Search results for: life cycle sustainability assessment

Authors: Babarina Maria, Andropova Margarita

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Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Gabriel I. Oke, Faremi O. Ayodeji

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Background: Access to youth Friendly Health Corners is vital for ensuring sexual reproductive health and total well being of young Adults since human sexuality has been widely misunderstood. Meanwhile, behavior of young people towards it remains at variance with the alarm. This study attempt to access the impact of youth corners also called Adolescent Friendly Health Corners on manifestation of human sexual behavior among Nigerian adolescent and young adults. Description: Hundred young adults and adolescents of both sex between the Age range of 12-25years were randomly selected from 5 secondary schools and 3 prominent universities in Southwestern Nigeria and focal group discussions (FGD) were conducted among them. Fifty secondary and primary health facilities were visited between February and June 2017 to conduct interviews for health workers and to ascertain the presence or absence of youth corners. Results: 95% of the health facilities visited lack Youth Corners section neither are they willing to make provision for it due to lack of workmanship and sponsorship. However, 5% with Youth corners does not have well-trained Counselors or a Health Educator but health professionals from nursing profession. 90% of the respondents of which 16-17 years of Age is the mean age had their first sexual exposure with no use of protection even before been introduced to what Sexuality is all about. Virtually, none of the respondents had ever visited a Youth Corner before or heard the term before. 86% have heard about the term STI before of which 60% are using protection, 10% care less about any information attached to the term STI, 4% have not heard of the term STI before even when translated to their local dialect. 20% are abstaining as at the time the study was conducted and they attribute their sexual decision to religion and parental influence. Of the age group 20-25, 45% claimed they have had symptoms of one STI or the other and 40% claimed they have been tested positive for an STI before of which 12% have positive HIV status. Promiscuous behaviors were found among them before they reach the age 16years with pornography ranking the highest, followed by masturbation. Respondents blame this on peer pressure, the lack of Youth Friendly Centers in their locality and lack of proper Sexual Orientation on time. About half of the respondents make use of contraceptives while others have varying views. We found out that inability to access Youth Friendly Centers amongst the respondents might be one of the singular reasons of their early experimentation of their sex life and lack of healthy sexual lifestyle. (95% CI, P=0.922) Conclusion: The study reveals that a connection between youth Friendly Centers and Prevention of Sexually Transmitted Diseases, therefore more sustainable Friendly Youth Corners with well-trained educators are needed in various Health facilities to checkmate the numerous risks of Young People along the path of adulthood.

Keywords: adolescents, sexually transmitted infections, reproductive health, youth corners

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Authors: Kush Kumar, Varun Joshi

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Slope instability is a major problem of the mountainous region, especially in parts of the Indian Himalayan Region (IHR). The on-going tectonic, rugged topography, steep slope, heavy precipitation, toe erosion, structural discontinuities, and deformation are the main triggering factors of landslides in this region. Besides the loss of life, property, and infrastructure caused by a landslide, it also results in various environmental problems, i.e., degradation of slopes, land use, river quality by increased sediments, and loss of well-established vegetation. The Indian state of Uttarakhand, being a part of the active Himalayas, also faces numerous cases of slope instability. Therefore, the vulnerable landslide zones need to be delineated to safeguard various losses. The study area is focused in Garhwal and Tehri -Garhwal district of Uttarakhand state along National Highway 58, which is a strategic road and also connects the four important sacred pilgrims (Char Dham) of India. The lithology of these areas mainly comprises of sandstone, quartzite of Chakrata formation, and phyllites of Chandpur formation. The greywacke and sandstone rock of Saknidhar formation dips northerly and is overlain by phyllite of Chandpur formation. The present research incorporates the lineament density mapping using remote sensing satellite data supplemented by a detailed field study via kinematic analysis. The DEM data of ALOS PALSAR (12.5 m resolution) is resampled to 10 m resolution and used for preparing various thematic maps such as slope, aspect, drainage, hill shade, lineament, and lineament density using ARCGIS 10.6 software. Furthermore, detailed field mapping, including structural mapping, geomorphological mapping, is integrated for kinematic analysis of the slope using Dips 6.0 software of Rockscience. The kinematic analysis of 40 locations was carried out, among which 15 show the planar type of failure, five-show wedge failure, and rest, 20 show no failures. The lineament density map is overlapped with the location of the unstable slope inferred from kinematic analysis to infer the association of the field information and remote sensing derived information, and significant compatibility was observed. With the help of the present study, location-specific mitigation measures could be suggested. The mitigation measures would be helping in minimizing the probability of slope instability, especially during the rainy season, and reducing the hampering of road traffic.

Keywords: Indian Himalayan Region, kinematic analysis, lineament density mapping, slope instability

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Authors: Lennart Dimberg, Lala Joulha Ian

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Introduction: Overweight (BMI 25-30) and obesity (BMI 30+) have consistently been associated with cardiovascular (CV) risk and death since the Framingham heart study in 1948, and BMI was included in the original Framingham risk score (FRS). Background: Myocardial infarction (MI) poses a serious threat to the patient's life. In addition to BMI, several other indices of overweight have been presented and argued to replace FRS as more relevant measures of CV risk. These indices include waist circumference (WC), waist/hip ratio (WHR), sagittal abdominal diameter (SAD), and sagittal abdominal diameter to height (SADHtR). Specific research question: The research question of this study is to evaluate the interrelationship between the various body measurements, BMI, WC, WHR, SAD, and SADHtR, and which measurement is strongly associated with MI and death. Methods: In 1993, 1,000 middle-aged Caucasian, randomly selected working men of the Swedish Volvo-Renault cohort were surveyed at a nurse-led health examination with a questionnaire, EKG, laboratory tests, blood pressure, height, weight, waist, and sagittal abdominal diameter measurements. Outcome data of myocardial infarction over 28 years come from Swedeheart (the Swedish national myocardial infarction registry) and the Swedish death registry. The Aalen-Johansen and Kaplan–Meier methods were used to estimate the cumulative incidences of MI and death. Multiple logistic regression analyses were conducted to compare BMI with the other four body measurements. The risk for the various measures of obesity was calculated with outcomes of accumulated first-time myocardial infarction and death as odds ratios (OR) in quartiles. The ORs between the 4th and the 1st quartile of each measure were calculated to estimate the association between the body measurement variables and the probability of cumulative incidences of myocardial infarction (MI) over time. Double-sided P values below 0.05 will be considered statistically significant. Unadjusted odds ratios were calculated for obesity indicators, MI, and death. Adjustments for age, diabetes, SBP, and the ratio of total cholesterol/HDL-C and blue/white collar status were performed. Results: Out of 1000 people, 959 subjects had full information about the five different body measurements. Of those, 90 participants had a first MI, and 194 persons died. The study showed that there was a high and significant correlation between the five different body measurements, and they were all associated with CVD risk factors. All body measurements were significantly associated with MI, with the highest (OR=3.6) seen for SADHtR and WC. After adjustment, all but SADHtR remained significant with weaker ORs. As for all-cause mortality, WHR (OR=1.7), SAD (OR=1.9), and SADHtR (OR=1.6) were significantly associated, but not WC and BMI. However, after adjustment, only WHR and SAD were significantly associated with death, but with attenuated ORs.

