Search results for: social needs and impact

Authors: Chiranjit Das, Sanjay Jharkharia

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This study is focused on transport mode selection under lead time variability and emissions constraint. In order to reduce the carbon emissions generation due to transportation, organization has often faced a dilemmatic choice of transport mode selection since logistic cost and emissions reduction are complementary with each other. Another important aspect of transportation decision is lead-time variability which is least considered in transport mode selection problem. Thus, in this study, we provide a comprehensive mathematical based analytical model to decide transport mode selection under emissions constraint. We also extend our work through analysing the effect of lead time variability in the transport mode selection by a sensitivity analysis. In order to account lead time variability into the model, two identically normally distributed random variables are incorporated in this study including unit lead time variability and lead time demand variability. Therefore, in this study, we are addressing following questions: How the decisions of transport mode selection will be affected by lead time variability? How lead time variability will impact on total supply chain cost under carbon emissions? To accomplish these objectives, a total transportation cost function is developed including unit purchasing cost, unit transportation cost, emissions cost, holding cost during lead time, and penalty cost for stock out due to lead time variability. A set of modes is available to transport each node, in this paper, we consider only four transport modes such as air, road, rail, and water. Transportation cost, distance, emissions level for each transport mode is considered as deterministic and static in this paper. Each mode is having different emissions level depending on the distance and product characteristics. Emissions cost is indirectly affected by the lead time variability if there is any switching of transport mode from lower emissions prone transport mode to higher emissions prone transport mode in order to reduce penalty cost. We provide a numerical analysis in order to study the effectiveness of the mathematical model. We found that chances of stock out during lead time will be higher due to the higher variability of lead time and lad time demand. Numerical results show that penalty cost of air transport mode is negative that means chances of stock out zero, but, having higher holding and emissions cost. Therefore, air transport mode is only selected when there is any emergency order to reduce penalty cost, otherwise, rail and road transport is the most preferred mode of transportation. Thus, this paper is contributing to the literature by a novel approach to decide transport mode under emissions cost and lead time variability. This model can be extended by studying the effect of lead time variability under some other strategic transportation issues such as modal split option, full truck load strategy, and demand consolidation strategy etc.

Keywords: carbon emissions, inventory theoretic model, lead time variability, transport mode selection

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Authors: Lucas Peries, Rolla Monib

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The construction industry plays a vital role in the global economy, contributing billions of dollars annually. However, the industry has been struggling with persistently low productivity levels for years, unlike other sectors that have shown significant improvements. Modular and prefabricated construction methods have been identified as potential solutions to boost productivity in the construction industry. These methods offer time advantages over traditional construction methods. Despite their potential benefits, modular and prefabricated construction face hindrances and limitations that are not present in traditional building systems. Building information modelling (BIM) has the potential to address some of these hindrances, but barriers are preventing its widespread adoption in the construction industry. This research aims to enhance understanding of the shortcomings of modular and prefabricated building systems and develop BIM-based solutions to alleviate or eliminate these hindrances. The research objectives include identifying and analysing key issues hindering the use of modular and prefabricated building systems, investigating the current state of BIM adoption in the construction industry and factors affecting its successful implementation, proposing BIM-based solutions to address the issues associated with modular and prefabricated building systems, and assessing the effectiveness of the developed solutions in removing barriers to their use. The research methodology involves conducting a critical literature review to identify the key issues and challenges in modular and prefabricated construction and BIM adoption. Additionally, an online questionnaire will be used to collect primary data from construction industry professionals, allowing for feedback and evaluation of the proposed BIM-based solutions. The data collected will be analysed to evaluate the effectiveness of the solutions and their potential impact on the adoption of modular and prefabricated building systems. The main findings of the research indicate that the identified issues from the literature review align with the opinions of industry professionals, and the proposed BIM-based solutions are considered effective in addressing the challenges associated with modular and prefabricated construction. However, the research has limitations, such as a small sample size and the need to assess the feasibility of implementing the proposed solutions. In conclusion, this research contributes to enhancing the understanding of modular and prefabricated building systems' limitations and proposes BIM-based solutions to overcome these limitations. The findings are valuable to construction industry professionals and BIM software developers, providing insights into the challenges and potential solutions for implementing modular and prefabricated construction systems in future projects. Further research should focus on addressing the limitations and assessing the feasibility of implementing the proposed solutions from technical and legal perspectives.

Keywords: building information modelling, modularisation, prefabrication, technology

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Authors: Medhat Tawfik, Ezzat Abd El Lateef, Bahr Amany, Mohamed Magda

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Applying organic farming systems in biosaline agriculture is unconventional approach for sustainable use of marginal soil and desert land for planting non-traditional halophytic crops such as Leptochloa fusca, Kochia indica, Sporobolus virginicus and Spartina patens. These plants are highly salt tolerant C4 halophytic forage plants grown well in coastal salt marsh. These halophytic plant will take important place in the farming system, especially in the coastal areas and salt-affected land. We can call it environmentally smart crops because they ensure food security, contribute to energy security, guarantee environmental sustainability, and mitigate the negative impacts of climate change. Organic Agriculture is the most important and widely practiced agro-ecological farming system. It is claimed to be the most sustainable approach and long term adaptation strategy. It promotes soil fertility and diversity at all levels and makes soils less susceptible to erosion. It is also reported to be climate change resilience farming systems as it promotes the proper management of soil, water, biodiversity and local knowledge and provides producers with ecologically sound management decisions. A field experiment was carried out at the Model Farm of National Research Centre, El Tour, South Sinai to study the impact of (Mycorrhiza 1kg/fed., charcoal 4 tons/fed., chicken manure 5 tons/fed., in addition to control treatment) on some growth characters, photosynthetic pigments content, and some physiological aspects i.e. prolind and soluble carbohydrates content, succulence and osmotic pressure values, as well as nutritive values i.e. Crude fat (CF), Acid detergent fiber (ADF), Neutral detergent fiber (NDF), Ether extract (EE) and Nitrogen-free extract (NFE) of five halophytic plant species (Leptochloa fusca, Kochia indica, Sporobolus virginicus and Spartina patens). Our results showed that organic fertilizer treatment enhanced all the previous character as compared with control with superiority to chicken manure over the other treatments.

