Search results for: stress related traits

Authors: Farhat Imtiaz, Umar Farooq

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In this work, we developed a computational model to predict ply level failure in impacted composite laminates. Data obtained from physical testing from flat and round nose impacts of 8-, 16-, 24-ply laminates were considered. Routine inspections of the tested laminates were carried out to approximate ply by ply inflicted damage incurred. Plots consisting of load–time, load–deflection, and energy–time history were drawn to approximate the inflicted damages. Impact test generated unwanted data logged due to restrictions on testing and logging systems were also filtered. Conventional filters (built-in, statistical, and numerical) reliably predicted load thresholds for relatively thin laminates such as eight and sixteen ply panels. However, for relatively thick laminates such as twenty-four ply laminates impacted by flat nose impact generated clipped data which can just be de-noised using oscillatory algorithms. The literature search reveals that modern oscillatory data filtering and extrapolation algorithms have scarcely been utilized. This investigation reports applications of filtering and extrapolation of the clipped data utilising fast Fourier Convolution algorithm to predict load thresholds. Some of the results were related to the impact-induced damage areas identified with Ultrasonic C-scans and found to be in acceptable agreement. Based on consistent findings, utilizing of modern data filtering and extrapolation algorithms to data logged by the existing machines has efficiently enhanced data interpretations without resorting to extra resources. The algorithms could be useful for impact-induced damage approximations of similar cases.

Keywords: fibre reinforced laminates, fast Fourier algorithms, mechanical testing, data filtering and extrapolation

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Authors: Jose Manuel Rodriguez-Dominguez, Rodrigo Barba-Gonzalez, Ernesto Tapia-Campos

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Sprekelia formosissima (L.) Herbert is a bulbous ornamental species of the monocotyledonous Amaryllidaceae family, and it is a perennial, herbaceous monotypic plant commonly known as ‘Aztec Lily’ or ‘Jacobean Lily’; it is distributed through Mexico and Guatemala. Its scarlet flowers with curved petals have made it an exceptional ornamental pot plant. Cytogenetic studies in this species have shown differences in chromosome number (2n=60, 120, 150, 180) with a basic number x=30. Different reports have shown a variable ploidy level (diploid, tetraploid, pentaploid and hexaploid); however, triploid plants have not been reported. In this work, triploid plants of S. formosissima were obtained by crossing tetraploid (2n=4x=120) with diploid (2n=2x=60) genotypes of this species; the seeds obtained from the crosses were placed in pots with a moist substrate made of Peat Moss: Vermiculite (7:3) for germination. Root tips were collected, and metaphasic chromosome preparations were performed. For chromosome counting, the best five metaphases obtained were photographed with a Leica DMRA2 microscope (Leica Microsystems, Germany) microscopy coupled to an Evolution QEI camera under phase contrast (Media-Cybernetics). Chromosomes counting in root-tip cells showed that 100% of the plants were triploid (2n=3x=90). Although tetraploid or pentaploid plants of S. formosissima are highly appreciated, they usually have lower growth rates than related diploid ones. For this reason, it is important to obtain triploid plants, which have advantages such as higher growth rates than tetraploid and pentaploid, larger flowers than those of the diploid plants and they are expected to not be able to produce seeds because their gametes are aneuploids. Furthermore, triploids may become very important for genomic research in the future, creating opportunities for discovering and monitoring genomic and transcriptomic changes in unbalanced genomes, hence the importance of this work.

Keywords: Amaryllidaceae, cytogenetics, ornamental, ploidy level

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Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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Authors: Marinete Araujo da Silva Fobister

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This presentation aims to discuss how the feeling of ‘nostalgia’ both present on Westerns and migrants could shed light to a mutual recognition and an exchange of ways of life that could enhance mutual possibilities of self-realization. It seems that this feeling of nostalgia is related to another unfolding of the nihilism of the death of God diagnosed by Nietzsche. Westerns are feeling on the margins of the values of their own culture as they feel such values as external to them. At the same time, some groups are claiming the return of the old devalued values. In this scenario, the West is receiving many migrants from different parts of the world since the second half of the last century. Migrants might be suffering from nostalgia or homesickness for having left their home. It might be that sharing a sense of nostalgia, although with different meanings, can bring together Westerns and migrants. Migrants bring ways of life that might be unknown and inexperienced in the West, and these can shed light to new forms of interpretation and cultivation of ones’ drives, and forces and this could become a source of mutual strength cultivation. Therefore, this mutual feeling of nostalgia could lead to ways of exploring the idea of self- realization in Nietzsche detaching it from the idea of being mainly individual to a more trans-individual-cultural claim. Nietzsche argues that nihilism is a European event here translated as a Western event, which would take 200 years until it could be overcome. To overcome nihilism a new kind of human would be needed, a creative and strong kind. For Nietzsche, there is not a fixed or true self, hence one possibility for one to achieve self-realization would reside on cultivating their multiple creative forces. The argument here is that in this recent unfolding of nihilism, translated in the sense of nostalgia, the encounter between the mainstream western immersed on nihilism with migrants could create a sense of a shared temporary home, where these different ways of life could inspire each other to create new meanings. Indeed, contributing to the expansion of one’s world view, drives and forces. Therefore, fertilizing the soil for the cultivation of self-realization and consequently the creation of new values.

