Search results for: quality care

Authors: Mostafa Gabr, Rania Abdul Galil, Nihal Salim

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Various interventions are applied in cities with the aim to improve living and acoustic environmental conditions. Noise is one of the most influential and critical factors in the environment that has an effect on the QOL (quality of life) and urban environment. It ranks second among environmental pollution issues according to EEAA. Traffic noise is a major source of noise. Noise barriers are one of the physical techniques in landscape design used to reduce the impact of noise pollution in urban areas. Roadways noise pollution can be best controlled by a noise barrier. The aim of this paper is to consider all facets of sustainability when designing a comfortable acoustic environment in roadways, through different strategies related to planning and the design process. The study focuses on the relation between the design of noise barriers as a landscape noise mitigation installation and their materiality in so far as it influences the sustainability of the open space and the acceptability of users. According to previous studies, design of noise barrier mainly depends on cost as a decisive factor. This study asserts that environmental and socioeconomic costs associated are equally important. Hence, the paper presents a strategy for sustainable soundscape design. It builds a framework focusing on materiality considering the environmental and socioeconomic impact of noise barriers shaping urban open space around the road ways, and the different academic and market positions on noise barrier types and materials. Finally, it concludes with a matrix of the relation between the noise barrier design consideration and the three pillars of sustainability (social, economic and environmental).

Keywords: traffic noise level, acoustic sustainability, noise barrier, noise reduction, noise control, acoustical level

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Authors: Abdalaziz M. Alsalhabi, Loai M. Alowa

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This paper investigates Weld Rejection Rate (WRR) limits and tracer effects in construction projects, with a specific focus on a Gas Plant Project, a mega-project held by Saudi Aramco (SA) in Saudi Arabia. The study included a comprehensive examination of various factors impacting WRR limits. It commenced by comparing the Company practices with ASME standards, followed by an in-depth analysis of both weekly and cumulative projects' historical WRR data, evaluation of Radiographic Testing (RT) reports for rejected welds, and proposal of mitigation methods to eliminate future rejections. Additionally, the study revealed the causes of fluctuation in WRR data and benchmarked with the industry practices. Furthermore, a case study was conducted to explore the impact of tracers on WRR, providing insights into their influence on the welding process. This paper aims to achieve three primary objectives. Firstly, it seeks to validate the existing practices of WRR limits and advocate for their inclusion within relevant International Industry Standards. Secondly, it aims to validate the effectiveness of the WRR formula that incorporates tracer effects, ensuring its reliability in assessing weld quality. Lastly, this study aims to identify opportunities for process improvement in WRR control, with the ultimate goal of enhancing project processes and ensuring the integrity, safety, and efficiency of constructed assets.

Keywords: weld rejection rate, weld repair rate in joint and linear basis, tracers effects, construction projects

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Authors: Mohamed Bendoukha, Mustapha Mosbah

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The Radiographic apparent assumed that the asymptomatic adjacent segment disease ASD is common after lumbar fusion, but this does not correlate with the functional outcomes while compensatory increased motion and stresses at the adjacent level of fusion is well-known to be associated to ASD. Newly developed, the hybrid stabilization are allocated to substituted for mostly the superior level of the fusion in an attempt to reduce the number of fusion levels and likelihood of degeneration process at the adjacent levels during the fusion with pedicle screws. Nevertheless, its biomechanical efficiencies still remain unknown and complications associated with failure of constructs such screw loosening and toggling should be elucidated In the current study, a finite element (FE) study was performed using a validated L2/S1 model subjected to a moment of 7.5 Nm and follower load of 400 N to assess the biomedical behavior of hybrid constructs based on dynamic topping off, semi rigid fusion. The residual range of motion (ROM), stress distribution at the fused and adjacent levels, stress distribution at the disc and the cage-endplate interface with respect to changes of bone quality were investigated. The hybrid instrumentation was associated with a reduction in compressive stresses compared to the fusion construct in the adjacent-level disc and showed high substantial axial force in the implant while fusion instrumentation increased the motion for both flexion and extension.

Keywords: intervertebral disc, lumbar spine, degenerative nuclesion, L4-L5, range of motion finite element model, hyperelasticy

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Authors: Taiwo Ebenezer Abioye, Alexis Medrano-Tellez, Peter Kayode Farayibi, Peter Kayode Oke,

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Laser metal deposition by wire feedstock has been established as a process which can provide a high material deposition rate with good quality. Sound mechanical properties of the deposited parts are the pre-requisites for the real applications of this process. This paper investigates the laser metal deposition of 308LSi stainless steel wire within a process window. Single tracks and multiple layer thin-walls of 308LSi stainless steel wire were deposited on 304 stainless steel substrate. The grain structures of the built walls were examined using optical microscopy. The mechanical properties of the built walls including the micro-hardness and tensile properties along the transverse and longitudinal directions were investigated using Vickers hardness tester and tensile test machine. Long columnar grains were found growing in the wall building direction (transverse) and nucleation were observed at the boundary between two deposited layers due to remelting of the previously deposited layers. The results showed that the hardness values of the deposited walls (ranging between 194 HV and 167 HV) decreased from the track-substrate interface to the top of the wall. The ultimate tensile strength (UTS) of the wall (518 ± 7 MPa) showed dependence on wall building directions.