Keywords: organic agriculture, halophytic plants, saline environment, water security

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Authors: Rebecca Richards Steed, James Van Derslice, Ken Smith, Richard Medina, Amanda Bakian

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Elucidating gene-environment interactions for heritable disease outcomes is an emerging area of disease research, with genetic studies informing hypotheses for environment and gene interactions underlying some of the most confounding diseases of our time, like autism spectrum disorder (ASD). Geography has thus far played a key role in identifying environmental factors contributing to disease, but its use can be broadened to include genetic and environmental factors that have a synergistic effect on disease. Through the use of family pedigrees and disease outcomes with life-course residential histories, space-time clustering of generations at critical developmental windows can provide further understanding of (1) environmental factors that contribute to disease patterns in families, (2) susceptible critical windows of development most impacted by environment, (3) and that are most likely to lead to an ASD diagnosis. This paper introduces a retrospective case-control study that utilizes pedigree data, health data, and residential life-course location points to find space-time clustering of ancestors with a grandchild/child with a clinical diagnosis of ASD. Finding space-time clusters of ancestors at critical developmental windows serves as a proxy for shared environmental exposures. The authors refer to geographic life-course exposures as geographic legacies. Identifying space-time clusters of ancestors creates a bridge for researching exposures of past generations that may impact modern-day progeny health. Results from the space-time cluster analysis show multiple clusters for the maternal and paternal pedigrees. The paternal grandparent pedigree resulted in the most space-time clustering for birth and childhood developmental windows. No statistically significant clustering was found for adolescent years. These results will be further studied to identify the specific share of space-time environmental exposures. In conclusion, this study has found significant space-time clusters of parents, and grandparents for both maternal and paternal lineage. These results will be used to identify what environmental exposures have been shared with family members at critical developmental windows of time, and additional analysis will be applied.

Keywords: family pedigree, environmental exposure, geographic legacy, medical geography, transgenerational inheritance

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Authors: Nurten Akgun, Dilum Dissanayake, Neil Thorpe, Margaret C. Bell

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Cycling has gained a great attention with comparable speeds, low cost, health benefits and reducing the impact on the environment. The main challenge associated with cycling is the provision of safety for the people choosing to cycle as their main means of transport. From the road safety point of view, cyclists are considered as vulnerable road users because they are at higher risk of serious casualty in the urban network but more specifically at roundabouts. This research addresses the development of an enhanced mathematical model by including a broad spectrum of casualty related variables. These variables were geometric design measures (approach number of lanes and entry path radius), speed limit, meteorological condition variables (light, weather, road surface) and socio-demographic characteristics (age and gender), as well as contributory factors. Contributory factors included driver’s behavior related variables such as failed to look properly, sudden braking, a vehicle passing too close to a cyclist, junction overshot, failed to judge other person’s path, restart moving off at the junction, poor turn or manoeuvre and disobeyed give-way. Tyne and Wear in the UK were selected as a case study area. The cyclist casualty data was obtained from UK STATS19 National dataset. The reference categories for the regression model were set to slight and serious cyclist casualties. Therefore, binary logistic regression was applied. Binary logistic regression analysis showed that approach number of lanes was statistically significant at the 95% level of confidence. A higher number of approach lanes increased the probability of severity of cyclist casualty occurrence. In addition, sudden braking statistically significantly increased the cyclist casualty severity at the 95% level of confidence. The result concluded that cyclist casualty severity was highly related to approach a number of lanes and sudden braking. Further research should be carried out an in-depth analysis to explore connectivity of sudden braking and approach number of lanes in order to investigate the driver’s behavior at approach locations. The output of this research will inform investment in measure to improve the safety of cyclists at roundabouts.

Keywords: binary logistic regression, casualty severity, cyclist safety, roundabout

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Authors: Sara Fioretti

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In the 2nd millennium BCE, maritime networks became essential to the Mediterranean lifestyle, creating an interconnected world. This phenomenon of interconnected cultures has often been misinterpreted as an “effect” of the Mycenaean “influence” without considering the complexity and role of regional and cross-cultural exchanges. This paper explores the socio-economic relationships, in both cross-cultural and potentially inter-regional settings, present within the archaeological repertoire of the southern Italian Late Bronze Age (LBA 1600 -1140 BCE). The emergence of economic relations within the connectivity of the regional settlements is explored through ceramic contexts found in the case studies Punta di Zambrone, Broglio di Trebisacce, and Nuraghe Antigori. This work-in-progress research is situated in the shifting theoretical views of the last ten years that discuss the Late Bronze Age’s connectivity through Social Networks, Entanglement, and Assertive Objects combined with a comparative statistical study of ceramic frequency distribution. Applying these theoretical frameworks with a quantitative approach demonstrates the specific regional economic relationships that shaped the cultural interactions of the Late Bronze Age. Through this intersection of theory and statistical analysis, the case studies establish a small percentage of pottery as imported, whilst assertive productions have a relatively higher quantity. Overall, the majority still adheres to regional Italian traditions. Therefore, we can dissect the rhizomatic relationships cultivated by the Italian coasts and Mycenaeans and their roles within their networks through the intersection of theoretical and statistical analysis. This research offers a new perspective on the connectivity of the Late Bronze Age relational structures.