Keywords: migration, nihilism, nostalgia, self-realization

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Authors: Shiv Jyoti Pandey, Shveta Puri, G. M. Bhat, Neha Raina

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The Jammu and Kashmir (J&K) region of Northwest Himalaya has a long history of earthquake activity which falls within Seismic Zones IV and V. To know the crustal structure beneath this region, we utilized teleseismic receiver function method. This paper presents the results of the analyses of the teleseismic earthquake waves recorded by 10 seismic observatories installed in the vicinity of major thrusts and faults. The teleseismic waves at epicentral distance between 30o and 90o with moment magnitudes greater than or equal to 5.5 that contains large amount of information about the crust and upper mantle structure directly beneath a receiver has been used. The receiver function (RF) technique has been widely applied to investigate crustal structures using P-to-S converted (Ps) phases from velocity discontinuities. The arrival time of the Ps, PpPs and PpSs+ PsPs converted and reverberated phases from the Moho can be combined to constrain the mean crustal thickness and Vp/Vs ratio. Over 500 receiver functions from 10 broadband stations located in the Jammu & Kashmir region of Northwest Himalaya were analyzed. With the help of H-K stacking method, we determined the crustal thickness (H) and average crustal Vp/Vs ratio (K) in this region. We also used Neighbourhood algorithm technique to verify our results. The receiver function results for these stations show that the crustal thickness under Jammu & Kashmir ranges from 45.0 to 53.6 km with an average value of 50.01 km. The Vp/Vs ratio varies from 1.63 to 1.99 with an average value of 1.784 which corresponds to an average Poisson’s ratio of 0.266 with a range from 0.198 to 0.331. High Poisson’s ratios under some stations may be related to partial melting in the crust near the uppermost mantle. The crustal structure model developed from this study can be used to refine the velocity model used in the precise epicenter location in the region, thereby increasing the knowledge to understand current seismicity in the region.

Keywords: H-K stacking, Poisson’s ratios, receiver function, teleseismic

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Authors: Oluwaseun A. Oyetade, Roelof J. Kriek

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The development of effective catalysts for the oxygen evolution reaction (OER) is of great importance to combat energy-related concerns in the environment. Herein, we report a one-step solvothermal method employed for the fabrication of nickel selenide hybrids (NiSe-Ni₃Se₂) and a series of nickel selenide hybrid/multiwalled carbon nanotube composites (NiSe-Ni₃Se₂/MWCNT) as electrocatalysts for OER in alkaline media. The catalytic activities of these catalysts were investigated via several electrochemical characterization techniques, such as linear sweep voltammetry, chronoamperometric studies at constant potential, electrochemical surface area determination, and Tafel slope calculation, under alkaline conditions. Morphological observations demonstrated the agglomeration of non-uniform NiSe-Ni₃Se₂ microspheres around carbon nanotubes (CNTs), demonstrating the successful synthesis of NiSe-Ni₃Se₂/MWCNT nanocomposites. Among the tested electrocatalysts, the 20% NiSe-Ni₃Se₂/MWCNT nanocomposite demonstrated the highest activity, exhibiting an overpotential of 325 mV to achieve a current density of 10 mA.cm⁻² in 0.1 mol.dm⁻³ KOH solution. The NiSe-Ni₃Se₂/MWCNT nanocomposites showed improved activity toward OER compared to bare NiSe-Ni₃Se₂ hybrids and MWCNTs, exhibiting an overpotential of 528, 392 and 434 mV for 10%, 30% and 50% NiSe-Ni₃Se₂/MWCNT nanocomposites, respectively. These results compare favourably to the overpotential of noble catalysts, such as RuO₂ and IrO₂. Our results imply that the addition of MWCNTs increased the activity of NiSe-Ni₃Se₂ hybrids due to an increased number of catalytic sites, dispersion of NiSe-Ni₃Se₂ hybrid nanoparticles, and electronic conductivity of the nanocomposites. These nanocomposites also demonstrated better long-term stability compared to NiSe-Ni₃Se₂ hybrids and MWCNTs. Hence, NiSe-Ni₃Se₂/MWCNT nanocomposites possess the potential as effective electrocatalysts for OER in alkaline media.

