchasing fashion apparels decreases with age. Hypothesis two was accepted which suggested that motivation of ‘Attention seeking’ for purchasing fashion apparel decreases with age. Hypothesis three and four also accepted which suggested that the importance of ‘Quality’ and ‘Price’ increases with age but hypothesis five was rejected which suggested that the importance of ‘Fit’ increases with age and last but not the least hypothesis six was accepted which suggested that the ‘duration’ of using fashion apparel increases with age. Limitation of the study deals with the sample of only female respondents. Implication can be made from this research in the field of Fashion apparel industry with respect to consumer segmentation and better marketing approaches can be implemented by the marketers form this study. Further research can be concluded by including male respondents also.

Keywords: fashion, consumption behavior, age cohorts, motivation

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Authors: Musaab Salman Sultan

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The surface and bulk magnetization behavior of template released isolated ferromagnetic Ni₆₀Fe₄₀ nanowires of relatively thick diameters (~200 nm), deposited from a dilute suspension onto pre-patterned insulating chips have been investigated experimentally, using a highly sensitive Magneto-Optical Ker Effect (MOKE) magnetometry and Magneto-Resistance (MR) measurements, respectively. The MR data were consistent with the theoretical predictions of the anisotropic magneto-resistance (AMR) effect. The MR measurements, in all the angles of investigations, showed large features and a series of nonmonotonic "continuous small features" in the resistance profiles. The extracted switching fields from these features and from MOKE loops were compared with each other and with the switching fields reported in the literature that adopted the same analytical techniques on the similar compositions and dimensions of nanowires. A large difference between MOKE and MR measurments was noticed. The disparate between MOKE and MR results is attributed to the variance in the micro-magnetic structure of the surface and the bulk of such ferromagnetic nanowires. This result was ascertained using micro-magnetic simulations on an individual: cylindrical and rectangular cross sections NiFe nanowires, with the same diameter/thickness of the experimental wires, using the Object Oriented Micro-magnetic Framework (OOMMF) package where the simulated loops showed different switching events, indicating that such wires have different magnetic states in the reversal process and the micro-magnetic spin structures during switching behavior was complicated. These results further supported the difference between surface and bulk magnetization behavior in these nanowires. This work suggests that a combination of MOKE and MR measurements is required to fully understand the magnetization behavior of such relatively thick isolated cylindrical ferromagnetic nanowires.

Keywords: MOKE magnetometry, MR measurements, OOMMF package, micromagnetic simulations, ferromagnetic nanowires, surface magnetic properties

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Authors: Aslihan Caliskan

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The term Mediterranean comes from the Latin “mediterraneus” (Medius, "middle" plus Terra, "land, earth"). For the ancient Romans, the Mediterranean was the center of the earth as they knew it. The desire to gain control of the Mediterranean has led to disputes between many nations throughout history, some of which continue to this day. The recent major natural gas discoveries in the Mediterranean have aggravated ongoing tensions in some neighboring countries. The sea border dispute between Turkey and Greece & Greek-Cypriot side is one of the most critical conflicts in the Mediterranean Sea region. This unresolved dispute has many implications for all countries involved, as well as for third parties that have direct or indirect interests in the region. The research question of this context is what are the implications of this controversial sea border problem on the maritime security of Turkey and its military spending. In this paper, the quantitative method is used. Records from the Turkish Defense Ministry, data from the Turkish naval forces have been obtained. In addition, literature research and the United Nations Convention on the Law of the Sea (UNCLOS) application cases were evaluated, and an incident analysis was carried out. This research shows that the sea border dispute issue has a significant impact on the Turkish military both in terms of the structures required to ensure maritime and border security, as well as rising military costs and its macroeconomic implications. The paper begins with a brief overview of relevant principles and methods applied for delimiting th esea borders. The paper continues with a brief description and a background of the sea border dispute between Turkey and Greece & Greek-Cypriot side in the light of the United Nations Convention on the Law of the Sea (UNCLOS). An analysis of the implications of the dispute on Turkey’s maritime security and its military spending is provided in the following chapters. The paper ends with concluding remarks of the author, including suggestions for the way forward.