Keywords: laser metal deposition, ultimate tensile strength, hardness, wall, microstructure

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Authors: Vesa Salminen, Esa Santakallio, Heikki Ruohomaa

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Introduction: The city of Riihimäki has decided robotics on well-being, service and industry as the main focus area on their ecosystem strategy. Robotics is going to be an important part of the everyday life of citizens and present in the working day of the average citizen and employee in the future. For that reason, also education system and education programs on all levels of education from diaper age to doctorate have been directed to fulfill this ecosystem strategy. Goal: The objective of this activity has been to develop education continuity from diaper age to doctorate. The main target of the development activity is to create a unique robotics study entity that enables ongoing robotics studies from preprimary education to university. The aim is also to attract students internationally and supply a skilled workforce to the private sector, capable of the challenges of the future. Methodology: Education instances (high school, second grade, Universities on all levels) in a large area of Tavastia Province have gradually directed their education programs to support this goal. On the other hand, applied research projects have been created to make proof of concept- phases on areal real environment field labs to test technology opportunities and digitalization to change business processes by applying robotic solutions. Customer-oriented applied research projects offer for students in robotics education learning environments to learn new knowledge and content. That is also a learning environment for education programs to adapt and co-evolution. New content and problem-based learning are used in future education modules. Major findings: Joint robotics education entity is being developed in cooperation with the city of Riihimäki (primary education), Syria Education (secondary education) and HAMK (bachelor and master education). The education modules have been developed to enable smooth transitioning from one institute to another. This article is introduced a case study of the change of education of wellbeing education because of digitalization and robotics. Riihimäki's Elderly citizen's service house, Riihikoti, has been working as a field lab for proof-of-concept phases on testing technology opportunities. According to successful case studies also education programs on various levels of education have been changing. Riihikoti has been developed as a physical learning environment for home care and robotics, investigating and developing a variety of digital devices and service opportunities and experimenting and learn the use of equipment. The environment enables the co-development of digital service capabilities in the authentic environment for all interested groups in transdisciplinary cooperation.

Keywords: ecosystem strategy, digitalization and robotics, education continuity, learning environment, transdisciplinary co-operation

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Authors: Raju Murugan, Pankaj S. Kolhe

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The present study is mainly focusing on the numerical simulation of Flow Blurring (FB) twin fluid injection concept was proposed by Ganan-Calvo, which involves back flow atomization based on global bifurcation of liquid and gas streams, thus creating two-phase flow near the injector exit. The interesting feature of FB injector spray is an insignificant effect of variation in atomizing air to liquid ratio (ALR) on a spray cone angle. Besides, FB injectors produce a nearly uniform spatial distribution of mean droplet diameter and are least susceptible to variation in thermo-physical properties of fuels, making it a perfect candidate for fuel flexible combustor development. The FB injector working principle has been realized through experimental flow visualization techniques only. The present study explores potential of ANSYS Fluent based Large Eddy Simulation(LES) with volume of fluid (VOF) method to investigate two-phase flow just upstream of injector dump plane and spray quality immediate downstream of injector dump plane. Note that, water and air represent liquid and gas phase in all simulations and ALR is varied by changing the air mass flow rate alone. Preliminary results capture two phase flow just upstream of injector dump plane and qualitative agreement is observed with the available experimental literature.

Keywords: flow blurring twin fluid atomization, large eddy simulation, volume of fluid, air to liquid ratio

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Authors: Hatice Özbek, Caner Çil, Ahmet Rodoplu

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Automotive lighting is the leading function in the configuration of vehicle architecture. Especially headlights and taillights from external lighting functions are among the structures that determine the stylistic character of the vehicle. At the same time, the fact that lighting functions are related to many other functions brings along difficulties in design. Customers expect maximum quality from the vehicle. In these circumstances, it is necessary to make designs that aim to keep the performance of bulbs with limited working lives at the highest level. With this study, the factors that influence the working lives of filament lamps were examined and bulb explosions that can occur sooner than anticipated in the future were prevented while the vehicle was still in the design phase by determining the relations with electrical, dynamical and static variables. Especially the filaments of the bulbs used in the front lighting of the vehicle are deformed in a shorter time due to the high voltage requirement. In addition to this, rear lighting lamps vibrate as a result of the tailgate opening and closing and cause the filaments to be exposed to high stress. With this study, the findings that cause bulb explosions were evaluated. Among the most important findings: 1. The structure of the cables to the lighting functions of the vehicle and the effect of the voltage values are drawn; 2. The effect of the vibration to bulb throughout the life of the vehicle; 3 The effect of the loads carried to bulb while the vehicle doors are opened and closed. At the end of the study, the maximum performance was established in the bulb lifetimes with the optimum changes made in the vehicle architecture based on the findings obtained.

Keywords: vehicle architecture, automotive lighting functions, filament lamps, bulb lifetime

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Authors: Balthazar Temu, Zhao Yan, Bogdan-Petrin Ratiu, Sang Soon Oh, Qiang Li

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Quantum confinement can be used to increase efficiency and control the emitted spectra in lasers and LEDs. In semiconductor nanowires, quantum confinement can be achieved in the axial direction by stacking multiple quantum disks or in the radial direction by forming a core-shell structure. In this work we demonstrate room temperature lasing in topological photonic crystal nanowire array lasers by using the InGaAs radial quantum well as the gain material. The nanowires with the GaAs/ InGaAs/ InGaP quantum well structure are arranged in a deformed honeycomb lattice, forming a photonic crystal surface emitting laser (PCSEL) . Under optical pumping we show that the PCSEL lase at the wavelength of 1001 nm (undeformed pattern) and 966 nm (stretched pattern), with the lasing threshold of 103 µJ〖/cm 〗^2. We compare the lasing wavelengths from devices with three different nanowire diameters for undeformed compressed and stretched devices, showing that the lasing wavelength increases as the nanowire diameter increases. The impact of deforming the honeycomb pattern is studied, where it was found out that the lasing wavelengths of undeformed devices are always larger than the corresponding stretched or compressed devices with the same nanowire diameter. Using photoluminescence results and numerical simulations on the field profile and the quality factors of the devices, we establish that the lasing of the device is from the radial quantum well structure.