Keywords: BMI, death, epidemiology, myocardial infarction, risk factor, sagittal abdominal diameter, sagittal abdominal diameter to height, waist circumference, waist-hip ratio

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Authors: Sabeeh Lafta Farhan, Ihsan Abbass Jasim, Sohaib Kareem Al-Mamoori

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This study addresses the subject of transformation of urban structures and how does this transformation affect the character of traditional cities, which represents the research issue. Hence, the research has aimed at studying and learning about the urban structure characteristics and morphological transformation features in the traditional cities centers, and to look for means and methods to preserve the character of those cities. Cities are not merely locations inhabited by a large number of people, they are political and legal entities, in addition to economic activities that distinguish these cities, thus, they are a complex set of institutions, and the transformation in urban environment cannot be recognized without understanding these relationships. The research presumes an existing impact of urbanization on the properties of traditional structure of the Holy City of Najaf. The research has defined urbanization as restructuring and re-planning of urban areas that have lost their functions and bringing them into social and cultural life in the city, to be able to serve economy in order to better respond to the needs of users. Sacred Cities provide the organic connection between acts of worship and dealings and reveal the mechanisms and reasons behind the regulatory nature of the sacred shrine and their role in achieving organizational assimilation of urban morphology. The research has reached a theoretical framework of the particulars of urbanization. This framework has been applied to the historic center of the old city of Najaf, where the most important findings of the research were that the visual and structural dominant presence of holy shrine of Imam Ali (peace be upon him) remains to emphasize the visual particularity, and the main role of the city, which hosts one of the most important Muslim shrines in the world, in addition to the visible golden dome rising above the skyline, and the Imam Ali Mosque the hub and the center for religious activities. Thus, in view of being a place of main importance and a symbol of religious and Islamic culture, it is very important to have the shrine of Imam Ali (AS) prevailing on all zones of re-development in the old city. Consequently, the research underlined that the distinctive and unique character of the city of Najaf did not proceed from nothing, but was achieved through the unrivaled characteristics and features possessed by the city of Najaf alone, which allowed it and enabled it to occupy this status among the Arab and Muslim cities. That is why the activities arising from the development have to enhance the historical role of the city in order to have this development as clear support, strength and further addition to the city assets and its cultural heritage, and not seeing the developmental activities crushing the city urban traditional fabric, cultural heritage and its historical specificity.

Keywords: Iraq, the city of Najaf, heritage, traditional cities, morphological transformation

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Authors: Louise Reyntjens

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The last quarter of the twentieth century was characterized by the emergence of a new kind of terrorism: religiously-inspired terrorism. Islam finds itself at the heart of this new wave, considering the number of international attacks committed by Islamic-inspired perpetrators. With religiously inspired terrorism as an operating framework, governments increasingly rely on immigration law to counter such terrorism. Immigration law seems particularly useful because its core task consists of keeping ‘unwanted’ people out. Islamic terrorists more often than not have an immigrant background and will be subject to immigration law. As a result, immigration law becomes more and more ‘securitized’. The European migration crisis has reinforced this trend. The research explores the human rights consequences of immigration law’s securitization in Europe. For this, the author selected four European countries for a comparative study: Belgium, France, the United Kingdom and Sweden. All these countries face similar social and security issues but respond very differently to them. The United Kingdom positions itself on the repressive side of the spectrum. Sweden on the other hand also introduced restrictions to its immigration policy but remains on the tolerant side of the spectrum. Belgium and France are situated in between. This contribution evaluates the situation in Belgium. Through a series of legislative changes, the Belgian parliament (i) greatly expanded the possibilities of expelling foreign nationals for (vaguely defined) reasons of ‘national security’; (ii) abolished almost all procedural protection associated with this decision (iii) broadened, as an extra security measure, the possibility of depriving individuals condemned of terrorism of their Belgian nationality. Measures such as these are obviously problematic from a human rights perspective; they jeopardize the principle of legality, the presumption of innocence, the right to protection of private and family life and the prohibition on torture. Moreover, this contribution also raises questions about the efficacy of immigration law’s suitability as a counterterrorism instrument. Is it a legitimate step, considering the type of terrorism we face today? Or, is it merely a strategic move, considering the broader maneuvering space immigration law offers and the lack of political resistance governments receive when infringing the rights of foreigners? Even more so, figures demonstrate that today’s terrorist threat does not necessarily stem from outside our borders. Does immigration law then still absorb - if it has ever done so (completely) - the threat? The study’s goal is to critically assess, from a human rights perspective, the counterterrorism strategies European governments have adopted. As most governments adopt a variation of the same core concepts, the study’s findings will hold true even beyond the four countries addressed.

