Search results for: medication administration

Authors: Saeed Nazari, Masoom Nazari, Ali Hejazi, Siamak Sanoobari Ghazi Jahani, Mohammad Dehghani, Javad Vakili

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More than ever, digitization is an imperative for businesses to keep their competitive advantages, foster innovation and reduce paperwork. To design and successfully implement digital transformation initiatives within process safety management system, employees need to be equipped with the right tool, frameworks, and best practices. we developed a unique full stack application so-called SHEQTool which is entirely dynamic based on our extensive expertise, experience, and client feedback to help business processes particularly operations safety management. We use our best knowledge and scientific methodologies published by CCPS and OSHA Guidelines to streamline operations and integrated them into task management within Petrochemical Companies. We digitalize their main process safety management system elements and their sub elements such as hazard identification and risk management, training and communication, inspection and audit, critical changes management, contractor management, permit to work, pre-start-up safety review, incident reporting and investigation, emergency response plan, personal protective equipment, occupational health, and action management in a fully customizable manner with no programming needs for users. We review the feedback from main actors within petrochemical plant which highlights improving their business performance and productivity as well as keep tracking their functions’ key performance indicators (KPIs) because it; 1) saves time, resources, and costs of all paperwork on our businesses (by Digitalization); 2) reduces errors and improve performance within management system by covering most of daily software needs of the organization and reduce complexity and associated costs of numerous tools and their required training (One Tool Approach); 3) focuses on management systems and integrate functions and put them into traceable task management (RASCI and Flowcharting); 4) helps the entire enterprise be resilient to any change of your processes, technologies, assets with minimum costs (through Organizational Resilience); 5) reduces significantly incidents and errors via world class safety management programs and elements (by Simplification); 6) gives the companies a systematic, traceable, risk based, process based, and science based integrated management system (via proper Methodologies); 7) helps business processes complies with ISO 9001, ISO 14001, ISO 45001, ISO 31000, best practices as well as legal regulations by PDCA approach (Compliance).

Keywords: process, safety, digitalization, management, risk, incident, SHEQTool, OSHA, CCPS

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Authors: Rishi Pal Singh

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In Indian Scenario, Organic agriculture is growing by the conscious efforts of inspired people who are able to create the best promising relationship between the earth and men. Nowadays, the major challenge is its entry into the policy-making framework, its entry into the global market and weak sensitization among the farmers. But, during the last two decades, the contamination in environment and food which is linked with the bad agricultural potential/techniques has diverted the mind set of farmers towards the organic farming. In the view of above concept, a small-scale project has been installed to promote the 20 farmers from the Kunjura and surrounding villages for organic farming. This project is working since from the last 3 crops (starting from October, 2016) and found that it can meet both demands and complete development of rural areas. Farmers of this concept are working on the principles such that the nature never demands unreasonable quantities of water, mining and to destroy the microbes and other organisms. As per details of Organic Monitor estimates, global sales reached in billion in the present analysis. In this initiative, firstly, wheat and rice were considered for farming and observed that the production of crop has grown almost 10-15% per year from the last crop production. This is not linked only with the profit or loss but also emphasized on the concept of health, ecology, fairness and care of soil enrichment. Several techniques were used like use of biological fertilizers instead of chemicals, multiple cropping, temperature management, rain water harvesting, development of own seed, vermicompost and integration of animals. In the first year, to increase the fertility of the land, legumes (moong, cow pea and red gram) were grown in strips for the 60, 90 and 120 days. Simultaneously, the mixture of compost and vermicompost in the proportion of 2:1 was applied at the rate of 2.0 ton per acre which was enriched with 5 kg Azotobacter and 5 kg Rhizobium biofertilizer. To complete the amount of phosphorus, 250 kg rock phosphate was used. After the one month, jivamrut can be used with the irrigation water or during the rainy days. In next season, compost-vermicompost mixture @ 2.5 ton/ha was used for all type of crops. After the completion of this treatment, now the soil is ready for high value ordinary/horticultural crops. The amount of above stated biofertilizers, compost-vermicompost and rock phosphate may be increased for the high alternative fertilizers. The significance of the projects is that now the farmers believe in cultural alternative (use of disease-free their own seed, organic pest management), maintenance of biodiversity, crop rotation practices and health benefits of organic farming. This type of organic farming projects should be installed at the level of gram/block/district administration.

Keywords: organic farming, Kunjpura, compost, bio-fertilizers

Procedia PDF Downloads 196

Authors: Jyoti Singh, Ranju Bansal

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Fighting pain and inflammation is a common problem faced by physicians while dealing with a wide variety of diseases. Since ancient time nonsteroidal anti-inflammatory agents (NSAIDs) and opioids have been the cornerstone of treatment therapy, however, the usefulness of both these classes is limited due to severe side effects. NSAIDs, which are mainly used to treat mild to moderate inflammatory pain, induce gastric irritation and nephrotoxicity whereas opioids show an array of adverse reactions such as respiratory depression, sedation, and constipation. Moreover, repeated administration of these drugs induces tolerance to the analgesic effects and physical dependence. Further discovery of selective COX-2 inhibitors (coxibs) suggested safety without any ulcerogenic side effects; however, long-term use of these drugs resulted in kidney and hepatic toxicity along with an increased risk of secondary cardiovascular effects. The basic approaches towards inflammation and pain treatment are constantly changing, and researchers are continuously trying to develop safer and effective anti-inflammatory drug candidates for the treatment of different inflammatory conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriasis and multiple sclerosis. Synthetic 3(2H)-pyridazinones constitute an important scaffold for drug discovery. Structure-activity relationship studies on pyridazinones have shown that attachment of a lactam at N-2 of the pyridazinone ring through a methylene spacer results in significantly increased anti-inflammatory and analgesic properties of the derivatives. Further introduction of the heterocyclic ring at lactam nitrogen results in improvement of biological activities. Keeping in mind these SAR studies, a new series of compounds were synthesized as shown in scheme 1 and investigated for anti-inflammatory, analgesic, anti-platelet activities and docking studies. The structures of newly synthesized compounds have been established by various spectroscopic techniques. All the synthesized pyridazinone derivatives exhibited potent anti-inflammatory and analgesic activity. Homoveratryl substituted derivative was found to possess highest anti-inflammatory and analgesic activity displaying 73.60 % inhibition of edema at 40 mg/kg with no ulcerogenic activity when compared to standard drugs indomethacin. Moreover, 2-substituted-4-benzo[d][1,3]dioxole-6-phenylpyridazin-3(2H)-ones derivatives did not produce significant changes in bleeding time and emerged as safe agents. Molecular docking studies also illustrated good binding interactions at the active site of the cyclooxygenase-2 (hCox-2) enzyme.

Keywords: anti-inflammatory, analgesic, pyridazin-3(2H)-one, selective COX-2 inhibitors

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Authors: V. K. Rajaletchumy, S. L. Chia, M. I. Setyawati, M. S. Muthu, S. S. Feng, D. T. Leong

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Triple negative breast cancers (TNBC) can be classified as one of the most aggressive with a high rate of local recurrences and systematic metastases. TNBCs are insensitive to existing hormonal therapy or targeted therapies such as the use of monoclonal antibodies, due to the lack of oestrogen receptor (ER) and progesterone receptor (PR) and the absence of overexpression of human epidermal growth factor receptor 2 (HER2) compared with other types of breast cancers. The absence of targeted therapies for selective delivery of therapeutic agents into tumours, led to the search for druggable targets in TNBC. In this study, we developed a targeted micellar system of cetuximab-conjugated micelles of D-α-tocopheryl polyethylene glycol succinate (vitamin E TPGS) for targeted delivery of docetaxel as a model anticancer drug for the treatment of TNBCs. We examined the efficacy of our micellar system in xenograft models of triple negative breast cancers and explored the effect of the micelles on post-treatment tumours in order to elucidate the mechanism underlying the nanomedicine treatment in oncology. The targeting micelles were found preferentially accumulated in tumours immediately after the administration of the micelles compare to normal tissue. The fluorescence signal gradually increased up to 12 h at the tumour site and sustained for up to 24 h, reflecting the increases in targeted micelles (TPFC) micelles in MDA-MB-231/Luc cells. In comparison, for the non-targeting micelles (TPF), the fluorescence signal was evenly distributed all over the body of the mice. Only a slight increase in fluorescence at the chest area was observed after 24 h post-injection, reflecting the moderate uptake of micelles by the tumour. The successful delivery of docetaxel into tumour by the targeted micelles (TPDC) exhibited a greater degree of tumour growth inhibition than Taxotere® after 15 days of treatment. The ex vivo study has demonstrated that tumours treated with targeting micelles exhibit enhanced cell cycle arrest and attenuated proliferation compared with the control and with those treated non-targeting micelles. Furthermore, the ex vivo investigation revealed that both the targeting and non-targeting micellar formulations shows significant inhibition of cell migration with migration indices reduced by 0.098- and 0.28-fold, respectively, relative to the control. Overall, both the in vivo and ex vivo data increased the confidence that our micellar formulations effectively targeted and inhibited EGF-overexpressing MDA-MB-231 tumours.