Keywords: honeycomb PCSEL, nanowire laser, photonic crystal laser, quantum well laser

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Authors: Jacobo Tabla, P. F. Rodriguez-Espinosa, M. E. Perez-Lopez

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Valsequillo reservoir located in Puebla City, Central Mexico receives water from the Atoyac River (Northwest) and from Alseseca River in the north. It has been the receptacle of municipal and industrial wastes for the past few decades affecting the water quality lethally. As a result, there is an outburst of water hyacinths (Eichhornia crassipes) in the reservoir occupying around 50 % of the total area. Therefore, the aim of the present work was to assess the concentration levels of toxic metals (Co, Zn, Ni, Cu and As) in the water hyacinths and the ambient waters during the dry season. Fourteen water samples and three water hyacinth samples were procured from the Valsequillo reservoir. The collected samples of water hyacinth (roots, rhizome, stems and leaves) were analyzed using an Inductively coupled plasma mass spectrometry (ICP-MS) Ultramass 700 (Varian Inc.) to determine the metal levels. Results showed that water hyacinth presented an exhaustion in metal capture from the inlet to outlet of the reservoir. The maximum bioaccumulation factors (BF) of Co, Zn, Ni, Cu and As were 5000, 47474, 4929, 17090 and 74000 respectively. On the other hand, the maximum Translocation Factor (TF) of 0.85 was observed in Zn, whilst Co presented the minimum TF of 0.059. Thus, the results presented the fact that water hyacinth in Valsequillo reservoir proves to be an important environmental utility for efficiently accumulating and translocating heavy metals from the ambient waters to its organelles (stems and leaves).

Keywords: bioaccumulation factor, toxic metals, translocation factor, water hyacinth

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Authors: Gali Moritz, Jacqueline H. Becker, Jyoti V. Ankam, Kimberly Arcoleo, Matthew Wysocki, Roee Holtzer, Juan Wisnivesky, Paula J. Busse, Alex D. Federman, Sunit P. Jariwala, Jonathan M. Feldman

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Objective: Cognitive impairment (CI), whose incidence is greater among ethnic/racial minorities, is a significant barrier to asthma self-management (SM) behaviors and outcomes in older adults. The aim of this study was to examine the relationships between CI, assessed using the Montreal Cognitive Assessment (MoCA), and asthma SM behaviors and outcomes in a sample of predominantly Black and Hispanic participants. Additionally, we evaluated whether using two different MoCA cutoff scores influenced the association between CI and study outcomes. Methods: Baseline cross-sectional data were extracted from a longitudinal study of older adults with asthma (N=165) age≥ 60 years and used for analysis. Cognition was assessed using the MoCA. Asthma control, asthma-related quality of life (QOL), inhaled corticosteroid (ICS) dosing, and ICS adherence were assessed using self-report. The inhaler technique was observed and rated. Results: Using established MoCA cutoff scores of 23 and 26 yielded 45% and 74% CI rates, respectively. CI, defined using the 23 cutoff score, was significantly associated with worse asthma control (p=.04) and worse ICS adherence (p=.01). With a cutoff score of 26, only asthma-related QOL was significantly associated with CI (p=.03). Race/ethnicity and education did not moderate the relationships between CI and asthma SM behaviors and outcomes. Conclusions: CI in older adults with asthma is associated with important clinical outcomes, but this relationship is influenced by the cutoff score used to define CI.

Keywords: cognition, respiratory, elderly, testing, adherence, validity

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Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

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Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

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Authors: Suriyani Ariffin, Nor Aziah Alias, Khairil Iskandar Othman, Haslinda Yusoff

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An Integrated Cumulative Grade Point Average (iCGPA) is a mechanism and strategy to ensure the curriculum of an academic programme is constructively aligned to the expected learning outcomes and student performance based on the attainment of those learning outcomes that is reported objectively in a spider web. Much effort and time has been spent to develop a viable mechanism and trains academics to utilize the platform for reporting. The question is: How well do learners conceive the idea of their achievement via iCGPA and whether quality learner attributes have been nurtured through the iCGPA mechanism? This paper presents the architecture of an integrated CGPA mechanism purported to address a holistic evaluation from the evaluation of courses learning outcomes to aligned programme learning outcomes attainment. The paper then discusses the students’ understanding of the mechanism and evaluation of their achievement from the generated spider web. A set of questionnaires were distributed to a group of students with iCGPA reporting and frequency analysis was used to compare the perspectives of students on their performance. In addition, the questionnaire also explored how they conceive the idea of an integrated, holistic reporting and how it generates their motivation to improve. The iCGPA group was found to be receptive to what they have achieved throughout their study period. They agreed that the achievement level generated from their spider web allows them to develop intervention and enhance the programme learning outcomes before they graduate.

Keywords: learning outcomes attainment, iCGPA, programme learning outcomes, spider web, iCGPA reporting skills

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Authors: S. Visetpotjanakit, C. Khrautongkieo

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Radiation monitoring in the environment and foodstuffs is one of the main responsibilities of Office of Atoms for Peace (OAP) as the nuclear regulatory body of Thailand. The main goal of the OAP is to assure the safety of the Thai people and environment from any radiological incidents. Various radioanalytical methods have been developed to monitor radiation and radionuclides in the environmental and foodstuff samples. To validate our analytical performance, several proficiency test exercises from the International Atomic Energy Agency (IAEA) have been performed. Here, the results of a proficiency test exercise referred to as the Proficiency Test for Tritium, Cobalt, Strontium and Caesium Isotopes in Seawater 2017 (IAEA-RML-2017-01) are presented. All radionuclides excepting ³H were analysed using various radioanalytical methods, i.e. direct gamma-ray counting for determining ⁶⁰Co, ¹³⁴Cs and ¹³⁷Cs and developed radiochemical techniques for analysing ¹³⁴Cs, ¹³⁷Cs using AMP pre-concentration technique and 90Sr using di-(2-ethylhexyl) phosphoric acid (HDEHP) liquid extraction technique. The analysis results were submitted to IAEA. All results passed IAEA criteria, i.e. accuracy, precision and trueness and obtained ‘Accepted’ statuses. These confirm the data quality from the OAP environmental radiation laboratory to monitor radiation in the environment.