Keywords: Belgium, counterterrorism strategies, human rights, immigration law

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Authors: Tanmaya Pradhan, K. Midhun, M. Joy Thomas

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Increasing the shelf life and improving the quality are important objectives for the success of packaged liquid food industry. One of the methods by which this can be achieved is by deactivating the micro-organisms present in the liquid food through pasteurization. Pasteurization is done by heating, but some serious disadvantages such as the reduction in food quality, flavour, taste, colour, etc. were observed because of heat treatment, which leads to the development of newer methods instead of pasteurization such as treatment using UV radiation, high pressure, nuclear irradiation, pulsed electric field, etc. In recent years the use of the pulsed electric field (PEF) for inactivation of the microbial content in the food is gaining popularity. PEF uses a very high electric field for a short time for the inactivation of microorganisms, for which we require a high voltage pulsed power source. Pulsed power sources used for PEF treatments are usually in the range of 5kV to 50kV. Different pulse shapes are used, such as exponentially decaying and square wave pulses. Exponentially decaying pulses are generated by high power switches with only turn-on capacity and, therefore, discharge the total energy stored in the capacitor bank. These pulses have a sudden onset and, therefore, a high rate of rising but have a very slow decay, which yields extra heat, which is ineffective in microbial inactivation. Square pulses can be produced by an incomplete discharge of a capacitor with the help of a switch having both on/off control or by using a pulse forming network. In this work, a pulsed power-based system is designed with the help of high voltage capacitors and solid-state switches (IGBT) for the inactivation of pathogenic micro-organism in liquid food such as fruit juices. The high voltage generator is based on the Marx generator topology, which can produce variable amplitude, frequency, and pulse width according to the requirements. Liquid food is treated in a chamber where pulsed electric field is produced between stainless steel electrodes using the pulsed output voltage of the supply. Preliminary bacterial inactivation tests were performed by subjecting orange juice inoculated with Escherichia Coli bacteria. With the help of the developed pulsed power source and the chamber, the inoculated orange has been PEF treated. The voltage was varied to get a peak electric field up to 15kV/cm. For a total treatment time of 200µs, a 30% reduction in the bacterial count has been observed. The detailed results and analysis will be presented in the final paper.

Keywords: Escherichia coli bacteria, high voltage generator, microbial inactivation, pulsed electric field, pulsed forming line, solid-state switch

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Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain

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Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.

Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore

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Authors: Benedetta Caglioti

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The ecclesiastical complex of San Paolo in Ferrara represents a monument of great historical, religious and architectural importance. Its long and articulated story, over time, is already manifested by the mere reading of its planimetric and altimetric configuration, apparently unitary but, in reality, marked by modifications and repeated additions, even of high quality. It follows, in terms of protection, restoration and enhancement, a commitment of due respect for how the ancient building was built and enriched over its centuries of life. Hence a rigorous methodological approach, while being aware of the fact that every monument, in order to live and make use of the indispensable maintenance, must always be enjoyed and visited, therefore it must enjoy, in the right measure and compatibly with its nature, the possibility of improvements and functional, distributive, technological adjustments and related to the safety of people and things. The methodological approach substantiates the different elements of the project (such as distribution functionality, safety, structural solidity, environmental comfort, the character of the site, building and urban planning regulations, financial resources and materials, the same organization methods of the construction site) through the guiding principles of restoration, defined for a long time: the 'minimum intervention,' the 'recognisability' or 'distinguishability' of old and new, the Physico-chemical and figurative 'compatibility,' the 'durability' and the, at least potential, 'reversibility' of what is done, leading to the definition of appropriate "critical choices." The project tackles, together with the strictly functional ones, also the directly conservative and restoration issues, of a static, structural and material technology nature, with special attention to precious architectural surfaces, In order to ensure the best architectural quality through conscious enhancement, the project involves a redistribution of the interior and service spaces, an accurate lighting system inside and outside the church and a reorganization of the adjacent urban space. The reorganization of the interior is designed with particular attention to the issue of accessibility for people with disabilities. To accompany the community to regain possession of the use of the church's own space, already in its construction phase, the project proposal has hypothesized a permeability and flexibility in the management of the works such as to allow the perception of the found Monument to gradually become more and more familiar at the citizenship. Once the interventions have been completed, it is expected that the Church of San Paolo, second in importance only to the Cathedral, from which it is a few steps away, will be inserted in an already existing circuit of use of the city which over the years has systematized the different aspects of culture, the environment and tourism for the creation of greater awareness in the perception of what Ferrara can offer in cultural terms.

Keywords: conservation, accessibility, regeneration, urban space

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Authors: Palash Bandyopadhyay

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Background and significance of the study: Crude oil and natural gas is of crucial importance due to its increasing demand in India. The demand has been increased because of change of lifestyle overtime. Since India has poor utilization of oil production capacity, constantly the import of it has been increased progressively day by day. This ultimately hit the foreign exchange reserves of India, however it negatively affect the Indian economy as well. The financial performance of crude oil and natural gas companies in India has been trimmed down year after year because of underutilization of production capacity, enhancement of demand, change in life style, and change in import bill and outflows of foreign currencies. In this background, the current study seeks to measure the financial performance of crude oil and natural gas companies of India in the post liberalization period. Keeping in view of this, this study assesses the financial performance in terms of liquidity management, solvency, efficiency, financial stability, and profitability of the companies under study. Methodology: This research work is encircled on yearly ratio data collected from Centre for Monitoring Indian Economy (CMIE) Prowess database for the periods between 1993-94 and 2012-13 with 20 observations using liquidity, solvency and efficiency indicators, profitability indicators and financial stability indicators of all the major crude oil and natural gas companies in India. In the course of analysis, descriptive statistics, correlation statistics, and linear regression test have been utilized. Major findings: Descriptive statistics indicate that liquidity position is satisfactory in case of three crude oil and natural gas companies (Oil and Natural Gas Companies Videsh Limited, Oil India Limited and Selan exploration and transportation Limited) out of selected companies under study but solvency position is satisfactory only for one company (Oil and Natural Gas Companies Videsh Limited). However, efficiency analysis points out that Oil and Natural Gas Companies Videsh Limited performs effectively the management of inventory, receivables, and payables, but the overall liquidity management is not well. Profitability position is very much satisfactory in case of all the companies except Tata Petrodyne Limited, but profitability management is not satisfactory for all the companies under study. Financial stability analysis shows that all the companies are more dependent on debt capital, which bears a financial risk. Correlation and regression test results illustrates that profitability is positively and negatively associated with liquidity, solvency, efficiency, and financial stability indicators. Concluding statement: Management of liquidity and profitability of crude oil and natural gas companies in India should have been improved through controlling unnecessary imports in spite of the heavy demand of crude oil and natural gas in India and proper utilization of domestic oil reserves. At the same time, Indian government has to concern about rupee depreciation and interest rates.