Keywords: biodegradable polymers, cancer nanotechnology, drug targeting, molecular biomaterials, nanomedicine

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Authors: Aaron Akinloye

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this research focuses on the impact of jungle justice on the emotional health challenges experienced by residents in the Lagos metropolitan city in Nigeria. Jungle justice refers to the practice of individuals taking the law into their own hands and administering punishment without proper legal procedures. The aim of this study is to investigate the influence of jungle justice on the emotional challenges faced by residents in Lagos. The specific objectives of the study are to examine the effects of jungle justice on trauma, pressure, fear, and depression among residents. The study adopts a descriptive survey research design and uses a questionnaire as the research instrument. The population of the study consisted of residents in the three senatorial districts that make up Lagos State. A simple random sampling technique was used to select two Local Government Areas (Yaba and Shomolu) from each of the three senatorial districts of Lagos State. Also, a simple random sampling technique was used to select fifty (50) residents from each of the chosen Local Government Areas to make three hundred (300) residents that formed the sample of the study. Accidental sampling technique is employed to select a sample of 300 residents. Data on the variables of interest is collected using a self-developed questionnaire. The research instrument undergoes validation through face, content, and construct validation processes. The reliability coefficient of the instrument is found to be 0.84. The study reveals that jungle justice significantly influences trauma, pressure, fear, and depression among residents in Lagos metropolitan city. The statistical analysis shows significant relationships between jungle justice and these emotional health challenges (df (298) t= 2.33, p< 0.05; df (298) t= 2.16, p< 0.05; df (298) t= 2.20, p< 0.05; df (298) t= 2.14, p< 0.05). This study contributes to the literature by highlighting the negative effects of jungle justice on the emotional well-being of residents. It emphasizes the importance of addressing this issue and implementing measures to prevent such vigilante actions. Data is collected through the administration of the self-developed questionnaire to the selected residents. The collected data is then analyzed using inferential statistics, specifically mean analysis, to examine the relationships between jungle justice and the emotional health challenges experienced by the residents. The main question addressed in this study is how jungle justice affects the emotional health challenges faced by residents in Lagos metropolitan city. Conclusion: The study concludes that jungle justice has a significant influence on trauma, pressure, fear, and depression among residents. To address this issue, recommendations are made, including the implementation of comprehensive awareness campaigns, improvement of law enforcement agencies, development of support systems for victims, and revision of the legal framework to effectively address jungle justice. Overall, this research contributes to the understanding of the consequences of jungle justice and provides recommendations for intervention to protect the emotional well-being of residents in Lagos metropolitan city.

Keywords: jungle justice, emotional health, depression, anger

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Authors: Sofia Papadimitriou

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INTRODUCTION: The differential diagnosis between acute viral and bacterial infections is an important cost-effectiveness parameter at the stage of the treatment process in order to achieve the maximum benefits in therapeutic intervention by combining the minimum cost to ensure the proper use of antibiotics.The discovery of sensitive and robust molecular diagnostic tests in response to the role of the host in infections has enhanced the accurate diagnosis and differentiation of infections. METHOD: The study used a sample of six independent blood samples (total=756) which are associated with human proteins-proteins, each of which at the transcription stage expresses a different response in the host network between viral and bacterial infections.Τhe individual blood samples are subjected to a sequence of computer filters that identify a gene panel corresponding to an autonomous diagnostic score. The data set and the correspondence of the gene panel to the diagnostic patents a new Bangalore -Viral Bacterial (BL-VB). FINDING: We use a biomarker based on the blood of 10 genes(Panel-VB) that are an important prognostic value for the detection of viruses from bacterial infections with a weighted average AUROC of 0.97(95% CL:0.96-0.99) in eleven independent samples (sets n=898). We discovered a base with a patient score (VB 10 ) according to the table, which is a significant diagnostic value with a weighted average of AUROC 0.94(95% CL: 0.91-0.98) in 2996 patient samples from 56 public sets of data from 19 different countries. We also studied VB 10 in a new cohort of South India (BL-VB,n=56) and found 97% accuracy in confirmed cases of viral and bacterial infections. We found that VB 10 (a)accurately identifies the type of infection even in unspecified cases negative to the culture (b) shows its clinical condition recovery and (c) applies to all age groups, covering a wide range of acute bacterial and viral infectious, including non-specific pathogens. We applied our VB 10 rating to publicly available COVID 19 data and found that our rating diagnosed viral infection in patient samples. RESULTS: Τhe results of the study showed the diagnostic power of the biomarker VB 10 as a diagnostic test for the accurate diagnosis of acute infections in recovery conditions. We look forward to helping you make clinical decisions about prescribing antibiotics and integrating them into your policies management of antibiotic stewardship efforts. CONCLUSIONS: Overall, we are developing a new property of the RNA-based biomarker and a new blood test to differentiate between viral and bacterial infections to assist a physician in designing the optimal treatment regimen to contribute to the proper use of antibiotics and reduce the burden on antimicrobial resistance, AMR.

Keywords: acute infections, antimicrobial resistance, biomarker, blood transcriptome, systems biology, classifier diagnostic score

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Authors: Nima Samie, Sekaran Muniandy, Zahurin Mohamed, M. S. Kanthimathi

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Although number of indole containing compounds have been reported to have anticancer properties in vitro but only a few of them show potential as anticancer compounds in vivo. The current study was to evaluate the mechanism of cytotoxicity of selected indolic compound in vivo and in vitro. In this context, we determined the potency of the compound in the induction of apoptosis, cell cycle arrest, and cytoskeleton rearrangement. HT-29, WiDr, CCD-18Co, human monocyte/macrophage CRL-9855, and B lymphocyte CCL-156 cell lines were used to determine the IC50 of the compound using the MTT assay. Analysis of apoptosis was carried out using immunofluorescence, acridine orange/ propidium iodide double staining, Annexin-V-FITC assay, evaluation of the translocation of NF-kB, oxygen radical antioxidant capacity, quenching of reactive oxygen species content, measurement of LDH release, caspase-3/-7, -8 and -9 assays and western blotting. The cell cycle arrest was examined using flowcytometry and gene expression was assessed using qPCR array. Results displayed a potent suppressive effect on HT-29 and WiDr after 24 h of treatment with IC50 value of 2.52±0.34 µg/ml and 2.13±0.65 µg/ml respectively. This cytotoxic effect on normal, monocyte/macrophage and B-cells was insignificant. Dipping in the mitochondrial membrane potential and increased release of cytochrome c from the mitochondria indicated induction of the intrinsic apoptosis pathway by the compound. Activation of this pathway was further evidenced by significant activation of caspase-9 and 3/7. The compound was also shown to activate the extrinsic pathways of apoptosis via activation of caspase-8 which is linked to the suppression of NF-kB translocation to the nucleus. Cell cycle arrest in the G1 phase and up-regulation of glutathione reductase, based on excessive ROS production were also observed. These findings were further investigated for inhibitory efficiency of the compound on colonic aberrant crypt foci in male rats. Rats were divided in to 5 groups: vehicle, cancer control, positive control groups and the groups treated with 25 and 50 mg/kg of compounds for 10 weeks. Administration of compound suppressed total colonic ACF formation up to 73.4%. The results also showed that treatment with the compound significantly reduced the level of malondialdehyde while increasing superoxide dismutase and catalase activities. Furthermore, the down-regulation of PCNA and Bcl2 and the up-regulation of Bax was confirmed by immunohistochemical staining. The outcome of this study suggest sthat the indolic compound is a potent anti-cancer agent against colon cancer and can be further evaluated by animal trial.