Keywords: late bronze age, mediterranean archaeology, exchanges and trade, frequency distribution of ceramic assemblages

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Authors: Edeaghe Ehikhamenor, Jennifer Nnamdi

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Introduction: Gender-based violence (GBV) was a well-known global crisis before the COVID-19 pandemic. The pandemic burden only intensified the crisis. With prevailing lockdowns, increased poverty due to high unemployment, especially affecting females, and other mobility restrictions that have left many women trapped with their abusers, plus isolation from social contact and support networks, GBV cases spiraled out of control. Prevalence of economic with cultural disparity, which is greatly manifested in Nigeria, is a major contributory factor to GBV. This is made worst by religious adherents where the females are virtually relegated to the background. Our societal approaches to investigations and sanctions to culprits have not sufficiently applied forensic/DNA tools in combating these major vices. Violence against women or some rare cases against men can prevent them from carrying out their duties regardless of the position they hold. Objective: The main objective of this research is to highlight the origin of GBV, the victims, types, contributing factors, and the applications of forensics/DNA tools and remedies so as to minimize GBV in our society. Methods: Descriptive information was obtained through the search on our daily newspapers, electronic media, google scholar websites, other authors' observations and personal experiences, plus anecdotal reports. Results: Findings from our exploratory searches revealed a high incidence of GBV with very limited or no applications of Forensics/DNA tools as an intervening mechanism to reduce GBV in Nigeria. Conclusion: Nigeria needs to develop clear-cut policies on forensics/DNA tools in terms of institutional framework to develop a curriculum for the training of all stakeholders to fast-track justice for victims of GBV so as to serve as a deterrent to other culprits.

Keywords: gender-based violence, forensics, DNA, justice

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Authors: Katie E. Jennings

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The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.

Keywords: family dynamics, forensic, mental disorder, positive psychology

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Authors: Made Kurnia Widiastuti Giri, Nyoman Kanca, Arie Swastini, Bambang Purwanto

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Aim: Waria transgenders are a phenomenon whose existence is undeniable. The sexual behaviours of waria transgenders belong to the groups of high-risk STDs infections, especially HIV/AIDS. The present study was aimed at finding out the general idea of the existence of waria transgenders in Singaraja, their sexual transactions, their sexual behaviours, and at exploring the factors affecting their sexual behaviours along with their participation in regular reproduction health control. Methods: The subjects of the present research were male-to-female transgenders living in the town of Singaraja. The research applied a qualitative approach. Data collection in this research was conducted through in-depth interview and observation. Results: The results of the study exposed 1) the existence of waria transgender community in Singaraja observed from their active participation in social events such as taking the roles of counsellors in the campaign of prevention and control of HIV/AIDS with the Local Commission of AIDS Control and other foundations; 2) the sexual services provided by waria transgenders which were performed in squeeze method, oral and anal sex which could be categorized as HIV/AIDS high-risk sexual behaviours, while the consistency in doing safe sex among the trangenders in Singaraja showed that most of the waria transgenders (80%) were aware of the urgency of using condoms during sexual intercourse; and 3) the low participation of the waria transgenders in Singaraja in regular reproduction health check up at the local Centre of Public Health Service was caused by their negative perception about being examined by female doctors. Conclucions: Waria in singaraja categorized as HIV/AIDS high-risk sexual behaviours but they do have consistency in doing safe sex by using condoms. They have a negative psychological perception about being examined by female doctors.

Keywords: waria transgenders, sexual behaviours, reproduction health, hiv/aids

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Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

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West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: elder care settings, family caregiver, home care, geriatric hospital care, long term care facility

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Authors: Orapan Thosingha, Tassana Boontong, Prapa Yuttatri, Vilaivan Thongcharoen, Soparn Potaya, Mattika Chaichan, Chanin Chakkrapopyodhin, Khwanthida Phimphakarn, Taddao Nabnean

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This research aimed to explore symptom experiences among Thai adults with chronic illnesses living in an urban community area of Bangkok. The sample was 670 adults with ages ranging from 20-59 years. The majority of them (65.2%) had more than one disease. Hypertension, dyslipidemia, and diabetes were the first three diseases among them. About 58% were female, and 51.1 % stayed with their couples. The studied sample had relatively low socioeconomic status; 33.7% were wage workers, 15.2% were street vendors, and 10.4% were unemployed. About 54 % had family incomes less than 10,000 baht (300 US Dollars) per month, and 41.6% addressed that their incomes were not adequate for daily living. Although the majority of them (63.7%) did not have to pay for hospital visits, they still had to pay for public transportation and could not earn a wage or any income on the hospital visit day. The first three physical symptoms they experienced were knee pain (60.5%) due to being overweight, headache (47.0%), and insomnia (44.6%). About 45% stated that their incomes decreased after having chronic illnesses and 37.2% expressed that having lower incomes affected their living, 34.5% perceived being a burden, and 34.3% regret about depending on others. It can be concluded that adults with low socioeconomic status who experienced chronic illnesses and resided in an urban community area had complex needs. While caring for them, nurses should pay attention not only to a disease-related domain but also to a social-related domain. Reached-out clinics led by professional nurses who are well-prepared for primary medical care and home visit are strongly recommended. National Health Security Office should adopt this policy and develop an action plan to serve the needs of chronically ill adults with low socioeconomic status.

Keywords: chronic illnesses, urban community, socioeconomic status, symptom experiences, low incomes

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Authors: Undiyaundeye Florence Atube, Ugar Innocent A.

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Young children are active learners who use all their senses to build concepts and ideas from their experiences. The process of learning, the content and the outcomes, is vital for young children. They need time to explore whether they are satisfied with what is learnt. Of all levels of education, early childhood education is considered to be most critical for the social, emotional, cognitive and physical development. For this reason, the teachers for early years need to play a significant role in the teaching and learning process through the provision of a friendly environment in the school. A case study approach was used in this study. The information was gathered through various methods like class observation, field notes, documents analysis, group processes, and semi structured interviews. The group processes participants and interviewees were taken from some stakeholders such as parents, students, teachers, and head teachers from public schools, to have a broad and comprehensive analysis, informal interaction with different stakeholders and self-reflection was used to clarify aspects of varying issues and findings. The teachers’ roles in developing a child friendly environment in personal capacity to learning were found to improve a pupils learning ability. Prior to early child development education, learning experiences and pedagogical content knowledge played a vital role in engaging teachers in developing their thinking and teaching practice. Children can be helped to develop independent self-control and self-reliance with careful planning and development of the child’s experience with sensitive and appropriate interaction by the educator to propel eagerness to learn through the provision of a friendly environment.