Keywords: financial performance, crude oil and natural gas companies, India, linear regression

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Authors: Gilda Santos, Rita Marques, Francisca Marques, João Ribeiro, André Fonseca, João M. Miranda, João B. L. M. Campos, Soraia F. Neves

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Every year, an unacceptable number of firefighters are seriously burned during firefighting operations, with some of them eventually losing their life. Although thermal protective clothing research and development has been searching solutions to minimize firefighters heat load and skin burns, currently commercially available solutions focus in solving isolated problems, for example, radiant heat or water-vapor resistance. Therefore, episodes of severe burns and heat strokes are still frequent. Taking this into account, a consortium composed by Portuguese entities has joined synergies to develop an innovative protective clothing system by following a procedure based on the application of numerical models to optimize the design and using a combinationof protective clothing components disposed in different layers. Recently, it has been shown that Phase Change Materials (PCMs) can contribute to the reduction of potential heat hazards in fire extinguish operations, and consequently, their incorporation into firefighting protective clothing has advantages. The greatest challenge is to integrate these materials without compromising garments ergonomics and, at the same time, accomplishing the International Standard of protective clothing for firefighters – laboratory test methods and performance requirements for wildland firefighting clothing. The incorporation of PCMs into the firefighter's protective jacket will result in the absorption of heat from the fire and consequently increase the time that the firefighter can be exposed to it. According to the project studies and developments, to favor a higher use of the PCM storage capacityand to take advantage of its high thermal inertia more efficiently, the PCM layer should be closer to the external heat source. Therefore, in this stage, to integrate PCMs in firefighting clothing, a mock-up of a vest specially designed to protect the torso (back, chest and abdomen) and to be worn over a fire-resistant jacketwas envisaged. Different configurations of PCMs, as well as multilayer approaches, were studied using suitable joining technologies such as bonding, ultrasound, and radiofrequency. Concerning firefighter’s protective clothing, it is important to balance heat protection and flame resistance with comfort parameters, namely, thermaland water-vapor resistances. The impact of the most promising solutions regarding thermal comfort was evaluated to refine the performance of the global solutions. Results obtained with experimental bench scale model and numerical simulation regarding the integration of PCMs in a vest designed as protective clothing for firefighters will be presented.

Keywords: firefighters, multilayer system, phase change material, thermal protective clothing

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Authors: Amit Sarkar, Jayanta K. Mahato, Tushar Bhattacharya, Amrita Kundu, P. C. Chakraborti

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With increasing the demand for safety and fuel efficiency of automobiles, automotive manufacturers are looking for light weight, high strength steel with excellent formability and corrosion resistance. Dual-phase steel is finding applications in automotive sectors, because of its high strength, good formability, and high corrosion resistance. During service automotive components suffer from environmental attack and thereby gradual degradation of the components occurs reducing the service life of the components. The objective of the present investigation is to assess the effect of deformation on corrosion behaviour of DP590 grade dual phase steel which is used in automotive industries. The material was received from TATA Steel Jamshedpur, India in the form of 1 mm thick sheet. Tensile properties of the steel at strain rate of 10-3 sec-1: 0.2 % Yield Stress is 382 MPa, Ultimate Tensile Strength is 629 MPa, Uniform Strain is 16.30% and Ductility is 29%. Rectangular strips of 100x10x1 mm were machined keeping the long axis of the strips parallel to rolling direction of the sheet. These strips were longitudinally deformed at a strain rate at 10-3 sec-1 to a different percentage of strain, e.g. 2.5, 5, 7.5,10 and 12.5%, and then slowly unloaded. Small specimens were extracted from the mid region of the unclamped portion of these deformed strips. These small specimens were metallographic polished, and corrosion behaviour has been studied by potentiodynamic polarization, electrochemical impedance spectra, and cyclic polarization and potentiostatic tests. Present results show that among three different environments, the 3.5 pct NaCl solution is most aggressive in case of DP 590 dual-phase steel. It is observed that with the increase in the amount of deformation, corrosion rate increases. With deformation, the stored energy increases and leads to enhanced corrosion rate. Cyclic polarization results revealed highly deformed specimen are more prone to pitting corrosion as compared to the condition when amount of deformation is less. It is also observed that stability of the passive layer decreases with the amount of deformation. With the increase of deformation, current density increases in a passive zone and passive zone is also decreased. From Electrochemical impedance spectroscopy study it is found that with increasing amount of deformation polarization resistance (Rp) decreases. EBSD results showed that average geometrically necessary dislocation density increases with increasing strain which in term increased galvanic corrosion as dislocation areas act as the less noble metal.

Keywords: dual phase 590 steel, prestrain, potentiodynamic polarization, cyclic polarization, electrochemical impedance spectra

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Authors: Mokhlisur Rahman

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The growing consensus among scientists and world leaders indicates that immediate action should be considered regarding the climate change phenomenon. However, climate change is no more a global issue but a personal one. Thus, individual participation is necessary to address such a significant issue. Studies show that individuals who perceive climate change as a personal issue are more likely to act toward it. This abstract presents augmented reality (A.R.) technology in the social media platform Facebook video advertising. The idea involves creating a video advertisement that enables users to interact with the video by navigating its features and experiencing the result uniquely and engagingly. This advertisement uses A.R. to bring changes, such as people making changes in real-life scenarios by simple clicks on the video and hearing an instant rewarding fact about their choices. The video shows three options: room, lawn, and driveway. Users select one option and engage in interaction based on while holding the camera in their personal spaces: Suppose users select the first option, room, and hold their camera toward spots such as by the windows, balcony, corners, and even walls. In that case, the A.R. offers users different plants appropriate for those unoccupied spaces in the room. Users can change the options of the plants and see which space at their house deserves a plant that makes it more natural. When a user adds a natural element to the video, the video content explains a piece of beneficiary information about how the user contributes to the world more to be livable and why it is necessary. With the help of A.R., if users select the second option, lawn, and hold their camera toward their lawn, the options are various small trees for their lawn to make it more environmentally friendly and decorative. The video plays a beneficiary explanation here too. Suppose users select the third option, driveway, and hold their camera toward their driveway. In that case, the A.R. video option offers unique recycle bin designs using A.I. measurement of spaces. The video plays audio information on anthropogenic contribution to greenhouse gas emission. IoT embeds tracking code in the video ad on Facebook, which stores the exact number of views in the cloud for data analysis. An online survey at the end collects short qualitative answers. This study helps understand the number of users involved and willing to change their behavior; It makes personalized advertising in social media. Considering the current state of climate change, the urgency for action is increasing. This ad increases the chance to make direct connections with individuals and gives a sense of personal responsibility for climate change to act