Keywords: carbon nanotubes, electrocatalysts, nanocomposites, nickel selenide hybrids, oxygen evolution reaction

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Authors: Naomi W. Maina

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Fertility preference is a subject of great significance in developing countries. Studies reveal that the preferences of fertility are actually significant in determining the society’s fertility levels because the fertility behavior of the future has a high likelihood of falling under the effect of currently observed fertility inclinations. The objective of this study was to establish the factors associated with fertility preference amongst couples in Kenya by fitting a multinomial logistic regression model against 5,265 couple data obtained from Kenya demographic health survey 2014. Results revealed that the type of place of residence, the region of residence, age and spousal age gap significantly influence desire for additional children among couples in Kenya. There was the notable high likelihood of couples living in rural settlements having similar fertility preference compared to those living in urban settlements. Moreover, geographical disparities such as in northern Kenya revealed significant differences in a couples desire to have additional children compared to Nairobi. The odds of a couple’s desire for additional children were further observed to vary dependent on either the wife or husbands age and to a large extent the spousal age gap. Evidenced from the study, was the fact that as spousal age gap increases, the desire for more children amongst couples decreases. Insights derived from this study would be attractive to demographers, health practitioners, policymakers, and non-governmental organizations implementing fertility related interventions in Kenya among other stakeholders. Moreover, with the adoption of devolution, there is a clear need for adoption of population policies that are County specific as opposed to a national population policy as is the current practice in Kenya. Additionally, researchers or students who have little understanding in the application of multinomial logistic regression, both theoretical understanding and practical analysis in SPSS as well as application on real datasets, will find this article useful.

Keywords: couples' desire, fertility, fertility preference, multinomial regression analysis

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Authors: Ghalia Shamlan, M. Denise Robertson, Adam Collins

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Appetite control (i.e. control of energy intake) is important for weight maintenance. Exercise contributes to the most variable component of energy expenditure (EE) but its impact is beyond the energy cost of exercise including physiological, behavioural, and appetite effects. Exercise is known to acutely influence effect appetite but evidence as to the independent effect of intensity is lacking. This study investigated the role of exercise intensity on appetite, energy intake (EI), appetite related hormone, fat utilisation and subjective measures of appetite. One hour after a standardised breakfast, 10 sedentary overweight volunteers. Subjects undertook either 8 repeated 60 second bouts of cycling at 95% VO2max (high intensity) or 30 minutes of continuous cycling, at a fixed cadence, equivalent to 50% of the participant’s VO2max (low intensity) in a randomised crossover design. Glucose, NEFA, glucagon-like peptide-1 (GLP-1) were measured fasted, postprandial, and pre and post-exercise. Satiety was assessed subjectively throughout the study using visual analogue scales (VAS). Ad libitum intake of a pasta meal was measured at the end (3-h post-breakfast). Interestingly, there was not significant difference in EE fat oxidation between HI and LI post-exercise. Also, no significant effect of high intensity (HI) was observed on the ad libitum meal, 24h and 48h EI post-exercise. However the mean 24h EI was 3000 KJ lower following HI than low intensity (LI). Despite, no significant differences in hunger score, glucose, NEFA and GLP-1 between both intensities were observed. However, NEFA and GLP-1 plasma level were higher until 30 min post LI. In conclusion, the similarity of EE and oxidation outcomes could give overweight individuals an option to choose between intensities. However, HI could help to reduce EI. There are mechanisms and consequences of exercise in short and long-term appetite control; however, these mechanisms warrant further explanation. These results support the need for future research in to the role of in regulation energy balance, especially for obese people.

Keywords: appetite, exercise, food intake, energy expenditure

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Authors: Olayide Ogunsiji, Glenda McDonald

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Engendering cultural competence in nursing and midwifery students is germane to reducing disparities in contemporary health care settings, increasingly patronized by people from diverse background. Professional standards for registration in Australia require nurses and midwives to be culturally competent. Nursing and midwifery academics worldwide are responsible for preparing students for clinical practice, yet limited attention is paid to exploring how students are being prepared to care for a culturally diverse population. This paper provides insight into the perceptions of academics about how they are preparing undergraduate nursing and midwifery students for culturally competent health care. Academics were drawn from a tertiary educational institution in metropolitan Australia. They responded to a generic email indicating their interest in participating in the study. A total of nine academics who have taught undergraduate nursing and midwifery students in a unit that focused on health and illness perspectives for culturally diverse communities; and provided written consent to participate were included. These academics were engaged in a qualitative digitally-recorded semi-structured face-to-face or telephone interviews which lasted for about 45-60 minutes. Interview data were transcribed verbatim. Through constant comparison, three themes emerged: experiences of the teachers, strategies used for preparing students and challenges in preparing students. The participants spoke about their experiences of teaching in the unit and with the students. They faced challenges related to physical and relational space. They utilised a number of didactic approaches in teaching the unit and critiqued the adequacy of the content in preparing students for practice. This study demonstrated that didactic classroom approaches need to be supported with clinical practice and cultural immersion for a meaningful preparation of nursing and midwifery students to care for culturally diverse populations.