Keywords: sea border security, mediterranean sea, greece-turkey dispute, limitation of sea, united nations convention on the law of the sea (UNCLOS)

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Authors: Zydrunas Kavaliauskas, Aleksandras Iljinas, Liutauras Marcinauskas, Mindaugas Milieska, Vitas Valincius

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The magnetron sputtering deposition method is often used to obtain thin film coatings. The main advantage of magnetron vaporization compared to other deposition methods is the high rate erosion of the cathode material (e.g., copper, aluminum, etc.) and the ability to operate under low-pressure conditions. The structure of the formed coatings depends on the working parameters of the magnetron deposition system, which is why it is possible to influence the properties of the growing film, such as morphology, crystal orientation, and dimensions, stresses, adhesion, etc. The properties of these coatings depend on the distance between the substrate and the magnetron surface, the vacuum depth, the gas used, etc. Using this deposition technology, substrates are most often placed near the anode. The magnetic trap of the magnetrons for localization of electrons in the cathode region is formed using a permanent magnet system that is on the side of the cathode. The scientific literature suggests that, after insertion of a small amount of copper into graphite, the electronic conductivity of graphite increase. The aim of this work is to create thin (up to 300 nm) layers on a graphite surface using a magnetron evaporation method, to investigate the formation peculiarities and microstructure of thin films, as well as the mechanism of copper diffusion into graphite inner layers at different thermal treatment temperatures. The electron scanning microscope was used to investigate the microrelief of the coating surface. The chemical composition is determined using the EDS method, which shows that, with an increase of the thermal treatment of the copper-carbon layer from 200 °C to 400 °C, the copper content is reduced from 8 to 4 % in atomic mass units. This is because the EDS method captures only the amount of copper on the graphite surface, while the temperature of the heat treatment increases part of the copper because of the diffusion processes penetrates into the inner layers of the graphite. The XRD method shows that the crystalline copper structure is not affected by thermal treatment.

Keywords: carbon, coatings, copper, magnetron sputtering

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Authors: Palak J. Shukla, Atul K. Desai, Chentankumar D. Modhera

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For any country in the world, it has become a priority to protect the critical infrastructure from looming risks of terrorism. In any infrastructure system, the structural elements like lower floors, exterior columns, walls etc. are key elements which are the most susceptible to damage due to blast load. The present study revisits the state of art review of the design and analysis of reinforced concrete panels subjected to blast loading. Various aspects in association with blast loading on structure, i.e. estimation of blast load, experimental works carried out previously, the numerical simulation tools, various material models, etc. are considered for exploring the current practices adopted worldwide. Discussion on various parametric studies to investigate the effect of reinforcement ratios, thickness of slab, different charge weight and standoff distance is also made. It was observed that for the simulation of blast load, CONWEP blast function or equivalent numerical equations were successfully employed by many researchers. The study of literature indicates that the researches were carried out using experimental works and numerical simulation using well known generalized finite element methods, i.e. LS-DYNA, ABAQUS, AUTODYN. Many researchers recommended to use concrete damage model to represent concrete and plastic kinematic material model to represent steel under action of blast loads for most of the numerical simulations. Most of the studies reveal that the increase reinforcement ratio, thickness of slab, standoff distance was resulted in better blast resistance performance of reinforced concrete panel. The study summarizes the various research results and appends the present state of knowledge for the structures exposed to blast loading.

Keywords: blast phenomenon, experimental methods, material models, numerical methods

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Authors: Jayotpaul Chaudhuri, Lutz Goedeke, Torsten Hallenga, Peter Ehrhard

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Purification of gases from aerosols or airborne particles via filters is widely applied in the industry and in our daily lives. This separation especially in the micron and submicron size range is a necessary step to protect the environment and human health. Fibrous filters are often employed due to their low cost and high efficiency. For designing any filter the two most important performance parameters are capture efficiency and pressure drop. Since the capture efficiency is directly proportional to the pressure drop which leads to higher operating costs, a detailed investigation of the separation mechanism is required to optimize the filter designing, i.e., to have a high capture efficiency with a lower pressure drop. Therefore a two-dimensional flow simulation around a single fiber using Ansys CFX and Matlab is used to get insight into the separation process. Instead of simulating a solid fiber, the present Ansys CFX model uses a fictitious domain approach for the fiber by implementing a momentum loss model. This approach has been chosen to avoid creating a new mesh for different fiber sizes, thereby saving time and effort for re-meshing. In a first step, only the flow of the continuous fluid around the fiber is simulated in Ansys CFX and the flow field data is extracted and imported into Matlab and the particle trajectory is calculated in a Matlab routine. This calculation is a Lagrangian, one way coupled approach for particles with all relevant forces acting on it. The key parameters for the simulation in both Ansys CFX and Matlab are the porosity ε, the diameter ratio of particle and fiber D, the fluid Reynolds number Re, the Reynolds particle number Rep, the Stokes number St, the Froude number Fr and the density ratio of fluid and particle ρf/ρp. The simulation results were then compared to the single fiber theory from the literature.