Keywords: motivations, climate, iot, personalized-advertising, action

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Authors: Fouad Mrad, Viviane Zaccour

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The accelerated developments in the political, economic, environmental, security, health, and social folders are exhausting planners across the world, especially in Arab countries. The impact of the tension is multifaceted and has resulted in conflicts, wars, migration, and human insecurity. The potential cross-cutting role that science, innovation and technology can play in supporting Arab societies to address these pressing challenges is a serious, unique chance for the people of the region. This opportunity is based on the existing capacity of educated youth and inaccessible talents in the local universities and research centers. It has been accepted that Arab countries have achieved major advancements in the economy, education and social wellbeing since the 70s of the 20th Century. Mainly direct outcome of the oil and other natural resources. The UN Secretary-General, during the Education Summit in Sep 2022, stressed that “Learning continues to underplay skills, including problem-solving, critical thinking and empathy.” Stars of Science by Qatar Foundation was launched in 2009 and has been sustained through 2023. Consistent mission from the start: To mobilize a new generation of Pan-Arab innovators and problem solvers by encouraging youth participation and interest in Science, Technology and Entrepreneurship throughout the Arab world via the program and its social media activities. To make science accessible and attractive to mass audiences by de-mystifying the process of innovation. Harnessing best practices within reality TV to show that science, engineering, and innovation are important in everyday life and can be fun.” Thousands of Participants learned unforgettable lessons; winners changed their lives forever as they learned and earned seed capital; they became drivers of change in their countries and families; millions of viewers were exposed to an innovative experimental process, and culturally, several relevant national institutions adopted the SOS track in their national initiatives. The program exhibited experientially youth self-efficacy as the most distinct core property of human agency, which is an individual's belief in his or her capacity to execute behaviors necessary to produce specific performance attainments. In addition, the program proved that innovations are performed by networks of people with different sets of technological, useful knowledge, skills and competencies introduced by socially shared technological knowledge as a main determinant of economic activities in any economy.

Keywords: science, invention, innovation, Qatar foundation, QSTP, prototyping

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Authors: Ilona Buchem, Carolin Gellner

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Over the last few years, the call for the support of senior learners in the development of their digital literacy has become prevalent, mainly due to the progression towards ageing societies paired with advances in digitalisation in all spheres of life, including e-health and electronic patient record (EPA). While major research efforts in supporting senior learners in developing digital literacy have been invested so far in e-learning focusing on knowledge acquisition and cognitive tasks, little research exists in learning models which target virtual mentoring and coaching with the help of pedagogical agents and address the social dimensions of learning. Research from studies with students in the context of formal education has already provided methods for designing intelligent virtual agents in support of personalised learning. However, this research has mostly focused on cognitive skills and has not yet been applied to the context of mentoring/coaching of senior learners, who have different characteristics and learn in different contexts. In this paper, we describe how insights from previous research can be used to develop an intelligent virtual learning coach (agent) for senior learners with a focus on building the social relationship between the agent and the learner and the key task of the agent to socialize learners to the larger context of digital literacy with a focus on electronic health records. Following current approaches to mentoring and coaching, the agent is designed not to enhance and monitor the cognitive performance of the learner but to serve as a trusted friend and advisor, whose role is to provide one-to-one guidance and support sharing of experiences among learners (peers). Based on literature review and synopsis of research on virtual agents and current coaching/mentoring models under consideration of the specific characteristics and requirements of senior learners, we describe the design framework which was applied to design an intelligent virtual learning coach as part of the e-learning system for digital literacy of senior learners in the ePA-Coach project founded by the German Ministry of Education and Research. This paper also presents the results from the evaluation study, which compared the use of the first prototype of the virtual learning coach designed according to the design framework with a voice narration in a multimedia learning environment with senior learners. The focus of the study was to validate the agent design in the context of the persona effect (Lester et al., 1997). Since the persona effect is related to the hypothesis that animated agents are perceived as more socially engaging, the study evaluated possible impacts of agent coaching in comparison with voice coaching on motivation, engagement, experience, and digital literacy.

Keywords: virtual learning coach, virtual mentor, pedagogical agent, senior learners, digital literacy, electronic health records

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Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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Authors: Neha Batra Bali, Monika Tomar, Vinay Gupta

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A reagentless biosensor for detection of urea based on ZnO-CuO composite thin film is presented in following work. Biosensors have immense potential for varied applications ranging from environmental to clinical testing, health care, and cell analysis. Immense growth in the field of biosensors is due to the huge requirement in today’s world to develop techniques which are both cost effective and accurate for prevention of disease manifestation. The human body comprises of numerous biomolecules which in their optimum levels are essential for functioning. However mismanaged levels of these biomolecules result in major health issues. Urea is one of the key biomolecules of interest. Its estimation is of paramount significance not only for healthcare sector but also from environmental perspectives. If level of urea in human blood/serum is abnormal, i.e., above or below physiological range (15-40mg/dl)), it may lead to diseases like renal failure, hepatic failure, nephritic syndrome, cachexia, urinary tract obstruction, dehydration, shock, burns and gastrointestinal, etc. Various metal nanoparticles, conducting polymer, metal oxide thin films, etc. have been exploited to act as matrix to immobilize urease to fabricate urea biosensor. Amongst them, Zinc Oxide (ZnO), a semiconductor metal oxide with a wide band gap is of immense interest as an efficient matrix in biosensors by virtue of its natural abundance, biocompatibility, good electron communication feature and high isoelectric point (9.5). In spite of being such an attractive candidate, ZnO does not possess a redox couple of its own which necessitates the use of electroactive mediators for electron transfer between the enzyme and the electrode, thereby causing hindrance in realization of integrated and implantable biosensor. In the present work, an effort has been made to fabricate a matrix based on ZnO-CuO composite prepared by pulsed laser deposition (PLD) technique in order to incorporate redox properties in ZnO matrix and to utilize the same for reagentless biosensing applications. The prepared bioelectrode Urs/(ZnO-CuO)/ITO/glass exhibits high sensitivity (70µAmM⁻¹cm⁻²) for detection of urea (5-200 mg/dl) with high stability (shelf life ˃ 10 weeks) and good selectivity (interference ˂ 4%). The enhanced sensing response obtained for composite matrix is attributed to the efficient electron exchange between ZnO-CuO matrix and immobilized enzymes, and subsequently fast transfer of generated electrons to the electrode via matrix. The response is encouraging for fabricating reagentless urea biosensor based on ZnO-CuO matrix.