Keywords: international atomic energy agency, proficiency test, radiation monitoring, seawater

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Authors: Abhishek Singh, Rajlakshmi Barman, Tanmay Shah

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Coagulation is considered to be one of the predominant water treatment processes which improve the cost effectiveness of wastewater. The sole purpose of this experiment on thermal coagulation is to increase the efficiency and the rate of reaction. The process uses renewable sources of energy which comprises of improved and minimized time method in order to eradicate the water scarcity of the regions which are on the brink of depletion. This paper includes the various effects of temperature on the standard coagulation treatment of wastewater and their effect on water quality. In addition, the coagulation is done with the mix of bottom/fly-ash that will act as an adsorbent and removes most of the minor and macro particles by means of adsorption which not only helps to reduce the environmental burden of fly ash but also enhance economic benefit. Also, the method of sand filtration is amalgamated in the process. The sand filter is an environmentally-friendly wastewater treatment method, which is relatively simple and inexpensive. The existing parameters were satisfied with the experimental results obtained in this study and were found satisfactory. The initial turbidity of the wastewater is 162 NTU. The initial temperature of the wastewater is 27 C. The temperature variation of the entire process is 50 C-80 C. The concentration of alum in wastewater is 60mg/L-320mg/L. The turbidity range is 8.31-28.1 NTU after treatment. pH variation is 7.73-8.29. The effective time taken is 10 minutes for thermal mixing and sedimentation. The results indicate that the presence of thermal energy affects the coagulation treatment process. The influence of thermal energy on turbidity is assessed along with renewable energy sources and increase of the rate of reaction of the treatment process.

Keywords: adsorbent, sand filter, temperature, thermal coagulation

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Authors: Xiaofang Wei

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Harmful Algal Blooms are a recurrent disturbing occurrence in Lake Erie that has caused significant negative impacts on water quality and aquatic ecosystem around Great Lakes areas in the United States. Targeting the recent HAB events in western Lake Erie, this paper utilizes satellite imagery and hydrological modeling to monitor HAB cyanobacteria blooms and analyze the impacts of agricultural activities from Maumee watershed, the biggest watershed of Lake Erie and agriculture dominant.SWAT (Soil & Water Assessment Tool) Model for Maumee watershed was established with DEM, land use data, crop data layer, soil data, and weather data, and calibrated with Maumee River gauge stations data for streamflow and nutrients. Fast Line-of-sight Atmospheric Analysis of Hypercubes (FLAASH) was applied to remove atmospheric attenuation and cyanobacteria Indices were calculated from Landsat OLI imagery to study the intensity of HAB events in the years 2015, 2017, and 2019. The agricultural practice and nutrients management within the Maumee watershed was studied and correlated with HAB cyanobacteria indices to study the relationship between HAB intensity and nutrient loadings. This study demonstrates that hydrological models and satellite imagery are effective tools in HAB monitoring and modeling in rivers and lakes.

Keywords: harmful algal bloom, landsat OLI imagery, SWAT, HAB cyanobacteria

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Authors: Mercedes Sepulveda, Saras Henderson, Dana Farrell, Gaby Heuft

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In Australia, there is a significant number of Culturally and Linguistically Diverse (CALD) Grandparent Carers who are sole carers for their grandchildren. Services in the community such as accessible healthcare, financial support, legal aid, and transport to services can assist Grandparent Carers to continue to live in their own home whilst caring for their grandchildren. Community nurses can play a major role by being aware of the needs of these grandparents and link them to services via information and referrals. The CALD Grandparent Carer experiences have only been explored marginally and may be similar to the general Grandparent Carer population, although cultural aspects may add to their difficulties. This Needs-Gap Analysis aimed to uncover ‘hidden issues’ for CALD Grandparent Carers such as service gaps and actions needed to address these issues. The stakeholders selected for this Needs-Gap Analysis were drawn from relevant service providers such as community and aged care services, child and/or grandparents support services and CALD specific services. One hundred relevant service providers were surveyed using six structured questions via face to face, phone interviews, or email correspondence. CALD Grandparents who had a significant or sole role of being a carer for grandchildren were invited to participate through their CALD community leaders. Consultative Forums asking five questions that focused on the caring role, issues encountered, and what needed to be done, were conducted with the African, Asian, Spanish-Speaking, Middle Eastern, European, Pacific Islander and Maori Grandparent Carers living in South-east Queensland, Australia. Data from the service provider survey and the CALD Grandparent Carer forums were content analysed using thematic principles. Our findings highlighted social determinants of health grouped into six themes. These were; 1) service providers and Grandparent Carer perception that there was limited research data on CALD grandparents as carers; 2) inadequate legal and financial support; 3) barriers to accessing information and advice; 4) lack of childcare options in the light of aging and health issues; 5) difficulties around transport; and 6) inadequate technological skills often leading to social isolation for both carer and grandchildren. Our Needs-Gap Analysis provides insight to service providers especially health practitioners such as doctors and community nurses, particularly on the impact of caring for grandchildren on CALD Grandparent Carers. Furthermore, factors such as cultural differences, English language difficulties, and migration experiences also impacted on the way CALD Grandparent Carers are able to cope. The findings of this Need-Gap Analysis signposts some of the ‘ hidden issues’ that CALD Grandparents Carers face and draws together recommendations for the future as put forward by the stakeholders themselves.