Keywords: indolic compound, chemoprevention, crypt, azoxymethane, colon cancer

Procedia PDF Downloads 348

Authors: A. F. Huseynov, N. T. Mardanov, J. Y. Nakhchivanski

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This practical research is aimed to improve the management quality and efficiency of public administration agencies providing e-services. The monitoring system developed will provide continuous review of the websites compliance with the selected indicators, their evaluation based on the selected indicators and ranking of services according to the quality criteria. The responsible departments in the government agencies were surveyed; the questionnaire includes issues of management and feedback, e-services provided, and the application of information systems. By analyzing the main affecting factors and barriers, the recommendations will be given that lead to the relevant decisions to strengthen the state agencies competencies for the management and the provision of their services. Component 1. E-services monitoring system. Three separate monitoring activities are proposed to be executed in parallel: Continuous tracing of e-government sites using built-in web-monitoring program; this program generates several quantitative values which are basically related to the technical characteristics and the performance of websites. The expert assessment of e-government sites in accordance with the two general criteria. Criterion 1. Technical quality of the site. Criterion 2. Usability/accessibility (load, see, use). Each high-level criterion is in turn subdivided into several sub-criteria, such as: the fonts and the color of the background (Is it readable?), W3C coding standards, availability of the Robots.txt and the site map, the search engine, the feedback/contact and the security mechanisms. The on-line survey of the users/citizens – a small group of questions embedded in the e-service websites. The questionnaires comprise of the information concerning navigation, users’ experience with the website (whether it was positive or negative), etc. Automated monitoring of web-sites by its own could not capture the whole evaluation process, and should therefore be seen as a complement to expert’s manual web evaluations. All of the separate results were integrated to provide the complete evaluation picture. Component 2. Assessment of the agencies/departments efficiency in providing e-government services. - the relevant indicators to evaluate the efficiency and the effectiveness of e-services were identified; - the survey was conducted in all the governmental organizations (ministries, committees and agencies) that provide electronic services for the citizens or the businesses; - the quantitative and qualitative measures are covering the following sections of activities: e-governance, e-services, the feedback from the users, the information systems at the agencies’ disposal. Main results: 1. The software program and the set of indicators for internet sites evaluation has been developed and the results of pilot monitoring have been presented. 2. The evaluation of the (internal) efficiency of the e-government agencies based on the survey results with the practical recommendations related to the human potential, the information systems used and e-services provided.

Keywords: e-government, web-sites monitoring, survey, internal efficiency

Procedia PDF Downloads 304

Authors: Idowu R. Akomolafe, Naven Chetty

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Background: The widespread medical application of ionizing radiation has raised public concern about radiation exposure and, thus, associated cancer risk. The production of reactive oxygen species and free radicals as a result of radiation exposure can cause severe damage to deoxyribonucleic acid (DNA) of cells, thus leading to biological effect. Radiotherapy is an excellent modality in the treatment of cancerous cells, comes with a few challenges. A significant challenge is the exposure of healthy cells surrounding the tumour to radiation. The last few decades have witnessed lots of attention shifted to plants, herbs, and natural product as an alternative to synthetic compound for radioprotection. Thus, the study investigated the radioprotective efficacy of Costus afer against whole-body radiation-induced haematological, histopathological disorder in mice. Materials and Method: Fifty-four mice were randomly divided into nine groups. Animals were pretreated with the extract of Costus afer by oral gavage for six days before irradiation. Control: 6 mice received feed and water only; 6 mice received feed, water, and 3Gy; 6 mice received feed, water, and 6Gy; experimental: 6 mice received 250 mg/kg extract; 6 mice received 500 mg/kg extract; 6 mice received 250 mg/kg extract and 3Gy; 6 mice received 500 mg/kg extract and 3Gy; 6 mice received 250 mg/kg extract and 6Gy; 6 mice received 500 mg/kg extract and 6Gy in addition to feeding and water. The irradiation was done at the Radiotherapy and Oncology Department of Grey's Hospital using linear accelerator (LINAC). Thirty-six mice were sacrificed by cervical dislocation 48 hours after irradiation, and blood was collected for haematology tests. Also, the liver and kidney of the sacrificed mice were surgically removed for histopathology tests. The remaining eighteen (18) mice were used for mortality and survival studies. Data were analysed by one-way ANOVA, followed by Tukey's multiple comparison test. Results: Prior administration of Costus afer extract decreased the symptoms of radiation sickness and caused a significant delay in the mortality as demonstrated in the experimental mice. The first mortality was recorded on day-5 post irradiation, and this happened to the group E- that is, mice that received 6Gy but no extract. There was significant protection in the experimental mice, as demonstrated in the blood counts against hematopoietic and gastrointestinal damage when compared with the control. The protection was seen in the increase in blood counts of experimental animals and the number of survivor. The protection offered by Costus afer may be due to its ability to scavenge free radicals and restore gastrointestinal and bone marrow damage produced by radiation. Conclusions: The study has demonstrated that exposure of mice to radiation could cause modifications in the haematological and histopathological parameters of irradiated mice. However, the changes were relieved by the methanol extract of Costus afer, probably through its free radical scavenging and antioxidant properties.

Keywords: costus afer, hematological, mortality, radioprotection, radiotherapy

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Authors: Tamas Dani

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The author’s research explores the geo-economical role and importance of some small and medium sized states, reviews their adaption strategies in foreign trade and also in foreign affairs in the course of changing into a multipolar world, uses international background. With these, the paper analyses the recent years and the future of ‘Opening towards Eastern foreign economic policies’ from East-Central Europe and parallel with that the ‘Western foreign economy policies’ from Asia, as the Chinese One Belt One Road new silk route plans (so far its huge part is an infrastructural development plan to reach international trade and investment aims). It can be today’s question whether these ideas will reshape the global trade or not. How does the new silk road initiatives and the Eurasian Union reflect the effect of globalization? It is worth to analyse that how did Central and Eastern European countries open to Asia; why does China have the focus of the opening policies in many countries and why could China be seen as the ‘winner’ of the world economic crisis after 2008. The research is based on the following methodologies: national and international literature, policy documents and related design documents, complemented by processing of international databases, statistics and live interviews with leaders from East-Central European countries’ companies and public administration, diplomats and international traders. The results also illustrated by mapping and graphs. The research will find out as major findings whether the state decision-makers have enough margin for manoeuvres to strengthen foreign economic relations. This work has a hypothesis that countries in East-Central Europe have real chance to diversify their relations in foreign trade, focus beyond their traditional partners. This essay focuses on the opportunities of East-Central-European countries in diversification of foreign trade relations towards China and Russia in terms of ‘Eastern Openings’. The effects of the new silk road initiatives and the Eurasian Union to Hungary’s economy with a comparing outlook on East-Central European countries and exploring common regional cooperation opportunities in this area. The essay concentrate on the changing trade relations between East-Central-Europe and China as well as Russia, try to analyse the effects of the new silk road initiatives and the Eurasian Union also. In the conclusion part, it shows how the cooperation is necessary for the East-Central European countries if they want to have a non-asymmetric trade with Russia, China or some Chinese regions (Pearl River Delta, Hainan, …). The form of the cooperation for the East-Central European nations can be Visegrad 4 Cooperation (V4), Central and Eastern European Countries (CEEC16), 3 SEAS Cooperation (or BABS – Baltic, Adriatic, Black Seas Initiative).