Keywords: biosensor, reagentless, urea, ZnO-CuO composite

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Authors: Igone Guerra, Xabier Barandiaran

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The deep crisis (economic, social and cultural) in which Europe and Gipuzkoa, in the Basque Country (Spain), have been immersed in since 2008 forces governments to face a necessary transformation. These challenges demand different solutions and answers to meet the needs of the citizens. Adapting to continuous and sometimes abrupt changes in the social and political landscape requires an undeniable will to reinvent the way in which governments practice politics. This reinvention of government should help us build different organizations that, first, develop challenging public services, second, respond effectively to the needs of the citizens, and third, manage scarce resources, ultimately offering a contemporary concept of public value. In this context, the Etorkizuna Eraikiz initiative was designed to face the future challenges of the territory in a collaborative way. The aim of the initiative is to promote an alternative form of governance to generate common good and greater public value. In Etorkizuna Eraikiz democratic values, such as collaboration, participation, and accountability are prominent. This government approach is based on several features such as the creation of relational spaces to design and deliberate about the public politics or the promotion of a team-working approach, breaking down the silos between and within organizations, as an exercise in defining a shared vision regarding the Future of the Territory. A future in which the citizens are becoming actors in the problem-solving process and in the construction of a culture of participation and collective learning. In this paper, the Etorkizuna Eraikiz initiative will be presented (vision and methodology) as a model of a local approach to public policy innovation resulting in a way of governance that is more open and collaborative. Based on this case study, this paper explores the way in which collaborative governance leads to better decisions, better leadership, and better citizenry. Finally, the paper also describes some preliminary findings of this local approach, such as the level of knowledge of the citizenry about the projects promoted within Etorkizuna Eraikiz as well as the link between the challenges of the territory, as identified by the citizenry, and the political agenda promoted by the provincial government. Regarding the former, the Survey on the socio-political situation of Gipuzkoa showed that 27.9% of the respondents confirmed that they knew about the projects promoted within the initiative and gave it a mark of 5.71. In connection with the latter, over the last three years, 65 millions of euros have been allocated for a total of 73 projects that have covered socio-economic and political challenges such as aging, climate change, mobility, participation in democratic life, and so on. This governance approach of Etorkizuna Eraikiz has allowed the local government to match the needs of citizens to the political agenda fostering in this way a shared vision about the public value.

Keywords: collaborative governance, citizen participation, public good, social listening, public innovation

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Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

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Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

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Authors: Chamaraja Parulli

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Family is an important social institution devoted to the growth of a child, and parents are the important agents of socialization. Mentally challenged children are those who are affected by intellectual disability, which is manifested by limitation in intellectual functioning and adoptive behavior. Intellectual disability affects about 3-4 percentage of the general population. Intellectual disability is caused by genetic condition, problems during pregnancy, problems during childbirth, or illness. Mental retardation is the world’s most complex and challenging issue. The stigmatization of disability results in social and economic marginalization. Parents of the mentally challenged children will have a very high level of parenting stress, which is significantly more than the stress perceived by the parents of the children without disability. The prevalence of severe mental disorder called Schizophrenia is among 1.1 percent of the total population in India. On the other hand, 11 to 12 percent is the overall lifetime occurrence rate of mental disorders. While the government has a separate program for mental health, the segment is marred by lack of adequate doctors and infrastructure. Mentally retarded children have certain limitations in mental functioning and skills, which makes them slow learners in speaking, walking, and taking care of their personal needs such as dressing and eating. Accepting a child with mental handicap becomes difficult for parents and to the whole family, as they have to face many problems, including those of management, finance, deprivation of rest, and leisure. Also, the problems faced by the parents can be seen in different areas like – educational, psychological, social, emotional, financial and family related issues. The study brought out various difficulties and problems faced by the parents as well as family members. The findings revealed that the mental retardation is not only a medico-psychological problem but also a socio-cultural problem. The study results, however, indicate that the quality of life of the family having children with mental retardation can be improved to a greater extent by building up a child-friendly ambience at home. The main aim of the present study is to assess the problems faced by the parents of mentally challenged children, with the help of personal interview data collected from the parents of mentally challenged children, residing in Shimoga District of Karnataka State, India. These individuals were selected using stratified random sampling method. Organizing effective intervention programs for parents, family, society, and educational institutions towards reduction of family stress, augmenting the family’s strengths, increasing child’s competence and enhancing the positive attitudes and values of the society will go a long way for the peaceful existence of the mentally challenged children.

Keywords: mentally challenged children, intellectual disability, special children, social infrastructure, differently abled, psychological stress, marginalization

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Authors: M. Moncef Khaddar

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This paper focuses mainly on a contextualized understanding of ‘autocratic authoritarianism’ in Tunisia without approaching its peculiarities in reference to the ideal type of capitalist-liberal democracy but rather analysing it as a Tunisian ‘civilian dictatorship’. This is reminiscent, to some extent, of the French ‘colonial authoritarianism’ in parallel with the legacy of the traditional formal monarchic absolutism. The Tunisian autocratic political system is here construed as a state manufactured nationalist-populist authoritarianism associated with a de facto presidential single party, two successive autocratic presidents and their subservient autocratic elites who ruled with an iron fist the de-colonialized ‘liberated nation’ that came to be subjected to a large scale oppression and domination under the new Tunisian Republic. The diachronic survey of Tunisia’s autocratic authoritarian system covers the early years of autocracy, under the first autocratic president Bourguiba, 1957-1987, as well as the different stages of its consolidation into a police-security state under the second autocratic president, Ben Ali, 1987-2011. Comparing the policies of authoritarian regimes, within what is identified synchronically as a bi-cephalous autocratic system, entails an in-depth study of the two autocrats, who ruled Tunisia for more than half a century, as modern adaptable autocrats. This is further supported by an exploration of the ruling authoritarian autocratic elites who played a decisive role in shaping the undemocratic state-society relations, under the 1st and 2nd President, and left an indelible mark, structurally and ideologically, on Tunisian polity. Emphasis is also put on the members of the governmental and state-party institutions and apparatuses that kept circulating and recycling from one authoritarian regime to another, and from the first ‘founding’ autocrat to his putschist successor who consolidated authoritarian stability, political continuity and autocratic governance. The reconfiguration of Tunisian political life, in the post-autocratic era, since 2011 will be analysed. This will be scrutinized, especially in light of the unexpected return of many high-profile figures and old guards of the autocratic authoritarian apparatchiks. How and why were, these public figures, from an autocratic era, able to return in a supposedly post-revolutionary moment? Finally, while some continue to celebrate the putative exceptional success of ‘democratic transition’ in Tunisia, within a context of ‘unfinished revolution’, others remain perplexed in the face of a creeping ‘oligarchic transition’ to a ‘hybrid regime’, characterized rather by elites’ reformist tradition than a bottom-up genuine democratic ‘change’. This latter is far from answering the 2010 ordinary people’s ‘uprisings’ and ‘aspirations, for ‘Dignity, Liberty and Social Justice’.

