Search results for: power quality recognition

Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Kgabo H. Badimo, Sheryl Buckley

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Knowledge is increasingly recognised in this, the knowledge era, as a strategic resource, by public sector organisations, in view of the public sector reform initiatives. People and knowledge play a vital role in attaining improved organisational performance and high service quality. Many government departments in the public sector have started to realise the importance of knowledge management in streamlining their operations and processes. This study focused on knowledge management in the public healthcare service organisations, where the concept of service provider competitiveness pales to insignificance, considering the huge challenges emanating from the healthcare and public sector reforms. Many government departments are faced with challenges of improving organisational performance and service delivery, improving accountability, making informed decisions, capturing the knowledge of the aging workforce, and enhancing partnerships with stakeholders. The purpose of this paper is to examine the knowledge management practices of the Gauteng Department of Health in South Africa, in order to understand how knowledge management practices influence improvement in organisational performance and healthcare service delivery. This issue is explored through a review of literature on dominant views on knowledge management and healthcare service delivery, as well as results of interviews with, and questionnaire responses from, the general staff of the Gauteng Department of Health. Web-based questionnaires, face-to-face interviews and organisational documents were used to collect data. The data were analysed using both the quantitative and qualitative methods. The central question investigated was: To what extent can the conditions required for successful knowledge management be observed, in order to improve organisational performance and healthcare service delivery in the Gauteng Department of Health. The findings showed that the elements of knowledge management capabilities investigated in this study, namely knowledge creation, knowledge sharing and knowledge application, have a positive, significant relationship with all measures of organisational performance and healthcare service delivery. These findings thus indicate that by employing knowledge management principles, the Gauteng Department of Health could improve its ability to achieve its operational goals and objectives, and solve organisational and healthcare challenges, thereby improving organisational.

Keywords: knowledge management, Healthcare Service Delivery, public healthcare, public sector

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Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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Authors: N. B. Ikenweiwe, A. A. Alimi, N. A. Bamidele, A. O. Ewumi, J. Dairo, I. A. Akinnubi, S. O. Otubusin

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A study on the physical, chemical and biological parameters of the lower course of Ogun River, Isheri-Olofin was carried out between January and December 2014 in order to determine the effects of the anthropogenic activities of the Kara abattoir and domestic waste depositions on the quality of the water. Water samples were taken twice each month at three selected stations A, B and C (based on characteristic features or activity levels) along the water course. Samples were analysed using standard methods for chemical and biological parameters the same day in the laboratory while physical parameters were determined in-situ with water parameters kit. Generally, results of Transparency, Dissolved Oxygen, Nitrates, TDS and Alkalinity fall below the permissible limits of WHO and FEPA standards for drinking and fish production. Results of phosphates, lead and cadmium were also low but still within the permissible limit. Only Temperature and pH were within limit. Low plankton community, (phytoplankton, zooplankton), which ranges from 3, 5 to 40, 23 were as a result of low levels of DO, transparency and phosphate. The presence of coliform bacteria of public health importance like Escherichia coli, Proteus vulgaris, Aeromonas sp., Shigella sp, Enterobacter aerogenes as well as gram negative bacteria Proteus morganii are mainly indicators of faecal pollution. Fish and other resources obtained from this water stand the risk of being contaminated with these organisms and man is at the receiving end. The results of the physical, chemical and some biological parameters of Isheri, Ogun River, according to this study showed that the live forms of aquatic and fisheries resources there are dwelling under stress as a result of deposition of bones, horns, faecal components, slurry of suspended solids, fat and blood into the water. Government should therefore establish good monitoring system against illegal waste depositions and create education programmes that will enlighten the community on the social, ecological and economic values of the river.

Keywords: water parameters, Isheri Ogun river, anthropogenic activities, Kara abattoir

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Authors: M. Masroor Akhtar Khan, Moin Uddin, Lalit Varshney

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Recently, there has been a rapidly expanding interest in finding applications of natural polymers in view of value addition to agriculture. It is now being realized that radiation processing of natural polysaccharides can be beneficially utilized either to improve the existing methodologies used for processing the natural polymers or to impart value addition to agriculture by converting them into more useful form. Gamma-ray irradiation is employed to degrade and lower the molecular weight of some of the natural polysaccharides like alginates, chitosan and carrageenan into small sized oligomers. When these oligomers are applied to plants as foliar sprays, they elicit various kinds of biological and physiological activities, including promotion of plant growth, seed germination, shoot elongation, root growth, flower production, suppression of heavy metal stress, etc. Furthermore, application of these oligomers can shorten the harvesting period of various crops and help in reducing the use of insecticides and chemical fertilizers. In recent years, the oligomers of sodium alginate obtained by irradiating the latter with gamma-rays at 520 kGy dose are being employed. It was noticed that the oligomers derived from the natural polysaccharides could induce growth, photosynthetic efficiency, enzyme activities and most importantly the production of secondary metabolite in the plants like Artemisia annua, Beta vulgaris, Catharanthus roseus, Chrysopogon zizanioides, Cymbopogon flexuosus, Eucalyptus citriodora, Foeniculum vulgare, Geranium sp., Mentha arvensis, Mentha citrata, Mentha piperita, Mentha virdis, Papaver somniferum and Trigonella foenum-graecum. As a result of the application of these oligomers, the yield and/or contents of the active constituents of the aforesaid plants were significantly enhanced. The productivity, as well as quality of medicinal and aromatic plants, may be ameliorated by this novel technique in an economical way as a very little quantity of these irradiated (depolymerised) polysaccharides is needed. Further, this is a very safe technique, as we did not expose the plants directly to radiation. The radiation was used to depolymerize the polysaccharides into oligomers.