Keywords: child friendly environment, early childhood, education and development, teaching, learning and the curriculum

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Authors: Zorica Tomičić, Ružica Tomičić, Peter Raspor

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Growing resistance of pathogenic yeast Candida glabrata to many classes of antifungal drugs has stimulated efforts to discover new agents to combat a rising number of invasive C. glabrata infections, which deserves a great deal of concern due to the high mortality rate in immunocompromised populations. One promising strategy is the use of probiotic microorganisms, which, when administered in adequate amounts, confers a health benefit. A selected number of probiotic organisms, Saccharomyces boulardii among them, have been tested as potential biotherapeutic agents. The aim of this study was to investigate the effect of the probiotic yeast S. boulardii on the adhesion of clinical isolates of C. glabrata at different temperatures, pH values, and in the presence of three clinically important antifungal drugs, such as fluconazole, itraconazole and amphotericin B. The method used to assess adhesion was crystal violet staining. The selection of antimycotics concentrations used in the adhesion assay was based on minimum inhibitory concentrations (MICs) obtained by the preliminarily performed microdilution modification of the Reference method for broth dilution antifungal susceptibility testing of yeast (Clinical and Laboratory Standards Institute (CLSI), standard M27-A2). the results showed that despite the nonadhesiveness of S. boulardii cells, probiotic yeast significantly suppressed the adhesion of C. glabrata strains. Besides, at specific strain ratios, a slight stimulatory effect was observed in some C. glabrata strains, which highlights the importance of strain specificity and opens up further research interests. When environmental conditions are considered, temperature and pH significantly influenced co-culture adhesion of C. glabrata and S. boulardii. The adhesion of C. glabrata strains was relatively equally reduced over all tested temperature range (28°C, 37°C, 39°C and 42°C) in the presence of S. boulardii cells, while the adhesion of a few C. glabrata strains were significantly stimulated at 28°C and suppressed at 42°C. Further, the adhesion was highly dependent on pH, with the highest adherence at pH 4 and lowest at pH 8.5. It was observed that S. boulardii did not manage to suppress the adhesion of C. glabrata strains at high pH. Antimycotics on the other hand showed a greater impact, since S. boulardii failed to affect co-culture adhesion at higher antimycotics concentrations. As expected, exposure to various concentrations of amphotericin B significantly reduced the adherence ability of C.glabrata strains both in a single culture and co-culture with S. boulardii. Therefore, it can be speculated that S. boulardii could substitute the effect of antimycotics in a range concentrations and with specific type of strains. This would certainly change the view on the treatment of yeast infections in the future.

Keywords: adhesion, antimycotics, candida glabrata, saccharomyces boulardii

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Authors: Dumith Kulasekara

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This paper examines the representation of the body that particularly stresses the anatomical organs and the psychic conditions in contemporary art. The paper looks closely at the works that address personal and social meanings implying psychic conditions by bringing the internal hidden anatomical organs of the body to the surface of the visual language. The paper argues that contemporary artists conceptualize the idea of the body as a site of generating psychic conditions by excavating the body as material, subject, and object in art practice. The paper conceptualizes this excavating process of the body acts similarly to the idea of dissecting the corporeal body to understand its internal organism that again shapes the materiality of the surface of the body. In doing so, the paper brings together this argument, knowledge produced in the historical and contemporary anatomical education in art and science, and psychoanalytical approaches to the theme to develop new interpretations of representing psyche in the anatomical-bodied. The present paper defines this new form of body conceptually and materially addresses the issues related to psychic conditions: sexual desires, gender, traumas, and memories. The paper suggests that representation of the anatomical-bodied brings a new direction of the multidisciplinary approach introduced by artists to visualize the body and psyche in the contemporary context. The paper also presents an in-depth- discussion on technological, scientific, and philosophical knowledge employed in representing the idea of the body in addressing different psychic conditions to challenge the experiencing the body in contemporary art. Therefore, the paper focuses on examining the theme in the different forms of visual language and contexts in contemporary art. Finally, this research aims to offer a theoretical and conceptual background to curate an exhibition on the title of the anatomical-bodied and psyche in contemporary art with the body of work discussed in this paper.

Keywords: anatomy, body, contemporary art, psyche, psychoanalysis, representation, trauma

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Authors: Almutazballlah Bassam Qablan, Jihan M. Muhaidat, bana Abu Rajab

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Background: Acne vulgaris is considered one of the most common skin conditions encountered by dermatologists. It is a chronic inflammation affecting the pilosebaceous unit. Although acne vulgaris is not fatal, it leads to permanent scarring and disfigurement, and even without scarring, it has a huge effect on patients, causing negative health outcomes. Acne vulgaris patients experience psychological, and emotional ramifications as those with chronic health problems; they feel depressed, angry, anxious, and confused. Although acne is a popular disease, many thoughts and myths are still discussed about its origins and triggering factors. These myths can make you feel guilt as if you were somehow responsible for your acne. In this case control study, we want to define the relationship between two modifiable risk factors ;BMI and smoking, with acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Ramtha, Jordan in 2019/2020. A total number of 325 participants between 14 and 33 years of age were interviewed by the authors; including 163 acne vulgaris cases and 162 controls without acne vulgaris. Anthropometric measures and smoking for Acne patients and control participants were the independent variables used to assess acne. Univariate and multivariate analysis were used to compare the characteristics of people who reported acne with those with no acne. The collected data analyzed by using the Statistical Package for Social Sciences (SPSS). Results: Cigarette smoking was highly associated with controls; odds ratio 0.4 (95% CI: 0.2–0.9) , P-value = 0.018. BMI and waterpipe smoking were statistically insignificant with acne in the multivariate analysis. Conclusion: We found that cigarette smoking was protective against Acne. There was a statistically insignificant relation between BMI, waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, adolescents, BMI, smoking, case-control, risk factors