Keywords: cultural competence, nursing students, preparation, undergraduate

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Authors: Julian Dario Castro Cifuentes

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In Colombia, the armed conflict has lasted for more than sixty years bringing poverty, internal displacement of people, deaths from both government and insurgent forces and other violence-related problems that has damaged its social fabric. In 2016, the peace process between the Colombian government and the FARC rebels brought the possibility of ending this war and a new set of challenges to Colombian society in order to achieve pacific coexistence and reconciliation. In this scenario, there have been different efforts from diverse social actors in order to build peace and reconciliation mainly within the victims of the armed conflict. In the case of music, there have been multiple programs for social transformation through music and pedagogical experiences. Nevertheless, the need to strengthen this initiative by giving ‘peace building oriented’ pedagogical tools to the musicians that lead this experiences and understanding which aspects make this practices ‘musically meaningful’, has been recognized. For this reason, the purpose of this study is to discuss the convergences and divergences of music, and educational experiences applied to peacebuilding in the context of Colombia’s post-conflict. In this research, the hermeneutic phenomenology paradigm is applied in a case study of a peace building music education experience in the department of Nariño, Colombia articulated with the program ‘Manos a la Paz’. Two particular experiences, one on musical practice and another on music education are taken as a unit of analysis to understand its essence and structure in order to find ways to articulate efforts in peace building actions from music. This study shows how the existent gap between music experience and its subjacent pedagogical knowledge, can be reduced through deconstruction of the music and pedagogical experience. The ‘Manos a la Paz’ program showed how a peace building approach to music education can make major contributions to Pacific Coexistence and Reconciliation in Colombia’s Post-Conflict.

Keywords: music education, music for peace, music pedagogy, peace building, social fabric

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Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.

Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium

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Authors: M. Towhidur Rahman, Nasim Zaman Piyas, M. Sadiqul Baree, Shahnewaz Ahmed

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The design of high-speed craft has recently become one of the most active areas of naval architecture. Speed increase makes these vehicles more efficient and useful for military, economic or leisure purpose. The planing hull is designed specifically to achieve relatively high speed on the surface of the water. Speed on the water surface is closely related to the size of the vessel and the installed power. The Savitsky method was first presented in 1964 for application to non-monohedric hulls and for application to stepped hulls. This method is well known as a reliable comparative to CFD analysis of hull resistance. A computer program based on Savitsky’s method has been developed using MATLAB. The power of high-speed vessels has been computed in this research. At first, the program reads some principal parameters such as displacement, LCG, Speed, Deadrise angle, inclination of thrust line with respect to keel line etc. and calculates the resistance of the hull using empirical planning equations of Savitsky. However, some functions used in the empirical equations are available only in the graphical form, which is not suitable for the automatic computation. We use digital plotting system to extract data from nomogram. As a result, value of wetted length-beam ratio and trim angle can be determined directly from the input of initial variables, which makes the power calculation automated without manually plotting of secondary variables such as p/b and other coefficients and the regression equations of those functions are derived by using data from different charts. Finally, the trim angle, mean wetted length-beam ratio, frictional coefficient, resistance, and power are computed and compared with the results of Savitsky and good agreement has been observed.

Keywords: nomogram, planing hull, principal parameters, regression

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Authors: Suheyla Demi̇rkol Orak

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The requirement of inclusive education is one of the utmost important results of both regular and irregular immigration. The matter in the case of Syrian immigrants is even worse than the other immigrants cases in world history since a massive immigration wave has affected all world countries' socio-economic profiles. When Syrians immigrated from Syria all over the world, they aimed to survive and left behind the war, but surviving is not optional occasion without handling language-related problems. Humans exist and preserve their existence with their language. That is a matter of concern for the integration of Syrians into the hosting countries. Many countries are proceeding with various programs to integrate Syrians into the majority groups by either assimilation or adaptation policies. Turkey has got the lion's share of the Syrian immigration apple, and in the same vein with this situation, its language education system should be analyzed severely in order to come up with a perfect match program for the integration of Syrians. It aimed to generate an inclusive education model for catalyzing the integration process of immigrant Syrian students into the majority socio-economic group via overcoming the language barrier. The identity of the immigrants is prioritized. The study follows a narrative literature review, which aims to review and critique relevant literature and offers a new conceptualization derived from the previous literature. The study derives a critical localized bilingual education model. As the outcome of the narrative literature review, a bilingual education model which prioritized the identity of the target community was designed. In the present study, main bilingual education programs and most of the countries' bilingual education policies were reviewed critically and suggestions were listed for the Syrian immigrants dominantly in Turkey and suggested to be benefitted by the other countries through localizing the practices.

Keywords: bi/multilingual education, sheltered education, immigrants, glocalization, submersion program, immersion program

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Authors: Agnes Anyango Andollo, Jane Achieng Achola