Keywords: China, East-Central Europe, foreign trade relations, geoeconomics, geopolitics, Russia

Procedia PDF Downloads 182

Authors: Amornchai Challcharoenwattana, Chanathip Pharino

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Rising amount of MSW every day, maximizing material diversions from landfills via recycling is a prefer method to land dumping. Characteristic of Thai MSW is classified as 40 -60 per cent compostable wastes while potentially recyclable materials in waste streams are composed of plastics, papers, glasses, and metals. However, rate of material recovery from MSW, excluding composting or biogas generation, in Thailand is still low. Thailand’s recycling rate in 2010 was only 20.5 per cent. Central government as well as local governments in Thailand have tried to curb this problem by charging some of MSW management fees at the users. However, the fee is often too low to promote MSW minimization. The objective of this paper is to identify levels of willingness-to-pay (WTP) for MSW recycling in different social structures with expected outcome of sustainable MSW managements for different town settlements to maximize MSW recycling pertaining to each town’s potential. The method of eliciting WTP is a payment card. The questionnaire was deployed using online survey during December 2012. Responses were categorized into respondents living in Bangkok, living in other municipality areas, or outside municipality area. The responses were analysed using descriptive statistics, and multiple linear regression analysis to identify relationships and factors that could influence high or low WTP. During the survey period, there were 168 filled questionnaires from total 689 visits. However, only 96 questionnaires could be usable. Among respondents in the usable questionnaires, 36 respondents lived in within the boundary of Bangkok Metropolitan Administration while 45 respondents lived in the chartered areas that were classified as other municipality but not in BMA. Most of respondents were well-off as 75 respondents reported positive monthly cash flow (77.32%), 15 respondents reported neutral monthly cash flow (15.46%) while 7 respondent reported negative monthly cash flow (7.22%). For WTP data including WTP of 0 baht with valid responses, ranking from the highest means of WTP to the lowest WTP of respondents by geographical locations for good MSW management were Bangkok (196 baht/month), municipalities (154 baht/month), and non-urbanized towns (111 baht/month). In-depth analysis was conducted to analyse whether there are additional room for further increase of MSW management fees from the current payment that each correspondent is currently paying. The result from multiple-regression analysis suggested that the following factors could impacts the increase or decrease of WTP: incomes, age, and gender. Overall, the outcome of this study suggests that survey respondents are likely to support improvement of MSW treatments that are not solely relying on landfilling technique. Recommendations for further studies are to obtain larger sample sizes in order to improve statistical powers and to provide better accuracy of WTP study.

Keywords: MSW, willingness to pay, payment card, waste seperation

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Authors: Maria R. Mula-Molina, Juan A. Ferriz-Papi

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Environmental concerns are increasingly obtaining higher priority in sustainability agenda of educational establishments. This is important not only for its environmental performance in its own right as an organization, but also to present a model for its students. On the other hand, universities play an important role on research and innovative solutions for measuring, analyzing and reducing environmental impacts for different activities. The assessment and decision-making process during the activity of educational establishments is linked to the application of robust indicators. In this way, the carbon footprint is a developing indicator for sustainability that helps understand the direct impact on climate change. But it is not easy to implement. There is a large amount of considering factors involved that increases its complexity, such as different uses at the same time (research, lecturing, administration), different users (students, staff) or different levels of activity (lecturing, exam or holidays periods). The aim of this research is to develop a simplified methodology for calculating and comparing carbon emissions per user at university campus considering two main aspects for carbon accountings: Building operations and transport. Different methodologies applied in other Spanish university campuses are analyzed and compared to obtain a final proposal to be developed in this type of establishments. First, building operation calculation considers the different uses and energy sources consumed. Second, for transport calculation, the different users and working hours are calculated separately, as well as their origin and traveling preferences. For every transport, a different conversion factor is used depending on carbon emissions produced. The final result is obtained as an average of carbon emissions produced per user. A case study is applied to the University of Alicante campus in San Vicente del Raspeig (Spain), where the carbon footprint is calculated. While the building operation consumptions are known per building and month, it does not happen with transport. Only one survey about the habit of transport for users was developed in 2009/2010, so no evolution of results can be shown in this case. Besides, building operations are not split per use, as building services are not monitored separately. These results are analyzed in depth considering all factors and limitations. Besides, they are compared to other estimations in other campuses. Finally, the application of the presented methodology is also studied. The recommendations concluded in this study try to enhance carbon emission monitoring and control. A Carbon Action Plan is then a primary solution to be developed. On the other hand, the application developed in the University of Alicante campus cannot only further enhance the methodology itself, but also render the adoption by other educational establishments more readily possible and yet with a considerable degree of flexibility to cater for their specific requirements.

Keywords: building operations, built environment, carbon footprint, climate change, transport

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Authors: Urvi Panwar, Kanchan Mishra, Kanjaksha Ghosh, ShankerLal Kothari

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Background: Day-by-day the increasing prevalence of neurodegenerative diseases have become a global issue to manage them by medical sciences. The adult neural stem cells are rare and require an invasive and painful procedure to obtain it from central nervous system. Mesenchymal stem cell (MSCs) therapies have shown remarkable application in treatment of various cell injuries and cell loss. MSCs can be derived from various sources like adult tissues, human bone marrow, umbilical cord blood and cord tissue. MSCs have similar proliferation and differentiation capability, but the human umbilical cord-derived mesenchymal stem cells (hUCMSCs) are proved to be more beneficial with respect to cell procurement, differentiation to other cells, preservation, and transplantation. Material and method: Human umbilical cord is easily obtainable and non-controversial comparative to bone marrow and other adult tissues. The umbilical cord can be collected after delivery of baby, and its tissue can be cultured using explant culture method. Cell culture medium such as DMEMF12+10% FBS and DMEMF12+Neural growth factors (bFGF, human noggin, B27) with antibiotics (Streptomycin/Gentamycin) were used to culture and differentiate mesenchymal stem cells into neural cells, respectively. The characterisations of MSCs were done with Flow Cytometer for surface markers CD90, CD73 and CD105 and colony forming unit assay. The differentiated various neural cells will be characterised by fluorescence markers for neurons, astrocytes, and oligodendrocytes; quantitative PCR for genes Nestin and NeuroD1 and Western blotting technique for gap43 protein. Result and discussion: The high quality and number of MSCs were isolated from human umbilical cord via explant culture method. The obtained MSCs were differentiated into neural cells like neurons, astrocytes and oligodendrocytes. The differentiated neural cells can be used to treat neural injuries and neural cell loss by delivering cells by non-invasive administration via cerebrospinal fluid (CSF) or blood. Moreover, the MSCs can also be directly delivered to different injured sites where they differentiate into neural cells. Therefore, human umbilical cord is demonstrated to be an inexpensive and easily available source for MSCs. Moreover, the hUCMSCs can be a potential source for neural cell therapies and neural cell regeneration for neural cell injuries and neural cell loss. This new way of research will be helpful to treat and manage neural cell damages and neurodegenerative diseases like Alzheimer and Parkinson. Still the study has a long way to go but it is a promising approach for many neural disorders for which at present no satisfactory management is available.

Keywords: bone marrow, cell therapy, explant culture method, flow cytometer, human umbilical cord, mesenchymal stem cells, neurodegenerative diseases, neuroprotective, regeneration

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Authors: Palak Sadhwani, Susie Pryor

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This paper investigates interprofessional collaboration (IPC) in the context of entrepreneurship education. Collaboration has been found to enhance problem solving, leverage expertise, improve resource allocation, and create organizational efficiencies. However, research suggests that successful collaboration is hampered by individual and organizational characteristics. IPC occurs when two or more professionals work together to solve a problem or achieve a common objective. The necessity for this form of collaboration is particularly prevalent in cross-disciplinary fields. In this study, we utilize social exchange theory (SET) to examine IPC in the context of an entrepreneurship living learning community (LLC) at a large university in the Western United States. Specifically, we explore these research questions: How are rules or norms established that govern the collaboration process? How are resources valued and distributed? How are relationships developed and managed among and between parties? LLCs are defined as groups of students who live together in on-campus housing and share similar academic or special interests. In 2007, the Association of American Colleges and Universities named living communities a high impact practice (HIP) because of their capacity to enhance and give coherence to undergraduate education. The entrepreneurship LLC in this study was designed to offer first year college students the opportunity to live and learn with like-minded students from diverse backgrounds. While the university offers other LLC environments, the target residents for this LLC are less easily identified and are less apparently homogenous than residents of other LLCs on campus (e.g., Black Scholars, LatinX, Women in Science and Education), creating unique challenges. The LLC is a collaboration between the university’s College of Business & Public Administration and the Department of Housing and Residential Education (DHRE). Both parties are contributing staff, technology, living and learning spaces, and other student resources. This paper reports the results an ethnographic case study which chronicles the start-up challenges associated with the co-creation of the LLC. SET provides a general framework for examining how resources are valued and exchanged. In this study, SET offers insights into the processes through which parties negotiate tensions resulting from approaching this shared project from very different perspectives and cultures in a novel project environment. These tensions occur due to a variety of factors, including team formation and management, allocation of resources, and differing output expectations. The results are useful to both scholars and practitioners of entrepreneurship education and organizational management. They suggest probably points of conflict and potential paths towards reconciliation.