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Authors: Ioannis Souris

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In this paper, we would like to present how we taught German through playwriting and analyze the usefulness of this method for teaching languages and cultivating a sense of political agency in students and teachers alike. Last academic year, we worked at the German Saturday School in Greenwich, London. This school offers Saturday German lessons to children whose parents are German, living in London. The lessons are two hours long, and the children’s level of German varies according to how often or how much German is spoken at home or how often the families visit Germany (as well as other factors which will be discussed in more detail in the paper). The directors of the school provide teachers with learning material and course books, but they strongly encourage individual input on lesson structure and methods of teaching German. The class we taught consisted of six eight-to-nine-year-olds. Midway into the academic year, we ran out of teaching material, and we, therefore, decided to write a play. In the paper, we would like to explore the process we followed in creating or writing this play and how this encouraged the children to collaborate and exercise their skills in writing, storytelling, speaking, and opinion-sharing. We want to examine the impact this project had on the children who wrote and performed the play, the wider community of the Saturday school, and the development of our language teaching practice. We found, for instance, that some students, who were quiet or shy, became very open and outspoken in the process of writing and performing the play. They took the initiative and led the process, putting us, their teachers, in the role of simple observers or facilitators. When we showed the play in front of the school, the other children and teachers, as audience members, also became part of the process as they commented on the plot, language, and characters and gave feedback on further development. In the paper, we will discuss how this teaching project fits into recent developments in the research of creativity and the teaching of languages and how engagement with creative approaches to teaching has the potential to question and subvert traditional notions of ‘lesson’, ‘teacher’, and ‘student’. From the moment a questioning of norms takes place, we inadvertently raise questions about politics, agency, and resistance. We will conclude the paper with a definition of what we mean by ‘political agency’ within the context of our teaching project and education, in general, and why inspiring creativity and imagination within teaching can be considered a political act. Finally, our aim in this paper will be to propose the possibility of analyzing teaching languages through creativity and political agency theories.

Keywords: innovation in language teaching and learning, language acquisition and learning, language curriculum development, language education

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Authors: Oscar H. Malaco Jr.

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Homosexuality has been adapted as the universal concept that defines the deviations from the heteronormative parameters of society. Sexual orientation and gender identities have been used in a concretely separate manner the same way as the dynamics between man and woman, male and female, gender and sex operate. These terms are all products of human beings’ utilization of language. Language has proven its power to define and determine the status and the categories of the subjects in society. This tool developed by human beings provides a definition of their own specific cultural community and their individual selves that either claim or oppugn their space in the social hierarchy. The label ‘bakla’ is reasoned as an identity which is a reaction to the spectral disposition of gender and sexuality in the Philippine society. To expose the Filipino constitutes of bakla is the major attempt of this study. Through the methods of Sikolohiyang Pilipino (Filipino Psychology), namely Pagtatanung-tanong (asking questions) and Pakikipagkuwentuhan (story-telling), the utterances of the bakla were gathered and analyzed in a rhetorical and ideological manner. Furthermore, the Dramatistic Pentad of Kenneth Burke was adapted as a methodology and also utilized as a perspective of analysis. The results suggest that the bakla as an identity carries the hurdles of class. The performativity of the bakla is proven to be a cycle propelled by their guilt to be identified and recognized as subjects in a society where heteronormative power contests their gender and sexual expressions as relatively aberrational to the binary gender and sexual roles. The labels, hence, are potent structures that control the disposition of the bakla in the society, reflecting an aspect of the disposition of Filipino identities. After all, performing kabaklaan in the Philippine society is interplay between resistance and conformity to the hegemonic dominions as a result of imperial attempts to universalize the concept of homosexuality between and among distant cultural communities.

Keywords: gender identity, sexual orientation, rhetoric, performativity

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Authors: R. Vidhya

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Diasporic writings present a comprehensive view of social, cultural and psychological dualities of immigrants. Isolation and the strong feelings of insecurity and inferiority due to constant marginalization coupled with a nostalgia for their motherland, its customs, culture, language, food and people which keep haunting the minds of immigrants are the major themes that are handled by diasporic writers. In the African diaspora, more than the men, it is the women who face the brunt and burden of the triple jeopardy – the racial, class and gender discrimination. Women writers from Africa have successfully sketched the plight of African women in the diaspora. Buchi Emecheta, a Nigerian woman writer deftly portrays the African Diaspora in her novels. She skillfully weaves her stories with her own experiences as an immigrant in the United Kingdom. She portrays the immigrant life and psychology through numerous themes like exile, geographical shift of locations, transactions of culture, political instability and the dilemma of moral and religious ideologies in her diasporic novels Second-class Citizen, Gwendolyn and Kehinde. The contemporary Nigerian woman writer Chimamanda Ngozi Adichie has also dexterously depicted the diasporic dilemma of her protagonist Ifemelu in Americannah, who initially has the experience of a despondent and a downcast in the United States of America. This paper aims to analyse the diasporic sentiments and sensibilities of the Nigerian Igbo women writers Buchi Emecheta and Chimamanda Ngozi Adichie whose women characters finally find emancipation and empowerment in the African Diaspora. This study is based on the Africana Womanist Literary theory propounded by Clenora Hudson-Weems.

Keywords: African Diaspora, Nigerian women writers, Buchi Emecheta, Chimamanda Ngozi Adichie, emancipation, empowerment

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Authors: Abdelmanie Suleimat, Nagham Abu Shaqra, Sawsan Majali, Issam Adawi, Heba Abo Shindi, Anas Al Mohtaseb