Keywords: essential oil, medicinal and aromatic plants, plant production, radiation processed polysaccharides, active constituents

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Authors: M. Achemo, O. Saito

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Jefoure land use system is one of the traditional landscape human settlement patterns, and it is a cultural design and peculiar art of the people of Gurage in Ethiopia via which houses and trees flank roads left and right. Assessment of the multiple benefits of the traditional road that benefit society and development could enhance the understanding of the land use planners and decision makers to pay attention while planning and managing the land use system. Recent trend shows that the Jefoure land use is on the threshold of change as a result of flourishing road networks, overgrazing, and agricultural expansion. This study aimed to evaluate the multiple ecosystem services provided by the Jefoure land use system after characterization of the socio-ecological landscape. Information was compiled from existing data sources such as ordnance survey maps, aerial photographs, recent high resolution satellite imageries, designated questionnaires and interviews, and local authority contacts. The result generated scientific data on the characteristics, ecosystem services provision, and drivers of changes. The cultural landscape has novel characteristics and providing multiple ecosystem services to the community for long period of time. It is serving as road for humans, livestock and vehicles, habitat for plant species, regulating local temperature, climate, runoff and infiltration, and place for meeting, conducting religious and spiritual activities, holding social events such as marriage and mourning, playing station for children and court for football and other traditional games. As a result of its aesthetic quality and scenic beauty, it is considered as recreational place for improving mental and physical health. The study draws relevant land use planning and management solution in the improvement of socio-ecological resilience in the Jefoure land use system. The study suggests the landscape needs to be registrar as heritage site for recognizing the wisdom of the community and enhancing the conservation mechanisms.

Keywords: cultural landscape, ecosystem services, Gurage, Jefoure

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Authors: Hanan K. Hassanein

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Task-based language teaching (TBLT) and focus on form instruction (FFI) methods were proven to improve quality and quantity of immediate language production. However, studies that compare between the effectiveness of the language production when using TBLT versus FFI are very little with results that are not consistent. Moreover, teaching Arabic using TBLT is a new field with few research that has investigated its application inside classrooms. Furthermore, to the best knowledge of the researcher, there are no prior studies that compared teaching Arabic as a foreign language in a classroom setting using computer-assisted task-based language teaching (CATBLT) with computer-assisted form focused language instruction (CAFFI). Accordingly, the focus of this presentation is to display CATBLT and CAFFI tools when teaching Arabic as a foreign language as well as demonstrate an experimental study that aims to identify whether or not CATBLT is a more effective instruction method. The effectiveness will be determined through comparing CATBLT and CAFFI in terms of accuracy, lexical complexity, and fluency of language produced by students. The participants of the study are 20 students enrolled in two intermediate-level Arabic as a foreign language classes. The experiment will take place over the course of 7 days. Based on a study conducted by Abdurrahman Arslanyilmaz for teaching Turkish as a second language, an in-house computer assisted tool for the TBLT and another one for FFI will be designed for the experiment. The experimental group will be instructed using the in-house CATBLT tool and the control group will be taught through the in-house CAFFI tool. The data that will be analyzed are the dialogues produced by students in both the experimental and control groups when completing a task or communicating in conversational activities. The dialogues of both groups will be analyzed to understand the effect of the type of instruction (CATBLT or CAFFI) on accuracy, lexical complexity, and fluency. Thus, the study aims to demonstrate whether or not there is an instruction method that positively affects the language produced by students learning Arabic as a foreign language more than the other.

Keywords: computer assisted language teaching, foreign language teaching, form-focused instruction, task based language teaching

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Authors: Riina I. Bray, Yifan Wang, Nikolas Argiropoulos, Stephanie Robins, John Molot, Kelly Tragash, Lynn M. Marshall, Margaret E. Sears, Marie-Andrée Pigeon, Michel Gaudet, Pierre Auger, Emily Bélanger, Rohini Peris

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Multiple chemical sensitivity (MCS) is a chronic medical condition characterized by intolerances to chemical substances. Since the arrival of the COVID-19 pandemic and associated health measures, people experiencing MCS (PEMCS) are at a heightened risk of environmental exposures associated with cleaners, disinfectants, and sanitizers. Little attention has been paid to the well-being of PEMCS in the context of the COVID-19 pandemic. Objective: This study assesses the lived experiences of Canadian adults with MCS in relation to their living environment, access to healthcare, and levels of perceived social support before and during the pandemic. Methods: A total of 119 PEMCS completed an online questionnaire. McNemar Chi-Squared and Wilcoxon Signed Rank tests were used to evaluate if there were statistically significant changes in participants’ perception of their living environment, access to healthcare, and levels of social support before and after March 11, 2020. Results: Both positive and negative outcomes were noted. Participants reported an increase in exposure to disinfectants/sanitizers that entered their living environment (p<.001). There was a reported decrease in access to a family doctor during the pandemic (p<0.001). Although PEMCS experienced increased social isolation (p<0.001), they also reported an increase in understanding from family (p<0.029) and a decrease in stigma for wearing personal protective equipment (p<0.001). Conclusion: PEMCS reported experiencing: increased exposure to disinfectants or sanitizers, a loss of social support, and barriers in accessing healthcare during the pandemic. However, COVID-19 provided an opportunity to normalize the living conditions of PEMCS, such as wearing masks and social isolation. These findings can guide decision-makers on the importance of implementing nontoxic alternatives for cleaning and disinfection, as well as improving accommodation measures for PEMCS.

Keywords: covid-19, multiple chemical sensitivity, MCS, quality of life, social isolation, physical environment, healthcare

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Authors: Madifedile Thasi, Azola Mayeza

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In South Africa, provision of housing to the growing population has been described as one of the greatest challenges facing the government. Between 1994 to 2015, more than 2.5 million housing units were provided by the government for the poorest households and the low-income earners under the Reconstruction and Development Programme (RDP). Yet, the latest census figure revealed that about 2.1 million households still live in shacks and informal dwellings. Human settlements patterns remain dysfunctional across in South Africa because of rapid urbanisation. The housing backlog is growing at a rate of 178 000 units a year. The aforementioned predicament calls the need for innovative approaches to address the issue in a sustainable way and this need not be overemphasized. Aside from the issue of cost, the delivery of more housing units comes with environmental and sustainability issues. The prefabrication building technology has resulted into accelerated housing delivery to a satisfactory level in some countries such as Nigeria and Malaysia that are facing similar issue. It is therefore expected to be a foremost option to address the social housing backlog in South Africa and within the country housing sustainability agenda. This paper appraises the factors responsible for the limited implementation of prefabrication technology in South African housing projects. The objective is to recommend the method and materials that can be best sustained in the country in terms of local availability, cost effectiveness and environmental friendliness. It presents empirical data to support the hypothesis that a wider implementation of prefabrication technology in the social housing projects will be of significant benefit, by providing fast turnaround, cost-effective and sustainable solution that will dent the housing backlog, as well as improving the quality of the social housings. It was found that only 17 000 units of the RDP housings provided were constructed using alternative building technologies. Furthermore, there are variety of prefabricated technologies in the market but mostly have limited production capacity, minimal manufacturing capacity and most materials are imported, which leads to unavailability of the technology for large scale delivery and utilization despite its obvious advantages.