Keywords: BBO-equation, capture efficiency, CFX, Matlab, fibrous filter, particle trajectory

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Authors: Tara Panday, Despina Learmonth

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Sex work is often constructed as being an interaction between male clients and female sex workers. As a result, street-based male sex workers are continuously overlooked in the South African literature. This qualitative study explored male sex workers’ subjective experiences and constructions of their male clients’ identities and the client-sex worker relationship. This research was conducted from a social-constructionist perspective, which allowed for a deeper understanding of the reasons and context driving the choices and actions of male sex workers. Semi-structured face-to-face interviews were conducted with 10 South African men working as sex workers in Cape Town. Data was analysed through thematic analysis. The findings of the study construct the client-sex worker relationship in terms of a professional relationship, constrained choice, sexual identity and need, as well as companionship for pay, potentially highlighting underlying reasons for supply and demand. The data which emerged around the client-sex worker relationship and the clients’ identities also served to illuminate the power-dynamics in the client-sex worker relationship. This data increases insight into the exploitation and disempowerment experienced by male sex workers through verbal abuse, physical and sexual violence, and unfairly enforced laws and regulations. The findings of this study suggest that, in the context of South Africa, male sex workers' experiences of the client-sex worker relationship cannot be completely understood without considering the intersectionality of the triple stigmatisation of: the criminality of sex work, race, and the lack of economic power, which systematically maintains marginalization. Motivating for the Law Reform Commission to continue to review all emerging research may assist with guiding related policy and thereby, the provision of equal human rights and adequate health and social interventions for all sex workers in South Africa.

Keywords: human rights, prostitution, power relations, sex work

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Authors: Lokanath Barik, Abinash Kumar Swain

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This paper presents vibration analysis of FGM sandwich structure with a complex profile governed by refined higher-order shear deformation theory (RHSDT) using isogeometric analysis (IGA). Functionally graded sandwich plates provide a wide range of applications in aerospace, defence, and aircraft industries due to their ability to distribute material functions to influence the thermo-mechanical properties as desired. In practical applications, these structures generally have intrinsic profiles, and their response to loads is significantly affected due to cut-outs. IGA is primarily a NURBS-based technique that is effective in solving higher-order differential equations due to its inherent C1 continuity imposition in solution space for a single patch. Complex structures generally require multiple patches to accurately represent the geometry, and hence, there is a loss of continuity at adjoining patch junctions. Therefore, patch coupling is desired to maintain continuity requirements throughout the domain. In this work, a novel strong coupling approach is provided that generates a well-defined NURBS-based model while achieving continuity. The methodology is validated by free vibration analysis of sandwich plates with present literature. The results are in good agreement with the analytical solution for different plate configurations and power law indexes. Numerical examples of rectangular and annular plates are discussed with variable boundary conditions. Additionally, parametric studies are provided by varying the aspect ratio, porosity ratio and their influence on the natural frequency of the plate.

Keywords: vibration analysis, FGM sandwich structure, multipatch geometry, patch coupling, IGA

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Authors: Opara Monica Onyinyechi, Ahmad Iqmer Nashriq Mohd Nazan, Suriani Ismail

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Introduction: Global estimates of malaria indicate that at least 3.3 billion people are at risk of being infected with malaria and 1.2 billion are at high risk. The review investigates the effectiveness of health education strategies to increase the level of malaria knowledge and ITN ownership among the populations of sub-Sahara African countries. Methods: A literature search was conducted using Science direct, CINAHL, PubMed, Prisma, Pico, Cochrane library and PsycINFO databases to retrieve articles published between 2000 until 2020. Eleven studies that reported on malaria prevention and intervention using health education strategies conducted in sub-Saharan Africa were included in the final review. Results: Four studies used educational interventions to teach appropriate ITN strategies and promote ITN usage. Two others focused on improving knowledge of malaria transmission, prevention, treatment, and its signs and symptoms. The remaining five studies assessed both ITN use and malaria knowledge. Of these, 10 were eligible for meta-analysis. On average, health education interventions significantly increase the odds of a person in the intervention group to report better malaria knowledge (odds ratio 1.30, 95% CI: 1.00 to 1.70, P= 0.05) and higher ITN ownership (odds ratio 1.53, 95% CI: 1.02 to 2.29, P= 0.004) compared to those in the control group. The odds of ITN ownership also substantially increases when the intervention was based on a theory or model (odds ratio 5.27, 95% CI: 3.24 to 8.58, P= 0.05). Conclusion: Our review highlights the various health education strategies used in sub-Saharan Africa to curb malaria over the past two decades. Meta-analysis findings show that health education intervention is moderately effective in improving malaria knowledge and ITN ownership and has contributed to the effort of global malaria strategy.