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The use of Information and Communication Technologies (ICTs) has become one of the driving forces in facilitation of learning in most colleges. The ability to effectively harness the technology varies from college to college. The study objective was to determine the lecturers’, institutional attributes and policies that influence the utilization of ICT by the lecturers’. A cross sectional survey design was employed in order to empirically investigate the extent to which lecturers’ personal, institutional attributes and policies influence the utilization of ICT to facilitate learning. The target population of the study was 295 lecturers who facilitate learning at KMTC-Nairobi. Structured self-administered questionnaire was given to the lecturers. Quantitative data was scrutinized for completeness, accuracy and uniformity then coded. Data were analyzed in frequencies and percentages using Statistical Package for Social Sciences (SPSS) version 19, this was a reliable tool for quantitative data analysis. A total of 155 completed questionnaires administered were obtained from the respondents for the study that were subjected to analysis. The study found out that 93 (60%) of the respondents were male while 62 (40%) of the respondents were female. Individual’s educational level, age, gender and educational experience had the greatest impact on use of ICT. Lecturers’ own beliefs, values, ideas and thinking had moderate impact on use of ICT. And that institutional support by provision of resources for ICT related training such as internet, computers, laptops and projectors had moderate impact (p = 0.049) at 5% significant level on use of ICT. The study concluded that institutional attributes and ICT policy were keys to utilization of ICT by lecturers at KMTC Nairobi also mandatory policy on use of ICT by lecturers to facilitate learning was key. It recommended that policies should be put in place for Technical support to lecturers when in problem during utilization of ICT and also a mechanism should be put in place to make the use of ICT in teaching and learning mandatory.

Keywords: policy, computers education, medical training institutions, ICTs

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Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

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Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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Authors: Sachin Sharma

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Sexual consent is integral to every sexual relationship. It is a process to facilitate sexual autonomy and bodily integrity. It assures complete sexual personhood and allows an individual to explore her sexual expressions independently. But the said proposition is not true for people with psychosocial disabilities. Generally, they are considered seraphic or mephistophelic and denied access to sexual autonomy. This result in institutionalizing the sexuality of disabled persons, where the eugenics-ableist narrative defines assessment and access to consent. This way, sexuality and disability are distanced apart. It is primarily due to the stigmatized socio-cultural constructs of sexuality that define sex within a “standard” and “charmed” circle. Such stigmatized expression influences the law, as it considers people with psychosocial disabilities incapable of sexual consent. The approach of legal institutions is very narrow towards interpreting their sexual rights. It echoes the modernist-ableism and strangulates the sexual choices. This way, it reflects the repressive model of sex and denies space to people with psychosocial disabilities. Moreover, judicial courts follow old and conservative methods while dealing with sexual issues. For instance, courts still practice the “standardized” norm of intelligence quotient (IQ) for determining the credibility of persons with psychosocial disabilities. Further, there is still doubt about assistive communicative techniques. This paper will try to question the normative structure of sexual consent and related laws while specifically addressing the issues of sex as desire and abuse. Considering the commitment to the United Nations Convention on the Rights of Persons with Disabilities (herein referred to as UNCRPD) and common law experience, the paper will draw a comparative study on the legal position of sexual rights in India. The paper will also analyze the role of UNCRPD in addressing sexual rights. The author will examine the position of sexual rights of people with psychosocial disabilities after the drafting of UNCRPD and specific state laws. The paper primarily follows the doctrinal method.

Keywords: sexual autonomy, institutionalized choices, overregulated laws, violation of individuality

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Authors: Sebastianus Menggo

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The aim of communicative language teaching is to enable learners to communicate in the target language. Each learner is required to perform the micro and macro components in each utterance produced. Utterances produced must be in line with the understanding of competence and performance of each speaker. These are inter-depended. Competence and performance are obliged to be appeared proportionally in creating the utterances. The representative of competence and performance reflects the linguistics identity of a speaker in providing sentences in each certain language community. Each lexicon spoken may lead that interlocutor in comprehending the intentions utterances given. However proportional performance of both components in an utterance needed to be further elaborated. Finding appropriate gap between competence and performance components in a communicative competence must be supported positive response given by the learners.The learners’ inability to keep communicative competence proportionally is caused by inside and outside factors. The inside factors are certain lacks such as lack of self-confidence and lack of motivation which could make students feel ashamed to produce utterances, scared to make mistakes, and have no enough confidence. Knowing learner’s English learning motivation is an urgent variable to be considered in creating conducive atmosphere classroom which will raise the learners to do more toward the achievement of communicative competence. Meanwhile, the outside factor is related with the teacher. The teacher should be able to recognize the students’ problem in creating conducive atmosphere in the classroom that will raise the students’ ability to be an English speaker qualified. Moreover, the aim of this research is to know and describe the English learning motivation affecting students’ communicative competence of 48 students of XI grade of science program at catholic senior of Saint Ignasius Loyola Labuan Bajo, West Flores, Indonesia. Correlation design with purposive procedure applied in this research. Data were collected through questionnaire, interview, and students’ speaking achievement document. Result shows the description of motivation significantly affecting students’ communicative competence.