Keywords: CALD grandparents, carer needs, community nurses, grandparent carers

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Authors: K. M. Shahunja, Peter D. Sly, Tahmina Begum, Tuhin Biswas, Abdullah Mamun

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Background: Various associations between different environmental exposures and asthma have been reported in different countries and populations. We aimed to investigate the associations between family, neighbourhood, and psychosocial environmental factors and asthma in Australia by conducting a systematic review and meta-analysis. Methods: We analysed the primary research studies conducted in Australia across multiple databases, including PubMed, EMBASE, and Scopus, and published between 2000 and 2020. The reviews and analyses focused on the overall association of different environmental exposures with the development or exacerbation of asthma symptoms or asthma-related hospital visits. Quality-effect meta-analysis was done to estimate the pooled odds ratio for different environmental exposures for asthma symptoms. Findings: Among the 4,799 unique published articles found, 46 were included here for systematic review and 28 for meta-analysis. Our review found that psychosocial factors, including low socioeconomic condition, maternal depression, mental stress, ethnicity, and discrimination, are associated with asthma symptoms. Pooled analysis was conducted on family and neighbourhood environmental factors and revealed that environmental tobacco smoking (ETS) (OR 1·69, 95% CI 1·19–2.38), synthetic bedding (OR 1·91, 95% CI 1·48–2·47) and gas heaters (OR 1·40, 95% CI 1·12–1·76) had significant overall associations with asthma-symptoms in Australia. Conclusion: Although the studies were heterogeneous, both systematic review and meta-analysis found several psychosocial and family environmental exposures to be significantly associated with asthma symptoms. Further study to identify their causal relationship and modification may reduce asthma symptoms in the Australian population.

Keywords: asthma, Australia, environment, systematic review

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Authors: Rayah Asiri, Anna Robinson-Barella, Adam Todd, Andy Husband

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Introduction: A high prevalence of diabetes and diabetes-related complications in ethnic minority communities is of significant concern. Several studies have indicated low adherence rates to antidiabetic medications in ethnic minorities. Poor adherence to antidiabetic medications leads to a higher risk of complications and mortality. This review aims to explore the barriers to and facilitators of adherence to antidiabetic medication among ethnic minority groups in high-income countries. Methods: A comprehensive search of MEDLINE, Embase, CINAHL, and PsycINFO databases for qualitative studies exploring the barriers to or facilitators of adherence to antidiabetic medication in ethnic minority groups were conducted from database inception to March 2022 (PROSPERO CRD42022320681). A quality assessment of the studies was conducted using the Critical Appraisal Skills Programme (CASP) tool. Key concepts and themes from relevant studies were synthesised using a meta-ethnographic approach. Result: A total of 18 studies were included in the review, and three major themes were developed: 1) cultural underpinnings, 2) communication and building relationships, and 3) managing diabetes during holidays. Conclusion: Multiple barriers and facilitators of adherence to antidiabetic medication among ethnic minority people in high-income countries have been identified. A medication adherence intervention focusing on identified barriers to adherence to antidiabetic medication in ethnic minorities may help in improving diabetes outcomes in these groups.

Keywords: medication adherence, diabetes, ethnic minority, barriers, facilitators

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Authors: Kumaran Letchmanan, Shou-Cang Shen, Wai Kiong Ng

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Postoperative implant-associated infections in soft tissues and bones remain a serious complication in orthopaedic surgery, which leads to impaired healing, re-implantation, prolong hospital stay and increase cost. Drug-loaded implants with sustained release of antibiotics at the local site are current research interest to reduce the risk of post-operative infections and osteomyelitis, thus, minimize the need for follow-up care and increase patient comfort. However, the improved drug release of the drug-loaded bone cements is usually accompanied by a loss in mechanical strength, which is critical for weight-bearing bone cement. Recently, more attempts have been undertaken to develop techniques to enhance the antibiotic elution as well as preserve the mechanical properties of the bone cements. The present study investigates the potential influence of addition of mesoporous silica nanoparticles (MSN) on the in vitro drug release kinetics of gentamicin (GTMC), along with the mechanical properties of bone cements. Simplex P was formulated with MSN and loaded with GTMC by direct impregnation. Meanwhile, Simplex P with water soluble poragen (xylitol) and high loading of GTMC as well as commercial bone cement CMW Smartset GHV were used as controls. MSN-formulated bone cements are able to increase the drug release of GTMC by 3-fold with a cumulative release of more than 46% as compared with other control groups. Furthermore, a sustained release could be achieved for two months. The loaded nano-sized MSN with uniform pore channels significantly build up an effective nano-network path in the bone cement facilitates the diffusion and extended release of GTMC. Compared with formulations using xylitol and high GTMC loading, incorporation of MSN shows no detrimental effect on biomechanical properties of the bone cements as no significant changes in the mechanical properties as compared with original bone cement. After drug release for two months, the bending modulus of MSN-formulated bone cements is 4.49 ± 0.75 GPa and the compression strength is 92.7 ± 2.1 MPa (similar to the compression strength of Simplex-P: 93.0 ± 1.2 MPa). The unaffected mechanical properties of MSN-formulated bone cements was due to the unchanged microstructures of bone cement, whereby more than 98% of MSN remains in the matrix and supports the bone cement structures. In contrast, the large portions of extra voids can be observed for the formulations using xylitol and high drug loading after the drug release study, thus caused compressive strength below the ASTM F541 and ISO 5833 minimum of 70 MPa. These results demonstrate the potential applicability of MSN-functionalized poly(methyl methacrylate)-based bone cement as a highly efficient, sustained and local drug delivery system with good mechanical properties.

Keywords: antibiotics, biomechanical properties, bone cement, sustained release

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Authors: Samar Alharbi, Yota Dimitriadi

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With the exponential growth of information and communication technologies in higher education, new online teaching strategies have become increasingly important for student engagement and learning. In particular, some institutions depend solely on asynchronous e-learning to provide courses for their students. The major challenge facing these institutions is how to improve the quality of teaching and learning in their asynchronous tools. One of the most important methods that can help e-learner to enhance their social learning and social presence in asynchronous learning setting is immediacy. This study explores tutors perceptions of their instructional immediacy practices as part of their communication actions in online learning environments. It was used a mixed-methods design under the umbrella of pragmatic philosophical assumption. The participants included tutors at an educational institution in a Saudi university. The participants were selected with a purposive sampling approach and chose an institution that offered fully online courses to students. The findings of the quantitative data show the importance of teachers’ immediacy practices in an online text-based learning environment. The qualitative data contained three main themes: the tutors’ encouragement of student interaction; their promotion of class participation; and their addressing of the needs of the students. The findings from these mixed methods can provide teachers with insights into instructional designs and strategies that they can adopt in order to use e-immediacy in effective ways, thus improving their students’ online learning experiences.