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The Government of Jordan recognizes that maternal mortality constitutes a grave public health problem. Over the past two decades, there has been significant progress in improving the quality of maternal health services, resulting in improved maternal and child health outcomes. Despite these efforts, measurement and analysis of maternal mortality remained a challenge, with significant discrepancies from previous national surveys that inhibited accuracy. In response with support from USAID, the Jordan Maternal Mortality Surveillance Response (JMMSR) System was established to collect, analyze, and equip policymakers with data for decision-making guided by interdisciplinary multi-levelled advisory groups aiming to eliminate preventable maternal deaths, A 2016 Public Health Bylaw required the notification of deaths among women of reproductive age. The JMMSR system was launched in 2018 and continues annually, analyzing data received from health facilities, to guide policy to prevent avoidable deaths. To date, there have been four annual national maternal mortality reports (2018-2021). Data is collected, reviewed by advisory groups, and then consolidated in an annual report to inform and guide the Ministry of Health (MOH); JMMSR collects the necessary information to calculate an accurate maternal mortality ratio and assists in identifying leading causes and contributing factors for each maternal death. Based on this data, national response plans are created. A monitoring and evaluation plan was designed to define, track, and improve implementation through indicators. Over the past four years, one of these indicators, ‘percent of facilities notifying respective health directorates of all deaths of women of reproductive age,’ increased annually from 82.16%, 92.95%, and 92.50% to 97.02%, respectively. The Government of Jordan demonstrated commitment to the JMMSR system by designating the MOH to primarily host the system and lead the development and dissemination of policies and procedures to standardize implementation. The data was translated into practical and evidence-based recommendations. The successful impact of results deepened the understanding of maternal mortality in Jordan, which convinced the MOH to amend the Bylaw now mandating electronic reporting of all births and neonatal deaths from health facilities to empower the JMMSR system, by developing a stillbirths and neonatal mortality surveillance and response system.

Keywords: maternal health, maternal mortality, preventable maternal deaths, maternal morbidity

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Authors: Titia Izzati, Pebri Hastuti, Gusti Ayu Arwati

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Based on the program of The Ministry of Youth and Sports of Republic of Indonesia, this study compares the Statistikdata of the educational factors and the number of young people to a survey conducted in the five years, 2009-2013. As a result, significant trends are traced through an era filled with events that deeply affected the lives of young people, such as the peak and the ending of the political issues. Changing values under examination include attitudes toward authority and obligations toward others; social values dealing with attitudes toward the work ethic; marriage, family, and the importance of money in defining the meaning of success; and self-fulfillment. While the largest portion of the sample contains college youth, other people between the ages of 16 and 30 are considered, including high school students, blue collar workers, housewives, and high school dropouts. The report provides an overview and interpretation of the data with the presents the research contrasting the values of the college and non-college youth. In the other hand, the youth education profile data also can be utilized in making arrange the youth development index, especially in educational dimension. In order to the formulation of this youth development index, the basic needs of youth in Indonesia have to be listed as the variables. So that, the indicators of the youth development index are really in accordance withthe actual conditions of Indonesian youth. The indicators are the average number of old-school youth, the rate of youth illiterate people, the numbers of youth who are continuing their studies or who have completed the study in college, the number of youth graduate high school/vocational or college graduates were engaged in the labor fair. The formula for the youth development index is arranged in educational dimension with all actual indicators

Keywords: education, young people, Indonesia, ministry programs, youth index development

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Authors: Anwar Hassen Tsega

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International labor migration is an integral part of the modern globalized world. However, the phenomenon has its roots in some earlier periods in human history. This paper discusses the relatively new phenomenon of female migration in Africa. In the past, African women migrants were only spouses or dependent family members. But as modernity swept most African societies, with rising unemployment rates, there is evidence everywhere in Africa that women labor migration is a growing phenomenon that deserves to be understood in the context of human security research. This work explores these issues further, focusing on the experience of Ethiopian women labor migrants to Sudan. The migration of Ethiopian people to Sudan is historical; nevertheless, labor migration mainly started since the discovery and subsequent exploration of oil in the Sudan. While the paper is concerned with the human security aspect of the migrant workers, we need to be certain that the migration process will provide with a decent wage, good working conditions, the necessary social security coverage, and labor protection as a whole. However, migration to Sudan is not always safe and female migrants become subject to violence at the hands of brokers, employers and migration officials. For this matter, the paper argued that identifying the vulnerable stages and major problem facing female migrant workers at various stages of migration is a prerequisite to combat the problem and secure the lives of the migrant workers. The major problems female migrants face include extra degrees of gender-based violence, underpayment, various forms of abuse like verbal, physical and sexual and other forms of torture which include beating and slaps. This peculiar situation could be attributed to the fact that most of these women are irregular migrants and fall under the category of unskilled and/or illiterate migrants.

Keywords: Ethiopia, human security, labor migration, Sudan

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Authors: Michio Kurosu

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Alterations in glycosylation not only directly impact cell growth and survival but also facilitate tumor-induced immunomodulation and eventual metastasis. Identification of cell type-specific glycoconjugates (tumor markers) has led to the discovery of new assay systems for certain cancers via immunodetection reagents. N- and O-linked glycans are the most abundant forms of glycoproteins. Recent studies of cancer immunotherapy are based on the immunogenicity of truncated O-glycan chains (e.g., Tn, sTn, T, and sLea/x). The prevalence of N-linked glycan changes in the development of tumor cells is known; however, therapeutic antibodies against N-glycans have not yet been developed. This is due to the lack of specificity of N-linked glycans between normal/healthy and cancer cells. Abnormal branching of N-linked glycans has been observed, particularly in solid cancer cells. While the discovery of drug-like glycosyltransferase inhibitors that block the biosynthesis of specific branching has a very low likelihood of success, altered glycosylation levels can be exploited by suppressing N-glycan biosynthesis through the inhibition of dolichyl-phosphate N-acetylglucosaminephosphotransferase1 (DPAGT1) activity. Inhibition of DPAGT1 function leads to changes of O-glycosylation on proteins associated with mitochondria and zinc finger binding proteins (indirect effects). On the basis of dynamic crosstalk between DPAGT1 and Snail/Slung/ZEB1 (a family of transcription factors that promote the repression of the adhesion molecules), we have developed pharmacologically acceptable selective DPAGT1 inhibitors. Tunicamycin kills a wide range of cancer and healthy cells in a non-selective manner. In sharp contrast, our DPAGT1 inhibitors display strong cytostatic effects against 16 solid cancers, which require the overexpression of DPAGT1 in their progression but do not affect the cell viability of healthy cells. The identified DPAGT1 inhibitors possess impressive anti-metastatic ability in various solid cancer cell lines and induce their mitochondrial structural changes, resulting in apoptosis. A prototype DPAGT1 inhibitor, APPB has already been proven to shrink solid tumors (e.g., pancreatic cancers, triple-negative breast cancers) in vivo while suppressing metastases and has strong synergistic effects when combined with current cytotoxic drugs (e.g., paclitaxel). At this conference, our discovery of selective DPAGT1 inhibitors with drug-like properties and proof-of-pharmaceutical concept studies of a novel DPAGT1 inhibitor are presented.