Keywords: communicative, competence, English, learning, motivation

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Authors: Wenru Wang

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Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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Authors: Tunde Puskas, Anita Andersson

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In Swedish early childhood education research, the issues related to religious identifications and practices have often been marginalized or relegated either to the realm of diversity and multiculturalism or to the realm of national traditions. This paper is part of a research project about whether religion is considered as part of Swedish cultural heritage in Swedish preschools. Our aim in this paper is to explore how a Swedish preschool balance between keeping the education non-confessional and at the same time introducing the traditions associated with advent and Christmas. Christmas was chosen because of the religious background of the holiday and because it is a tradition widely celebrated in Swedish preschools. In Swedish education system, the concept of freedom of religion is understood in the sense that education is declared to be non-confessional. Nevertheless, as the major state holidays in Sweden are tied to Lutheran Christian traditions, and according to the curriculum preschool educators, are given the task to pass on a cultural heritage, defined in terms of values, traditions, history, language, and knowledge, it is the preschool teams or individual preschool teachers who determine whether and to what extent religious considerations are/ought to be seen as part of the cultural heritage the preschool passes on. The data consists of ten video taped observations from two preschools. The video data was transcribed and the transcripts were thereafter analysed through content analysis. In the analysis, we draw on the concept of banal religiosity that has helped us to draw attention to the workings of religious considerations that are so familiar that they rarely are noticed as religious and on Ninian Smart’s theory on the dimensions of religion. The analysis shows that what the adults actually do with religion fulfils six of seven dimensions common to religious traditions as outlined by Smart. At the same time, Christmas is performed as a lived tradition within which the commercial and religious rituals intersect and result in a banal, national religiosity.

Keywords: secular advent, banal religiosity, dimensions of religion, rites

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Authors: Deyu Yuan

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Discourse analysis as an interdisciplinary approach has more than 60-years-history since it was first named by Zellig Harris in 'Discourse Analysis' on Language in 1952. Ferdinand de Saussure differentiated the 'parole' from the 'langue' that established the principle of focusing on language but not speech. So the rising of discourse analysis can be seen as a discursive turn for the entire language research that closely related to the theory of Speech act. Critical discourse analysis becomes the mainstream of contemporary language research through drawing upon M. A. K. Halliday's socio-semiotic theory and Foucault, Barthes, Bourdieu's views on the sign, discourse, and ideology. So in contrast to general semiotics, social semiotics mainly focuses on parole and the application of semiotic theories to some applicable fields. The article attempts to discuss this applicable sociosemiotics and show the features of it that differ from the Saussurian and Peircian semiotics in four aspects: 1) the sign system is about meaning-generation resource in the social context; 2) the sign system conforms to social and cultural changes with the form of metaphor and connotation; 3) sociosemiotics concerns about five applicable principles including the personal authority principle, non-personal authority principle, consistency principle, model demonstration principle, the expertise principle to deepen specific communication; 4) the study of symbolic functions is targeted to the characteristics of ideational, interpersonal and interactional function in social communication process. Then the paper describes six features which characterize this sociosemiotics as applicable semiotics: social, systematic, usable interdisciplinary, dynamic, and multi-modal characteristics. Thirdly, the paper explores the multi-modal choices of sociosemiotics in the respects of genre, discourse, and style. Finally, the paper discusses the relationship between theory and practice in social semiotics and proposes a relatively comprehensive theoretical framework for social semiotics as applicable semiotics.

Keywords: discourse analysis, sociosemiotics, pragmatics, ideology

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Authors: Alexandra-Monica Toma

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Internet memes are an element of computer mediated communication and an important part of online culture that combines text and image in order to generate meaning. This term coined by Richard Dawkings refers to more than a mere way to briefly communicate ideas or emotions, thus naming a complex and an intensely perpetuated phenomenon in the virtual environment. This paper approaches memes as a cultural artefact and a virtual trope that mirrors societal concerns and issues, and analyses the pragmatics of their use. Memes have to be analysed in series, usually relating to some image macros, which is proof of the interplay between imitation and creativity in the memes’ writing process. We believe that their potential to become viral relates to three key elements: adaptation to context, reference to a successful meme series, and humour (jokes, irony, sarcasm), with various pragmatic functions. The study also uses the concept of multimodality and stresses how the memes’ text interacts with the image, discussing three types of relations: symmetry, amplification, and contradiction. Moreover, the paper proves that memes could be employed as speech acts with illocutionary force, when the interaction between text and image is enriched through the connection to a specific situation. The features mentioned above are analysed in a corpus that consists of memes related to the COVID-19 pandemic. This corpus shows them to be highly adaptable to context, which helps build the feeling of connection and belonging in an otherwise tremendously fragmented world. Some of them are created based on well-known image macros, and their humour results from an intricate dialogue between texts and contexts. Memes created in relation to the COVID-19 pandemic can be considered speech acts and are often used as such, as proven in the paper. Consequently, this paper tackles the key features of memes, makes a thorough analysis of the memes sociocultural, linguistic, and situational context, and emphasizes their intertextuality, with special accent on their illocutionary potential.