Keywords: malaria, health education, insecticide treated nets, sub-Saharan Africa, meta-analysis

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Authors: Catherine Mangan, Beth Anderson

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There has been a significant drive to use online or hybrid learning in Higher Education (HE) over recent years. HEs with a virtual presence offer their communities a range of benefits, including the potential for greater inclusivity, diversity, and collaboration; more flexible learning packages; and more engaging, dynamic content. Institutions can also experience significant challenges when seeking to extend learning spaces in this way, as can learners themselves. For example, staff members’ and learners’ digital literacy varies (as do their perceptions of technologies in use), and there can be confusion about optimal approaches to implementation. Furthermore, the speed with which HE institutions have needed to shift to fully online or hybrid models, owing to the COVID19 pandemic, has highlighted the significant barriers to successful implementation. HE environments have been shown to predict a range of organisational, academic, and experiential outcomes, both positive and negative. Much research has focused on the social aspect of virtual platforms, as well as the nature and effectiveness of the technologies themselves. There remains, however, a relative paucity of synthesised knowledge on the psychology of learners’ relationships with their institutions; specifically, how individual difference and interpersonal factors predict students’ ability and willingness to engage with novel virtual learning spaces. Accordingly, extending learning spaces remains challenging for institutions, and wholly remote courses, in particular, can experience high attrition rates. Focusing on the last five years, this pragmatic review summarises evidence from the psychological and pedagogical literature. In particular, the review highlights the importance of addressing the psychological and relational complexities of students’ shift from offline to online engagement. In doing so, it identifies considerations for HE institutions looking to deliver in this way.

Keywords: higher education, individual differences, interpersonal relationships, online learning, virtual environment

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Authors: Khaled Igbaria

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While Ba'albakī ceased writing or publishing since 1964, it is considerable and significant to investigate Ba'albakī's influence on others. This paper examines her influence on three Lebanese women writers: Emily Nasrallah, Muná Jabbūr, and Hanan al-Shaykh. However, the aim is not simply to examine the influence of the writer on these three authors, but rather to note similarities and differences in the challenges they faced and the agendas they followed in their fiction writing. For each of these writers, this article will describe elements of their literature, and then sketch out the influence which Ba'albakī has had on them. This paper relies on material from Sidawi because it includes interviews with the female writers discussed that are relevant to the current discussion. Sidawi asked them about Ba'albakī and her influence on them, the challenges they faced, and how they coped with them. This paper points out their comments using their own words. To be clear, examining these writers' notes and works is beyond the scope of this paper. To sum up, there are significant parallels between the life and work of Ba'albakī, and other Lebanese women writers such as Nasrallah, Jabbūr and al-Shaykh. Like Ba'albakī, Nasrallah and al-Shaykh also suffered in their struggle against their families. Nasrallah and al-Shaykh, like Ba'albakī, suffered because their society did not trust in their abilities and creativity. Ba'albakī opted for isolation because of her conflict with patriarchal society including the Lebanese women’s groups, while Nasrallah's isolation was because she preferred individualism and autonomy, and Jabbūr, as could be speculated, was not able to cope with the suffering caused by her role as a woman writer within Lebanese society. Whereas Ba'albakī isolated herself from the Lebanese women’s groups, focusing instead on her feminist writing and joining the Shi'r group, Al-Shaykh and the Lebanese women’s groups are able to cooperate in harmony. Furthermore, while Nasrallah and Al-Shaykh continued to publish fiction, Ba'albakī stopped publishing fiction in 1964. All of the above confirms not only that it is worthy to investigate deeply and academically both the biography and the works of Ba'albakī, but also that she deserves to include her throughout the top great Arab female writers, at the time, like Al-Shaykh and Nawal El Saadawi.