Keywords: asynchronous e-learning, higher education, immediacy, tutor

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Authors: G. S. Sumanasekara, W. M. P. B. Weerasingheg

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The major problem associated with concentrate feeds used for feeding cattle is declining quality by contamination with Aflatoxins. Objective: The aim of the study was to detect levels of Aflatoxin M1(AFM1) in cow milk , AFM1 levels present in milk related to different feed types and to identify the relationship between feed type and Aflatoxin M1 in milk. Design: cross sectional study design. Milk samples from each farm assessed for presence of AFM1 using High Performance Liquid Chromatographic method. Setting: Ten dairy farms located in Nuwara-Eliya district were randomly selected.AFM1 analysis was done using High Performance Liquid Chromatography(HPLC). Results: The results indicated that AFM1 was present in 50% of samples. Coconut poonac shown the most significant relationship among individual feeds having a correlation of 0.65 and P value of 0.042 . Among feed combinations, coconut poonac and beer pulp combination showed the highest correlation of 0.77 and P value of 0.05. Grasses had shown a very poor relationship with the AFM1 occurrence in milk (r=0.053, P=0.885). Relationship between overall concentrate feeds in the study and AFM1 in milk, it was clear that they had a significant relationship having correlation of 0.65 and P value of 0.042. Majority of samples lied between 0-10 ng L-1 of AFM1 and one sample exceeded above 30 ng L-1. Two samples had AFM1 concentrations between 22-32 ng L-1. One sample lied between 32-42ng L-1, did not exceed the EU recommended level of 50 ng L-1. The presence of AFM1 in milk under various management and feeding conditions is yet to be investigated in Sri Lanka.

Keywords: aflatoxin M1, aspergillus, cattle feed, concentrates, cow milk, high perforamance liquid chromatography

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Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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Authors: S. Hatamikia, A. Biguri, H. Furtado, G. Kronreif, J. Kettenbach, W. Birkfellner

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Nowadays, three dimensional Cone Beam CT (CBCT) has turned into a widespread clinical routine imaging modality for interventional radiology. In conventional CBCT, a circular sourcedetector trajectory is used to acquire a high number of 2D projections in order to reconstruct a 3D volume. However, the accumulated radiation dose due to the repetitive use of CBCT needed for the intraoperative procedure as well as daily pretreatment patient alignment for radiotherapy has become a concern. It is of great importance for both health care providers and patients to decrease the amount of radiation dose required for these interventional images. Thus, it is desirable to find some optimized source-detector trajectories with the reduced number of projections which could therefore lead to dose reduction. In this study we investigate some source-detector trajectories with the optimal arbitrary orientation in the way to maximize performance of the reconstructed image at particular regions of interest. To achieve this approach, we developed a box phantom consisting several small target polytetrafluoroethylene spheres at regular distances through the entire phantom. Each of these spheres serves as a target inside a particular region of interest. We use the 3D Point Spread Function (PSF) as a measure to evaluate the performance of the reconstructed image. We measured the spatial variance in terms of Full-Width-Half-Maximum (FWHM) of the local PSFs each related to a particular target. The lower value of FWHM shows the better spatial resolution of reconstruction results at the target area. One important feature of interventional radiology is that we have very well-known imaging targets as a prior knowledge of patient anatomy (e.g. preoperative CT) is usually available for interventional imaging. Therefore, we use a CT scan from the box phantom as the prior knowledge and consider that as the digital phantom in our simulations to find the optimal trajectory for a specific target. Based on the simulation phase we have the optimal trajectory which can be then applied on the device in real situation. We consider a Philips Allura FD20 Xper C-arm geometry to perform the simulations and real data acquisition. Our experimental results based on both simulation and real data show our proposed optimization scheme has the capacity to find optimized trajectories with minimal number of projections in order to localize the targets. Our results show the proposed optimized trajectories are able to localize the targets as good as a standard circular trajectory while using just 1/3 number of projections. Conclusion: We demonstrate that applying a minimal dedicated set of projections with optimized orientations is sufficient to localize targets, may minimize radiation.

Keywords: CBCT, C-arm, reconstruction, trajectory optimization

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Authors: Watin Alkhelaiwi, Iseult Wilson, Marian Traynor, Katherine Rogers

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Clinical nursing education allows nursing students to gain essential knowledge from practice experience and develop nursing skills in a variety of clinical environments. Integrating theoretical knowledge and practical skills is made easier for nursing students by providing opportunities for practice in a clinical environment. Nursing competency is an essential capability required to fulfill nursing responsibilities. Effective mentoring in clinical settings helps nursing students develop the necessary competence and promotes the integration of theory and practice. Preceptors play a considerable role in clinical nursing education, including the supervision of nursing students undergoing a rigorous clinical practicum. Preceptors are also involved in the clinical assessment of nursing students’ competency. The assessment of nursing students’ competence by professional practitioners is essential to investigate whether nurses have developed an adequate level of competence to deliver safe nursing care. Competency assessment remains challenging among nursing educators and preceptors, particularly owing to the complexity of the process. Consistency in terms of assessment methods and tools and valid and reliable assessment tools for measuring competence in clinical practice are lacking. Nurse preceptors must assess students’ competencies to prepare them for future professional responsibilities. Preceptors encounter difficulties in the assessment of competency owing to the nature of the assessment process, lack of standardised assessment tools, and a demanding clinical environment. The purpose of the study is to examine nursing preceptors’ experiences of assessing nursing interns’ competency in Saudi Arabia. There are three objectives in this study; the first objective is to examine the preceptors’ view of the Saudi assessment tool in relation to preceptorship, assessment, the assessment tool, the nursing curriculum, and the grading system. The second and third objectives are to examine preceptors’ view of "competency'' in nursing and their interpretations of the concept of competency and to assess the implications of the research in relation to the Saudi 2030 vision. The study uses an exploratory sequential mixed-methods design that involves a two-phase project: a qualitative focus group study is conducted in phase 1, and a quantitative study- a descriptive cross-sectional design (online survey) is conducted in phase 2. The results will inform the preceptors’ view of the Saudi assessment tool in relation to specific areas, including preceptorship and how the preceptors are prepared to be assessors, and assessment and assessment tools through identifying the appropriateness of the instrument for clinical practice. The results will also inform the challenges and difficulties that face the preceptors. These results will be analysed thematically for the focus group interview data, and SPSS software will be used for the analysis of the online survey data.