Keywords: case study, ethnography, interprofessional collaboration, social exchange theory

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Authors: Agnieszka Antończyk, MałGorzata Ochota, Wojciech Niżański, ZdzisłAw Kiełbowicz

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The goal of the cesarean section (CS) is the delivery of healthy, vigorous pups with the provision of surgical plane anesthesia, appropriate analgesia, and rapid recovery of the dam. In human medicine, spinal or epidural anesthesia is preferred for a cesarean section as associated with a lower risk of neonatal asphyxia and the need for resuscitation. Nevertheless, the specificity of veterinary patients makes the application of regional anesthesia as a sole technique impractical, thus to obtain patient compliance the general anesthesia is required. This study aimed to compare the influence of balanced (inhalant with epidural) and inhalant anesthesia on neonatal umbilical cord blood gas (UCBG) parameters and vitality (modified Apgar scoring). The bitches (31) undergoing elective CS were enrolled in this study. All females received a single dose of 0.2 mg/kg s.c. Meloxicam. Females were randomly assigned into two groups: Gr I (Isoflurane, n=16) and Gr IE (Isoflurane plus Epidural, n=15). Anesthesia was induced with propofol at 4-6 mg/kg to effect, and maintained with isoflurane in oxygen; in IE group epidural anesthesia was also done using lidocaine (3-4 mg/kg) into the lumbosacral space. CSs were performed using a standard mid-line approach. Directly after the puppy extraction, the umbilical cord was double clamped before the placenta detachment. The vessels were gently stretched between forceps to allow blood sampling. At least 100 mcl of mixed umbilical cord blood was collected into a heparinized syringe for further analysis. The modified Apgar scoring system (AS) was used to objectively score neonatal health and vitality immediately after birth (before first aid or neonatal care was instituted), at 5 and 20 min after birth. The neonates were scored as normal (AS 7-10), weak (AS 4-6), or critical (AS 0-3). During surgery, the IE group required a lower isoflurane concentration compared to the females in group I (MAC 1.05±0.2 and 1.4±0.13, respectively, p<0.01). All investigated UCBG parameters were not statistically different between groups. All pups had mild acidosis (pH 7.21±0.08 and 7.21±0.09 in Gr I and IE, respectively) with moderately elevated pCO2 (Gr I 57.18±11.48, Gr IE 58.74±15.07), HCO3- on the lower border (Gr I 22.58±3.24, Gr IE 22.83±3.6), lowered BE (Gr I -6.1±3.57, Gr IE -5.6±4.19) and mildly elevated level of lactates (Gr I 2.58±1.48, Gr IE2.53±1.03). The glucose levels were above the reference limits in both groups of puppies (74.50±25.32 in Gr I, 79.50±29.73 in Gr IE). The initial Apgar score results were similar in I and IE groups. However, the subsequent measurements of AS revealed significant differences between both groups. Puppies from the IE group received better AS scores at 5 and 20 min compared to the I group (6.86±2.23 and 8.06±2.06 vs 5.11±2.40 and 7.83±2.05, respectively). The obtained results demonstrated that administration of epidural anesthesia reduced the requirement for isoflurane in dams undergoing cesarean section and did not affect the neonatal umbilical blood gas results. Moreover, newborns from the epidural anesthesia group were scored significantly higher in AS at 5 and 20 min, indicating their better vitality and quicker improvement post-surgery.

Keywords: apgar scoring, balanced anesthesia, cesarean section, umbilical blood gas

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Authors: Layla Mujahed

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Amman, the capital of Jordan, is the main political, economic, social and cultural center of Jordan and beyond. The city faces multitude demographic challenges related to the unstable political situation in the surrounded countries. It has regional and local migrants who left their homes to find better life in the capital. This resulted with random and unequaled population distribution. Some districts have high population and pressure on the infrastructure and services more than other districts.Government works to resolve this challenge in compliance with 100 Cities Resilience Framework (CRF). Amman participated in this framework as a member in December 2014 to work in achieving the four goals: health and welfare, infrastructure and utilities, economy and education as well as administration and government.  Previous research studies lack in studying Amman resilient work in neighborhood scale and the population growth as resilient challenge. For that, this study focuses on Al-Thahabiah neighborhood in Shafa Badran district in Amman. This paper studies the reasons and drivers behind this population growth during the selected period in this area then provide strategies to improve the resilient work in neighborhood scale. The methodology comprises of primary and secondary data. The primary data consist of interviews with chief officer in the executive part in Great Amman Municipality and resilient officer. The secondary data consist of papers, journals, newspaper, articles and book’s reading. The other part of data consists of maps and statistical data which describe the infrastructural and social situation in the neighborhood and district level during the studying period. Based upon those data, more detailed information will be found, e.g., the centralizing position of population and the provided infrastructure for them. This will help to provide these services and infrastructure to other neighborhoods and enhance population distribution. This study develops an analytical framework to assess urban demographical time series in accordance with the criteria of CRF to make accurate detailed projections on the requirements for the future development in the neighborhood scale and organize the human requirements for affordable quality housing, employment, transportation, health and education in this neighborhood to improve the social relations between its inhabitants and the community. This study highlights on the localization of resilient work in neighborhood scale and spread the resilient knowledge related to the shortage of its research in Jordan. Studying the resilient work from population growth challenge perspective helps improve the facilities provide to the inhabitants and improve their quality of life.

Keywords: city resilience framework, demography, population growth, stakeholders, urban resilience

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Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

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HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

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Authors: M. A. Rahman, A. T. Ohta, H. V. Trinh, J. Hyvl

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Atmospheric pressure and oxygen (O2) concentration are critical life support parameters for human-occupied aerospace vehicles and habitats. Various medical conditions may require medical O2; for example, the American Medical Association has determined that commercial air travel exposes passengers to altitude-related hypoxia and gas expansion. It may cause some passengers to experience significant symptoms and medical complications during the flight, requiring supplemental medical-grade O2 to maintain adequate tissue oxygenation and prevent hypoxemic complications. Although supplemental medical grade O2 is a successful lifesaver for respiratory and cardiac failure, O2-enriched exhaled air can contain more than 95 % O2, increasing the likelihood of a fire. In an aerospace environment, a localized high concentration O2 bubble forms around a patient being treated for hypoxia, increasing the cabin O2 beyond the safe limit. To address this problem, this work describes a medical O2 delivery system that can reduce the O2 concentration from patient-exhaled O2-rich air to safe levels while maintaining the prescribed O2 administration to the patient. The O2 delivery system is designed to be a part of the medical O2 kit. The system uses cationic multimetallic cobalt complexes to reversibly, selectively, and stoichiometrically chemisorb O2 from the exhaled air. An air-release sub-system monitors the exhaled air, and as soon the O2 percentage falls below 21%, the air is released to the room air. The O2-enriched exhaled air is channeled through a layer of porous, thin-film heaters coated with the cobalt complex. The complex absorbs O2, and when saturated, the complex is heated to 100°C using the thin-film heater. Upon heating, the complex desorbs O2 and is once again ready to absorb or remove the excess O2 from exhaled air. The O2 absorption is a sub-second process, and desorption is a multi-second process. While heating at 0.685 °C/sec, the complex desorbs ~90% O2 in 110 sec. These fast reaction times mean that a simultaneous absorb/desorb process in the O2 delivery system will create a continuous absorption of O2. Moreover, the complex can concentrate O2 by a factor of 160 times that in air and desorb over 90% of the O2 at 100°C. Over 12 cycles of thermogravimetry measurement, less than 0.1% decrease in reversibility in O2 uptake was observed. The 1 kg complex can desorb over 20L of O2, so simultaneous O2 desorption by 0.5 kg of complex and absorption by 0.5 kg of complex can potentially continuously remove 9L/min O2 (~90% desorbed at 100°C) from exhaled air. The complex is synthesized and characterized for reversible O2 absorption and efficacy. The complex changes its color from dark brown to light gray after O2 desorption. In addition to thermogravimetric analysis, the O2 absorption/desorption cycle is characterized using optical imaging, showing stable color changes over ten cycles. The complex was also tested at room temperature in a low O2 environment in its O2 desorbed state, and observed to hold the deoxygenated state under these conditions. The results show the feasibility of using the complex for reversible O2 absorption in the proposed fire safe medical O2 delivery system.