Keywords: prefabrication technology, sustainable social housings, South Africa, housing delivery

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Authors: Shan Jiang

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China is a country with a distinct cultural system. The Chinese Communist Party (CCP) is the central factor for everything, which naturally includes culture. There are quite a lot of cultural policies in China. The same goes for TV dramas. This paper traces the evolution of Chinese TV drama policy since 1986, examines the realistic situation behind the changes, and explores the structure and role of the government in shaping the process. Using historical documents and media reports, it first analyzes four key time nodes: 1986, 2003, 2012, and 2022. It shows how the policy shifts from restricting private production to opening up to public participation, from imposing one censorship to another, and from promoting some content to restricting some other area. It finds that the policy process is not simply rectilinear but rather wandering between deregulation and strengthening control. Secondly, it divides the policies into "basic" policies that establish the overall layout and more refined "strategic" policies that respond to more refined needs. It argues that the "basic" policy process is caused by China's political, economic, and cultural system reform, and then the "strategic" policy process is affected by more environmental factors, such as the government's follow-up development strategy, industrial development, technological innovation, and specific situations. Thirdly, it analysis the main body of the 104 policies from 2000 to 2021 and puts these subjects into China's power structure and cultural system, revealing that the policy issuers are all under the highest leadership of the Chinese Central Committee. Further, the paper challenges the typical description of Chinese cultural policy, which focuses on state control exclusively, identifies the forces within and outside the system that participate in or affect the policy-making process, and reveals the inter-subjective mechanism of policy change. In conclusion, the paper reveals that China's TV drama policy is under the unified leadership of the Party and the government, which greatly guarantees the consistency of the overall direction of cultural policy, that is, the right to speak firmly in the hands. The forces within the system can sometimes promote policy changes due to common development needs. However, folk discourse is only the object of control: when it breeds a certain amount of industrial space, the government will strengthen control over this space, suppress its potential "adverse effects", and instead provide protection and create conditions for the cultivation and growth of its mainstream discourse. However, the policy combination of basic policy and strategic policy, while having a strong effect and emergency capacity, also inhibits the innovation and diversification of the TV drama market. However, the state's substantial regulation will continue to exist in the future.

Keywords: TV Policy, China, policy process, cultural policy, culture management

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Authors: O. J. Osunkeye, P. O. Fakolade, B. E. Olorede

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Broilers productions depend on the provision of adequate and goo quality feed containing all the nutrients, including proteins, carbohydrate, fats, vitamins, minerals and water. All these nutrients have to be provided at a required amount to support maximum productivity and normal physiological functions and demands. Among these nutrients proteins are particularly important, since they are essential for meat and muscle production, optimum growth and health status. Poultry production industry in the developing countries is been threatened because of the over dependency on Soybean meal as one of the key/major conventional protein stuff for feeding livestock. Even the competition between man and livestock for Soybean and other protein sources made the price of this feed stuff to be on the increase. Hence the needs to seek for an alternative feed stuff which is cheap and less competitive. This study showed the blood profile, organ and carcass characteristics and performance of broilers fed with Cowpea Testa Meal (CTM) based diets. Four diets were formulated with Cowpea Testa replacing Soybean at 0%, 15%, 30%, and 50% graded levels. One hundred and twenty day-old unsexed broiler birds were allotted to these four treatments with 3 replicates of 10 birds per replicate. The results showed no significant differences in all the haematological parameters measured (P>0.05), the serum metabolites analysis revealed significant different in Cholesterol (99.8 mg/dl, 112.84 mg/dl, 131.07 mg/dl and 97.66 mg/dl respectively) (P<0.05) among others. There were significant differences within the diets for average daily weight gain, average feed intake and feed to gain ratio. The birds on control (0%) and CTM gained more weight than those fed with 30% and 50% CTM diets. The organs and carcass primal cuts of the broilers expressed significant different for the spleen (0.12 g, 0.09 g, 0.11 g and 0.14 g respectively), lungs (0.97 g, 0.72 g, 0.77 g and 1.01g respectively) and proventriculus (0.96 g, 0.99 g, 0.81 g and 0.85 g respectively) (P<0.05). For the carcass, there were no significant differences (P<0.05) in the breast, thigh, drumstick, wing and neck except for the Back (21.27 g, 21.04 g, 17.71 g, and 17.89 g respectively). In conclusion, CTM inclusion in broiler’s diet could be used as an alternative feed stuff in replacement of Soybean meal up to 15% without any adverse effects as revealed by the blood profile and to increase the growth performance of the birds.