Keywords: authoritarianism, autocracy, democratization, democracy, populism, transition, Tunisia

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Authors: Naava Dihi, Jon Anson

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Love, so it appears, is not socially blind. We show that partner selection is socially constrained, and the freedom to choose is limited by at least two major factors or capitals: on the one hand, material resources and education, locating the partners on a scale of personal achievement and economic independence. On the other, the partners' ascriptive belonging to particular ethnic, or origin, groups, differentiated by the groups' social prestige, as well as by their culture, history and even physical characteristics. However, the relative importance of achievement and ascriptive factors, as well as the overlap between them, varies from society to society, depending on the society's structure and the factors shaping it. Israeli social structure has been shaped by the waves of new immigrants who arrived over the years. The timing of their arrival, their patterns of physical settlement and their occupational inclusion or exclusion have together created a mosaic of social groups whose principal common feature has been the country of origin from which they arrived. The analysis of marriage patterns helps illuminate the social meanings of the groups and their borders. To the extent that ethnic group membership has meaning for individuals and influences their life choices, the ascriptive factor will gain in importance relative to the achievement factor in their choice of marriage partner. In this research, we examine Jewish Israeli marriage patterns by looking at the marriage choices of 5,041 women aged 15 to 49 who were single at the census in 1983, and who were married at the time of the 1995 census, 12 years later. The database for this study was a file linking respondents from the 1983 and the 1995 censuses. In both cases, 5 percent of household were randomly chosen, so that our sample includes about 4 percent of women in Israel in 1983. We present three basic analyses: (1) Who was still single in 1983, using personal and household data from the 1983 census (binomial model), (2) Who married between 1983 and a1995, using personal and household data from the 1983 census (binomial model), (3) What were the personal characteristics of the womens’ partners in 1995, using data from the 1995 census (loglinear model). We show (i) that material and cultural capital both operate to delay marriage and to increase the probability of remaining single; and (ii) while there is a clear association between ethnic group membership and education, endogamy and homogamy both operate as separate forces which constraint (but do not determine) the choice of marriage partner, and thus both serve to reproduce the current pattern of relationships, as well as identifying patterns of proximity and distance between the different groups.

Keywords: Israel, nuptiality, ascription, achievement

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Authors: George Hanna Abdelmelek Henien

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Quality and safety issues are common in Ethiopia's food processing industry, which can negatively impact consumers' health and livelihoods. The country is known for its various agricultural products that are important to the economy. However, food quality and safety policies and management practices in the food processing industry have led to many health problems, foodborne illnesses and economic losses. This article aims to show the causes and consequences of food safety and quality problems in the food processing industry in Ethiopia and discuss possible solutions to solve them. One of the main reasons for food quality and safety in Ethiopia's food processing industry is the lack of adequate regulation and enforcement mechanisms. Inadequate food safety and quality policies have led to inefficiencies in food production. Additionally, the failure to monitor and enforce existing regulations has created a good opportunity for unscrupulous companies to engage in harmful practices that endanger the lives of citizens. The impact on food quality and safety is significant due to loss of life, high medical costs, and loss of consumer confidence in the food processing industry. Foodborne diseases such as diarrhoea, typhoid and cholera are common in Ethiopia, and food quality and safety play an important role in . Additionally, food recalls due to contamination or contamination often cause significant economic losses in the food processing industry. To solve these problems, the Ethiopian government began taking measures to improve food quality and safety in the food processing industry. One of the most prominent initiatives is the Ethiopian Food and Drug Administration (EFDA), which was established in 2010 to monitor and control the quality and safety of food and beverage products in the country. EFDA has implemented many measures to improve food safety, such as carrying out routine inspections, monitoring the import of food products and implementing labeling requirements. Another solution that can improve food quality and safety in the food processing industry in Ethiopia is the implementation of food safety management system (FSMS). FSMS is a set of procedures and policies designed to identify, assess and control food safety risks during food processing. Implementing a FSMS can help companies in the food processing industry identify and address potential risks before they harm consumers. Additionally, implementing an FSMS can help companies comply with current safety and security regulations. Consequently, improving food safety policy and management system in Ethiopia's food processing industry is important to protect people's health and improve the country's economy. . Addressing the root causes of food quality and safety and implementing practical solutions that can help improve the overall food safety and quality in the country, such as establishing regulatory bodies and implementing food management systems.