Keywords: fire risk, medical oxygen, oxygen removal, reversible absorption

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Authors: D. S. N. K. Liyanagamage, V. Karunaratne, A. P. Attanayake, S. Jayasinghe

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Diabetes mellitus is an ever increasing global health problem which causes disability and untimely death. Current treatments using synthetic drugs have caused numerous adverse effects as well as complications, leading research efforts in search of safe and effective alternative treatments for diabetes mellitus. Even though there are traditional Ayurvedic remedies which are effective, due to a lack of scientific exploration, they have not been proven to be beneficial for common use. Hence the aim of this study is to evaluate the traditional remedy made of mixture of plant components, namely leaves of Murraya koenigii L. Spreng (Rutaceae), cloves of Allium sativum L. (Amaryllidaceae), fruits of Garcinia queasita Pierre (Clusiaceae) and seeds of Piper nigrum L. (Piperaceae) used for the treatment of diabetes. We report herein the preliminary results for the in vivo study of the anti-hyperglycaemic activity of the extracts of the above plant mixture in Wistar rats. A mixture made out of equal weights (100 g) of the above mentioned medicinal plant parts were extracted into cold water, hot water (3 h reflux) and water: acetone mixture (1:1) separately. Male wistar rats were divided into six groups that received different treatments. Diabetes mellitus was induced by intraperitoneal administration of streptozotocin at a dose of 70 mg/ kg in male Wistar rats in group two, three, four, five and six. Group one (N=6) served as the healthy untreated and group two (N=6) served as diabetic untreated control and both groups received distilled water. Cold water, hot water, and water: acetone plant extracts were orally administered in diabetic rats in groups three, four and five, respectively at different doses of 0.5 g/kg (n=6), 1.0 g/kg(n=6) and 1.5 g/kg(n=6) for each group. Glibenclamide (0.5 mg/kg) was administered to diabetic rats in group six (N=6) served as the positive control. The acute anti-hyperglycemic effect was evaluated over a four hour period using the total area under the curve (TAUC) method. The results of the test group of rats were compared with the diabetic untreated control. The TAUC of healthy and diabetic rats were 23.16 ±2.5 mmol/L.h and 58.31±3.0 mmol/L.h, respectively. A significant dose dependent improvement in acute anti-hyperglycaemic activity was observed in water: acetone extract (25%), hot water extract ( 20 %), and cold water extract (15 %) compared to the diabetic untreated control rats in terms of glucose tolerance (P < 0.05). Therefore, the results suggest that the plant mixture has a potent antihyperglycemic effect and thus validating their used in Ayurvedic medicine for the management of diabetes mellitus. Future studies will be focused on the determination of the long term in vivo anti-diabetic mechanisms and isolation of bioactive compounds responsible for the anti-diabetic activity.

Keywords: acute antihyperglycemic activity, herbal mixture, oral glucose tolerance test, Sri Lankan medicinal plant extracts

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Authors: Neeti Nayak, Khalid Duri

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Despite the many advances made in transportation planning, the number of injuries and fatalities in the United States which involve motorized vehicles near intersections remain largely unchanged year over year. Data from the National Highway Traffic Safety Administration for 2018 indicates accidents involving motorized vehicles at traffic intersections accounted for 8,245 deaths and 914,811 injuries. Furthermore, collisions involving pedal cyclists killed 861 people (38% at intersections) and injured 46,295 (68% at intersections), while accidents involving pedestrians claimed 6,247 lives (25% at intersections) and injured 71,887 (56% at intersections)- the highest tallies registered in nearly 20 years. Some of the causes attributed to the rising number of accidents relate to increasing populations and the associated changes in land and traffic usage patterns, insufficient visibility conditions, and inadequate applications of traffic controls. Intersections that were initially designed with a particular land use pattern in mind may be rendered obsolete by subsequent developments. Many accidents involving pedestrians are accounted for by locations which should have been designed for safe crosswalks. Conventional solutions for evaluating intersection safety often require costly deployment of engineering surveys and analysis, which limit the capacity of resource-constrained administrations to satisfy their community’s needs for safe roadways adequately, effectively relegating mitigation efforts for high-risk areas to post-incident responses. This paper demonstrates how geospatial technology can identify high-risk locations and evaluate the viability of specific intersection management techniques. GIS is used to simulate relevant real-world conditions- the presence of traffic controls, zoning records, locations of interest for human activity, design speed of roadways, topographic details and immovable structures. The proposed methodology provides a low-cost mechanism for empowering urban planners to reduce the risks of accidents using 2-dimensional data representing multi-modal street networks, parcels, crosswalks and demographic information alongside 3-dimensional models of buildings, elevation, slope and aspect surfaces to evaluate visibility and lighting conditions and estimate probabilities for jaywalking and risks posed by blind or uncontrolled intersections. The proposed tools were developed using sample areas of Southern California, but the model will scale to other cities which conform to similar transportation standards given the availability of relevant GIS data.

Keywords: crosswalks, cyclist safety, geotechnology, GIS, intersection safety, pedestrian safety, roadway safety, transportation planning, urban design

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Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores

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Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.

Keywords: knowledge and attitude, nurses, pain management, practices on pain management

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Authors: Qi Peng

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The Chinese sport sector is currently undergoing a dramatic institutional change. A sport system that was heavily dominated by the government is starting to shift towards one that is driven by the market. During the past sixty years, the Chinese Football Association (CFA), although ostensibly a ‘non-governmental organization’, has been in fact operated under the close supervision and control of the government. The double-identity of CFA has taken most of the blame for the poor performance of the Chinese football team, especially the men’s team. In 2015, a policy initiated by the Chinese government introduced a potentially radical change to the institutional structure of CFA by delegating the power of government agency – the General Administration of Sport of China - to the organization (CFA) itself. Against such background, an overarching research question was brought up- will an organization remained institutionalized within the system change in response to the external (policy) jolt? To answer this question, three principal data collection methods were employed: document review, participant observation and semi-structured interviews. Document review provides the mapping of the structural and cultural framework in which the CFA functions during the change process. The author have had the chance to interact closely with the organization as participant observer in the organization for a period of time, long enough to collect the data, but never too long to get biased view of the situation. This stage enables the author to gain an in-depth understanding of how CFA managed to restructure the governance and legitimacy. Conducting semi-structured interviews with staff within the CFA and from staff within selected stakeholders of CFA also provided a crucial step to gain an insight into the factors for change as well as the implications of the change. A wide range of interviewees that have been and to be interviewed include: CFA members (senior officials and staff); local football associations members; senior Chinese Super League football club managers; CFA Super League Co., LTD (senior officials and staff); CSL broadcasters; Chinese Olympic Committee members. The preliminary research data shows that the CFA is currently undergoing two levels of change: although the settings of CFA has been gradually restructured (organizational framework), the organizational values and beliefs remain almost the same as the CFA before the reform. This means that the plan of shifting from a governmental agency to an autonomous association is an going process, and that organizational core beliefs and values are more difficult to change than its structural framework. This is due to the inertia of the organizational history and the effect of institutionalization. The change of Chinese Football Association is looked at as a pioneering sport organization in China to undertake the “decoupling” road. It is believed that many other sport organizations, especially sport governing bodies will follow the step of CFA in the near future. Therefore, the experience of CFA change is worthy of studying.