Keywords: physiological functions, cholesterol, blood profiles, CTM and carcass analysis

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Authors: Faezeh Mosallat, Eric L. Bibeau, Tarek El Mekkawy

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Availability of a wide variety of renewable resources, such as large reserves of hydro, biomass, solar and wind in Canada provides significant potential to improve the sustainability of energy uses. As buildings represent a considerable portion of energy use in Canada, application of distributed solar energy systems for heating and cooling may increase the amount of renewable energy use. Parabolic solar trough systems have seen limited deployments in cold northern climates as they are more suitable for electricity production in southern latitudes. Heat production by concentrating solar rays using parabolic troughs can overcome the poor efficiencies of flat panels and evacuated tubes in cold climates. A numerical dynamic model is developed to simulate an installed parabolic solar trough facility in Winnipeg. The results of the numerical model are validated using the experimental data obtained from this system. The model is developed in Simulink and will be utilized to simulate a tri-generation system for heating, cooling and electricity generation in remote northern communities. The main objective of this simulation is to obtain operational data of solar troughs in cold climates as this is lacking in the literature. In this paper, the validated Simulink model is applied to simulate a solar assisted absorption cooling system along with electricity generation using organic Rankine cycle (ORC) and thermal storage. A control strategy is employed to distribute the heated oil from solar collectors among the above three systems considering the temperature requirements. This modeling provides dynamic performance results using real time minutely meteorological data which are collected at the same location the solar system is installed. This is a big step ahead of the current models by accurately calculating the available solar energy at each time step considering the solar radiation fluctuations due to passing clouds. The solar absorption cooling is modeled to use the generated heat from the solar trough system and provide cooling in summer for a greenhouse which is located next to the solar field. A natural gas water heater provides the required excess heat for the absorption cooling at low or no solar radiation periods. The results of the simulation are presented for a summer month in Winnipeg which includes the amount of generated electric power from ORC and contribution of solar energy in the cooling load provision

Keywords: absorption cooling, parabolic solar trough, remote community, validated model

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Authors: Iram Zahair, Tanith Rose, Oyinlola Oyebode, Stephen Clayton, Iman Ghosh, Michelle Maden, Ben Barr

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Background: Gastrointestinal infections exert a significant public health burden on UK healthcare services and the community. However, there are conflicting findings on where ethnic inequalities are likely to persist. This systematic review aimed to identify studies that ascertain differences in the incidence and prevalence of gastrointestinal infections within and between UK ethnic groups and explore possible explanations for heterogeneity observed within the literature. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance, a systematic review methodology was used. Medline, Web of Science, CINAHL Plus, and grey literature were searched from 1980 to 2021 for studies reporting an association between ethnicity and gastrointestinal infections in UK population samples. Two reviewers independently screened the articles and conducted quality appraisals; data extraction was undertaken by one reviewer and verified by two reviewers (PROSPERO CRD 42021240714). A narrative synthesis was undertaken to synthesise the study findings. Results: The searches identified 8134 studies; 13 met the inclusion criteria. 12 out of 13 studies found a difference in the prevalence of gastrointestinal infections between different ethnic groups. UK ethnic minorities, predominantly men and children of Asian ethnicity, had an increased risk of infection than the white British majority in 12 studies; the Pakistani ethnic group had a higher risk of infection in three out of 13 studies. Studies reported that age and sex confounded the relationship between ethnicity and gastrointestinal infections. At the same time, the country of birth, socioeconomic status, and geographical location of ethnic groups mediated this association and significantly explained the heterogeneity observed across the studies. Harvest plots supported the textual synthesis. Conclusion: This systematic review elucidates the lack of extensive UK quantitative evidence examining the association between ethnicity and gastrointestinal infections. Insights into gastrointestinal infections and ethnicity's association can help address policy actions to mitigate the inequalities identified within and between UK ethnic groups.

Keywords: ethnic and racial populations, public health, public health policy, systematic review

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Authors: Claudia Aguilar, Amen Farooq

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Among other cities in the United States, the city of Atlanta is experiencing levels of growth that surpass anything we have witnessed in the last century. With the surge of population influx, the available housing is practically bursting at the seams. Supply is low, and demand is high. In effect, the average one-bedroom apartment runs for 1,800 dollars per month. The city is desperately seeking new opportunities to provide affordable housing at an expeditious rate. This has been made evident by the recent updates to the city’s zoning. With the recent influx in the housing market, young professionals, in particular millennials, are desperately looking for alternatives to stay within the city. To remedy Atlanta’s affordable housing crisis, the city of Atlanta is planning to introduce 40 thousand of new affordable housing units by 2026. To achieve the urgent need for more affordable housing, the architectural response needs to adapt to overcome this goal. A method that has proven successful in modern housing is to practice modular means of development. A method that has been constrained to the dimensions of the max load for an eighteen-wheeler. This approach has diluted the architect’s ability to produce site-specific, informed design and rather contributes to the “cookie cutter” stigma that the method has been labeled with. This thesis explores the design methodology for modular housing by revisiting its constructability and adaptability. This research focuses on a modular housing type that could break away from the constraints of transport and deliver adaptive reconfigurable assemblies. The adaptive assemblies represent an integrated design strategy for assembling the future of affordable dwelling units. The goal is to take advantage of a component-based system and explore a scalable solution to modular housing. This proposal aims specifically to design a kit of parts that are made to be easily transported and assembled but also gives the ability to customize the use of components to benefit all unique conditions. The benefits of this concept could include decreased construction time, cost, on-site labor, and disruption while providing quality housing with affordable and flexible options.

Keywords: adaptive assemblies, modular architecture, adaptability, constructibility, kit of parts

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Authors: Silvia Miele, Patrice Rusconi, Harriet Tenenbaum

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An increasingly multi-ethnic Europe has been pushing citizens’ boundaries on who should be entitled and to what extent to practise their own diversity. Indeed, according to a Standard Eurobarometer survey conducted in 2017, immigration is seen by Europeans as the most serious issue facing the EU, and a third of respondents reported they do not feel comfortable interacting with migrants from outside the EU. Many of these come from Muslim countries, accounting for 4.9% of Europe population in 2016. However, the figure is projected to rise up to 14% by 2050. Additionally, political debates have increasingly focused on Muslim immigrants, who are frequently portrayed as difficult to integrate, while nationalist parties across Europe have fostered the idea of insuperable cultural differences, creating an atmosphere of hostility. Using a 3 X 3 X 2 between-subjects design, it was investigated how people reason about endorsing religious and non-religious rights to minorities. An online survey has been administered to university students of three different countries (Italy, Spain and the UK) via Qualtrics, presenting hypothetical scenarios through a vignette methodology. Each respondent has been randomly allocated to one of the three following conditions: Christian, Muslim or non-religious (vegan) target. Each condition entailed three questions about children self-determination rights to exercise some control over their own lives and 3 questions about children nurturance rights of care and protection. Moreover, participants have been required to further elaborate on their answers via free-text entries and have been asked about their contact and quality of contact with the three targets, and to self-report religious, national and ethnic identification. Answers have been recorded on a Likert scale of 1-5, 1 being "not at all", 5 being "very much". A two-way ANCOVA will be used to analyse answers to closed-ended questions, while free-text answers will be coded and data will be dichotomised based on Social Cognitive Domain Theory for four categories: moral, social conventional and psychological reasons, and analysed via ANCOVAs. This study’s findings aim to contribute to the implementation of educational interventions and speak to the introduction of governmental policies on human rights.