Keywords: feminist writing, Hanan Al-Shaykh, Laylá Ba'albakī, Lebanese women writers, Muná Jabbūr

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Authors: Nima Safaei, Arezoo Masoud, Babak Safaei

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In recent years, there has been a growing emphasis on the role of urban planning in walking capability and the effects of individual and socioeconomic factors on the physical activity levels of city dwellers. Although considerable number of studies are conducted about walkability and for identifying the effective factors in walking mode choice in developed countries, to our best knowledge, literature lacks in the study of factors affecting choice of walking mode in developing countries. Due to the high importance of health aspects of human societies and in order to make insights and incentives for reducing traffic during rush hours, many researchers and policy makers in the field of transportation planning have devoted much attention to walkability studies; they have tried to improve the effective factors in the choice of walking mode in city neighborhoods. In this study, effective factors in walkability that have proven to have significant impact on the choice of walking mode, are studied at the same time in work trips. The data for the study is collected from the employees in their workplaces by well-instructed people using questionnaires; the statistical population of the study consists of 117 employed people who commute daily from work to home in Rasht city of Iran during the beginning of spring 2015. Results of the study which are found through the linear regression modeling, show that people who do not have freedom of choice for choosing their living locations and need to be present at their workplaces in certain hours have lower levels of walking. Additionally, unlike some of the previous studies which were conducted in developed countries, coincidental effects of Body Mass Index (BMI) and the income level of employees, do not have a significant effect on the walking level in work travels.

Keywords: BMI, linear regression, transportation, walking, work trips

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Authors: Shoba Bandi-Rao

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The lack of college readiness is one of the major contributors to low graduation rates at community colleges, especially among educationally and financially disadvantaged students. About 45% of underprepared high school graduates are required to complete ‘remedial’ reading/writing courses before they can begin taking college-level courses. Mobile apps present ‘bite-size’ learning materials that can be useful for practicing certain literacy skills, such as vocabulary learning. The convenience of mobile phones is ideal for a majority of students at community colleges who hold full or part-time jobs. Mobile apps allow students to learn during small ‘chunks’ of time available to them outside of the class—during subway commute, between classes, etc. Learning with mobile apps is a relatively new area in research, and their effectiveness for learning new words has been inconclusive. Using Mishra & Koehler’s TPCK theoretical framework, this study explored the effectiveness of the mobile app (Quizlet) for learning one hundred common college-level words in ‘remedial’ writing class over one semester. Each week, before coming to class, students studied a list of 10-15 words presented in context within sentences. Students came across these words in the article they read in class making their learning more meaningful. A pre and post-test measured the number of words students knew, learned and remembered. Statistical analysis shows that students performed better by 41% on the post-test indicating that the mobile app was helpful for learning words. Students also completed a short survey each week that sought to determine the amount of time students spent on the vocabulary app. A positive correlation was found between the amount of time spent on the mobile app and the number of words learned. The goal of this research is to capitalize on the convenience of smartphones to (1) better prepare them for college-level course work, and (2) contribute to current literature on mobile learning.

Keywords: mobile learning, vocabulary learning, literacy skills, Quizlet

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Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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Contraceptives are an effective public health achievement, allowing for family planning and reducing the risk of sexually transmitted diseases (STDs). California’s rural Central Valley has high rates of teenage pregnancy and STDs. Factors affecting contraceptive usage here may include religious concerns, financial issues, and regional variations in the accessibility and availability of contraceptives. The increasing population and diversity of the Central Valley make the understanding of the determinants of unintended pregnancy and STDs increasingly nuanced. Patients in California’s Central Valley were surveyed at 6 surgical clinics to assess attitudes toward contraceptives. The questionnaire consisted of demographics and 14 Likert-scale statements investigating patients’ feelings regarding contraceptives. Parametric and non-parametric analysis was performed on the Likert statements. A correlation matrix for the Likert-scale statements was used to evaluate the strength of the relationship between each question. 76 patients aged 18-75 years completed the questionnaire. 90% of the participants were female, 76% Hispanic, 36% married, 44% with an income range between 30-60K, and 83% were between childbearing ages. 60% of participants stated they are currently using or had used some type of contraceptive. 25% of participants had at least one unplanned pregnancy. The most common type of contraceptives used were oral contraceptives(28%) and condoms(38%). The top reasons for patients’ contraceptive usage were: prevention of pregnancy (72%), safe sex/prevention of STDs (32%), and regulation of menstrual cycle (19%). Further analysis of Likert responses revealed that contraception usage increased due to approval of contraceptives (x̄=3.98, σ =1.02); partner approval of contraceptives (x̄=3.875, σ =1.16); and reduced anxiety about pregnancy (x̄=3.875, σ =1.23). Younger females (18-34 years old) agreed more with the statement that the cost of contraceptive supplies is too expensive than older females (35-75 years old), (x̄=3.2, σ = 1.4 vs x̄=2.8, σ =1.3, p<0.05). Younger females (44%) were also more likely to use short-acting contraceptive methods (oral and male condoms) compared to older females (64%) who use long-acting methods (implants/ intrauterine devices). 51% of Hispanic females were using some type of contraceptive. Of those Hispanic females who do not use contraceptives, 33% stated having no children, and all plan to have at least one child in the future. 35% of participants had a bachelor's degree. Those with bachelor’s degrees were more likely to use contraceptives, 58% vs 51%, p<0.05, and less likely to have unplanned pregnancy, 50% vs. 12%, p<0.01. There is increasing use and awareness among patients in rural settings concerning contraceptives. Our finding shows that younger women and women with higher educational attainment tend to have more positive attitudes towards the use of contraceptives. This work gives physicians an understanding of patients’ concerns about contraceptive methods and offers insight into culturally competent intervention programs that respect individual values.