Keywords: DPAGT1 inhibitors, anti-metastatic drugs, natural product based drug designs, cytostatic effects

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Authors: Daniel Fundi Murithi

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Data from economic, social, clinical, and industrial studies are in some way incomplete or incorrect due to censoring. Such data may have adverse effects if used in the estimation problem. We propose the use of Maximum Likelihood Estimation (MLE) under a progressive type-II censoring scheme to remedy this problem. In particular, maximum likelihood estimates (MLEs) for the location (µ) and scale (λ) parameters of two Parameter Rayleigh distribution are realized under a progressive type-II censoring scheme using the Expectation-Maximization (EM) and the Newton-Raphson (NR) algorithms. These algorithms are used comparatively because they iteratively produce satisfactory results in the estimation problem. The progressively type-II censoring scheme is used because it allows the removal of test units before the termination of the experiment. Approximate asymptotic variances and confidence intervals for the location and scale parameters are derived/constructed. The efficiency of EM and the NR algorithms is compared given root mean squared error (RMSE), bias, and the coverage rate. The simulation study showed that in most sets of simulation cases, the estimates obtained using the Expectation-maximization algorithm had small biases, small variances, narrower/small confidence intervals width, and small root of mean squared error compared to those generated via the Newton-Raphson (NR) algorithm. Further, the analysis of a real-life data set (data from simple experimental trials) showed that the Expectation-Maximization (EM) algorithm performs better compared to Newton-Raphson (NR) algorithm in all simulation cases under the progressive type-II censoring scheme.

Keywords: expectation-maximization algorithm, maximum likelihood estimation, Newton-Raphson method, two-parameter Rayleigh distribution, progressive type-II censoring

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Authors: Raymond E. Raguindin

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Objective: This research studied the teaching improvement of daycare workers in imitation, joint attention, and language activities using the play-based early intervention training program in Cabanatuan City, Nueva Ecija. Methods: Focus group discussions were developed to explore the attitude, beliefs, and practices of daycare workers. Results: Findings of the study revealed that daycare workers have existing knowledge and experience in teaching children with autism. Their workshops on managing inappropriate behaviors of children with autism resulting in a general positive perception of accepting and teaching children with autism in daycare centers. Play based activities were modelled and participated in by daycare workers. These include demonstration, modelling, prompting and providing social reinforcers as reward. Five lectures and five training days were done to implement the training program. Daycare workers’ levels of skill in teaching imitation, joint attention and language were gathered before and after the participation in the training program. Findings suggest significant differences between pre-test and post test scores. They have shown significant improvement in facilitating imitation, joint attention, and language children with autism after the play-based early intervention training. They were able to initiate and sustain imitation, joint attention, and language activities with adequate knowledge and confidence. Conclusions: 1. Existing attitudes and beliefs greatly influenced the positive delivery mode of instruction. 2. Teacher-directed approach to improve attention, imitation, joint attention, and language of children with autism can be acquired by daycare workers. 3. Teaching skills and experience can be used as reference and basis for identifying future training needs.

Keywords: early intervention, imitation, joint attention, language

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Authors: Xue Ma, Yang Fu, Dangyuan Lei

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Passive daytime radiative cooling is an emerging technology which has attracted worldwide attention in recent years due to its huge potential in cooling buildings without the use of electricity. Various coating materials with different optical properties have been developed to improve the daytime radiative cooling performance. However, commercial cooling coatings comprising functional fillers with optical bandgaps within the solar spectral range suffers from severe intrinsic absorption, limiting their cooling performance. Fortunately, it has recently been demonstrated that introducing fluorescent materials into polymeric coatings can covert the absorbed sunlight to fluorescent emissions and hence increase the effective solar reflectance and cooling performance. In this paper, we experimentally investigate the key factors for fluorescence-assisted radiative cooling with TiO2-based white coatings. The surrounding TiO2 nanoparticles, which enable spatial and temporal light confinement through multiple Mie scattering, lead to Purcell enhancement of phosphors in the coating. Photoluminescence lifetimes of two phosphors (BaMgAl10O17:Eu2+ and (Sr, Ba)SiO4:Eu2+) exhibit significant reduction of ~61% and ~23%, indicating Purcell factors of 2.6 and 1.3, respectively. Moreover, smaller Stokes shifts of the phosphors are preferred to further diminish solar absorption. Field test of fluorescent cooling coatings demonstrate an improvement of ~4% solar reflectance for the BaMgAl10O17:Eu2+-based fluorescent cooling coating. However, to maximize solar reflectance, a white appearance is introduced based on multiple Mie scattering by the broad size distribution of fillers, which is visually pressurized and aesthetically bored. Besides, most colored pigments absorb visible light significantly and convert it to non-radiative thermal energy, offsetting the cooling effect. Therefore, current colored cooling coatings are facing the compromise between color saturation and cooling effect. To solve this problem, we introduced colored fluorescent materials into white coating based on SiO2 microspheres as a top layer, covering a white cooling coating based on TiO2. Compared with the colored pigments, fluorescent materials could re-emit the absorbed light, reducing the solar absorption introduced by coloration. Our work investigated the scattering properties of SiO2 dielectric spheres with different diameters and detailly discussed their impact on the PL properties of phosphors, paving the way for colored fluorescent-assisted cooling coting to application and industrialization.