Keywords: children's rights, Europe, migration, minority

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Authors: Shalinawati Ramli, Khairani Omar, Nurul Azmawati Mohamed, Zarini Ismail, Nur Syahrina Rahim, Nurul Hayati Chamhuri

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Medical doctors’ work to prevent, diagnose, treat diseases, disorders, and injuries as well as prescribing medication. Many people are attracted to this profession because it gives them the opportunity to help others. Doctors’ improve quality of life by providing advice, healing physical ailments and performing complex surgeries. Medicine is a profession in which dedication to the wellbeing of others is of paramount importance. Balancing the requirements of work and personal life can be a struggle as the demand of work as a doctors’ is great. Perception and expectation of medical students regarding the lifestyle of doctors’ is important to ensure that they had made the right career choice. Thus, the aim of this study is to assess the perception of pre-clinical students regarding doctors’ lifestyle. This study is a cross-sectional study involving all third-year pre-clinical medical students at University Sains Islam Malaysia. A total of 81 students participated in this study. Participants were given a set of questionnaire consisting of demographic data, open-ended questions on their perception on doctors’ lifestyle of working environment, salary expectation and family life. Thematic analysis were used to analyse the data. The participants comprised 69% female and their age range was between 20-21 years old. Majority of them were from middle-income families. Majority of the students perceived that the doctors’ lifestyle would be busy (72%). Approximately 30% of them expected that the time schedule will be unpredictable, 21% mentioned that sacrifice is required and 16% perceived it as a tiring job. Other themes emerged were ‘requiring high commitment’ (6%), challenging (7%) and risky (4%). With regards to salary expectation, 48% expected reasonable salary, 33% high salary and 12% described it as 'not worth compared to the workload'. Majority of them perceived that their family life will be restricted (62%) and time management is important (33%). Only 15% mentioned that family members have to sacrifice and spousal understanding is important (7%). About 10% of them perceived that their family will not be affected by their profession. Majority of the medical students perceived a busy doctors’ lifestyle, reasonable salary and restricted family life. However, there was a significant proportion of them who required counselling for better preparation of their future lifestyle.

Keywords: doctors lifestyle, pre-clinical students, perception, understanding

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Authors: Seydou Sinde

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The aims of this paper are to formulate mathematical expressions that can be used to estimate the standpipe pressure (SPP). The developed formulas take into account the main factors that, directly or indirectly, affect the behavior of SPP values. Fluid rheology and well hydraulics are some of these essential factors. Mud Plastic viscosity, yield point, flow power, consistency index, flow rate, drillstring, and annular geometries are represented by the frictional pressure (Pf), which is one of the input independent parameters and is calculated, in this paper, using Herschel-Bulkley rheological model. Other input independent parameters include the rate of penetration (ROP), applied load or weight on the bit (WOB), bit revolutions per minute (RPM), bit torque (TRQ), and hole inclination and direction coupled in the hole curvature or dogleg (DL). The technique of repeating parameters and Buckingham PI theorem are used to reduce the number of the input independent parameters into the dimensionless revolutions per minute (RPMd), the dimensionless torque (TRQd), and the dogleg, which is already in the dimensionless form of radians. Multivariable linear and polynomial regression technique using PTC Mathcad Prime 4.0 is used to analyze and determine the exact relationships between the dependent parameter, which is SPP, and the remaining three dimensionless groups. Three models proved sufficiently satisfactory to estimate the standpipe pressure: multivariable linear regression model 1 containing three regression coefficients for vertical wells; multivariable linear regression model 2 containing four regression coefficients for deviated wells; and multivariable polynomial quadratic regression model containing six regression coefficients for both vertical and deviated wells. Although that the linear regression model 2 (with four coefficients) is relatively more complex and contains an additional term over the linear regression model 1 (with three coefficients), the former did not really add significant improvements to the later except for some minor values. Thus, the effect of the hole curvature or dogleg is insignificant and can be omitted from the input independent parameters without significant losses of accuracy. The polynomial quadratic regression model is considered the most accurate model due to its relatively higher accuracy for most of the cases. Data of nine wells from the Middle East were used to run the developed models with satisfactory results provided by all of them, even if the multivariable polynomial quadratic regression model gave the best and most accurate results. Development of these models is useful not only to monitor and predict, with accuracy, the values of SPP but also to early control and check for the integrity of the well hydraulics as well as to take the corrective actions should any unexpected problems appear, such as pipe washouts, jet plugging, excessive mud losses, fluid gains, kicks, etc.