Keywords: Chinese Football Association, Organizational Change, Organizational Culture, Structural Framework

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Authors: Leonardo Coloma

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The world changes constantly, every second its properties vary due either natural factors or human intervention. As the most intelligent creatures on the planet, human beings have transformed the environment and paradoxically –have allowed ‘mother nature’ to lose species, accelerate the processes of climate change, the deterioration of the ozone layer, among others. The rapid population growth, the procurement, administration and distribution of resources, waste management, and technological advances are some of the factors that boost urban sprawl whose gray stain extends over the territory, facing challenges such as pollution, overpopulation and scarcity of resources. In Ecuador, these problems are added to the social, cultural, economic and political anomalies that have historically affected it. This fact can represent a greater delay when trying to solve global problems, without having paid attention to local inconveniences –smaller ones, but ones that could be the key to project smart solutions on bigger ones. This research aims to highlight the main characteristics of the development models adopted by two Amazonian cities, and analyze the impact of such urban growth on society; to finally define the parameters that would allow the development of an intelligent city in Ecuador, prepared for the challenges of the XXI Century. Contrasts in the climate, temperature, and landscape of Ecuadorian cities are fused with the cultural diversity of its people, generating a multiplicity of nuances of an indecipherable wealth. However, we strive to apply development models that do not recognize that wealth, not understanding them and ignoring that their proposals will vary according to where they are applied. Urban plans seem to take a bit of each of the new theories and proposals of development, which, in the encounter with the informal growth of cities, with those excluded and ‘isolated’ societies, generate absurd morphologies - where the uncertain becomes tangible. The desire to project smart cities is ever growing, but it is important to consider that this concept does not only have to do with the use of information and communication technologies. Its success is achieved when advances in science and technology allow the establishment of a better relationship between people and their context (natural and built). As a research methodology, urban analysis through mappings, diagrams and geographical studies, as well as the identification of sensorial elements when living the city, will make evident the shortcomings of the urban models adopted by certain populations of the Ecuadorian Amazon. Following the vision of previous investigations started since 2014 as part of ‘Centro de Acciones Urbanas,’ the results of this study will encourage the dialogue between the city (as a physical fact) and those who ‘make the city’ (people as its main actors). This research will allow the development of workshops and meetings with different professionals, organizations and individuals in general.

Keywords: Latin American cities, smart cities, urban development, urban morphology, urban sprawl

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Authors: Deborah Weidner, Melissa Morgera

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The model of care delivery in the Behavioral Health Network (BHN) is integrated across all five regions of Hartford Healthcare and thus spans the entirety of the state of Connecticut, with care provided in seven inpatient settings and over 30 ambulatory outpatient locations. While safety has been a core priority of the BHN in alignment with High Reliability practices, safety initiatives have historically been facilitated locally in each region or within each entity, with interventions implemented locally as opposed to throughout the network. To address this, the BHN introduced a network wide Safety Huddle during 2022. Launched in January, the BHN Safety Huddle brought together internal stakeholders, including medical and administrative leaders, along with executive institute leadership, quality, and risk management. By bringing leaders together and introducing a network-wide safety huddle into the way we work, the benefit has been an increase in awareness of safety events occurring in behavioral health areas as well as increased systemization of countermeasures to prevent future events. One significant discussion topic presented in huddles has pertained to environmental design and patient access to potentially dangerous items, addressing some of the most relevant factors resulting in harm to patients in inpatient and emergency settings for behavioral health patients. The safety huddle has improved visibility of potential environmental safety risks through the generation of over 15 safety alerts cascaded throughout the BHN and also spurred a rapid improvement project focused on standardization of patient belonging searches to reduce patient access to potentially dangerous items on inpatient units. Safety events pertaining to potentially dangerous items decreased by 31% as a result of standardized interventions implemented across the network and as a result of increased awareness. A second positive outcome originating from the BHN Safety Huddle was implementation of a recommendation to increase the emergency Narcan®(naloxone) supply on hand in ambulatory settings of the BHN after incidents involving accidental overdose resulted in higher doses of naloxone administration. By increasing the emergency supply of naloxone on hand in all ambulatory and residential settings, colleagues are better prepared to respond in an emergency situation should a patient experience an overdose while on site. Lastly, discussions in safety huddle spurred a new initiative within the BHN to improve responsiveness to assaultive incidents through a consultation service. This consult service, aligned with one of the network’s improvement priorities to reduce harm events related to assaultive incidents, was borne out of discussion in huddle in which it was identified that additional interventions may be needed in providing clinical care to patients who are experiencing multiple and/ or frequent safety events.

Keywords: quality, safety, behavioral health, risk management

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Authors: Tuji Jemal Ahmed

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Food quality and safety challenges are prevalent in Ethiopia's food processing industry, which can have adverse effects on consumers' health and wellbeing. The country is known for its diverse range of agricultural products, which are essential to its economy. However, poor food quality and safety policies and management systems in the food processing industry have led to several health problems, foodborne illnesses, and economic losses. This paper aims to highlight the causes and effects of food safety and quality issues in the food processing industry of Ethiopia and discuss potential solutions to address these issues. One of the main causes of poor food quality and safety in Ethiopia's food processing industry is the lack of adequate regulations and enforcement mechanisms. The absence of comprehensive food safety and quality policies and guidelines has led to substandard practices in the food manufacturing process. Moreover, the lack of monitoring and enforcement of existing regulations has created a conducive environment for unscrupulous businesses to engage in unsafe practices that endanger the public's health. The effects of poor food quality and safety are significant, ranging from the loss of human lives, increased healthcare costs, and loss of consumer confidence in the food processing industry. Foodborne illnesses, such as diarrhea, typhoid fever, and cholera, are prevalent in Ethiopia, and poor food quality and safety practices contribute significantly to their prevalence. Additionally, food recalls due to contamination or mislabeling often result in significant economic losses for businesses in the food processing industry. To address these challenges, the Ethiopian government has begun to take steps to improve food quality and safety in the food processing industry. One of the most notable initiatives is the Ethiopian Food and Drug Administration (EFDA), which was established in 2010 to regulate and monitor the quality and safety of food and drug products in the country. The EFDA has implemented several measures to enhance food safety, such as conducting routine inspections, monitoring the importation of food products, and enforcing strict labeling requirements. Another potential solution to improve food quality and safety in Ethiopia's food processing industry is the implementation of food safety management systems (FSMS). An FSMS is a set of procedures and policies designed to identify, assess, and control food safety hazards throughout the food manufacturing process. Implementing an FSMS can help businesses in the food processing industry identify and address potential hazards before they cause harm to consumers. Additionally, the implementation of an FSMS can help businesses comply with existing food safety regulations and guidelines. In conclusion, improving food quality and safety policies and management systems in Ethiopia's food processing industry is critical to protecting public health and enhancing the country's economy. Addressing the root causes of poor food quality and safety and implementing effective solutions, such as the establishment of regulatory agencies and the implementation of food safety management systems, can help to improve the overall safety and quality of the country's food supply.

Keywords: food quality, food safety, policy, management system, food processing industry

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Authors: G. Iacoviello, A. Lazzini

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This paper focuses on the development of the study of accounting in the Italian education system between the 19th and 20th centuries. It also focuses on the subsequent formation of a scientific and experimental forma mentis that would prepare students for administrative and managerial activities in industry, commerce and public administration. From a political perspective, the period was characterized by two dominant movements - liberalism (1861-1922) and fascism (1922-1945) - that deeply influenced accounting practices and the entire Italian education system. The materials used in the study include both primary and secondary sources. The primary sources used to inform this study are numerous original documents issued from 1890-1935 by the government and maintained in the Historical Archive of the State in Rome. The secondary sources have supported both the development of the theoretical framework and the definition of the historical context. This paper assigns to the educational system the role of cultural producer. Foucauldian analysis identifies the problem confronted by the critical intellectual in finding a way to deploy knowledge through a 'patient labour of investigation' that highlights the contingency and fragility of the circumstances that have shaped current practices and theories. Education can be considered a powerful and political process providing students with values, ideas, and models that they will subsequently use to discipline themselves, remaining as close to them as possible. It is impossible for power to be exercised without knowledge, just as it is impossible for knowledge not to engender power. The power-knowledge relationship can be usefully employed for explaining how power operates within society, how mechanisms of power affect everyday lives. Power is employed at all levels and through many dimensions including government. Schools exercise ‘epistemological power’ – a power to extract a knowledge of individuals from individuals. Because knowledge is a key element in the operation of power, the procedures applied to the formation and accumulation of knowledge cannot be considered neutral instruments for the presentation of the real. Consequently, the same institutions that produce and spread knowledge can be considered part of the ‘power-knowledge’ interrelation. Individuals have become both objects and subject in the development of knowledge. If education plays a fundamental role in shaping all aspects of communities in the same way, the structural changes resulting from economic, social and cultural development affect the educational systems. Analogously, the important changes related to social and economic development required legislative intervention to regulate the functioning of different areas in society. Knowledge can become a means of social control used by the government to manage populations. It can be argued that the evolution of Italy’s education systems is coherent with the idea that power and knowledge do not exist independently but instead are coterminous. This research aims to reduce such a gap by analysing the role of the state in the development of accounting education in Italy.