Keywords: contraceptives, public health, rural california, women of child baring age

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Authors: Poonam Malik, Ravi Bhushan

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This work describes a very efficient approach for synthesis of activated ester of (S)-naproxen which was characterized by UV, IR, ¹HNMR, elemental analysis and polarimetric studies. It was used as a C-N bond forming chiral derivatizing reagent for further synthesis of diastereomeric amides of (RS)-salbutamol (a β₂ agonist that belongs to the group β-adrenolytic and is marketed as racamate) under microwave irradiation. The diastereomeric pair was separated by achiral phase HPLC, using mobile phase in gradient mode containing methanol and aqueous triethylaminephosphate (TEAP); separation conditions were optimized with respect to pH, flow rate, and buffer concentration and the method of separation was validated as per International Council for Harmonisation (ICH) guidelines. The reagent proved to be very effective for on-line sensitive detection of the diastereomers with very low limit of detection (LOD) values of 0.69 and 0.57 ng mL⁻¹ for diastereomeric derivatives of (S)- and (R)-salbutamol, respectively. The retention times were greatly reduced (2.7 min) with less consumption of organic solvents and large (α) as compared to literature reports. Besides, the diastereomeric derivatives were separated and isolated by preparative HPLC; these were characterized and were used as standard reference samples for recording ¹HNMR and IR spectra for determining absolute configuration and elution order; it ensured the success of diastereomeric synthesis and established the reliability of enantioseparation and eliminated the requirement of pure enantiomer of the analyte which is generally not available. The newly developed reagent can suitably be applied to several other amino group containing compounds either from organic syntheses or pharmaceutical industries because the presence of (S)-Npx as a strong chromophore would allow sensitive detection.This work is significant not only in the area of enantioseparation and determination of absolute configuration of diastereomeric derivatives but also in the area of developing new chiral derivatizing reagents (CDRs).

Keywords: chiral derivatizing reagent, naproxen, salbutamol, synthesis

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Authors: Acha Mildred Endam

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Gentrification brings changes in socio-economic and environmental aspects in cities. This is a concern for local governments and urban residents, as rapid urbanization poses a challenge to SDGs 11 and 13. This paper aims to: (1) examine the dominant gentrification actions that counteract the drive towards green urbanism; (2) evaluate policy actions and institutions created to promote green urbanism; (3) explore the constraints that hinder development proponents from achieving the goal of green urbanism. A mixed research design (survey and exploratory) was used, along with snowball sampling techniques, to administer the questionnaire. Structured interviews and focus group discussions were also conducted to assess the efforts and success rate of planning and development proponents in achieving green urbanism. Secondary data provided the basis for a literature review on activities that promote brown cities, which hinder green urbanism. The results of the study revealed that gentrification in Bamenda is mainly focused on upgrading infrastructure within the city centre. This transition is accompanied by unsustainable architectural developments, sprawl into peri-urban ecosystems, and climate-incompatible developments. Efforts to achieve green urbanization in Bamenda are insignificant. Socio-economic and policy actions of residents do not reflect a move towards sustainable cities, which is a common theme in most development agendas. This undermines the ecology, health, and general well-being of its inhabitants, increasing vulnerability. The study suggests that there is a need to learn from the few green cities in Africa and adopt a holistic approach towards green urbanization. This approach should include green transportation, preservation of green spaces, and retrofitting brown buildings to green buildings, through synergies, motivation and subsidization through green governance.