Keywords: standpipe, pressure, hydraulics, nondimensionalization, parameters, regression

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Authors: Aiydh Aljeddani, Fran Martin

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The study mainly aims at exploring and understanding the current practice of social studies and citizenship education curriculum contribution to sustainability literacy and competency of the ninth and tenth grade students in the Saudi general education context. This study stems from a need for conducting research in general education contexts in order to prepare future graduate students who possess fundamental elements of education for sustainable development. To the best of our knowledge, the literature on education for sustainable development reveals that little research has been conducted so far on general education contexts and this study will add new knowledge in the literature. The study is interpretive in nature and employs a qualitative case study approach, and ethnography methodologies to understand deeply this complex educational phenomenon. 167 participants took part in this study, they were from six general education schools and made up of 25 teachers, and 142 students. Document analysis, semi-structured interviews, nominal group technique, and passive participant observation were used in order to gather the data for this study. The outcomes of the study showed the keenness of the Saudi government on promoting and raising awareness education for sustainable development among its younger generation via a sustainable development promoting curriculum. However, applying this vision in a real school setting, particularly via the social studies and citizenship education curriculum in grades nine and ten, has been challenging for different reasons as revealed by this study. First, incorporating sustainability in the social studies and citizenship education curriculum in the Saudi grade ninth and tenth grade, is based on the vision of the Saudi government but the ministry of education’s rules and regulations do not support it. Moreover, the circulars issued by the ministry are also not supportive of teachers and students efforts to implement a sustainable development education curriculum. Second, teachers, as members of this community who play a significant role in achieving the objectives of incorporating sustainability, are often seen as technicians and not as professional human beings. They are confined to the curriculum, the classroom and stripped of their will power by the school management and the educational administration. The subjects, who are students here, are also not prepared nor guided to achieve the objects. In addition, the tools mediated between subjects and objects are not convenient. There were some major challenges regarding the contradictions in incorporating sustainability processes such as demanding creativity from a teacher who is overloaded with tasks irrelevant to teaching and teachers’ training programs not meeting the teachers’ training needs.

Keywords: practice, integrating sustainability, curriculum, educational context

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Authors: Godian Asami Mabindah

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The convergence of knowledge management (KM) and competitive intelligence (CI) has gained significant attention in recent years as organizations seek to enhance their competitive advantage in an increasingly complex and dynamic business environment. This research study aims to explore and understand the synergistic relationship between KM and CI and its impact on organizational performance. By investigating how the integration of KM and CI practices can contribute to decision-making, innovation, and competitive advantage, this study seeks to unlock the potential benefits and challenges associated with this integration. The research employs a mixed-methods approach to gather comprehensive data. A quantitative analysis is conducted using survey data collected from a diverse sample of organizations across different industries. The survey measures the extent of integration between KM and CI practices and examines the perceived benefits and challenges associated with this integration. Additionally, qualitative interviews are conducted with key organizational stakeholders to gain deeper insights into their experiences, perspectives, and best practices regarding the synergistic relationship. The findings of this study are expected to reveal several significant outcomes. Firstly, it is anticipated that organizations that effectively integrate KM and CI practices will outperform those that treat them as independent functions. The study aims to highlight the positive impact of this integration on decision-making, innovation, organizational learning, and competitive advantage. Furthermore, the research aims to identify critical success factors and enablers for achieving constructive interaction between KM and CI, such as leadership support, culture, technology infrastructure, and knowledge-sharing mechanisms. The implications of this research are far-reaching. Organizations can leverage the findings to develop strategies and practices that facilitate the integration of KM and CI, leading to enhanced competitive intelligence capabilities and improved knowledge management processes. Additionally, the research contributes to the academic literature by providing a comprehensive understanding of the synergistic relationship between KM and CI and proposing a conceptual framework that can guide future research in this area. By exploring the synergies between KM and CI, this study seeks to help organizations harness their collective power to gain a competitive edge in today's dynamic business landscape. The research provides practical insights and guidelines for organizations to effectively integrate KM and CI practices, leading to improved decision-making, innovation, and overall organizational performance.

Keywords: Competitive Intelligence, Knowledge Management, Organizational Performance, Incusivity, Optimum Performance

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Authors: Yu Yoshihara, Chika Tada, Moe Takada, Nyam-Osor Purevdorj, Khorolmaa Chimedtseren, Yutaka Nakai

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Water pollution from animal waste and its influence on grazing animals is a current concern regarding Mongolian grazing lands. We allocated 32 free-grazing lambs to four groups and provided each with water from a different source (upper stream, lower stream, well, and pond) for 49 days. We recorded the amount of water consumed by the lambs, as well as their body weight, behavior, white blood cell count, acute phase (haptoglobin) protein level, and fecal condition. We measured the chemical and biological qualities of the four types of water, and we detected enteropathogenic and enterohemorrhagic Escherichia coli in fecal samples by using a genetic approach. Pond water contained high levels of nitrogen and minerals, and well water contained high levels of bacteria. The odor concentration index decreased in order from pond water to upper stream, lower stream, and well. On day 15 of the experiment, the following parameters were the highest in lambs drinking water from the following sources: water intake (pond or lower stream), body weight gain (pond), WBC count (lower stream), haptoglobin concentration (well), and enteropathogenic E. coli infection rate (lower stream). Lambs that drank well water spent more time lying down and less time grazing than the others, and lambs that drank pond water spent more time standing and less time lying down. Lambs given upper or lower stream water exhibited more severe diarrhea on day 15 of the experiment than before the experiment. Mongolian sheep seemed to adapt to chemically contaminated water: their productivity benefited the most from pond water, likely owing to its rich mineral content. Lambs that drank lower stream water showed increases in enteropathogenic E. coli infection, clinical diarrhea, and WBC count. Lambs that drank well water, which was bacteriologically contaminated, had increased serum acute phase protein levels and poor physical condition; they were thus at increased risk of negative health and production effects.

Keywords: DNA, Escherichia coli, fecal sample, lower stream, well water

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Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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Authors: Usman Bawa

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Macro-invertebrates have been used to monitor organic pollution in rivers and streams. Several biotic indices based on macro-invertebrates have been developed over the years including the Biological Monitoring Working Party (BMWP). A new biotic index, the Gammarus:Asellus ratio has been recently proposed as an index of organic pollution. This study tested the validity of the Gammarus:Asellus ratio as an index of organic pollution, by examining the relationship between the Gammarus:Asellus ratio and physical-chemical parameters, and other biotic indices such as BMWP and, Average Score Per Taxon (ASPT) from lakes and streams at Markeaton Park, Allestree Park, and Kedleston Hall, Derbyshire. Macro invertebrates were sampled using the standard five-minute kick sampling techniques physical and chemical environmental variables were obtained based on standard sampling techniques. Eighteen sites were sampled, six sites from Markeaton Park (three sites across the stream and three sites across the lake). Six sites each were also sampled from Allestree Park and Kedleston Hall lakes. The Gammarus:Asellus ratio showed an opposite significant positive correlations with parameters indicative of organic pollution such as the level of nitrates, phosphates, and calcium and also revealed a negatively significant correlations with other biotic indices (BMWP/ASPT). The BMWP score correlated positively significantly with some water quality parameters such as dissolved oxygen and flow rate, but revealed no correlations with other chemical environmental variables. The BMWP score was significantly higher in the stream than the lake in Markeaton Park, also The ASPT scores appear to be significantly higher in the upper Lakes than the middle and lower lakes. This study has further strengthened the use of BMWP/ASPT score as an index of organic pollution. But, additional application is required to validate the use of Gammarus:Asellus as a rapid bio monitoring tool.