Keywords: clinical assessment tools, clinical competence, competency assessment, mentor, nursing, nurses, preceptor

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Authors: Pedro A. S. Bergamo, Emilia S. Streng, Jan Rosenkranz, Yousef Ghorbani

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Within the often-hazardous mineral industry, simulation training has speedily gained appreciation as an important method of increasing site safety and productivity through enhanced operator skill and knowledge. Performance calculations related to froth flotation, one of the most important concentration methods, is probably the hardest topic taught during the training of plant operators. Currently, most training teach those skills by traditional methods like slide presentations and hand-written exercises with a heavy focus on memorization. To optimize certain aspects of these pieces of training, we developed “MinFloat”, which teaches the operation formulas of the froth flotation process with the help of gamification. The simulation core based on a first-principles flotation model was implemented in Unity3D and an instructor tutoring system was developed, which presents didactic content and reviews the selected answers. The game was tested by 25 professionals with extensive experience in the mining industry based on a questionnaire formulated for training evaluations. According to their feedback, the game scored well in terms of quality, didactic efficacy and inspiring character. The feedback of the testers on the main target audience and the outlook of the mentioned solution is presented. This paper aims to provide technical background on the construction of educational games for the mining industry besides showing how feedback from experts can more efficiently be gathered thanks to new technologies such as online forms.

Keywords: training evaluation, simulation based training, modelling, and simulation, froth flotation

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Authors: Yun Ma, Jiajun Lu

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President Xi Jinping has clearly stated the need to more effectively advance the process of urbanization centered on people, striving to shape cities into spaces that are healthier, safer, and more livable. However, during the development and construction of mountainous cities, numerous uncertain disruptive factors have emerged, one after another, posing severe challenges to the city's overall development. Therefore, building resilient cities and creating high-quality urban ecosystems and safety systems have become the core and crux of achieving sustainable urban development. This paper takes the central urban area of Chongqing as the research object and establishes an urban resilience assessment indicator system from four dimensions: society, economy, ecology, and infrastructure. It employs the entropy weight method and TOPSIS model to assess the urban resilience level of the central urban area of Chongqing from 2019 to 2022. The results indicate that i. the resilience level of the central urban area of Chongqing is unevenly distributed, showing a spatial pattern of "high in the middle and low around"; it also demonstrates differentiation across different dimensions; ii. due to the impact of the COVID-19 pandemic, the overall resilience level of the central urban area of Chongqing has declined significantly, with low recovery capacity and slow improvement in urban resilience. Finally, based on the four selected dimensions, this paper proposes optimization strategies for urban resilience in mountainous cities, providing a basis for Chongqing to build a safe and livable new city.

Keywords: mountainous urban areas, central urban area of chongqing, entropy weight method, TOPSIS model, ArcGIS

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Authors: Novia Liza Rahmawaty, Wilson Novarino, Muhammad Nazri Janra

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Indonesian people love to keep songbird in cage to be competed, such as White-rumped Shama (Copsychus malabaricus). Each individual White-rumped Shama will be pitted their song and try to imitate the rhythm of the enemy with its songs. This study was conducted to see the natural song characters of White-rumped Shama and song character from birds that had been trained and comparison in three different places in West Sumatra. Individuals were recorded totaling 30 individuals in three areas in West Sumatra namely Padang, Solok and Pariaman and sound recordings of White-rumped Shama in nature were taken in HBW and Xenocanto website. Research has done conducted from June to October 2016 at place group practice of birdsongs and recorded at 16:00 to 18:00 pm. These voices were analyzed by Avisoft SAS-Lab Lite inform of oscillogram and sonogram. Measured parameters included: the length of voice, repertoire size, number of syllable type, syllable repertoire, and song repertoire. The results showed that repertoire composition of White-rumped Shama in nature less than the sound which was trained and has repeat songs composed by the same type of repertoire composition. Comparison of song character White-rumped Shama in three different places in West Sumatra, those birds in Solok had the best quality of voice or song than Padang and Pariaman. It showed by higher repertoire composition in Solok.