Keywords: food quality, food safety, policy, management system, food processing industry food traceability, industry 4.0, internet of things, block chain, best worst method, marcos

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Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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Authors: Bagam Venkateswarlu

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NMDC Limited, Indian multinational mining company operates under administrative control of Ministry of Steel, Government of India. This study is undertaken to evaluate how sustainable mining practiced by the company fulfils the provisions of Indian Constitution to secure to its citizen – justice, equality of status and opportunity, promoting social, economic, political, and religious wellbeing. The Constitution of India lays down a road map as to how the goal of being a “Welfare State” shall be achieved. The vision of sustainable mining being practiced is oriented along the constitutional responsibilities on Indian Citizens and the Corporate World. This qualitative study shall be backed by quantitative studies of National Mineral Development Corporation performances in various domains of sustainable mining and ESG, that is, environment, social and governance parameters. For example, Five Star Rating of mine is a comprehensive evaluation system introduced by Ministry of Mines, Govt. of India is one of the methodologies. Corporate Social Responsibilities is one of the thrust areas for securing social well-being. Green energy initiatives in and around the mines has given the title of “Eco-Friendly Miner” to NMDC Limited. While operating fully mechanized large scale iron ore mine (18.8 million tonne per annum capacity) in Bacheli, Chhattisgarh, M/s NMDC Limited caters to the needs of mineral security of State of Chhattisgarh and Indian Union. It preserves forest, wild-life, and environment heritage of richly endowed State of Chhattisgarh. In the remote and far-flung interiors of Chhattisgarh, NMDC empowers the local population by providing world class educational & medical facilities, transportation network, drinking water facilities, irrigational agricultural supports, employment opportunities, establishing religious harmony. All this ultimately results in empowered, educated, and improved awareness in population. Thus, the basic tenets of constitution of India- secularism, democracy, welfare for all, socialism, humanism, decentralization, liberalism, mixed economy, and non-violence is fulfilled. Constitution declares India as a welfare state – for the people, of the people and by the people. The sustainable mining practices by NMDC are in line with the objective. Thus, the purpose of study is fully met with. The potential benefit of the study includes replicating this model in existing or new establishments in various parts of country – especially in the under-privileged interiors and far-flung areas which are yet to see the lights of development.

Keywords: ESG values, Indian constitution, NMDC limited, sustainable mining, CSR, green energy

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Authors: Danish Gadda

Abstract:

Kashmir has been a bleeding-spot in the South Asian politics since 1947 when the subcontinent was bifurcated into Hindu, India and Muslim Pakistan by the departing British colonisers. Kashmir couldn’t accede to either of the two new-born, sovereign nations until tribal invasion from Pakistan forced an unfortunate change of events. India, driven by conditional accession signed by the Kashmir’s last monarch, sent its army to defend Kashmir Valley, with a promise, made subsequently, that the region’s fate would be decided by the natives through an internationally-monitored plebiscite. The country, however, broke its promise, choosing not to withdraw its military to allow the plebiscite, and, instead, strengthened its claim over Kashmir, which it later started describing as her integral part. War, fought in the shape of three and a half bloody battles, ensued between India and Pakistan, even as the United Nations’ intervention managed a ceasefire as early as in the 1950s, though not before Kashmir had come to be divided into its India-controlled and Pakistan-controlled halves. Prolonged, the dispute over Kashmir took a violent turn in 1989-90 with the start of an anti-India armed rebellion. Kashmiris have been fighting for their right to self-determination, and bringing their own life to a grinding halt has been one of their preferred forms of protest against the Indian rule. This form of resistance is locally called ‘Hartals’, and recognised as shutdowns, which have often been prolonged and violent. Since 1989-90, the shutdowns have become only more frequent and forceful, and there are marked days on which Kashmir shuts down in protest every year, like a ritual. This paper is based on a study of how the Indian and Kashmir press covered the shutdowns observed in the troubled valley on four such days: January 26 (Indian Republic Day), February 11 (the day on which India executed a prominent Kashmiri resistance leader), August 15 (India’s Independence Day), and October 27 (the day on which the Indian military has landed in Kashmir). The coverage given by the Indian and Kashmiri press to the shutdowns observed on these days has been studied using the multi-tier content analysis approach: 1) Difference in the number of shutdowns covered by the two section is looked at, 2) the placement of the stories in the two section of the press is analysed, 3) the discourse highlighted by the two section of the press is compared, and 4) the editorials written by the two section of the press about the shutdowns are analysed. The findings show the Indian and the local press have been focussing on the two, predictable extremes of the situation: the Indian press has favoured the state, while the Kashmir or the local press has focussed on the narrative opposing the state’s. The difference is noticed in the quantitative as well as the qualitative aspects of their coverage.

Keywords: Indo-Pak tension, Kashmir conflict, protest shutdowns, South-Asian politics

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Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

Abstract:

Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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Authors: Angeliki Gkiouzeli, Christine Rotonda, Elise Eby, Claire Touchet, Marie-Jo Brennstuhl, Cyril Tarquinio

Abstract:

Resilience is a psychological concept of possible relevance to the development and maintenance of chronic pain (CP). It refers to the ability of individuals to maintain reasonably healthy levels of physical and psychological functioning when exposed to an isolated and potentially highly disruptive event. Extensive research in recent years has supported the importance of this concept in the CP literature. Increased levels of resilience were associated with lower levels of perceived pain intensity and better mental health outcomes in adults with persistent pain. The ongoing project seeks to include the concept of pain-specific resilience in the French literature in order to provide more appropriate measures for assessing and understanding the complexities of CP in the near future. To the best of our knowledge, there is currently no validated version of the pain-specific resilience measure, the Pain Resilience scale (PRS), for French-speaking populations. Therefore, the present work aims to address this gap, firstly by performing a linguistic and cultural translation of the scale into French and secondly by studying the internal validity and reliability of the PRS for French CP populations. The forward-translation-back translation methodology was used to achieve as perfect a cultural and linguistic translation as possible according to the recommendations of the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) group, and an online survey is currently conducted among a representative sample of the French population suffering from CP. To date, the survey has involved one hundred respondents, with a total target of around three hundred participants at its completion. We further seek to study the metric properties of the French version of the PRS, ''L’Echelle de Résilience à la Douleur spécifique pour les Douleurs Chroniques'' (ERD-DC), in French patients suffering from CP, assessing the level of pain resilience in the context of CP. Finally, we will explore the relationship between the level of pain resilience in the context of CP and other variables of interest commonly assessed in pain research and treatment (i.e., general resilience, self-efficacy, pain catastrophising, and quality of life). This study will provide an overview of the methodology used to address our research objectives. We will also present for the first time the main findings and further discuss the validity of the scale in the field of CP research and pain management. We hope that this tool will provide a better understanding of how CP-specific resilience processes can influence the development and maintenance of this disease. This could ultimately result in better treatment strategies specifically tailored to individual needs, thus leading to reduced healthcare costs and improved patient well-being.

Keywords: chronic pain, pain measure, pain resilience, questionnaire adaptation

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