Keywords: Asellus, biotic index, Gammarus, macro invertebrates, organic pollution

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Authors: Urrutia Fernando, López Jessica, Sánchez Carlos, San Antonio Thalía

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Ecuador, as a signatory country of the convention of the rights of persons with disabilities (CRPD) has, in the recent years, strengthened the structures and legal framework required to protect this minority comprised of 13.2% of its total population. However, the reality is that this group has disproportionately low earnings and low educational attainment in comparison with the general population. The main struggles, to promote job placement of wheelchairs users, are environmental discrimination caused by accessibility in structures and transportation, this mainly due to the cost, for private and public entities, of performing the reasonable accommodation they require. It is widely known that product development and production is needed to support effective implementation of the CRPD and that walking and standing are the major life activities, in this context the objective of this investigation is to promote job placement of wheelchair user in the province of Tungurahua by means of the design, production and marketing of a customized stand up wheelchair. Exploratory interviews and measurements were performed in a representative sample of working age wheelchairs users that develop their disability after achieving their physical maturity and that are capable of performing professional activities with their upper limbs, this in order to detect the user’s preference and determine the local economic and anthropometric parameters to be included in the wheelchair design. The findings reveal factors that uniquely impact quality of life and development for people with a mobility disability within the context of the province, first that transportation is a big issue since public buses does not have accessibility for wheelchair users and the absence of curb cuts and the presence of trash bins over the sidewalks among other hinders an economic independent mobility, second that the proposal based in the idea of modifying the wheelchairs to make it able to overcome certain obstacles helps people in wheelchair to improve their independent living and by reducing the costs of modification for the employer could improve their chances of finding work.

Keywords: anthropometrics, job placement, stand up wheelchair, user centered design

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Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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Authors: Filip Rusak, Yulia Arzhaeva, Dadong Wang

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Machine learning based Computer-Aided Diagnosis (CAD) is gaining much popularity in medical imaging and diagnostic radiology. However, it requires a large amount of high quality and labeled training image datasets. The training images may come from different sources and be acquired from different radiography machines produced by different manufacturers, digital or digitized copies of film radiographs, with various sizes as well as different pixel intensity distributions. In this paper, a content-aware image augmentation method is presented to deal with these variations. The results of the proposed method have been validated graphically by plotting the removed and added seams of pixels on original images. Two different chest X-ray (CXR) datasets are used in the experiments. The CXRs in the datasets defer in size, some are digital CXRs while the others are digitized from analog CXR films. With the proposed content-aware augmentation method, the Seam Carving algorithm is employed to resize CXRs and the corresponding labels in the form of image masks, followed by histogram matching used to normalize the pixel intensities of digital radiography, based on the pixel intensity values of digitized radiographs. We implemented the algorithms, resized the well-known Montgomery dataset, to the size of the most frequently used Japanese Society of Radiological Technology (JSRT) dataset and normalized our digital CXRs for testing. This work resulted in the unified off-the-shelf CXR dataset composed of radiographs included in both, Montgomery and JSRT datasets. The experimental results show that even though the amount of augmentation is large, our algorithm can preserve the important information in lung fields, local structures, and global visual effect adequately. The proposed method can be used to augment training and testing image data sets so that the trained machine learning model can be used to process CXRs from various sources, and it can be potentially used broadly in any medical imaging applications.

Keywords: computer-aided diagnosis, image augmentation, lung segmentation, medical imaging, seam carving

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Authors: Hendri Purwadi, Christine McCloud

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Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.

Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system

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Authors: Samantha Burns, Melissa Brown, Judith Rankin

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Background: As a specialised intervention, NEWPIP provides a service which supports both parents and their babies from conception to two years, who are experiencing issues which may affect the quality of their relationship and development of the infant. This evaluation of the NEWPIP approach was undertaken in response to the need for rich, in-depth data to understand the lived experiences of the parents who experienced the service to improve the service. NEWPIP is currently one of 34 specialised parent–infant relationship teams across England. This evaluation contributes to increasing understanding of the impact and effectiveness of this specialised service to inform future practice. Aim: The aim of this evaluation was to explore the perspectives and experiences of parents or caregivers (service users), to assess the impact of the NEWPIP service on the parents themselves and the relationship with their baby. Methods: The exploratory nature of the aim and focus on service users’ experience and perspectives provided scope for a qualitative approach for this evaluation. This consisted of 10 semi-structured interviews with parents who had received the service within the last two years. Recruitment involved both purposive and convenience sampling. The interviews took place between February 2021 – March 2021, lasting between 30-90 minutes and were guided by open-ended questions from a topic guide. The interviews adopted a narrative approach to enable the parents to share their lived experiences. The researchers transcribed the interviews and analysed the data thematically by using a coding method which is grounded in the data. Results: The analysis and findings from the data gathered illuminated an approach which supports parents to build a better bond with their baby and provides a safe space for parents to heal through their relationships. While the parents shared their experiences, the interviews were intended to receive feedback, so questions were asked about what could be improved and what recommendations could be offered to Children North East. Guided by the voice of the parents, this evaluation provides recommendations to support the future of the NEWPIP approach. Conclusions: The NEWPIP approach appears to successfully provide early and flexible support for new parents, increasing a parent’s confidence in their ability to not only cope but thrive as a new parent.