Keywords: context, memes, multimodality, speech acts

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Authors: Mariam G. Eshak, Ahmed Abbas, M. I. El-Sabry, M. M. Mashaly

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This investigation was conducted to determine the physiological response and evaluate the expression of inflammatory and cell death genes and DNA damage induced by endotoxic shock in laying hens. Endotoxic shock was induced by a single intravenous injection of 107 Escherichia coli (E. coli,) colony/hen. In the present study, 240 forty-week-old laying hens (H&N) were randomly assigned into 2 groups with 3 replicates of 40 birds each. Hens were reared in battery cages with wire floors in an open-sided housing system under natural conditions. Housing and general management practices were similar for all groups. At 42-wk of age, 45 hens from the first group (15 replicate) were infected with E. coli, while the same number of hens from the second group was injected with saline and served as a control. Heat shock protein-70 (HSP-70) expression, plasma corticosterone concentration, body temperature, and the gene expression of bax, caspase-3 activity, P38, Interlukin-1β (Il-1β), and tumor necrosis factor alpha (TNF-α) genes and DNA damage in the brain and liver were measured. Hens treated with E. coli showed significant (P≤0.05) increase of body temperature by 1.2 ᴼC and plasma corticosterone by 3 folds compared to the controls. Further, hens injected with E.Coli showed markedly over-expression of HSP-70 and increase DNA damage in brain and liver. These results were synchronized with activating cell death program since our data showed significant (P≤0.05) high expression of bax and caspase-3 activity genes in the brain and liver. These results were related to remarkable over-inflammation gene expression of P38, IL-1β, and TNF-α in brain and liver. In conclusion, our results indicate that endotoxic shock induces inflammatory physiological response and triggers cell death program by promoting P38, IL-1β, and TNF-α gene expression in the brain and liver.

Keywords: chicken, DNA damage, Escherichia coli, gene expression, inflammation

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Authors: Makhlouf Mourad, Messabih Sidi Mohamed, Bouchher Omar, Houali Farida, Benrachedi Khaled

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Mesoporous materials are very commonly used as adsorbent materials for removing phenolic compounds. However, the adsorption mechanism of these compounds is still poorly controlled. However, understanding the interactions mesoporous materials/adsorbed molecules is very important in order to optimize the processes of liquid phase adsorption. The difficulty of synthesis is to keep an orderly and cubic pore structure and achieve a homogeneous surface modification. The grafting of Si(CH₃)₃ was chosen, to transform hydrophilic surfaces hydrophobic surfaces. The aim of this work is to study the kinetics and thermodynamics of two volatile organic compounds VOC phenol (PhOH) and P hydroxy benzoic acid (4AHB) on a mesoporous material of type MCM-48 grafted with an organosilane of the Trimethylchlorosilane (TMCS) type, the material thus grafted or functionalized (hereinafter referred to as MCM-48-G). In a first step, the kinetic and thermodynamic study of the adsorption isotherms of each of the VOCs in mono-solution was carried out. In a second step, a similar study was carried out on a mixture of these two compounds. Kinetic models (pseudo-first order, pseudo-second order) were used to determine kinetic adsorption parameters. The thermodynamic parameters of the adsorption isotherms were determined by the adsorption models (Langmuir, Freundlich). The comparative study of adsorption of PhOH and 4AHB proved that MCM-48-G had a high adsorption capacity for PhOH and 4AHB; this may be related to the hydrophobicity created by the organic function of TMCS in MCM-48-G. The adsorption results for the two compounds using the Freundlich and Langmuir models show that the adsorption of 4AHB was higher than PhOH. The values ​​obtained by the adsorption thermodynamics show that the adsorption interactions for our sample with the phenol and 4AHB are of a physical nature. The adsorption of our VOCs on the MCM-48 (G) is a spontaneous and exothermic process.

Keywords: adsorption, kinetics, isotherm, mesoporous materials, Phenol, P-hydroxy benzoique acid

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Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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Authors: K. A. Ghazaryan, H. S. Movsesyan, N. P. Ghazaryan

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The present study was aimed in assessing the heavy metal pollution of the soils around Agarak copper-molybdenum mine complex and related environmental risks. This mine complex is located in the south-east part of Armenia, and the present study was conducted in 2013. The soils of the five riskiest sites of this region were studied: surroundings of the open mine, the sites adjacent to processing plant of Agarak copper-molybdenum mine complex, surroundings of Darazam active tailing dump, the recultivated tailing dump of “ravine - 2”, and the recultivated tailing dump of “ravine - 3”. The mountain cambisol was the main soil type in the study sites. The level of soil contamination by heavy metals was assessed by Contamination factors (Cf), Degree of contamination (Cd), Geoaccumulation index (I-geo) and Enrichment factor (EF). The distribution pattern of trace metals in the soil profile according to Cf, Cd, I-geo and EF values shows that the soil is much polluted. Almost in all studied sites, Cu, Mo, Pb, and Cd were the main polluting heavy metals, and this was conditioned by Agarak copper-molybdenum mine complex activity. It is necessary to state that the pollution problem becomes pressing as some parts of these highly polluted region are inhabited by population, and agriculture is highly developed there; therefore, heavy metals can be transferred into human bodies through food chains and have direct influence on public health. Since the induced pollution can pose serious threats to public health, further investigations on soil and vegetation pollution are recommended. Finally, Cf calculating based on distance from the pollution source and the wind direction can provide more reasonable results.