Keywords: education system, government, knowledge, power

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Authors: Arlene Villarama, Micol Grace Guanzon, Zenaida Ramos

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This paper provides insights into teaching English as a Foreign Language in the Philippines. The authors reviewed relevant theories and literature, and provide an analysis of the issues in teaching English in the Philippine setting in the light of these theories. The authors made an investigation in Bagong Barrio National High School (BBNHS) - a public school in Caloocan City. The institution has a population of nearly 3,000 students. The performances of randomly chosen 365 respondents were scrutinised. The study regarding the success of teaching English as a foreign language to Filipino children were highlighted. This includes the respondents’ family background, surroundings, way of living, and their behavior and understanding regarding education. The results show that there is a significant relationship between demonstrative, communal, and logical areas that touch the efficacy of introducing English as a foreign Dialectal. Filipino children, by nature, are adventurous and naturally joyful even for little things. They are born with natural skills and capabilities to discover new things. They highly consider activities and work that ignite their curiosity. They love to be recognised and are inspired the most when given the assurance of acceptance and belongingness. Fun is the appealing influence to ignite and motivate learning. The magic word is excitement. The study reveals the many facets of the accumulation and transmission of erudition, in introduction and administration of English as a foreign phonological; it runs and passes through different channels of diffusion. Along the way, there are particles that act as obstructions in protocols where knowledge are to be gathered. Data gained from the respondents conceals a reality that is beyond one’s imagination. One significant factor that touches the inefficacy of understanding and using English as a foreign language is an erroneous outset gained from an old belief handed down from generation to generation. This accepted perception about the power and influence of the use of language, gives the novices either a negative or a positive notion. The investigation shows that a higher number of dislikes in the use of English can be tracked down from the belief of the story on how the English language came into existence. The belief that only the great and the influential have the right to use English as a means of communication kills the joy of acceptance. A significant notation has to be examined so as to provide a solution or if not eradicate the misconceptions that lie behind the substance of the matter. The result of the authors’ research depicts a substantial correlation between the emotional (demonstrative), social (communal), and intellectual (logical). The focus of this paper is to bring out the right notation and disclose the misconceptions with regards to teaching English as a foreign language. This will concentrate on the emotional, social, and intellectual areas of the Filipino learners and how these areas affect the transmittance and accumulation of learning. The authors’ aim is to formulate logical ways and techniques that would open up new beginnings in understanding and acceptance of the subject matter.

Keywords: accumulation, behaviour, facets, misconceptions, transmittance

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Authors: Roberta Martino, Viviana Ventre

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Every day we face choices whose consequences are deferred in time. These types of choices are the intertemporal choices and play an important role in the social, economic, and financial world. The Discounted Utility Model is the mathematical model of reference to calculate the utility of intertemporal prospects. The discount rate is the main element of the model as it describes how the individual perceives the indeterminacy of subsequent periods. Empirical evidence has shown a discrepancy between the behavior expected from the predictions of the model and the effective choices made from the decision makers. In particular, the term temporal inconsistency indicates those choices that do not remain optimal with the passage of time. This phenomenon has been described with hyperbolic models of the discount rate which, unlike the linear or exponential nature assumed by the discounted utility model, is not constant over time. This paper explores the problem of inconsistency by tracing the decision-making process through the concept of impatience. The degree of impatience and the degree of decrease of impatience are two parameters that allow to quantify the weight of emotional factors and cognitive limitations during the evaluation and selection of alternatives. In fact, although the theory assumes perfectly rational decision makers, behavioral finance and cognitive psychology have made it possible to understand that distortions in the decision-making process and emotional influence have an inevitable impact on the decision-making process. The degree to which impatience is diminished is the focus of the first part of the study. By comparing consistent and inconsistent preferences over time, it was possible to verify that some anomalies in the discounted utility model are a result of the combination of cognitive bias and emotional factors. In particular: the delay effect and the interval effect are compared through the concept of misperception of time; starting from psychological considerations, a criterion is proposed to identify the causes of the magnitude effect that considers the differences in outcomes rather than their ratio; the sign effect is analyzed by integrating in the evaluation of prospects with negative outcomes the psychological aspects of loss aversion provided by Prospect Theory. An experiment implemented confirms three findings: the greatest variation in the degree of decrease in impatience corresponds to shorter intervals close to the present; the greatest variation in the degree of impatience occurs for outcomes of lower magnitude; the variation in the degree of impatience is greatest for negative outcomes. The experimental phase was implemented with the construction of the hyperbolic factor through the administration of questionnaires constructed for each anomaly. This work formalizes the underlying causes of the discrepancy between the discounted utility model and the empirical evidence of preference reversal.

Keywords: decreasing impatience, discount utility model, hyperbolic discount, hyperbolic factor, impatience

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Authors: Rozh Abdulrahman Kareem

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The displacement of individuals has become a common interest for international players. Mostly occurs in Islamic states, as religion is considered the most common cause of this form of displacement. Therefore, this thesis aims to depict the reality of the situations of the refugees, particularly in KRI, illustrating how they are treated and protected and if the treatment merits the protection clause as envisaged in the 1951 Refugee Convention. Overall, the aim is to touch on the issue of protection by non-governmental organizations and government towards the refugees here. In light of this, it focused on the adequate protection of refugees in relation to the refugee law. In the Middle East, including Iraq, there have been multiple reports on violations of these refugee laws and human rights. Protection involves providing physical security to the concerned parties, functional administration with legal structures, and infrastructural setup that could help citizens exercise rights. The KRI has provided the refugees with various benefits, including education, access to residency, and employment. It also provided transitionary in various social dimensions like gender-based violence. The Convention on Status of Refugees 1951 tried to resolve this problem, whereby the principle of ‘nonrefoulement’ under Article 33 was passed. The ‘nonrefoulement’, an exceptional reference, was enacted to protect refugees from forcible return to their countries of the original. However, the convention never addressed an unusual scenario regarding the application of this principle, ‘Extradition Treaties.’ Even though some scholarly article exists regarding the problems of refugees, the topic of interplay between Nonrefoulement and Extradition Treaties has never been explained in detail in the available books on refugee laws and practices. Each year, millions of refugees seek protection from foreign countries for fear of being tortured, victimized, or executed. People seeking international protection are susceptible and insecure. The main objective of the prevention is to provide security to citizens susceptible to inhuman treatment, distress, oppression, or other human rights defilements when they arrive back in their own countries. The refugee situation may get worse in the near future. Just like several nations within the Middle East, Iraq is not a signatory to the globally acknowledged legal structure for the protection of refugees. The first law of 1971 in Iraq was issued only for military or political causes. This law also establishes benefits such as the right to education and health services and the right to acquire employment just as the Iraqi nationals. The other legislative instrument is the 21st law from the ministry of migration of Iraq widened the description of an immigrant to incorporate the definition from the refugee resolution. Nonetheless, there is a lack of overall consistency in the protection provided under these legislations regarding rights and entitlement. A Memorandum of Understanding was signed in October 2016 by the UNHCR and the Iraq government to develop the protection of refugees. Under the term of this MoU, the Iraqi Government is obligated to provide identity documents to asylum seekers beside that UNHCR provides more guidance.

Keywords: law, refugee, protection, Kurdistan

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Authors: Fayez Hanna, Viet Tran

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A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

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