Keywords: repertoire composition, song characters, songbird, white-rumped shama

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Authors: Monira Nazmi Jahan, Nusrat Jahan Nishat

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'Child Pornography' is a sex crime that portrays illegal images and videos of a minor over the Internet and now has become a social concern with the increase of commission of this crime. The major objective of this paper is to identify and examine the laws relating to child pornography in Bangladesh and to compare this with other South Asian countries. In Bangladesh to prosecute under child pornography, provisions have been made in ‘Digital Security Act, 2018’ where it has been defined as involving child in areas of child sexuality or in sexuality and whoever commits the crime will be punished for 10 years imprisonment or 10 lac taka fine. In India, the crime is dealt with ‘The Protection of Children from Sexual Offences Act, 2012’ (POSCO) where the offenders for commission of this crime has been divided separately and has provision for punishments starting from three years to rigorous life imprisonment and shall also be liable to fine. In the Maldives, there is ‘Special Provisions Act to Deal with Child Sex Abuse Offenders, Act number 12/2009’. In this act it has been provided that a person is guilty of such an act if intentionally runs child prostitution, involves child in the creation of pornography or displays child’s sexual organ in pornography then shall be punished between 20 to 25 years of imprisonment. Nepal prosecutes this crime through ‘Act Relating to Children, 2018’ and the conviction of using child in prostitution or sexual services is imprisonment up to fifteen years and fine up to one hundred fifty thousand rupees. In Pakistan, child pornography is prosecuted with ‘Pakistan Penal Code Child Abuse Amendment Act, 2016’. This provides that one is guilty of this offence if he involves child with or without consent in such activities. It provides punishment for two to seven years of imprisonment or fine from two hundred thousand to seven hundred thousand rupees. In Bhutan child pornography is not explicitly addressed under the municipal laws. The Penal Code of Bhutan penalizes all kinds of pornography including child pornography under the provisions of computer pornography and the offence shall be a misdemeanor. Child Pornography is also prohibited under the ‘Child Care and Protection Act’. In Sri Lanka, ‘The Penal Code’ de facto criminalizes child prohibition and has a penalty of two to ten years and may also be liable to fine. The most shocking scenario exists in Afghanistan. There is no specific law for the protection of children from pornography, whereas this serious crime is present there. This paper will be conducted through a qualitative research method that is, the primary sources will be laws, and secondary sources will be journal articles and newspapers. The conclusion that can be drawn is except Afghanistan all other South Asian countries have laws for controlling this crime but still have loopholes. India has the most amended provisions. Nepal has no provision for fine, and Bhutan does not mention any specific punishment. Bangladesh compared to these countries, has a good piece of law; however, it also has space to broaden the laws for controlling child pornography.

Keywords: child abuse, child pornography, life imprisonment, penal code, South Asian countries

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Authors: Yousuf Nasser Al Khamisi

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Purpose: This paper presents a Knowledge Transfer (KT) Framework in healthcare sectors by applying a systematic literature review process to the healthcare organizations domain to identify enablers and barriers of KT in Healthcare. Methods: The paper conducted a systematic literature search of peer-reviewed papers that described key elements of KT using four databases (Medline, Cinahl, Scopus, and Proquest) for a 10-year period (1/1/2008–16/10/2017). The results of the literature review were used to build a conceptual framework of KT in healthcare organizations. The author used a systematic review of the literature, as described by Barbara Kitchenham in Procedures for Performing Systematic Reviews. Findings: The paper highlighted the impacts of using Knowledge Management (KM) concept at a healthcare organization in controlling infectious diseases in hospitals, improving family medicine performance and enhancing quality improvement practices. Moreover, it found that good-coding performance is analytically linked with a knowledge sharing network structure rich in brokerage and hierarchy rather than in density. The unavailability or ignored of the latest evidence on more cost-effective or more efficient delivery approaches leads to increase the healthcare costs and may lead to unintended results. Originality: Search procedure produced 12,093 results, of which 3523 were general articles about KM and KT. The titles and abstracts of these articles had been screened to segregate what is related and what is not. 94 articles identified by the researchers for full-text assessment. The total number of eligible articles after removing un-related articles was 22 articles.

Keywords: healthcare organisation, knowledge management, knowledge transfer, KT framework

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Authors: Hamdan Hamood Aldumaini, Amjad Hussein Meqdam, Shamsaldeen kassim Ali, Hamed Mohammed Al-Yousefi, Haron Ahmed Al-Badawi

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Background: Autism Spectrum Disorder (ASD) is a complex developmental challenge characterized by significant impairments in social interaction, communication, and behavioral patterns. Diagnosing ASD is challenging due to the lack of definitive medical tests, making early identification crucial. Therefore, increasing people's awareness about autism leads to early diagnosis and better prognosis. Objective: Our study aims to identify the initial symptoms prompting families to seek medical advice, determine the timeline between symptom onset and formal diagnosis, and explore methods for assessing the severity of ASD. Subjects and Methods: The study design employed was a descriptive cross-sectional design, which was suitable for the nature of the research. The data collection took place from March 5, 2022, to April 5, 2022, in Autism Rehabilitation Centers in Sana'a, Yemen. The study population consisted of all children who were diagnosed with autism and visited Autism rehabilitation centers in Sana'a city. The sample size was determined using Epi info version 7, and a total population of 587 autistic children attending the treatment was calculated, but only 250 children were included in this study (176 were male vs. 74 female). Result: In terms of sociability problems, it was found that a significant proportion of Yemeni children with autism experienced difficulties in this area. Specifically, 39.6% were classified as having severe sociability problems, while 28.4% were classified as having moderate issues. Sensory-cognitive awareness problems were also prevalent among the respondents, with 29.6% exhibiting severe difficulties in this domain. Health and physical problems were identified as significant concerns for Yemeni children with autism. The results indicated that 38.4% of the participants experienced severe health and physical issues. Identifying the first symptoms of autism is crucial for early detection and intervention. According to the study, speech delay was the most commonly observed first abnormality, reported by 71.3% of parents. Communication difficulties with others were the second most noticed abnormality, reported by 54.9% of parents. Repetitive movements were the third most commonly observed abnormality, reported by 18% of parents. Regarding the awareness among parents of ASD, our study showed that a significant portion (62%) of parents lack awareness about Autism Spectrum Disorder (ASD) and its causes. Surprisingly, a majority of these parents (over 80%) believe that autism is a curable condition. Additionally, more than half (51.2%) of the parents surveyed reported insufficient knowledge about medication options available to support therapy and rehabilitation for their autistic children.

Keywords: autism characteristics, rehabilitation centres, yemen, children

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