Keywords: Agarak copper-molybdenum mine complex, heavy metals, soil contamination, enrichment factor (EF), Armenia

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Authors: Jang-Hwan Jo

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The supply management of ecosystem services of local forests is an essential issue as it is linked to the ecological welfare of local residents. This study aims to estimate the supply, trade-offs, and synergies of local forest regulating ecosystem services using a land cover classification map (LCCM) and a forest types map (FTM). Rigorous literature reviews and Expert Delphi analysis were conducted using the detailed variables of 1:5,000 LCCM and FTM. Land-use scoring method and Getis-Ord Gi* Analysis were utilized on detailed variables to propose a method for estimating supply, trade-offs, and synergies of the local forest regulating ecosystem services. The analysis revealed that the rank order (1st to 5th) of supply of regulating ecosystem services was Erosion prevention, Air quality regulation, Heat island mitigation, Water quality regulation, and Carbon storage. When analyzing the correlation between defined services of the entire city, almost all services showed a synergistic effect. However, when analyzing locally, trade-off effects (Heat island mitigation – Air quality regulation, Water quality regulation – Air quality regulation) appeared in the eastern and northwestern forest areas. This suggests the need to consider not only the synergy and trade-offs of the entire forest between specific ecosystem services but also the synergy and trade-offs of local areas in managing the regulating ecosystem services of local forests. The study result can provide primary data for the stakeholders to determine the initial conditions of the planning stage when discussing the establishment of policies related to the adjustment of the supply of regulating ecosystem services of the forests with limited access. Moreover, the study result can also help refine the estimation of the supply of the regulating ecosystem services with the availability of other forms of data.

Keywords: ecosystem service, getis ord gi* analysis, land use scoring method, regional forest, regulating service, synergies, trade-offs

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Authors: Saad Roustom, Hajo Ribberink

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In most cities in the world, traffic has increased strongly over the last decades, causing high levels of congestion and deteriorating inner-city air quality. This study analyzes the impact of connected and automated vehicles (CAVs) on traffic performance and greenhouse gas (GHG) emissions under different CAV penetration rates in mixed fleet environments of CAVs and driver-operated vehicles (DOVs) and under three different traffic demand levels. Utilizing meso-scale traffic simulations of the City of Ottawa, Canada, the research evaluates the traffic performance of three distinct CAV driving behaviors—Cautious, Normal, and Aggressive—at penetration rates of 25%, 50%, 75%, and 100%, across three different traffic demand levels. The study employs advanced correlation models to estimate GHG emissions. The results reveal that Aggressive and Normal CAVs generally reduce traffic congestion and GHG emissions, with their benefits being more pronounced at higher penetration rates (50% to 100%) and elevated traffic demand levels. On the other hand, Cautious CAVs exhibit an increase in both traffic congestion and GHG emissions. However, results also show deteriorated traffic flow conditions when introducing 25% penetration rates of any type of CAVs. Aggressive CAVs outperform all other driving at improving traffic flow conditions and reducing GHG emissions. The findings of this study highlight the crucial role CAVs can play in enhancing urban traffic performance and mitigating the adverse impact of transportation on the environment. This research advocates for the adoption of effective CAV-related policies by regulatory bodies to optimize traffic flow and reduce GHG emissions. By providing insights into the impact of CAVs, this study aims to inform strategic decision-making and stimulate the development of sustainable urban mobility solutions.

Keywords: connected and automated vehicles, congestion, GHG emissions, mixed fleet environment, traffic performance, traffic simulations

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Authors: Yusuf Ismaila

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The developing countries are characterized by inefficient production systems and unequal distribution of wealth. Developing countries are largely populated, yet under developed. This can be attributed partly to the unplanned efforts towards the development of human capital through education and training. In the developed nations a huge attention is accorded to indices such as life expectancy, literacy, infant mortality, education, and the efficient delivery of social services. This is the reason why many developing countries have been scored low by the United Nations in terms of its human development indicators. The population growth continued to expand far beyond the rate of economic growth, a situation that gave rise to increasing poverty. This paper examines the effect of selected human development indicators on the economic development. Thus human capital development is one of the fundamental solutions to enter the international arena. Both quantitative and qualitative analyses were used to demonstrate the effect of selected human capital indices and related literatures were also reviewed for exposition of the human capital concept. It was found that there are no conscious efforts in human capital planning. This has therefore resulted to continuing dwindling of production system and poverty. Recommendations made to redress the situation include that human capital development should be planned and adequately funded in line with the needs of the economy and by applying international standards. Specifically, developing countries must invest necessary resources in developing human capital which tend to have a great impact on sustainable development. Information about the labour market should improve while government policy should favour labour mobility. HCD strategy must focus on improving the skills of the workforce, reducing the cost of doing business and making available the resources business needs to compete and thrive in a fast globalizing economy. There should be regular interaction of planners, employers and builders of human capital to facilitate the process of meaningful national development.

Keywords: economic development, human capital, economic growth, developing countries

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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