Keywords: environmental sustainability, green urbanism, green governace, retrofitting

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Authors: Keyao Li, Sai On Cheung

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Incorporation of alternative dispute resolution (ADR) mechanism has been the main feature of current trend of construction project dispute resolution (CPDR). ADR approaches have been identified as efficient mechanisms and are suitable alternatives to litigation and arbitration. Moreover, the use of ADR in this multi-tiered dispute resolution process often leads to repeated evaluations of a same dispute. Multi-tiered CPDR may become a breeding ground for cognitive biases. When completed knowledge is not available at the early tier of construction dispute resolution, disputing parties may form preconception of the dispute matter or the counterpart. This preconception would influence their information processing in the subsequent tier. Disputing parties tend to search and interpret further information in a self-defensive way to confirm their early positions. Their imbalanced information collection would boost their confidence in the held assessments. Their attitudes would be hardened and difficult to compromise. The occurrence of cognitive bias, therefore, impedes efficient dispute settlement. This study aims to explore ways to minimize bias in CPDR. Based on a comprehensive literature review, three types of bias minimizing approaches were collected: strategy-based, attitude-based and process-based. These approaches were further operationalized into bias minimizing measures. To verify the usefulness and practicability of these bias minimizing measures, semi-structured interviews were conducted with ten CPDR third party neutral professionals. All of the interviewees have at least twenty years of experience in facilitating settlement of construction dispute. The usefulness, as well as the implications of the bias minimizing measures, were validated and suggested by these experts. There are few studies on cognitive bias in construction management in general and in CPDR in particular. This study would be the first of its type to enhance the efficiency of construction dispute resolution by highlighting strategies to minimize the biases therein.

Keywords: bias, construction project dispute resolution, minimization, multi-tiered, semi-structured interview

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Authors: Nuhu Mohammed Gali, Kenichi Matsui

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Climate change poses a significant threat to agriculture and food security in Africa. The UNFCC recognized the need to address climate change adaptation in the broader context of sustainable development. African countries have initiated a governance system for adapting and responding to climate change in their Nationally Determined Contributions (NDCs). Despite the implementation limitations, Africa’s adaptation initiatives highlight the need to strengthen and expand adaptation responses. This paper looks at the extent to which South-South cooperation facilitates the implementation of adaptation actions between nations for agriculture and sustainable development. We conducted a literature review and content analysis of reports prepared by international organizations, reflecting the diversity of adaptation activities taking place in Sub-Saharan Africa. Our analysis of the connection between adaptation and nationally determined contributions (NDCs) showed that climate actions are mainstreamed into sustainable development. The NDCs in many countries on climate change adaptation action for agriculture aimed to strengthen the resilience of the poor. We found that climate-smart agriculture is the core of many countries target to end hunger. We revealed that South-South Cooperation, in terms of capacity, technology, and financial support, can help countries to achieve their climate action priorities and the Sustainable Development Goals (SDGs). We found that inadequate policy and regulatory frameworks between countries, differences in development priorities and strategies, poor communication, inadequate coordination, and the lack of local engagement and advocacy are some key barriers to South-South Cooperation in Africa. We recommend a multi-dimensional partnership, provisionoffinancialresources, systemic approach for coordination and engagement to promote and achieve the potential of SSC in Africa.

Keywords: climate change, adaptation, food security, sustainable development goals

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Authors: Pontus Backstrom

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In the educational literature on peer effects, attention has been brought to the fact that the mechanisms creating peer effects are still to a large extent hidden in obscurity. The hypothesis in this study is that the Frame Factor Theory can be used to explain these mechanisms. At heart of the theory is the concept of “time needed” for students to learn a certain curricula unit. The relations between class-aggregated time needed and the actual time available, steers and hinders the actions possible for the teacher. Further, the theory predicts that the timing and pacing of the teachers’ instruction is governed by a “criterion steering group” (CSG), namely the pupils in the 10th-25th percentile of the aptitude distribution in class. The class composition hereby set the possibilities and limitations for instruction, creating peer effects on individual outcomes. To test if the theory can be applied to the issue of peer effects, the study employs multilevel structural equation modelling (M-SEM) on Swedish TIMSS 2015-data (Trends in International Mathematics and Science Study; students N=4090, teachers N=200). Using confirmatory factor analysis (CFA) in the SEM-framework in MPLUS, latent variables are specified according to the theory, such as “limitations of instruction” from TIMSS survey items. The results indicate a good model fit to data of the measurement model. Research is still in progress, but preliminary results from initial M-SEM-models verify a strong relation between the mean level of the CSG and the latent variable of limitations on instruction, a variable which in turn have a great impact on individual students’ test results. Further analysis is required, but so far the analysis indicates a confirmation of the predictions derived from the frame factor theory and reveals that one of the important mechanisms creating peer effects in student outcomes is the effect the class composition has upon the teachers’ instruction in class.