Keywords: maternal health, mental health, parent infant relationship, therapy

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Authors: Reena K., Mamatha H. G., Somshekarayya, P. Kumar

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Objectives: The annual proficiency testing of intermediate reference laboratories is conducted by the National Reference Laboratory (NRL) to assess the efficiency of the laboratories to correctly identify Mycobacterium tuberculosis and to determine its drug susceptibility pattern. The proficiency testing results from 2013 to 2017 were analyzed to determine laboratories that were consistent in reporting quality results and those that had difficulty in doing so. Methods: A panel of twenty cultures were sent out to each of these laboratories. The laboratories were expected to grow the cultures in their own laboratories, set up drug susceptibly testing by all the methods they were certified for and report the results within the stipulated time period. The turnaround time for reporting results, specificity, sensitivity positive and negative predictive values and efficiency of the laboratory in identifying the cultures were analyzed. Results: Most of the laboratories had reported their results within the stipulated time period. However, there was enormous delay in reporting results from few of the laboratories. This was mainly due to improper functioning of the biosafety level III laboratory. Only 40% of the laboratories had 100% efficiency in solid culture using Lowenstein Jensen medium. This was expected as a solid culture, and drug susceptibility testing is not used for diagnosing drug resistance. Rapid molecular methods such as Line probe assay and Genexpert are used to determine drug resistance. Automated liquid culture system such as the Mycobacterial growth indicator tube is used to determine prognosis of the patient while on treatment. It was observed that 90% of the laboratories had achieved 100% in the liquid culture method. Almost all laboratories had achieved 100% efficiency in the line probe assay method which is the method of choice for determining drug-resistant tuberculosis. Conclusion: Since the liquid culture and line probe assay technologies are routinely used for the detection of drug-resistant tuberculosis the laboratories exhibited higher level of efficiency as compared to solid culture and drug susceptibility testing which are rarely used. The infrastructure of the laboratory should be maintained properly so that samples can be processed safely and results could be declared on time.

Keywords: annual proficiency testing, drug susceptibility testing, intermediate reference laboratory, national reference laboratory

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Authors: Michal Almagor, Rivka Tuval-Mashiach

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This presentation will explore the main processes identified in women writing group, as an interdisciplinary field with personal and social effects. It is based on the initial findings of a Ph.D. research focus on the intersection of group processes with the element of writing, in the context of gender. Writing as a therapeutic mean has been recognized and found to be highly effective. Additionally, a substantial amount of research reveals the psychological impact of group processes. However, the combination of writing and groups as a therapeutic tool was hardly investigated; this is the contribution of this research. In the following qualitative-phenomenological study, the experiences of eight women participating in a 10-sessions structured writing group were investigated. We used the meetings transcripts, semi-structured interviews, and the texts to analyze and understand the experience of participating in the group. The two significant findings revealed were spiral intersubjectivity and archaic level of semiotic language. We realized that the content and the process are interwoven; participants are writing, reading and discussing their texts in a group setting that enhanced self-dialogue between the participants and their own narratives and texts, as well as dialogue with others. This process includes working through otherness within and between while discovering and creating a multiplicity of narratives. A movement of increasing shared circles from the personal to the group and to the social-cultural environment was identified, forming what we termed as spiral intersubjectivity. An additional layer of findings was revealed while we listened to the resonance of the group-texts, and discourse; during this process, we could trace the semiotic level in addition to the symbolic one. We were witness to the dominant presence of the body, and primal sensuality, expressed by rhythm, sound and movements, signs of pre-verbal language. Those findings led us to a new understanding of the semiotic function as a way to express the fullness of women experience and the enabling role of writing in reviving what was repressed. The poetic language serves as a bridge between the symbolic and the semiotic. Re-reading the group materials, exposed another layer of expression, an old-new language. This approach suggests a feminine expression of subjective experience with personal and social importance. It is a subversive move, encouraging women to write themselves, as a craft that every woman can use, giving voice to the silent and hidden, and experiencing the power of performing 'my story'. We suggest that women writing group is an efficient, powerful yet welcoming way to raise the awareness of researchers and clinicians, and more importantly of the participants, to the uniqueness of the feminine experience, and to gender-sensitive curative approaches.

Keywords: group, intersubjectivity, semiotic, writing

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Authors: Ademola A. Ladele, Peace I. Aburime

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Fake and substandard agricultural inputs pose a serious stumbling block to farm productivity and subsequently improved livelihood. There is, therefore, a need to pave ways for sustainable agriculture and self-sufficiency in food production by proffering solutions to this challenge. Maize farmers' perception of sharp practices among agro-input dealers in Ibadan/Ibarapa agricultural zone in Oyo state was therefore investigated. A multi-stage random sampling technique was used to select registered maize farmers in the Ibadan/Ibarapa agricultural zone of the Oyo State Agricultural Development Programme (OYSADEP). A structured questionnaire was used to collect information on the perception of sharp practices and the effects of sharp practices. A total of seventy-five maize farmers were interviewed. A focus group discussion was organized to identify ways of curbing sharp practices to complement the survey. Data were analyzed using descriptive statistics, Chi-square, and Pearson Product Moment Correlation (PPMC). Forms of sharp practices indicated were sales of expired fertilizers, expired pesticides, expired herbicides, underweight fertilizers, adulterated fertilizers, adulterated herbicides, packs containing broken seeds, infested seeds, lack of truth in labeling/wrong labels, manipulation of measuring scales, and false declaration of hecterages covered by tractor operators. The majority had unfavorable perception of agro-input dealers on sharp practices. A significant relationship was observed between respondents’ level of education and their perception of sharp practices. There were no significant relationships between respondents’ sex, marital status and religion, and their perception of sharp practices. A significant correlation exists between the forms of sharp practices and the perceived effect on agricultural production. It is concluded that the perceived effect of sharp practices was critical and the endemic culture of sharp practices prevailed in agro-input in Ibadan/Ibarapa agricultural zone. A standard regulatory system that will certify and monitor the quality of inputs should be put in place.

Keywords: agricultural productivity, agro-input dealers, maize farmers, sharp practices

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