Keywords: solar reflection, infrared emissivity, mie scattering, photoluminescent emission, radiative cooling

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Authors: Meng Qing Feng, Otsile Morake

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Background: Successful implementation of the COVID-19 vaccination ensures the prevention of virus infection. Postponement and refusal of the vaccination will threaten public health, which is now common among the general public across the world. In addition, an acceptance of the COVID-19 vaccine appears as a decisive factor in controlling the COVID-19 pandemic. Purpose: This study's objective is to explore the factors influencing the public intention to be vaccinated (ITBV). Design/methodology/approach: The web-based survey included socio-demographics and questions related to the theory of planned behavior (TPB) and the health belief model (HBM). An online survey was administered using Google Form to collect data from participants of Botswana. The sample included 339 participants, half-half of the participants were female. Data analysis was run using the Statistical Package for the Social Sciences (SPSS). Findings: The study results highlight that perceived severity, perceived barriers, health motivation, and attitude have a positive and significant effect on ITBV, while perceived susceptibility, benefits, subjective norms, and perceived behavior control do not affect ITBV. Among all of the predictors, perceived barriers have the most significant influence on ITBV. Conclusion: Theoretically, this research stated that both HBM and TPB are effective in predicting and explaining the general public ITBV. Practically, this study offers insights to the government and health departments to arrange and launch health awareness programs and provide a better guide to vaccination so that doubts about vaccine confidence and the level of uncertainty can be decreased.

Keywords: COVID-19, Omicron, intention to be COVID-19 vaccine, health behavior model, theory of planned behavior, Botswana

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Authors: Elham Fariborzi, Hoda Anvari Kazemabad

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Today, ICT plays an important role in all matters and it affects the development of creative cities. According to virtual space in this technology, it use especially for expand terms like smart schools, Virtual University, web-based training and virtual classrooms that is in parallel with the traditional teaching. Nowadays, the educational systems in different countries such as Iran are changing and start increasing creativity in the learning environment. It will contribute to the development of innovative ideas and thinking of the people in this environment; such opportunities might be cause scientific discovery and development issues. The creativity means the ability to generate ideas and numerous, new and suitable solutions for solving the problems of real and virtual individuals and society, which can play a significant role in the development of creative current physical cities or virtual borders ones in the future. The purpose of this paper is to study strategies to increase creativity in a virtual learning to develop a creative city. In this paper, citation/ library study was used. The full description given in the text, including how to create and enhance learning creativity in a virtual classroom by reflecting on performance and progress; attention to self-directed learning guidelines, efficient use of social networks, systematic discussion groups and non-intuitive targeted controls them by involved factors and it may be effective in the teaching process regarding to creativity. Meanwhile, creating a virtual classroom the style of class recognizes formally the creativity. Also the use of a common model of creative thinking between student/teacher is effective to solve problems of virtual classroom. It is recommended to virtual education’ authorities in Iran to have a special review to the virtual curriculum for increasing creativity in educational content and such classes to be witnesses more creative in Iran's cities.

Keywords: virtual learning, creativity, e-learning, bioinformatics, biomedicine

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Authors: Siobhan Laird

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Under article 12 of the Convention on the Rights of the Child, which extends human rights in their application to those under the age of 18 years, children must be consulted ‘in all matters affecting the child’. The Office of the Children’s Commissioner for England is responsible for improving the welfare of children and young people by ensuring that their Convention rights are respected and realised and their views taken seriously. In 2014 the Children’s Commissioner engaged a team of researchers at the Centre for Social Work, University of Nottingham to develop and roll out an online survey to gather information from children and young people about their exercise of choice within the public care system. Approximately 3,000 children responded to this survey, which comprised both closed and open-ended questions. SPSS was used to analyse the numerical data and a thematic analysis of textual data was conducted on answers to open-ended questions. Findings revealed that children exercised considerable choice over personal space and their spare time, but had much less choice in relation to contact with their birth families, where they lived, or the timings of moves from one placement into another. The majority of children described how they were supported to express their opinions and believed that these were taken seriously. However, a significant number reported problems and explained how specific behaviours by professionals and carers made it difficult for them to express their opinion or to feel that they had influenced decisions which affected them. In open-ended questions eliciting information about their experiences, children and young people were asked to describe how they could be better supported to make choices and what changes would assist for these to be better acknowledged and acted upon by professionals and carers. This paper concludes by presenting the ideas and suggestions of children and young people for improving the public care system in Britain in relation to their exercise of choice.

Keywords: children, choice, participation, public care

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Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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Authors: Berker Bayazit, Gulgun Kayakutlu

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The World Energy Outlook shows that energy markets will substantially change within a few forthcoming decades. First, determined action plans according to COP21 and aim of CO₂ emission reduction have already impact on policies of countries. Secondly, swiftly changed technological developments in the field of renewable energy will be influential upon medium and long-term energy generation and consumption behaviors of countries. Furthermore, share of electricity on global energy consumption is to be expected as high as 40 percent in 2040. Electrical vehicles, heat pumps, new electronical devices and digital improvements will be outstanding technologies and innovations will be the testimony of the market modifications. In order to meet highly increasing electricity demand caused by technologies, countries have to make new investments in the field of electricity production, transmission and distribution. Specifically, electricity generation mix becomes vital for both prevention of CO₂ emission and reduction of power prices. Majority of the research and development investments are made in the field of electricity generation. Hence, the prime source diversity and source planning of electricity generation are crucial for improving the wealth of citizen life. Approaches considering the CO₂ emission and total cost of generation, are necessary but not sufficient to evaluate and construct the product mix. On the other hand, employment and positive contribution to macroeconomic values are important factors that have to be taken into consideration. This study aims to constitute new investments in renewable energies (solar, wind, geothermal, biogas and hydropower) between 2018-2023 under 4 different goals. Therefore, a multi-objective programming model is proposed to optimize the goals of minimizing the CO₂ emission, investment amount and electricity sales price while maximizing the total employment and positive contribution to current deficit. In order to avoid the user preference among the goals, Dinkelbach’s algorithm and Guzel’s approach have been combined. The achievements are discussed with comparison to the current policies. Our study shows that new policies like huge capacity allotment might be discussible although obligation for local production is positive. The improvements in grid infrastructure and re-design support for the biogas and geothermal can be recommended.

Keywords: energy generation policies, multi-objective linear programming, portfolio planning, renewable energy

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