Keywords: compositional effects, frame factor theory, peer effects, structural equation modelling

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Authors: Mergim Gasia, Bojan Milovanovica, Sanjin Gumbarevic

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Better energy performance of the building envelope is one of the most important aspects of energy savings if the goals set by the European Union are to be achieved in the future. Dynamic heat transfer simulations are being used for the calculation of building energy consumption because they give more realistic energy demands compared to the stationary calculations that do not take the building’s thermal mass into account. Software used for these dynamic simulation use methods that are based on the analytical models since numerical models are insufficient for longer periods. The analytical models used in this research fall in the category of the conduction transfer functions (CTFs). Two methods for calculating the CTFs covered by this research are the Laplace method and the State-Space method. The literature review showed that the main disadvantage of these methods is that they are inadequate for heavyweight façade elements and shorter time periods used for the calculation. The algorithms for both the Laplace and State-Space methods are implemented in Mathematica, and the results are compared to the results from EnergyPlus and TRNSYS since these software use similar algorithms for the calculation of the building’s energy demand. This research aims to check the efficiency of the Laplace and the State-Space method for calculating the building’s energy demand for heavyweight building elements and shorter sampling time, and it also gives the means for the improvement of the algorithms used by these methods. As the reference point for the boundary heat flux density, the finite difference method (FDM) is used. Even though the dynamic heat transfer simulations are superior to the calculation based on the stationary boundary conditions, they have their limitations and will give unsatisfactory results if not properly used.

Keywords: Laplace method, state-space method, conduction transfer functions, finite difference method

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Authors: Dessy Pinem, Rahmadian Sembiring, Adanil Bushra

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Medan Belawan is one of the subdistricts of 21 districts in Medan. Medan Belawan Sub-district is directly adjacent to the Malacca Strait in the North. Due to its direct border with the Malacca Strait, the problem in this sub-district, which has continued for many years, is a flood of rob. In 2015, rob floods inundated Sicanang urban village, Belawan I urban village, Belawan Bahagia urban village and Bagan Deli village. The extent of inundation in the flood of rob that occurred in September 2015 reached 540, 938 ha. Rob flood is a phenomenon where the sea water is overflowing into the mainland. Rob floods can also be interpreted as a puddle of water on the coastal land that occurs when the tidal waters. So this phenomenon will inundate parts of the coastal plain or lower place of high tide sea level. Rob flood is a daily disaster faced by the residents in the district of Medan Belawan. Rob floods can happen every month and last for a week. The flood is not only the residents' houses, the flood also soaked the main road to Belawan Port reaching 50 cm. To deal with the problems caused by the flood and to prepare coastal communities to face the character of coastal areas, it is necessary to know the vulnerability of the people who are always the victims of the rob flood. Are the people of Medan Belawan sub-district, especially in the flood-affected villages, able to cope with the consequences of the floods? To answer this question, it is necessary to assess the vulnerability of the Belawan District community in the face of the flood disaster. This research is descriptive, qualitative and quantitative. Data were collected by observation, interview and questionnaires in 4 urban villages often affected by rob flood. The vulnerabilities measured are physical, economic, social, environmental, organizational and motivational vulnerabilities. For vulnerability in the physical field, the data collected is the distance of the building, floor area ratio, drainage, and building materials. For economic vulnerability, data collected are income, employment, building ownership, and insurance ownership. For the vulnerability in the social field, the data collected is education, number of family members, children, the elderly, gender, training for disasters, and how to dispose of waste. For the vulnerability in the field of organizational data collected is the existence of organizations that advocate for the victims, their policies and laws governing the handling of tidal flooding. The motivational vulnerability is seen from the information center or question and answer about the rob flood, and the existence of an evacuation plan or path to avoid disaster or reduce the victim. The results of this study indicate that most people in Medan Belawan sub-district have a high-level vulnerability in physical, economic, social, environmental, organizational and motivational fields. They have no access to economic empowerment, no insurance, no motivation to solve problems and only hope to the government, not to have organizations that support and defend them, and have physical buildings that are easily destroyed by rob floods.

Keywords: disaster, rob flood, Medan Belawan, vulnerability

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Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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